Routine Check-up Research Articles

Correlation between the neuroendocrine axis, microbial species, inflammatory response, and gastrointestinal symptoms in irritable bowel syndrome.

This study examines the complex relationships among the neuroendocrine axis, gut microbiome, inflammatory responses, and gastrointestinal symptoms in patients with irritable bowel syndrome (IBS). The findings provide new insights into the pathophysiology of IBS and suggest potential therapeutic targets for improving patient outcomes. To investigate the interactions between the neuroendocrine axis, gut microbiome, inflammation, and gastrointestinal symptoms in patients with IBS. Patients diagnosed with IBS between January 2022 and January 2023 were selected for the study. Healthy individuals undergoing routine check-ups during the same period served as the control group. Data were collected on neuroendocrine hormone levels, gut microbiome profiles, inflammatory biomarkers, and gastrointestinal symptomatology to analyze their interrelations and their potential roles in IBS pathogenesis. IBS patients exhibited significant dysregulation of the neuroendocrine axis, with altered levels of cortisol, serotonin, and neuropeptides compared to healthy controls. The gut microbiome of IBS patients showed reduced diversity and specific alterations in bacterial genera, including Bifidobacterium, Lactobacillus, and Faecalibacterium, which were associated with neuroendocrine disturbances. Additionally, elevated levels of inflammatory markers, such as C-reactive protein, interleukin-6, and tumor necrosis factor-α, were observed and correlated with the severity of gastrointestinal symptoms like abdominal pain, bloating, and altered bowel habits. The findings suggest that targeting the neuroendocrine axis, gut microbiome, and inflammatory pathways may offer novel therapeutic strategies to alleviate symptoms and improve the quality of life in IBS patients.

A Retrospective Study Examining Self-Reported Physical Activity Levels Among Asthma Patients Using the Behavioural Risk Factor Surveillance System (BRFSS) Database.

Regular physical activity benefits respiratory health by reducing the risk of developing asthma. This is achieved by reducing bronchial hyperresponsiveness and preventing lung function decline. The objective of the study is to assess the prevalence of self-reported physical activity among asthma patients in the United States in 2021, based on demographic, socioeconomic, and healthcare access variables. The original research study was conducted using the Behavioural Risk Factor Surveillance System (BRFSS) database for the year 2021. Data regarding asthma status, physical activity, age, gender, race, education level, income level, employment status, and time since the last routine check-up were collected. In the BRFSS study conducted in the USA in 2021, there were 43,6121 participants in total. Of these, 61,362 (14.07%) had asthma and 374,759 (85.93%) did not; 43,678 (71.2%) participants with asthma were engaging in physical activity while 17,684 (28.8%) were not. In the group of participants who did not have the disease, 285,932 (76.3%) were engaging in physical activity and 88,827 (23.7%) were not. Demographically, the highest physical activity among those with asthma was observed in the age group of 18 to 24 years (4,079, 83%), male participants (17,725, 76.4%), and white non-Hispanics (31,964, 72.5%). Higher physical activity levels among asthma patients were associated with advanced education 31,947 (76.5%), employment 23,233 (79.8%), and annual incomes exceeding $150,000, 4,091 (89.9%). Participants who self-reported not having asthma have a higher prevalence of physical activity in all categories studied. There is a significant association between physical activity and self-reported asthma, shaped by demographic and socioeconomic factors, as well as the frequency of routine medical check-ups.

The Association of Cognitive Impairment and Depression with Malnutrition among Vulnerable, Community-Dwelling Older Adults: A Large Cross-Sectional Study.

(1) Background: Mental health issues in older adults, particularly cognitive impairment and depression, can affect nutritional status. This study investigates the prevalence of malnutrition among community-dwelling older adults at risk of social exclusion and dependency in Lebanon and its association with cognitive impairment and depression. (2) Methods: This cross-sectional study used secondary data from the TEC-MED project, involving 1410 older adults aged 60 and above in Beirut. Nutritional status was assessed with the Mini Nutritional Assessment _Short Form (MNA_SF), cognitive impairment with the AD8 Dementia Screening Interview, and depression with the Geriatric Depression Scale (GDS-15). (3) Results: 87.2% of participants were at risk of malnutrition, and 2.5% were malnourished. Cognitive impairment was present in 82.2% of the sample and 45% experienced moderate to severe depression. Malnourished individuals had significantly higher rates of cognitive impairment (96.7% vs. 57.8%) and depression (85.7% vs. 23.2%). Significant associations were found between the risk of malnutrition, decreased food intake, cognitive impairment, and depression; however, no significant association was found with BMI. Logistic regression analysis indicated that older age, cognitive impairment, and depression were significant predictors of malnutrition, while having a caregiver was protective. (4) Conclusions: The high prevalence of risk of malnutrition among vulnerable older adults with cognitive impairment and depression underscores the need for policies integrating nutritional screening into routine health check-ups for older adults.

