Regular Medication Use Research Articles

A comprehensive analysis and performance evaluation for osteoporosis prediction models

Medical data analysis is an expanding area of study that holds the promise of transforming the healthcare landscape. The use of available data by researchers gives guidelines to improve health practitioners’ decision-making capacity, thus enhancing patients’ lives. The study looks at using deep learning techniques to predict the onset of osteoporosis from the NHANES 2017–2020 dataset that was preprocessed and arranged into SpineOsteo and FemurOsteo datasets. Two feature selection methods, namely mutual information (MI) and recursive feature elimination (RFE), were applied to sequential deep neural network models, convolutional neural network models, and recurrent neural network models. It can be concluded from the models that the mutual information method achieved higher accuracy than recursive feature elimination, and the MI feature selection CNN model showed better performance by showing 99.15% accuracy for the SpineOsteo dataset and 99.94% classification accuracy for the FemurOsteo dataset. Key findings of this study include family medical history, cases of fractures in patients and parental hip fractures, and regular use of medications like prednisone or cortisone. The research underscores the potential for deep learning in medical data processing, which eventually opens the way for enhanced models for diagnosis and prognosis based on non-image medical data. The implications of the study shall then be important for healthcare providers to be more informed in their decision-making processes for patients’ outcomes.

Nursing Students’ Health Perceptions and Affecting Factors

This research was conducted to determine the health perception levels of nursing students and the influencing factors. The descriptive cross-sectional study was conducted between August 2023 and September 2023. The sample of the study consisted of 138 students studying in the Nursing Department of the Faculty of Health Sciences in the Aegean region who volunteered to participate in the study. The socio-demographic information (12 questions) questionnaire form and the Health Perception scale (15 questions) developed in line with the literature were used to collect data. The data were evaluated in the SPSS 27.00 package program. As a result of the research, it was determined that the average score that the students got from the health perception scale was 38.99±5.24. When the sub-dimensions of the health perception scale were examined; The Control Center sub-scale average score was determined as 12.82±3.15, the Certainty sub-scale average score as 12.44±2.75, the Importance of Health sub-scale average score as 6.90±1.97, and the Self-awareness sub-scale average score as 6.83±1.70. While there was a significant difference between the students' family type, smoking, financial level, health level, place of residence and family health status and health perception and its subgroups (P<0.05), it was determined that there was no statistically significant difference between age, gender, parental education level, chronic disease and regular medication use (P>0.05). It was concluded that the students' health perception general score and subscale scores were not at the desired level and that various factors negatively affected these scores in general. Various strategies should be planned to strengthen students' health perceptions.

An examination of levels of depression, the probability of suicide, and autistic traits in medical faculty students: A cross-sectional study.

Depression and suicide attempts are reported to be high among medical students. It has also been reported that depression, suicide attempts, and autistic traits may be significantly related. The aim of this study was to determine the suicide probability and autistic traits of medical students with and without depression symptoms, and to examine the relationship between depression symptoms, suicide probability, and autistic traits together in these students. This cross-sectional study was conducted among 313 medical students, 206 female, and 107 male, who, according to the sociodemographic form, did not have any current psychiatric diagnosis, chronic medical or neurological disorders requiring treatment, or regular use of psychotropic medications, and who completed the forms in full. All the study participants completed a sociodemographic form, the Beck depression inventory (BDI), the suicide probability scale (SPS), and the autism spectrum quotient (ASQ).The entire study sample was divided into 2 groups: students with and without symptoms of depression, based on BDI scores. In the multivariate analysis, independent predictors of depression symptoms were examined using logistic regression analysis. The BDI total points (z = -13.99, P < .001), SPS total points (z = 10.61, P < .001), and subscale points of hopelessness (z = -9.28, P < .001), suicidal ideation (z = 8.48, P < .001), negative self-evaluation (z = -9.26, P < .001), and hostility (z = -8.10, P < .001), and the ASQ subscale points of communication (z = -5.05, P < .001), social skills (z = -6.05, P < .001), imagination (z = -3.27, P = .001), attention shifting (z = -4.35, P < .001), and ASQ total points (z = -6.64, P < .001) were significantly higher for the participants with BDI total points above the cutoff value compared to those with BDI total points below the cutoff value. Statistically significant positive correlations were found between BDI total points and SPS total points (R = 0.710, P < .001), ASQ total points (R = 0.451, P < .001), and between ASQ total points and SPS total points (R = 0.534, P < .001). The contribution of age, gender, ASQ, and SPS total points to explaining depression symptoms was evaluated using logistic regression analysis. This analysis showed that the SPS total points could be a significant predictor of depression symptoms (B = 0.112, P < .001). The findings of this study showed that the probability of suicide and the ASQ total and subscale points of communication, social skills, imagination, and attention shifting were significantly higher in medical students with symptoms of depression compared to those without depressive symptoms. Given the important relationship between symptoms of depression, suicidality, and autistic traits, it is crucial to raise awareness of these issues among medical education departments, health practitioners, medical students, and to provide the necessary guidance and clinical support for medical students to address these problems.

