Burden landscape of hepatobiliary and pancreatic cancers in Chinese young adults:30 years’overview and forecasted trends

BACKGROUND Hepatobiliary and pancreatic(HBP)cancers impose a considerable burden on young populations(aged 15 to 49 years),resulting in a substantial number of new cases and fatalities each year.In young populations,the HBP cancers shows extensive variance worldwide and the updated data in China is lacking.AIM To investigate the current status,trends,projections,and underlying risk factors of HBP cancers among young populations in China.METHODS The Global Burden of Disease Study 2019 provided data on the annual incidence,mortality,disability-adjusted life years(DALYs),age-standardized incidence rate(ASIR),mortality rate(ASMR),and DALYs rate(ASDR)of HBP cancers in young Chinese adults between 1990 and 2019.Temporal trends were assessed using estimated annual percentage change and hierarchical clustering.Sex-specific mortality and DALYs caused by various risks were analyzed across China and other regions,with future trends until 2035 projected using the Bayesian age-period-cohort model.RESULTS From 1990 to 2019,incident cases,deaths,DALYs,ASIR,ASMR,and ASDR for liver cancer(LC)in young Chinese individuals decreased,classified into'significant decrease'group.Conversely,cases of gallbladder and biliary tract cancer and pancreatic cancer rose,categorized as either'significant increase'or'minor increase'groups.The contribution of risk factors to mortality and DALYs for HBP tumors increased to varying degrees.Healthy lifestyle behaviors,such as tobacco control,weight management,alcohol moderation,and drug avoidance,could lower HBP cancers incidence.Moreover,except for LC in females,which is likely to initially decline slightly and then rise,the forecasting model predicted that the ASIR and ASMR for all HPB cancers subtypes by gender will increase among young adults.CONCLUSION HBP cancers burden among young adults in China is expected to increase until 2035,necessitating lifestyle interventions and targeted treatment strategies to mitigate the public health impact of these cancers.

Validity and Reliability of a Mental Health Recovery Checklist for Young Adults

The purpose of the present study is to evaluate the internal consistency and construct validity of a self-report checklist measuring clinical mental health recovery across six key domains:family and relationships,occupation and school,physical health,mental health,spirituality,and social support systems.The Mental Health Recovery Checklist(MHRC)was developed at The Dorm,an intensive outpatient mental health treatment program for young adults in New York,NY,and Washington DC that services individuals between the ages of 18 and 35 years old.The present study is cross-sectional,as data were pulled from clients’records who were discharged between January 2018 and May 2023.Pearson Correlations and Cronbach’s alpha were used to determine scale reliability.To establish validity,an Exploratory Factor Analysis(EFA)was conducted to assess a single-factor model using Principal Axis Factoring.Cronbach’s alpha was high(α=0.88),indicating good reliability.In the EFA,all items loaded strongly on a single factor.The unidimensional structure revealed in the EFA highlights the interconnected nature of various life domains as they pertain to mental health recovery in young adults.Future research is warranted to explore whether there are additional dimensions of mental health recovery that have not been assessed in the present scale.

Multimodal abnormalities of brain structures in adolescents and young adults with major depressive disorder:An activation likelihood estimation meta-analysis

BACKGROUND Major depressive disorder(MDD)in adolescents and young adults contributes significantly to global morbidity,with inconsistent findings on brain structural changes from structural magnetic resonance imaging studies.Activation likeli-hood estimation(ALE)offers a method to synthesize these diverse findings and identify consistent brain anomalies.METHODS We performed a comprehensive literature search in PubMed,Web of Science,Embase,and Chinese National Knowledge Infrastructure databases for neuroi-maging studies on MDD among adolescents and young adults published up to November 19,2023.Two independent researchers performed the study selection,quality assessment,and data extraction.The ALE technique was employed to synthesize findings on localized brain function anomalies in MDD patients,which was supplemented by sensitivity analyses.RESULTS Twenty-two studies comprising fourteen diffusion tensor imaging(DTI)studies and eight voxel-based morphome-try(VBM)studies,and involving 451 MDD patients and 465 healthy controls(HCs)for DTI and 664 MDD patients and 946 HCs for VBM,were included.DTI-based ALE demonstrated significant reductions in fractional anisotropy(FA)values in the right caudate head,right insula,and right lentiform nucleus putamen in adolescents and young adults with MDD compared to HCs,with no regions exhibiting increased FA values.VBM-based ALE did not demonstrate significant alterations in gray matter volume.Sensitivity analyses highlighted consistent findings in the right caudate head(11 of 14 analyses),right insula(10 of 14 analyses),and right lentiform nucleus putamen(11 of 14 analyses).CONCLUSION Structural alterations in the right caudate head,right insula,and right lentiform nucleus putamen in young MDD patients may contribute to its recurrent nature,offering insights for targeted therapies.

