This study aims to comprehensively examine the interrelationships among physical activity, stress, and oral health status in university students to provide empirical evidence for targeted oral health promotion strategies. A survey was conducted among current university students in mainland China. Physical activity was evaluated via the International Physical Activity Questionnaire Short Form, and stress was measured through the 14-item Perceived Stress Scale. Oral health status was evaluated through self-reported indicators, including gingival bleeding, toothache, and oral ulcer. Data were analyzed using multivariable logistic regression and structural equation modeling. A P value < .05 was considered statistically significant. A total of 1578 participants were included. Findings revealed that 47.7% of students had insufficient physical activity, while 38.7% reported high or excessive stress. Multivariable logistic regression showed that insufficient physical activity and elevated stress levels were associated with an increased risk of gingival bleeding and oral ulcers (P < .05). Structural equation modeling showed that physical activity was negatively associated with perceived stress (standardized coefficient = -0.360, P < .05), and perceived stress was positively associated with self‑reported oral symptoms (standardized coefficient = 0.411, P < .05). However, the direct association between physical activity and oral symptoms was not statistically significant (standardized coefficient = -0.009, P = .765). Physical activity, stress, and oral health are closely intertwined. Insufficient activity and high stress are critical determinants of poor oral health among university students. The observed association between physical activity and oral symptoms was mediated primarily through perceived stress rather than a direct effect. Universities should implement integrated interventions that encourage regular exercise and provide mental health support to enhance the holistic and oral well-being of the student population.

Substance abuse among university students is a significant public health concern that is typically linked to underlying mental health issues such as depression, stress, and a lack of social support networks. Thus, the study's goal was to investigate the link between social support, depression, and substance abuse. A cross-sectional design was used. Students were given 3 measures to complete for the current study: the Multidimensional Scale of Perceived Social Support, the Beck Depression Inventory, and the Alcohol, Smoking, and Substance Involvement Screening Test. The study included 257 regular undergraduate students from Addis Ababa Institute of Technology. As a result, the multivariate test of significance demonstrates that parents' marital status, monthly income, and the presence or absence of intimate friends all have a significant influence on student substance abuse and depression. The Pearson correlation demonstrated a substantial positive relationship between depression and substance abuse; however, higher levels of social support are associated with a decreased likelihood of substance abuse and depression among students. Finally, depression has a mediating role in the relationship between social support and substance abuse. These findings suggest that investing in supportive relationships and communities might be an effective way to improve mental health while simultaneously lowering risky behavior like substance abuse. Furthermore, the researchers proposed that the institution establish its own substance abuse prevention and treatment center, available to psychologists, therapists, and other health practitioners.

To compare early radiographic bone healing 45 days after tibial plateau levelling osteotomy performed with popliteus muscle detachment versus a modified technique preserving the muscle and to determine whether muscle preservation influences post-operative osteotomy stability through measurement of rock-back.

In this prospective, blinded, randomised clinical study (2022 to 2025), 100 client-owned dogs with unilateral cranial cruciate ligament rupture were allocated to traditional surgery (n = 50) or popliteus-sparing surgery (n = 50). Radiographic assessment was performed preoperatively, immediately post-operatively and 45 days after surgery. Bone healing was evaluated using two validated radiographic scoring systems. Osteotomy stability was assessed by measuring the change in tibial plateau angle between the immediate post-operative and 45-day radiographs. Multivariable linear regression models were used to adjust for baseline clinical variables. A P-value <.05 was considered statistically significant.

Dogs undergoing popliteus-sparing surgery demonstrated higher bone healing scores at 45 days, with an adjusted mean difference of 1.95 (95% confidence interval 0.91 to 2.99) on the 10-point bone healing scale and 1.87 (95% confidence interval 0.88 to 2.86) on the modified radiographic union scale. There was no clinically relevant difference in post-operative tibial plateau angle change between groups, with an adjusted mean difference of 0.26 degrees (95% confidence interval -0.10 to 0.63). No major intraoperative vascular complications were recorded.

Tibial plateau levelling osteotomy performed without detachment of the popliteus muscle represents a safe and effective alternative to the traditional technique. Popliteus muscle preservation during tibial plateau levelling osteotomy was associated with higher radiographic bone healing scores at 45 days, without evidence of increased osteotomy instability. Whether this radiographic difference translates into improved clinical recovery or limb function remains unknown.

Peripheral facial paralysis (PFP) is a nonspecific inflammatory disease of the facial nerve, and the resulting sequelae seriously affect social function and mental health. Bibliometric analysis determines the focus and status of current research. However, no comprehensive bibliometric study has yet focused on PFP treatment.

