Yaling Li

Objective: To systematically evaluate the association between current statin use and global cognitive impairment in US older adults and examine potential variations across treatment intensity, duration, and specific cognitive domains to guide clinical cardiometabolic management. Methods: This survey‐weighted cross‐sectional study included 3137 National Health and Nutrition Examination Survey 2011–2014 participants aged ≥60 years. Cognitive performance across Consortium to Establish a Registry for Alzheimer's Disease, animal fluency, and digit symbol substitution test (DSST) was composite‐summarized to define impairment ( Z ‐score ← 1.5 standard deviation). Survey‐weighted multivariable models adjusted for sociodemographic, lifestyle, cardiometabolic, psychotropic medication, polypharmacy, and substance‐use proxies, supplemented by inverse probability of treatment weighting (IPTW) and multiple imputation. Results: In the primary fully adjusted model, current statin use was not associated with global cognitive impairment (odds ratio [OR] = 0.90, 95% confidence interval: 0.48–1.67, p = 0.736). Results remained consistent across psychotropic‐adjusted (OR = 0.91), IPTW (OR = 1.03), and multiply imputed models (OR = 0.86). Domain‐specific analyses showed statin use was associated with lower odds of DSST impairment (OR = 0.51, p = 0.009), with no clear trend across statin intensity or duration categories. Conclusion: Current statin use was not significantly associated with global cognitive impairment in older adults. Although cross‐sectional observational neutrality precludes inferring long‐term safety, indicated statin therapy should not be routinely withheld over cognitive concerns, with prescribing remaining firmly guided by established atherosclerotic cardiovascular disease risk guidelines.

This study comprehensively evaluated the epidemiological links between five classes of endocrine-disrupting chemicals—bisphenols, polychlorinated biphenyls, organochlorine pesticides, phthalates, and per- and polyfluoroalkyl substances—and thyroid cancer risk, aiming to lay an evidence-based foundation for clarifying environmental etiology and informing public health policy. A systematic search of databases including PubMed/MEDLINE, Cochrane Library, Web of Science, and Embase was conducted up to July 22, 2025. Meta-analysis was performed using Stata 17.0, with subgroup analyses based on geographical region, pathological subtype, and covariate adjustment for factors like BMI and sex. From 1,365 initially identified articles, 22 were included, encompassing 22,916 cases. The meta-analysis revealed that PAE metabolites MEHP, MEOHP, and MEHHP had significant positive associations with thyroid cancer risk. In contrast, the PFAS perfluorooctanoic acid showed a significant negative association. No significant associations were found for bisphenols, polychlorinated biphenyls, or organochlorine pesticides. Subgroup analyses suggested that region, pathological subtype, sample type, and covariate adjustment may influence the observed associations. In conclusion, specific PAE metabolites significantly increase thyroid cancer risk, representing potential new environmental risk factors, whereas the negative correlation with PFOA requires further mechanistic investigation. The findings highlight the need to strengthen monitoring and intervention regarding PAE exposure and to promote individualized risk early warning based on pathological typing.

1. Gastric cancer (GC) is the fifth most common malignant tumor and the third leading cause of cancer-related deaths globally, with a significant regional disparity in disease burden. East Asia acc...

To identify key risk factors associated with mortality in necrotizing fasciitis (NF) and provide clinicians with evidence-based guidance for risk stratification and management. A systematic review and meta-analysis was conducted. PubMed, Embase, Web of Science, Cochrane Library, and ProQuest were searched from inception to 19 May 2023, with an update on 31 May 2025. Cohort studies reporting adjusted risk estimates for NF-related mortality were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Of 30,563 identified articles, 14 studies involving 26,242 patients were included. The strongest predictors of NF mortality were advanced age (odds ratio [OR] 1.160, 95% CI 1.100-1.223), cardiopathy (OR 2.210, 95% CI 1.274-3.833), elevated creatinine (OR 2.200, 95% CI 1.127-4.294), and Clostridium infection (OR 6.422, 95% CI 2.171-19.003). Race appeared protective, particularly among Black patients (OR 0.780, 95% CI 0.645-0.943). No significant associations were found for gender, pneumopathy, hepatopathy, nephropathy, diabetes, malignancy, or several laboratory and microbial factors. Advanced age, cardiopathy, elevated creatinine, and Clostridium infection are significant mortality risk factors in NF. Race may have a protective effect. Further research is warranted to clarify the roles of other clinical and laboratory variables.