BACKGROUND: Body weight has been recognized as a driving factor of osteoarthritis. Few studies had investigated the association between weight status across adulthood and risk of osteoarthritis (OA). This study investigates the association of weight change patterns across adulthood (lasting at least 25 years) with the risk of OA from the National Health and Nutrition Examination Survey (NHANES) 2013-2018.
METHODS: The study assessed the relationship between weight change across adulthood and OA in 7392 individuals aged > 50 spanning a minimum of 25 years. Multivariate linear regression analyses were utilized to detect the association between weight change patterns and self-reported OA. Restricted cubic splines (RCS) were used to examine the nonlinear relationship between absolute weight change and OA risk.
RESULTS: From 10 years ago to survey, the risk of OA was 1.34-fold (95% CI 1.07-1.68) in people changed from obese to non-obese, 1.61-fold (95% CI 1.29-2.00) in people change from non-obese to obese, and 1.82-fold (95% CI 1.49-2.22) in stable obese people compared with people who were at stable normal weight. Similar patterns were also observed at age 25 years to baseline and age 25 years to 10 years before the baseline. The dose-response association of RCS found a U-shaped relationship between absolute weight change and OA risk.
CONCLUSIONS: The study suggests that weight patterns across adulthood are associated with the risk of OA. These findings stressed important to maintain a normal weight throughout adulthood, especially to prevent ignored weight gain in early adulthood to reduce OA risk later.

Although machine learning methods have enabled considerable progress in air quality assessment, challenges persist regarding data privacy, cross-regional data processing, and model generalization. To address these issues, we introduce an advanced federated Bayesian network (FBN) approach. By integrating federated learning, adaptive optimization algorithms, and homomorphic encryption technologies, we substantially enhanced the efficiency and security of cross-regional air quality data processing. The novelty of this research lies in the improvements implemented in federated learning for air quality data analysis, particularly in distributed model training optimization and data consistency. Through the integration of adaptive structural modification strategies and simulated annealing immune optimization algorithms, we markedly enhanced the structural learning accuracy of the Bayesian network, resulting in a 20% improvement in prediction accuracy. Moreover, employing homomorphic encryption ensured data transmission security and confidentiality. In our Beijing-Tianjin-Hebei case study, our method demonstrated a 15% improvement in air quality classification accuracy compared to conventional methods and exhibited superior interpretability in analyzing environmental factor interactions. We quantified complex air pollution patterns across regions and found that a 30% fluctuation in the air quality index correlated with NO2 concentrations. We also observed a moderate positive correlation between specific pollutant indicators in Hebei Province and Tianjin and changes in air quality. Additionally, the FBN exhibited better operational efficiency and data confidentiality than other machine learning models in handling large-scale and multisource environmental data. Our FBN approach presents a novel perspective for environmental monitoring and assessment, vital for understanding complex air pollution patterns and formulating future ecological protection policies.

UNASSIGNED: To assess the association of age-related macular degeneration (AMD) progression and statins, connected with AMD genetic risk, and if there is an interplay between statins and genetics.
UNASSIGNED: In this analysis, 682 subjects made two visits (6.5-year follow-up) of the Coimbra Eye Study. Subjects who started taking statins at any time point between the two visits were considered. Progressors were defined as not having AMD at baseline and having any AMD at follow-up. Genetic risk scores (GRSs) were calculated individually with 52 independent variants associated with AMD. Time to progression was estimated using unadjusted Kaplan-Meier curves. An extended Cox model was used for the association between statins and GRS with the risk for AMD progression. Multiplicative and additive interactions were assessed.
UNASSIGNED: Median survival time was 7.50 years for subjects not taking statins and 7.62 for subjects taking statins (P < 0.001). Statin intake reduced the risk for progression to AMD in 48%, adjusting for age, sex, body mass index, smoking, and diabetes (model 1) and GRS (model 2). The combined effects of not taking statins and having high GRS increased the progression risk fourfold compared to taking statins and having low GRS (hazard ratio [HR] = 4.25; 95% confidence interval [CI], 1.62-11.16; P = 0.003). For subjects not taking statins, an increased risk of progression was found for those subjects with high GRS compared to subjects with low GRS (HR = 1.80; 95% CI, 1.13-2.85; P = 0.013). No statistically significant multiplicative or additive interactions were found.
UNASSIGNED: Statins seem to be protective against AMD progression, and genetics may play a role in treatment response.