Relevant publications from 2004 to 2024 were retrieved from the Web of Science. Visualization and bibliometric analyses were conducted using VOSviewer, CiteSpace, and Scimago Graphica to explore collaborative networks among countries, institutions, and authors, as well as key journals and references.

A total of 2426 publications were identified, authored by 10,111 researchers from 2749 institutions across 84 countries/regions. Publication output has shown a general upward trend. The United States led in publication volume and international collaborations. The institution and author with the most publications were Kyung Hee University and Hadlock TA, respectively. Plastic and Reconstructive Surgery ranked highest in both publication count and citations, while Terzis JK was the most frequently co-cited author. Over the years, the research hotspots in PFP treatment shifted from antivirals, steroids, and muscle transplantation therapies to include nerve transplantation, acupuncture, electrical stimulation, and other rehabilitation therapies.

This analysis captured the research hotspots and frontiers in PFP therapy. This study highlights the developmental trajectory and emerging trends in PFP therapy, providing a comprehensive reference for future research directions in the field.

The prevalence of sleep disorders has been rising over recent decades. Sleep disorders are frequently associated with disruptions in resting-state functional brain networks. Despite these associations, the direction and genetic basis of the relationships between brain functional networks and sleep disorders remain unclear. Utilizing bidirectional two-sample Mendelian randomization (MR), we examined bidirectional associations between 191 resting-state functional magnetic resonance imaging (rsfMRI) phenotypes (n = 34,691 individuals) and 8 sleep disorder phenotypes (N = 307,843-410,385 individuals). Forward MR identified 14 rsfMRI traits that showed significant associations with sleep disorder phenotypes. Notably, the inverse variance-weighted method showed that increased amplitude in the precuneus or occipital regions within the default mode or central executive network was associated with 13.2% higher odds of sleep disorders (combined; odds ratio = 1.132, 95% confidence interval: 1.064-1.204, P = 8.30 × 10-5). In addition, reverse MR identified 6 sleep disorder phenotypes with significant associations involving 18 rsfMRI traits. For example, higher genetic liability to sleep disorders (combined) was associated with a 14.2% lower strength of functional connectivity between precentral, frontal, or supplementary motor and frontal networks (odds ratio = 0.858, 95% confidence interval: 0.795-0.927, P = 9.62 × 10-5). This study identified 32 bidirectional MR associations between sleep disorders and brain functional networks, providing candidate neural circuits for future mechanistic and interventional studies of sleep disorders.

Endurance exercise, characterized by sustained low-to-moderate intensity training, enhances physiological performance during prolonged physical activity and is widely used in sports training and the rehabilitation of chronic diseases. Central fatigue, a key issue in endurance sports, arises from fatigue mechanisms within the central nervous system, affecting both performance and emotional well-being. Although endurance training can improve performance and mood by modulating neurotransmitter balance, the onset and exacerbation of central fatigue remain unresolved challenges.

A bibliometric approach was employed, using the Web of Science Core Collection (WoSCC) database to retrieve literature published between 2005 and 2024 on endurance exercise and central fatigue. Data analysis and visualization were conducted using CiteSpace, VOSviewer, and the R-Bibliometrix tool to explore research trends, hotspots, and future directions.

The study reveals a year-on-year increase in publications on endurance exercise and central fatigue, especially since 2014. Research has progressively focused on exercise performance, fatigue mechanisms, and neurotransmitter regulation. Keyword analysis highlights growing interest in the impact of prolonged exercise on central fatigue and the rising focus on psychological fatigue and cognitive function. Increasing interdisciplinary collaboration, international cooperation, and citation bursts from seminal works in exercise neurobiology and psychology are evident.

The mechanistic literature mapped in this analysis suggests that endurance exercise may influence performance and emotional well-being via neurotransmitter modulation; however, as a bibliometric study, the present analysis cannot itself establish causal biological mechanisms, and this interpretation should be corroborated by dedicated experimental and clinical research. The onset and progression of central fatigue remain significant challenges. Future research should focus on the neurobiological mechanisms of endurance exercise, particularly neurotransmitter regulation and neuroprotection, and explore its clinical potential in treating chronic fatigue syndrome, mental health disorders, and cognitive impairments.