Predictors of tobacco use among pregnant women: a large-scale, retrospective study

ObjectiveTo investigate the predictors of smoking among pregnant women in Iran, focusing on health literacy and associated socioeconomic factors.MethodsThis retrospective cohort study included 103,042 pregnant women aged 18–45 years who attended healthcare centers affiliated with Mashhad University of Medical Sciences for routine prenatal and postnatal checkups between 2017 and 2020. Data were collected from the Sina Electronic Health Record System (SinaEHR®), which recorded sociodemographic characteristics, medical history, and lifestyle behaviors, including tobacco use.ResultsSmoking prevalence was 0.9%. Women with undergraduate or higher education had significantly lower odds of smoking (OR = 0.36; 95% CI = 0.28–0.47) compared to those with primary education or less. Maternal age was marginally associated with increased smoking risk (OR = 1.01; 95% CI = 1.00-1.03). While unemployment showed an increased crude risk for smoking, this was not significant after adjustment (adjusted OR = 1.02; 95% CI = 0.86–1.21). Strong associations were found between tobacco use and alcohol consumption (OR = 46.3; 95% CI = 24.8–83.4) and opium addiction (OR = 23.4; 95% CI = 14.5–36.3). Chronic disease history also increased smoking odds (OR = 1.51; 95% CI = 1.17–1.92).ConclusionLower education, substance use, and chronic disease are significant predictors of smoking among pregnant women in Iran. Targeted interventions to improve health literacy and address these factors are essential to reduce tobacco use during pregnancy.

Data-driven risk stratification and precision management of pulmonary nodules detected on chest computed tomography.

The widespread implementation of low-dose computed tomography (LDCT) in lung cancer screening has led to the increasing detection of pulmonary nodules. However, precisely evaluating the malignancy risk of pulmonary nodules remains a formidable challenge. Here we propose a triage-driven Chinese Lung Nodules Reporting and Data System (C-Lung-RADS) utilizing a medical checkup cohort of 45,064 cases. The system was operated in a stepwise fashion, initially distinguishing low-, mid-, high- and extremely high-risk nodules based on their size and density. Subsequently, it progressively integrated imaging information, demographic characteristics and follow-up data to pinpoint suspicious malignant nodules and refine the risk scale. The multidimensional system achieved a state-of-the-art performance with an area under the curve (AUC) of 0.918 (95% confidence interval (CI) 0.918-0.919) on the internal testing dataset, outperforming the single-dimensional approach (AUC of 0.881, 95% CI 0.880-0.882). Moreover, C-Lung-RADS exhibited a superior sensitivity compared with Lung-RADS v2022 (87.1% versus 63.3%) in an independent cohort, which was screened using mobile computed tomography scanners to broaden screening accessibility in resource-constrained settings. With its foundation in precise risk stratification and tailored management, this system has minimized unnecessary invasive procedures for low-risk cases and recommended prompt intervention for extremely high-risk nodules to avert diagnostic delays. This approach has the potential to enhance the decision-making paradigm and facilitate a more efficient diagnosis of lung cancer during routine checkups as well as screening scenarios.

Association between body mass index and physical activity among prostate cancer survivors.

We assessed the associations between (1) body mass index (BMI) and participating in any physical activities (PAs) in past 30days and (2) cancer and behavioral-related variables and participating in any PAs in past 30days among prostate cancer (PCa) survivors. We conducted a cross-sectional analysis of data from the 2018-2022 Behavioral Risk Factor Surveillance System. Multivariable weighted logistic regression was used to examine the associations. Of the 4944 PCa respondents, 22.9% were classified as obese class I and 10.6% as obese class II or III. Obese class I and obese class II or III respondents were significantly less likely to participate in any PAs in past 30days (odds ratio (OR) = 0.48; 95% confidence interval (CI): 0.28-0.84 and OR = 0.37; 95% CI: 0.20-0.67, respectively). Men who received a summary of their cancer treatment were significantly more likely to participate in any PAs in past 30days (OR = 1.53; 95% CI: 1.03-2.28). Men who received instructions from a doctor for routine check-ups after completing treatment for cancer were not significantly more likely to participate in any PAs in past 30days (OR = 1.36; 95% CI: 0.87-2.12). Current smokers were less likely to participate in any PAs in past 30 days (OR = 0.50; 95% CI: 0.26-0.96). Obese men and current smokers were less likely to participate in any PAs in past 30days. Men who received a summary of their cancer treatment were more likely to participate in any PAs in past 30days. Health care providers should talk to their patients about the benefits of participating in PA and refer PCa patients to available exercise programs. PA was lowest among obese class II or III PCa survivors. These men could benefit from a coordinated multidisciplinary health care team effort to improve PCa prognosis and QoL.

