Background: Metabolic syndrome (MetS), a worldwide public health problem, affects human health and quality of life in a dramatic manner. A growing evidence base suggests that MetS is strongly associated with levels of systemic immune inflammation. The present study aimed to investigate the possible relationship between the systemic immune-inflammation index (SII), a novel inflammatory marker, and MetS to provide data support for effective MetS prevention by reducing the systemic inflammatory response. Methods: We included adult participants with complete SII and MetS information from the 2011–2016 National Health and Nutrition Examination Survey (NHANES). MetS was defined as using the criteria developed by the Adult Treatment Program III of the National Cholesterol Education Program. The formula for SII was as follows: SII = platelet counts × neutrophil counts/ lymphocyte counts. Weighted linear regression was used to assess differences in variables across SII quartile groups after the SII score was divided into 4 quartiles. The independent interaction between SII and MetS was investigated using weighted multivariate logistic regression analysis and subgroup analysis, and the relationship between SII levels and 5 particular MetS items was further explored in depth. Results: A total of 12,402 participants, 3,489 of whom were diagnosed with MetS, were included in this study. After correcting for covariates, the results of a logistic regression of multistage weighted complex sampling data revealed that participants with higher SII scores had a higher chance of developing MetS (odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.14–1.55) and that SII levels could be used as an independent risk factor to predict that likelihood of MetS onset. In the Q1–Q4 SII quartile group, the risk of developing MetS was 1.33 times higher in the Q4 group, which had the highest level of systemic immune inflammation than in the Q1 group. After adjusting for all confounding factors, SII scores were found to have a negative correlation with high-density lipoprotein cholesterol (OR = 1.29; 95% CI, 0.99–1.67, P = 0.056) and a significant positive correlation with waist circumference (OR = 2.17; 95% CI, 1.65–2.87, P < 0.001) and blood pressure (BP) (OR = 1.65; 95% CI, 1.20–2.27, P = 0.003). Gender, age, and smoking status were shown to alter the positive association between SII and MetS in subgroup analyses and interaction tests (p for interaction < 0.05). Additionally, we demonstrated a nonlinear correlation between SII and MetS. The findings of the restricted cubic spline indicated that there was an inverted U-shaped association between SII and MetS. Conclusions: Our findings imply that increased SII levels are related to MetS, and SII may be a simple and cost-effective method to identify individuals with MetS. Therefore, protective measures such as early investigation and anti-inflammatory interventions are necessary to reduce the overall incidence of MetS.

A nomogram model combining intratumoral heterogeneity score and clinicopathologic variables predicted pathologic complete response to neoadjuvant chemotherapy well, and nomogram scores were associated with recurrence-free survival and biologic pathways.

Obesity, a growing global health crisis, is driven by a complex interplay of genetic, biological, environmental, behavioral, socio-cultural, and economic factors. This comprehensive review encapsulates the epidemiology, pathophysiological mechanism, and the myriad of health complications it triggers, such as cardiovascular diseases (CVDs), cancer, neurological disorders, respiratory ailments, digestive diseases, mobility impairments, and psychological stress. The etiology of obesity is multifaceted, involving genetic predispositions, environmental influences, behavioral tendencies, and socio-economic elements. The pathophysiological underpinnings of obesity encompass multifaceted aspects of energy metabolism, including the regulation of appetite, glucose, lipid, and amino acid metabolism. This review also addresses the seemingly contradictory roles of obesity in various diseases, offering insights into these phenomena. The management of obesity is multi-pronged, including lifestyle modifications, pharmacological interventions, and metabolic surgeries. Lifestyle changes are foundational, but advancements in molecular techniques, digital technology, wearable devices, and artificial intelligence are opening new avenues for personalized treatment and early intervention. Pharmacological treatment and metabolic surgery are effective but should be judiciously tailored to individual patient needs. This review underscores the importance of a multifaceted approach to obesity management, aiming to curb the escalating trend and enhance future interventions and treatments. The ultimate goal is to synthesize current evidence and innovative strategies to combat obesity effectively.

Introduction Upadacitinib, an oral, selective Janus kinase inhibitor, is approved in Japan for the treatment of moderate-to-severe atopic dermatitis (AD), a chronic inflammatory skin disease characterized by eczematous morphology and intense itch. Methods Rising Up is an ongoing phase 3, randomized, multicenter study evaluating the long-term safety and efficacy of upadacitinib in Japan. Patients with moderate-to-severe AD were randomized 1:1:1 to topical corticosteroids plus upadacitinib 15 mg (UPA15), upadacitinib 30 mg (UPA30), or placebo at baseline; at week 16, placebo patients were rerandomized 1:1 to UPA15 or UPA30 (plus topical corticosteroids per investigator discretion). This 2-year interim analysis evaluated safety and efficacy through 112 weeks (data cutoff date: 11 August 2021). Adverse events (AEs), AEs of special interest (AESIs), and laboratory data were assessed. Efficacy assessments included ≥ 75% and ≥ 90% improvement from baseline in Eczema Area and Severity Index (EASI 75/90), achievement of clear or almost clear on the validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD 0/1), and ≥ 4-point improvement in the Worst Pruritus Numerical Rating Scale (WP-NRS). Results A total of 272 patients were enrolled and 242 were ongoing at data cutoff (UPA15, n = 120; UPA30, n = 122). After 112 weeks of treatment, serious AEs, AEs leading to discontinuation, and most AESIs were generally infrequent, and rates were similar between the two upadacitinib groups. One event each of rectal cancer and cerebellar hemorrhage was reported in the UPA15 group; no thrombosis events were observed. The most common AEs included acne, nasopharyngitis, and herpes zoster. EASI 75, EASI 90, vIGA-AD 0/1, and WP-NRS response rates were maintained through week 112. Conclusion UPA15 and UPA30 were well tolerated through 112 weeks of treatment with similar safety profiles to short-term studies and demonstrated durable long-term efficacy for the treatment of moderate-to-severe AD in adults and adolescents. Trial Registration ClinicalTrials.gov identifier, NCT03661138.

CT imaging of one extended family cluster of corona virus disease 2019 (COVID-19) including adolescent patients and “silent infection”