Association of longitudinal trajectories of fasting plasma glucose with all-cause and cardiovascular mortality among a Chinese older population: a retrospective cohort study.

The association between fasting plasma glucose (FPG), an important indicator of overall glycemic status, and the risk of cardiovascular mortality has been well investigated. The longitudinal study can repeatedly collect measured results for the variables to be studied and then consider the potential effects of intraindividual changes in measurement. This study aimed to identify long-term FPG trajectories and investigate the association between trajectory groups and cardiovascular and all-cause mortality. A latent class growth mixture modeling (LCGMM) was used to identify FPG trajectories. Cox proportional hazard models were used to estimate associations between FPG trajectories and the risk of all-cause and cardiovascular mortality. A U-shaped relationship between FPG and all-cause and cardiovascular mortality was observed in the restricted cubic spline regression models. Two FPG longitudinal trajectories of low-level (mean FPG = 5.12mmol/L) and high-level (mean FPG = 6.74mmol/L) were identified by LCGMM. After being adjusted for potential confounders, compared with the low-level category, the hazard ratios (HRs) for all-cause and cardiovascular mortality were 1.23(1.16-1.30) and 1.25(1.16-1.35), respectively, for the high-level group. Long-term FPG trajectories are significantly associated with and potentially impact the risk of all-cause and cardiovascular mortality.

Subjective poverty, mental health, and mortality among Chinese older people: a prospective cohort study from 2008 to 2018.

PURPOSE: The associations of duration of subjective poverty and poverty status with mortality among older people remains inconclusive, and the underlying mechanisms of mental health on them are rarely discussed in population-based epidemiological studies. METHODS: We used the data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (2008-2018). The Cox regression model was used to estimate hazard ratio (HR) and 95% confidence intervals (CIs) for mortality. Mediation analysis was applied to assess the effect of mental health. RESULTS: When compared with participants without subjective poverty, those who reported subjective poverty at one time point (2008 or 2011) or two time points (2008 and 2011) had a higher risk of death, with multivariable-adjusted HR (95% CIs) of 1.08 (1.00-1.16) and 1.22 (1.06-1.39), respectively. For poverty status, the multivariable-adjusted HR (95% CIs) of mortality were 0.81 (0.66-0.98) for "just objective poverty" and 0.78 (0.62-0.98) for "neither subjective nor objective poverty" compared with participants who reported "just subjective poverty", while there was no statistically significant association between "poverty subjectively and objectively" and mortality (HR = 0.88, 95% CI 0.72-1.07). Besides, we found that the proportion mediated by mental health was 26.6%, and age was a significant effect modifier. CONCLUSIONS: Subjective poverty may be associated with a higher risk of death among Chinese older people. This study showed that promoting mental health alone may not substantially reduce socioeconomic inequality in health. Further explorations of measures to tackle the social determinants of health are still needed.

Association of the serum transaminase with mortality among the US elderly population.

BACKGROUND AND AIM: Considering the inconsistent findings of research into the associations between serum levels of liver enzymes (alanine aminotransferase [ALT], aspartate aminotransferase [AST], and gamma-glutamyltransferase [GGT]) and mortality among elderly people, we aimed to investigate the associations of ALT, AST, GGT, and De-Ritis ratio (DRR, defined as AST/ALT) and all-cause or cause-specific mortality among the US elderly people using National Health and Nutrition Examination Surveys data. METHODS: We included 6415 elderly participants (≥ 65 years). Exclusion criteria included positive test for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus infection at baseline. Multivariable-adjusted Cox regression models calculating hazard ratios (HR) and 95% confidence intervals were developed for each of the liver enzyme measures. RESULTS: All-cause cumulative mortality was 33.8%, of which 23.8% were cardiovascular disease (CVD) deaths, 15.6% were cancer deaths, and 60.6% were other cause deaths. Adjusted Cox models found increased all-cause mortality risk for low ALT (HR: 1.70), low AST (HR: 1.13), high GGT (HR: 1.25), and high DRR (HR: 1.68). Low ALT and high DRR predicted CVD mortality. Low ALT (HR: 1.91), low AST (HR: 1.16), high GGT (HR: 1.40), and high DRR (HR: 1.76) predicted other cause mortality. CONCLUSIONS: Low ALT and high DRR were associated with increased CVD and cancer mortality. All serum liver enzyme measures were associated with all-cause mortality and other cause mortality in the US elderly population. Further studies may validate these findings in other elderly populations.

