Diagnostic accuracy of endoscopic ultrasonographic shear wave elastography for assessing early chronic pancreatitis using the Japanese diagnostic criteria 2019.

Background and Aim: Endoscopic ultrasound shear wave elastography (EUS-SWE) can facilitate an objective evaluation of pancreatic fibrosis. Although it is primarily applied in evaluating chronic pancreatitis, its efficacy in assessing early chronic pancreatitis (ECP) remains underinvestigated. This study evaluated the diagnostic accuracy of EUS-SWE for assessing ECP diagnosed using the Japanese diagnostic criteria 2019. Methods: In total, 657 patients underwent EUS-SWE. Propensity score matching was used, and the participants were classified into the ECP and normal groups. ECP was diagnosed using the Japanese diagnostic criteria 2019. Pancreatic stiffness was assessed based on velocity (Vs) on EUS-SWE, and the optimal Vs cutoff value for ECP diagnosis was determined. A practical shear wave Vs value of ≥50% was considered significant. Results: Each group included 22 patients. The ECP group had higher pancreatic stiffness than the normal group (2.31 ± 0.67 m/s vs. 1.59 ± 0.40 m/s, p < 0.001). The Vs cutoff value for the diagnostic accuracy of ECP, as determined using the receiver operating characteristic curve, was 2.24m/s, with an area under the curve of 0.82 (95% confidence interval: 0.69-0.94). A high Vs was strongly correlated with the number of EUS findings (rs = 0.626, p < 0.001). Multiple regression analysis revealed that a history of acute pancreatitis and ≥2 EUS findings were independent predictors of a high Vs. Conclusions: There is a strong correlation between EUS-SWE findings and the Japanese diagnostic criteria 2019 for ECP. Hence, EUS-SWE can be an objective and invaluable diagnostic tool for ECP diagnosis.

Family Resilience in Patients With Schizophrenia: Potential Influencing Factors and Mediating Effect.

OBJECTIVE: To identify the determinants of family resilience in the recovery of individuals with schizophrenia using Walsh's family resilience framework. DESIGN: A cross-sectional study. METHODS: In Northeast China, 403 patients diagnosed with schizophrenia were enrolled for this study, assessing family resilience, family communication, social support, illness knowledge, hope and family functioning. Regression analyses were conducted using SPSS 27.0, and mediation effects were examined using Mplus 7.0. RESULTS: Logistic regression showed that female gender and having a sibling as a caregiver were negatively associated with family resilience, while a higher educational level was positively associated. Mediation analysis showed that family functioning and hope levels mediated the impact of family communication, social support and disease knowledge on family resilience, confirming their crucial roles. CONCLUSION: Family functioning and hope are central in mediating the relationships between family communication, social support, illness knowledge and family resilience in families dealing with schizophrenia. IMPACT: The findings of this study enable psychiatric nurses and policymakers to devise intervention strategies that enhance family resilience among patients with schizophrenia, thereby facilitating their recovery and well-being. PATIENT OR PUBLIC CONTRIBUTION: No patient or public engagement.

Analysis of Alzheimer's Disease-Related Mortality Rates Among the Elderly Populations Across the United States: An Analysis of Demographic and Regional Disparities from 1999 to 2020.

INTRODUCTION: Alzheimer's Disease (AD) is the leading cause of dementia and a significant public health concern, characterized by high incidence, mortality, and economic burden. This study analyzes the mortality patterns and demographic disparities in Alzheimer's disease-related deaths among the elderly population in the United States from 1999 through 2020. METHODS: Alzheimer's disease mortality data for individuals 65 and older were obtained from the CDC WONDER database, utilizing ICD-10 codes G30.0, G30.1, G30.8, and G30.9 for identification. Demographic and regional variables included age, gender, race/ethnicity, place of death, urban- rural status, and geographic region. Crude death rates (CR) and age-adjusted mortality rates (AAMR) per 100,000 individuals were calculated. Joinpoint Regression Program 5.0.2 was used to analyze trends, calculating Annual Percentage Changes (APCs) and Average Annual Percentage Changes (AAPCs). RESULTS: From 1999 to 2020, 1,852,432 deaths were attributed to AD among individuals aged 65 and older. The AAMR increased from 128.8 in 1999 to 254.3 in 2020, with an AAPC of 2.99% (95% CI = 2.61-3.48). The age-adjusted mortality rate (AAMR) was higher in females (218.5) than in males (163.5). Among racial and ethnic groups, non-Hispanic whites had the highest AAMR, followed by Non-Hispanic Blacks and Hispanics. Regionally, the West reported the highest AAMR, while the Northeast recorded the lowest. Most deaths occurred in nursing homes (57.3%), with a significant portion also occurring at decedents' homes (22.4%). CONCLUSION: AD mortality rates in the U.S. have risen significantly, with notable disparities across age, gender, race, and geographic regions. These findings highlight the need for targeted interventions and research to address the growing burden of AD, particularly among the most affected demographic groups.

