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Background: The cardiometabolic index (CMI) is a novel metric for assessing cardiometabolic health and type 2 diabetes mellitus (DM), yet its relationship with insulin resistance (IR) and prediabetes (preDM) is not well-studied. There is also a gap in understanding the nonlinear associations between CMI and these conditions. Our study aimed to elucidate these associations. Methods: We included 13,142 adults from the National Health and Nutrition Examination Survey (NHANES) 2007–2020. CMI was calculated by multiplying the triglyceride-to-high density lipoprotein cholesterol (TG/HDL-C) by waist-to-height ratio (WHtR). Using weighted multivariable linear and logistic regression explored the relationships of CMI with glucose metabolism markers, IR, preDM, and DM. Nonlinear associations were assessed using generalized additive models (GAM), smooth curve fittings, and two-piecewise logistic regression. Results: Multivariate regression revealed positive correlations between CMI and glucose metabolic biomarkers, including FBG (β = 0.08, 95% CI: 0.06–0.10), HbA1c (β = 0.26, 95% CI: 0.22–0.31), FSI (β = 4.88, 95% CI: 4.23–5.54), and HOMA-IR (β = 1.85, 95% CI: 1.56–2.14). There were also significant correlations between CMI and increased risk of IR (OR = 3.51, 95% CI: 2.94–4.20), preDM (OR = 1.49, 95% CI: 1.29–1.71), and DM (OR = 2.22, 95% CI: 2.00-2.47). Inverse nonlinear L-shaped associations were found between CMI and IR, preDM, and DM, with saturation inflection points at 1.1, 1.45, and 1.6, respectively. Below these thresholds, increments in CMI significantly correlated with heightened risks of IR, preDM, and DM. Conclusions: CMI exhibited inverse L-shaped nonlinear relationships with IR, preDM, and DM, suggesting that reducing CMI to a certain level might significantly prevent these conditions. [ABSTRACT FROM AUTHOR]

This research investigates the effects of age and gender on children's color-form preference of package design. With two datasets from China and the U.S., we also explore cultural differences. Two separate 2 (color) x 2 (form) experimental surveys were conducted among 837 and 761 children of age 3-12 from China and the U.S., respectively. The results reveal that Chinese and U.S. children share the same tendency of switching from color to form with the increase in age. Nevertheless, gender effect and age-gender interaction are found in the Chinese sample only. More Chinese boys than girls show preference by color. The difference in the color-form package preference between Chinese younger girls and older girls is significantly greater than that of boys. [ABSTRACT FROM AUTHOR]

This study examines how consumers from two different cultures react to the luxury brand retailer co-branding strategy. A 2 (Familiarity: Familiar vs. Unfamiliar) × 2 (Product Fit: Fit vs. Unfit) × 2 (Brand Fit: Fit vs. Unfit) × 2 (Country: U.S. vs. Indonesia) between-subjects design was conducted. The results show that co-branding with retailers is not a good strategy for luxury brands in Indonesia, which is characterized by a high level of collectivism. However, consumers in the U.S., which is characterized by a low level of collectivism, demonstrate a positive attitude change toward the luxury brand when they are not familiar with the luxury brand or when the luxury brand collaborates with a high-end retailer. This study provides some valuable insights for luxury brands regarding their expansion strategy into foreign countries. One contribution is that we demonstrate that cross-cultural theories on brand extension and co-branding literature might not be applied to luxury brands. We find that Hofstede's power distance and individualism/collectivism dimensions could be used to explain the discrepancy. We also provide valuable insights for co-branding strategy for luxury brands. [ABSTRACT FROM PUBLISHER]