Association of the Time to First Cigarette and the Prevalence of Chronic Respiratory Diseases in Chinese Elderly Population.

BACKGROUND: Increasing number of studies have suggested the time to first cigarette after waking (TTFC) have significant positive effect on respiratory diseases. However, few of them focused on the Chinese population. This study aims to estimate the impact of TTFC on the prevalence of chronic respiratory diseases (CRD) in Chinese elderly and explore the association in different sub-populations. METHODS: Cross-sectional data of demographic characteristics, living environment, smoking-related variables, and CRD were drawn from the Chinese Longitudinal Healthy Longevity Survey in 2018. Multivariate stepwise logistic regression analyses were conducted to examine the association of the TTFC with the prevalence of CRD. RESULTS: This study includes 13,208 subjects aged 52 years and older, with a mean age of 85.3 years. Of them, 3,779 participants were ex- or current smokers (44.9% had the TTFC ≤30 minutes, 55.1% >30 minutes) and 1,492 had suffered from CRD. Compared with non-smokers, participants with TTFC ≤30 minutes seemed to have higher prevalence of CRD (OR 1.97; 95% CI, 1.65-2.35) than those with TTFC >30 minutes (OR 1.70; 95% CI, 1.44-2.00), although the difference was statistically insignificant (Pinteraction = 0.12). Compared with TTFC >30 minutes, TTFC ≤30 minutes could drive a higher prevalence of CRD among female participants, those aged 90 years and older, urban residents, and ex-smokers (Pinteraction < 0.05). CONCLUSION: Shorter TTFC relates to higher prevalences of CRD in Chinese older females, those aged 90 years and older, urban residents, and ex-smokers. Delaying TTFC might partially reduce its detrimental impact on respiratory disease in these specific subpopulations.

Cooking with biomass fuels and mortality among Chinese elderly people: A prospective cohort study.

This study used data from the Chinese Longitudinal Healthy Longevity Survey (n = 9765, age 65+) to investigate the impact of biomass fuels on the mortality of the Chinese elderly population. The association between biomass fuels and mortality was examined using a Cox proportional hazards model. We evaluated the difference in risk of death between those who switched fuel types from biomass to clean fuels and from clean to biomass fuels versus those who did not during the follow-up period. Participants who used biomass fuels had a higher risk of death than participants who used clean fuels (HR = 1.09, 95% CI: 1.01-1.17). For participants who switched cooking fuel types during the follow-up period, switching from biomass to clean fuels significantly reduced the risk of death (HR = 0.78, 95% CI: 0.67-0.91), while no evidence of an association between switching from clean to biomass fuels and risk of death was found (p > 0.05). Interactions and subgroup analyses indicated that effect estimates were greater for women and non-smokers. Biomass fuels may be associated with a higher risk of death among Chinese elderly. Research measuring personal exposure levels to indoor air pollution caused by biomass fuels combustion is required to confirm our results.

A study on the current state and equity level of social participation ability among older adults in Henan Province, China.

BACKGROUND: The social participation ability among older adults (SPAOA) plays an important role in enhancing their quality of life and utilization of medical services. This study aimed to evaluate the current state and equity level of SPAOA in Henan Province, China, as well as explore the factors associated with the current state and equity level of SPAOA. METHODS: This study analyzed data from the "2019 Henan Provincial Older Adults Ability Assessment Survey", which included 4,593 older people (over 60 years old). The relationships among the SPAOA indicators were explored using the Structural Equation Model (SEM). The Dynamic Material Element Analysis (DMA) and Logistic Regression (LR) were used to examine the current state of SPAOA and its associated factors. The equity level of SPAOA and its correlated factors were determined using the concentration index and T Theil index. RESULTS: SPAOA received an overall score of 91.89 ± 9.83. Daily living, perception ability and mental state were positively correlated with SPAOA (r = 0.13, 0.83, 0.11, all P < 0.05). Results of LR indicated that the most significant predictors of SPAOA were age, education level, pre-retirement occupation, and income (all P < 0.05). The concentration index of SPAOA based on age and income were -0.0058 and 0.0096, respectively. SPAOA had a total T Theil index of 0.030-0.031, and the contribution rate of the difference within the group was greater than 94%. CONCLUSIONS: While the overall level of SPAOA has been demonstrated to be outstanding, persons with a higher educational level and income are likely to benefit the most. The observed unequal distribution of SPAOA is primarily related to disparities in age or income within the group. To better serve older adults and improve their position and equity in terms of social participation ability, policymakers could emphasize older males with little income who live in urban areas, as well as unhealthy older females who live in rural residences.

