Bisphenol A (BPA) is a growing concern as an endocrine-disrupting chemical due to its adverse health effects. However, the association between BPA and sperm quality in adult human males remains unclear. The aim of this study was to assess the daily life exposure level of BPA and analyze its correlation with sperm quality in males. Patients who sought treatment in Chinese infertility clinics between May and October 2023 were selected as study subjects. We determined participants\' serum BPA content using high-performance liquid chromatography. Sperm count and motility were assessed using a computer-aided sperm analysis system, while sperm morphology was analyzed using an improved Papanicolaou stain. A total of 405 participants, averaging 33.01 ± 5.44 years old, were included. We observed low semen quality among participants in infertility clinics. Principal component analysis was performed for each semen quality index, and three principal components reflecting sperm motility, count, and morphology were extracted. The participants\' mean serum BPA level was 6.96 ng/mL. Negative correlations were observed between serum BPA content and total sperm count, sperm density, forward motility rate, and non-forward motility rate. A positive correlation was found between the non-motile sperm rate and the head deformity rate. Morphological abnormalities were the predominant adverse effects observed. Despite low daily life BPA exposure, long-term low-dose exposure in the general population may damage semen quality. This study provides a scientific basis for managing health risks associated with BPA exposure.

UNASSIGNED: This study examined gender differences in the association of Triglyceride-Glucose (TyG) index with the prevalence of chronic obstructive pulmonary disease (COPD), particularly in a non-diabetic population.
UNASSIGNED: The study leveraged data from the National Health and Nutrition Examination Survey (NHANES), spanning from 1999 to 2018, with a cohort of 23,456 participants. Logistic regression and restricted cubic spline analyses were employed to explore the relationship between the TyG index and COPD prevalence.
UNASSIGNED: Statistical analyses revealed a significant positive association between the TyG index and COPD prevalence among non-diabetic women after adjustment for all covariates (OR=1.50; 95% CI, 1.08-2.08), supported by a linear relationship (P for non-linearity=0.298). No equivalent significant association was found in non-diabetic men (OR=1.00; 95% CI, 0.67-1.48). Within the diabetic group, the TyG index did not show a significant association with COPD prevalence, regardless of gender.
UNASSIGNED: Our study reveals a significant positive correlation between the TyG index and COPD prevalence in the non-diabetic population, marked by notable gender differences.

BACKGROUND: Patient perception of quality of care is an essential component in evaluating healthcare delivery. This article reports data from primary health care (PHC) centers before Greece\'s most recent PHC reform. The study was undertaken to offer some baseline information about patient experience, support the decision-making processes taking place, and provide valuable input for future policy-making comparisons in Greece.
METHODS: The research was conducted across the 16 PHC centers of Epirus, a region of north-western Greece, from June to September 2017, with 532 patients rating the importance of different aspects of three main healthcare domains (clinical behavior, support and services, and organization of care) of PHC provision. The Greek version of the European Task Force on Patient Evaluations of General Practice (EUROPEP) questionnaire was implemented for research purposes. Univariate comparisons were performed for patients with and without chronic disease, using Pearson\'s χ2 test for categorical data.
RESULTS: Study findings support that the organization of care domain is of highest importance and priority, with clinical behavior and support and services following closely. Among recruited patients, on average, only 2.1% of patients with a chronic disease were satisfied (rated 4 or 5 on the Likert scale) with the organization of care aspects under consideration, compared to 18.4% of patients without a chronic disease. Furthermore, only 4% of patients with a chronic disease were satisfied with the aspects examined in the clinical behavior domain, compared to 27% of patients without a chronic disease. Finally, 18% of sampled patients with a chronic disease reported being satisfied with the quality of support and services provided, compared to 38% of patients without a chronic disease.
CONCLUSIONS: It is necessary to back up available past information to afterwards estimate reform imprinting on expectations and perceptions. The items and aspects of EUROPEP, in line with the new tasks of the personal doctor within the PHC system that patients perceive as most essential, can be used to prioritize quality improvement activities to strengthen PHC delivery in Greece. Communication skills, practices, and behavioral change skills seem to need more attention for an efficient PHC model.

BACKGROUND: Low protein intake and physical inactivity are factors that associated with muscle deterioration and poor physical performance among older adults.
OBJECTIVE: To assess the association between dietary protein intake and physical fitness tests among older adults with pre-sarcopenia and sarcopenia.
METHODS: A total of 110 older adults were recruited through a convenience sampling method. Data including sociodemography, anthropometry, body composition, medical history, and dietary protein intake were obtained through the interview-administered method.
RESULTS: Most of the subjects have low household income (CONCLUSIONS: In conclusion, lifestyle interventions among older adults are important, including ensuring adequate protein intake and encouraging appropriate physical activity to enhance muscle mass, strength, and performance to improve their daily life efficiency and quality of life.

