Objective: Recognizing discrimination as a significant public health risk during the coronavirus disease 2019 (COVID-19) pandemic, which coincided with increased drug use and heightened awareness of structural disparities in the United States, we investigated its association with the odds of drug use in a large and diverse cohort from the All of Us Research Program. Methods: In this cross-sectional study, data from 68,976 participants completed the COVID-19 participant experiences (COPE) survey. We applied logistic regression models with propensity score-based overlap weighting to examine associations between everyday discrimination and drug use. Self-reported everyday discrimination score and drug use were the primary exposure and outcome measures, respectively. Results: Of the 67,662 COPE respondents (mean [standard deviation] age, 57.5 [15.9] years; female sex at birth, 43,658 [64.5%]), we identified 15,493 participants with no reported discrimination and 15,493 participants with reported discrimination, after overlap weighting. The odds of drug use in those who reported discrimination was 1.38 (95% confidence interval, 1.32–1.43), with a dose-dependent association based on discrimination score. Participants who experienced discrimination had significantly higher odds of using drugs and this association was particularly pronounced in those under 40 years of age, those assigned female sex at birth, current smokers, individuals undergoing chemotherapy or immunotherapy, and those experiencing unemployment or COVID-19/flu-like symptoms. Conclusion This relationship was observed across various types of drugs and different reasons for discrimination, and it was particularly pronounced in specific subgroups. These findings provide critical evidence for developing targeted preventive interventions; however, further longitudinal studies for causality are warranted.

BACKGROUND: The choice of unicompartmental knee arthroplasty (UKA) vs . total knee arthroplasty (TKA) in the surgical treatment of knee osteoarthritis (KOA) remains controversial. This study aimed to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the clinical results of UKA and TKA for treating unicompartmental KOA. METHODS: PubMed, Embase, and the Cochrane Library were systematically searched for articles published up to January 2, 2023. The literature was rigorously screened to include only RCTs comparing UKA and TKA for unicompartmental KOA. A systematic review and meta-analysis were performed to calculate the mean difference (MD), relative risk (RR), and 95% confidence interval (CI) according to the Cochrane standards. RESULTS: Thirteen publications involving 683 UKAs and 683 TKAs were analyzed. Except for one study with a follow-up period of 15 years, all outcome measures reported were within 5 years of follow-up. Meta-analysis showed better knee recovery (MD: 1.23; 95% CI: 1.01-1.45; P  <0.001), greater knee function (MD: 1.78; 95% CI: 0.34-3.22; P  = 0.020), less pain (MD: 0.75; 95% CI: 0.43-1.06; P  <0.001), and better health status (MD: 3.75; 95% CI: 0.81-6.69; P  = 0.010) after UKA than TKA. However, considering the minimal clinically important difference values for these variables, the findings were not clinically relevant. Moreover, UKA patients had fewer complications (RR: 0.59; 95% CI: 0.45-0.78; P  <0.001) and shorter hospital stays (MD: -0.89; 95% CI: -1.57 to -0.22; P  = 0.009) than did TKA patients. There were no statistically significant differences in terms of postoperative range of movement, revision, failure, operation time, and patient satisfaction. CONCLUSIONS In terms of clinical efficacy, there was no obvious advantage of UKA over TKA in the surgical treatment of knee OA when considering the minimal clinically important difference. The main advantage of UKA over TKA is that it leads to fewer complications and a shorter length of hospital stay. It is ideal to perform prospective studies with longer follow-up periods to fully evaluate the long-term efficacy and safety of the two procedures in the future.
Humans ; Arthroplasty, Replacement, Knee/methods* ; Osteoarthritis, Knee/surgery* ; Randomized Controlled Trials as Topic ; Treatment Outcome