Long-Term Change in BMI for Children with Obesity Treated in Family-Centered Lifestyle Interventions

Introduction: Several evaluations of lifestyle interventions for childhood obesity exist; however, follow-up beyond 2 years is necessary to validate the effect. The aim of the present study was to investigate long-term weight development following children participating in one of two pragmatic family-centered lifestyle interventions treating childhood obesity. Methods: This real-life observational study included Danish children 4–17 years of age classified as having obesity. Data from 2010 to 2020, from two community-based family-centered lifestyle interventions (designated hereafter as the Aarhus- and the Randers-intervention) were merged with national registers and routine health check-ups, including height and weight. Adjusted mixed effect models were used to model changes in body mass index (BMI) z score. We performed exploratory analyses of the development in BMI z-score within stratified subgroups of children treated in the interventions before investigating potential effect modifications induced by sex, age, family structure, socioeconomic, or immigration status. Results: With a median follow-up of 2.8 years (interquartile range: 1.3; 4.8), 703 children participated in an intervention (445 the Aarhus-intervention; 258 the Randers-intervention) and 2,337 children were not invited to participate (no-intervention). Children in both interventions experienced a comparable reduction in BMI z-scores during the first 6 months compared to the no-intervention group (Aarhus-intervention: −0.12 SD/year and Randers-intervention: −0.25 SD/year). Only children in the Randers-intervention reduced their BMI z-score throughout follow-up (Aarhus-intervention vs. no-intervention: 0.01 SD/year; confidence interval [CI]: −0.01; 0.04; Randers-intervention vs. no-intervention: −0.05 SD/year; CI: −0.08; −0.02). In subgroup comparisons, combining the two interventions, family income below the median (−0.05 SD/year, CI: −0.02; −0.09), immigrant background (0.04 SD/year, CI: 0.00; 0.07), or receiving intervention less than 1 year (0.04 SD/year, CI: 0.00; 0.08) were associated with a yearly increase in BMI z score. In addition, effect modification analyses did not observe any interaction by sex, age, family structure, socioeconomic, or immigration. Conclusions: Although the more dynamic intervention with longer duration obtained and sustained a minor reduction in BMI z score, the clinical impact may only be modest and still not effective enough to induce a long-term beneficial development in BMI in children with obesity.

Computational Modeling Approach to Profile Hemodynamical Behavior in a Healthy Aorta.

Cardiovascular diseases (CVD) remain the leading cause of mortality among older adults. Early detection is critical as the prognosis for advanced-stage CVD is often poor. Consequently, non-invasive diagnostic tools that can assess hemodynamic function, particularly of the aorta, are essential. Computational fluid dynamics (CFD) has emerged as a promising method for simulating cardiovascular dynamics efficiently and cost-effectively, using increasingly accessible computational resources. This study developed a CFD model to assess the aorta geometry using tetrahedral and polyhedral meshes. A healthy aorta was modeled with mesh sizes ranging from 0.2 to 1 mm. Key hemodynamic parameters, including blood pressure waveform, pressure difference, wall shear stress (WSS), and associated wall parameters like relative residence time (RRT), oscillatory shear index (OSI), and endothelial cell activation potential (ECAP) were evaluated. The performance of the CFD simulations, focusing on accuracy and processing time, was assessed to determine clinical viability. The CFD model demonstrated clinically acceptable results, achieving over 95% accuracy while reducing simulation time by up to 54%. The entire simulation process, from image construction to the post-processing of results, was completed in under 120 min. Both mesh types (tetrahedral and polyhedral) provided reliable outputs for hemodynamic analysis. This study provides a novel demonstration of the impact of mesh type in obtaining accurate hemodynamic data, quickly and efficiently, using CFD simulations for non-invasive aortic assessments. The method is particularly beneficial for routine check-ups, offering improved diagnostics for populations with limited healthcare access or higher cardiovascular disease risk.