Hypertension modifies the associations of body mass index and waist circumference with all-cause mortality among older Chinese: a retrospective cohort study.

BACKGROUND: The effect of baseline hypertension status on the BMI-mortality association is still unclear. We aimed to explore the relationships of body mass index (BMI) and waist circumference (WC) with all-cause mortality among older hypertensive and normotensive Chinese individuals. METHODS: This retrospective cohort study was conducted in Xinzheng, Henan Province, Central China. The data came from the residents' electronic health records of the Xinzheng Hospital Information System. A total of 77,295 participants (41,357 hypertensive participants and 35,938 normotensive participants) aged ≥ 60 years were included from January 2011 to November 2019. Cox proportional hazard regression model was used to examine the relationships. RESULTS: During a mean follow-up of 5.3 years, 10,755 deaths were identified (6,377 in hypertensive participants and 4,378 in normotensive participants). In adjusted models, compared with a BMI of 18.5-24 kg/m2, the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of BMI < 18.5, 24-28 and ≥ 28 kg/m2 for mortality in hypertensive participants were 1.074 (0.927-1.244), 0.881 (0.834-0.931) and 0.856 (0.790-0.929), respectively, and 1.444 (1.267-1.646), 0.884 (0.822-0.949) and 0.912 (0.792-1.051), respectively, in normotensive participants. Compared with normal waist circumference, the adjusted HRs and 95% CIs of central obesity for mortality were 0.880 (0.832-0.931) in hypertensive participants and 0.918 (0.846-0.996) in normotensive participants. A sensitivity analysis showed similar associations for both hypertensive and normotensive participants. CONCLUSION: Low BMI and WC were associated with a higher risk of all-cause mortality regardless of hypertension status in older Chinese individuals. The lowest risk of death associated with BMI was in the overweight group in normotensive participants and in the obesity group in hypertensive participants.

Nano-drug delivery system with enhanced tumour penetration and layered anti-tumour efficacy.

The low delivery efficiency of nano-drugs and limited tumour penetration are still huge challenges in treating solid tumours. Herein, we developed a pH-responsive nano-drug delivery system, CALS/PDMA@DOX, with a size conversion-layered delivery function. The system is composed of a pH-responsive cationic liposome loaded with DOX (CALS) and a polyamidoamine dendrimer loaded with DOX (PAMAM@DOX) modified with 2,3-dimethylmaleic anhydride (PDMA@DOX) using electrostatic adsorption. In the tumour microenvironment, the positively-charged large-size CALS and the positively-charged small-size PAMAM@DOX were dissociated to exert anti-tumour effects. CALS preferentially targeted tumour angiogenesis endothelial cells. Because of its small size and positive charge, PAMAM@DOX showed excellent tumour penetration. Significant tumour suppression by the system in vivo was confirmed in a 4T1 tumour xenograft mouse model. This pH-triggered size-switching layered delivery nanosystem is a safe and effective cancer treatment delivery platform that improves drug permeability and therapeutic efficacy.

Relationship between dietary niacin intake and diabetes mellitus in the National Health and Nutrition Examination Survey (NHANES) 2003-2018.