Objective: To investigate the prevalence of sleep disturbance in outpatients with chronic pain and evaluate the mediating effect of depressive symptoms on the association between sleep disturbance and pain severity. Methods: A cross-sectional survey was conducted in 2023 in outpatients with chronic pain from medical institutions in Beijing, Jiangxi, and Chongqing based on multistage stratified sampling. The patients who were aged ≥45 years and had pain duration ≥3 months were included. The information about their sociodemographic characteristics, pain severity, sleep status, and depressive symptoms were collected by using structured questionnaires. Correlation analysis and multiple linear regression models were applied to evaluate the association between sleep disturbance and pain severity. After controlling for potential confounders, a mediation effect model was used to analyze the mediating effect of depressive symptoms. Results: A total of 4 151 study participants were included. Sleep disturbance was identified in 1 784 participants (42.98%), and depressive symptoms were identified in 378 participants (9.11%). Moderate pain was reported by 2 535 participants (61.07%), mild pain by 1 079 participants (25.99%), and severe pain by 537 participants (12.94%). Sleep disturbance was positively associated with pain severity (r=0.239, P<0.001), and sleep disturbance was also positively associated with depressive symptoms (r=0.186, P<0.001); depressive symptoms were likewise positively associated with pain severity (r=0.235, P<0.001). After adjustment for covariates, each one-point increase in the sleep disturbance score was associated with a 0.287-point increase in the Patient Health Questionnaire-2 (PHQ-2) score (β=0.287), and each one-point increase in the sleep disturbance score was associated with a 0.156-point increase in the pain score (β=0.156). After depressive symptoms were added to the model, the direct effect of sleep disturbance on pain severity remained significant (β=0.143), and each one-point increase in the PHQ-2 score was associated with a 0.048-point increase in the pain score (β=0.048). Depressive symptoms partially mediated the association between sleep disturbance and pain severity, accounting for 8.75% of the total effect. Conclusions: The prevalence of sleep disturbance was high in outpatients with chronic pain in Beijing, Jiangxi, and Chongqing. Sleep disturbance was associated with pain severity and might be also indirectly associated with pain severity through depressive symptoms. In clinical practice, more attention should be paid to the comprehensive assessment and management of sleep quality and emotional status in patients with chronic pain to mitigate pain severity and improve overall health outcomes.

Objective: To analyze the prevalence of chronic obstructive pulmonary disease (COPD) and its change trend in residents aged ≥40 years in Hubei Province from 2014 to 2024, and provide data support for COPD prevention and control. Methods: The COPD prevalence data were from three cross-sectional surveys of the China COPD surveillance from 2014 to 2024. Complex weighted sampling were used to analyze the prevalence of COPD and the changing trend of related factors in people with different demographic characteristics. A multivariate logistic regression model was used to analyze the correlated factors of COPD in Hubei. Results: The prevalence rates of COPD in people aged ≥40 years in Hubei in 2014-2015, 2019-2020 and 2024 were 12.5% (95%CI: 10.1%-14.8%), 10.7% (95%CI: 7.8%-13.6%) and 8.1% (95%CI: 5.8%-10.5%), respectively, with no statistical significance in downward trend (t=-2.06, P=0.079). The exposure rates of occupational dust and/or harmful gases, the use rate of coal fuel for household heating, the exposure rate of low BMI, the prevalence of dyspnea and any respiratory symptom decreased significantly. The protection rate against occupational exposure to dust or harmful gas increased significantly. The results of multivariate Logistic regression showed that the COPD risk was higher in rural population (OR=1.38, 95%CI: 1.06-1.81), men (OR=3.45, 95%CI: 1.80-6.61), those with older age (50- years old: OR=2.81, 95%CI: 2.05-3.85; 60- years old: OR=3.04, 95%CI: 1.29-7.16; ≥70 years old: OR=8.43, 95%CI: 4.51-15.73), retired group (OR=2.60, 95%CI: 1.12-6.02), smokers (OR=2.48, 95%CI: 1.75-3.52), people with family history of chronic respiratory diseases (OR=1.54, 95%CI: 1.29-1.84).The unemployed (OR=0.73, 95%CI: 0.54-0.97), middle-high per capita annual income (OR=0.46, 95%CI: 0.27-0.79), people with normal BMI (OR=0.21, 95%CI: 0.11-0.42), overweight people (OR=0.19, 95%CI: 0.10-0.33), and obese people (OR=0.07, 95%CI: 0.02-0.30) had lower risk for COPD. Conclusions: From 2014 to 2024, there was no statistically significant downward trend in the prevalence of COPD in residents aged ≥40 years in Hubei. Rural residents, men, the elderly, smokers, and those with a family history of chronic respiratory diseases were the population at high risk for COPD. It is necessary to further strengthen the surveillance for COPD and associated factors.