Accuracy and reliability of the Ipswich touch test in identifying loss of protective sensation among diabetic patients

ObjectiveTo evaluate the accuracy of the Ipswich touch test compared to the 10-g monofilament test for identifying of loss of protective sensation in Thai patients with diabetes mellitus. MethodsA cross-sectional observational study was conducted on Thai patients with diabetes mellitus who attended routine annual foot check-ups in an outpatient diabetes clinic. The loss of protective sensation was assessed by the Ipswich touch test and compared with the Semmes-Weinstein 10-g monofilament test. Sensitivity, specificity, predictive values and likelihood ratios were calculated to measure the accuracy of the Ipswich touch test against 10-g monofilament as a reference standard. The interrater reliability of the Ipswich touch test was assessed by two raters. ResultsIn a study of 283 diabetic patients, 10-g monofilament detected a 25 % prevalence of loss protective sensation. The Ipswich touch test demonstrated a good diagnostic accuracy, with a sensitivity of 70.8 %, specificity of 98.6 %, and an area under the curve of 0.85 when compared to 10-g monofilament. Positive and negative predictive values were 94.4 % and 90.8 % respectively. The positive likelihood ratio was 49.82, and the negative likelihood ratio was 0.30. Interrater reliability, assessed with two raters in a subset of 93 participants, yielded a kappa of 0.88, indicating almost perfect agreement. ConclusionsThe Ipswich Touch Test demonstrated good accuracy and interrater reliability compared to the standard 10-g monofilament, thus establishing its effectiveness as a valuable diagnostic tool for identifying loss of protective sensation among diabetic patients. However, its relatively low sensitivity suggests it should be used with caution as a screening tool.

Migration background and use of preventive healthcare services: Findings of the German Ageing Survey

BackgroundThis study aimed to investigate the relationship between migration background and the utilization of preventive healthcare services.MethodsCross-sectional data from wave 5 in the year 2014, with a sample size of 7,684 individuals, were extracted from the nationally representative German Ageing Survey. The survey included community-dwelling individuals aged 40 years and above, with migration background serving as the primary independent variable. The outcomes measured included participation in cancer screenings, flu vaccinations, and routine health check-ups. Multiple logistic regressions were used to examine the association between migration background and preventive healthcare services.ResultsRegressions showed that the presence of a migration background with personal migration experience (compared with not having a migration background) was associated with a lower likelihood of using preventive healthcare services. More precisely, compared to individuals not having a migration background, individuals with a migration background and personal migration experience had a lower likelihood of routine health check-ups (OR = 0.76, 95% CI: 0.61 to 0.95), flu vaccinations (OR = 0.75, 95% CI: 0.59 to 0.95) and cancer screenings (OR = 0.71, 95% CI: 0.57 to 0.89). In contrast, there was no significant association between the presence of a migration background without personal migration experience (compared with not having a migration background) and the use of preventive healthcare services.ConclusionIn conclusion, results showed differences between individuals without migration background and individuals with migration background (and with personal migration experience) in terms of using preventive healthcare services. It may be helpful to specifically address individuals with migration background (and with migration experience) in terms of using preventive healthcare services.

Socio-Cultural Study of Nutrition in Families of Stunted Toddlers in Coastal Communities in Jember Regency

Background: Cultures, traditions, or habits that exist in society, such as dietary restrictions and wrong eating patterns, can lead to increased nutritional problems, especially in toddlers, which ultimately impacts their growth and development. Low-income family parenting patterns in feeding and primary health care for toddlers can also increase the incidence of stunting in toddlers. This could be the cause of the stunting rate in the Jember Regency, especially in coastal areas. Dietary problems, including stunting, in coastal areas should be less likely to occur because the availability of high-protein animal foods such as fish is quite high, but Curahnongko Village is included in the stunting locus area in Jember Regency. Aims: This research aims to describe the socio-cultural nutrition and parenting styles of toddlers in Curahnongko Village. Methods: The study used qualitative and research methods with a case study approach. Results: The socio-culture during pregnancy in the coastal communities of Jember Regency regarding TTD consumption, routine check-ups, taboos during pregnancy, and visits to midwives are quite good. Socio-culturally during the breastfeeding period, it can be concluded that all informants carried out Early Breastfeeding Initiation (IMD). Socio-culturally during the feeding period for toddlers, all informants do not give food other than breast milk to babies when they are born. Conclusion: The socio-cultural aspect that appears to influence the occurrence of stunting is during the feeding period for toddlers, namely the frequency of children's snack consumption outside the home.

