The connection between six common air pollution particles and adult brain tumors: a meta-analysis of 26,217,930 individuals

Environmental air pollutants (black carbon (BC), nitrogen oxides (NOx), particulate matter with diameter < 2.5 μm (PM2.5), nitrogen dioxide (NO2), particulate matter with diameter <10 μm (PM10), and ozone (O3)) are one of the major menaces to mankind's health globally. This analysis reviews the association between exposure to these air pollutants and the chance of developing brain tumors in adults (total brain tumors, malignant brain tumors, and benign brain tumors). Studies published by April 2022 were searched. Raw effect sizes were converted to standardized effect sizes per 10 μg/m3 increase. Random effect models were applied to calculate combined effect size and 95% confidence intervals (CIs) were computed. A total of 8 articles were included for meta-analysis. The pooled effect size (ES) for per 10 μg/m3 BC intake was 1.67 (95% CI: 1.25, 2.22), P = 0.449. For every 10 μg/m3 rise in NO2 concentration, ES was 1.03 (95% CI: 1.01, 1.05), P = 0.319. Meanwhile, there was a boundary association between NOx and adult brain tumors (ES and 95% CI: 1.01; 1.00, 1.01/10 μg/m3; P = 0.716). While there was no conjunction between PM2.5, PM10, O3 (PM2.5: ES and 95% CI: 1.04; 0.99, 1.08/10 μg/m3; P = 0.834; PM10: ES and 95% CI: 1.01; 0.97, 1.04/10 μg/m3; P = 0.627; O3: ES and 95% CI: 0.97; 0.94, 1.00/10 μg/m3; P = 0.253). This research shows testimony of a significant link between air pollutants and brain tumors in adults, especially when exposed to BC, NO2, and NOx. This evidence emphasizes the importance of improving air quality as part of a comprehensive approach to prevent the occurrence and deterioration of brain tumors.

Effect of Socioeconomic Disparities on Suicide Risk in Patients With Prostate Cancer During 2005 to 2020: A Population Study

PURPOSE

To determine whether socioeconomic disparities have an impact on the likelihood of suicide among prostate cancer patients.

METHODS

Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with malignant prostate cancer between 2005 and 2020. The socioeconomic disparities of the patients were evaluated by median household income (MHI) and ethnicity. Ethnicity included Spanish-Hispanic-Latino and non-Spanish-Hispanic-Latino. A Cox proportional risk model was utilized. Using the Kaplan-Meier approach, the cumulative incidence of suicide mortality was measured.

RESULTS

A total of 857,418 US population with prostate cancer were included. In the multivariate analysis, individuals with MHI over $75,000 had a lower risk of suicide mortality than those with MHI between $54,999 and $74,999 in all patients (aHRs: 0.693, 95 CI%: 0.603-0.797). Spanish-Hispanic-Latino displayed lower overall suicide mortality in all patients (aHRs: 0.426, 95% CI: 0.323-0.561). In the subgroup analysis of different ages, individuals with MHI over $75,000 had a lower risk of suicide than those with MHI between $54,999 and $74,999 in patients 60 to 79 years (aHRs: 0.668, 95% CI: 0.562-0.794) and individuals with MHI below $54,999 had higher suicide risk than those with MHI between $54,999 and $74,999 in patients 80+ years (aHRs: 1.786, 95% CI: 1.100-2.902). Hispanic-Latino individuals had lower overall suicide mortality in 00 to 59 years (aHRs: 0.420, 95% CI: 0.240-0.734), 60 to 79 years (aHRs: 0.445, 95% CI: 0.319-0.621), 80+ years (aHRs: 0.363, 95% CI: 0.133-0.988).

CONCLUSION

Socioeconomic disparities, including MHI and ethnicity, are important factors strongly related to suicide risk in prostate cancer patients. The lower MHI individuals and non-Spanish-Hispanic-Latino individuals were associated with higher suicide risk.

