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Cureus Jun 2024Dementia is an insidious cognitive disorder featuring a decline in cognition that is not well explained by the physiology of aging. Dementia includes a group of...
INTRODUCTION
Dementia is an insidious cognitive disorder featuring a decline in cognition that is not well explained by the physiology of aging. Dementia includes a group of disorders that are distinguished by a gradual loss of both cognition and the capability to execute day-to-day functions.
MATERIALS AND METHODS
We conducted a cross-sectional study among 384 elderly participants in areas surrounding the All India Institute of Medical Sciences, Bibinagar, Telangana, India. Those with more than 65 years of age were included in the study, and those suffering from serious illnesses were excluded. The Montreal Cognitive Assessment (MOCA) scale, the University of California and Los Angeles (UCLA) Loneliness Scale, and the Patient Health Questionnaire (PHQ-9) were used to assess cognitive status, loneliness, and depression, respectively, among the study participants. Logistic regression was performed to identify factors associated with cognitive impairment (CI), depression, and loneliness.
RESULTS
The average MOCA score of the study participants was 14.9 ± 6.9, with 28.6% of the participants exhibiting severe CI. Nearly half of the participants (49.2%) experienced moderate to high degrees of loneliness, and 39.3% experienced moderate to severe depression. Important factors found to be associated with severe CI were illiteracy (adjusted odds ratio (AOR): 2.85, 95% CI: 1.35-4.45), urban residence (AOR: 0.18, 95% CI: 0.04-0.81), living with a spouse (AOR: 0.23, 95% CI: 0.11-0.78), not consuming alcohol (AOR: 0.35, 95% CI: 0.14-0.87), and depression (AOR: 4.49, 95% CI: 1.37-14.67).
CONCLUSION
CI is a serious public health problem in India. With the increasing proportion of the elderly population in the near future, CI levels will increase, especially in countries like India. Timely interventions such as early identification through community-based screening, the inclusion of a geriatric health component in primary health care, and proper counseling will help address this problem at a grassroots level.
PubMed: 38957261
DOI: 10.7759/cureus.61535 -
Frontiers in Public Health 2024In 2017, China launched a comprehensive reform of public hospitals and eliminated drug markups, aiming to solve the problem of expensive medical treatment and allow poor...
BACKGROUND
In 2017, China launched a comprehensive reform of public hospitals and eliminated drug markups, aiming to solve the problem of expensive medical treatment and allow poor and low-income people to enjoy basic health opportunities. This study attempts to evaluate the policy impact of public hospital reform on the health inequality of Chinese residents and analyze its micro-level mechanism from the perspective of household consumption structure. Studying the inherent causal connection between public hospital reform and health inequality is of paramount significance for strengthening China's healthcare policies, system design, raising the average health level of Chinese residents, and achieving the goal of ensuring a healthy life for individuals of all age groups.
METHODS
Based on the five waves of data from the China Family Panel Studies (CFPS) conducted in 2012-2020, We incorporates macro-level statistical indicators such as the time of public hospital reforms, health insurance surplus, and aging, generating 121,447 unbalanced panel data covering 27 provinces in China for five periods. This data was used to explore the impact of public hospital reform on health inequality. Logical and empirical tests were conducted to determine whether the reform, by altering family medical care and healthy leisure consumption expenditures, affects the micro-pathways of health inequality improvement. We constructed a two-way fixed model based on the re-centralized influence function (RIF_CI_OLS) and a chained mediation effects model to verify the hypotheses mentioned above.
RESULTS
Public hospital reform can effectively improve the health inequality situation among Chinese residents. The reform significantly reduces household medical expenses, increases healthy leisure consumption, promotes the upgrading of family health consumption structure, and lowers the health inequality index. In terms of indirect effects, the contribution of the increase in healthy leisure consumption is relatively greater.
CONCLUSION
Public hospital reform significantly alleviates health inequality in China, with household health consumption serving as an effective intermediary pathway in the aforementioned impact. In the dual context of global digitization and exacerbated population aging, enhancing higher education levels and vigorously developing the health industry may be two key factors contributing to this effect.
