To analyze the research development trends of telemedicine applications in cardiovascular disease management in low- and middle-income countries based on bibliometric methods.

Research articles related to the application of telemedicine in cardiovascular disease management within middle-and low-income countries were retrieved from the Web of Science database, covering the period from January 1, 1998, to April 30, 2024. Using Excel, VOS viewer, and R software, we analyzed and visualized annual publication volume, regional research intensity, keywords, country citations, and conducted regional disparity and research topic analyses.

A total of 514 articles were included in the study. The number of publications on telemedicine in cardiovascular disease management in low- and middle-income countries showed an upward trend from 1998 to 2023, particularly experiencing rapid growth since 2012. China (21%), the United States (13%), and India (11%) ranked as the top three countries in terms of research output. Among 134 low- and middle-income countries, 57(43%) reported the application of telemedicine in cardiovascular disease management, with the highest research output from China, India, Brazil, Iran, and Bangladesh. The research primarily focused on upper-middle-income (50.3%) and lower-middle-income countries (40.9%). The technological applications were concentrated in disease risk factor control, screening, and diagnosis, covering all stages of prevention. The most commonly used tools included mobile applications and wearable electrocardiogram devices, which have increasingly incorporated machine learning, deep learning, and artificial intelligence technologies in recent years. The target users of these technologies included the general public, patients, and healthcare service providers.

The volume of literature on telemedicine in cardiovascular disease management in low- and middle-income countries continues to grow, integrating into the entire management process of cardiovascular diseases in these regions.However, challenges such as the digital divide due to regional development disparities persist. There is an urgent need to promote the implementation of technology support and economic incentive policies, particularly in African countries, to establish an efficient, safe, and convenient digital cardiovascular disease management system.

To evaluate the clinical value of maternal liver function indicators combined with umbilical artery blood flow parameters in diagnosing fetal growth restriction (FGR).

This study employed a case-control design, including pregnant women who underwent prenatal examinations and delivered at Southern Hospital of Southern Medical University from December 2017 to July 2022. The case group consisted of 172 pregnant women clinically diagnosed with FGR, while the control group included 292 pregnant women with normal pregnancies who were examined at the same hospital during the same period. Maternal late-pregnancy liver function indicators and umbilical artery blood flow parameters were collected. Multivariate logistic regression analysis was conducted to assess the association of these indicators with the risk of FGR. The performance of each indicator and the combined model was evaluated using receiver operating characteristic curves, net reclassification improvement index, and integrated discrimination improvement index.

In this study, pregnant women in the FGR group had significantly higher levels of ALT, ALB, and S/D ratio of umbilical artery blood flow compared to the control group. Multivariate logistic regression analysis indicated that ALT (OR=1.744, 95%CI: 1.332-2.283), ALB (OR=1.290, 95%CI: 1.002-1.661), and S/D ratio (OR=1.778,95%CI: 1.324-2.387) were significant risk factors for FGR, and the combined model of these three indicators exhibited high diagnostic value for fetal growth restriction.

Maternal liver function indicators (ALT, ALB) and umbilical artery blood flow parameters (S/D ratio) are associated with the risk of FGR, and the combined analysis of these factors can significantly enhance the diagnostic efficiency for FGR.

To analyze the malaria disease burden and trends in China from 1990 to 2021, providing a feasibility basis for malaria prevention and control strategies in the context of globalization.

Based on the 2021 Global Burden of Disease (GBD 2021) study data, we obtained malaria prevalence, incidence, mortality, disability-adjusted life years (DALY),and their age-standardized rates in China from 1990 to 2021. The Join point model was used to analyze the average annual percentage change (AAPC) in malaria disease over the years.

In 1990, there were in total 292 387 malaria cases, 787 611 prevalent cases, and 997 deaths in all age groups in China, with an absolute number of DALY of 64 233. The age-standardized incidence, prevalence, mortality, and DALY rates were 24.48/100 000, 66.10/100 000, 0.08/100 000, and 5.18/100 000, respectively. All age-standardized rates showed a significant downward trend from 1990 to 2021 (AAPC=-61.90%,-68.77%, -51.36%, and -66.25%, all P < 0.05). From 1990 to 2021, the number of cases, prevalence, and deaths among males were consistently higher than those among females, although the absolute number of DALY gradually fell below that of females over the years. In 1990, the highest malaria incidence was observed in the 15 to 49 age group (29.06/100 000), while the lowest was in the under-5 age group (9.08/100 000). The highest prevalence occurred in the 5 to 14 age group (89.90/100 000), and the lowest in those aged 70 and above (59.17/100 000). The mortality rate was highest in those aged 70 and above (0.09/100 000) and lowest in the under-5 age group (0.05/100 000), with a 100.00% reduction in all age group indicators from 1990 to 2021.