BACKGROUND/OBJECTIVES: The increasing prevalence of overweight and obesity has become a significant global burden, with more than 40% of the global adult population attempting to lose weight. Previous studies on the impact of weight-control methods on mental health, especially among adolescents, are limited. Thus, this study aimed to investigate the association between various weight-control methods and depression among adolescents, with the goal of informing healthier weight management decisions and promoting effective methods. SUBJECTS/METHODS: This nationwide study utilized data from the Korea Youth Risk Behavior Web-based Survey, including a sample of 418,254 adolescents collected over 12yrs (2007–2019). We conducted a weighted complex sample analysis to compare depression rates associated with specific weight-control methods, including exercise, fasting (≥ 24 h), eating less, taking prescriptionon-prescription weight-loss medication, taking laxatives or diuretics, vomiting, one-food diet, taking oriental medicine, and diet foods. RESULTS: Of the 418,254 participants, 45.96% (192,246) were male. Among male participants, fasting (≥ 24 h; weighted odds ratio [wOR], 1.43; 95% confidence interval [CI], 1.36–1.51) and vomiting (wOR, 1.49; 95% CI, 1.35–1.66) were associated with an increased risk of depression. Among female participants, prescribed (wOR, 0.82; 95% CI, 0.74–0.90) and non-prescribed (wOR, 0.89; 95% CI, 0.82–0.97) weight-loss medication reduced the risk of depression. However, fasting (≥ 24 h; wOR, 1.47; 95% CI, 1.41–1.52) vomiting (wOR, 1.45;95% CI, 1.36–1.55) significantly increased the risk of depression. CONCLUSION The risk of depression varies depending on the weight-control method, with a consistent trend observed across both sexes. Methods such as vomiting, fasting, taking oriental medicine for weight loss, and consuming diet foods increased the risk of depression, while weight-loss medications were associated with reduced depression symptoms in females. These findings highlight the need for further research on weightcontrol medications and policies that support effective weight management while reducing depressive effects.

Background: Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050. Methods: This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents. The rates over time were calculated using a locally weighted scatter plot smoother curve, with weights assigned based on the population of each country. Furthermore, this study projected liver disease-related mortality rates up to 2050 using a Bayesian age-periodcohort (BAPC) model. Additionally, a decomposition analysis was conducted to discern influencing factors such as population growth, aging, and epidemiological changes. Results: The estimated global age-standardized liver disease-related mortality rates surged significantly from 1990 to 2021 across 112 countries, rising from 103.4 deaths per 1,000,000 people (95% confidence interval [CI], 88.16, 118.74) in 1990 to 173.0 deaths per 1,000,000 people (95% CI, 155.15, 190.95) in 2021. This upward trend was particularly pronounced in low- and middle-income countries, in Africa, and in populations aged 65 years and older.Moreover, age-standardized liver disease-related mortality rates were correlated with a lower Human Development Index (P < 0.001) and sociodemographic index (P = 0.001). According to the BAPC model, the projected trend indicated a sustained and substantial decline in liver disease-related mortality rates, with an estimated decrease from 185.08 deaths per 1,000,000 people (95% CI, 179.79, 190.63) in 2021 to 156.29 (112.32, 214.77) in 2050. From 1990 to 2021, age-standardized liver disease-related deaths surged primarily due to epidemiological changes, whereas from 1990 to 2050, the impact of population aging and growth became the primary contributing factors to the overall increase. Conclusion Global age-standardized liver disease-related mortality has increased significantly and continues to emerge as a crucial global public health issue. Further investigation into liver disease-related mortality rates in Africa is needed, and updating policies is necessary to effectively manage the global burden of liver disease.

Background: Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050. Methods: This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents. The rates over time were calculated using a locally weighted scatter plot smoother curve, with weights assigned based on the population of each country. Furthermore, this study projected liver disease-related mortality rates up to 2050 using a Bayesian age-periodcohort (BAPC) model. Additionally, a decomposition analysis was conducted to discern influencing factors such as population growth, aging, and epidemiological changes. Results: The estimated global age-standardized liver disease-related mortality rates surged significantly from 1990 to 2021 across 112 countries, rising from 103.4 deaths per 1,000,000 people (95% confidence interval [CI], 88.16, 118.74) in 1990 to 173.0 deaths per 1,000,000 people (95% CI, 155.15, 190.95) in 2021. This upward trend was particularly pronounced in low- and middle-income countries, in Africa, and in populations aged 65 years and older.Moreover, age-standardized liver disease-related mortality rates were correlated with a lower Human Development Index (P < 0.001) and sociodemographic index (P = 0.001). According to the BAPC model, the projected trend indicated a sustained and substantial decline in liver disease-related mortality rates, with an estimated decrease from 185.08 deaths per 1,000,000 people (95% CI, 179.79, 190.63) in 2021 to 156.29 (112.32, 214.77) in 2050. From 1990 to 2021, age-standardized liver disease-related deaths surged primarily due to epidemiological changes, whereas from 1990 to 2050, the impact of population aging and growth became the primary contributing factors to the overall increase. Conclusion Global age-standardized liver disease-related mortality has increased significantly and continues to emerge as a crucial global public health issue. Further investigation into liver disease-related mortality rates in Africa is needed, and updating policies is necessary to effectively manage the global burden of liver disease.

