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Ma CL, Yu B, Fan YZ, Ye TT, Cai CW, Yang B, Zeng HL, Jia P, Yang SJ. [Association between unhealthy lifestyles and diabetic dyslipidemia in occupational population and network analysis]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:425-431. [PMID: 38514320 DOI: 10.3760/cma.j.cn112338-20230715-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Objective: To understand the influence of unhealthy lifestyle on diabetic dyslipidemia and the key influencing factors in occupational population and provided scientific evidence for the prevention of diabetic dyslipidemia. Methods: Based on baseline data and follow-up data of Southwest Occupational Population Cohort from China Railway Chengdu Group Co., Ltd. during 2021. Diabetic dyslipidemia was defined as diabetes plus one or more forms of dyslipidemia, and unhealthy lifestyle factors included smoking, alcohol consumption, unhealthy dietary patterns, low physical activity, and abnormal BMI. Multivariate logistic regression model was used to analyze the relationship between unhealthy lifestyle scores and diabetic dyslipidemia, network analysis was used to find and explore the key lifestyles influencing glycolipid metabolism. Results: A total of 25 631 subjects were included. People with unhealthy lifestyle score 2 and 3 were 1.93 (95%CI: 1.31-2.86) times and 2.37 (95%CI: 1.60-3.50) times more likely to have diabetes with ≥1 forms of dyslipidemia than those with scores of 0; People with unhealthy lifestyle score 1, 2 and 3 were 1.98 (95%CI: 1.08-3.61) times, 2.87 (95%CI: 1.60-5.14) times and 3.95 (95%CI: 2.22-7.06) times more likely to have diabetes with ≥2 forms of dyslipidemia than those with score 0. Network analysis found that abnormal BMI and HDL-C were the "bridge nodes" that link unhealthy lifestyles with diabetic dyslipidemia. Conclusion: The higher the score of unhealthy lifestyle, the higher the risk for diabetic dyslipidemia, abnormal BMI and HDL-C are key factors influencing the association between unhealthy lifestyle and diabetic dyslipidemia.
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Affiliation(s)
- C L Ma
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - B Yu
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
| | - Y Z Fan
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - T T Ye
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - C W Cai
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - B Yang
- Affiliated Hospital of Chengdu University, Chengdu 610081, China
| | - H L Zeng
- Affiliated Hospital of Chengdu University, Chengdu 610081, China
| | - P Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan 430072, China School of Public Health, Wuhan University, Wuhan 430071, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
| | - S J Yang
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Affiliated Hospital of Chengdu University, Chengdu 610081, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
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Wang ZH, Hu YQ, Yang B, Fan YZ, Cai CW, Ye TT, Ma CL, Feng CT, Jia P, Yang SJ. [Association between unhealthy lifestyles and hyperuricemia in occupational population and modification effect of hypertension and dyslipidemia]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:432-439. [PMID: 38514321 DOI: 10.3760/cma.j.cn112338-20230715-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Objective: To understand the relationship between unhealthy lifestyle and hyperuricemia, as well as the modification effects of hypertension and dyslipidemia in occupational population and provide a theoretical basis for the prevention of hyperuricemia. Methods: A cross-sectional survey design was adopted, based on baseline data from the Southwest Occupational Population Cohort from China Railway Chengdu Group Co., Ltd., which included the population in 28 prefectures from Sichuan Province and Guizhou Province, and 33 districts (counties) from Chongqing Municipality between October and December 2021. This study collected the information about the demographics characteristics, lifestyles, and prevalence of chronic non-communicable diseases of the study subjects through questionnaire, physical measurement and laboratory biochemical test. The unhealthy lifestyle score was scored based on smoking, alcohol consumption, dietary patterns, physical activity, and low weight or overweight, with higher scores being associated with more unhealthy lifestyles. The multivariate logistic regression model was used to analyze the relationship between unhealthy lifestyle score, smoking, alcohol consumption, other factors and hyperuricemia, and the stratified analysis was used to explore the modification effect of hypertension and other diseases on the relationship between unhealthy lifestyle and hyperuricemia. Results: A total of 11 748 participants were included in this study, the prevalence of hyperuricemia was 34.4%. Multivariate logistic regression model showed that current/previous smoking, current/previous alcohol consumption and BMI abnormality were risk factors for hyperuricemia, and the unhealthy lifestyle score showed a "cumulative" effect on the risk for hyperuricemia, with higher score increasing the risk of hyperuricemia, and the OR increased from 1.64 (95%CI: 1.34-2.00) to 2.89 (95%CI: 2.39-3.50). Stratified analysis showed that unhealthy lifestyles had a greater impact on the risk for hyperuricemia in people with hypertension and dyslipidemia. Conclusions: The coexistence of multiple unhealthy lifestyles might increase the risk of hyperuricemia, and this effect was stronger in participants with hypertension and dyslipidemia. Timely correction of unhealthy lifestyles, and control of hypertension and dyslipidemia might reduce the risk for hyperuricemia.