UNASSIGNED: In recent years, the impact of the COVID-19 pandemic and various public crises has highlighted the importance of cultivating high-quality public health talents, especially those with innovative capabilities. This study focuses on the academic innovation ability of public health postgraduate students, which can provide important theoretical support for the cultivation of more public health workers with high innovative capabilities.
UNASSIGNED: From May to October 2022, a cluster sampling method was used to select 1,076 public health postgraduate students from five universities in Shandong Province. A self-designed questionnaire survey was conducted. A chi-square test and binary logistic regression analysis were used to analyze the influencing factors of students\' academic innovation ability. Based on these factors, a nomogram was constructed to intuitively demonstrate the impact of these complex factors on students\' innovation ability.
UNASSIGNED: The results showed that gender, whether serving as a student leader, teacher-student relationship, academic motivation, learning style, academic environment, and teaching mode were the influencing factors of postgraduate students\' academic innovation ability. The column-line diagram (AUC = 0.892, 95% CI = 0.803 ~ 0.833) constructed based on the above influencing factors has good differentiation. The area under the ROC curve is 0.892 (95% CI = 0.803 ~ 0.833), and the calibration curve shows that the predicted value is the same as the measured value.
UNASSIGNED: The nomogram constructed in this study can be used to predict the academic innovation level of public health graduate students, which is helpful for university education administrators to evaluate students\' academic innovation ability based on nomogram scores and carry out accurate and efficient training.

UNASSIGNED: This study aimed to investigate the factors associated with online dating among college students engaging in casual sexual behavior, by understanding these factors, targeted intervention measures can be formulated for relevant departments to help college students better manage their sexual health and offer useful reference for the development of sexual health education.
UNASSIGNED: A cross-sectional survey was conducted using a stratified cluster sampling method. Demographic and behavioral information was gathered through questionnaires for univariable and multivariable logistic regression analysis.
UNASSIGNED: A total of 595 college students engaging in casual sexual behavior were included in the study, of whom 345 (57.98%) had found casual sexual partners through the internet. Multiple regression analysis indicated that male participants, those aged 20-21 years, those who had recently attended AIDS-themed lectures or health education classes at school, participants who were willing to engage in commercial sexual activities during online dating, participants who accepted sexual activities among men who have sex with men (MSM), those who reported having sexual intercourse with regular partners in the past year, participants who wanted to know if their online dating partners were HIV-diagnosed, those who had engaged in commercial sexual behavior in the past year and those who perceived themselves to be at risk of HIV infection were more likely to engage in online dating. Participants with general/disharmonious family relationships, those who consistently used condoms during casual sexual behavior and those who occasionally used condoms were less likely to engage in online dating.
UNASSIGNED: There were a certain extent proportion of casual partners among college students were sourced from the internet, indicating the profound influence of online dating on casual sexual behavior. Therefore, future research and intervention measures should focus on sexual health education and promotion on online dating platforms, strengthen regulations and guidance on college students\' online dating behavior, and raise awareness of HIV prevention in this group.

UNASSIGNED: Bone mineral density (BMD) is a crucial index for predicting fracture risk and diagnosing osteoporosis. With the global rise in osteoporosis prevalence, understanding the relationship between dietary patterns and BMD is vital for public health. This study aimed to explore the association between various dietary patterns and BMD among adults using data from the National Health and Nutrition Examination Survey (NHANES).
UNASSIGNED: Data were analyzed from 8,416 NHANES participants aged 40 years and older across three non-consecutive survey cycles from 2013 to 2020. Dietary patterns were identified using a combination of factor analysis and cluster analysis. BMD measurements were then assessed, and associations with the identified dietary patterns were analyzed, with adjustments made for demographic variables.
UNASSIGNED: The analysis identified three distinct dietary patterns: \"Low protein-High Dietary fiber-Vitamin A-Magnesium (LP-HDF-Vit A-Mg)\", \"High macronutrient-Choline-Selenium (HM-Cho-Se)\", and \"Low macronutrient-Vitamin D-Calcium (LM-Vit D-Ca)\", and then we found that women, older adults, and certain ethnic groups were at higher risk for low BMD. Participants adhering to the \"HM-Cho-Se\" and \"LP-HDF-Vit A-Mg\" dietary patterns exhibited significantly higher BMD compared to those following the \"LM-Vit D-Ca\" pattern. After adjusting for demographic variables, the \"HM-Cho-Se\" pattern remained positively associated with BMD, while the \"LM-Vit D-Ca\" pattern showed no significant association with BMD or the risk of low BMD.
UNASSIGNED: The findings suggest that adherence to the \"HM-Cho-Se\" dietary pattern may reduce the risk of low BMD, indicating potential synergies between these nutrients for bone health. However, the study has limitations, including the cross-sectional design and potential subjectivity in factor analysis. Future research should focus on longitudinal studies involving diverse age groups to better understand the causal relationship between dietary patterns and BMD. Despite these limitations, the study highlights the importance of dietary factors in maintaining bone health and suggests potential dietary interventions to reduce the risk of low BMD and osteoporosis.