Stress Relief Measurements in Young Adults and Adolescents—A Comparative Pilot Study with Different Relaxation Programs

Background: Chronic stress is a emotional challenge. Constant pressure presents a serious risk of damage to mental and physical health and hence is associated with increased incidence of various diseases. The ability to cope with chronic stress may be a function of psychological resilience including intellectual capacities, but more so of external factors such as life experience and education. Adolescents are more vulnerable to chronic stress than adults. The measures introduced during the COVID-19 pandemic brought up major societal problems. As both children and adolescents lost their life anchors, the prevalence of stress in adolescents increased from 20% to 45%. Chronic psychological stress can impede the normal development of schoolchildren. It may cause anxiety, social withdrawal, interpersonal conflicts and aggression. This applies particularly to those in puberty, with the adolescent already facing unstable social bonds and elevated fear about the future. It is likely that the puberty cohort accounts for the dramatic increase in the prevalence of stress. Since it impacts public health, chronic stress among school-age children is increasingly taking on a socio-political dimension. Non-clinical stress intervention studies can investigate how to achieve stress reduction in school children. Methods: In a small pilot study, we analysed the effects of a training program with four different standard interventions, i.e. mindfulness training, progressive muscle reflection, autogenic training, and sound meditation. We obtained baseline scores of 10 stress-indicators, and re-tested after the interventions were performed. Results: The four applied interventions resulted in a reduction of 8 (out of 10) stress-indicators, such as “feeling stressed” or stress related symptoms (headaches, dizziness, sweating). This positive impact of the interventions significantly reduced “Fears about the future” (p Discussion: School children recognise the positive potential of stress reducing training or interventions. Our results provide evidence in support of integrating the training of relaxation techniques in the school curriculum. We propose that a larger study be undertaken to determine which methods would be most effective.

Study on the association of multimorbidity with sleep and diet in young and middle-aged adults in Chongqing region,China

Background:The prevalence of multimorbidity is increasing,with a notable shift towards younger age groups.Methods:Convenience sampling was employed to select 15,988 young and middle-aged adults in Chongqing as the study population.The Apriori algorithm was used to identify the multimorbidity patterns within this population,while an unordered binary logistic regression model was applied to assess the association between sleep,diet and the risk of multimorbidity.Results:The study population had an average age of 39.2±10.1 years.Apriori association rules revealed that the most prevalent binary chronic disease multimorbidity pattern was dyslipidaemia+hypertension(14.78%),while the most common ternary chronic disease multimorbidity pattern was diabetes+dyslipidaemia+hypertension(9.66%).The logistic regression analysis revealed that a lower rating of sleep quality was associated with an elevated risk of multimorbidity(odds ratio(OR)=1.17,95%confidence interval(CI):1.01,1.36).Individuals who adhere to a meat-based diet(OR=1.45,95%CI:1.25,1.68)and those with elevated salt intake(OR=1.22,95%CI:1.01,1.47)were also observed to have an increased risk of multimorbidity.Additionally,a greater likelihood of multimorbidity was observed among those following a spicy diet(OR=1.3,95%CI:1.11,1.52)and consuming more oil(OR=1.16,95%CI:1.01,1.33).Conclusion:A poor sleep quality and a dietary preference for meat-based,salt,spicy and oils were found to be associated with an increased risk of multimorbidity progression among young and middle-aged populations.It is recommended that young and middle-aged adults should pay attention not only to sleep duration but also to sleep quality and improve dietary habits to reduce the likelihood of multimorbidity.