PURPOSES: Previous studies show inconsistent associations between niacin supplementation and diabetes mellitus (DM) in high-risk population, but little is known about the relationship between dietary intake of niacin and DM in the generation population. Our study aimed to explore the associations of dietary niacin intake with the risk of DM in the United States (US) adult population. METHODS: These data were derived from the National Health and Nutrition Examination Survey (NHANES) 2003-2018 of 35,606 individuals aged 20 years or older. Niacin intake and food sources were measured by two 24-h dietary recall interviews. The diagnosis of DM was established according to the American Diabetes Association (ADA) criteria. Binary logistic regression and restricted cubic spline models were applied to evaluate the association of dietary niacin intake and DM. RESULTS: Among the 35,606 individuals, the prevalence of DM was 11.47%. The full-adjusted odds ratio(aOR) of DM was 1.27(95%CI 1.06-1.52) for quartile (Q) 4 v. Q1 of dietary niacin intake. In the dose-response analysis, the shape of the association of niacin intake with the risk of DM was approximately J-shaped (non-linear, p < 0.05). Energy-adjusted niacin of 26.08 mg/day was the optimal cut-off value for predicting DM. CONCLUSIONS: High dietary niacin intake was positively associated with DM among US adults. LEVEL OF EVIDENCE: Level V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Comparison of obesity indices and triglyceride glucose-related parameters to predict type 2 diabetes mellitus among normal-weight elderly in China.

PURPOSE: Although a significant proportion of type 2 diabetes mellitus (T2DM) cases arose from normal-weight individuals, studies on indicators of T2DM in normal-weight people are limited. Accordingly, this study aims to investigate the predictive value of obesity indices and triglyceride glucose-related parameters (TyG-related parameters) in T2DM among normal-weight Chinese elderly. METHODS: A total of 24,215 normal-weight Chinese elderly (age ≥ 60 years) [body mass index-BMI (18.5-23.9 kg/m2)] were included. Obesity indices and triglyceride glucose-related parameters (TyG-related parameters) included waist circumference (WC), waist-to-height ratio (WHtR), visceral adiposity index (VAI), lipid accumulation product (LAP), and TyG-related parameters (TyG, TyG-BMI, TyG-WC, and TyG-WHtR). Multivariate logistic regression analysis was performed to examine the associations between obesity- and TyG-related indices and T2DM. The areas under the curve (AUC) of the receiver-operating characteristic (ROC) curve analyses were used to evaluate and compare the predictive value of the different indices. RESULTS: The prevalence of T2DM was 14.2% in normal-weight individuals. Among the indices, TyG was significantly associated with T2DM among men and women, respectively, (adjusted odds ratio-aOR per SD 3.46; 95% CI 3.23-3.71) and (aOR per SD 3.64; 95% CI 3.43-3.86). Compared with other indices, TyG had the highest AUC value for T2DM in men (AUC: 0.818, 95% CI 0.810-0.825) and women (AUC: 0.824, 95% CI 0.814-0.833). CONCLUSIONS: TyG is an effective marker and outperforms other indices when predicting T2DM in the normal-weight Chinese elderly population. LEVEL OF EVIDENCE: Level V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Association of adiposity with diabetes: A national research among Chinese adults.

BACKGROUND: Adiposity is an established risk factor for diabetes. The different measurements of adiposity for predicting diabetes have been compared in recent studies in Western countries. However, similar researches among Chinese adults are limited. METHODS: Data were collected from a national survey conducted during September 2014 and May 2015 Among Chinese adults aged 40 years and older across 30 China's provinces. Multilevel model analysis was performed to examine the impacts of different obesity indices [body mass index (BMI), waist circumference (WC), lipid accumulation product index (LAP), visceral adiposity index (VAI), and body adiposity index (BAI)] on the risk of diabetes. RESULTS: A total of 162 880 participants were included in this study. Of them, 54.47% were female. With an increase in BMI, WC, LAP, VAI, and BAI, the prevalence of diabetes significantly grew (P < 0.001). The multilevel model analysis showed that WC has the strongest impact on diabetes prevalence, while BAI was the weakest. For one SD increment in BMI, WC, LAP, VAI, and BAI, the prevalence of diabetes increased by 27.0% (Odds Ratio (OR) = 1.270, 95% Confidence interval (CI) = 1.251-1.289), 37.4% (OR = 1.374, 95% CI = 1.346-1.401), 28.1% (OR = 1.281, 95% CI = 1.266-1.297), 22.0% (OR = 1.220, 95% CI = 1.204-1.236), and 17.4% (OR = 1.174, 95% CI = 1.151-1.192), respectively. CONCLUSION: Obesity indicators of BMI, WC, LAP, VAI, and BAI have significant positive relationships with the risk of diabetes. WC has the strongest impact on diabetes, while BAI has the weakest.

Residents' Willingness to Maintain Contracts with Family Doctors: a Cross-sectional Study in China.