Background: Metabolic syndrome (MetS) is a risk factor for cardiovascular disease (CVD), and CVD is a major challenge for cancer patients. This study aimed to investigate the prevalence and association of MetS and CVD among adult cancer patients., Methods: This cross-sectional study included cancer patients aged > 18 years from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. The prevalence of MetS and CVD was calculated using weighted analysis. Multivariable logistic regression was used to assess the association between MetS and CVD., Results: The study included 2658 adult cancer patients, of whom 1260 exhibited MetS and 636 had CVD. The weighted prevalence of MetS and CVD in cancer patients was 45.44%, and 19.23%, respectively. Multivariable logistic regression showed a 79% increased risk in higher CVD prevalence in cancer patients with MetS, with the OR (95% CI) of 1.79 (1.31, 2.44). Notably, obesity, elevated blood pressure (BP), high glucose, and low high density lipoprotein cholesterol (HDL-C) in the MetS components were significantly associated with higher CVD prevalence after adjusting for covariates. Moreover, the risk of CVD prevalence in cancer patients increased with more MetS components. Notably, MetS was more strongly linked to CVD in patients aged < 65 and women., Conclusions: Among adult cancer patients, over two-fifths (45.44%) were estimated to have MetS, while about one-fifth (19.23%) were considered to have CVD. Notably, obesity, elevated BP, high glucose, low HDL-C, and higher number of MetS components were found to be significantly associated with higher CVD prevalence among cancer adults. Cancer patients under 65 and women with MetS may be at increased risk of CVD., (© 2024. The Author(s).)

Purpose: To investigate suicide mortality and the related factors among female breast cancer patients in the United States., Methods: The SEER database was used to identify 716,422 patients diagnosed with breast cancer between 2010 and 2018 to calculate a standardized mortality rate (SMR). An analysis of risk factors for suicide death was conducted using the univariate and multivariate Cox proportional risk model. An estimation of suicide probability was performed through a nomogram model., Results: Compared with the expected suicide cases (n = 155) in the general population of the United States at the corresponding period (a suicide death rate of 5.71 per 100,000 person-years), the suicide rate among 716,422 breast cancer patients was followed during 2010-2018 and showed a relatively higher rate of 9.02 per 100,000 person-years. The SMR was 1.58 (95%CI: 1.39-1.79). White and other races were nine and seven times more likely to complete suicide than Black race, respectively (aHR = 9.013, 95%CI: 3.335-24.36, P < 0.001; aHR = 7.129, 95%CI: 2.317-21.931, P = 0.001); unmarried or single patients were at higher risk than married patients (aHR = 1.693, 95%CI: 1.206-2.377, P = 0.002). Patients receiving radiotherapy (aHR = 0.731, 95%CI: 0.545-0.980, P = 0.036) were less likely to complete suicide than those who did not., Conclusion: Female breast cancer patients in the United States have a higher suicide rate than the general public, and the risk factors consist of non-black ethnicity, being single or unmarried, and not being treated with radiotherapy. As a result of this study, clinicians may be able to identify female breast cancer patients who are at high risk of suicide, thus providing appropriate psychological support at the early stage., Competing Interests: Declaration of competing interest None declared., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: This study aims to investigate the relationship between obesity and constipation among American adults., Methods: Our study leveraged data from the National Health and Nutrition Examination Survey (NHANES). This comprehensive approach enabled us to summarize the weighted prevalence rates of obesity in adults. To further deepen our understanding, we employed a variety of analytical methods. These included multivariable logistic regression, subgroup analysis and restricted cubic splines. Through these methodologies, we were able to effectively evaluate the correlation between various obesity indicators and constipation, offering new insights into this complex relationship., Results: The weighted prevalence of constipation stands at 9.42%. Notably, an increased risk of constipation is linked with a BMI (body mass index) exceeding 28 kg/m2, WSR (waist-stature ratio) that is either between 58.3 and 64.8 or above 64.8, as well as a LAP (lipid accumulation products) ranging from 50.8 to 90.1. In contrast, a reduced risk of constipation is associated with WWI (weight-adjusted-waist index) that falls between 0.015 and 0.020, exceeds 0.020, and without the presence of central obesity (P < 0.05). Restricted cubic spline analysis, a significant non-linear relationship was discerned between BMI, WSR, and LAP in relation to constipation., Conclusions: This pioneering large-scale study explores the relationship between various obesity indices and constipation. It reveals that reducing the BMI, WSR, LAP and waist circumference can decrease the risk of constipation. Conversely, a higher value of WWI correlates with a lower constipation risk, and this remains true even after adjusting for a wide range of variables., (© 2024. The Author(s).)

