Search Results (812)

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

Background: In Bangladesh, a number of sex workers are involved in commercial sex work in different brothels in both legal and illegal settlements due to reasons such as lack of social support, depression, forced sex, abuse, violence, polyamory, being kidnapped, and unemployment. In this study, we tried to evaluate the demographic characteristics and prevalence of viral and sexually transmitted diseases (STDs) among the study population. Methods: A total of 250 female sex workers were interviewed and tested from the Daulatdia brothel of Rajbari district, Bangladesh, who had been working there for at least 1 month. Through questionnaires, demographic data were collected. Primarily, lateral flow immunoassay (LFIA) tests were used to investigate HCV (Hepatitis C Virus), HBV (Hepatitis B Virus), and Syphilis, which were reconfirmed using enzyme-linked immunosorbent assay (ELISA) in cases of positive results. Results: The mean age was 27.51 ± 6.69 years with a range of 18–50 years. Most of them (n = 243, 97.98%) had elementary knowledge of STDs. We determined that overall, 96 (38.40%) were positive for either of these diseases. Individually, 10 (4.00%), 18 (7.20%), and 68 (27.20%) were positive for HCV, HBV, and syphilis, respectively. Conclusions: Our observation indicates that females of all ages should be strictly protected from forced sex work. Current sex workers should be educated regarding the dangers and protective mechanisms of STDs. In addition, as a public health concern, regular clinical check-ups and STD associated diagnoses are necessary to ensure the safety of FSW from these highly infectious and concerning diseases. Due to their socio-economic condition, proper treatment and rehabilitation are highly recommended. Full article

Background and Objectives: Early detection of chronic diseases is essential for improving health outcomes and reducing long-term complications. In Poland, the POZ PLUS pilot programme introduced the Health Check-up (Bilans Zdrowia, BZ) tool, a structured preventive assessment designed to support early identification of chronic conditions in primary care. This study aimed to assess the association between participation in the Health Check-up and the detection (diagnostic yield) of hypertension, type 2 diabetes, lipid metabolism disorders, elevated fasting blood glucose, hypothyroidism, and non-toxic goiter by comparing outcomes in an intervention group and a control group. Materials and Methods: A non-randomised comparative study was conducted using routine clinical data from Health Check-ups performed within the POZ PLUS pilot. Detection rates were compared with those obtained in standard primary care practice during the same period. The study group consisted of 865 adults who met the inclusion criteria and underwent the BZ procedure, while the control group comprised 3199 patients with comparable eligibility who received usual care. Data analysis was performed using R and RStudio. Results: Hypertension detection was similar in both groups: 4.6% (95% CI: 3.3–6.3%) in the intervention group versus 4.5% (95% CI: 3.8–5.3%) in the control group (p = 0.9505). No significant difference was observed in type 2 diabetes detection: 0.7% (95% CI: 0.3–1.5%) versus 0.4% (95% CI: 0.2–0.7%) (p = 0.4134). In contrast, detection rates were significantly higher in the Health Check-up group for lipid metabolism disorders (10.3% vs. 2.6%; p < 0.001), abnormal fasting glucose (2.9% vs. 1.8%; p = 0.0465), and thyroid diseases, including hypothyroidism and non-toxic goiter (4.3% vs. 2.3%; p = 0.0016). Conclusions: The Health Check-up tool was associated with higher detection rates of lipid disorders, impaired fasting glucose, and thyroid diseases compared with usual care, suggesting increased diagnostic yield under a structured preventive assessment pathway. Further research should evaluate downstream clinical outcomes and cost-effectiveness. Given the non-randomised design and differential diagnostic intensity between groups, these findings should be interpreted as associations with diagnostic yield rather than causal effects on disease incidence or clinical outcomes. Full article