BACKGROUND: Most previous studies of the family doctor contract services (FDCS) evaluated its quality by using residents' signing rates, awareness, and satisfaction. We hypothesize that renewal willingness could be another important indicator to examine the quality of FDCS. OBJECTIVE: To measure residents' willingness to maintain contracts with family doctors and examine the influencing factors. DESIGN: Cross-sectional study. PARTICIPANTS: 11,250 residents in 31 provincial administrative regions across China. MAIN METHODS: A multistage stratified random sampling method was used to recruit participants. Univariate analysis, mixed-effect regression model analysis, and stepwise multivariate logistic regression analysis were performed to determine the influencing factors of residents' willingness to maintain contracts with family doctors. KEY RESULTS: About 71.3% participants who contracted with and received healthcare services from family doctors were willing to maintain contracts with family doctors in China. Residents registering as local households (OR = 1.192, 95% CI = 1.039-1.368), enrolled in medical insurance (OR = 1.299, 95% CI = 1.011-1.668), reporting better health (OR = 1.246, 95% CI = 1.100-1.413), with shorter walking time to the nearest healthcare center (compared with > 30 min walking time, < 15 min: OR = 1.209, 95% CI = 1.003-1.458; 15-30 min: OR = 1.288, 95% CI = 1.124-1.475), and trusting in (OR = 4.403, 95% CI = 3.849-5.036) and satisfied with (OR = 18.514, 95% CI = 16.195-21.165) their family doctors had significantly higher willingness to maintain contracts with family doctors. CONCLUSIONS: Residents' willingness to maintain contracts with family doctors could be another evaluation indicator of the quality of FDCS in China. Improving the accessibility and quality of healthcare services from family doctors may increase residents' willingness to keep contracts with family doctors and promote the implementation of FDCS.

Association of adiposity indicators with hypertension among Chinese adults.

BACKGROUND AND AIMS: Obesity has been linked to the development of hypertension, but the comparison of relationships between different obesity parameters with hypertension are scarcely studied with nationally representative Chinese adults samples. We sought to compare the predictive strengths of different obesity indicators to hypertension. METHODS AND RESULTS: Data in this study were obtained from the Chinese National Stroke Prevention Project with a nationally representative sample of Chinese aged 40 years and older. A total of 162,880 individuals were included. Multi-level analyses and Receiver Operating Characteristic (ROC) curves were used to examine the risk of hypertension in relation to different obesity parameters, including body mass index (BMI), waist circumference (WC), lipid accumulation product index (LAP), visceral adiposity index (VAI), and body adiposity index (BAI). As results, the BMI, WC, LAP, VAI, and BAI were positively associated with the risk of hypertension (P < 0.001). In total, BMI had the strongest association with hypertension when compared with other obesity indicators, and one SD up of BMI would increase the risk of hypertension by 53.9% (95% CI: 1.514-1.566). For men, WC was most associated with hypertension, and one SD up of WC would increase the risk of hypertension by 73.3% (95% CI: 1.685-1.782). For women, BMI showed the strongest predictive power, one SD up of BMI would increase the risk of hypertension by 51.0% (95% CI: 1.479-1.543). CONCLUSIONS: BMI, WC, LAP, VAI, and BAI are all positively corrected to hypertension, but gender disparities should be considered in predicting hypertension by obesity indicators.

Co-administration of paclitaxel and 2-methoxyestradiol using folate-conjugated human serum albumin nanoparticles for improving drug resistance and antitumor efficacy.

The use of chemotherapeutic drug paclitaxel (PTX) for the treatment of tumors has several limitations, including multidrug resistance (MDR) and serious adverse reactions. This research aims to co-encapsulate PTX and the chemosensitizer 2-methoxyestradiol (2-ME) into folate-conjugated human serum albumin nanoparticles (FA-HSANPs) to reduce multiple drug resistance and improve antitumor efficiency. The results show PTX/2-ME@FA-HSANPs had uniform particle size (180 ± 12.31 nm) and high encapsulation efficacy. It also exhibited highly potent cytotoxicity and apoptosis-inducing activities in the G2/M phase of PTX-resistant EC109/Taxol cells. Moreover, PTX/2-ME@FA-HSANPs not only displayed better inhibition of tumor growth in S-180 tumor-bearing mice than PTX alone but also reduced pathological damage to normal tissues. In summary, PTX/2-ME@FA-HSANPs could be a promising vehicle for tumor therapy and reducing drug resistance. This research will also provide references for other MDR treatment.

