Dental and oral health assessments in the German National Cohort (NAKO).

Background: Despite considerable improvements in oral health in recent decades, caries and periodontitis are still widespread, ranking among the most prevalent diseases worldwide and requiring future research. The German National Cohort (NAKO Gesundheitsstudie, NAKO) is a large-scaled, multidisciplinary, nationwide, multi-centre, population-based, prospective cohort study with oral examinations that aims to provide a resource to study risk factors for major diseases. The aim of the present article is to provide the methodological background, to report on the data quality, and to present initial results of the oral examinations.

Associations between common genetic variants and income provide insights about the socio-economic health gradient.

We conducted a genome-wide association study on income among individuals of European descent (N = 668,288) to investigate the relationship between socio-economic status and health disparities. We identified 162 genomic loci associated with a common genetic factor underlying various income measures, all with small effect sizes (the Income Factor). Our polygenic index captures 1-5% of income variance, with only one fourth due to direct genetic effects.

Diurnal timing of physical activity in relation to obesity and diabetes in the German National Cohort (NAKO).

Background: Physical activity supports weight regulation and metabolic health, but its timing in relation to obesity and diabetes remains unclear. We aimed to assess the diurnal timing of physical activity and its association with obesity and diabetes.

Methods: We cross-sectionally analyzed hip-worn accelerometry data from 61,116 participants aged 20-75 in the German National Cohort between 2015 and 2019.

How does an intervention work?-English Version : Development of an effect model for a complex intervention to prevent recurring or persistent pain using the example of PAIN 2.0.

In addition to the usual evaluation approach (usually a clinical randomized trial in the sense of the question: does an intervention work), complex interventions require further systematic investigations to prove their effectiveness. The role of the context in which the intervention is delivered is essential here, as is consideration of the question of why an intervention works (or does not work). Detailed recommendations exist for the planning and implementation of effectiveness studies on complex interventions, to which interdisciplinary multimodal pain therapy undoubtedly belongs.

App-Based Coaching to Prevent Addictive Behaviors in Vocational School Students: A Cluster Randomized Trial.

Purpose: This two-arm cluster randomized controlled trial evaluated the effectiveness of an app-based addiction prevention program in German vocational school students.

Methods: Schools from 5 German federal states were recruited. No eligibility criteria for classes were applied; enrollment decisions were made by school heads or teachers.

Modifiable risk factors and symptom progression in dementia over up to 8 years-Results of the DelpHi-MV trial.

Introduction: This study investigated the association between modifiable factors and symptom progression in dementia over up to 8 years.

Methods: Multilevel growth curve models assessed the role of modifiable risk factors (low education, hearing impairment and its treatment, depression, physical inactivity, diabetes and its treatment, smoking, hypertension and its treatment, obesity, alcohol consumption, social isolation, and visual impairment) on cognitive and functional trajectories in 353 people with dementia.

Results: Higher education was associated with higher initial cognitive status but faster decline.

Online survey on barriers and drivers to flu vaccination among staff at a German university hospital during the Covid-19 pandemic 2022 (flu-vaccination motive study).

Introduction: The success of flu vaccination depends primarily on the willingness of health care workers (HCWs) to be vaccinated. To identify barriers and drivers to vaccination, an online survey among employees and students of a university hospital was performed to develop a local strategy to increase the vaccination willingness in line with the WHO recommendation.

Method: A cross-sectional, anonymous, self-administered online survey was performed among HCWs, other staff, trainees and students of the Greifswald University Hospital between 17.

Identifying genetic differences between bipolar disorder and major depression through multiple genome-wide association analyses.

Background: Accurate diagnosis of bipolar disorder (BPD) is difficult in clinical practice, with an average delay between symptom onset and diagnosis of about 7 years. A depressive episode often precedes the first manic episode, making it difficult to distinguish BPD from unipolar major depressive disorder (MDD).