Background/Objectives: High-density lipoprotein cholesterol (HDL-C) regulates muscle energy metabolism and function, enhancing glucose uptake and promoting glycogen synthesis. However, studies on the association between HDL-C levels and sarcopenia remain controversial. We therefore investigated the association between HDL-C levels and sarcopenia in elderly Koreans. Methods: This cross-sectional study was based on previously collected, anonymous health checkup data. Participants included 3776 individuals aged 65 years and older who underwent body composition analysis using a bioelectrical impedance meter during a health checkup in 2024. Sarcopenia was defined as an appendicular skeletal muscle index of <7.0 kg/m² for males and <5.7 kg/m² for females. Logistic regression analyses were performed for each variable, including HDL-C levels, to identify sarcopenia association expressed as odds ratios (ORs). Participants were further divided into four quartiles according to HDL-C levels, and comparative multivariable analyses were performed, with the quartile with the lowest HDL-C level serving as the reference. Results: Of the 3776 Koreans with a mean age of 70.5 years, sarcopenia was diagnosed in 23.1% (n = 872) of participants. Sarcopenia prevalence showed a steadily increasing trend from the lowest quartile group (Q1, n = 977) with HDL-C levels ≤48 mg/dL to the highest quartile group (Q4, n = 974) at ≥67 mg/dL (p < 0.001). After adjusting for sarcopenia-associated risk factors, a significant association was found between the condition and HDL-C levels (OR 1.01, 95% CI 1.00–1.02; p = 0.008). Q4 showed a consistent sarcopenia association compared with Q1, even after adjusting for all variables (OR 1.36, 95% CI 1.05–1.75; p = 0.018). Conclusions: In Koreans aged 65 years and older, we found an association between high HDL-C levels and sarcopenia. Full article

Background/Objectives: This study aimed to examine awareness and behaviors related to injury prevention in the home among community-dwelling older adults according to age and gender. Methods: In this cross-sectional descriptive study, 299 adults aged ≥65 years who visited 10 senior welfare centers in Korea were included. Data were collected through structured face-to-face interviews using a questionnaire assessing general characteristics, awareness, and behaviors related to home injury prevention. Descriptive statistics, the chi-squared test, independent t-test, and one-way analysis of variance were used for data analysis. Results: Levels of interest in home injuries and awareness of first aid differed significantly by age and gender. The possession of a home emergency kit and participation in regular health check-ups varied by age, while the intention to participate in injury-prevention education differed by gender. Overall, female participants demonstrated higher levels of injury-prevention behavior than male participants. Conclusions: Older adults showed lower awareness and practice of specific home injury–prevention strategies, while women exhibited greater awareness and preventive behaviors than men. These findings suggest that tailored home injury–prevention interventions that consider age and gender characteristics may yield more effective and positive outcomes. Full article

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) has been linked to dietary fat quality and polyunsaturated fatty-acid metabolism. We evaluated whether dietary n-6 fatty-acid intake, serum dihomo-γ-linolenic acid (DGLA), and desaturase-based indices for Δ5-desaturase (D5D) and Δ6-desaturase (D6D) are associated with MASLD. Methods: We conducted a cross-sectional analysis within the HOZUGAWA health checkup cohort in Japan (n = 289; 100 MASLD, 189 non-MASLD). Participants underwent hepatic ultrasonography, dietary assessment using the Brief Self-Administered Diet History Questionnaire, and fasting serum metabolomics by gas chromatography–mass spectrometry with solid-phase dehydration derivatization. Enzyme indices were defined as the D5D index = arachidonic acid/DGLA and the D6D proxy index = DGLA/linoleic acid (hereafter referred to as the D6D index) because γ-linolenic acid was not measured. Natural-log-transformed D5D index, D6D index, DGLA, and total dietary n-6 fatty-acid intake were entered into multivariable logistic regression models for MASLD adjusted for age, sex, BMI, alcohol intake, and total energy. Results: Compared with non-MASLD, MASLD showed higher serum DGLA, lower D5D index, and higher D6D index (all p ≤ 0.005), with no between-group differences in total energy intake, linoleic acid, total polyunsaturated fatty acids, or total dietary n-6 fatty-acid intake. Higher ln D5D was independently associated with lower odds of MASLD (OR 0.62, 95% CI 0.42–0.86), whereas higher ln D6D index (OR 1.42, 95% CI 1.04–1.95) and ln DGLA (OR 1.62, 95% CI 1.13–2.43) were each positively associated. Total dietary n-6 fatty-acid intake was not independently associated with MASLD. Conclusions: In this Japanese health examination cohort, an imbalance in estimated desaturase activities—lower D5D index and higher D6D index—together with higher serum DGLA was independently associated with MASLD, whereas n-6 intake showed no group difference or independent association. These findings suggest that enzyme-linked endogenous n-6 metabolic status may be more closely related to the MASLD phenotype than intake quantity alone. Full article