Depressive symptoms among rural left-behind children and adolescents in China: a large-scale cross-sectional study

BackgroundLeft-behind children(LBC) in rural China are at increased risk for mental health problems, including depression. This study aimed to estimate the prevalence of depression and identify key associate factors among Chinese rural LBC.MethodsA cross-sectional study was conducted using data from 36,612 LBC aged 6 to 18 years old across 596 data collection sites in Nanchong, Sichuan Province, China. Participants completed questionnaires assessing individual factors, family parenting situation, living events, and health-related data. Depression was measured using the Center for Epidemiological Studies-Depression Scale (CES-D). T-tests, chi-square, and logistic regression were performed to identify factors associated with depression.ResultsThe overall prevalence of depression among LBC was 6.75%. Logistic regression analysis revealed that family parenting situations, such as being from blended families (OR = 1.45) or being cared for by other family members (OR = 1.64), and dissatisfaction with the parenting situation (OR = 1.57) were significantly associated with higher odds of depression. Living events, including being misunderstood (OR = 1.82) and having disputes (OR = 1.48), and health-related factors, such as chronic diseases and regular medication use (OR = 2.38), also increased the risk of depression.ConclusionsThis study highlights the high prevalence of depression among Chinese rural LBC and identifies key associate factors, including family parenting situation, negative living events and health-related factors. Targeted interventions and policies addressing these factors are needed to promote the mental health of this vulnerable population.

Dietary patterns as predictors of adverse antidiabetics reactions - A cross-sectional study of polish diabetes sufferers

Background: Diabetes mellitus (DM) is a multifaceted problem. There is a need to coordinate the diet with pharmacological interventions, because of the possible interaction between the two. The present study aimed to identify the factors related to the dietary habits of people suffering with diabetes that may increase the risk of adverse reactions to anti-diabetic medication. Methods: Between 2019 and 2020, patients with DM (N=203), aged 18-65, were enrolled for analysis. A quantitative and cross-sectional survey was applied. The study employed a Dietary Habits and Nutrition Beliefs Questionnaire devised in Poland for people aged 15–65 years (KomPAN) and a self-designed questionnaire as research tools. Results: The majority of the patients with DM studied confirmed the use of a low carbohydrate diet in relation to their disease (87.7%). The mean pHDI-10 score for the study group was 22.55±8.67 points and the mean nHDI-14 score was 15.00±9.88 points. The place of residence, education and general financial situation of the subjects had a statistically significant effect on the results (p&lt;0.05). The majority of subjects reported regular use of anti-diabetic medication (77.8%). Of those treated with oral medication, 61.1% had experienced adverse effects and 49.3% had been hospitalized as a result. Of those treated with insulin, 40.9% reported adverse effects. Conclusions: Health professionals should be proactive in giving people with DM, particularly those who are less educated, financially disadvantaged, aged 41-55 and are working, adequate counseling about dietary recommendations from the very onset of their illness.

Mobile apps for diabetes self-management: An updated review of app features and effectiveness.