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Affiliation(s)
- Z H Wang
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - Y Q Hu
- Social Insurance Management Department of China Railway Chengdu Bureau Group, Co., Ltd., Chengdu 610081, China
| | - B Yang
- Affiliated Hospital of Chengdu University, Chengdu 610081, China
| | - Y Z Fan
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - C W Cai
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - T T Ye
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - C L Ma
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - C T Feng
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
| | - P Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan 430072, China School of Public Health, Wuhan University, Wuhan 430071, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
| | - S J Yang
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Affiliated Hospital of Chengdu University, Chengdu 610081, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
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Yang SJ, Yu B, Dong S, Cai CW, Liu HY, Ye TT, Jia P. [Progress in complex network theory-based studies on the associations between health-related behaviors and chronic non-communicable diseases]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:408-416. [PMID: 38514318 DOI: 10.3760/cma.j.cn112338-20230715-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
In recent years, the research focus on health-related behavior and chronic non-communicable diseases has shifted from the analysis on independent effects of multiple causes on a single outcome to the evaluation the complex relationships between multiple causes and multiple effects. Complex network theory, an important branch of system science, considers the relationships among factors in a network and can reveal how health-related behaviors interact with chronic diseases through a series of complex network models and indicators. This paper summarizes the definition and development of complex network theory and its commonly used models, indicators, and case studies in the field of health-related behavior and chronic disease to promote the application of complex network theory in the field of health and provide reference and tools for future research of the relationship between health-related behavior and chronic disease.
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Affiliation(s)
- S J Yang
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Affiliated Hospital of Chengdu University, Chengdu 610081, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
| | - B Yu
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
| | - S Dong
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - C W Cai
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - H Y Liu
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - T T Ye
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - P Jia
- International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China School of Resource and Environmental Sciences, Wuhan University, Wuhan 430072, China School of Public Health, Wuhan University, Wuhan 430071, China
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Dong S, Yu B, Yang B, Fan YZ, Fu Y, Feng CT, Zeng HL, Jia P, Yang SJ. [Mediating effects of body mass index and lipid levels on the association between alcohol consumption and hypertension in occupational population]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:440-446. [PMID: 38514322 DOI: 10.3760/cma.j.cn112338-20230715-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Objective: To investigate the association between alcohol consumption and hypertension and SBP, DBP and the mediating effects of body mass index (BMI) and lipid level in occupational population, and provide reference for the intervention and prevention of hypertension. Methods: Based on the data of Southwest Occupational Population Cohort from China Railway Chengdu Group Co., Ltd., the information about the demographic characteristics, behavior and lifestyle, blood pressure and lipids level of the participants were collected through questionnaire survey, physical examination and blood biochemical test. Logistic/linear regression was used to analyze the association between alcohol consumption and hypertension, SBP and DBP. The individual and joint mediating effects of BMI, HDL-C, LDL-C, TG, and TC were explored through causal mediating analysis. A network analysis was used to explore the correlation between alcohol consumption, BMI and lipid levels, and hypertension. Results: A total of 22 887 participants were included, in whom 1 825 had newly detected hypertension. Logistic regression analysis found that current/former drinkers had a 33% increase of risk for hypertension compared with never-drinkers (OR=1.33, 95%CI:1.19-1.48). Similarly, alcohol consumption could increase SBP (β=1.05, 95%CI:0.69-1.40) and DBP (β=1.10, 95%CI:0.83-1.38). Overall, BMI and lipid levels could mediate the associations between alcohol consumption and hypertension, SBP and DBP by 21.91%, 28.40% and 22.64%, respectively. BMI and TG were the main mediators, and they were also the two nodes with the highest edge weight and bridge strength centrality in the network of alcohol consumption, BMI, lipid levels and hypertension. Conclusions: Alcohol consumption was associated with increased risk for hypertension, and BMI and TG were important mediators and key nodes in the network. It is suggested that paying attention to the alcohol consumption, BMI and TG might help prevent hypertension in occupational population.