Objectives: In the absence of massive screening programs, it is imperative to develop and validate a candidate selection strategy for opportunistic endoscopic screening (OES) targeting the early detection of gastric cancer. Methods: A hospital-based cross-sectional study was conducted, enrolling both health check-up controls and gastric cancer patients. Data collection included two components: (1) a questionnaire including demography, self-reported comorbidities, and family history of cancers; (2) serology including hemoglobin, carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9). Associations between potential variables and gastric cancer risk were assessed and the predictive efficacy of these risk factors was quantified. Sequentially, risk stratification scoring systems were constructed and their cost-effectiveness profiles were evaluated. Results: A total of 58,218 participants were included in the analysis, among whom 619 (1.1%) were gastric cancer patients. Multivariate analyses identified male, age >40 years, family history of gastric cancer, comorbidities of upper digestive tract benign diseases (UDTBDs), anemia, and elevated serum CEA and/or CA19-9 as independent risk factors of increasing gastric cancer risk. Cost-effectiveness analysis demonstrated that individuals, especially those symptomatic, presenting any of following conditions should be recommended for OES: (1) age ≥50 years, (2) family history of gastric cancer, and/or (3) comorbid UDTBDs. Elsewise, unclear anemia and/or elevated serum CEA and/or CA19-9 presenting among males and/or persons 41–50 years of age should be considered for OES. Notably, this selection strategy achieved a detection rate comparable to that of alternative protocols while yielding superior cost-effectiveness outcomes. Conclusions: The integrated strategy combining questionnaire and sequential serology represents an effective and cost-effective approach to identifying high-risk candidates for gastric cancer OES. Further investigations are warranted to develop more precise and tailored screening and surveillance protocols, with the aim of optimizing both detection rates and cost-effectiveness in clinical practice. Full article

The Japanese version of the eHealth Literacy Scale (J-eHEALS) measure has primarily been applied to younger populations; however, the psychometric properties of the J-eHEALS in older adults have not been investigated. Therefore, in this cross-sectional study, we aimed to evaluate the psychometric properties of the J-eHEALS in community-dwelling older adults. A total of 553 adults aged ≥ 65 years (mean age, 73.5 years) attending routine health checkups in a single Japanese municipality completed the J-eHEALS and the Japanese version of the 12-item Health Literacy Scale (J-HLS-Q12). We examined internal consistency, item characteristics, factorial validity using exploratory and confirmatory factor analyses, measurement invariance by sex, and convergent and criterion-related validity with general health literacy. The J-eHEALS scores indicated moderate to slightly low perceived eHealth literacy in this population. The scale demonstrated excellent internal consistency (Cronbach’s α = 0.94), a stable unidimensional factor structure with acceptable model fit across sexes, and moderate positive associations with general health literacy. Overall, these findings support the J-eHEALS as a reliable and valid instrument for assessing perceived eHealth literacy in older Japanese adults and its suitability for use in research and practice. Full article