Self-management of diabetes is extremely challenging and non-adherence is common. Health consequences are significant for those unable to adhere to the complex treatment regimen, which includes regular oral medication and/or insulin use, frequent blood sugar checks, strict dietary management, and regular physical activity. Mobile applications (apps) present a tremendous opportunity to help patients improve adherence to these behaviors. The availability of commercial diabetes self-management apps is increasing exponentially, making it difficult for patients and providers to stay informed about app options and benefits. Previous reviews have described commercial diabetes apps and their features and usability for patients with diabetes. A smaller number have reviewed the effectiveness of these apps in improving blood glucose as well as other aspects of diabetes management. The aim of this article is to update our 2016 review, summarize the results of new reviews, review outcomes of diabetes apps described in the literature, and offer recommendations for app features, effectiveness research, and marketing in apps for diabetes self-management. Although higher-quality research is needed, current reviews suggest that many diabetes apps are effective in lowering HbA1c. Recommendations for future research include reporting critical details such as patient demographics and intervention elements and designing studies to identify the most effective components of diabetes management apps. Furthermore, clearly labeling apps that have data supporting clinical efficacy in app stores would allow both providers and patients to easily identify apps that might be most beneficial. Future research should explore the use of apps for the prevention of diabetes in individuals diagnosed with prediabetes.

Nationwide trends in major cardiovascular risk factors in England in the last 2 decades: Health Survey of England 2003-2019

Abstract Cardiovascular disease (CVD) accounts for a quarter of deaths annually in the UK, with more than 7.6 million people living with the disease. Hypertension, diabetes, and obesity are among the most prevalent modifiable risk factors for CVD, and the strategies to reduce the incidence and prevalence of these CV risk factors are deemed the most effective to reduce this immense toll. In the UK, over the last few decades, several health policy decisions and pathways have been developed to reduce this toll. We used data from 11 nationally representative, cross-sectional surveys from the Health Survey of England between 2003 and 2019 to evaluate trends in the prevalence of these CV risk factors and whether there has been any population-wide improvement in them. These surveys have cumulative information on 94,100 adults, and we applied sample weights, accounting for oversampling and nonresponse. We used "period definitions and cut-offs" to define those with diabetes. For example, for undiagnosed diabetes, we used glycated haemoglobin cut-off equivalent of 7% or more for years before 2011 and the current diagnostic threshold of &amp;gt; 6.5% thereafter. This was done to facilitate and compare the trends after accounting for changes in medical practice and understanding across this period. Similarly, hypertension was defined as doctor-diagnosed hypertension or in its absence regular use of antihypertensive medications or blood pressure ≥ 140/90mmHg (period diagnostic threshold remains unchanged during). Python and STATA were used to conduct analyses, and Join Point regression software was used to develop and compare trends. In England, from 2003-2019, mean population BMI consistently increased over this period, rising by 0.8kg/m2 from 27.6 to 28.8 kg/m2. Obesity prevalence (BMI ≥30kg/m2) increased by 5.4% from 22.6% to 28.0%. Concurrently, mean glycated haemoglobin increased by 0.36% from 6.18% to 6.54%, surpassing the current diabetes diagnostic threshold. Diabetes period prevalence surged from 4.2% to 11.6%, a trend consistent when the current diagnostic threshold was alternatively applied across all periods. Conversely, doctor-diagnosed and total hypertension (including those who are unaware) prevalence exhibited a slight decrease (1.4% and 3%, respectively), mirrored by reductions in population-wide mean systolic and diastolic blood pressure by 4.6mmHg and 1.9mmHg. These results suggest that, with the total population in England standing at 56.3 million in 2019, an estimated 15.8 million adults were within the obese BMI range, 6.5 million had diabetes and 17.6 million had hypertension. The obesity epidemic is likely fuelling the increase in diabetes prevalence. These findings underscore the importance of prioritising obesity reduction in public health initiatives, aiming to subsequently curb diabetes prevalence. Hypertension still remains a major CV risk factor, affecting almost one third of the adult population.

Impact of local anesthesia on ciliary dyskinesia diagnosis by digital high-speed videomicroscopy.