Effects of enriched environments on behavioral development at toddler period of preterm experienced early repeated procedural pain

Objective: To investigate the effects of enriched environments on behavioral development at toddler period of preterm who had experienced early repeated operative pain. Methods: A cross-sectional study was conducted. A total of 80 high-risk preterm children of 2 years of age, who had experienced repeated pain stimuli in the neonatal intensive care unit (NICU), were enrolled as preterm group from the High-risk Children Clinic of Children's Hospital of Nanjing Medical University from October 2016 to March 2021. Furthermore, 39 full-term healthy children, aged 2 years, who were undergoing routine check-ups during the same period, were selected as the full-term group. The preterm group was further divided into preterm intervention group and preterm non-intervention group based on the implementation of enriched environment interventions. Data of neonatal characteristics from 3 groups were collected. Growth and development indicators at the age of 2 years were measured. Neuropsychological development evaluated by Gesell developmental scale. Behavioral development evaluated by child behavior check list. The salivary cortisol levels in response to novelty (baseline, task, end) were collected. The family environment, including maternal parenting pressure, were evaluated through a survey questionnaire. One-way ANOVA and least significant difference (LSD) tests were used to compare physical development, maternal parenting stress, Gesell neuropsychological development, and behavioral problems among the 3 groups. A repeated-ANOVA and LSD tests were employed to compare the patterns of salivary cortisol secretion. Pearson correlation analysis was used to explore the influencing factors related to neuropsychological and behavioral development and cortisol level. Results: There were 44 cases in the preterm intervention group (17 males, gestational age of (31.3±2.8) weeks), and 36 in the preterm non-intervention group (29 males, gestational age of (32.5±2.6) weeks). The full-term group consisted of 39 children (23 males, gestational age of (39.3±2.1) weeks). At 2 years of age, the height, weight, and head circumference of the preterm intervention group and non-intervention group were all lower than those of the full-term group (all P<0.05).The Gesell developmental schedule showed that the preterm non-intervention group scored all lower in gross motor, fine motor, adaptive, language and personal-social domains compared to the full-term group (91±7 vs. 97±6, 88±9 vs. 94±6, 89±8 vs. 99±8, 84±10 vs. 100±15, 89±7 vs. 95±6), with statistical significance (all P<0.01). The preterm intervention group scored all higher than the preterm non-intervention group in gross motor, fine motor, adaptive and language domains (all P<0.05), with no significant difference compared to the full-term group (all P>0.05). The number of needle painful procedures during hospitalization in NICU of the non-intervention group was negatively correlated to the adaptive development quotient (r=-0.48, P<0.05). Furthermore, the preterm non-intervention group exhibited higher scores in social withdrawal, depression, somatic complaints, aggression, and destructive behaviors compare to the full-term group and preterm intervention group (F=8.07, 5.67, 7.72, 7.90, 7.06; all P<0.05); while the preterm intervention group showed no significant difference compared to full-term group (all P>0.05). Behavioral problems (social withdrawal and depression) in the preterm non-intervention group were positively correlated with maternal parenting stress (r=0.66, 0.50; both P<0.05). In response to novel visual stimuli and cognitive challenges, the preterm non-intervention group had significantly higher salivary cortisol levels compared to the full-term group (P=0.006), which were negatively correlated with the frequency of early painful procedures (r=-0.83, -0.80; both P<0.01). There was no significant difference in cortisol secretion pattern between the intervention group and the full-term group (P=0.772). Conclusion: Enriched environmental interventions can improve neuropsychological development, decrease behavioral problems, and down-regulate consistent high cortisol response to task in preterm infants who have experienced repeated procedural pain in the NICU by the age of 2 years.

Prediction of transfusion risk after total knee arthroplasty: use of a machine learning algorithm