BACKGROUND: Many countries prioritize health-related research and policy around socioeconomic inequality. In India, data on socioeconomic disparity and risk factors for noncommunicable diseases (NCDs) are limited. The study provides empirical information on socioeconomic disparities in NCD risk factors in India as part of a preventative and policy initiative.
METHODS: The study used nationally representative data from wave 1 of the Longitudinal Ageing Study in India which adopted a multistage random sampling design. To achieve the objectives of the study, binary logistic regression was used to demonstrate the association between socioeconomic status and NCD risk factors, and further analysis was conducted employing the decomposition method approach using STATA 14 software to assess socioeconomic disparity.
RESULTS: Concentration Indices (CIs) revealed that overweight/obesity (CI = 0.157) was more prevalent among the nonpoor, whereas smoking (CI = -0.067) and alcohol consumption (CI = -0.014) were more prevalent among the poor. Wealth status was identified as the primary contributor to socioeconomic inequality for all of the risk factors of NCDs. Education was also the leading cause of socioeconomic inequality with respect to alcohol, smoking, high blood pressure, and obesity.
CONCLUSIONS: Identifying the specific needs of impoverished and nonpoor populations is necessary for addressing NCD risk factors and inequalities. It is essential to implement interventions that address the underlying social determinants of health and promote health equality to reduce the burden of NCDs and enhance health outcomes for all.

CONCLUSIONS: Depression is a common illness, it being the fourth-leading cause of disability in the world. The global lifetime prevalence falls between 8% and 12%, with female preponderance. A cross-sectional study was designed to assess the burden of depression among married women in a rural setting in North Kerala and identify its sociodemographic risk factors. The sample size was calculated to be 453 (prevalence = 24.9%; error = 20%; design-effect = 1.5). Systematic random sampling was used to select the participants from the eligible couple register. They were interviewed using MINI and Montgomery-Ashberg Depression Rating Scales. Descriptive analysis showed that 24.2% was suffering from current depression, mostly mild and none severe. Two percent reported past depression and 5.4% experienced spousal violence. Poor family support, experience of domestic violence, morbidity, and older spouses were found to be significant risk factors. The provision of mental health services by trained personnel and strict vigilance against the marriage of girls below the legal age and domestic violence are need of the hour.

OBJECTIVE: This study aimed to predict oral health behaviour (OHB) using the theory of planned behaviour (TPB) and determine its influence on oral health status and oral health-related quality of life (OHRQoL) among subjects attending the outpatient department of a tertiary dental hospital in India.
METHODS: A pre-validated questionnaire was used among 240 randomly selected study subjects to record their demographic details, attitudes (Att), subjective norms (SN) and perceived behaviour control (PBC) with regard to dietary habits (DH), oral hygiene habits (OH) and dental attendance (DA) behaviours. OHRQoL and oral health status of study participants were recorded using Oral Health Impact Profile-14 (OHIP-14) and World Health Organization (WHO) Oral Health Assessment Form (2013), respectively. Multivariate analysis was performed after the necessary bivariate comparisons.
RESULTS: Among demographic characteristics, the Socioeconomic status (SES) of the study subjects highly influenced their DH and OH (P < 0.05). DA was largely affected by the age of the study subjects (P < 0.05). While attitude of the study participants greatly affected their DH, PBC largely influenced their OH and DA behaviours (P < 0.05). The OHRQoL and Decayed Missing Filled Teeth (DMFT) levels were strongly influenced by the participants\' DA behaviours (P < 0.05).
CONCLUSIONS: DMFT scores and OHRQoL were highly influenced by DA behaviour besides others. DA instead was influenced by PBC. Hence, there needs to be a conscious shift towards strengthening the skills of the population to promote oral health.

UNASSIGNED: Our aim was to better understand and raise awareness of the diagnosis journey and quantify any barriers for timely diagnosis of haemophagocytic lymphohistiocytosis (HLH), to support patients\' struggle with diagnosis and reduce time to diagnosis.
UNASSIGNED: Patients diagnosed with, or caregivers for those diagnosed with primary or secondary HLH and physicians involved in the treatment of HLH were recruited. Quantitative interviews were undertaken with patients/caregivers to quantify key elements of the diagnosis journey, followed by qualitative interviews with participants. Interviews took place between March-May 2021.
UNASSIGNED: Thirty-three patients/caregivers and nine physicians took part in this mixed methods study. Lack of physician awareness of HLH was a common frustration for patients/caregivers, causing delayed diagnosis. All physicians indicated bone-marrow testing is a key step in the diagnosis process, and some patients/caregivers had frustrations around testing. Emergency care doctors, although not usually involved in the diagnosis process, were among the most-seen specialists by patients/caregivers. Patients/caregivers suggested potential improvements in available information, such as providing information on treatment options and condition management.
UNASSIGNED: Patients/caregivers and physicians agreed on the need to raise overall awareness of HLH signs/symptoms among priority groups of physicians to recognise how signs/symptoms can progress and develop. Improvements in the testing process and communication would directly impact the speed of diagnosis and support patients/caregivers during the diagnostic journey, respectively.
UNASSIGNED: Raising awareness of key issues, such as signs/symptoms, tests and diagnostic procedures, and improved communication and support for patients/caregivers, are key to speeding up HLH diagnosis and improving outcomes.