China has made significant achievements in malaria prevention and control, but attention must still be given to monitoring malaria in males and the elderly. Strengthening surveillance of imported cases is essential to prevent re- ransmission while improving domestic control efforts.

To investigate the relationship between body roundness index (BRI) and sleep disorders.

Adults aged 20 and above from the National Health and Nutrition Examination Survey (NHANES) from 2015 to 2018 were selected as the research subjects. A multivariate logistic regression model was used to analyze the relationship between BRI and sleep disorders.Finally, subgroup analysis was performed to explore the association between BRI and sleep disorders in the population.

A total of 6 891 eligible participants were included in the study. After adjusting for confounders, there was a significant association between BRI and sleep disorders (OR=1.08, 95% CI: 1.03-1.14, P=0.022). Subgroup analysis showed that BRI was significantly associated with sleep disorders in the population under 60 years old (OR=1.12), and the association was more significant among those who had never been married (OR=1.19), patients with hypertension (OR=1.12), and patients with diabetes (OR=1.18). Multiple imputation analysis confirmed the robustness of the results.

A higher BRI is positively correlated with sleep disorders. This result supplements the existing research, but large-scale prospective cohort studies are still needed for verification.

To understand the species composition, density, seasonal fluctuation of mosquitoes and the virus-carrying situation in Tianjin from 2019 to 2023, and to provide a reference for reducing mosquito density and controlling mosquito-borne diseases.

According to the “Monitoring Work Plan for Vector Control in Tianjin”, from April to November each year, the number of adult mosquitoes was monitored in 16 districts of Tianjin using the mosquito-attracting lamp method. Habitats such as residential areas, parks, hospitals, livestock sheds, and rural households were selected as monitoring sites. In addition, from June to October, adult mosquitoes or mosquito larvae were captured using methods such as the mosquito-attracting lamp method and the mosquito-and-egg trap method. Reverse transcription polymerase chain reaction (RT-PCR) technology was used to detect the presence of Japanese encephalitis virus and dengue virus in the samples.

From 2019 to 2023, a total of 12 641 mosquito-attracting lamps were deployed in Tianjin, and 54 870 female mosquitoes were captured, with an average mosquito density of 0.72 mosquitoes/(lamp·h). Among them, 52 569 were Culex pipiens pollens (accounting for 95.81%),followed by 1 402 Aedes albopictus (accounting for 2.56%). From 2019 to 2023, the overall mosquito density showed a downward trend. The mosquito density was the highest in July each year, showing a single-peak distribution. Among different habitats, the mosquito density was the highest in livestock sheds, reaching 1.45 mosquitoes/(lamp·h), followed by rural households at 0.96 mosquitoes/(lamp·h), and the lowest in hospitals at 0.42 mosquitoes/(lamp·h). Culex pipiens pollens was the dominant mosquito species in all habitats. Neither Japanese encephalitis virus nor dengue virus was detected in Culex pipiens pollens or Aedes albopictus.

The dominant mosquito species in Tianjin is Culex pipiens pollens, and the key period for mosquito density control is from June to September. Priority should be given to improving the environmental conditions of livestock sheds, and targeted mosquito- vector control strategies should be implemented according to the mosquito population distribution, density changes, and seasonal fluctuation patterns.

To understand the health poverty vulnerability of the elderly in rural areas of Sichuan Province in the post-poverty-alleviation era and analyze its main influencing factors.

From July to August 2022, a multi-stage sampling method was used to conduct a questionnaire survey on 601 rural elderly people in Sichuan. The three-stage generalized least-squares method was used to calculate the health poverty vulnerability index of rural elderly people in Sichuan, and the influencing factors of health poverty vulnerability were explored through multivariate logistic regression.

Among the 601 people, 35 were in a state of health poverty vulnerability (health poverty vulnerability index ≥ 0.29),and the health poverty vulnerability rate was 5.82%. There were statistically significant differences in the health poverty vulnerability rates among the elderly with different genders (OR=3.69, 95%CI: 1.28-10.61), educational levels (OR=0.14,95%CI: 0.05-0.35), proportions of out-of-pocket medical expenses to income (OR=49.10, 95%CI: 15.99-150.91), and living types (taking living alone as the reference, living only with a spouse: OR=0.09, 95%CI: 0.03-0.29; living with children: OR=0.15, 95%CI: 0.05-0.44) (P < 0.05).