IntroductionTotal knee arthroplasty (TKA) carries a significant hemorrhagic risk, with a non-negligible rate of postoperative transfusions. The blood-sparing strategy has evolved to reduce blood loss after TKA by identifying the patient's risk factors preoperatively. In practice, a blood count is often performed postoperatively but rarely altering the patient's subsequent management. This study aimed to identify the preoperative variables associated with hemorrhagic risk, enabling the creation of a machine-learning model predictive of transfusion risk after total knee arthroplasty and the need for a complete blood count. HypothesisBased on preoperative data, a powerful machine learning predictive model can be constructed to estimate the risk of transfusion after total knee arthroplasty. Material and methodsThis retrospective single-centre study included 774 total knee arthroplasties (TKA) operated between January 2020 and March 2023. Twenty-five preoperative variables were integrated into the machine learning model and filtered by a recursive feature elimination algorithm. The most predictive variables were selected and used to construct a gradient-boosting machine algorithm to define the overall postoperative transfusion risk model. Two groups were formed of patients transfused and not transfused after TKA. Odds ratios were determined, and the area under the curve evaluated the model's performance. ResultsOf the 774 TKA surgery patients, 100 were transfused postoperatively (12.9%). The machine learning predictive model included five variables: age, body mass index, tranexamic acid administration, preoperative hemoglobin level, and platelet count. The overall performance was good with an area under the curve of 0.97 [95% CI 0.921 - 1], sensitivity of 94.4% [95% CI 91.2 - 97.6], and specificity of 85.4% [95% CI 80.6 - 90.2]. The tool developed to assess the risk of blood transfusion after TKA is available at https://arthrorisk.com. ConclusionThe risk of postoperative transfusion after total knee arthroplasty can be predicted by a model that identifies patients at low, moderate, or high risk based on five preoperative variables. This machine learning tool is available on a web platform that is accessible to all, easy to use, and has a high prediction performance. The model aims to limit the need for routine check-ups, depending on the risk presented by the patient. Level of evidenceII; diagnostic study

Guardians of memory: The urgency of early dementia screening in an aging society.

The global aging population has led to a significant rise in the prevalence of age-related non-communicable diseases such as dementia and other cognitive disorders. In 2019, there were 57.4 million people with dementia worldwide, and this number is projected to triple by 2050. Intervening in and managing 12 potentially modifiable dementia risk factors can prevent or delay the onset and progression of about 40% of dementia cases. Neuroimaging, biomarkers, and advanced neuropsychological testing offer promising pathways for the early detection of dementia. Emphasis should be placed on educating the public about the importance of brain health and the early signs of cognitive impairment, as well as promoting dementia prevention measures. Adopting a healthy lifestyle - including a balanced diet, regular physical exercise, active social engagement, cognitive activities, and avoiding smoking and excessive alcohol consumption - can help reduce the risk of cognitive decline and prevent cognitive disorders. Government policies on dementia prevention and health care, along with early and regular dementia screening programs, can enhance the early identification and management of individuals at risk. In addition, integrating cognitive health assessments into routine medical check-ups is essential for the early screening and management of dementia.

A SYSTEMATIC REVIEW OF PARENTS' PATTERNS AND BARRIERS TO BRINGING CHILDREN TO THE DENTIST

Caries at an early age is a global problem that affects almost half of preschool children, the prevalence of early childhood caries (ECC) globally varies widely. One of the causes of caries in children less than 5 years old is the delay in the first visit to the dentist. The purpose of this study is to identify patterns of service utilization and obstacles that cause low visits to dentists so that programs can be planned that are able to increase the number of dental visits. A literature review was conducted using PubMed, ProQuest, SpringerLink, and ScienceDirect databases with keywords such as Dental care, Dental attendance, dental utilization, and Oral health promotion. The data were then thematically analyzed to uncover trends, common challenges, and effective interventions across the literature. The results of this systematic review show a pattern in visiting the dentist, including visiting for routine dental checkups, preventive treatments, acute pain conditions that have been experienced and trauma. The patterns of use of dental and oral health services in children are influenced by the level of parental education, the type of dental health care that is covered by limited health insurance, low socio-economic factors, socio-demographic factors, and lack of adequate insurance. This study aims to offer valuable insights into the patterns of dental care utilization and the obstacles preventing higher visitation rates to dental services. The findings are synthesized to highlight consistencies and gaps, ultimately providing insights to inform the development of programs aimed at improving dental visit rates.

The effect of Previous Dental Treatments on Dental Anxiety in Children Aged 4-12

Objective: The patient’s cooperation is crucial for the success of dental treatment. In addition to previous treatments, various factors such as socio-economic status, age, gender, and oral hygiene can influence dental anxiety. The aim of this study is to evaluate the impact of previous dental treatment experiences on dental anxiety. Material and Method: Children aged 4-12 years who applied for dental treatment, along with their families, participated in the study. During their children’s dental treatment, families completed a survey form containing sociodemographic data and information about previous dental treatments. Before the procedure, children were shown five pictures from the Facial Image Scale and asked to choose the picture that best represented their current emotion. The degree of cooperation during the procedure was assessed using the Frankl Behavior Scale. The interaction of patients’ dental anxiety with various factors was analyzed. ANOVA post-hoc analysis and Tukey’s test were used for multiple comparisons of normally distributed variables among continuous variation variables. Kruskal-Wallis post-hoc analysis and the Mann-Whitney U test were used for variables that did not follow a normal distribution. Results: Dental anxiety was found to be higher in girls and younger age groups, although this difference was not statistically significant. According to the Frankl scale, children who attended routine dental check-ups and had previous dental treatment experiences had higher scores, regardless of whether the previous treatment was favorable or unfavorable. Based on the Facial Image Scale, it was observed that children with no previous dental treatment selected more positive faces, whereas children with negative dental treatment experiences selected more negative faces. Conclusion: Previous dental treatment experiences and routine check-ups significantly impact reducing dental anxiety by familiarizing the child with the clinical environment and the dentist, as well as by reducing the need for invasive dental procedures. Therefore, to eliminate the negative effects of dental anxiety, preventive dental treatments should be emphasized by bringing children to regular dental check-ups at an early age, thus minimizing the need for invasive dental treatments.