Topics: Humans; China; Hospitals, Public; Health Care Reform; Health Status Disparities; Family Health; Male; Female; Adult; Middle Aged
PubMed: 38957205
DOI: 10.3389/fpubh.2024.1352417 -
Frontiers in Public Health 2024Since its emergence in late 2019, the SARS-CoV-2 virus has led to a global health crisis, affecting millions and reshaping societies and economies worldwide....
INTRODUCTION
Since its emergence in late 2019, the SARS-CoV-2 virus has led to a global health crisis, affecting millions and reshaping societies and economies worldwide. Investigating the determinants of SARS-CoV-2 diffusion and their spatiotemporal dynamics at high spatial resolution is critical for public health and policymaking.
METHODS
This study analyses 194,682 georeferenced SARS-CoV-2 RT-PCR tests from March 2020 and April 2022 in the canton of Vaud, Switzerland. We characterized five distinct pandemic periods using metrics of spatial and temporal clustering like inverse Shannon entropy, the Hoover index, Lloyd's index of mean crowding, and the modified space-time DBSCAN algorithm. We assessed the demographic, socioeconomic, and environmental factors contributing to cluster persistence during each period using eXtreme Gradient Boosting (XGBoost) and SHapley Additive exPlanations (SHAP), to consider non-linear and spatial effects.
RESULTS
Our findings reveal important variations in the spatial and temporal clustering of cases. Notably, areas with flatter epidemics had higher total attack rate. Air pollution emerged as a factor showing a consistent positive association with higher cluster persistence, substantiated by both immission models and, to a lesser extent, tropospheric NO estimations. Factors including population density, testing rates, and geographical coordinates, also showed important positive associations with higher cluster persistence. The socioeconomic index showed no significant contribution to cluster persistence, suggesting its limited role in the observed dynamics, which warrants further research.
DISCUSSION
Overall, the determinants of cluster persistence remained across the study periods. These findings highlight the need for effective air quality management strategies to mitigate air pollution's adverse impacts on public health, particularly in the context of respiratory viral diseases like COVID-19.
Topics: Humans; COVID-19; Spatio-Temporal Analysis; SARS-CoV-2; Switzerland; Air Pollution; Pandemics; Socioeconomic Factors
PubMed: 38957202
DOI: 10.3389/fpubh.2024.1298177 -
Cureus Nov 2023Acute myocardial infarction (AMI), commonly referred to as a heart attack, is a leading global cause of mortality, necessitating immediate recognition and appropriate...
INTRODUCTION
Acute myocardial infarction (AMI), commonly referred to as a heart attack, is a leading global cause of mortality, necessitating immediate recognition and appropriate actions. This study aims to assess AMI awareness and response among the general population in Alahssa, Saudi Arabia.
METHODOLOGY
A descriptive cross-sectional design was employed, with surveys distributed via online platforms. Participants aged 18 years and older, residing in Alahssa, and providing informed consent were included.
RESULTS
Among 406 participants, 74.1% had good knowledge levels. Notably, 216 (53.2%) recognized calling an ambulance as the initial response to AMI symptoms. The Internet (140, 28.9%) and healthcare professionals (113, 23.3%) were primary information sources, with "sudden pain or discomfort in arms or hands" (287, 27.8%) as the most recognized symptom. "Obesity" and "heart disease" (304, 12.3%) were the most common risk factors. Demographic variations in knowledge were observed.
CONCLUSION
This study highlights the need to enhance public awareness of AMI, particularly among specific demographic groups. Targeted educational campaigns can improve knowledge, promote appropriate actions, and ultimately enhance outcomes during AMI events in Alahssa, Saudi Arabia.
PubMed: 38957197
DOI: 10.7759/cureus.49300 -
Frontiers in Neuroscience 2024The presence of mental fatigue seriously affects daily life and working conditions. Non-invasive transcranial electrical stimulation has become an increasingly popular...
OBJECTIVE
The presence of mental fatigue seriously affects daily life and working conditions. Non-invasive transcranial electrical stimulation has become an increasingly popular tool for relieving mental fatigue. We investigated whether transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS) could be used to alleviate the state of mental fatigue in a population of healthy young adults and compared their effects.