Determinants of Knowledge, Attitudes, and Practices among Young Adults Type 2 Diabetes Patients in Selected Tertiary Hospitals in Shandong Province, China

Objective: The purpose of this study is to understand the current situation of knowledge, attitude, and practice of self-management in young patients with type 2 diabetes mellitus (T2DM) and to explore the relationship between general conditions (personal, social, and environment, clinical factors) and their knowledge, attitude, and practices (KAP) of diabetes self-management, This aims to provide patients with high-quality nursing care management and services, as well as to provide relevant recommendations for effective self-management. Methods: This study is a descriptive correlational study that used the purposive sampling method to investigate 359 patients with T2DM aged 18-25 years in four designated tertiary hospitals in Shandong Province. Results: Knowledge of self-management was correlated with sex, age, education level, occupation and work situation, monthly household income, medical payment method, family and friend support, frequency of diabetes health education, and diabetes complications. The attitude subscale was correlated with sex, age, education level, work situation, and family and friend support. The practice subscale was associated with age, education level, work situation, family and friend support, frequency of diabetes health education, and HbA1c values. Conclusion: Young adults aged 18-25 with T2DM have positive attitudes towards diabetes self-management, but there are still deficiencies in knowledge acquisition and behavioral practice. The KAP of self-management of diabetes is influenced by personal factors such as sex, age, and education level, and socio-environmental factors such as family income and family or friends’ social support. Additionally, clinical factors such as complications and HbA1c values significantly impacted the patient’s disease self-management ability.

Maturity-onset diabetes of the young type 9 or latent autoimmune diabetes in adults:A case report and review of literature

BACKGROUND Maturity-onset diabetes of the young(MODY)is a monogenic genetic disease often clinically misdiagnosed as type 1 or type 2 diabetes.MODY type 9(MODY9)is a rare subtype caused by mutations in the PAX4 gene.Currently,there are limited reports on PAX4-MODY,and its clinical characteristics and treatments are still unclear.In this report,we described a Chinese patient with high autoimmune antibodies,hyperglycemia and a site mutation in the PAX4 gene.CASE SUMMARY A 42-year-old obese woman suffered diabetes ketoacidosis after consuming substantial amounts of beverages.She had never had diabetes before,and no one in her family had it.However,her autoantibody tested positive,and she managed her blood glucose within the normal range for 6 mo through lifestyle interventions.Later,her blood glucose gradually increased.Next-generation sequencing and Sanger sequencing were performed on her family.The results revealed that she and her mother had a heterozygous mutation in the PAX4 gene(c.314G>A,p.R105H),but her daughter did not.The patient is currently taking liraglutide(1.8 mg/d),and her blood glucose levels are under control.Previous cases were retrieved from PubMed to investigate the relationship between PAX4 gene mutations and diabetes.CONCLUSION We reported the first case of a PAX4 gene heterozygous mutation site(c.314G>A,p.R105H),which does not appear pathogenic to MODY9 but may facilitate the progression of latent autoimmune diabetes in adults.

Effects of long COVID-19 among young adults in Turkey:A cross-sectional study

Objective:To investigate the cognitive state,psychological problems such as depression and anxiety,and pain in the musculoskeletal system among young adults with post-COVID-19(long COVID)syndrome.Methods:This descriptive study included 361 students studying at the Vocational School of Health Services of Bingöl University in Turkey.Data were collected using the Socio-Demographic Information form,the Beck’s Depression Inventory,the Cognitive Appraisal Scale,and the Visual Analogue Scale for pain.Results:Compared to those without COVID-19,the mean depression score,cognitive appraisal score,and mean Visual Analogue Scale score of the young adults with COVID-19 were significantly higher.There was no significant difference in pain assessment at rest between those with COVID-19 and those without COVID-19.Conclusions:Young adults with COVID-19 are more depressed,their cognitive functions are more easily negatively affected,and experience more pain during exercise.

Video-Based Interventions for Adolescents and Young Adults with Autism Spectrum Disorder:A Systematic

Many individuals with autism spectrum disorder(ASD)experience delays in the development of social and communications skills,which can limit their opportunities in higher education and employment resulting in an overall negative impact to their quality of life.This systematic review identifies 15 studies that explored the effectiveness of Video-Based Interventions(VBIs)for those with ASD during the critical years of adolescence and young adulthood.The 15 studies described herein found this to be an effective intervention for this population for the improvement of their vocational,daily living,and academic skills.In addition,VBIs allow for the maintenance and generalization of the different target behaviors that were examined.The majority of the studies located by this review also investigated the social validity of the intervention method with participants and caregivers and found these VBIs to have high social validity.Although a few studies that implemented VBIs to improve academic skills were located,the research on their use in this area was found to be lacking,indicating a gap in the research on VBIs.Increased usage of VBIs—including video modeling and video prompting—with the target population of those aged 15–28 with ASD is recommended with specific attention given to the use of VBIs to improve the academic and social skills of adolescents and young adults with ASD.