Reaching adolescents with health services: Systematic development of an adolescent health check-ups and wellbeing programme in Ghana (Y-Check, Ghana).

Routine health check-ups may improve adolescent health, but global guidelines are lacking. Phase 1 of the WHO-coordinated Y-Check Research Programme involved three African cities to co-produce a programme of adolescent health check-ups. We describe a systematic approach to developing a routine adolescent health check-ups and wellbeing programme (Y-Check) to contribute evidence on whether adolescent health check-ups should be part of routine health services in Ghana. Y-Check Phase 1 was conducted in four communities in Cape Coast Ghana, over two stages using a variety of methods: (a) needs assessment and landscape analysis on the health of adolescents (existing policies/programmes, school system, adolescent health conditions) was conducted through desk-review and interviews with key informants to identify the potential content, delivery strategy and settings for adolescent health check-ups in this context; (b) co-designing the Y-Check intervention framework through person-centred participatory workshops and a consensus-building workshop with multiple stakeholders, including adolescents (10-19 years) and their parents. The study was conducted between January 2020 and October 2020. The Y-Check intervention consists of two check-ups with content that is tailored to the needs of younger adolescents and older adolescents; delivered at both school and community settings by a team of trained staff in multiple steps involving up to four stations. Y-Check includes a referral system for adolescents with any problems that cannot be investigated or treated on-the-spot. Our systematic approach to co-producing Y-Check has resulted in an intervention whose content and structure is determined by the local context, and which was adjudged by multiple stakeholders to be likely to be both useful and acceptable, and which builds on best practice. As a logical next step, the Y-Check will be subjected to pilot testing and implementation research to rigorously evaluate the feasibility, acceptability, coverage, yield of previously undiagnosed conditions and cost of these health check-ups.

Impact of psychological correlates, Social isolation and loneliness on the management and self care behaviors of Cardio-vascular Disease after COVID- 19 Pandemic

The present research paper examines the impact of psychological correlates (stress, anxiety and depression), social isolation and loneliness in the management and self care behaviors of cardiovascular disease after Covid 19 pandemics. According to World Heart Federation 2023 report shows that more than half a billion people around the world continue to be affected by cardiovascular diseases, which accounted for 20.5 million deaths in 2021 – close to a third of all deaths globally and an overall increase on the estimated 121 million CVD deaths. Over three quarters of Cardiovascular disease deaths take place in low- and middle-income countries. Out of the 17 million premature deaths (under the age of 70) due to non-communicable diseases in 2019 (World Health Organization), 38% were caused by cardiovascular diseases. Most cardiovascular diseases can be prevented by addressing psychologically, socially, behavioral and environmental risk factors such as anxiety, anger, stress, depression, social isolation, loneliness, tobacco use, unhealthy diet and obesity, physical inactivity, harmful use of alcohol and air pollution. Anxiety is associated with a variety of physical and psychological symptoms that can negatively impact the health outcome. Anxiety can lead to increased blood pressure, heart rate, and cortisol levels, which can contribute to the development and progression of Cardio vascular disease. Psychological interventions can help individuals with Cardio vascular disease better cope with the disease, improve their quality of life, and reduce the risk of adverse health outcomes. It is important to detect cardiovascular disease as early as possible for the management and prevention of it. Research involves 300 participants with cardiovascular disease during 2021 to 2024. The data was collected by the participant of Chhattisgarh and Madhya Pradesh visited to the private clinics and hospital for their routine checkups. Using standardized questionnaire following information was gathered i.e. Demographic, biomedical information, anxiety, depression, stress, as well as feelings of social isolation and loneliness, self health care inventory for cardio vascular disease and their lifestyle related information for preventing from the diseases. The data was analyzed using descriptive statistics, and one way ANOVA. The results revealed a significant relationship with psychological correlates, social isolation and loneliness in the management and care of cardiovascular diseases participants after Covid 19 pandemic. The results of the study are fruitful for Health Care Professionals and Health Care Providers for the management of cardiovascular diseases; also it’s useful for Ministry of Health to make a policy related to the control the death rate which is caused due to cardiovascular diseases. Hence it is important to "Identifying sustainable ways to work with communities to take action to prevent and control modifiable risk factors for heart disease is essential for reducing the global burden of heart disease," said George A. Mensah, MD, FACC, director of the Center for Translation Research and Implementation Science at the NHLBI.