Aims: We use genome-wide association analyses (GWAS) to identify differential genetic factors and to develop predictors based on polygenic risk scores (PRS) that may aid early differential diagnosis.

Comparative effectiveness of laparoscopic versus open colectomy in colon cancer patients: a study protocol for emulating a target trial using cancer registry data.

Introduction: The objective of this study is to compare the 5 year overall survival of patients with stage I-III colon cancer treated by laparoscopic colectomy versus open colectomy.

Methods: Using Mecklenburg-Western Pomerania Cancer Registry data from 2008 to 2018, we will emulate a phase III, multicenter, open-label, two-parallel-arm hypothetical target trial in adult patients with stage I-III colon cancer who received laparoscopic or open colectomy as an elective treatment. An inverse-probability weighted Royston‒Parmar parametric survival model (RPpsm) will be used to estimate the hazard ratio of laparoscopic versus open surgery after confounding factors are balanced between the two treatment arms.

The Association Between Nutritional Risk and Bone Stiffness in Elderly Men and Women in a Population-Based Study in Northeast Germany.

Background: The Geriatric Nutritional Risk Index (GNRI) has shown promising potential for identifying individuals at risk for osteoporosis in various patient cohorts. However, data from the general population confirming or refuting the usefulness of the GNRI as a risk factor for osteoporosis are sparse. We therefore aimed to clarify whether the GNRI is associated with the ultrasound-based bone stiffness index and the osteoporotic fracture risk in a sample of elderly men and women from the general population.

XModNN: Explainable Modular Neural Network to Identify Clinical Parameters and Disease Biomarkers in Transcriptomic Datasets.

The Explainable Modular Neural Network (XModNN) enables the identification of biomarkers, facilitating the classification of diseases and clinical parameters in transcriptomic datasets. The modules within XModNN represent specific pathways or genes of a functional hierarchy. The incorporation of biological insights into the architectural design reduced the number of parameters.

Judged by your neighbors: Brain structural normativity profiles for large and heterogeneous samples.

The detection of norm deviations is fundamental to clinical decision making and impacts our ability to diagnose and treat diseases effectively. Current normative modeling approaches rely on generic comparisons and quantify deviations in relation to the population average. However, generic models interpolate subtle nuances and risk the loss of critical information, thereby compromising effective personalization of health care strategies.

Cost-effectiveness of a multicomponent intervention against cognitive decline.

Introduction: The societal costs of dementia and cognitive decline are substantial and likely to increase during the next decades due to the increasing number of people in older age groups. The aim of this multicenter cluster-randomized controlled trial was to assess the cost-effectiveness of a multi-domain intervention to prevent cognitive decline in older people who are at risk for dementia.

Methods: We used data from a multi-centric, two-armed, cluster-randomized controlled trial ( trial, ID: DRKS00013555).

Guidelines and standard frameworks for artificial intelligence in medicine: a systematic review.

Objectives: The continuous integration of artificial intelligence (AI) into clinical settings requires the development of up-to-date and robust guidelines and standard frameworks that consider the evolving challenges of AI implementation in medicine. This review evaluates the quality of these guideline and summarizes ethical frameworks, best practices, and recommendations.

Materials And Methods: The Appraisal of Guidelines, Research, and Evaluation II tool was used to assess the quality of guidelines based on 6 domains: scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence.

Periodontal Probing Depth Trajectory in 10 Years of Follow-Up as Associated With Tooth Loss.

Aim: To elucidate whether ranked probing depth (PD) data translate into ranked PD outcomes after 10 years of follow-up and the associated tooth loss.

Materials And Methods: From the Study of Health in Pomerania (SHIP-START), all participants were retrospectively included with complete PD measurements in both baseline and 10-year follow-up, comprising 1887 participants. The trajectory of percentile-based quintiles of mean PD measurements was followed.

Dietary changes following a lifestyle-based intervention for dementia risk reduction - results from the AgeWell.de study.