METHODS
We recruited 10 participants for a blank control, repeated measures study. Each participant received 15 min of anodal tDCS, α-tACS, and blank stimulation. Participants were required to fill in the scale, perform the test task and collect ECG signals in the baseline, fatigue and post-stimulus states. We then assessed participants' subjective fatigue scale scores, test task accuracy and HRV characteristics of ECG signals separately.
RESULTS
We found that both anodal tDCS and α-tACS significantly ( < 0.05) reduced subjective fatigue and improved accuracy on the test task compared to the blank group, and the extent of change was greater with tACS. For the HRV features extracted from ECG signals. After tACS intervention, SDNN ( = -3.241, = 0.002), LF ( = -3.511, = 0.001), LFn ( = -3.122, = 0.002), LFn/HFn (-2.928, = 0.005), TP ( = -2.706, = 0.008), VLF ( = -3.002, = 0.004), SD2 ( = -3.594, = 0.001) and VLI ( = -3.564, = 0.001) showed a significant increasing trend, and HFn ( = 3.122, = 0.002), SD1/SD2 ( = 3.158, = 0.002) and CCM_1 ( = 3.106, = 0.003) showed a significant decreasing trend. After tDCS intervention, only one feature, TINN, showed a significant upward trend ( < 0.05). The other features showed non-significant changes but roughly the same trend as the tACS group.
CONCLUSION
Both tDCS and α-tACS can be effective in relieving mental fatigue, and α-tACS is more effective than tDCS. This study provides theoretical support for tDCS with α-tACS having a alleviating effect on mental fatigue and the use of ECG as a valid objective assessment tool.
PubMed: 38957184
DOI: 10.3389/fnins.2024.1359446 -
Journal of Cellular and Molecular... Jul 2024A genome-wide association study (GWAS) is a powerful tool in investigating genetic contribution, which is a crucial factor in the development of complex multifactorial...
A genome-wide association study (GWAS) is a powerful tool in investigating genetic contribution, which is a crucial factor in the development of complex multifactorial diseases, such as type 2 diabetes mellitus. Type 2 diabetes mellitus is a major healthcare burden in the Western Pacific region; however, there is limited availability of genetic-associated data for type 2 diabetes in Southeast Asia, especially among the Kinh Vietnamese population. This lack of information exacerbates global healthcare disparities. In this study, 997 Kinh Vietnamese individuals (503 with type 2 diabetes and 494 controls) were prospectively recruited and their clinical and paraclinical information was recorded. DNA samples were collected and whole genome genotyping was performed. Standard quality control and genetic imputation using the 1000 Genomes database were executed. A polygenic risk score for type 2 diabetes was generated in different models using East Asian, European, and mix ancestry GWAS summary statistics as training datasets. After quality control and genetic imputation, 107 polymorphisms reached suggestive statistical significance for GWAS (≤5 × 10) and rs11079784 was one of the potential markers strongly associated with type 2 diabetes in the studied population. The best polygenic risk score model predicting type 2 diabetes mellitus had AUC = 0.70 (95% confidence interval = 0.62-0.77) based on a mix of ancestral GWAS summary statistics. These data show promising results for genetic association with a polygenic risk score estimation in the Kinh Vietnamese population; the results also highlight the essential role of population diversity in a GWAS of type 2 diabetes mellitus.
Topics: Humans; Diabetes Mellitus, Type 2; Genome-Wide Association Study; Male; Female; Polymorphism, Single Nucleotide; Vietnam; Genetic Predisposition to Disease; Multifactorial Inheritance; Pilot Projects; Middle Aged; Risk Factors; Asian People; Case-Control Studies; Aged; Adult; Genetic Risk Score; Southeast Asian People
PubMed: 38957036
DOI: 10.1111/jcmm.18526 -
Health Expectations : An International... Aug 2024Limited research concerning existing inequities in mental health care and support services in the United Kingdom captures perceptions and lived experiences of the...
BACKGROUND
Limited research concerning existing inequities in mental health care and support services in the United Kingdom captures perceptions and lived experiences of the significantly underrepresented Muslim population.