Time trends and advances in the management of global, regional, and national diabetes in adolescents and young adults aged 10-24 years, 1990-2021: analysis for the global burden of disease study 2021.

BACKGROUND: Estimation of global diabetes burden in adolescents and young adults (10-24 years) from 1990 to 2021. METHODS: Data were extracted from the 2021 Global Burden of Disease Study. Joinpoint regression analysis was employed to examine trends over the past 30 years, frontier analysis identified regions with potential for improvement, and the slope index of inequality and the relative concentration index were used to assess health inequalities. RESULTS: From 1990 to 2021, the age-standardized prevalence rates (ASPR) and age-standardized disability-adjusted life years rates (ASDR) of diabetes in adolescents and young adults increased globally, while age-standardized death rates (ASMR) remained stable. Oceania bore the highest burden regionally, East Asia experienced the fastest rise in ASPR and ASDR, and High-income Asia Pacific saw the most significant decrease in ASMR. Among 204 countries, Marshall Island and Hait reported the highest ASPR, ASDR, and ASMR in 2021. Health inequality analysis confirmed that the burden was concentrated in countries with lower Socio-Demographic Index (SDI). Frontier analysis showed that ASMR and ASDR were negatively correlated with SDI, with Yemen and Honduras, which have lower socio-demographic indices, exhibiting more smaller overall differences from frontier boundaries. CONCLUSIONS: The analysis revealed a sharp increase in the global ASPR and ASDR of diabetes in adolescents and young adults. Additionally, the disease burden is typically concentrated in countries with lower SDI, highlighting an urgent need for governments to develop flexible health policies to mitigate the escalating threat of diabetes in this demographic.

Analysis of Prevalence and Related Factors of Cyberbullying-Victimization among Adolescents.

BACKGROUND/OBJECTIVES: Cyberbullying is an increasingly serious issue that negatively impacts the mental and physical health of adolescents. This study aims to report the prevalence rates of adolescent cyberbullying-victimization and its associated related factors, providing a scientific basis for targeted efforts to protect the mental and physical well-being of adolescents; Methods: From March to May 2019, there were 13 high schools and 33 middle schools in Yixing, with a student ratio of 2:1 between middle and high school. Using a random cluster sampling method, we selected four high schools and three middle schools based on this ratio, resulting in a total of 13,258 students. We conducted a survey using a self-designed questionnaire to investigate the experiences of adolescents with cyberbullying and victimization, comparing the differences in cyberbullying-victimization based on various demographic characteristics. Additionally, we employed a multifactorial logistic regression model to analyze the associated factors; Results: The rate of adolescents who declared themselves as cyberbully-victims is 2.9%. The results of the logistic regression analysis indicate that being male, having both parents working outside the home, experiencing occasional or large conflicts among family members, being subjected to punishment-and-abuse child discipline, always or often using social software (websites), enjoying playing single or multiplayer games, self-smoking, and self-drinking were associated with a higher likelihood of being a cyberbully-victim (p < 0.05); Conclusions: Adolescent cyberbullying-victimization is affected by personal, family, and social factors. Therefore, comprehensive strategies and measures are needed to intervene in this problem.

Influencing factors analysis of asymmetry in knee adduction moment among patients with unilateral knee osteoarthritis.