[Effectiveness of the "14 plus 7 day quarantine" and "nucleic acid plus total antibody testing" strategy for screening imported patients with COVID-19 in Xiamen]

Objective: To analysis effectiveness of the "14 plus 7 day quarantine" and "nucleic acid plus total antibody testing" strategy (combined screening strategy) for screenin the imported patients with COVID-19 in Xiamen. Methods: The study populations were overseas travelers arriving in Xiamen from March 17 to December 31, 2020, and overseas travelers who had quarantine outside Xiamen for less than 21 days from July 18 to December 31, 2020. Data were collected and analyzed on the timing of detection, pathways, and test results of the imported patients with COVID-19 after implementing combined screening strategy. Results: A total of 304 imported patients with COVID-19 were found from 174 628 overseas travelers and 943 overseas travelers from other cities. A total of 163 cases (53.6%) were diagnosed by multitime, multisite intensive nucleic acid testing after positive finding in total antibody testing. Among them, 27 (8.9%) were first positive for nucleic acid in 14 plus 7 day quarantine and 136 were first positive for nucleic acid in 14-day quarantine. Only 8 of these individuals were tested positive for nucleic acid after positive total antibody testing. The other 128 individuals were tested positive for nucleic acid after being negative for average 2.3 times (maximum of 6 times). Aditional 155 cases might be detected by using the combined "14 plus 7 day quarantine" and " nucleic acid plus total antibody testing" strategy compared with "14-day quarantine and nucleic acid testing" strategy, accounting for 51.0% of the total inbound infections. So the combined screening strategy doubled the detection rate for imported patients with COVID-19. No second-generation case caused by overseas travelers had been reported in Xiamen as of February 26, 2021. Conclusions: Xiamen's combined screening strategy can effectively screen the imported patients with COVID-19 who were first positive for nucleic acid after 14 day quarantine. Compared with "14 day quarantine and nucleic acid testing", the combined screening strategy improved detection rate and further reduced the risk of the secondary transmission caused by the imported patients with COVID-19.

Prevalence of anxiety, depression, sleeping problems, cognitive impairment, and suicidal ideation in people with autoimmune skin diseases

BACKGROUND

Autoimmune skin diseases (ASDs) such as psoriasis and vitiligo, in addition to causing visible skin symptoms, are closely associated with psychological health issues. However, a comprehensive understanding of the prevalence of these psychological comorbidities in affected individuals is lacking. This study aims to identify the prevalence of anxiety, depression, sleeping problems, cognitive impairment, and suicidal ideation in people with ASDs.

METHOD

PubMed, MEDLINE, Web of Science, and Cochrane Library searches were conducted from 1993 to May 2024. Observational studies reporting prevalence data for anxiety, depression, sleeping problems, cognitive impairment, and suicidal ideation among people with ASDs were included in the analysis. The Newcastle-Ottawa scale was used to evaluate the quality of studies.

RESULTS

The study included 114 studies from 37 countries including 823,975 participants. The estimated pooled prevalence of anxiety in patients with ASDs was 33.3% (95% CI: 27.3-29.3%). The estimated pooled prevalence of depression was 33.7% (95% CI: 29.2-38.1%). The estimated pooled prevalence of sleeping problems was 45.0% (95% CI:31.6-58.4%). The estimated pooled prevalence of cognitive impairment and suicidal ideation was 30.8% (95% CI:15.0-46.7%) and 21.6% (95% CI:13.4-29.8%), respectively. The most common mental disorder in patients with systemic lupus erythematosus and psoriasis was sleeping problems at 55.9% (95% CI: 35.6-76.1%, I2 = 97%) and 39.0% (95% CI: 21.1-56.9%, I2 = 99%).

CONCLUSION

Among patients with ASDs, anxiety, depression, sleeping problems, cognitive impairment, and suicidal ideation were common. The most prevalent mental disorder among patients with systemic lupus erythematosus and psoriasis was sleeping problems. Those with ASDs may experience considerable psychological burdens, and integrated mental health support is necessary for their treatment.

Higher socioeconomic status is associated with higher ultra-processed food intake: a cross-sectional analysis

OBJECTIVE

To explore the differences in ultra-processed food (UPF) consumption across different socioeconomic status (SES) levels.