A systematic review of anxiety across smoking stages in adolescents and young adults.

BACKGROUND: In adolescence and young adults, inconsistence of the association between anxiety and smoking remains to be investigated and clarified. The aim of this study is investigated and clarified the association between anxiety and smoking stages in adolescence and young adults. METHODS: The data on the causal influence of anxiety on smoking in adolescents and young adults aged 14 to 25 years old was retrieved from electronic databases. RESULTS: Nineteen of 668 articles were subjected to a systematic review. Definitional differences with respect to smoking stages constrained homogeneity across the nineteen analyzed reports. Anxiety appears to play a more consistent risk role for nicotine dependent (ND) smokers than for non-nicotine dependent (non-ND) regular or daily smokers. Anxious non-ND smokers are at higher risk to become nicotine dependent. CONCLUSIONS: A ununified definition of smoking stages is responsible for the production of inconsistent results. The analysis reinforced anxiety as a significant risk factor for smoking in one's lifetime. Anxious non-ND smokers are the key target for interventions aimed at preventing nicotine dependence and smoking-related health problems.

MMP-2-responsive gelatin nanoparticles for synergistic tumor therapy.

Purpose: The aim of this study was to develop a new type of nanoparticle that enables concentrated drug release and synergistic therapy. Methods: To this end, we synthesized Ge-DOX-5-ALA/NPs, which can enter tumor tissue by the enhanced permeability and retention (EPR) effect and release drugs by utilizing matrix metalloproteinase-2 (MMP-2). Results: The Ge-DOX-5-ALA/NPs were synthesized by a single-phase coacervation method, and the hydrodynamic diameters of all nanoparticles were under 200 nm. The drug encapsulation and loading efficiency were 92%±1.13% and 6.02% ± 0.48%, respectively. Gelatin zymography was performed to detect the expression of MMP-2 in MCF-7 and Hs578Bst cells. The nanoparticle sensitivity to MMP-2 was examined by comparing the release behavior and cellular uptake in MCF-7 and Hs578Bst cells. In vitro cytotoxicity of the nanoparticles was measured by an MTT assay. An in vivo anticancer efficacy study in S180-bearing mice demonstrated that Ge-DOX-5-ALA/NPs provide a substantial curative effect. A pharmacokinetics experiment demonstrated that the nanoparticles have a sustained release effect. Conclusions: The MMP-2-triggered nanoparticles can transport drugs successfully into the tumor site and enable combined chemotherapy and photodynamic therapy.

Investigation of an antitumor drug-delivery system based on anti-HER2 antibody-conjugated BSA nanoparticles.

Conjugation of a monoclonal antibody with a nanoparticle often improves its specificity and drug loading in cancer therapy. In this study, we prepared a novel targeting nanodrug-delivery system using 2-methoxy-estradiol (2-ME) based on anti-human epidermal growth factor receptor 2 (HER2) antibody-modified BSA to improve the clinical application and antitumor effect of 2-ME. 2-ME-loaded albumin nanoparticles (2-ME-BSANPs) were prepared using a desolvation method and the anti-HER2 antibodies were conjugated to 2-ME-BSANPs (HER2-2-ME-BSANPs) using the coupling agent, succinimidyl 3-(2-pyridyldithio)propionate. HER2-2-ME-BSANPs were characterized using SDS-polyacrylamide gel electrophoresis, an agglutination test, and an immunofluorescence assay. We found that mouse anti-human anti-HER2 monoclonal antibody was successfully conjugated to the 2-ME-BSANPs. Thereafter, the in-vitro and in-vivo toxicities were evaluated using two cancer cell lines, SK-BR-3 (HER2-overexpressing) and MCF-7 (HER2-underexpressing), using classic pharmacological methods and in-vivo imaging technology. We found that the HER2-2-ME-BSANPs retained the immunospecificity of the anti-HER2 monoclonal antibody, rapidly localized to HER2 receptors, and could be used for targeted cancer therapy.

Impact of internal identity asymmetry on employee's behaviors and feelings: A mediating role of psychological distress.