Body mass index and its effects on liver fat content in overweight and obese young adults by proton magnetic resonance spectroscopy technique

AIM To assess the association between liver fat content(LFC) and weight status in young adults using proton magnetic resonance spectroscopy(1H MRS) technique.METHODSSeventy-eight healthy young adults, between 19-30 years of age participated in this study. This group was then separated into a control of 39 subjects and an overweight/obese group(OW/OB group) consisting of 39 subjects. Blood biochemical quantity and 1 H MRS was performed for LFC assessment.RESULTS LFC was found to be almost three times higher in OW/OB group when compared to the control group. A 48.7% incidence of non-alcoholic fatty liver disease in the OW/OB group was found. Blood biochemical measurements showed statistically higher low-density lipoproteins and triglyceride, lower highdensity lipoproteins, and increased glycosylated hemoglobin and fasting glucose in the OW/OB group. Body mass index was a significant independent predictor for LFC after adjusting for age and sex(multiple linear regression; β = 0.459, P <0.001).CONCLUSION Due to the prevalence of high LFC in the OW/OB group, it can be proposed that weight gain and obesity are sensitive indicators of high hepatic fat content.

Choroidal thickness measurements in young Saudi adult population: a cross-sectional study

AIM:To determine the choroidal thickness(CT)in young healthy Saudi adults using spectral-domain optical coherence tomography(SD-OCT)with an automated CT segmentation software.METHODS:Fifty-eight young adults(total of 116 eyes),39 males and 19 females participated in this study between the ages of 18 and 38y(mean 22.65±3.9y).All participants underwent ophthalmic screening examination,including the SD-OCT for measurements of CT in each quadrant egmented into five eccentric regions starting from the foveal region up to 4.5 mm towards the periphery.RESULTS:The choroid was thickest in the foveal region(central 1 mm,300±60μm)and began to progressively thinner beyond the parafovea(1.5–2.5 mm,284±67μm)towards the peripheral region(3.5–4.5 mm from the fovea,254±83μm).The superior choroid showed the thickest profile(309±57μm),while the nasal choroid exhibited the thinnest(229±76μm).The rate of the thinning with increasing eccentricity was more predominant in the nasal choroid,which thinned from the foveal region(294±58μm)to the peripheral region(158±55μm).The superior and inferior choroid did not show a statistically significant thinning with eccentricity(all P>0.05).There was no statistically significant difference in the CT between gender,age,and laterality of the eyes(all P>0.05).A significant association of myopia with thinner subfoveal choroid was observed(Pearson’s,r=0.37),and regression analysis showed that a 10.3μm choroidal thinning for each diopter increase of myopia.CONCLUSION:CT profile depends on eccentric and the quadrant.The CT profile across the measured area in the young Saudi adult population is comparable to other previous reports.Refractive error is critical for CT evaluation.

Digestive cancer incidence and mortality among young adults worldwide in 2020:A population-based study

BACKGROUND Digestive cancer has traditionally been thought of as a disease that mainly occurs in elderly individuals,and it has been ignored in young adults by both patients and physicians.AIM To describe the worldwide profile of digestive cancer incidence,mortality and corresponding trends among 20–39-year-olds,with major patterns highlighted by age,sex,development level,and geographical region.METHODS I performed a population-based study to quantify the burden of young adult digestive cancers worldwide.Global,regional,sex,and country-specific data estimates of the number of new cancer cases and cancer-associated deaths that occurred in 2020 were extracted from the GLOBOCAN Cancer Today database.To assess long-term trends in young adult digestive cancer,cancer incidence data and mortality data were obtained from the Cancer in Five Continents Plus database and the World Health Organization mortality database,respectively.The associations between the human development index(HDI)and digestive cancer burden in young adults were evaluated by linear regression analyses.RESULTS In 2020,there were an estimated 19292789 new cancer cases,resulting in 9958133 deaths worldwide,which equated to an age-standardized incidence rate(ASIR)of 5.16 and age-standardized mortality rate(ASMR)of 3.04,accounting for 12.24%of all new cancer cases and 25.26%of all cancer deaths occurring in young adults.The burden was disproportionally greater among males,with male:female ratios of 1.34 for incidence and 1.58 for mortality.The ASIRs were 2.1,1.4,and 1.0 per 100000 people per year,whereas the ASMRs were 0.83,1.1,and 0.62 per 100000 people per year for colorectal,liver,and gastric cancer,respectively.When assessed by geographical region and HDI levels,the cancer profile varied substantially,and a strong positive correlation between the mortality-to-incidence ratio of digestive cancer and HDI ranking was found(R^(2)=0.7388,P<0.001).CONCLUSION The most common digestive cancer types are colorectal,liver and gastric cancer.The global digestive cancer burden among young adults is greater among males and exhibits a positive association with socioeconomic status.The digestive cancer burden is heavy in young adults,reinforcing the need for primary and secondary prevention strategies.

