Search Results (822)

Background/Objectives: Viral hepatitis A–E represents a significant public health problem. Data on the prevalence of viral hepatitis markers among alcoholics are inconsistent. Methods: The study included 151 patients treated for alcohol abuse in one Croatian center. The control group consisted of 110 individuals from the general population tested for a routine check-up. The prevalence of viral hepatitis markers was assessed using serology and molecular methods. Results: The prevalence rates of hepatitis markers among patients were as follows: anti-HAV, 15.2%; anti-HBs, 11.9%; anti-HBc/anti-HBs, 2.6%; anti-HCV, 4.0%; and anti-HEV, 14.6%. HCV RNA was detected in one patient (0.6%). Compared with the control group, patients showed significantly higher HCV seroprevalence (4.0 vs. 0%), while the prevalence of other hepatitis markers did not differ significantly between the groups. The anti-HAV prevalence was associated with age (from 0% in patients aged <40 years to 42.9% in patients aged 60+ years), employment status (highest among retired individuals at 46.2%), and age of occasional alcohol consumption (highest seroprevalence of 26.3% in those who reported consumption between 22 and 25 years). The association between anti-HEV and educational level was of borderline significance. Logistic regression showed that older and retired patients and those who consumed alcohol occasionally between 22 and 25 years showed higher odds for HAV seropositivity (OR = 11.454–49.400, OR = 6.857, and OR = 4.464, respectively). Patients with university degrees were at lower risk for HEV seroprevalence (OR = 0.083). Conclusions: Alcoholic patients showed a higher HCV seroprevalence than the general population, while the prevalence of other viral hepatitis markers did not differ between the groups. Further studies on a larger cohort of patients are needed to confirm these findings. Full article

Background/Objectives: Greece has been a major host country for refugee populations, operating under conditions of limited resources and strained healthcare services. Refugee women residing in accommodation facilities face barriers to accessing primary prevention and health promotion services, including limited health literacy and cultural and linguistic challenges. This study aimed to assess the level of primary prevention and health promotion among refugee women living in accommodation facilities in Greece and to identify their health needs and barriers to accessing healthcare services. Methods: A quantitative cross-sectional study was conducted among 150 adult refugee women residing in the Malakasa accommodation facility in Greece. Participants voluntarily agreed to take part in the study. Data were collected between December 2024 and March 2025 using a structured questionnaire assessing sociodemographic characteristics, primary prevention, health promotion, and barriers to healthcare access. Descriptive statistical analysis was performed. The study was approved by the relevant ethics committee, and informed consent was obtained from all participants. Results: The study included 150 refugee women, primarily young adults with low educational attainment. Familiarity with primary prevention was reported as moderate or lower by the majority of participants, with only 24% indicating high or excellent familiarity, while familiarity with health promotion was even lower (8%). Participation in preventive practices varied, with 42.7% reporting frequent health check-ups; however, uptake of key preventive behaviors remained limited, including vaccination (30%) and adoption of a healthy diet (32.7%). During their stay in Greece, 97.3% participated in regular health check-ups, 32.7% adopted a healthy diet and 30% were vaccinated. Cardiovascular and gynecological conditions were the most frequently reported health problems (76.7% and 73.3%, respectively). The most prominent barrier to healthcare access was long distance from health facilities (97.3%), followed by lack of information or health education (24.7%). Conclusions: The study identified low levels of preventive health knowledge and limited uptake of key preventive practices among refugee women, alongside persistent barriers to healthcare access, underscoring the need for targeted and culturally sensitive health promotion interventions. Full article

Background: This study compared the reasons for dental presentations between Indigenous and non-Indigenous Australian adults at the Nepean Centre for Oral Health, NSW, Australia. Methods: A retrospective cohort study was conducted on adult patients presenting between 1 July and 31 December 2019. Clinical notes were audited and categorized as either ‘emergency’ (pain, dental infection, dental trauma, loose teeth or dental implants, bleeding) or ‘conservative’ (dental check-ups, examinations, prosthodontic, restorative, periodontal, or non-emergency endodontic therapy). Results: A total of 4663 patients met the inclusion criteria; 61.6% were female, and 6.4% were identified as Indigenous Australians. Overall, 41.3% of presentations were for emergency dental care. Indigenous Australians were significantly more likely to present for dental emergencies compared with non-Indigenous (58.2% vs. 40.2%; χ²(1, N = 4663) = 53.4, p < 0.00001; OR = 2.07, 95% CI: 1.64–2.63), and were also more likely to undergo emergency tooth extractions (p < 0.05). Conclusions: Indigenous Australians demonstrated a higher proportion of emergency and oral surgery-related presentations and underwent tooth extractions as the primary treatment compared to their non-Indigenous counterparts. These findings suggest a higher burden of oral disease and delayed access to general dental services among Indigenous Australians, highlighting the need for targeted and culturally appropriate public health interventions. Full article