Background: Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050. Methods: This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents. The rates over time were calculated using a locally weighted scatter plot smoother curve, with weights assigned based on the population of each country. Furthermore, this study projected liver disease-related mortality rates up to 2050 using a Bayesian age-periodcohort (BAPC) model. Additionally, a decomposition analysis was conducted to discern influencing factors such as population growth, aging, and epidemiological changes. Results: The estimated global age-standardized liver disease-related mortality rates surged significantly from 1990 to 2021 across 112 countries, rising from 103.4 deaths per 1,000,000 people (95% confidence interval [CI], 88.16, 118.74) in 1990 to 173.0 deaths per 1,000,000 people (95% CI, 155.15, 190.95) in 2021. This upward trend was particularly pronounced in low- and middle-income countries, in Africa, and in populations aged 65 years and older.Moreover, age-standardized liver disease-related mortality rates were correlated with a lower Human Development Index (P < 0.001) and sociodemographic index (P = 0.001). According to the BAPC model, the projected trend indicated a sustained and substantial decline in liver disease-related mortality rates, with an estimated decrease from 185.08 deaths per 1,000,000 people (95% CI, 179.79, 190.63) in 2021 to 156.29 (112.32, 214.77) in 2050. From 1990 to 2021, age-standardized liver disease-related deaths surged primarily due to epidemiological changes, whereas from 1990 to 2050, the impact of population aging and growth became the primary contributing factors to the overall increase. Conclusion Global age-standardized liver disease-related mortality has increased significantly and continues to emerge as a crucial global public health issue. Further investigation into liver disease-related mortality rates in Africa is needed, and updating policies is necessary to effectively manage the global burden of liver disease.

BACKGROUND/OBJECTIVES: The increasing prevalence of overweight and obesity has become a significant global burden, with more than 40% of the global adult population attempting to lose weight. Previous studies on the impact of weight-control methods on mental health, especially among adolescents, are limited. Thus, this study aimed to investigate the association between various weight-control methods and depression among adolescents, with the goal of informing healthier weight management decisions and promoting effective methods. SUBJECTS/METHODS: This nationwide study utilized data from the Korea Youth Risk Behavior Web-based Survey, including a sample of 418,254 adolescents collected over 12yrs (2007–2019). We conducted a weighted complex sample analysis to compare depression rates associated with specific weight-control methods, including exercise, fasting (≥ 24 h), eating less, taking prescriptionon-prescription weight-loss medication, taking laxatives or diuretics, vomiting, one-food diet, taking oriental medicine, and diet foods. RESULTS: Of the 418,254 participants, 45.96% (192,246) were male. Among male participants, fasting (≥ 24 h; weighted odds ratio [wOR], 1.43; 95% confidence interval [CI], 1.36–1.51) and vomiting (wOR, 1.49; 95% CI, 1.35–1.66) were associated with an increased risk of depression. Among female participants, prescribed (wOR, 0.82; 95% CI, 0.74–0.90) and non-prescribed (wOR, 0.89; 95% CI, 0.82–0.97) weight-loss medication reduced the risk of depression. However, fasting (≥ 24 h; wOR, 1.47; 95% CI, 1.41–1.52) vomiting (wOR, 1.45;95% CI, 1.36–1.55) significantly increased the risk of depression. CONCLUSION The risk of depression varies depending on the weight-control method, with a consistent trend observed across both sexes. Methods such as vomiting, fasting, taking oriental medicine for weight loss, and consuming diet foods increased the risk of depression, while weight-loss medications were associated with reduced depression symptoms in females. These findings highlight the need for further research on weightcontrol medications and policies that support effective weight management while reducing depressive effects.

BACKGROUND/OBJECTIVES: The increasing prevalence of overweight and obesity has become a significant global burden, with more than 40% of the global adult population attempting to lose weight. Previous studies on the impact of weight-control methods on mental health, especially among adolescents, are limited. Thus, this study aimed to investigate the association between various weight-control methods and depression among adolescents, with the goal of informing healthier weight management decisions and promoting effective methods. SUBJECTS/METHODS: This nationwide study utilized data from the Korea Youth Risk Behavior Web-based Survey, including a sample of 418,254 adolescents collected over 12yrs (2007–2019). We conducted a weighted complex sample analysis to compare depression rates associated with specific weight-control methods, including exercise, fasting (≥ 24 h), eating less, taking prescriptionon-prescription weight-loss medication, taking laxatives or diuretics, vomiting, one-food diet, taking oriental medicine, and diet foods. RESULTS: Of the 418,254 participants, 45.96% (192,246) were male. Among male participants, fasting (≥ 24 h; weighted odds ratio [wOR], 1.43; 95% confidence interval [CI], 1.36–1.51) and vomiting (wOR, 1.49; 95% CI, 1.35–1.66) were associated with an increased risk of depression. Among female participants, prescribed (wOR, 0.82; 95% CI, 0.74–0.90) and non-prescribed (wOR, 0.89; 95% CI, 0.82–0.97) weight-loss medication reduced the risk of depression. However, fasting (≥ 24 h; wOR, 1.47; 95% CI, 1.41–1.52) vomiting (wOR, 1.45;95% CI, 1.36–1.55) significantly increased the risk of depression. CONCLUSION The risk of depression varies depending on the weight-control method, with a consistent trend observed across both sexes. Methods such as vomiting, fasting, taking oriental medicine for weight loss, and consuming diet foods increased the risk of depression, while weight-loss medications were associated with reduced depression symptoms in females. These findings highlight the need for further research on weightcontrol medications and policies that support effective weight management while reducing depressive effects.

