Objective: To explore the association between the triglyceride-glucose-frailty index and the risk of diabetes mellitus among middle-aged and elderly population, so as to provide the evidence for diabetes mellitus risk screening and management among middle-aged and elderly population. Methods: Based on data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, middle-aged and elderly individuals aged ≥45 years without diabetes mellitus at baseline were selected as study participants. Demographic characteristics, lifestyles, and laboratory test data were collected. The triglyceride-glucose index was calculated using triglyceride and fasting blood glucose levels, and the frailty index was derived from a 29-item health deficit accumulation model. The triglyceride-glucose-frailty index was obtained by multiplying the two indices, and participants were divided into four groups according to quartiles. Association between the triglyceride-glucose-frailty index and diabetes mellitus incidence risk was analyzed using a multivariable Cox proportional hazards regression model, and the dose-response relationship was assessed using a restricted cubic spline model. Results: A total of 5 246 participants were included, including 2 364 males (45.06%) and 2 882 females (54.94%). The mean age was (58.38±8.78) years. The median of the triglyceride-glucose-frailty index was 0.78 (interquartile range, 1.13). By 2018, 452 diabetes mellitus cases were identified, with a cumulative incidence of 8.62%. Multivariable Cox proportional hazards regression analysis showed that, after adjusting for demographic characteristics, lifestyle factors, and biochemical indicators, each one-standard-deviation increase of the triglyceride-glucose-frailty index was associated with a 37.5% higher risk of diabetes mellitus incidence (HR=1.375, 95%CI: 1.278-1.479). Compared with the Q1 group, the risk increased by 50.8% (HR=1.508, 95%CI: 1.072-2.123), 91.3% (HR=1.913, 95%CI: 1.380-2.651) and 241.6% (HR=3.416, 95%CI: 2.499-4.671) in the Q2, Q3 and Q4 groups, respectively, presenting an upward trend (Pfor trend <0.05). Restricted cubic spline analysis showed a non-linear relationship between the triglyceride-glucose-frailty index and diabetes mellitus incidence risk (P<0.05). Conclusion The triglyceride-glucose-frailty index was positively associated with diabetes mellitus risk among middle-aged and elderly population, and a nonlinear dose-response relationship was observed between the two.

Objective:To explore the potential categories and influencing factors of medication compliance in patients with cardiometabolic multimorbidity, and provide a reference for formulating targeted intervention measures.Methods:A cross-sectional study design was adopted. From March to October 2024, the patients with cardiometabolic multimorbidity in the First Hospital Affiliated with Hunan Normal University (Hunan Provincial People′s Hospital) were selected by convenience sampling method as research objects. Data were collected using a general information questionnaire, Medication Adherence Rating Scale (MARS), Perceived Social Support Scale (PSSS), and Medication Literacy Questionnaire. The latent class analysis was used to explore the characteristics and classifications of medication compliance in cardiometabolic multimorbidity, and unordered multivariate Logistic regression was used to analyze the influencing factors of different latent classes.Results:A total of 421 subjects were included, consisting of 291 males and 130 females, aged (64.28±9.74) years old. The overall medication adherence score was 6.00 (5.00, 8.00) points, which could be divided into four categories: overall good adherence group (24.47%, 103/421), subjective perception-poor adherence group (15.91%, 67/421), forgetfulness-poor adherence group (37.53%, 158/421), and overall poor adherence group (22.09%, 93/421). The results showed that when taking the overall good adherence group as a reference, the inability to obtain pharmaceutical information from social media, medication literacy scores, social support scores were the influencing factors for the subjective perception-poor adherence group ( OR=4.210, 0.516, 0.733, all P<0.05). Occupational characteristics (employees in public institutions or government-affiliated institutions), age, social support scores were the influencing factors for the forgetfulness-poor adherence group( OR=0.173, 1.155, 0.781, all P<0.05). Occupational characteristics (employees in public institutions or government-affiliated institutions), failure to receive medication guidance from medical staff, medication literacy scores and social support scores were the influencing factors for the overall poor adherence group( OR values were 0.136-5.275, all P<0.05). When taking the overall poor adherence group as a reference, failure to receive medication guidance from medical staff and medication literacy scores were the influencing factors for the subjective perception-poor adherence group ( OR=0.310, 1.752, both P<0.05). Failure to receive medication guidance from medical staff, age, medication literacy scores and social support scores were the influencing factors for the forgetfulness-poor adherence group ( OR values were 0.315-2.554, all P<0.05). Conclusions:There is significant heterogeneity in medication adherence among patients with cardiometabolic multimorbidity. Healthcare professionals should consider individual characteristics in clinical practice and provide targeted, precise interventions to improve adherence in different patient categories.