BACKGROUND: The knee adduction moment(KAM) of both lower limbs in patients with unilateral knee osteoarthritis(KOA) exhibits asymmetry during walking, but the factors influencing this asymmetry remain unclear. This study aimed to explore the influencing factors of KAM asymmetry in patients with unilateral KOA. METHODS: A total of 148 patients with unilateral medial compartment KOA were selected for this retrospective study, and general data such as gender, age, and duration of disease were collected. The hip-knee-ankle (HKA) angle, degree of pain, and knee-extension muscle strength on the affected side were assessed through radiographic outcomes, the visual analog scale(VAS), and the Biodex isokinetic system. The peak KAM of both lower limbs was analyzed using a BTS motion-capture system and force platform. The asymmetry index(ASI) of KAM was calculated, and the patients were further categorized into the KAM symmetry group(ASI value ≤ 10%) and the KAM asymmetry group(ASI value>10%).Binary logistic regression analysis was employed to analyze the factors influencing the asymmetry of KAM. RESULTS: 90 patients were categorized into the KAM asymmetry group, representing 60.8% of the cohort. A significant difference in the ASI value of KAM was observed between the two groups. Correlation analysis identified nine factors, including sex, age, and BMI, that were positively correlated with the ASI value of KAM. In contrast, knee-extension muscle strength and per-capita monthly household income were negatively correlated with the ASI value of KAM. Regression analysis revealed that being female(OR = 1.752), older age(OR = 2.472), increased BMI(OR = 1.535), larger varus angle(OR = 3.965), higher VAS score(OR = 2.617), Kellgren-Lawrence(K-L) grade IV(OR = 4.474), history of knee joint trauma(OR = 5.684), and living in a rural location(OR = 1.554) increased the risk of KAM asymmetry. Conversely, increased knee-extension muscle strength(OR = 0.758) and a per-capita monthly household income of 3000 ~ 6000 yuan(OR = 0.814) decreased the risk of KAM asymmetry. CONCLUSION: Female gender, older age, increased BMI, larger varus angle, higher VAS score, K-L grade IV, history of knee joint trauma, and living in a rural location are identified as risk factors for KAM asymmetry. Conversely, increased knee-extension muscle strength and a per-capita monthly household income of 3000 ~ 6000 yuan serve as protective factors against this asymmetry.

Acupuncture for Aromatase Inhibitor-Induced Arthralgia in Breast Cancer: An Umbrella Review.

Background: Acupuncture therapy shows promise in managing aromatase inhibitor-induced arthralgia (AIA) among breast cancer patients. An umbrella review synthesizes findings from systematic reviews and meta-analyses (SRs/MAs) to assess its effectiveness. Summary: This umbrella review aimed to evaluate the effectiveness of acupuncture therapy in treating AIA among breast cancer patients by analyzing existing evidence from SRs/MAs. Key Messages: Six SRs/MAs were analyzed, revealing shortcomings in reporting quality, methodological quality, and evidence quality assessment. Comprehensive searches across eight electronic databases were conducted. PRISMA, AMSTAR 2, and GRADE were utilized to assess reporting, methodological quality, and evidence quality, respectively. Despite methodological shortcomings, a recent meta-subgroup analysis suggests the efficacy of acupuncture therapy for AIA patients, recommending a 10-session treatment course. Conclusion: Acupuncture is identified as a secure and effective remedy for AIA sufferers, yet further high-quality research is needed to strengthen the evidence base and endorse acupuncture as a viable treatment option.

Serum microRNA-181a Expression Level in Patients with Acute Liver Failure and Its Correlation with Prognosis.