The Chronic Care Model (CCM) is a framework that supports the proactive, planned, coordinated and patient-centered care of chronic diseases. The Patient Assessment of Chronic Illness Care (PACIC) scale is a valuable tool for evaluating patients\' perspectives on chronic care delivery based on the CCM. Few studies have examined its application in China. This study assesses hypertension care in Chinese patients and explores how PACIC scores relate to patient compliance. A cross-sectional study was conducted in Hangzhou, China, from June to August 2021, including 253 hypertensive patients from 5 county hospitals and 13 primary healthcare centers. The study used the PACIC scale to assess hypertension care delivery and the Compliance of Hypertensive Patients scale (CHPS) to measure patient compliance. Multiple linear regression analyses were used to explore the relationship between demographic characteristics and the total and domain scores of PACIC, as well as the association between CHPS and the domain scores of PACIC. The mean value of overall the PACIC score was 3.12 (out of 5). Problem solving/contextual domain had the highest average score for each item, while follow up/coordination domain had the lowest. Patient activation had negative effects on intention (β = -.18, P < .05), attitude (β = -.21, P < .05), responsibility (β = -.17, P < .05), and the total score of CHPS (β = -.24, P < .01). Delivery system design/decision support was negatively associated with lifestyle (β = -.21, P < .05) and the total score of CHPS (β = -.26, P < .01). Hypertensive patients perceived that they sometimes received hypertension care consistent with the CCM in Chinese primary healthcare settings. A higher level of PACIC score was beneficial for improving hypertensive patient compliance.

BACKGROUND: Neonatal hypoxic ischemic encephalopathy (HIE) leads to different degrees of neurological sequelae. The incidence of HIE is relatively high, and the causal pathways leading to HIE are still controversial. This study aimed to investigate the risk factors associated with HIE comparing differences between genders.
METHODS: A cross-sectional study of 196 neonates diagnosed with HIE was conducted. Based on the severity of clinical findings, HIE was classified as mild, moderate or severe. For mild HIE, the outcomes were relatively less severe, whereas moderate to severe HIE could suffer serious consequences, including death, cerebral palsy, epilepsy. T-test, chi-square test and logistic regression were used to analyze data.
RESULTS: Among the 196 neonatal HIE, 39 (19.9%) had mild HIE,157 (80.1%) had moderate or severe HIE. The logistic regression analysis showed that gender was a specific stratified characteristic of moderate or severe HIE. In the male neonates group, emergency cesarean section, abnormal labor stage and amniotic fluid contamination were associated with an increased risk of moderate or severe HIE, where the adjusted odds ratios (ORs) were 4.378 (95% confidence intervals (CI):2.263-6.382), 2.827 (95% CI:1.743-5.196) and 2.653 (95%CI:1.645-3.972), respectively. As expected, a significant additive effect was found in the interactions between emergency cesarean section and abnormal labor stage, as well as between emergency cesarean section and amniotic fluid contamination, where the relative excess risk of interaction was 2.315(95%CI:1.573-3.652) and 1.896(95%CI: 1.337-3.861) respectively.
CONCLUSIONS: Emergency cesarean section, abnormal labor stage and amniotic fluid contamination were risk factors of moderate or severe HIE in neonates, and the associations were significantly correlated with male gender. Notably, coinciding incidences of emergency cesarean section with abnormal labor stage, or emergency cesarean section with amniotic fluid contamination were possibly synergistic in increasing the risk of moderate or severe HIE. These findings may assist clinicians in strengthening their awareness on risks affecting HIE and help reduce the incidence of moderate or severe HIE in clinical practice.

BACKGROUND: Heart failure (HF) is a condition caused by a malfunction of the heart\'s pumping function. The single-point insulin sensitivity estimator (SPISE) index is a novel indicator for assessing insulin resistance in humans. However, the connection between the SPISE index and the risk of HF in the elderly is unknown. Therefore, our study aims to evaluate the connection between the SPISE index and HF in older adults.
METHODS: The study was based on data collected from the 1999-2020 National Health and Nutrition Examination Survey database and included 6165 participants aged ≥60 years. The multivariable linear regression model and the smooth fitting curve model were applied to investigate the connection between the SPISE index and HF in the elderly. Furthermore, the subgroup analysis was performed to investigate the interactive factors.
RESULTS: In this study, the mean age of the population was 69.38 years. After adjusting for all covariates, we observed that the SPISE index was inversely related to the prevalence of HF (OR = 0.87, 95 % CI = 0.80-0.94, P < 0.001) in older adults. The interaction analysis showed that the association might be affected by diabetes mellitus and smoking status. Additionally, an inflection point between the SPISE index and HF was found among older women.
CONCLUSIONS: An inverse correlation was detected between the SPISE index and HF in the elderly. This could provide new insight into the prevention and management of HF in the elderly population.