Purpose: We investigated the effects of a multidomain lifestyle intervention conducted in older adults at increased risk for dementia on participants' diet.

Methods: Secondary analyses of the cluster-randomized AgeWell.de-trial, testing a multidomain intervention (optimization of nutrition and medication, enhancement of physical, social and cognitive activity) in older adults at increased dementia risk.

Tracking of serum lipids from prepuberty to young adulthood: results from the KiGGS cohort study.

Background: Universal lipid screening in childhood for early detection and treatment of familial hypercholesterolemia is under discussion, but will also detect children with multifactorial dyslipidemia. Results from population-based studies can support the design of public health strategies. As few previous studies considered pubertal changes in serum lipid levels, we examined tracking of serum lipids from prepuberty to young adulthood in a population-based cohort.

Cancer incidence and mortality in the occupational cohort of a German toxic waste landfill: a retrospective cohort study.

Background: Employees at the Ihlenberg toxic waste landfill in northern Germany were found to have an increased risk of cancer and cancer-related deaths in previous analyses covering the time period from 1983 to 2008. The present study aimed to quantify cancer risk and all-cause mortality in the employee cohort in 2009 to 2021.

Methods: In this retrospective cohort study, cancers were identified by linkage with cancer registries, and employee deaths were obtained from population registries.

Low income, being without employment, and living alone: how they are associated with cognitive functioning-Results from the German national cohort (NAKO).

Aim was to investigate to what extent cognitive functioning differs by three socioeconomic conditions: low income, being without employment, and living alone. A total of N = 158,144 participants of the population-based German National Cohort (NAKO) provided data on socioeconomic conditions and completed cognitive tests. Multivariable confounder-adjusted regression analyses indicated that cognitive functioning was lower in those with low income (b = -0.

Comparing Different Implementation Strategies for Collaborative Dementia Care Management in Terms of Patients' Characteristics, Unmet Needs, and the Impact on Quality of Life and Costs in Germany.

Objective: To compare the implementation of collaborative dementia care management (cDCM) across two settings regarding patients' characteristics, unmet needs, and the impact on health-related quality of life (HRQoL) and costs.

Methods: This analysis was based on data from the DCM:IMPact study, implementing cDCM in a physician network (n = 22 practices) and two day care centers (DCC) for community-dwelling persons with dementia over 6 months in Germany. Participants completed comprehensive assessments at baseline and 6 months after, soliciting sociodemographic and clinical characteristics, unmet needs, HRQoL and healthcare resource utilization.

Social participation and cognitive activities as explanation factor for the association between income and self-rated health for older adults.

Introduction: Health disparities pose a considerable challenge for older adults individuals, particularly those with a heightened risk of developing dementia. Discrepancies in health status among various income brackets are only partially attributable to structural factors such as working and living conditions or the quality of food. The aim of this study was therefore to explore whether and to what extent various health-promoting behaviors can explain the association between household income and self-rated health among older people at risk of dementia.

Associations between subclinical thyroid dysfunction and cardiovascular risk factors according to age and sex.

Context: Subclinical thyroid dysfunction (ScTD) comprising subclinical hypothyroidism (SHypo) and subclinical hyperthyroidism (SHyper) has been associated with increased risk for cardiovascular events.

Objective: To assess associations between ScTD and cardiovascular risk factors (cvRFs) according to age and sex.

Design And Setting: Pooled individual participant data analysis of large prospective cohort studies from the Thyroid Studies Collaboration.

Biological Age Affecting Attrition and Tooth Loss in a Follow-up Study.

In population-based longitudinal studies, bias caused by nonresponse among eligible participants and attrition during follow-up thwarts conclusions. As this issue is not commonly addressed in dental studies, it is the aim of this study to examine the consequences of attrition with respect to tooth loss and mortality in a 10-y follow-up study. From the Study of Health in Pomerania (SHIP-0), a biological age (BA) score was constructed from 10 systemic biomarkers and related to one's actual chronological age (CA).