BACKGROUND/OBJECTIVES: The increasing prevalence of overweight and obesity has become a significant global burden, with more than 40% of the global adult population attempting to lose weight. Previous studies on the impact of weight-control methods on mental health, especially among adolescents, are limited. Thus, this study aimed to investigate the association between various weight-control methods and depression among adolescents, with the goal of informing healthier weight management decisions and promoting effective methods. SUBJECTS/METHODS: This nationwide study utilized data from the Korea Youth Risk Behavior Web-based Survey, including a sample of 418,254 adolescents collected over 12yrs (2007–2019). We conducted a weighted complex sample analysis to compare depression rates associated with specific weight-control methods, including exercise, fasting (≥ 24 h), eating less, taking prescriptionon-prescription weight-loss medication, taking laxatives or diuretics, vomiting, one-food diet, taking oriental medicine, and diet foods. RESULTS: Of the 418,254 participants, 45.96% (192,246) were male. Among male participants, fasting (≥ 24 h; weighted odds ratio [wOR], 1.43; 95% confidence interval [CI], 1.36–1.51) and vomiting (wOR, 1.49; 95% CI, 1.35–1.66) were associated with an increased risk of depression. Among female participants, prescribed (wOR, 0.82; 95% CI, 0.74–0.90) and non-prescribed (wOR, 0.89; 95% CI, 0.82–0.97) weight-loss medication reduced the risk of depression. However, fasting (≥ 24 h; wOR, 1.47; 95% CI, 1.41–1.52) vomiting (wOR, 1.45;95% CI, 1.36–1.55) significantly increased the risk of depression. CONCLUSION The risk of depression varies depending on the weight-control method, with a consistent trend observed across both sexes. Methods such as vomiting, fasting, taking oriental medicine for weight loss, and consuming diet foods increased the risk of depression, while weight-loss medications were associated with reduced depression symptoms in females. These findings highlight the need for further research on weightcontrol medications and policies that support effective weight management while reducing depressive effects.

Background: Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050. Methods: This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents. The rates over time were calculated using a locally weighted scatter plot smoother curve, with weights assigned based on the population of each country. Furthermore, this study projected liver disease-related mortality rates up to 2050 using a Bayesian age-periodcohort (BAPC) model. Additionally, a decomposition analysis was conducted to discern influencing factors such as population growth, aging, and epidemiological changes. Results: The estimated global age-standardized liver disease-related mortality rates surged significantly from 1990 to 2021 across 112 countries, rising from 103.4 deaths per 1,000,000 people (95% confidence interval [CI], 88.16, 118.74) in 1990 to 173.0 deaths per 1,000,000 people (95% CI, 155.15, 190.95) in 2021. This upward trend was particularly pronounced in low- and middle-income countries, in Africa, and in populations aged 65 years and older.Moreover, age-standardized liver disease-related mortality rates were correlated with a lower Human Development Index (P < 0.001) and sociodemographic index (P = 0.001). According to the BAPC model, the projected trend indicated a sustained and substantial decline in liver disease-related mortality rates, with an estimated decrease from 185.08 deaths per 1,000,000 people (95% CI, 179.79, 190.63) in 2021 to 156.29 (112.32, 214.77) in 2050. From 1990 to 2021, age-standardized liver disease-related deaths surged primarily due to epidemiological changes, whereas from 1990 to 2050, the impact of population aging and growth became the primary contributing factors to the overall increase. Conclusion Global age-standardized liver disease-related mortality has increased significantly and continues to emerge as a crucial global public health issue. Further investigation into liver disease-related mortality rates in Africa is needed, and updating policies is necessary to effectively manage the global burden of liver disease.