The overall health poverty vulnerability of rural elderly people in Sichuan Province in the post-poverty-alleviation era is at a relatively low level. Rural elderly women, those with low educational levels, those with a large proportion of out-of-pocket medical expenses to income, and those living alone are at a higher risk of falling into health poverty in the future and need to be given key attention.

To investigate the association between anxiety disorders and the risk of developing non-alcoholic fatty liver disease (NAFLD) in Caucasians.

This study was a prospective cohort study based on the UK Biobank database.Individuals who were not Caucasian, had missing racial information, had liver disease at baseline, had alcohol/drug use disorders or missing relevant diagnosis dates, or developed NAFLD within two years of follow-up were excluded, resulting in a total of 465 621 participants for analysis. The baseline survey conducted from 2006 to 2010 served as the starting point for follow-up, with NAFLD incidence, loss to follow-up, death, or end of follow-up as the endpoints. A multivariable Cox proportional hazards regression model was used to explore the association between anxiety disorders and the risk of developing NAFLD.

The participants accumulated 6 058 222 person-years of follow-up, with a median follow-up time of 13.50 years. There were 5 184 cases of NAFLD, with an incidence density of 8.56 cases per 10 000 person-years. After adjusting for covariates, the risk of developing NAFLD in individuals with anxiety disorders was increased by 0.75 times compared to those without anxiety disorders (HR=1.75, 95%CI: 1.32-2.32).

Anxiety disorders are associated with an increased risk of developing NAFLD in Caucasians, highlighting the need for enhanced clinical monitoring and prevention of NAFLD in patients with anxiety disorders.

To investigate the dual mediating effects of frailty and health literacy on the relationship between social support and quality of life among older adults based on the health ecological model.

A convenience sampling method was employed to survey 1 497 older adults using a general information questionnaire, social network relationship scale, Tilburg Frailty Indicator, health literacy assessment scale, and SF-6Dv2 quality of life assessment scale. Descriptive statistics, non-parametric tests, and correlation analyses were performed on the data, and the PROCESS macro in SPSS 26.0 was used to construct a multiple mediation effect model.

Significant differences in quality-of-life scores among older adults were observed based on different living areas (Z=-4.171, P <0.001), gender (Z=-2.378, P < 0.05), age (H=58.938, P < 0.001), education level (H=66.224, P < 0.001), occupation (H=78.662, P <0.001), and income sources (H=87.730, P < 0.001). Social support was significantly negatively correlated with frailty (r=-0.314, P < 0.01),while positively correlated with health literacy (r=0.398, P < 0.01) and quality of life (r=0.253, P < 0.01). Frailty was significantly negatively correlated with health literacy (r=-0.320, P < 0.01) and quality of life (r=-0.391, P < 0.01), whereas health literacy was significantly positively correlated with quality of life (r=0.219, P < 0.01). Frailty (effect size=0.094, 95%CI: 0.071-0.119) and health literacy (effect size=0.011, 95%CI: 0.012-0.037) partially mediated the effect of social support on quality of life, accounting for 43.7% and 5.1% of the total effect, respectively.

Frailty and health literacy play dual mediating roles in the relationship between social support and quality of life among older adults. It is essential to implement interventions that help older adults expand their social support networks, reduce levels of frailty, and enhance health literacy to improve their quality of life.

To investigate the impact of serum vitamin C levels on metabolic syndrome in adults based on NHANES 2017-2018 data.

A total of 2 094 adults from the NHANES 2017-2018 dataset were included, with serum vitamin C levels as the primary exposure variable and metabolic syndrome, diagnosed according to the standards of the International Diabetes Federation and the American Heart Association, as the outcome variable. A multivariable logistic regression model was utilized to analyze the association between these variables, with subgroup analyses conducted for gender, age, and other factors.

The risk of metabolic syndrome decreased with increasing serum vitamin C levels (P _trend < 0.001). Compared to the lowest quartile of serum vitamin C levels (Q1), the highest quartile (Q4) exhibited a relatively lower risk of metabolic syndrome (OR=0.66, 95%CI:0.48-0.92). Subgroup analyses by gender and age indicated a more pronounced protective effect in women and individuals under 50 years of age; women in the highest serum vitamin C level group had a lower risk of metabolic syndrome (Q4 group: OR=0.42,95%CI: 0.28-0.63). Additionally, individuals under 50 years of age in the second and highest serum vitamin C level groups also had reduced risks of metabolic syndrome (Q3 group: OR=0.41, 95%CI: 0.25-0.68; Q4 group: OR=0.19, 95%CI: 0.13-0.30).

This study suggests that higher serum vitamin C levels may be associated with a lower risk of metabolic syndrome in adults, with a more pronounced effect observed in women and individuals under 50 years of age.