Grassroots recyclers play a fundamental role in solid waste management in Ecuador; however, they often work under precarious conditions that may compromise their health. This study aimed to identify factors associated with nutritional status, operationalized as the presence or absence of nutritional alterations, among grassroots recyclers through supervised machine learning approaches. Data from 303 recyclers from three Ecuadorian cities (Cuenca, Macas, and La Libertad) were analyzed, incorporating sociodemographic, occupational, and health-related variables. Nutritional alterations were defined based on anthropometric and biochemical indicators, specifically, excess body weight and/or elevated total lipid levels. The results showed that 71% presented nutritional alterations, evidencing an important public health problem in this vulnerable population. Significant associations were observed with sex, age, canton of residence, ability to ride a bicycle, bicycle use for work, and attendance at medical check-ups. Among the evaluated models, CatBoost trained with SMOTE achieved the highest ROC-AUC value and the most balanced performance between classes, although sensitivity for individuals without nutritional alterations remained limited. Feature importance analysis highlighted sociodemographic, occupational, economic, and healthcare access factors, underscoring the multidimensional nature of nutritional risk and supporting the use of machine learning as a support tool for public health planning and targeted interventions. Full article

Background and Objective: This study examines the factors associated with child undernutrition among children under five in Ethiopia, Kenya, Madagascar, and Tanzania. It uses the Composite Index of Anthropometric Failure to measure the full burden of undernutrition, combining weight-for-height (WHZ), weight-for-age (WAZ), and height-for-age (HAZ) indicators. This approach captures children facing multiple forms of failure that single indicators miss. Methods: The study analyzed 37,570 children using nationally representative Demographic and Health Survey (DHS) data for Ethiopia 2019, Kenya 2022, Madagascar 2021, and Tanzania 2022. A binary logistic regression model identified key predictors of child undernutrition across countries. Results: The prevalence of anthropometric failure ranged from 24% to 44%. Higher parental education, child’s age, socioeconomic status, child’s sex, and a postnatal checkup within 2 months were associated with a lower odds of anthropometric failure. Children of educated mothers in Ethiopia (AOR = 0.547) and Tanzania (AOR = 0.606) had better outcomes. Educated fathers in Kenya (AOR = 0.589) and Madagascar (AOR = 0.369) reduced the risk of child undernutrition. Children aged 13–24 months had a higher risk in all countries. In Madagascar (AOR = 0.309), children who received a postnatal checkup had a decreased risk of malnutrition. Children from rich households in Ethiopia (AOR = 0.645) and from middle (AOR = 0.683) and rich (AOR = 0.535) households in Kenya had significantly lower odds of undernutrition. In comparison, female children had lower odds of anthropometric failure in all four countries. Conclusions: Viewed through a nutrition equity lens, these findings underscore the importance of recognizing how the intersectionality of anthropometric failures disproportionately affects children from poorer households and communities with limited access to education and postnatal care. This study advances existing knowledge by using the Composite Index of Anthropometric Failure to show overlapping and hidden forms of undernutrition. The findings identify child age, parental education, postnatal checkup, child sex, and socioeconomic status as shared priorities for reducing undernutrition. The results provide country-specific insights for designing integrated, evidence-based nutrition interventions in Eastern Africa. Full article

Background: Specific health checkups in Japan aim to prevent and detect non-communicable diseases (NCDs). Lifestyle information and non-invasive measurements obtained during these checkups are valuable for population health monitoring. This study aimed to develop a predictive model for type 2 diabetes mellitus (T2DM) using only non-invasive measurements and to identify key predictors. Methods: A retrospective observational study was conducted using linked health checkup records and medical claims from a city in Japan. Logistic regression was performed to predict a T2DM diagnosis. Results: A total of 409 of the 1363 participants were diagnosed with T2DM, including 285 of the 950 participants aged 40–74 years and 124 of the 413 participants aged ≥75 years. The model achieved an area under the receiver operating characteristic curve of 0.680 for those aged 40–74 years and 0.665 for those aged ≥75 years, indicating moderate discrimination. Key predictors included male sex, use of antihypertensive drugs, walking speed, and eating habits within 2 h before bedtime. In particular, male sex, having a slower walking speed, and not eating within 2 h before bedtime were positively associated with T2DM diagnosis. Conversely, the absence of antihypertensive or lipid-lowering medications was negatively associated with T2DM diagnosis. Conclusion: A model based solely on non-invasive measurements moderately identified individuals at risk for T2DM in this community-based Japanese population. Routinely collected health checkup data may support early identification and targeted preventive strategies. Full article