It was hypothesized that local anesthesia administration would not significantly affect ciliary function in nasal epithelium. A prospective, simple-blind randomized study was conducted between 2020 and 2023. The study employed digital high-speed videomicroscopy to analyze ciliary beat frequency and pattern. A cohort of 38 participants was recruited, consisting of 25 healthy volunteers and 13 referred individuals (including seven diagnosed with PCD). Selection criteria ensured the absence of chronic respiratory diseases, recent respiratory tract infections, or regular use of nasal medications. Participants underwent nasal brushing with administration of lidocaine and naphazoline nasal spray in one nostril and saline in the contralateral nostril. Ciliary beat frequency and pattern were measured using digital high-speed video microscopy. Nasal spray administration did not significantly alter ciliary beat frequency or pattern compared to saline (p = 0.841 and p = 0.125, respectively). Subgroup analysis revealed consistent results across healthy volunteers, referred patients, and PCD patients. Local anesthesia with lidocaine and naphazoline spray did not affect ciliary function outcomes. These findings support the safe use of these agents in clinical practice for PCD diagnostic procedures. Further research with larger cohorts is warranted for validation.

Seasonal Influenza Vaccine Literacy and Hesitancy of Elderly Czechs: An Analysis Using the 5C Model of Psychological Antecedents.

Seasonal influenza vaccination rates among the elderly in the Czech Republic are alarmingly low, making it one of the least vaccinated countries in Europe. This study explored the role of vaccine literacy and insurance coverage on vaccination status. An analytical cross-sectional study was conducted in Summer 2023 using a self-administered questionnaire covering vaccine literacy (functional, interactive, and critical skills), negative perceptions towards influenza vaccination, and the 5C model (confidence, complacency, constraints, calculation, and collective responsibility). Individuals aged 55 and older were included in the study. Mediation analyses assessed the indirect effects of insurance coverage on vaccination status. Significant differences were noted in vaccination rates based on insurance coverage, chronic diseases, regular medication use, and previous COVID-19 and pneumococcal vaccinations. Vaccine literacy, especially interactive and critical skills, was higher among vaccinated individuals. Confidence and collective responsibility were significant promoters, while complacency and constraints were barriers to vaccination. Mediation analyses indicated that negative perceptions, confidence, and collective responsibility significantly mediated the relationship between insurance coverage and vaccination status. Enhancing vaccine literacy and addressing psychological antecedents are crucial for improving influenza vaccination rates among the elderly. Policy measures should include improving vaccine literacy, building public confidence, and addressing negative perceptions.

Association of Insomnia with Functional Outcomes Relevant to Daily Behaviors and Sleep-Related Quality of Life among First Nations People in Two Communities in Saskatchewan, Canada.

Insomnia is a common sleep complaint in Canada and is associated with increased use of health care services and economic burden. This paper examines the association of insomnia with functional outcomes relevant to daily behaviors and sleep-related quality of life among First Nations participants using the Functional Outcomes of Sleep Questionnaire (FOSQ-10). The First Nations Sleep Health Project follow-up survey was conducted in partnership with two Cree First Nations in the summer of 2022, where 355 individuals participated. Statistical analysis was conducted using logistic regression models. The mean age of the participants was 40.76 ± 14.60 (SD) years, and 59.4% were females. The prevalence of chronic insomnia (Insomnia Severity Index score of ≥15) was 21.0%, with more females (26.1%) than males (13.8%) experiencing it among the 348 participants. Overall, the mean FOSQ-10 score was 17.27 ± 2.98 among the 350 participants, with those who had clinical insomnia reporting significantly lower scores than those without clinical insomnia (mean ± SD: 14.6 ± 3.9 vs. 18.0 ± 2.1; p < 0.001). The FOSQ-10 scores indicated sleep-related functional impairment (FOSQ-10 total score < 17.90) in 46.6% of participants. After adjusting for age, excessive daytime sleepiness, sex, and regular use of prescription medication, we found that clinical insomnia was significantly associated with functional impairments. In fact, a person with clinical insomnia was 3.5 times more likely to have functional impairments than those without clinical insomnia. This study highlights the significant association between insomnia and functional impairments related to daily behaviors and quality of life in two First Nation communities. Identifying this association can help healthcare providers to diagnose and treat patients with insomnia in these communities.