Spontaneous Bilateral Pneumothorax in a Healthy Young Adult: A Comprehensive Case Report

Background: Spontaneous bilateral pneumothorax in healthy young adults is a rare and challenging condition that defies conventional diagnostic and etiological paradigms. This case report explores the presentation, diagnostic evaluation, management, and potential contributing factors in a 29-year-old male with no prior medical history who experienced bilateral spontaneous pneumothoraces. Aim: This case report aims to shed light on the complexities of managing spontaneous bilateral pneumothorax, particularly in the absence of common risk factors. It underscores the need for a thorough assessment and ongoing research to unravel the enigma surrounding this condition. Case Presentation: A healthy 29-year-old male presented with acute chest pain and shortness of breath, ultimately diagnosed with bilateral spontaneous pneumothoraces. Despite the absence of typical risk factors, advanced imaging techniques revealed valuable insights into the diagnosis and management of this unique presentation. Conclusion: Spontaneous bilateral pneumothorax in healthy individuals presents diagnostic challenges and raises questions about potential genetic predisposition, connective tissue disorders, and lifestyle-related triggers. While the acute phase was effectively managed, this case underscores the importance of interdisciplinary collaboration and ongoing research to comprehensively understand this condition.

Awareness and perceived barriers in practicing healthy living to prevent hypertension among young adults in Malaysia

Objective:To investigate the knowledge,attitude,and practice levels and perceived barriers towards healthy living to prevent hypertension among young adults in Malaysia.Methods:Adults aged 18-25 years reside in Malaysia were recruited via convenience sampling.Sociodemographic characteristics,medical knowledge on hypertension(K1),knowledge(K),attitude(A),practice(P)and perceived barriers in practising healthy living to prevent hypertension were assessed.Average scores were categorised into good(80%-100%),upper-moderate(70%-79%),lower-moderate(60%-69%)and poor(<60%).Multivariate analysis was performed to test the difference and relationship of variables.Pearson correlation test was used to test the association of two continuous variables.Results:A total of 1218 respondents participated in this survey.The mean score of K1 was 54.1%,while the knowledge,attitude,and practice towards healthy living were 82.7%,78.2%and 68.5%respectively.The prevalence of high salt intake,high fat intakes,low fibre intake,sedentary lifestyle and lack of annual health screening was 83.2%,81.4%,70.3%,and 73.2%,respectively.Abnormal BMI was associated with low P scores,while lower socio-economic status,unawareness of self-blood pressure reading and those without family history of hypertension were associated with lower scores in K1,K,A,and P.K1,K,A and P are significantly inter-related.The main perceived barriers included self-proclaimed good fit status,frequent consumption of out-of-home food,and addiction to high salt/fat food.Conclusions:The national strategies for health management should be prioritized in reducing salt and fat,promoting annual health screening,physical activities and fibre intake in this age group.

Physical exercise,Sedentary Behaviour,Sleep and Depression Symptoms in Chinese Young Adults During the COVID-19 Pandemic:A Compositional Isotemporal Analysis

Numerous studies links movement activity(e.g.,physical activity,sedentary behavior[SB],and sleep)with mental health or illness indicators during the COVID-19 pandemic;however,research has typically examined time-use behaviors independently,rather than considering daily activity as a 24-hour time-use composition.This cross-sec-tional study aimed to use compositional isotemporal analysis to estimate the association between reallocation of time-use behaviors and depression symptoms in young adults in China.Participants(n=1475;68.0%of female;20.7[1.60]years)reported their time spent in moderate to vigorous physical activity(MVPA),light physical activ-ity(LPA),SB,and sleep.Replacing SB with sleep,LPA,and MVPA at 5,10,or 15 min was significantly associated with lower estimated depression symptoms scores.For example,adding MVPA from SB at 15 min was associated with lower depression symptoms scores(estimated difference:-0.13[-0.17,-0.09]).The associations between reallocation of time use behaviors with depression symptoms scores were slightly differentiated.Our results emphasize the importance of increased MVPA and decreased SB as well as their mutual replacements for lowering the risks of depression symptoms in young adults during the COVID-19 pandemic.Our results can inform policy to develop effective plans and strategies for mental health promotion.