A constantly increasing incidence of chronic diseases is a challenge for healthcare worldwide, being directly associated with physical inactivity, which is considered an important cause of most chronic diseases. In contrast, physical exercise has been proven as a powerful instrument of healthcare to protect individuals against health-to-disease transition and against disease progression. Nonetheless, a number of studies warn against inappropriate high-intensity and/or unaccustomed exercise that exceeds an individual’s physical capacity. Indeed, extensive cardiac activity during prolonged exercise leads to significantly increased cardiac dimensions, triggering cardiac complications that may result in arrhythmogenic sudden cardiac death. The remarkable plasticity of mitochondria allows these organelles to sense and adapt to a variety of stressors and respond to stimuli by molecular signalling, regulating bioenergetics and cellular homeostasis, decisive for repair processes, proliferation, apoptosis, and tissue regeneration to combat degeneration, with whole body outcomes. Mitochondria act as biosensors in the human body; they are reactive to stimuli and protective against health-to-disease transition. To perform this life-important function throughout life, mitochondria need supportive measures, including physical activity, considered an essential pillar of mitochondrial medicine. This article highlights reciprocity between the quality of mitochondrial health and homeostasis on one hand and physical fitness and exercise intervention on the other hand. The proposed novelty relates to the monitoring of mitochondrial homeostasis, which is strongly recommended for creating individualised training programmes, and monitoring exercise efficacy during and after the programme is completed. To this end, a patient-friendly non-invasive approach is already established, utilising tear fluid multi-omics, mitochondria as the vital biosensors, and AI-based multi-professional data interpretation. Full article

Regular assessment of aerobic capacity is important in sports medicine and preventive health; however, cardiopulmonary exercise testing (CPX) is often impractical in field or clinical settings. Phase angle (PhA), derived from bioelectrical impedance analysis (BIA), has been proposed as a practical indicator of cellular health and membrane integrity; however, its relevance to aerobic capacity relative to skeletal muscle mass percentage (SMM%) in healthy young adults remains unclear. This cross-sectional study investigated the independent associations of PhA and SMM% with peak oxygen uptake (VO₂peak) and oxygen uptake at the anaerobic threshold (VO₂AT). Forty-one adults underwent same-day BIA and CPX using a cycle ergometer. VO₂peak was obtained from 37 participants who achieved maximal effort, while VO₂AT was identified in all. In multiple regression analyses adjusted for sex, PhA was independently associated with both VO₂peak and VO₂AT, whereas SMM% showed no independent association. These findings indicate that PhA may serve as a stronger determinant of aerobic capacity than SMM% in healthy young adults and highlight its potential utility in settings such as routine health check-ups or preliminary screening of aerobic capacity when CPX is impractical. Full article

In the United States, although the gaps in health insurance coverage by sexual orientation have been closing since the implementation of the Affordable Care Act and legalization of same-sex marriage, the LGB group (i.e., lesbian, gay, bisexual) continues to report healthcare utilization and access inequities such as more delayed or unmet care. The extant research has often examined healthcare utilization and access inequities due to affordability (e.g., out-of-pocket costs). However, healthcare utilization and access inequities are only partially explained by cost reasons; there are non-cost reasons that have not been adequately empirically examined. The present study innovatively includes discrimination structural variables to understand how social structure is associated with healthcare utilization and access inequities of LGB people. It focuses on two routine health services—regular check-ups and prescription medications—for LGB people who have chronic diseases. Additionally, sexual orientation may intersect with sex assigned at birth (sex, hereafter, i.e., male, female) to impact healthcare utilization and access inequities. The current study applies quantitative intersectional analysis to understand healthcare utilization and access inequities from a sexual orientation and sex intersectional lens and for easier and clearer interpretations of intersectional results and more actionable policy implications for inter-categorical groups. Using the 2023 National Health Interview Survey (weighted N = 136,231,053), we conducted quantitative intersectional analysis for logistic regression using complex survey data. First, we fit a series of logistic regression models with sexual orientation–sex interactions for routine healthcare utilization and access outcomes, adjusting for covariates. Second, we calculated average marginal predictions for inter-categorical groups by interacting sexual orientation and sex and other covariates. Third, we computed risk ratios of average marginal predictions for all the covariates. Lastly, we examined the interaction of inter-categorical groups/sexual orientation and structural variables. Our results show that experiencing a higher level of discrimination is positively associated with underutilization of regular check-ups and lower access to prescription medications, and this effect is stronger for LGB people. Further, LGB women are least likely to utilize regular check-ups and LGB men are least likely to access prescription medications among the inter-categorical groups. Highlighting structural issues of healthcare utilization and access offers new evidence on healthcare utilization and access inequities that can inform policies for raising awareness of and addressing structural issues. The intersectional analyses suggest that relevant policies target LGB women and LGB men. Full article