Pain and Discomfort Among Mohs Surgeons: An Ergonomic Model of Procedural Dermatologists

Background: Dermatologic surgeons are at risk for work-related injuries and chronic pain. Objectives: To investigate the prevalence and characteristics of pain and discomfort among fellowship trained Mohs surgeons across the United States Methods: A cross-sectional survey study was conducted of members of the American College of Mohs Surgery (ACMS).Participants reported the continuous variables of hours spent working, standing versus sitting while operating, typing to the electronic medical record, and exercising per week. Results: 107 male and female respondents participated. 88.7% of respondents reported chronic pain; the most common anatomic locations for pain were the neck (54.2%), upper back (38.2%), and lower back (33.6%). At these anatomic locations, male respondents less frequently complained of upper back pain (odds ratio (OR) 0.349, 95% confidence interval (CI) 0.155 to 0.787; P = 0.010) but more frequently complained of lower back pain (OR 2.462, 95% CI 1.606 to 13.320; P = 0.044), than female respondents. Respondents were significantly more likely to report regular pain-relieving medication use when suffering from pain at the neck (OR 4.665, 95% CI 1.450 to 15.007; P = 0.006) or upper back (OR 3.366, 95% CI 1.251 to 9.054; P = 0.013). Respondents regularly using sit-stand stools were less likely to report neck pain (OR 0.326, 95% CI 0.105 to 1.015; P = 0.046). Conclusions: Pain is prevalent among Mohs surgeons. Adopting and training in an ergonomically-friendly environment and incorporating an ergonomically aware mindset early in a surgeon’s career may decrease one’s risk for job-related injury and pain.

Determinants of medication adherence among elderly with high blood pressure living in deprived areas.

The current study was conducted to determine the impact of health literacy and factors related to adherence to drug treatment, using the model proposed by the World Health Organization, in older adults with hypertension residing in informal settlements in Hamadan. This cross-sectional study was conducted on 405 patients in Hamadan city, located in the western part of Iran. Data were collected using an interviewer-administered questionnaire that included the 5-dimensional model proposed by the World Health Organization, Health Literacy for Iranian Adults, and Morisky Medication Adherence Scale-8. A two-stage sampling procedure was used to select patients from 14 comprehensive health service centers and health bases. The data were analyzed using SPSS v.24. The study found that medication adherence was suboptimal in 63% of the participants. Additionally, 87.5% of patients had inadequate or insufficient health literacy. Factors related to medication adherence included age (odds ratio (OR) = 1.07), annual income (OR = 0.17), duration of hypertension (OR = 7.33), health literacy (OR = 1.03), self-reported health status (P < 0.05), and regular medication use (P < 0.008). The results of this study indicate that more than half of the older adults in the study had suboptimal medication adherence and insufficient health literacy. The study also found that various factors, such as socioeconomic status, disease and treatment-related factors, and patient-related factors, influence medication adherence among older adults.

Impact of temporomandibular disorder symptoms among 15-year-old girls.

Many adolescents, especially girls, report temporomandibular disorder (TMD) symptoms that may impact their daily life. At 19 different schools participating in the preventive program with dental nurses of FRAMM (Fluoride, Advise, Arena, Motivation, Food), at the Västra Götaland Region in Sweden, 15-year-old girls were invited to a cohort study about symptoms of TMD that also included headaches. Three hundred twenty-nine girls attended the study and answered a questionnaire regarding TMD symptoms and their consequences such as sick leave from school and consumption of analgesics. The girls were asked about the symptom's influence on their daily life, about their general health, use of regular medication, physical activity, and they answered the PHQ4 regarding experienced symptoms of anxiety and depression. There was a significant correlation between TMD symptoms and sick leave with 31% of the girls having stayed home due to symptoms. Of the girls who answered affirmative in the screening questions (3QTMD), nearly half the group had stayed at home due to their symptoms, 24% had consulted a physician, 42% had used analgesics weekly and 59% reported that they felt the symptoms negatively affected their school performance. The girls who had regular medication had more TMD symptoms. Anxiety and depression were associated with TMD symptoms. The study showed that TMD symptoms had a negative impact on the 15-year-old girls' daily life resulting in sick leave from school, consumption of analgesics, and experiences of negative impacts on their behavior and performance at school.