Different risk factors for advanced colorectal neoplasm in young adults

AIM: To compare the risk of developing advanced colorectal neoplasm(ACRN) according to age in Koreans.METHODS: A total of 70428 Koreans from an occupational cohort who underwent a colonoscopy between 2003 and 2012 at Kangbuk Samsung Hospital were retrospectively selected. We evaluated and compared odds ratios(OR) for ACRN between the young-adults(YA < 50 years) and in the older-adults(OA ≥ 50 years). ACRN was defined as an adenoma ≥ 10 mm in diameter, adenoma with any component of villous histology, high-grade dysplasia, or invasive cancer.RESULTS: In the YA group, age(OR = 1.08, 95%CI: 1.06-1.09), male sex(OR = 1.26, 95%CI: 1.02-1.55), current smoking(OR = 1.37, 95%CI: 1.15-1.63), family history of colorectal cancer(OR = 1.46, 95%CI: 1.01-2.10), diabetes mellitus related factors(OR = 1.27, 95%CI: 1.06-1.54), obesity(OR = 1.23, 95%CI: 1.03-1.47), CEA(OR = 1.04, 95%CI: 1.01-1.09) and low-density lipoprotein-cholesterol(OR = 1.01, 95%CI: 1.01-1.02) were related with an increased risk of ACRN. However, age(OR = 1.08, 95%CI: 1.06-1.09), male sex(OR = 2.12, 95%CI: 1.68-2.68), current smoking(OR = 1.38, 95%CI: 1.12-1.71), obesity(OR = 1.34, 95%CI: 1.09-1.65) and CEA(OR = 1.05, 95%CI: 1.01-1.09) also increased the risk of ACRN in the OA group.CONCLUSION: The risks of ACRN differed based on age group. Different colonoscopic screening strategies are appropriate for particular subjects with risk factors for ACRN, even in subjects younger than 50 years.

Risky Meetings Despite Knowledge of the Risk: A Qualitative Study of Young Adults Treated for Chlamydia Infection at a Sexual Transmitted Infection Clinic

The aim of the study was to describe the attitudes to risk behavior among patients diagnosed with a Chlamydia infection at a Sexual Transmitted Infection (STI) clinic. Qualitative interviews face-to-face were conducted with twenty patients, aged 18 - 30 years, with confirmed Chlamydia infections were included. An interview guide was used and the participants described the behavior that had led to the infection. The material was analyzed using qualitative content analysis. Eighteen informants were included and the theme was risk. Recurrent among the informants was risk behavior in sexual relations when using alcohol, while risk behavior in life in general was almost non-existent. Of the 18 informants, sixteen had previously been tested for STIs, and ten had had an STI before. Alcohol consumption emerged as a common denominator among the informants and as a contributor to risk. In contrast, almost none of the informants exposed themselves to any unnecessary risks in life in general.

Breastfeeding Knowledge, Attitude and Intention among Female Young Adults in Ibadan, Nigeria