METHODS

Data on UPF consumption (grams/day) were derived from the 2017-2018 National Health and Nutrition Examination Survey. The analysis controlled for age, marital status, race, and sex. A restricted cubic spline (RCS) model was applied to examine the nonlinear response curve.

RESULTS

UPF consumption increased with higher poverty income ratio (PIR), the ratio of household income to the established poverty line. Compared to the low PIR group, the medium group showed a non-significant increase (β = 34.23[95%CI: -28.81, 97.28], p = 0.287), while the high group exhibited a significant increase (β = 115.15[95%CI: 43.53, 186.76], p = 0.002). A linear positive correlation was observed in RCS analysis (p-nonlinear = 0.166, p-overall < 0.001).

CONCLUSIONS

The study highlights that higher SES is associated with greater consumption of UPF in the US. The findings suggest that policy interventions should take SES into consideration.

Prevalence of mental health problems in people living with HIV: a systematic review and meta-analysis

HIV remains a significant public health concern, with an estimation of 39 million people infected. There is a lack of universally accepted benchmarks for prevalence of mental health problems among people living with HIV. We aimed to compute aggregate estimates of mental health problems among people living with HIV. We conducted a comprehensive literature search in PubMed, Web of Science, and Embase. Our inclusion criteria encompassed peer-reviewed cross-sectional or longitudinal studies conducted in any country that investigated people living with HIV and provided data allowing us to determine the prevalence of mental health problems. We conducted a meta-analysis to determine the combined prevalence of mental health problems among people living with HIV and consider predefined moderators by subgroup meta-analysis and meta-regression analysis. Our initial search identified 31 407 records. After removing the duplication and excluding ineligible records, 240 studies were included in our meta-analysis. Six commonly reported mental health problems were identified (depression, anxiety, suicidal ideation, post-traumatic stress disorder, stigma, and psychological distress). The pooled prevalence was 31% (95% CI 28-34) for depression, 29% (24-34) for anxiety, 20% (17-24) for suicidal ideation, 20% (13-28) for post-traumatic stress disorder, 47% (40-55) for stigma, 44% (31-56) for psychological distress. After considering predefined moderators, the heterogeneity was still observed. A high prevalence of mental health problems was observed among people living with HIV. Effective prevention and treatment programs can alleviate symptoms and promote mental health. This, in turn, can have a positive impact on all aspects of HIV management, leading to improved overall health outcomes for people living with HIV.

Global Prevalence of Mental Health Problems Among Cancer Survivors: A Meta-Analysis From 31 Countries

BACKGROUND

With the improvement of medical treatment, the survival rate of cancer patients continues to rise; however, their psychological issues require further management. Currently, there is uncertainty regarding the prevalence of mental health problems among cancer survivors.

OBJECTIVE

To quantitatively summarize the global prevalence of mental health problems in cancer survivors.

METHODS

We searched CINAHL, PsychlNFO, Embase, Web of Science, and PubMed for studies reporting the prevalence of various mental health problems in cancer survivors who have survived at least 3 months. Subsequently, stratified analyses were conducted based on study design, region, cancer system, and time since diagnosis. Moreover, meta-regression was utilized to investigate sources of heterogeneity. We used Rstudio software 4.3.0, Stata 17.0 software and metaprop package.

RESULTS

A total of 147 studies involving 135,015 cancer survivors from over 30 countries were identified, primarily focusing on six mental health problems. Among 78 studies addressing anxiety, the prevalence was 24.4% (95% CI: 20.2%-28.8%). Among the 96 studies on depression, the prevalence was 23.7% (95% CI: 20.1%-27.4%). In the case of sleep disorders, 42 studies reported a prevalence of 34.1% (95% CI: 27.9%-40.6%). The overall prevalence decreased over time since diagnosis. Most of the analyzed data exhibited significant heterogeneity (I2 > 75%).

CONCLUSION

The analysis indicated that cancer survivors experience a diverse range of mental health problems, which were prevalent among them. The results emphasized the importance of recognizing and treating mental health problems in cancer survivors and served as a reminder for healthcare workers to address mental health problems in this population. The registration number was CRD42023466209.