Background and Purpose: The American Heart Association Life's Simple 7 (LS7) metric was used to define optimal cardiovascular and brain health, but the associations with macrostructural hyperintensities and microstructural white matter damage are unclear. The objective was to determine the association of LS7 ideal cardiovascular health factors with macrostructural and microstructural integrity., Method: A total of 37,140 participants with available LS7 and imaging data from UK Biobank were included in this study. Linear associations were implemented to examine the associations of LS7 score and subscores with white matter hyperintensity load (WMH) (WMH volume normalized by total white matter volume and logit-transformed) and diffusion imaging indices (fractional anisotropy [FA], mean diffusivity, orientation dispersion index [OD], intracellular volume fraction, isotropic volume fraction [ISOVF])., Results: In individuals (mean age 54.76 years; 19,697 females, 52.4%), higher LS7 score and subscores were strongly associated with lower WMH and microstructural white matter injury, including OD, ISOVF, FA. Both interaction analyses and stratified analyses of LS7 score and subscores with age and sex showed a strong association with microstructural damage markers, with remarkable age and sex differences. The association of OD was pronounced in females and populations younger than 50 years and FA, mean diffusivity and ISOVF were pronounced in males and populations older than 50 years., Conclusion: These findings suggest that healthier LS7 profiles are associated with better profiles of both macrostructural and microstructural markers of brain health, and indicate that ideal cardiovascular health is associated with improved brain health., (© 2023 European Academy of Neurology.)

Introduction: Due to the cardiotoxicity of cancer treatment and traditional risk factors for cardiovascular disease (CVD) such as obesity, diabetes, dyslipidemia, and hypertension, cancer patients are at higher risk of developing CVD. However, limited research exists on the correlation between chronic kidney disease (CKD) and CVD risk in cancer patients., Methods: This cross-sectional study selected cancer patients aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) conducted from 2015 to 2020. Multivariable logistic regression was used to assess the association between CKD and CVD in cancer patients. Additionally, subgroup analyses were conducted to investigate the association among different groups of cancer patients., Results: We included 1,700 adult cancer patients (52.53% were females). After multivariable adjustment for covariates including traditional CVD factors, CKD was significantly associated with CVD, with an odds ratio (95% confidence interval) and p value of 1.61 (1.18, 2.19) and 0.004. Subgroup analyses after multivariable adjustment showed a significant correlation between CKD and increased CVD risk in the following cancer patients: age ≥60 years, males, white ethnicity, and individuals with or without traditional CVD factors (obesity, diabetes, dyslipidemia, and hypertension)., Conclusions: CKD remains a significant factor in the higher risk of CVD among adult cancer patients in the United States, even after adjustment for traditional CVD risk factors. Therefore, to reduce the risk of CVD in cancer patients, it is important to treat CKD as a non-traditional risk factor for CVD and actively manage it., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Objective: This study aimed to analyze the progression and trends of multimorbidity in the elderly in China and internationally from a bibliometric perspective, and compare their differences on hotspots and research fronts., Methods: Publications between January 2001 and August 2021 were retrieved from WOS and CNKI databases. Endnote 20 and VOSviewer 1.6.8 were used to summarize bibliometric features, including publication years, journals, and keywords, and the co-occurrence map of countries, institutions, and keywords was drawn., Results: 3857 research papers in English and 664 research papers in Chinese were included in this study. The development trends of multimorbidity in the elderly are fully synchronized in China and other countries. They were divided into germination period, development period, and prosperity period. Research literature in English was found to be mainly focused on public health, and the IF of the literature is high; In China, however, most research papers are in general medicine and geriatrics with fewer core journals. Co-occurrence analysis based on countries and institutions showed that the most productive areas were the United States, Canada, the United Kingdom, and Australia, while the Chinese researchers have made little contribution. The clustering analysis of high-frequency keywords in China and around the globe shows that the hotspots have shifted from individual multimorbidity to group multimorbidity management. Sorting out the top 10 highly cited articles and highly cited authors, Barnett, K's article published in Lancet in 2012 is regarded as a milestone in the field., Conclusion: Multimorbidity in the elderly leads to more attention in the world. Although China lags behind global research the research fronts from disease-centered to patient-centered, and individual management to population management is consistent.