Objective: This paper examined miR-181a expression in the serum of patients with acute liver failure (ALF) and investigated the impact of its expression in the prognosis of ALF patients. Methods: A total of 112 ALF patients (ALF group) and 100 healthy controls during the same period (control group) were recruited as study subjects, and ALF patients were separated into the survival group and the death group. Serum ALT, AST, SCr, TBil, PTA, and International Normalized Ratio (INR) indices as well as serum miR-181a expression were assessed by using a fully automated biochemistry analyzer and RT-qPCR. Patients in the ALF group were evaluated using the Model for End-Stage Liver Disease (MELD) score. Correlation between serum miR-181a expression and MELD scores of ALF patients was processed by Pearson correlation analysis, and the diagnostic value of miR-181a level for the occurrence of ALF was estimated by ROC curve analysis. Multivariate logistic regression analysis was executed to assess the factors influencing the occurrence of death in ALF patients. Results: ALF patients had higher levels of ALT, AST, TBiL, SCr, INR and miR-181a and lower PTA levels in comparison to healthy controls. Serum miR-181a expression level in ALF patients revealed a significant positive correlation with MELD score. Multivariate logistic regression analysis unveiled that TBil, INR, SCr, and miR-181a were the independent risk factors for the occurrence of death in ALF patients, and that PTA was an independent protective factor for the prognosis of ALF patients. miR-181a exhibited a favorable diagnostic value in ALF and its prognosis. Conclusion: miR-181a expression is upregulated in the serum of ALF patients, and it can be utilized as an indicator for ALF diagnostic and prognostic assessment.

Analysis of relationship between pork belly preference and fat level by distributors in the Korean pork market: Utilizing belly cross-sectional assessment and belly fat percentage measured by VCS2000.

This study aimed to determine the relationship between the overall fat percentage of pork belly and the visual fat level of pork belly, and to determine whether these factors influence the distributor's preference. Fat percentages in LYD pigs' pork bellies were measured using VCS2000, and visual fat levels were assessed through cross-sectional photographs. Additionally, a survey was conducted across four distributor types (direct managed stores, supermarkets, National Agricultural Cooperative Federations (NACFs), and butcher shops) to understand distributor preferences in the pork market. The results demonstrated a moderate correlation between pork belly fat percentage and appearance-based belly fat level. The regression equations between distributors' pork belly preferences and pork belly fat percentage showed that all regression equations exhibited coefficient of determination (R2) values below 0.2, indicating that pork belly fat percentage could not be explained by distributors' pork belly preferences. The regression equations between appearance-based belly fat level and distributors' pork belly preferences demonstrated that all regression equations exhibited an R2 value of 0.75 or higher, indicating that appearance-based belly fat level can effectively explain distributors' pork belly preferences. Furthermore, it was observed that there were variations in distributors' preferences contingent on the appearance-based belly fat level. Appearance-based belly fat level was found to be reliable indicators for predicting pork belly preferences. The findings of this study are expected to assist in the reduction of unnecessary distribution costs when planning the delivery of pork belly.

Prevalence and risk factors of myopia among children and adolescents in Hangzhou.

To analyze the prevalence and influencing factors of myopia among children and adolescents in Hangzhou city, and provide ideas for the formulation of myopia prevention and control measures. A cross-sectional school-based study using stratified cluster random sampling method was used to select 31,880 students from 113 schools in Hangzhou city. Myopia screening and questionnaires on the influencing factors of poor visual acuity were carried out. Univariate and multivariate logistic regression were used to screen possible risk factors of myopia. The overall prevalence of myopia was found to be 55.3% (17,630/31,880), with the myopia rates observed among students in kindergarten, primary school, junior high school, and senior high school, at 5.8%, 34.9%, 74.2%, and 85.0%, respectively. As the academic year progresses, there has been an observable increase in the prevalence of myopia (χ2 = 8676.748, P<0.001), low myopia (χ2 = 5444.040, P<0.001) and high myopia (χ2 = 2171.073, P<0.001) among students, with the difference between the three groups being statistically significant. The myopia prevalence in girls is higher than that in boys (χ2 = 119.917, P<0.001); the prevalence of myopia in urban students is higher than that in suburban students (χ2 = 4.603, P = 0.032). The time spent on homework after school, the correctness of reading and writing postures, the duration of exposure to electronic screens, and the use of lighting in an appropriate manner all have an impact on the development of myopia (all P<0.05). The overall prevalence of myopia and high myopia in schools in eastern China, is notably high. The prevalence of myopia and high myopia increases with grade or age. Myopia is associated with increased age, parental myopia, extended periods of homework after school, poor reading and writing posture, prolonged exposure to electronic screens and inappropriate lighting. In light of the findings of the present survey, it is recommended that a comprehensive prevention and control intervention model for myopia in children and adolescents based on society-hospital-school-family-individual students with a view to preventing and controlling myopia.