Objective: To investigate the association of depressive symptoms with the incidence of cardiovascular disease (CVD), cancer, and chronic obstructive pulmonary disease (COPD). Methods: Baseline data were derived from the China Chronic Disease and Risk Factor Surveillance Survey conducted in Jiangsu Province in 2010. Depressive status of the study participants was evaluated by using Patient Health Questionnaire-9 (PHQ-9). A total of 7 709 study participants who completed the baseline survey were included in the follow-up, and additional data on the incidence of target diseases or deaths were collected from Jiangsu Provincial Cardiovascular and Cerebrovascular Disease Reporting System, Tumor Registry System, and Cause of Death Registry System, thus establishing a prospective cohort. The follow-up ended on December 31, 2021. In the follow-up, 220 study participants were lost to follow-up (2.85%, 220/7 709). In addition, 271 study participants with confirmed diagnoses of CVD, cancer or COPD at baseline survey were excluded. Finally, a total of 7 218 study participants were included in the final analysis. Cox proportional hazards regression model was used to analyze the association between depressive symptoms and the risk for CVD, cancer and COPD. Stratified analyses were further conducted according to baseline characteristics, including sex, age, marital status, educational level and smoking status. Results: During the follow-up period, a total of 692 cases of CVD, 362 cases of cancer, and 112 cases of COPD occurred. After adjusting for potential confounding factors, compared with the group with PHQ-9 score of 0, the HRs for CVD incidence were 1.44 (95%CI: 1.06-1.94) in the group with score of 5-9, and 2.00 (95%CI: 1.24-3.22) in the group with score of ≥10. For cancer incidence, the HR was 0.67 (95%CI: 0.51-0.89) in the group with PHQ-9 score of 1-4 compared with the group with the score of 0. As for COPD incidence, the HRs were 1.90 (95%CI: 1.25-2.89), 2.42 (95%CI: 1.26-4.66), and 3.52 (95%CI: 1.40-8.87) in the groups with PHQ-9 score of 1-, 5-, and ≥10, respectively. Compared with the study participants without depressive symptoms at baseline survey, those with depressive symptoms had 1.55-fold (HR=1.55, 95%CI: 1.20-2.00) increased risk for CVD and 2.16-fold (HR=2.16, 95%CI: 1.26-3.69) increased risk for COPD. In stratified analyses by baseline characteristics including sex, age, marital status, educational level, and smoking status, no significant interaction effects were found between depressive symptoms and the aforementioned baseline characteristics on the risk for CVD, cancer, and COPD (all interaction P>0.05). Conclusions: Depressive symptoms might be associated with increased risks for CVD and COPD. The prevention and management of depressive symptoms should be considered in the prevention and control of CVD and COPD.

Objective: To analyze the associations of exposure to single pollutants and their mixture with metabolic dysfunction-associated steatotic liver disease (MASLD) and MASLD with significant liver fibrosis in adults in China. Methods: A total of 23 806 participants from the third resurvey of the China Kadoorie Biobank were included. An elastic-net logistic regression model was used to calculate the weighted environmental risk score (WERS). Logistic regression models were used to evaluate the associations of the exposures to single pollutant [fine particulate matter (PM_2.5), inhalable particulate matter (PM₁₀), nitrogen dioxide (NO₂), and warm-season ozone (O₃)], and their mixture (WERS) with the risk for MASLD and MASLD with significant liver fibrosis. Restricted cubic spline models were used to evaluate non-linear relationships. Logistic regression models were also used to estimate the population attributable fraction (PAF) for air pollutants and major risk factors. Results: The mean age of the study participants was (65.3±9.1) years. Among them, 13 428 had MASLD, including 2 457 with significant liver fibrosis. Exposure to PM_2.5, PM₁₀, NO₂, and warm-season O₃ was positively associated with MASLD risk, with ORs of 1.27 (95%CI: 1.05-1.53), 1.77 (95%CI: 1.36-2.31), 1.20 (95%CI: 1.08-1.33), and 1.53 (95%CI: 1.20-1.95) per 1-SD increase, respectively. PM_2.5 showed a non-linear association with MASLD risk (P for nonlinear=0.007). The association between PM_2.5 and MASLD was mild at low exposure levels but increased obviously at higher concentrations. PM₁₀ and warm-season O₃ exposures were positively associated with significant liver fibrosis in MASLD patients. Each 1-unit increase in WERS (representing simultaneous 1-SD increases in the four pollutants) was associated with a 40% higher risk for MASLD (95%CI: 18%-65%) and a 42% higher risk for significant liver fibrosis (95%CI: 1%-100%). Compared with people with low exposure to air pollutants, the PAFs for MASLD in those with higher exposures to PM_2.5, PM₁₀, and warm-season O₃ ranged from 25.4% to 66.4%. Conclusion: Exposures to PM_2.5, PM₁₀, NO₂, and warm-season O₃, as well as their mixture, were associated with increased risk for MASLD and MASLD with significant liver fibrosis in adults in China.