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Affiliation(s)
- S Dong
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - B Yu
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
| | - B Yang
- Affiliated Hospital of Chengdu University, Chengdu 610081, China
| | - Y Z Fan
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - Y Fu
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - C T Feng
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
| | - H L Zeng
- Affiliated Hospital of Chengdu University, Chengdu 610081, China
| | - P Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan 430072, China School of Public Health, Wuhan University, Wuhan 430071, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
| | - S J Yang
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Affiliated Hospital of Chengdu University, Chengdu 610081, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
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Ye TT, Shao Y, Yu B, Cai CW, Feng CT, Jia P, Yang SJ. [Association between unhealthy lifestyles and hypertension, diabetes and dyslipidemia in old adults in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:385-392. [PMID: 38514315 DOI: 10.3760/cma.j.cn112338-20230715-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Objective: To analyze the individual and cumulative effects of unhealthy lifestyle on the prevalence of hypertension, diabetes and dyslipidemia in old adults in China, and find out the critical lifestyle in the network. Methods: Based on the baseline data of Yunnan Behavior and Disease Surveillance Cohort in 2021, a total of 16 763 older adults aged ≥60 years were included in our study. The unhealthy lifestyle factors including smoking, drinking, unhealthy eating habit, lower physical activity level, abnormal BMI and abnormal waist circumference. We calculated the unhealthy lifestyle score by using the cumulative exposures of each participant. Multiple logistic regression and mixed graphical models were used to describe the association between unhealthy lifestyle and the prevalence of hypertension, diabetes and dyslipidemia. Results: The prevalence of hypertension, diabetes and dyslipidemia were 57.0%, 11.5% and 37.0%, respectively. Most of the unhealthy lifestyles included in the study were risk factors for hypertension, diabetes and dyslipidemia, and the risks of disease increased with the increase of the unhealthy lifestyle score. The participants with the highest score (score: 6) had significantly higher prevalence of hypertension (OR=3.99, 95%CI: 1.81-8.80), diabetes (OR=4.64, 95%CI: 1.64-13.15) and dyslipidemia (OR=4.26, 95%CI: 2.08-8.73) compared with those with lowest score (score: 0). In the network constructed by mixed graphical model, abnormal waist circumference (bridge strength=0.81) and hypertension (bridge strength=0.55) were vital bridge nodes connecting unhealthy lifestyle and hypertension, diabetes and dyslipidemia. Conclusions: The unhealthy lifestyle score was associated with risks for hypertension, diabetes and dyslipidemia. Abnormal waist circumference was the key factor for chronic diseases in old adults.