Objective:To explore the heterogeneity of alienation among adolescents and examine the impact of child psychological maltreatment, childhood bullying, online social exclusion, and demographic variables.Methods:In October 2023, the alienation scale was administered to 1 316 adolescents. Latent profile analysis was conducted using Mplus 8.3, and multinomial Logistic regression analysis was performed using SPSS 26.0 to explore the factors associated with the heterogeneity of adolescent alienation.Results:(1) The score of adolescent alienation was 22.00 (17.00, 29.00). The results of latent profile analysis showed that there was heterogeneity in adolescent alienation, which could be divided into two categories as low alienation (66.79%, 879/1 316) and high alienation (33.21%, 437/1 316).(2) Binary Logistic regression analysis showed that gender ( B=0.57, OR=1.77, P<0.01), being an only child ( B=-0.34, OR=0.71, P<0.05) were significantly associated with adolescent alienation. Additionally, child psychological maltreatment( B=1.61, OR=5.02, P<0.01), childhood bullying ( B=1.09, OR=2.98, P<0.01), and online social exclusion ( B=1.64, OR=5.17, P<0.01) were identified as critical factors influencing adolescent alienation. Conclusion:There is heterogeneity in alienation among adolescents. Child psychological maltreatment, child bullying, online social exclusion and demographic variables are the main influencing factors of alienation among adolescents.

Objective:To evaluate the reliability and validity of the Chinese version of the Oxford agoraphobic avoidance scale (OAAS-C) in Chinese college students.Methods:A total of 1 030 college students were surveyed with OAAS-C, general anxiety disorder-7(GAD-7), the center for epidemiological studies depression scale-10 (CESD-10) and the symptom checklist-90(SCL-90). Sample 1( n=30) was carried out for popularity test. Sample 2( n=503) was carried out for item analysis and exploratory factor analysis. Sample 3( n=497) was carried out for confirmatory factor analysis. Two weeks later, 60 college students who came from sample 2 were asked to retest OAAS-C. SPSS 26.0 and Mplus 8.3 were used for data analysis. Results:According to exploratory factor analysis, the OAAS-C was a single dimension scale included with 8 items, and explained 60.75% of the total variance.The confirmatory factor analysis showed that the single factor model fitted the data well( χ2/ df=1.41, CFI=0.99, TLI=0.98, RMSEA=0.05). The score of OAAS-C was positively correlated with the scores of GAD-7, CESD-10 and the agoraphobic subscale of SCL-90 ( r=0.72, 0.71, 0.87, all P<0.01). In addition, the composite reliability coefficient was 0.91 and average variance extracted coefficient was 0.55.The Cronbach's α coefficient of the OAAS-C was 0.93, the retest reliability coefficients(ICC) was 0.86, and the split-half reliability coefficient was 0.90. Conclusion:OAAS-C has a good reliability and validity in Chinese college students and it can be used as a research tool for agoraphobic study.

Objective:To explore the heterogeneity of alienation among adolescents and examine the impact of child psychological maltreatment, childhood bullying, online social exclusion, and demographic variables.Methods:In October 2023, the alienation scale was administered to 1 316 adolescents. Latent profile analysis was conducted using Mplus 8.3, and multinomial Logistic regression analysis was performed using SPSS 26.0 to explore the factors associated with the heterogeneity of adolescent alienation.Results:(1) The score of adolescent alienation was 22.00 (17.00, 29.00). The results of latent profile analysis showed that there was heterogeneity in adolescent alienation, which could be divided into two categories as low alienation (66.79%, 879/1 316) and high alienation (33.21%, 437/1 316).(2) Binary Logistic regression analysis showed that gender ( B=0.57, OR=1.77, P<0.01), being an only child ( B=-0.34, OR=0.71, P<0.05) were significantly associated with adolescent alienation. Additionally, child psychological maltreatment( B=1.61, OR=5.02, P<0.01), childhood bullying ( B=1.09, OR=2.98, P<0.01), and online social exclusion ( B=1.64, OR=5.17, P<0.01) were identified as critical factors influencing adolescent alienation. Conclusion:There is heterogeneity in alienation among adolescents. Child psychological maltreatment, child bullying, online social exclusion and demographic variables are the main influencing factors of alienation among adolescents.