Background/Objectives: Skin carotenoid measurements have been proposed as an indicator to reflect of fruit and vegetable intake, but evidence from occupational settings remains limited. The primary aim of this study was to assess the association between fruit and vegetable intake and skin carotenoid levels in the workplace. The secondary aim was to examine the association of skin carotenoid levels with blood glucose levels and blood pressure (BP). Methods: This cross-sectional study included Japanese workers aged ≥20 years between 2022 and 2023. Skin carotenoid levels were measured, dietary intake was assessed using self-administered questionnaires, and data from workplace health check-up records were collected. Multiple regression analysis was conducted to examine the association between skin carotenoid levels and fruit and vegetable intake in 210 participants. Associations between skin carotenoid levels and log-transformed glycated haemoglobin (HbA1c), fasting blood glucose (FBG), systolic BP, and diastolic BP levels were examined in 162, 158, and 183 participants, respectively. Results: Skin carotenoid levels were positively associated with the number of vegetable dishes consumed and the frequency of fruit intake. A slight positive association was observed with HbA1c levels (partial regression coefficient = 0.00012), whereas no associations were found with FBG or BP. Conclusions: Skin carotenoid levels reflect self-reported fruit and vegetable intake, supporting their potential use as a non-invasive dietary assessment tool in workplace nutrition education. However, the associations observed with HbA1c were very small and of limited clinical significance, and the results should be interpreted with caution. Full article

Background/Objectives: In Romania, the oral health status of schoolchildren is insufficiently documented at the national level. This is due to the lack of systematic oral health reporting and fragmented access to dental care services. Methods: In this context, the main factors influencing schoolchildren’s access to dental services were identified through a triangulation approach that integrated documentary research, routine data on health service coverage, and oral health indicators collected through a survey conducted on 3843 schoolchildren. Results: The results highlight a multitude of interdependent factors that shape children’s access to dental care, namely policy-level constraints, dental workforce distribution and individual-level determinants—and provide insight into how public health policies can be adapted to more effectively meet the needs of this group. Conclusions: Despite legislative provisions on children’s oral health care in Romania, territorial disparities persist, and the use of preventive services remains low. These findings underscore the need for national- and county-level public health policies to improve access, promote preventive dental check-ups, strengthen health literacy, and develop targeted programs specifically dedicated to school-age children. Full article

Background/Objectives: Blood biomarkers for estimating alcohol consumption are useful for preventing alcohol-related harms. Although there are conventional blood biomarkers of heavy alcohol drinkers, it remains to be clarified whether their combination is useful for estimation of excessive alcohol consumption from the viewpoint of preventing hypertension. Methods: Participants included 8172 men aged from 31 to 70 years who had undergone health checkups. Overall, participants were classified into three groups of nondrinkers, occasional drinkers, and regular drinkers by frequency; regular drinkers were further classified into four groups of light (<22 g/day), moderate (≥22 and <44 g/day), heavy (≥44 and <66 g/day), and very heavy drinkers (≥66 g/day) according to the amount of average daily alcohol consumption. The relationships of blood biomarkers (mean corpuscular volume [MCV], gamma glutamyl transferase [GGT], and HDL cholesterol [HDL-C]) and their products with alcohol consumption were investigated by using correlation analysis and receiver-operating characteristics (ROC) analysis. Results: Seven variables of blood biomarkers and their products were significantly correlated with frequency and amount of alcohol consumption, and the degrees of the correlations were stronger in the following order: HDL-C alone < product of MCV and HDL-C < MCV alone < GGT alone < product of MCV and GGT < product of GGT and HDL-C < product of MCV, HDL-C and GGT. In the ROC analysis, the area under the ROC curve for the relationship between the product of MCV, HDL-C, and GGT (named the alcohol consumption index [ACI]) and excessive alcohol intake (22 g/day or more) was 0.819 (95% confidence interval: 0.809–0.830), and the cutoff of this index was 194,863 with a sensitivity and specificity of 0.745 and 0.751, respectively. The positive predictive value was 69.2%. Conclusions: Among the three conventional blood biomarkers and their combinations, ACI demonstrated the strongest associations with alcohol consumption and excessive alcohol intake in men. Although the combined biomarkers are unlikely to be useful as a diagnostic tool, there is a possibility of future application by integrating ACI with recent biomarkers including carbohydrate-deficient transferrin for estimation of alcohol consumption. Full article