Assessing Language Lateralization through Gray Matter Volume: Implications for Preoperative Planning in Brain Tumor Surgery.

BACKGROUND/OBJECTIVES: Functional MRI (fMRI) is widely used to assess language lateralization, but its application in patients with brain tumors can be hindered by cognitive impairments, compensatory neuroplasticity, and artifacts due to patient movement or severe aphasia. Gray matter volume (GMV) analysis via voxel-based morphometry (VBM) in language-related brain regions may offer a stable complementary approach. This study investigates the relationship between GMV and fMRI-derived language lateralization in healthy individuals and patients with left-hemisphere brain tumors, aiming to enhance accuracy in complex cases. METHODS: The MRI data from 22 healthy participants and 28 individuals with left-hemisphere brain tumors were analyzed. Structural T1-weighted and functional images were obtained during three language tasks. Language lateralization was assessed based on activation in predefined regions of interest (ROIs), categorized as typical (left) or atypical (right or bilateral). The GMV in these ROIs was measured using VBM. Linear regressions explored GMV-lateralization associations, and logistic regressions predicted the lateralization based on the GMV. RESULTS: In the healthy participants, typical left-hemispheric language dominance correlated with higher GMV in the left pars opercularis of the inferior frontal gyrus. The brain tumor participants with atypical lateralization showed increased GMV in six right-hemisphere ROIs. The GMV in the language ROIs predicted the fMRI language lateralization, with AUCs from 80.1% to 94.2% in the healthy participants and 78.3% to 92.6% in the tumor patients. CONCLUSIONS: GMV analysis in language-related ROIs effectively complements fMRI for assessing language dominance, particularly when fMRI is challenging. It correlates with language lateralization in both healthy individuals and brain tumor patients, highlighting its potential in preoperative language mapping. Further research with larger samples is needed to refine its clinical utility.

Nationwide distribution and factors related to indoor fine particulate matter concentrations in subway stations in Korea: Results of first-year measurement.

This study assessed the seasonal distribution and factors associated with PM2.5 in nationwide subway stations in Korea. A total of 229,644 data points collected over one year were used to determine one-day PM2.5 concentrations from 642 subway stations. The geometric mean of indoor PM2.5 concentrations was 26.6 µg/m3. PM2.5 concentrations were higher in the Seoul metropolitan area (SMA) compared to non-Seoul metropolitan areas (NSMA), with the highest level occurring in winter, followed by spring, fall, and summer, similar to the trend observed for outdoor PM2.5 concentrations. In SMA, PM2.5 concentrations were significantly associated with the operation year, number of air cleaners on platforms, and number of passengers. These findings may help in the development of national strategies for managing indoor PM2.5 concentrations in subway stations, taking into account spatial and temporal factors.

A comparative analysis of punching in boxing and sanda: kinematic differences based on the cross and uppercut.

Background: This research aims to compare the differences in kinematic parameters associated with cross and uppercut punches between Sanda athletes (SA) and Boxing athletes (BA) to analyze their impacts on peak punching speed. Methods: The punches of BA (n = 20) and SA (n = 20) were compared utilizing a three-dimensional (3D) framework and high-speed cameras in terms of 13 key parameters. An independent samples t-test (α = 0.05) was employed to analyze the differences in punching between BA and SA. Meanwhile, a stepwise multiple linear regression equation was developed to analyze the influence of selected parameters on peak punching speed. Results: The results reveal that, among the 13 kinematic parameters, the six cross-related parameters and four uppercut-related parameters are significantly different (both p ≤ 0.05). The results of multivariate regression analysis unveils that the peak punching speed for the cross are influenced by the anteroposterior position of the center of gravity (in BA) and the maximum angular velocity of the shoulder (in SA). In contrast, for both BA and SA, the maximum angular velocity of the shoulder plays a critical impact on uppercut. Conclusions: These findings indicate that trunk and upper limbs significantly influence the peak punching speed, which provides suggestions for daily training regimen of SA and BA as well as their coaches.