Evaluation of Sleep Behaviors in Male Football Players Participating in Youth Football Leagues

This article addresses a research study aimed at evaluating the sleep behaviors of young football players in Turkey. The research was conducted using a correlational survey design. The population consisted of male football players participating in the Turkey Football U 19 Elite A, U 17 Elite A, U 17 Elite B, U 19 Regional Development, U 17 Regional Development, and U 16 Development leagues, with a sample size of 203 players. Statistical methods such as normality analysis, Mann-Whitney U test, and Kruskal-Wallis H test were used for analysis. The study found no statistically significant differences in the variables of football year, position status, training day, regular medication use status, education level, and sleep duration among young football players. The data revealed that young players who stayed with friends at home or alone had higher sleep quality compared to those staying with their families at home. When analyzed according to the computer and phone usage variable, except for the sleep disorder factor, all sub-dimensions favored those using computers and phones. Regarding the playing status in development leagues, significant results were found in the sports factor sub-dimension for U 19 Elite A and U 19 Regional Development league players in relation to sleep quality factors. According to ASBQ Total Score averages, the values of U 19 Elite A league players were more significant compared to U 17 Elite A league players and U 16 Development league players. Regarding the sleep problem status variable, players indicating sleep problems had statistically higher values in sleep quality factors, Habitual sleep efficiency factors, and ASBQ Total Scores. In conclusion, it can be stated that there is a direct relationship between sleep and performance among U 19 Elite A young football players, and they act with this awareness.

Comparative analysis of antibiotics: Inhibition of protein synthesis versus DNA synthesis

In this piece of writing, we will be addressing the following factors: properties of antibiotics, mechanism of action, clinical safety profile, as well as toxicity, adverse event profile, and case fatality rate. From our evaluation, in terms of properties of the two groups of antibiotics, protein synthesis-inhibiting antibiotics displays a like number of lipophilic and hydrophilic properties, with the majority of Anti-30S inhibitor drugs being predominantly hydrophilic, and a higher number of lipophilic drugs amongst Anti-50S inhibitors. Anti-50S inhibitors could therefore be preferred in oral intake drug development. DNA synthesis-inhibiting antibiotics show a limited trend in their properties. The mechanism of action for protein synthesis-inhibiting antibiotics generally follows four steps: activation of amino acids, initiation, extension, and termination of peptide chain synthesis. On the other hand, DNA synthesis-inhibiting antibiotics exhibits a range of different mechanisms, all of which results in the damage of DNA structure of the bacterium. In both clinical safety and toxicity studies, it is concluded that the two groups of antibiotics have previous cases of side effects, with the DNA synthesis-inhibiting drug, fluoroquinolones, more dangerous due to its potential to result in ventricular fibrillation on a patient. By assessing and comparing all the factors, this review aims to present a precise comparison of the similarities and differences between the protein and DNA synthesis inhibitors, and an evaluation of the effectiveness of the two groups against bacterial infections, along with their safety for regular medication use.

Infections in residents of long- term care facilities in southern Poland, 12-month surveillance preliminary results