Background: This retrospective cohort study developed an artificial intelligence (AI) model to predict incident dementia and evaluated its predictive performance using a validation cohort. The study participants were 7384 older adults (age ≥ 75 years) who underwent regional dental checkup in Gifu Prefecture, Japan, in 2018 and 2020. Methods: The National Database of Health Insurance of Japan (NDB) was integrated with dental checkup data, and the participants were randomly divided into two datasets: training (n = 5169) and validation (n = 2215). A data analytics tool was utilized to create the AI model with training data in 2018 and data on the presence or absence of dementia development in 2020. Results: The AI model trained solely on NDB data showed a sensitivity of 0.73 and specificity of 0.91 in predicting the presence or absence of dementia development after 2 years. By contrast, the AI model trained on NDB and dental checkup data showed a sensitivity of 0.75 and specificity of 0.95, indicating improvement in both metrics. Conclusions: Combining different sets of data, such as NDB and dental checkup data, for training may be useful for improving the accuracy of AI models to predict dementia development. Full article

Background: Coronavirus disease 2019 (COVID-19) vaccines deliver mRNA packaged in lipid nanoparticles via intramuscular injection. This study investigated several factors influencing antibody production patterns and adverse reactions after vaccination with COVID-19 vaccines. Methods: Among the participants of the Iwaki Health Promotion Project (IHPP), 211 individuals who consented to this study were surveyed regarding antibody titers and adverse reaction symptoms following vaccination. A machine learning approaches such as ridge regression, elastic-net, light gradient boosting, and neural network were applied to extract the variables, and Bayesian network analysis was applied to explore causal relationships between health data and the multi-omics dataset obtained from the IHPP health checkups. Results: Females with lower levels of free testosterone experienced more adverse reactions than males. Moreover, the immune system is more active in younger individuals, causing adverse reactions and higher antibody production. The Spikevax vaccine induced adverse reaction symptoms with higher antibody production in cases of fever. Meanwhile, drinking 2–3 cups of green tea daily seemed to be effective in increasing antibody production. Factors increasing side effect risk include blood natural killer cell count and muscle quality in the vaccinated arm. Plasma metabolome metabolite concentrations, tongue coating bacterial colonization, and folate intake were also identified as factors influencing side effect risk. Furthermore, characteristics of participants at risk for fever symptoms included longer telomere length, higher antibody production patterns, and higher CD4-positive T cell counts. Conclusions: Further investigation of these identified influencing factors is expected to clarify the rationale for new vaccine development and identify lifestyle and dietary habits that enhance vaccine efficacy. Full article

Weight loss is an indicator of nutritional disorders, is associated with increased morbidity and mortality, and is more likely to be experienced by individuals with fewer teeth. In this study, we examined the relationship between 1-year body weight changes and variations in various oral function tests. In total, we examined 104 individuals aged 45–84 years (70 men and 34 women) who underwent health check-ups at our hospital in 2023 and 2024. Several oral function tests were performed, and changes over a 1-year period were compared using the Wilcoxon signed-rank test. The rate of change in oral function was compared between individuals who lost ≥5% of their body weight in 1 year and those who did not; no significant differences in body weight and oral function were observed between 2023 and 2024, and no significant differences in the rates of change in oral function or weight loss were observed based on sex and age. The rates of change in occlusal force and masticatory function were significantly correlated with weight loss rates, while no differences were observed in terms of sex or age between those who lost ≥5% of their body weight in 1 year and those who did not; the only significant difference was in occlusal force: weight loss was correlated with occlusal force over 1 year, with individuals who lost ≥5% of their body weight exhibiting significantly lower occlusal force, a risk factor for nutritional disorders. Full article