Logistic regression analysis of risk factors influencing postoperative keloid scar recurrence.

OBJECTIVE: To identify risk factors of postoperative keloid scar recurrence in patients using logistic regression analysis. METHODS: A retrospective analysis was conducted with the use of clinical data collected from 132 keloid scars patients undergoing keloidectomy under local anaesthesia between January 2020 and June 2023 at The First Affiliated Hospital of the WANNAN Medical College. The recurrence of keloid scars in the included patients was analyzed, and their clinical data were subjected to univariate analysis. Factors showing significant differences were included in the multivariate logistic regression analysis. A receiver operating characteristics (ROC) curve was generated based on the independent risk factors to explore the predictive performance of joint-factor prediction for postoperative recurrence of keloid scars, and a corresponding Nomogram was generated. RESULTS: Out of the 132 patients, 38 experienced keloid scar recurrence, accounting for 28.79% of the total cases. Logistic regression analysis identified infection, family history of keloid scars, relatively large scar size and the absence of radiotherapy and local hormone therapy as independent risk factors influencing postoperative recurrence of keloid scars. The prediction for postoperative recurrence of keloid scars based on the joint independent risk factors yielded an area under the ROC curve of 0.889, with a sensitivity, a specificity, and an accuracy of 78.72%, 86.84%, and 81.06%, respectively. CONCLUSION: Infection, family history of keloid scars, relatively large scar size, and the absence of radiotherapy and local hormone treatment have been identified as independent risk factors for postoperative recurrence of keloid scars in patients.

Impact of the COVID-19 Pandemic and Lockdown on Cancer Diagnoses Using Swiss Cantonal Cancer Registry Data.

Background/Objectives: This study aims to investigate differences in cancer diagnosis based on absolute case numbers and age-standardized incidence rate ratios (IRRs) in the pre-Coronavirus disease 2019 (COVID-19) years (2018/19) and the first two years of the COVID-19 pandemic (2020, 2021) in two Swiss cantons. Methods: Data of the Swiss cantonal cancer registry of the cantons of Zurich (ZH) and Zug (ZG) were used to descriptively investigate differences in annual and monthly absolute numbers regarding all-cancer and the five most common cancer types. Directly age-standardized monthly incidence rates (IRs) were calculated. Multivariate Quasipoisson regression models were fitted to determine the IRRs with 95% confidence intervals (95% CI). Results: Annual absolute numbers of all investigated cancers were similar in 2018/19, 2020, and 2021, except for prostate cancer (increase of 20.8% in 2021 compared to 2018/19). In 2020, there were generally more cancer diagnoses in January and February followed by a decrease in April and May. Compared to the pre-COVID-19 period, lower IRs were observed in 2020 for all-cancer (IRR = 0.96 [95% CI 0.96, 0.97]) and female breast cancer (0.92 [0.89, 0.96]), whereas higher IRs were observed in 2021 for all-cancer (1.02 [1.02, 1.02]) and prostate cancer (1.23 [1.18, 1.28]). Conclusions: Cancer detection and diagnoses decreased during the first year of the pandemic, especially during the most stringent lockdown phase in April. The findings of this study may inform the decisions of policymakers and public health system during future pandemics.

Investigating the impact of climatic and environmental factors on HFRS prevalence in Anhui Province, China, using satellite and reanalysis data.