Objective:To evaluate the reliability and validity of the Chinese version of the Oxford agoraphobic avoidance scale (OAAS-C) in Chinese college students.Methods:A total of 1 030 college students were surveyed with OAAS-C, general anxiety disorder-7(GAD-7), the center for epidemiological studies depression scale-10 (CESD-10) and the symptom checklist-90(SCL-90). Sample 1( n=30) was carried out for popularity test. Sample 2( n=503) was carried out for item analysis and exploratory factor analysis. Sample 3( n=497) was carried out for confirmatory factor analysis. Two weeks later, 60 college students who came from sample 2 were asked to retest OAAS-C. SPSS 26.0 and Mplus 8.3 were used for data analysis. Results:According to exploratory factor analysis, the OAAS-C was a single dimension scale included with 8 items, and explained 60.75% of the total variance.The confirmatory factor analysis showed that the single factor model fitted the data well( χ2/ df=1.41, CFI=0.99, TLI=0.98, RMSEA=0.05). The score of OAAS-C was positively correlated with the scores of GAD-7, CESD-10 and the agoraphobic subscale of SCL-90 ( r=0.72, 0.71, 0.87, all P<0.01). In addition, the composite reliability coefficient was 0.91 and average variance extracted coefficient was 0.55.The Cronbach's α coefficient of the OAAS-C was 0.93, the retest reliability coefficients(ICC) was 0.86, and the split-half reliability coefficient was 0.90. Conclusion:OAAS-C has a good reliability and validity in Chinese college students and it can be used as a research tool for agoraphobic study.

Objective:To explore the potential categories and influencing factors of medication compliance in patients with cardiometabolic multimorbidity, and provide a reference for formulating targeted intervention measures.Methods:A cross-sectional study design was adopted. From March to October 2024, the patients with cardiometabolic multimorbidity in the First Hospital Affiliated with Hunan Normal University (Hunan Provincial People′s Hospital) were selected by convenience sampling method as research objects. Data were collected using a general information questionnaire, Medication Adherence Rating Scale (MARS), Perceived Social Support Scale (PSSS), and Medication Literacy Questionnaire. The latent class analysis was used to explore the characteristics and classifications of medication compliance in cardiometabolic multimorbidity, and unordered multivariate Logistic regression was used to analyze the influencing factors of different latent classes.Results:A total of 421 subjects were included, consisting of 291 males and 130 females, aged (64.28±9.74) years old. The overall medication adherence score was 6.00 (5.00, 8.00) points, which could be divided into four categories: overall good adherence group (24.47%, 103/421), subjective perception-poor adherence group (15.91%, 67/421), forgetfulness-poor adherence group (37.53%, 158/421), and overall poor adherence group (22.09%, 93/421). The results showed that when taking the overall good adherence group as a reference, the inability to obtain pharmaceutical information from social media, medication literacy scores, social support scores were the influencing factors for the subjective perception-poor adherence group ( OR=4.210, 0.516, 0.733, all P<0.05). Occupational characteristics (employees in public institutions or government-affiliated institutions), age, social support scores were the influencing factors for the forgetfulness-poor adherence group( OR=0.173, 1.155, 0.781, all P<0.05). Occupational characteristics (employees in public institutions or government-affiliated institutions), failure to receive medication guidance from medical staff, medication literacy scores and social support scores were the influencing factors for the overall poor adherence group( OR values were 0.136-5.275, all P<0.05). When taking the overall poor adherence group as a reference, failure to receive medication guidance from medical staff and medication literacy scores were the influencing factors for the subjective perception-poor adherence group ( OR=0.310, 1.752, both P<0.05). Failure to receive medication guidance from medical staff, age, medication literacy scores and social support scores were the influencing factors for the forgetfulness-poor adherence group ( OR values were 0.315-2.554, all P<0.05). Conclusions:There is significant heterogeneity in medication adherence among patients with cardiometabolic multimorbidity. Healthcare professionals should consider individual characteristics in clinical practice and provide targeted, precise interventions to improve adherence in different patient categories.