Background: In recent years, electronic patient-reported outcome (ePRO) systems on electronic devices, such as smartphones, have been employed to collect patients’ self-assessments and symptom reports. However, these studies were limited to younger populations and patients with severe diseases. Objective: This study aimed to evaluate the ease of use and response continuity of an ePRO system used by healthy middle-aged and older adults. Methods: This prospective observational study included participants aged 40–74 years undergoing specific health checkups. The System Usability Scale (SUS) was used to assess ePRO usability. Response continuity was evaluated by assessing EuroQol 5-Dimensional 5-Level responses once a month for up to 3 months after the health checkup date. Results: Eleven participants, aged 47–73 years, participated in the study. The mean SUS on the screening date was 59.1 (95% CI: 50.0–68.1; a cut-off of 70 indicated “useful”). However, only one participant failed to complete the ePRO at one and two months post-examination, and responses were obtained from all participants at three months. Conclusions: Due to the small sample size, usability as measured by the SUS should be interpreted descriptively. While initial onboarding appeared to be a major implementation barrier, sustained monthly ePRO reporting over 3 months was achievable among participants who completed registration with support, suggesting the conditional feasibility of response continuity in this preventive health checkup setting. Full article

Background/Objectives: The Achilles tendon is the largest tendon in the human body; it is frequently ruptured during sports and other dynamic physical activities. The purpose of this study was to compare recovery patterns over time between injuries to the dominant (DMT) and non-dominant (NDMT) limbs, and to examine differences in the limb symmetry index (LSI) for the uninjured side. Methods: This study includes a retrospective analysis of individuals who completed a standard rehabilitation program for 12 months and had regular checkups every three months. The study sample comprised 17 patients with DMT injuries and 17 patients with NDMT injuries, all active male recreational participants who underwent surgical repair of an Achilles tendon rupture. Outcome measures included dorsiflexion range of motion (ROM), calf circumference, plantarflexion strength, hop test performance, and the Y-Balance Test (YBT). Results: Both groups demonstrated continuous, progressive improvement in ROM, plantarflexion strength, hop test distance, and YBT scores, showing a significant main effect of time (p < 0.05). Although DMT showed greater strength than NDMT at 6 and 9 months, this difference was no longer significant at 12 months (p > 0.05). In all three YBT directions, the DMT group achieved greater reach distances than the NDMT group at 12 months (p < 0.05). At the final follow-up, both groups exceeded 90% LSI in ROM, calf circumference, plantarflexion strength, and hop performance (p < 0.05). However, in the YBT, only the DMT group surpassed 90% LSI, whereas the NDMT group showed poorer recovery. Conclusions: ROM, calf circumference, and muscle strength ultimately showed no significant differences between groups, but dynamic balance recovery was superior in the DMT group. These findings suggest that clinicians and rehabilitation specialists should consider leg dominance when designing rehabilitation programs. Full article

Background: Despite its crucial role in overall health, oral health is frequently overlooked within healthcare systems, partly due to the misconception that oral diseases are neither life-threatening nor directly disabling. This perception has led to an underestimation of the psychological, social, and economic burden associated with oral diseases. Τhe present study aimed to assess oral health status and oral health-related quality of life among dental patients attending a public Special Care Center in Greece. Methods: A cross-sectional study was conducted among 400 dental patients aged 18 years and older who visited a public Special Care Center for a routine check-up or a dental problem between September and October 2024. Data was collected through personal interviews and clinical examinations after informed consent was obtained. Oral health-related quality of life was evaluated using the Oral Health Impact Profile-14 (OHIP-14) and the Oral Impacts on Daily Performance (OIDP) questionnaires. Categorical variables were presented as absolute and relative frequencies, while quantitative variables were summarized as mean, standard deviation, median, minimum, and maximum. Normality was assessed using the Kolmogorov–Smirnov test. Bivariate analyses and multivariate linear regression models were performed, with statistical significance set at p < 0.05. Statistical analyses were conducted using IBM SPSS 23.0. Results: The majority of participants were female (56.3%) with a mean age of 50.4 years (SD = 14.9). Overall oral health-related quality of life was moderate (OHIP-14: Mean = 21.0, SD = 14.8; OIDP: Mean = 14.0, SD = 12.8). Patients who attended the center due to a dental problem reported significantly poorer oral health outcomes than those attending routine check-ups (p < 0.001). Poorer self-rated oral health, having ≥12 missing teeth, prosthetic restoration, and foreign nationality were significantly associated with worse oral health-related quality of life. Conclusions: Dental patients attending the Special Care Center demonstrated moderate oral health status, which was associated with psychological distress, physical disability, and social limitations. These findings underline the need for targeted public oral health interventions, especially for vulnerable population groups. Full article