Inconsistencies in the definition of clinically unsuspected venous thromboembolism (VTE) in pediatric patients recently led to the recommendation of standardizing this terminology. Clinically unsuspected VTE (cuVTE) is defined as the presence of VTE on diagnostic imaging performed for indications unrelated to VTE in a patient without symptoms or clinical history of VTE. The prevalence of cuVTE in pediatric cancer patients is unclear. Therefore, the main objective of our study was to determine the prevalence of cuVTE in pediatric cancer patients. All patients 0-18 years old, treated at the IWK in Halifax, Nova Scotia, from August 2005 through December 2019 with a known cancer diagnosis and at least one imaging study were eligible (n = 743). All radiology reports available for these patients were reviewed (n = 18,120). The VTE event was labeled a priori as cuVTE event for radiology reports that included descriptive texts indicating a diagnosis of thrombosis including thrombus, central venous catheter-related, thrombosed aneurysm, tumor thrombosis, non-occlusive thrombus, intraluminal filling defect, or small fragment clot for patients without documentation of clinical history and or signs of VTE. A total of 18,120 radiology reports were included in the review. The prevalence of cuVTE was 5.5% (41/743). Echocardiography and computed tomography had the highest rate of cuVTE detection, and the most common terminologies used to diagnose cuVTE were thrombus and non-occlusive thrombus. The diagnosis of cuVTE was not associated with age, sex, and type of cancer. Future efforts should focus on streamlining radiology reports to characterize thrombi. The clinical significance of these cuVTE findings and their application to management, post-thrombotic syndrome, and survival compared to cases with symptomatic VTE and patients without VTE should be further studied.

BACKGROUND: Nephrolithiasis is frequently associated with cardiovascular diseases. These conditions present common risk factors: systemic inflammation that promotes oxidative stress leading to arterial wall stiffening may also play a role in plaque formation predisposing to nephrolithiasis.
OBJECTIVE: The aim of this study was to evaluate arterial stiffness indices at baseline and after a 10-year follow-up, in patients with nephrolithiasis compared with patients without.
METHODS: A total of 82 patients (37 men; mean age 45 ± 13 years) were enrolled at the Geriatrics and Nephrology Outpatient Clinic: 66 were diagnosed with nephrolithiasis, whereas the control group consisted of 16 individuals. At baseline and after 10 years, they underwent clinical evaluation and arterial stiffness measurement, such as carotid-femoral pulse wave velocity (CF-PWV), by arterial applanation tonometry.
RESULTS: At baseline, when compared with the control group, patients with nephrolithiasis showed higher SBP and CF-PWV. After 10 years, patients with nephrolithiasis, but not those without, showed a significant raise in CF-PWV, even after adjustment for age and sex. In a stepwise regression model, with CF-PWV changes during the follow-up as the dependent variable, and age, sex, follow-up years, Δ mean arterial pressure, BMI, hypertension and nephrolithiasis as independent variables, nephrolithiasis was proved to be the only significant predictor of ΔCF-PWV, accounting for 6% of the variance.
CONCLUSIONS: Our study shows higher baseline CF-PWV and greater increase in ΔCF-PWV within 10 years in individuals with nephrolithiasis than in those without, demonstrating an increased cardiovascular risk for nephrolithiasis patients.

UNASSIGNED: Carotid-femoral pulse wave velocity (cfPWV) is the gold standard for noninvasive arterial stiffness assessment, an independent predictor of cardiovascular disease, and a potential parameter to guide therapy. However, cfPWV is not routinely measured in clinical practice due to the unavailability of a low-cost, operator-friendly, and independent device. The current study validated a novel laser Doppler vibrometry (LDV)-based measurement of cfPWV against the reference technique.
UNASSIGNED: In 100 (50 men) hypertensive patients, cfPWV was measured using applanation tonometry (Sphygmocor) and the novel LDV device. This device has 2 handpieces with 6 laser beams each that simultaneously measure vibrations from the skin surface at carotid and femoral sites. Pulse wave velocity is calculated using ECG for the identification of cardiac cycles. An ECG-independent method was also devised. Cardiovascular risk score was calculated for patients between 40 and 75 years old using the WHO risk scoring chart.
UNASSIGNED: LDV-based cfPWV correlated significantly with tonometry (r=0.86, P<0.0001 ECG-dependent [cfPWVLDV_ECG] and r=0.80, P<0.001 ECG-independent [cfPWVLDV_w/oECG] methods). Bland-Altman analysis showed nonsignificant bias (0.65 m/s) and acceptable SD (1.27 m/s) between methods. Intraobserver coefficient of variance for LDV was 4.7% (95% CI, 3.0%-5.5%), and interobserver coefficient of variance was 5.87%. CfPWV correlated significantly with CVD risk (r=0.64, P<0.001; r=0.41, P=0.003; and r=0.37, P=0.006 for tonometry, LDV-with, and LDV-without ECG, respectively).
UNASSIGNED: The study demonstrates clinical validity of the LDV device. The LDV provides a simple, noninvasive, operator-independent method to measure cfPWV for assessing arterial stiffness, comparable to the standard existing techniques.
UNASSIGNED: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03446430.