Long-Term Care Facility (LTCF) residents are particularly vulnerable to infections due to factors such as advanced age, co-morbidities, and regular medication use. Data from American and European sources indicate an anticipated occurrence rate of 2 to 11 infections per 1000 patient-days (pds) in LTCFs. The incidence rate of Clostridioides difficile infections (CDI) is reported at 0.52 per 10,000 resident days. The research objectives aimed to assess infection epidemiology in Polish LTCFs. An observational prospective study was conducted on residents from five LTCFs (2 residential homes and 3 nursing homes) in southern Poland between September 2022 and September 2023, utilizing the definition from the pan-European HALT study. The study received approval from the Bioethics Committee of the JU (1072.6120.73.2022) and was funded by the Polish NCN grant No.2021/41/B/NZ6/00749. CDI was defined by positive toxins A and B enzyme immunoassays (EIA) and positive glutamate dehydrogenase (DHA) EIA. Results from the study, involving 250 residents, revealed 157 cases of Healthcare-Associated Infections (HAIs) excluding gastrointestinal and CDI, with an incidence rate of 1.97/1000 pds. Lower respiratory tract infections dominated with 77 cases, including 36 pneumonia cases (47%). Additionally, 25 cases of gastrointestinal infections were reported, including only 7 CDI cases, resulting in an incidence rate of 0.88 CDI per 10,000 pds. Norovirus was detected in only one case, while the microbiological results were negative in the remaining cases. The incidence rate among Polish LTCF residents was lower than expected, contrasting with the CDI incidence that aligned with other research findings. Notably, the etiology of diarrhea remained undetermined in 68% of cases.

The effect of frailty levels of older individuals on their mental well-being and depression levels.

Frailty has become an important public health issue. This study was conducted to determine the effect of frailty levels of older individuals on their mental well-being and depression levels. This descriptive cross-sectional study was conducted with a total of 325 older individuals aged 60 years and over. A demographic questionnaire form, the FRAIL Frailty Scale, the Warwick-Edinburgh Mental Well-Being Scale, and the Geriatric Depression Scale-Short Form were used to collect data. Data were evaluated using the SPSS 25.0 package program. Number, percentage, mean, standard deviation, Chi-square, correlation, and multiple regression analyses were used. The mean age of the older individuals was 69.56 ± 7.75 years, and the variables of age, education level, income status, the person they were living with, regular medication use, forgetting to take medication, urinary incontinence, hospitalisation, and accidents were found to affect both frailty and depression (P < 0.05). There was a positive correlation between frailty and depression (r: 0.460, P < 0.001) and a negative correlation between mental frailty and well-being (r: -0.391, P < 0.001). Socio-demographic variables, depression, and mental well-being had a 40% effect on frailty (P < 0.001). Depression status and mental well-being level are related to frailty, so negativity in one of them negatively affects the other. In line with these results, it is recommended to determine the level of depression and mental well-being of older individuals with high risk of frailty, and according to the results of the research, to provide care and support regarding the predictors affecting frailty.

Prader-Willi syndrome in a large sample from Spain: general features, obesity and regular use of psychotropic medication.

Prader-Willi syndrome (PWS), a genetically determined disorder, the most frequent cause of early onset obesity, is associated with physical and cognitive dysfunctions and behavioural disturbances; these disturbances are frequently treated with psychotropic medication. The aim of this cross-sectional study was to describe the characteristics of the first large national sample of persons with PWS in Spain and analyse the relationships of those characteristics with key demographic and clinical factors, particularly with obesity and the regular use of psychotropic medication. Participants were recruited among all members of the Spanish Prader-Willi Association who agreed to take part in the study and fulfilled its inclusion criteria. Family and patient demographic features, family size and birth order, intelligence quotient (IQ), anthropometric measures, lifestyle habits, behavioural disturbances (with the Aberrant Behavior Checklist) and clinical data, as well as use of psychotropic drugs and their side effects (with the UKU scale), were collected in genetically confirmed cases of PWS. Bivariate and logistic regression analyses were used for determining the associations of demographic and clinical factors with both obesity and the regular use of psychotropic medication. The cohort included 177 participants (aged 6-48years), that is, 90 (50.8%) males and 87 (49.2%) females. Behavioural disturbances were present in a range of 75% to 93% of participants; psychotropic medication was prescribed to 81 (45.8%) of them. Number of siblings showed a direct correlation with IQ, especially among males, and inappropriate speech was more intense in only-child females. Obesity was, in parallel, strongly associated with ascending age and with not being currently under growth hormone (GH) treatment. Participants taking any psychotropic medication were characterised by more frequent age ≥30years, high level of hyperactivity and a psychiatric diagnosis. Characterisation of persons with PWS in Spain confirms their physical and behavioural phenotype and supports the long-term application of GH therapy and the rational use of psychotropic medication.