Introduction: Hemorrhagic Fever with Renal Syndrome (HFRS) is the most commonly diagnosed zoonosis in Asia. Despite taking various preventive measures, HFRS remains prevalent across multiple regions in China. This study aims to investigate the impact of climatic and environmental factors on the prevalence of HFRS in Anhui Province, China, utilizing satellite and reanalysis data. Methods: We collect monthly HFRS data from Anhui Province spanning 2005 to 2019 and integrated MODIS satellite datasets and ERA5 reanalysis data, including variables such as precipitation, temperature, humidity, solar radiation, aerosol optical depth (AOD), and Normalized Difference Vegetation Index (NDVI). Continuous wavelet transform, Spearman correlation analysis, and Poisson regression analysis are employed to assess the association between climatic and environmental factors and HFRS cases. Results: Our findings reveal that HFRS cases predominantly occur during the spring and winter seasons, with the highest peak intensity observed in a 9-year cycle. Notably, the monthly average relative humidity exhibits a Spearman correlation coefficient of 0.404 at a 4-month lag, taking precedence over other contributing factors. Poisson regression analysis elucidates that NDVI at a 2-month lag, mean temperature (T) and solar radiation (SR) at a 4-month lag, precipitation (P), relative humidity (RH), and AOD at a 5-month lag exhibit the most robust explanatory power for HFRS occurrence. Moreover, the developed predictive model exhibiting commendable accuracy. Discussion: This study provides key evidence for understanding how climatic and environmental factors influence the transmission of HFRS at the provincial scale. Insights from this research are critical for formulating effective preventive strategies and serving as a resource for HFRS prevention and control efforts.

Comprehensive analysis of strabismus reoperations: clinical insights and progression factors.

BACKGROUND: To compare and analyze clinical characteristics of patients undergoing two surgeries and multiple surgeries and explore relevant factors to lay the foundation for clinical prediction. METHODS: A retrospective analysis was conducted on clinical data from all patients who underwent twice and multiple strabismus surgeries at Tianjin Eye Hospital between October 2012 and September 2021. Patients were divided into Group A (two surgeries) and Group B (more than two surgeries) based on the cumulative number of surgeries performed. Clinical details at the first recurrence, including sex, age, native place, overall medical history, onset time, visual acuity, affected muscle(s), etc., were documented. Non-parametric tests and chi-square tests were used to analyze clinical characteristics in each group. Binary and ordered logistic regression analysis assessed parameters associated with multiple reoperations. A linear mixed-term model observed factors impacting affected muscle(s) during surgery. Researchers examined clinical traits related to secondary strabismus variables. RESULTS: Among the 910 included patients, 840 required two surgeries (Group A) and 70 underwent more than two surgeries (Group B). Significant differences were found in age, onset time, interval time, and secondary factors. Regression analysis highlighted the significant impact of interval time on the reoperation rate, effectively predicting outcomes in patients with concomitant strabismus. Other ophthalmoplegia and secondary factors significantly influenced reoperation rates in patients with non-concomitant strabismus. Interval time, esotropia, and exotropia were linked to concomitant secondary strabismus patients, while the number of surgeries, DVD, esotropia, exotropia, and esotropia V-pattern were associated with non-concomitant secondary strabismus patients. In a longitudinal study, patients with multiple surgeries showed a correlation between the vertical deviation angle magnitude and the number of involved extraocular muscles. Regression analysis revealed that in patients with concomitant strabismus, interval time, exotropia, and esotropia influenced the total number of muscles during surgery. For patients with non-concomitant strabismus, interval time, secondary factors, and SOP impacted the total number of muscles during surgery. CONCLUSIONS: Interval time in patients with concomitant strabismus, as well as secondary and other ophthalmoplegia in non-concomitant strabismus, are the main factors for multiple reoperations.

Factors influencing health literacy in overweight management among late adolescents in Thailand: A cross-sectional study.

Background: Health literacy is crucial in managing health outcomes, including overweight, which is a significant issue among late adolescents. Despite the importance of health literacy in weight management, research focusing on this population remains limited. Objective: This study aimed to investigate the factors influencing health literacy in overweight management among late adolescents in Thailand. Methods: A cross-sectional study was conducted with late adolescents from five higher education institutions in Ubon Ratchathani Province, Thailand. A total of 403 participants were selected through multistage random sampling. Self-report questionnaires, validated for reliability and accuracy, were used to collect data from March to May 2023. Multiple regression analysis was employed, with a significance level set at 0.05. Results: The sample consisted predominantly of females (91.10%) with an average age of 20-21 years (54.30%). The prevalence of overweight/obesity among participants was 25.06%. Four factors were significantly associated with health literacy in overweight management: access to health and weight control resources (r = 0.368, p <0.001), access to online social learning resources (r = 0.321, p <0.001), access to books, journals, and websites (r = 0.340, p <0.001), and management of weight control behaviors (r = 0.145, p <0.001). These factors together accounted for 20% of the variance in health literacy (R2 = 0.200). Conclusion: The study identified key factors that enhance health literacy in overweight management among late adolescents in Thailand. It is recommended that nurses and other healthcare professionals develop targeted interventions focusing on these factors to effectively manage overweight in this population.