Body mass index and pressure injuries risk in hospitalized adult patients: A dose-response analysis

BACKGROUND

The association between underweight and pressure injuries (PIs) has been established in several studies. However, there is a lack of well-designed research investigating the connection between overweight and obesity with these injuries.

OBJECTIVE

This meta-analysis aims to investigate the dose-response relationship between body mass index (BMI) and the risk of PIs in adult hospitalized patients.

METHODS

PubMed, Web of Science, and MEDLINE Databases were searched from inception to May 2024. Observational articles with at least three BMI categories were included in the study. BMI was defined as underweight, normal weight, overweight, and morbid obesity for the meta-analysis. The non-linear relationship between BMI and the risk of PIs in hospitalized adults was investigated using restricted cubic spline models. Fractional polynomial modeling was used.

RESULTS

Eleven articles reporting at least 3 categories of BMI met the inclusion criteria, including 31,389 participants. Compared to patients with normal weight, those with underweight, obesity, and morbid obesity exhibited an increased risk of PIs, with odds ratios of 1.70 (95%CI:1.50-1.91), 1.12 (95%CI:1.02-1.24), 1.70 (95%CI:1.13-2.55), respectively. A J-shaped dose-response model was established for the relationship between PI risk and BMI (Pnon-linearity < 0.001, Plinearity = 0.745).

CONCLUSION

The J-shaped dose-response pattern revealed that underweight, obesity and morbid obesity heightened the risk of PIs in hospitalized adults. Lower and higher BMI values may signify an increased risk for PIs, particularly among the elderly with lower BMI, providing valuable guidance for medical staff.

Empathy as a Mediator of the Relation between Peer Influence and Prosocial Behavior in Adolescence: A Meta-Analysis

During adolescence, empathy and prosocial behavior contribute to the establishment of positive interpersonal relationships and social connections, promoting holistic development in youth. A substantial amount of research has provided compelling evidence that there is a relationship between peer relationships and empathy and prosocial behavior. Empathy, as a key mediating factor, links the influence of peers with prosocial behavior in adolescents, yet there is currently a lack of robust meta-analytic evidence regarding this mediating role. This study employed a two-stage structural equation modeling approach to synthesize existing research on peer influence, empathy, and prosocial behavior during adolescence. Systematic searches were conducted across three databases (PubMed, Web of Science, and PsycINFO), identifying a total of 49 studies, with a systematic assessment of study quality. The results indicated that empathy plays a mediating role between peer influence and prosocial behavior. Positive peer influence is positively correlated with empathy and prosocial behavior, while negative peer influence is negatively correlated with empathy and prosocial behavior, and empathy is positively correlated with prosocial behavior. This meta-analysis demonstrates that during adolescence, empathy mediates the connection between peer influence and prosocial behavior, representing a potential process that can explain the relationship between peer influence and prosocial behavior.

Application of artificial intelligence in medical education: A meta-ethnographic synthesis

With the advancement of Artificial Intelligence (AI), it has had a profound impact on medical education. Understanding the advantages and issues of AI in medical education, providing guidance for educators, and overcoming challenges in the implementation process is particularly important.

The objective of this study is to explore the current state of AI applications in medical education.

A systematic search was conducted across databases such as PsycINFO, CINAHL, Scopus, PubMed, and Web of Science to identify relevant studies. The Critical Appraisal Skills Programme (CASP) was employed for the quality assessment of these studies, followed by thematic synthesis to analyze the themes from the included research.

Ultimately, 21 studies were identified, establishing four themes: (1) Shaping the Future: Current Trends in AI within Medical Education; (2) Advancing Medical Instruction: The Transformative Power of AI; (3) Navigating the Ethical Landscape of AI in Medical Education; (4) Fostering Synergy: Integrating Artificial Intelligence in Medical Curriculum.

Artificial intelligence's role in medical education, while not yet extensive, is impactful and promising. Despite challenges, including ethical concerns over privacy, responsibility, and humanistic care, future efforts should focus on integrating AI through targeted courses to improve educational quality.