Objective: This study aimed to investigate the associations between previous TORCH infection (cytomegalovirus, toxoplasmosis, herpes simplex virus, and rubella) with pregnancy and neonatal outcomes in couples undergoing IVF/ICSI-ET. Materials and Methods: A total of 18,074 couples underwent fresh IVF/ICSI-ET ( in vitro fertilization/intracytoplasmic sperm injection-embryo transfer) cycles were included in our analyses. TORCH infection status was determined by serological confirmation of cytomegalovirus, toxoplasmosis, herpes simplex virus, and rubella IgG in the absence of IgM antibodies. Clinical pregnancy, ectopic pregnancy, miscarriage, live birth, preterm birth, congenital malformation, and perinatal death were evaluated in both infection and non-infection group. Multivariate logistic regression was applied to calculate odds ratio. Results: Previous toxoplasmosis infection is associated with a significantly decreased preterm birth rate [ P = 0.045, OR = 0.755 (95% CI, 0.571-0.997), Adjusted OR = 0.749 (95%CI, 0.566-0.991)]. No differences in clinical pregnancy, ectopic pregnancy, miscarriage, and perinatal death were observed between the corresponding TORCH infection group [IgM (-) IgG(+)] and the non-infection group [IgM (-) IgG (-)]. Conclusions: Previous TORCH infections were not associated with adverse pregnancy and neonatal outcomes in IVF/ICSI-ET overall, and toxoplasmosis infection might be associated with a lower preterm birth rate in patients underwent IVF/ICSI-ET. The necessity of TORCH IgG screening in IVF procedure might need re-evaluation, and further cost-effective analysis might be helpful for the clinical management strategy., (Copyright © 2020 Liu, Wu, Wang, Wang, Zhao, Chen, Tu, Qian, Liao, Huang, Zhang, Xu and Zhang.)