The Relationship between Maternal Smoking and Infant Birth Weight: Improving Accuracy through Urine Cotinine Analysis and Effective Medical Record Strategies.

We conducted a study to determine if antenatally collected maternal urine cotinine (a metabolite of nicotine) measurements can be used to assess the neonatal impact of nicotine exposure during pregnancy. This was a prospective longitudinal cohort of mother-infant dyads. Only term singleton pregnancies were included. The primary outcome measure was the correlation between maternal urine cotinine and infant birth weight. We analysed data from 238 mother-neonate dyads. Smoking habits were recorded during routine prenatal check-ups and urine samples were collected to measure cotinine and creatinine levels. Urine cotinine was detected in 50.4% (120/238) of women from the whole cohort, but only 16% (38/238) self-reported as smokers (chi-square 39.7, p < 0.0001), and these women had significantly smaller babies (p = 0.010). There was a significant negative correlation between maternal urine cotinine and birth weight (Spearman's coefficient = -0.0226, p = 0.013). Female babies born to women with nicotine in their urine were significantly smaller (p = 0.001). Infant birth weight significantly reduced in mothers with exposure to nicotine during pregnancy. The number of women exposed to nicotine during late pregnancy (measured in urine) was markedly higher than self-reported and national smoking percentages, suggesting an urgent need for an improvement in medical record reporting on smoking habits to better assess neonatal outcomes.

Novel metabolic and lipidomic biomarkers of sarcopenia.

The pathophysiology of sarcopenia is complex and multifactorial and has not been fully elucidated. The impact of resistance training and nutritional support (RTNS) on metabolomics and lipodomics in older adults with sarcopenia remains uncertain. This study aimed to explore potential biomarkers of sarcopenia and clinical indicators of RTNS in older sarcopenic adults. Older individuals diagnosed with sarcopenia through routine health checkups at a community hospital were recruited for a 12-week randomized controlled trial focusing on RTNS. Plasma metabolomic and lipidomic profiles of 45 patients with sarcopenia and 47 matched controls were analysed using 1H-nuclear magnetic resonance (1H-NMR) and liquid chromatography-mass spectrometer (LC-MS). At baseline, the patient and control groups had similar age, sex, and height distribution. The patient group had significantly lower weight, BMI, grip strength, gait speed, skeletal muscle index, lean mass of both the upper and lower limbs, and lower limb bone mass. There was a significant difference in 12 metabolites between the control and patient groups. They are isoleucine (patient/control fold change [FC]=0.86±0.04, P=0.0005), carnitine (FC=1.05±0.01, P=0.0110), 1-methylhistamine/3-methylhistamine (FC=1.24±0.14, P=0.0039), creatinine (FC=0.71±0.04, P<0.0001), carnosine (FC=0.71±0.04, P=0.0007), ureidopropionic acid (FC=0.61±0.10, P=0.0107), uric acid (FC=0.88±0.03, P=0.0083), PC (18:2/20:0) (FC=0.69±0.03, P=0.0010), PC (20:2/18:0) (FC=0.70±0.06, P=0.0014), PC (18:1/20:1) (FC=0.74±0.05, P=0.0015), PI 32:1 (FC=4.72±0.17, P=0.0006), and PI 34:3 (FC=1.88±0.13, P=0.0003). Among them, carnitine, 1-methylhistamine/3-methylhistamine, creatinine, ureidopropionic acid, uric acid, PI 32:1, and PI 34:3 were first identified. Notably, PI 32:1 had highest diagnostic accuracy (0.938) for sarcopenia. 1-Methylhistamine/3-methylhistamine, carnosine, PC (18:2/20:0), PI 32:1, and PI 34:3 levels were not different from the control group after RTNS. These metabolites are involved in amino acid metabolism, lipid metabolism, and the PI3K-AKT/mTOR signalling pathway through the ingenuity pathway analysis. These findings provide information on metabolic changes, lipid perturbations, and the role of RTNS in patients with sarcopenia. They reveal new insights into its pathological mechanisms and potential therapies.