Pincheng Luo

Introduction: Cardiogenic shock (CS) carries high morbidity and mortality. However, evidence for mechanical circulatory support (MCS) in non‐ischemic CS remains limited, as prior trials have focused on infarct‐related shock. Methods: We performed a retrospective cross‐sectional study using the Nationwide Inpatient Sample (2017–2019), identifying hospitalizations with a principal diagnosis of CS and excluding acute myocardial infarction. Patients were categorized into mutually exclusive groups: no MCS, intra‐aortic balloon pump (IABP) only, Impella only, or extracorporeal membrane oxygenation (ECMO) only. Primary outcomes were in‐hospital mortality, length of stay (LOS), and total hospital cost. Survey‐weighted multivariable models adjusted for demographics, hospital characteristics, and comorbidity burden using Elixhauser and Charlson indices. Results: Among 104 045 hospitalizations, 6040 received MCS. IABP was most common, followed by Impella and ECMO. Among patients receiving a single MCS strategy, overall in‐hospital mortality was 29.5%., with lower mortality in the IABP group (19.9%) compared with Impella (37.4%) and ECMO (44.3%). After adjustment, IABP was associated with lower observed in‐hospital mortality versus no MCS (aOR 0.58, 95% CI 0.53–0.64; p < 0.01), whereas Impella and ECMO showed increased aOR. IABP and ECMO were associated with longer LOS, while Impella was not. All MCS strategies were associated with higher costs, with ECMO showing the greatest increase (cost ratio 3.30, 95% CI 3.12–3.50). Conclusion: In non‐ischemic CS, MCS strategies demonstrate distinct profiles of mortality and resource utilization. IABP was associated with lower observed in‐hospital mortality, whereas all MCS were linked to higher costs, highlighting heterogeneity in outcomes and the need for further research.

Purpose: This study examined the independent and combined associations of handgrip strength weakness and asymmetry with incident stroke risk among adults aged ≥ 50 years. Method: Data were derived from the Survey of Health, Ageing and Retirement in Europe. Handgrip strength was objectively measured, while stroke was self‐reported as physician‐diagnosed. Asymmetry was defined using the ratio of left to right handgrip strength based on the “10% rule” and additionally assessed as the absolute difference between hands. Weakness was defined as < 16 kg for women and < 27 kg for men. Participants were further categorized into four groups according to weakness and asymmetry status. Cox proportional hazards models were applied to estimate associations. Results: Among 24 923 participants followed for a mean of 9.6 years, 1839 incident strokes occurred. Handgrip weakness was associated with higher stroke incidence (17.52 vs. 7.29 per 1000 person‐years) and a 55% increased risk compared with no weakness. Handgrip asymmetry was linked to a higher incidence (8.15 vs. 7.17 per 1000 person‐years) and a 13% increased risk. Each 1‐SD increase in asymmetry corresponded to a 2% higher risk. The highest risk was observed in participants with both weakness and asymmetry (18.29 per 1000 person‐years; HR: 1.70; 95% CI: 1.35–2.14). Interaction analyses indicated that the joint effect did not exceed the sum or product of individual effects. Conclusion: Handgrip weakness and asymmetry independently increased stroke risk, with the highest risk observed when both were present, yet their combined effect did not exceed what would be expected from each factor alone.

The aim of this study is to examine the association between physical activity patterns and all-cause mortality among U.S. adults with osteopenia or osteoporosis. Data from adults with osteopenia or osteoporosis were obtained from the National Health and Nutrition Examination Survey 2007 to 2018, a nationally representative survey of U.S. adults, with mortality follow-up through 2019. Bone mineral density was assessed at 4 femoral sites using dual-energy X-ray absorptiometry. Physical activity was self-reported and categorized as physically inactive (<150 minutes/week) or active (≥150 minutes/week). Active participants were further classified as weekend warriors (1–2 sessions/week) or regularly active (≥3 sessions/week). Cox proportional hazards models estimated hazard ratios (HRs) for all-cause mortality. Among 5522 participants (mean age: 61.74 years), 991 (17.95%) died during a mean follow-up of 85.0 months. Compared to regularly active participants, weekend warriors had no statistically significant difference in all-cause mortality risk (HR: 1.12; 95% confidence interval (CI): 0.62–2.03). Further subdivision of weekend warriors by frequency (1 vs 2 days/week) yielded similar results. In contrast, physical inactivity was associated with significantly higher mortality risk (HR: 1.78; 95% CI: 1.38–2.28). Among adults with osteopenia or osteoporosis, meeting physical activity guidelines, even over 1 or 2 days per week, was associated with lower mortality risk. These findings support the weekend warrior pattern as a viable strategy for improving longevity in this at-risk population.

Objective: This study investigates the association between body roundness index (BRI) and overall cancer incidence in a large population‐based cohort and explores the consistency of this association in individuals with and without cardiometabolic disease (CMD). Design: A prospective cohort study. Setting: Data for this study was extracted from three cohorts: the English Longitudinal Study of Aging, the Health and Retirement Study, and the China Health and Retirement Longitudinal Study. Participants: Among 33,624 individuals aged 50 and older, 2999 reported a cancer diagnosis. Measurements: BRI was calculated using measured height and waist circumference, while cancer and CMD were based on self‐reported physician diagnoses. Restricted cubic spline curves assessed nonlinearity and identified BRI cutoff points. Cox proportional hazards models were used to evaluate the association between BRI and cancer incidence, with subgroup and interaction analyses conducted by CMD status. Results: A non‐linear relationship was identified between BRI and cancer incidence, with an inflection point at BRI = 5.06. Participants with BRI > 5.06 had a 10% higher risk of cancer (HR: 1.10; 95% CI: 1.02–1.19) compared to those with BRI ≤ 5.06, while increases in BRI below this threshold were not significantly associated with risk. This remained consistent across CMD‐stratified analyses. No significant interaction was detected between BRI and CMD status. Conclusion: BRI is associated with cancer risk in a non‐linear manner, with increased risk above a defined threshold, irrespective of CMD status. These findings highlight the potential of BRI as a simple tool for cancer risk screening in older adults.

Objectives: This study aims to estimate the spatiotemporal variation in the burden of colorectal cancer (CRC) attributable to low physical activity (LPA) at global, regional, and national levels from 1990 to 2021. Study design: Cross-sectional study. Methods: Annual data on deaths of CRC related to LPA, age-standardized mortality rate (ASMR), disability-adjusted life years (DALYs), and the age-standardized DALYs rate (ASDR) for 204 countries and territories from 1990 to 2021 was extracted from the Global Health Data Exchange website. They were retrieved by age (5-year age groups from 25 to 94 years, and 95+ years), gender (male and female), and Socio-demographic Index (SDI). The association between age-standardized rates and SDI values was assessed by Spearman’s correlation. Results: Between 1990 and 2021, there was nearly a twofold increase in DALYs and mortality globally for CRC related to LPA, despite decreases in ASMR and ASDR (EAPC: −0.82% and −0.83%, respectively). However, on a national scale, ASMR and ASDR increased in more than half of the world’s countries and territories. Moreover, a greater burden of CRC related to LPA was observed in older populations, females, and those residing in regions with an SDI near 0.77. Conclusion: These findings indicate the critical need to raise awareness about the preventive role of physical activity in CRC. Policymakers should prioritize developing and implementing strategies that ensure equitable access to sports resources, enabling more people to meet the World Health Organization guidelines.