Constipation preceding depression: a population-based cohort study

Constipation is generally considered a common physical symptom of depression or a side effect of antidepressant treatments. However, according to the gut-brain axis hypothesis, the association between depression and constipation might be bi-directional. This study investigated the association between premorbid constipation and depression. We conducted a retrospective cohort study using data from UK Biobank. Individuals free of depression between 2006 and 2010 were included. Constipation status was determined using diagnostic codes from electronic health records or a baseline questionnaire. Data on covariates, including socio-demographic characteristics, lifestyle factors, health conditions, and regular medication use, were also collected through a baseline questionnaire. The primary outcome is incident depression, which was extracted from hospital inpatient admissions, primary care, self-report, and death data from baseline to 2022. The secondary outcome is depressive symptoms, which was assessed by Patient Health Questionnaire-9 (PHQ-9) from an online survey in 2016. Cox proportional hazard regression models were employed to assess the prospective association between constipation and incident depression. Logistic regression models were used to assess its association with depressive symptoms. Among the 449,459 participants included in the study, 18,596 (4.1%) experienced constipation at baseline, and 18,576 (4.1%) developed depression over a median follow-up period of 12.3 years. Premorbid constipation is associated with a 2.28-fold higher risk of depression. After adjusting the covariates, we found those with constipation still had a 48% higher risk of developing depression (adjusted hazard ratio [aHR] 1.48; 95% CI, 1.41-1.56) than those without constipation. Self-reported and diagnosed constipation were both associated with a higher risk of depression, with the aHR being 1.42 (95% CI: 1.34-1.51) and 1.66 (95% CI: 1.51-1.82), respectively. Participants with constipation were more likely to report depressive symptoms than people without (adjusted odds ratio 2.18; 95% CI, 1.97-2.43). These findings remained consistent in sensitivity analyses. Diagnosed and self-reported constipation are both prospectively associated with an elevated risk of depression. These explorative findings suggest that constipation may be an independent risk factor or a prodromal symptom of depression. Gastroenterologists and primary care physicians should pay more attention to the depressive symptoms of their constipation patients. The Shenzhen Science and Technology Program and the Strategic Priority Research Program of Chinese Academy of Sciences.

Monocyte-to-HDL cholesterol ratio and uric acid-to-HDL cholesterol ratio as predictors of vitamin D deficiency in healthy young adults: a cross-sectional study.

This study aimed to assess vitamin D deficiency in a cohort of healthy young adults using the novel inflammatory parameters neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), monocyte-to-high-density lipoprotein (HDL) cholesterol ratio (MHR), and uric acid-to-HDL cholesterol ratio (UHR). The study included 1,190 participants, with demographic and laboratory data retrieved retrospectively from our institution's database. The inclusion criteria were ages 22-35 years; absence of acute, subacute, or chronic diseases; no regular medication use; and laboratory values within specified reference ranges. The exclusion criteria were pregnancy, diagnosis of malignancy, and laboratory measurements indicating infection. Participants were categorized into four groups based on vitamin D levels for comparative analysis of study parameters. Correlation analyses were conducted between these parameters and 25-hydroxyvitamin D levels, followed by receiver-operating characteristic analyses to determine the parameters' sensitivity and specificity in detecting vitamin D deficiency. Additionally, regression analyses were performed to identify potential risk factors for vitamin D deficiency. Subjects in Groups A1 and A2 exhibited higher MHR and UHR than those in Groups A3 and A4 (p < 0.001). Both MHR and UHR correlated negatively with vitamin D levels (r = -0.377 and r = -0.363, respectively; p < 0.001). The area under the curve for MHR was 0.766 (95% confidence interval [CI] 0.739-0.794), with a 79% sensitivity and 61% specificity for identification of vitamin D deficiency. Increased MHR and UHR were independent risk factors for vitamin D deficiency (β = 0.219, odds ratio 1.244 95% CI 1.178-1.315, and β = 2.202, odds ratio 1.224, 95% CI 1.150-1.303). Both MHR and UHR can be useful in predicting vitamin D deficiency in healthy young adults and may serve as valuable screening tools.