FT4 is a novel indicator for risk assessment of severe hypocalcemia following parathyroidectomy.

OBJECTIVE: To analyze the risk factors associated with the development of severe hypocalcemia (SH) in patients who have undergone parathyroidectomy (PTX). METHODS: This research involved patients with chronic kidney disease-secondary hyperparathyroidism who underwent PTX between June 1, 2021, and May 31, 2023. SH was characterized by a serum total calcium (tCa) level below 1.8 mmol/L. This study aimed to analyze differences in preoperative laboratory findings and clinical manifestations between patients with and without SH. Logistic regression analysis was used to identify potential risk factors associated with the development of SH. RESULTS: The incidence of SH was 23% (n = 176). Significant differences were observed in free thyroxine (FT4), free triiodothyronine, alanine aminotransferase, osteocalcin, tCa, alkaline phosphatase (ALP), C-terminal cross-linked telopeptide of type I collagen, and parathyroid hormone between the SH and non-SH groups. The three independent risk factors for SH were tCa [odds ratio (OR) 0.063, 95% confidence interval (95% CI) 0.006-0.663], ALP (OR 1.003, 95% CI 1.001-1.005), and FT4 (OR 0.439, 95%CI 0.310-0.621). The area under the curve, sensitivity, specificity, and overall accuracy of this model were 0.904 (95% CI 0.856-0.952), 46.3%(95% CI 32.0%-61.3%), 94.8% (95% CI 89.7%-97.5%), and 83.5% (95% CI 77.3%-88.3%), respectively. CONCLUSION: The preoperative level of FT4 plays a crucial role in predicting the risk of SH after PTX. The combined FT4-ALP-tCa model demonstrates the ability to predict SH risk, providing valuable insights for customizing calcium supplementation strategies and improving clinical decision-making.

Clinical and hematological analysis of testicular torsion in children.

Purpose: Analyze the clinical manifestations, laboratory tests, and imaging data of testicular torsion to provide clinical insights for timely and accurate diagnosis and treatment of testicular torsion. Methods: A retrospective analysis was conducted on the clinical data of 67 pediatric patients suspected of testicular torsion, admitted and subjected to surgical exploration from June 2018 to June 2023. Based on whether the torsed testicle was excised during surgery, the patients were divided into orchiectomy group (40 cases) and orchidopexy group (27 cases). Combining clinical symptoms, signs, ultrasound examinations, and laboratory tests, the study aimed to summarize the influencing factors on the onset, diagnosis, and treatment of testicular torsion. Results: The clinical manifestations of all 67 pediatric patients were generally typical. Color Doppler Flow Imaging (CDFI) and surgical exploration were performed for all cases, and the results were consistent. Testicular color doppler ultrasound suggested reduced or absent blood flow, leading to surgical treatment in all cases. All patients had unilateral testicular torsion, with 46 cases (68.66%) on the left side and 21 cases (31.34%) on the right side. Intrafunicular torsion occurred in 60 cases (89.55%), while extrafunicular torsion occurred in 7 cases (10.45%). The onset distribution was as follows: 20 cases in spring, 16 cases in summer, 16 cases in autumn, and 15 cases in winter. Univariate analysis indicated significant statistical differences in age, degree of testicular torsion, duration of symptoms, NEUT, NLR, and occurrence of tunica fluid between the two groups of patients. Multivariate logistic regression analysis showed that the duration of symptoms and the occurrence of hydrocele were independent risk factors for determining testicular viability. Conclusion: Testicular torsion is more common in children and adolescents, with clinical manifestations including scrotal pain, scrotal redness and swelling, abdominal pain, nausea, and vomiting. In the early stages of testicular torsion, inflammatory markers in the blood increase, and preoperative ultrasound indicates hydrocele. This suggests that the testicle is in an early twisted state, with good viability and potential for preservation.