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Affiliation(s)
- T T Ye
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - Y Shao
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China
| | - B Yu
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
| | - C W Cai
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - C T Feng
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
| | - P Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan 430072, China School of Public Health, Wuhan University, Wuhan 430071, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
| | - S J Yang
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China Affiliated Hospital of Chengdu University, Chengdu 610081, China
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Cai CW, Yang B, Fan YZ, Yu B, Dong S, Fu Y, Feng CT, Zeng HL, Jia P, Yang SJ. [Association between work environment noise perception and cardiovascular diseases, depressive symptoms, and their comorbidity in occupational population]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:417-424. [PMID: 38514319 DOI: 10.3760/cma.j.cn112338-20230715-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Objective: To explore the association between occupational noise perception and cardiovascular disease (CVD), depression symptoms, as well as their comorbidity in occupational population and provide evidence for the prevention and control of physical and mental illnesses. Methods: A cross-sectional survey design was adopted, based on baseline data in population in 28 prefectures in Sichuan Province and Guizhou Province, and 33 districts (counties) in Chongqing municipality from Southwest Occupational Population Cohort from China Railway Chengdu Group Co., Ltd. during October to December 2021. A questionnaire survey was conducted to collect information about noise perception, depressive symptoms, and the history of CVD. Latent profile analysis model was used to determine identify noise perception type, and multinomial logistic regression analysis was conducted to explore the relationship between different occupational noise perception types and CVD, depression symptoms and their comorbidity. Results: A total of 30 509 participants were included, the mean age was (36.6±10.5) years, and men accounted for 82.0%. The direct perception of occupational noise, psychological effects and hearing/sleep impact of occupational noise increased the risk for CVD, depressive symptoms, and their comorbidity. By using latent profile analysis, occupational noise perception was classified into four levels: low, medium, high, and very high. As the level of noise perception increased, the association with CVD, depressive symptoms, and their comorbidity increased. In fact, very high level occupational noise perception were found to increase the risk for CVD, depressive symptoms, and their comorbidity by 2.14 (95%CI: 1.73-2.65) times, 8.80 (95%CI: 7.91-9.78) times, and 17.02 (95%CI: 12.78-22.66) times respectively compared with low-level occupational noise perception. Conclusions: Different types of occupational noise perception are associated with CVD and depression symptom, especially in the form of CVD complicated with depression symptom. Furthermore, the intensity of occupational noise in the work environment should be reduced to lower the risk for physical and mental health.
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Affiliation(s)
- C W Cai
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - B Yang
- Affiliated Hospital of Chengdu University, Chengdu 610081, China
| | - Y Z Fan
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - B Yu
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
| | - S Dong
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - Y Fu
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - C T Feng
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
| | - H L Zeng
- Affiliated Hospital of Chengdu University, Chengdu 610081, China
| | - P Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan 430072, China School of Public Health, Wuhan University, Wuhan 430071, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
| | - S J Yang
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Affiliated Hospital of Chengdu University, Chengdu 610081, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
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Zhu J, Sun W, Li L, Li H, Zou Y, Huang B, Ji W, Shi B. Accuracy and patient-centered results of marker-based and marker-free registrations for dynamic computer-assisted implant surgery: A randomized controlled trial. Clin Oral Implants Res 2024; 35:101-113. [PMID: 37955359 DOI: 10.1111/clr.14201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/07/2023] [Accepted: 10/31/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES To compare implant placement accuracy and patient-centered results between the dynamic computer-assisted implant surgeries (d-CAISs) using marker-based and marker-free registration methods. MATERIALS AND METHODS A double-armed, single-blinded randomized controlled trial was conducted, in which 34 patients requiring single implant placement at the esthetic zone were randomly assigned to the marker-based (n = 17) or marker-free (n = 17) groups. The marker-based registration was performed using a splint containing radiopaque markers, while the marker-free registration used natural teeth. The primary outcome assessed implant positioning accuracy via angular and linear deviations between preoperative and postoperative implant positions in CBCT. Patients were also surveyed about the intraoperative experience and oral health impact profile (OHIP). RESULTS The global linear deviations at the implant platform (0.82 ± 0.28 and 0.85 ± 0.41 mm) and apex (1.28 ± 0.34 and 0.85 (IQR: 0.64-1.50) mm) for the marker-based and marker-free groups respectively showed no significant difference. However, the angular deviation of the marker-free group (2.77 ± 0.92° ) was significantly lower than the marker-based group (4.28 ± 1.58° ). There was no significant difference in the mean postoperative OHIP scores between the two groups (p = .758), with scores of 2.74 ± 1.21 for marker-based and 2.93 ± 2.18 for marker-free groups, indicating mild oral health-related impairment in both. Notably, patients in the marker-free group showed significantly higher satisfaction (p = .031) with the treatment procedures. CONCLUSIONS D-CAIS with a marker-free registration method for single implantation in the anterior maxilla has advantages in improving implant placement accuracy and patients' satisfaction, without generating a significant increase in clinical time and expenses.