METHODS
Underpinned by social constructivist theory, we used consultation to facilitate public and patient involvement and engagement (PPIE) to identify inequities in mental health care and support experienced by Muslims from minoritised ethnic communities living in deprived areas in Liverpool, UK. The rationale was to (a) better inform standards and policies in healthcare and (b) provide a psychologically safe space to members of the Muslim community to share perceptions and experiences of mental health care and support services. To ensure trustworthiness of the data, member checking was adopted. This paper describes the procedure to achieving this consultation, including our recruitment strategy, data collection and analysis as well as key findings.
FINDINGS
Twenty-seven consultees attended the women's consultation and eight consultees attended the men's consultation. Consultees were from Yemeni, Somali, Sudanese, Egyptian, Algerian, Pakistani and Moroccan communities and share the Islamic faith. Four key interlinked themes were identified from consultees' narratives: (1) broken cycle of trust; (2) an overmedicalised model of care; (3) community mental health prevention initiatives; and (4) culturally conscious training and education.
CONCLUSIONS
The Muslim population has identified numerous barriers to accessing mental health support and there is a need to resource activities that would aid deeper understanding of mental health support needs through continuous and meaningful community initiatives. This would afford mental health practitioners and organisations opportunities for developing realistic anti-racism strategies, effectively adopting social prescription, strengthening partnerships and collaborations aimed at supporting delivery of evidence-based mental health care provisions to tackle mental health inequities.
PATIENT AND PUBLIC INVOLVEMENT
This paper reports on the involvement and engagement of Muslims from minoritised ethnic communities living in the Liverpool city region.
Topics: Humans; Islam; Female; Male; Mental Health Services; United Kingdom; Adult; Healthcare Disparities; Ethnicity; Middle Aged; Referral and Consultation
PubMed: 38956944
DOI: 10.1111/hex.14132 -
Pharmacology Research & Perspectives Aug 2024Contrast-induced nephropathy (CIN) is a serious complication that occurs subsequent to the administration of contrast media for therapeutic angiographic interventions.... (Randomized Controlled Trial)
Randomized Controlled Trial
Contrast-induced nephropathy (CIN) is a serious complication that occurs subsequent to the administration of contrast media for therapeutic angiographic interventions. As of present, no effective therapy exists to prevent its occurrence. This single-center double-blind randomized controlled trial aimed to evaluate the effect of edaravone, an antioxidant, in a group of high-risk patients undergoing coronary angiography. Ninety eligible patients with chronic kidney disease Stages 3-4 were randomly assigned to either the control group (n = 45) or the intervention group (n = 45). In the intervention group, one dosage of edaravone (60 mg) in 1 L of normal saline was infused via a peripheral vein 1 h prior to femoral artery-directed coronary angiography. Patients in the control group received an equal amount of infusion in their last hour before angiography. Both groups received intravenous hydration with 0.9% sodium 1 mL/kg/h starting 12 h before and continuing for 24 h after angiography. The primary outcome measure was the onset of CIN, defined as a 25% increase in serum creatinine levels 120 h after administration of contrast media. The occurrence of CIN was observed in 5.5% (n = 5) of the studied population: 2.2% of patients in the intervention group (n = 1) and 8.9% of controls (n = 4). However, this difference was not statistically significant. Administration of a single dosage of edaravone 1 h prior to infusion of contrast media led to a reduction in the incidence of CIN. Further investigations, employing larger sample sizes, are warranted to gain a comprehensive understanding of its efficacy.
Topics: Humans; Edaravone; Double-Blind Method; Contrast Media; Male; Female; Coronary Angiography; Middle Aged; Aged; Free Radical Scavengers; Creatinine; Kidney Diseases; Antipyrine; Treatment Outcome
PubMed: 38956898
DOI: 10.1002/prp2.1228 -
European Journal of Sport Science Jul 2024The neurological effects and underlying pathophysiological mechanisms of sports-related concussion (SRC) in active young boxers remain poorly understood. This study aims...