Polycyclic aromatic hydrocarbons (PAHs) are environmental endocrine disruptors, which may modify the bone mineralization. However, epidemiological evidences on this issue were scant. We aimed to investigate the associations of PAHs with bone mass density (BMD) and osteoporosis based on a nationally-representative sample from general U.S., Population: Data utilized were extracted from the 2005-2010 National Health and Nutrition Examination Survey (NHANES). Nine urinary PAHs (U-PAHs) metabolites were measured as exposure biomarkers. Associations of specific U-PAHs with BMD and osteoporosis were estimated by multivariable adjusted linear regression models and logistic regression models, respectively. Compared with women at the first tertiles, those at the third tertiles of 1-Hydroxynapthalene, 2-Hydroxyfluorene, 3-Hydroxyphenanthrene, 2-Hydroxyphenanthrene and 9-Hydroxyfluorene had significantly decreased BMD levels [coefficient (β) = -0.023 to -0.014, p < 0.05] or increased likelihoods of osteoporosis [odds ratios (ORs) = 1.86 to 3.36, p < 0.05] at different bone sites. Whereas, elevated BMD levels (β = 0.021, p < 0.05) at trochanter and decreased likelihoods of osteoporosis (OR = 0.33, p < 0.05) at intertrochanter were observed among women at the second tertiles of 1-Hydroxypyrene and 2-Hydroxynapthalene, respectively. Similar results were found for all the population, i.e., combination of men and women. Most of the significant associations disappeared among adult men only. Furthermore, Associations between U-PAHs and BMD were stronger for postmenopausal women when compared with premenopausal group. In conclusion, associations of U-PAHs with BMD and osteoporosis varied by specific U-PAHs and bone sites, as well as menopausal status and genders in U.S. adults., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: The incidence of thyroid cancer in black Americans is significantly lower than that in white Americans, and the impact of race on the prognosis of thyroid cancer remains controversial. The purpose of this study was to determine the risk factors for survival in black and white patients and to compare the survival of differentiated thyroid carcinoma subtypes between these two races. We further investigated the association of lymph node and distant metastases with races., Methods: This is a retrospective analysis using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. A total of 70,346 cases were included in our study. Patients' demographics and cancer- and treatment-related characteristics were compared between the black and white Americans using chi-square and Fisher's exact tests. For multivariate analysis, Cox proportional hazards regression were used to assess the association between potential risk factors and the survival in black and white patients., Result: Black Americans had a worse overall survival than white Americans (HR = 1.127, P = 0.002). While disease-specific survival (DSS) was comparable, the risk factors for DSS were different between white and black Americans. Black Americans had less lymph node metastasis of classical variant papillary thyroid carcinoma (CPTC, OR = 0.476, P < 0.001) and follicular variant papillary thyroid carcinoma (FVPTC, OR = 0.522, P < 0.001), but not follicular thyroid carcinoma (FTC). However, black Americans with FVPTC, but not CPTC or FTC, had a higher potential of distant metastasis (OR = 1.715, P = 0.026). Furthermore, only white patients with tumor > 2 cm and lymph node metastasis benefited from radioactive iodine., Conclusions: The risk factors for DSS were significantly different in white and black patients. The impact of race should be considered in treatment strategy for thyroid cancer.

Between 2004 and 2010, 189 adult patients were enrolled on the National Cancer Institute's cross-sectional chronic graft-versus-host disease (cGVHD) natural history study. Patients were evaluated by multiple disease scales and outcome measures, including the 2005 National Institutes of Health (NIH) Consensus Project cGVHD severity scores. The purpose of this study was to assess the validity of the NIH scoring variables as determinants of disease severity in severely affected patients in efforts to standardize clinician evaluation and staging of cGVHD. Out of 189 patients enrolled, 125 met the criteria for severe cGVHD on the NIH global score, 62 of whom had moderate disease, with a median of 4 (range, 1-8) involved organs. Clinician-assigned average NIH organ score and the corresponding organ scores assigned by subspecialists were highly correlated (r = 0.64). NIH global severity scores showed significant associations with nearly all functional and quality of life outcome measures, including the Lee Symptom Scale, Short Form-36 Physical Component Scale, 2-minute walk, grip strength, range of motion, and Human Activity Profile. Joint/fascia, skin, and lung involvement affected function and quality of life most significantly and showed the greatest correlation with outcome measures. The final Cox model with factors jointly predictive for survival included the time from cGVHD diagnosis (>49 versus ≤49 months, hazard ratio [HR] = 0.23; P = .0011), absolute eosinophil count at the time of NIH evaluation (0-0.5 versus >0.5 cells/μL, HR = 3.95; P = .0006), and NIH lung score (3 versus 0-2, HR = 11.02; P < .0001). These results demonstrate that NIH organs and global severity scores are reliable measures of cGVHD disease burden. The strong association with subspecialist evaluation suggests that NIH organ and global severity scores are appropriate for clinical and research assessments, and may serve as a surrogate for more complex subspecialist examinations. In this population of severely affected patients, NIH lung score is the strongest predictor of poor overall survival, both alone and after adjustment for other important factors., (Published by Elsevier Inc.)