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Affiliation(s)
- Jingxian Zhu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Sun
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lei Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Honglei Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yujie Zou
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bin Huang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Ji
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bin Shi
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Liu H, Feng C, Yu B, Ma H, Li Y, Wu J, Dong B, Wang Z, Jia P, Dou Q, Yang S. Influences of long-term care insurance on pulmonary and urinary tract infections among older people with disability. J Am Geriatr Soc 2023; 71:3802-3813. [PMID: 37715571 DOI: 10.1111/jgs.18554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 07/05/2023] [Accepted: 07/26/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND Pulmonary infection (PI) and urinary tract infection (UTI) have been the most common cause of hospitalization and most frequent infection respectively in older people with disability (OPWD). Long-term care insurance (LTCI) policy, intending to provide services to reduce the disease burden of OPWD, it remains unclear whether LTCI could reduce PI-, and UTI-related hospitalizations. This quasi-experimental study aimed to assess the influences of LTCI on all-cause, especially PI- and UTI-related hospitalizations among OPWD and the variation across sociodemographic characteristics. METHODS 32,120 participants in the Chengdu Long-term Care Insurance cohort were considered the intervention group, and 2,704 not covered by the LTCI were in the control group. A total of 3,134,160 hospitalization records were collected between January 2014 and June 2021. A doubly robust difference-in-differences (DID) method was used to estimate the average treatment effect on the treated (ATT), indicating the average effect of LTCI on intervention group. RESULTS The average monthly all-cause, PI-, and UTI-related hospitalization rates were 16.3%, 4.0% and 0.5% in the intervention group, respectively, and were 19.3%, 3.9% and 0.5% in the control group, respectively. Under LTCI, all-cause (ATT [95% CI]: 7.15% [6.41%, 7.88%]), PI- (3.25% [2.76%, 3.74%]), and UTI-related hospitalizations (0.46% [0.28%, 0.64%]) were decreased. The influences of LTCI became significant after 5 months since the LTCI implementation and remained stable over time. The impact was more pronounced among those with longer coverage. The overall reduction was stronger in those who were not married, lived alone, and resided in institutions. CONCLUSIONS LTCI may reduce the occurrence of all-cause, PI-, and UTI-related hospitalizations in OPWD, with stronger influences observed over an extended period of implementation. The implementation of LTCI can play a role in reducing the burden of infectious diseases in OPWD and the care burden of families and society.
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Affiliation(s)
- Hongyun Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chuanteng Feng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China
| | - Bin Yu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China
| | - Hua Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuchen Li
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Department of Geography, The Ohio State University, Columbus, Ohio, USA
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Jinhui Wu
- National Clinical Research Center for Geriatrics, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Birong Dong
- National Clinical Research Center for Geriatrics, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Zihang Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peng Jia
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
- Hubei Luojia Laboratory, Wuhan, China
- School of Public Health, Wuhan University, Wuhan, China
| | - Qingyu Dou
- National Clinical Research Center for Geriatrics, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
- Department of Health Management Center, Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu, China
- Respiratory Department, Chengdu Seventh People's Hospital, Chengdu, China
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