The neurological effects and underlying pathophysiological mechanisms of sports-related concussion (SRC) in active young boxers remain poorly understood. This study aims to investigate the impairment of white matter microstructure and assess changes in glymphatic function following SRC by utilizing neurite orientation dispersion and density imaging (NODDI) on young boxers who have sustained SRC. A total of 60 young participants were recruited, including 30 boxers diagnosed with SRC and 30 healthy individuals engaging in regular exercise. The assessment of whole-brain white matter damage was conducted using diffusion metrics, while the evaluation of glymphatic function was performed through diffusion tensor imaging (DTI) analysis along the perivascular space (DTI-ALPS) index. A two-sample t-test was utilized to examine group differences in DTI and NODDI metrics. Spearman correlation and generalized linear mixed models were employed to investigate the relationship between clinical assessments of SRC and NODDI measurements. Significant alterations were observed in DTI and NODDI metrics among young boxers with SRC. Additionally, the DTI-ALPS index in the SRC group exhibited a significantly higher value than that of the control group (left side: 1.58 vs. 1.48, P = 0.009; right side: 1.61 vs. 1.51, P = 0.02). Moreover, it was observed that the DTI-ALPS index correlated with poorer cognitive test results among boxers in this study population. Repetitive SRC in active young boxers is associated with diffuse white matter injury and glymphatic dysfunction, highlighting the detrimental impact on brain health. These findings highlight the importance of long-term monitoring of the neurological health of boxers.
Topics: Humans; White Matter; Diffusion Tensor Imaging; Glymphatic System; Male; Brain Concussion; Adolescent; Neurites; Boxing; Female; Case-Control Studies; Young Adult; Athletic Injuries
PubMed: 38956796
DOI: 10.1002/ejsc.12113 -
European Journal of Sport Science Jul 2024Improving peak oxygen uptake (V̇O) and maximal strength are key objectives of rehabilitation for patients with unspecific musculoskeletal disorders (MSDs). Although... (Randomized Controlled Trial)
Randomized Controlled Trial
Aerobic high-intensity interval training and maximal strength training in patients with unspecific musculoskeletal disorders improve V̇O and maximal strength more than moderate training.
Improving peak oxygen uptake (V̇O) and maximal strength are key objectives of rehabilitation for patients with unspecific musculoskeletal disorders (MSDs). Although high-intensity training yield superior outcomes for these factors, patients with MSDs may not tolerate high-intensity due to pain and fear. Therefore, we examined the effect and feasibility of incorporating aerobic high-intensity intervals (HIITs) and maximal strength training (MST) in a standard clinical rehabilitation program for patients with unspecific MSDs. 73 patients (45 ± 10 years) with MSDs partaking in a standard, public, and 4-week rehabilitation program were randomized to high-intensity training (HG: 4 × 4 minutes intervals at ∼90% of maximal heart rate; HR, and 4 × 4 repetitions leg press at ∼90% of 1 repetition maximum; 1RM, with maximal intended velocity) or keep todays treatment of low-to moderate-intensity training (MG: various cycling, walking, and/or running activities at ∼70%-80% of HR and 3 × 8 - 10 repetitions leg press at ∼75% of 1RM without maximal intended velocity). HG improved V̇O (12 ± 7%) and leg press 1RM (43 ± 34%) more than moderate-intensity group (V̇O; 5 ± 6%, 1RM; 19 ± 18%, both p < 0.001). We observed that no adverse events and no between-group differences in dropout rate or self-reported quality of life (both p > 0.05). There were positive correlations between improved V̇O and improved physical (p = 0.024) and emotional (0.016) role functioning. We conclude that both high-intensity interval training and MST are feasible and improve V̇O and maximal strength more than standard low-to moderate-intensity treatment of patients with unspecific MSDs. Our findings suggest that high-intensity training should be implemented as a part of standard clinical care of this patient population.
Topics: Humans; High-Intensity Interval Training; Male; Resistance Training; Middle Aged; Muscle Strength; Female; Adult; Oxygen Consumption; Musculoskeletal Diseases; Heart Rate
PubMed: 38956785
DOI: 10.1002/ejsc.12126