Background: The decision to breastfeed is largely dependent on mothers’ breastfeeding knowledge and attitude which are usually formed in their adolescence and early adulthood. It is important to focus research on female young adult who are at the verge of stepping into motherhood. Methods: The breastfeeding knowledge, attitude and intention of 457 female young adults in Ibadan, Nigeria were assessed through validated breastfeeding knowledge, attitude and intention scales. Results: Majority (87.5%) of the respondents had never given birth and 74.6% had previously participated in breastfeeding discussions. About half (52.1%) knew breastfeeding should be initiated within one hour of birth while 49.9% reported that pre-lacteal feed should not be given to newborn babies. Correct definition of exclusive breastfeeding was given by two-third of the respondents and three-quarter specified that breastfeeding was beneficial to both mother and child. Overall 43.1% of the respondents had good breastfeeding knowledge. About 80% of the respondents agreed that breastfeeding should be initiated within one hour after delivery, 37.8% were of the opinion that breast milk only was not sufficient for infants in the first 6 months of life while about half of the respondents agreed that water should be introduced to babies before 6 months. In all, 53.8% had positive attitude towards breastfeeding. Only a third of the respondents had good breastfeeding intention although 90.6% claimed that they intended to breastfeed. Only 35.9% indicated to have known all it took to breastfeed and 54% intended to introduce breastmilk within 1 hour of birth while 60% had the intention of breastfeeding exclusively. There was significant association between breastfeeding knowledge and attitude as well as breastfeeding knowledge and intention. Conclusion: Female young adult demonstrated relatively fair breastfeeding knowledge and attitude but poor intention to breastfeed. Intervention to improve breastfeeding knowledge, attitude and intention of this population is recommended.

Contemporary nationwide trends in major adverse cardiovascular events in young cannabis users without concomitant tobacco,alcohol,cocaine use

BACKGROUND Cannabis use has increased among young individuals in recent years.Although dependent cannabis use disorder(CUD)has been associated with various cardiac events,its effects on young adults without concurrent substance use remain understudied.AIM To examine trends in hospitalizations for major adverse cardiac and cerebrovascular events(MACCE)in this cohort.METHODSWe used the National Inpatient Sample(2016-2019)to identify hospitalized young individuals(18-44 years),excluding those with concurrent substance usage(tobacco,alcohol,and cocaine).They were divided into CUD+and CUD-.Using International Classification of Diseases-10 codes,we examined the trends in MACCE hospitalizations,including all-cause mortality(ACM),acute myocardial infarction(AMI),cardiac arrest(CA),and acuteischemic stroke(AIS).RESULTSOf 27.4 million hospitalizations among young adults without concurrent substance abuse,4.2%(1.1 million)hadco-existent CUD.In CUD+group,hospitalization rates for MACCE(1.71%vs 1.35%),AMI(0.86%vs 0.54%),CA(0.27%vs 0.24%),and AIS(0.49%vs 0.35%)were higher than in CUD-group(P<0.001).However,rate of ACMhospitalizations was lower in CUD+group(0.30%vs 0.44%).From 2016 to 2019,CUD+group experienced arelative rise of 5%in MACCE and 20%in AMI hospitalizations,compared to 22%and 36%increases in CUDgroup(P<0.05).The CUD+group had a 13%relative decrease in ACM hospitalizations,compared to a 10%relative rise in CUD-group(P<0.05).However,when adjusted for confounders,MACCE odds among CUD+cohort remain comparable between 2016 and 2019.CONCLUSIONThe CUD+group had higher rates of MACCE,but the rising trends were more apparent in the CUD-group overtime.Interestingly,the CUD+group had lower ACM rates than the CUD-group.

Inhibited and impulsive subgroups of socially anxious young adults: Their depressive symptoms and life satisfaction

Purpose: Socially anxious people are typically thought of as being behaviorally inhibited;however, an atypical subgroup, which is impulsive rather than inhibited, has recently been identified [1]. Theoretically, inhibition and impulsivity could be viewed as different strategies for coping with anxiety that have the same goal—escape from negative emotions—but they seem to have different implications. Previous studies have found that the socially anxious-impulsive subgroup was higher on risk-prone behavior, as for example drug use, compared with a socially anxious-inhibited subgroup [1]. In this study, we aimed to identify these subgroups in a general population, and asked whether they also experience various levels of depressive symptoms and life satisfaction, as well as moderating effects of gender. Methods: Cluster analysis was used to identify subgroups of young adults (20 - 24 years old;N = 772) characterized by different profiles of social anxiety and impulsivity. These subgroups were compared on levels of internal adjustment, and the moderating effects of gender were also tested. Results: We identified five clusters, including an Anxious-Inhibited and an Anxious-Impulsive cluster. In the interaction between gender and cluster membership, gender showed evidence of moderation regarding both depressive symptoms and life satisfaction, with the young women in the Anxious-Inhibited and the Anxious-Impulsive clusters faring worst. Conclusions: We replicated previous findings demonstrating the existence of a socially anxious-impulsive subgroup, thus solidifying current knowledge that may be important when it comes to diagnostics and treatment. This may prove particularly important for young women regarding internalizing symptoms.