Individuals may experience internal identity asymmetry when they feel misidentified and believe their colleagues do not recognize their work-related identities. This research examines the impact of internal identity asymmetry on their behavior and emotional outcomes at the workplace in Pakistan. Data was collected through a survey and received responses from 393 participants at different levels of management in various sectors of Pakistan. A partial least square-based structural equation modeling technique has been used to validate the proposed research model and develop hypotheses. The findings indicate that psychological distress has a positive indirect effect on both outcomes, such as individual work performance and well-being during personal and professional base asymmetries time. The result indicates that employees face psychological distress while experiencing internal identity asymmetries, which may decrease the performance and well-being of the employees. Findings highlight the importance of coping strategies in improving the performance and well-being of employees. Managers can be supportive in maintaining a positive workplace environment where individuals can have a more accurate self-perception and a better understanding of their colleagues' perspectives. This, in turn, enables them to adopt appropriate coping strategies to enhance both performance and well-being.

Association of the CUN-BAE body adiposity estimator and other obesity indicators with cardiometabolic multimorbidity: a cross-sectional study.

Cardiometabolic multimorbidity (CM), defined as the coexistence of two or three cardiometabolic disorders, is one of the most common and deleterious multimorbidities. This study aimed to investigate the association of Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with the prevalence of CM. The data were obtained from the 2021 health checkup database for residents of the Electronic Health Management Center in Xinzheng, Henan Province, China. 81,532 participants aged ≥ 60 years were included in this study. Logistic regression models were used to estimate the odd ratios (ORs) and 95% confidence intervals (CIs) for CUN-BAE, BMI, WC, and WHtR in CM. The area under the receiver operating characteristic curve (AUC) was used to compare the discriminatory ability of different anthropometric indicators for CM. The multivariable-adjusted ORs (95% CIs) (per 1 SD increase) of CM were 1.799 (1.710-1.893) for CUN-BAE, 1.329 (1.295-1.364) for BMI, 1.343 (1.308-1.378) for WC, and 1.314 (1.280-1.349) for WHtR, respectively. Compared with BMI, WC and WHtR, CUN-BAE had the highest AUC in both males and females (AUC: 0.642; 95% CI 0.630-0.653 for males, AUC: 0.614; 95% CI 0.630-0.653 for females). CUN-BAE may be a better measure of the adverse effect of adiposity on the prevalence of CM than BMI, WC, and WHtR.

Influence of comorbidity of chronic diseases on basic activities of daily living among older adults in China: a propensity score-matched study.

Rationale: With the accelerating process of population aging, the comorbidity of chronic disease (CCD) has become a major public health problem that threatens the health of older adults. Objective: This study aimed to assess whether CCD is associated with basic activities of daily living (BADL) and explore the factors influencing BADL in older adults. Method: A cross-sectional community health survey with stratified random sampling among older residents (≥60 years old) was conducted in 2022. A questionnaire was used to collect information on BADL, chronic diseases, and other relevant aspects. Propensity score matching (PSM) was used to match the older adults with and without CCD. Univariate and multivariate logistic regression analyses were used to explore the factors influencing BADL. PSM was used to match participants with single-chronic disease (SCD) and CCD. Results: Among the 47,720 participants, those with CCD showed a higher prevalence of BADL disability (13.07%) than those with no CCD (6.33%) and SCD (7.39%). After adjusting for potential confounders with PSM, 6,513 pairs of cases with and without CCD were matched. The univariate analysis found that the older adults with CCD had a significantly higher prevalence of BADL disability (13.07%, 851 of 6,513) than those without CCD (9.83%, 640 of 6,513, P < 0.05). The multivariate logistic regression analysis revealed that CCD was a risk factor for BADL in older adults [OR = 1.496, 95% CI: 1.393-1.750, P < 0.001]. In addition, age, educational level, alcohol intake, social interaction, annual physical examination, retirement benefits, depression, weekly amount of exercise, and years of exercise were related to BADL disability (P < 0.05). PSM matching was performed on participants with CCD and SCD and showed that the older adults with CCD had a significantly higher prevalence of BADL disability (13.07%, 851 of 6,513) than those with SCD (11.39%, 742 of 6,513, P < 0.05). Conclusion: The older adults with CCD are at a higher risk of BADL disability than their counterparts with no CCD or SCD. Therefore, we advocate paying attention to and taking measures to improve the health and quality of life of these individuals.