Mortality of children and adolescents co-infected with tuberculosis and HIV: a systematic review and meta-analysis

OBJECTIVE

Children and adolescents with HIV infection are well known to face a heightened risk of tuberculosis. However, the exact mortality rates and temporal trends of those with HIV-tuberculosis (TB) co-infection remain unclear. We aimed to identify the overall mortality and temporal trends within this population.

METHODS

PubMed, Web of Science, and Embase were employed to search for publications reporting on the mortality rates of children and adolescents with HIV-TB co-infection from inception to March 2, 2024. The outcome is the mortality rate for children and adolescents with HIV-TB co-infection during the follow-up period. In addition, we evaluate the temporal trends of mortality.

RESULTS

During the follow-up period, the pooled mortality was 16% [95% confidence interval (CI) 13-20]. Single infection of either HIV or TB exhibit lower mortality rates (6% and 4%, respectively). We observed elevated mortality risks among individuals aged less than 12 months, those with extrapulmonary TB, poor adherence to ART, and severe immunosuppression. In addition, we observed a decreasing trend in mortality before 2008 and an increasing trend after 2008, although the trends were not statistically significant ( P  = 0.08 and 0.2 respectively).

CONCLUSIONS

Children and adolescents with HIV-TB co-infection bear a significant burden of mortality. Timely screening, effective treatment, and a comprehensive follow-up system contribute to reducing the mortality burden in this population.

Association between frailty and suicidal ideation in older adults: A cross-sectional study

OBJECTIVES

This study seeks to investigate the potential correlation between various levels of frailty and suicidal ideation (SI) in older adults from the USA.

METHODS

Our cross-sectional study extracted data on adults ≥60 years from the NHANES in 2005-2018. Frailty levels were assessed by computing the Frailty Index, classifying individuals into robust, prefrail, and frail categories. SI was evaluated utilizing Item #9 of PHQ-9. Logistic regression and restricted cubic splines were employed for analysis.

RESULTS

The analysis comprised 8564 participants, revealing that 3.3% reported experiencing SI. The association between frailty and SI in older adults was statistically significant in crude model (OR: 5.94, 95% CI: 3.46-11.27, P < 0.001). Upon adjusting for baseline characteristics, the association remained robust (AOR: 5.35, 95% CI: 3.09-10.19, P < 0.001). Model II did not substantially alter the association between frailty and SI after further adjustment for lifestyle factors (AOR: 5.23, 95% CI: 3.02-9.98, P < 0.001). In a sensitivity analysis controlling for depression, the association remained statistically significant (AOR:3.62, 95%CI: 1.76-8.75, P = 0.001). Furthermore, the associations between the Frailty Index and SI were pronounced in the restricted cubic spline (RCS) models (P overall < 0.001, P nonlinearity = 0.771).

CONCLUSION

Frailty appears to heighten vulnerability to suicidal ideation in older adults. Training healthcare professionals to identify and address mental health issues related to frailty is crucial. Through comprehensive intervention measures, we can better safeguard the mental well-being of older adults and reduce the risk of suicide.

The moral dilemma of obstetric violence: A meta-synthesis

Although the global healthcare system is paying increasing attention to obstetric violence, this form of gender-based violence during childbirth remains a serious issue. The primary objective of this comprehensive study is to explore the experiences and needs of women subjected to obstetric violence on a global scale. A systematic search was conducted in December 2024 across the Web of Science, Embase, PubMed, and CINAHL databases to identify eligible studies. Data synthesis was performed using the three-stage thematic and content analysis method. A total of 39 eligible qualitative studies were included in this review. Thematic synthesis identified 6 themes and 17 sub-themes: (1) Obstetric Violence Types; (2) Gaslighting Effect: The Authoritative Position of Healthcare Providers; (3) Stigmatization and Discrimination Experienced by Women; (4) Who is Normalizing Obstetric Violence? (5) Substandard Medical Institutions; (6) Trauma Induced by Obstetric Violence. Obstetric violence continues to persist in various countries and regions. Women have endured various forms of obstetric violence, with their autonomy and rights to informed consent being severely compromised. They have experienced neglect and abandonment by healthcare providers, and face discrimination and differential treatment due to factors such as race, socioeconomic status, age, and culture. The primary cause of obstetric violence is the unequal power dynamics between healthcare providers and women, with the authoritative position of healthcare providers leading to a lack of communication and recognition between both parties.