Atopic dermatitis (AD) is a prevalent inflammatory skin disorder in which patients experience recurrent eczematous lesions and intense itching. The colonization of Staphylococcus aureus (S. aureus) is correlated with the severity of the disease, but its role in AD development remains elusive. Using single-cell RNA sequencing, we uncovered that keratinocytes activate a distinct immune response characterized by induction of Il24 when exposed to methicillin-resistant S. aureus (MRSA). Further experiments using animal models showed that the administration of recombinant IL-24 protein worsened AD-like pathology. Genetic ablation of Il24 or the receptor Il20rb in keratinocytes alleviated allergic inflammation and atopic march. Mechanistically, IL-24 acted through its heterodimeric receptors on keratinocytes and augmented the production of IL-33, which in turn aggravated type 2 immunity and AD-like skin conditions. Overall, these findings establish IL-24 as a critical factor for onset and progression of AD and a compelling therapeutic target.
Dermatitis, Atopic/genetics* ; Interleukins/metabolism* ; Animals ; Methicillin-Resistant Staphylococcus aureus/immunology* ; Mice ; Keratinocytes/microbiology* ; Humans ; Interleukin-33/immunology* ; Inflammation/microbiology* ; Staphylococcal Infections/microbiology* ; Disease Models, Animal ; Hypersensitivity/microbiology* ; Mice, Inbred C57BL

Objective:To summarize the current status and research hotspots in volume management among patients with heart failure, and to predict future research trends.Methods:Literature related to volume management in heart failure patients published between January 1, 2004 and August 1, 2024 was retrieved from the China National Knowledge Infrastructure and Web of Science Core Collection databases. CiteSpace software was used to perform visual analysis of publication volume, authors, institutions, countries, and keywords.Results:A total of 5 008 articles were retrieved, of which 145 were Chinese and 202 were English publications. The overall publication trend showed a steady increase over the past two decades. The most prolific author was Fudim (7 publications), the leading institution was Mayo Clinic (14 publications), and the country with the highest output was the United States (91 publications). Keyword co-occurrence, clustering, and burst detection analyses revealed that current research hotspots in both Chinese and English literature mainly focus on the management and control of volume overload, exploration of nursing strategies, and patient self-management and home-based rehabilitation. Emerging trends include out-of-hospital volume overload control and intelligent volume management technologies.Conclusions:Research on volume management in heart failure patients is evolving toward diversification and integration. Clinical interventions and standardized guidelines have gained increasing attention. Home-based volume management and overload control continue to be key areas of interest. In the future, the integration of artificial intelligence and the development of individualized home self-management programs will likely become important directions to improve the quality of life in patients with heart failure.

Objective:To summarize the current status and research hotspots in volume management among patients with heart failure, and to predict future research trends.Methods:Literature related to volume management in heart failure patients published between January 1, 2004 and August 1, 2024 was retrieved from the China National Knowledge Infrastructure and Web of Science Core Collection databases. CiteSpace software was used to perform visual analysis of publication volume, authors, institutions, countries, and keywords.Results:A total of 5 008 articles were retrieved, of which 145 were Chinese and 202 were English publications. The overall publication trend showed a steady increase over the past two decades. The most prolific author was Fudim (7 publications), the leading institution was Mayo Clinic (14 publications), and the country with the highest output was the United States (91 publications). Keyword co-occurrence, clustering, and burst detection analyses revealed that current research hotspots in both Chinese and English literature mainly focus on the management and control of volume overload, exploration of nursing strategies, and patient self-management and home-based rehabilitation. Emerging trends include out-of-hospital volume overload control and intelligent volume management technologies.Conclusions:Research on volume management in heart failure patients is evolving toward diversification and integration. Clinical interventions and standardized guidelines have gained increasing attention. Home-based volume management and overload control continue to be key areas of interest. In the future, the integration of artificial intelligence and the development of individualized home self-management programs will likely become important directions to improve the quality of life in patients with heart failure.