Current Status of Nursing Home Distribution in China: A National Cross-Sectional Study

AIMS

Population aging is a challenge that the whole world is facing, especially in China. This study aims to investigate the current distribution status of nursing homes in China using spatial epidemiology methods.

DESIGN

Cross-sectional study in China.

METHODS

The data were obtained from the Integrated Civil Affairs Government Service Platform 'China County Statistical Yearbook' for 2020 and the 'China City Statistical Yearbook' for 2020. Using global Moran's index to test the clustering of nursing homes, inter-group and intra-group Theil index was utilised to differentiate the sources of differences. The coupling coordination analysis was conducted to explore the coordination. Geographically weighted regression was utilised to investigate the impact of economic development and aging on nursing home resources. All analyses were conducted by Arcgis 10.8 and R Studio 4.3.2.

RESULTS

Global Moran's index indicated that the distribution of nursing homes in China exhibited clustering. The Theil index values for institutions and beds at the national county were 0.32450 and 0.30675. However, upon comparing provinces and regions, it was found that the differences across the country mainly stem from within provinces (contribution rate: institutions 65.0%; beds 73.0%) and within regions (contribution rate: institutions 99.0%; beds 91.0%). The majority of districts and counties had a coupling coordination index of institutions and bed numbers, both of which were < 0.5.

CONCLUSION

The development of nursing home resources in China has been rapid, generally presenting a balanced state, but further optimisation is needed. This study established a foundation for the targeted distribution of essential public services, focusing on nursing home healthcare resources tailored to the needs of older persons.

IMPLICATIONS

The study underscored the urgent need for targeted elderly care policies, emphasising the optimisation of resource distribution to enhance the overall quality of care provided to the aging population.

NO PATIENTS OR PUBLIC CONTRIBUTION

The study did not involve humans.

Frailty and all-cause and cancer-related mortality in cancer patients: A prospective cohort study

PURPOSE

To evaluate the associations between frailty and all-cause and cancer-related mortality. Additionally, the objective is to compare the magnitude of these associations between older adults and younger adults.

METHODS

We gathered baseline data from NHANES (1999-2018) and developed a cumulative index consisting of 39 items to evaluate frailty. The National Death Index database was utilized to track the survival status of individuals. The Cox regression model was employed to estimate the associations between frailty status and all-cause and cancer-related mortality.

RESULTS

Ultimately, 3398 cancer patients were included in the analysis, comprising 910 younger adults and 2488 older adults. Compared to non-frail patients, the elevated all-cause and cancer-related mortality among pre-frail patients was not statistically significant (HRs = 1.312, 95%CI: 0.956-1.800, P = 0.092; HRs = 1.462, 0.811-2.635, P = 0.207). However, a significant elevation of both all-cause and cancer-related mortality risk was observed among frail patients (HRs = 2.213, 1.617-3.030, P < 0.001; HRs = 2.463, 95%CI = 1.370-4.429, P = 0.003). Frailty individuals demonstrated a more pronounced association with the prediction of all-cause mortality in younger (HRs = 2.230, 1.073-4.634, P = 0.032) than in older adults (HRs = 2.090, 1.475-2.960, P < 0.001). Sensitivity analysis consistently revealed robust results. RCS plots suggested a progressively escalating dose-response correlation between frailty and both all-cause and cancer-related mortality risk.

CONCLUSIONS

Pre-frailty did not result in an increase in mortality risks compared to non-frailty. However, frailty caused a higher all-cause and cancer-related mortality risk than non-frailty. Identifying those at risk and implementing targeted interventions may contribute to extending healthy life expectancy, regardless of age.