Basic Principles and Role of Endoscopic Ultrasound in Diagnosis and Differentiation of Pancreatic Cancer from Other Pancreatic Lesions: A Comprehensive Review of Endoscopic Ultrasound for Pancreatic Cancer.

Pancreatic cancer is one of the leading causes of cancer-related deaths worldwide. Pancreatic lesions consist of both neoplastic and non-neoplastic lesions and often pose a diagnostic and therapeutic challenge due to similar clinical and radiological features. In recent years, pancreatic lesions have been discovered more frequently as incidental findings due to the increased utilization and widespread availability of abdominal cross-sectional imaging. Therefore, it becomes imperative to establish an early and appropriate diagnosis with meticulous differentiation in an attempt to balance unnecessary treatment of benign pancreatic lesions and missing the opportunity for early intervention in malignant lesions. Endoscopic ultrasound (EUS) has become an important diagnostic modality for the identification and risk stratification of pancreatic lesions due to its ability to provide detailed imaging and acquisition of tissue samples for analysis with the help of fine-needle aspiration/biopsy. The recent development of EUS-based technology, including contrast-enhanced endoscopic ultrasound, real-time elastography-endoscopic ultrasound, miniature probe ultrasound, confocal laser endomicroscopy, and the application of artificial intelligence has significantly augmented the diagnostic accuracy of EUS as it enables better evaluation of the number, location, dimension, wall thickness, and contents of these lesions. This article provides a comprehensive overview of the role of the different types of EUS available for the diagnosis and differentiation of pancreatic cancer from other pancreatic lesions while discussing their key strengths and important limitations.

Perceived Benefits and Disadvantages Associated with the Use of the Electronic Consultation Register by Health Providers in the Health District of Toma, Burkina Faso.

Background and Objective: Most countries in sub-Saharan Africa need to catch up in integrating information and communication technologies (ICT) into their health systems. This is mainly because of the need for more infrastructure that allows for reasonable use of the technologies. To support the actions of the Ministry of Health of Burkina Faso, a Non-governmental Organization (NGO) has implemented the integrated electronic diagnostic approach (IeDA) Project. The project includes the deployment of an electronic consultation register (ECR). This article aims to explore the perceptions of healthcare providers on the benefits and disadvantages of using the ECR. Methods: We conducted a qualitative, descriptive study through individual semi-structured interviews with healthcare providers. Data were collected in the Toma health district in December 2021. In addition, a thematic analysis was performed using NVivo software. Results: Thirty-five healthcare workers were interviewed (19 nurses, 7 midwives, 6 mobile community health and hygiene workers, and 3 birth attendants). Two main themes emerged from our analyses, which are the advantages and disadvantages perceived by ECR users. Our data suggest that using the ECR had many benefits ranging from improving healthcare providers' knowledge and performance in terms of patients' care, assisting and helping in patient diagnosis and treatment and improving patient satisfaction. However, the participants also shared their negative perceptions about the ECR, mentioning that it increased their workload. They also reported lengthened consultation time and work duplication as the tool was still in its trial phase and was used along with the paper consultation register. Conclusion and Global Health Implications: The ECR is an effective tool for diagnosis and management, which has several advantages and reasonably satisfies patients. However, disadvantages, including increased workload and lack of fluidity and stability of the system, must be considered to ensure better usability.

Neighborhood-level disadvantages increase risk for invasive pneumococcal disease.

BACKGROUND: Streptococcus pneumoniae (Spn) infection remains common worldwide despite recent vaccine efforts. Invasive pneumococcal disease (IPD) is the most severe form of Spn infection. Known individual risk factors for IPD include male gender and African American race. However, area-level socioeconomic factors have not been assessed. We examined the association of neighborhood-level disadvantages and risk of IPD in a tertiary medical center located in a socioeconomic diverse urban area in the Southeastern United States. METHODS: Patients hospitalized with culture-confirmed Streptococcus pneumoniae (Spn) infection from 01/01/2010 - 12/31/2019 were identified from electronic health record (EHR). The cohort's demographic and clinical information were obtained from EHR. Patients' residential address was geocoded and matched to 2015 area deprivation index (ADI). The association of ADI and IPD was evaluated using logistic regression after controlling for the demographic information (age, sex, race) and clinical factors (BMI, smoking status, alcoholism, immunosuppressive status, vaccination status, comorbidities). RESULTS: A total of 268 patients were hospitalized with culture-positive Streptococcus pneumoniae infection and 92 (34.3%) of them had IPD. The analysis showed that higher neighborhood deprivation (ADI in 79-100) was associated with increased risk of developing IPD in younger patients with age less than 65 (p = 0.007) after controlling for the individual demographic information and clinical factors. CONCLUSIONS: ADI is a risk factor for IPD in younger adults. Community-level socioeconomic risk factors should be considered when developing prevention strategies such as increasing vaccine uptake in high risk population to reduce the disease burden of IPD.

An Overview of Crosslinked Enzyme Aggregates: Concept of Development and Trends of Applications.

Enzymes are commonly used as biocatalysts for various biological and chemical processes in industrial applications. However, their limited operational stability, catalytic efficiency, poor reusability, and high-cost hamper further industrial usage. Thus, crosslinked enzyme aggregates (CLEAs) are developed as a better enzyme immobilization tool to extend the enzymes' operational stability. This immobilization method is appealing because it is simpler due to the absence of ballast and permits the collective use of crude enzyme cocktails. CLEAs, so far, have been successfully developed using a variety of enzymes, viz., hydrolases, proteases, amidases, lipases, esterases, and oxidoreductase. Recent years have seen the emergence of novel strategies for preparing better CLEAs, which include the combi- and multi-CLEAs, magnetics CLEAs, and porous CLEAs for various industrial applications, viz., laundry detergents, organic synthesis, food industries, pharmaceutical applications, oils, and biodiesel production. To better understand the different strategies for CLEAs' development, this review explores these strategies and highlights the relevant concerns in designing innovative CLEAs. This article also details the challenges faced during CLEAs preparation and solutions for overcoming them. Finally, the trending strategies to improve the preparation of CLEAs alongside their industrial application trends are also discussed.

The Role and Potential Contributions of the Artificial Intelligence Language Model ChatGPT.

This discussion paper aims to examine the potential benefits and limitations of using artificial intelligence (AI) chatbots in nursing practice, with a particular focus on the ChatGPT example. The study discusses how chatbots can serve as a valuable tool for nurses' continuing education, consultation, and information access. It is suggested that ChatGPT can contribute to enhancing nurses' knowledge and skill levels, providing rapid and accurate information, and improving time management. However, the potential risks and limitations of using AI chatbots have also been evaluated. The study highlights the possibility of negative impacts on the nurse-patient relationship due to chatbots' inadequacy in emotional and empathetic communication. Additionally, concerns about chatbots providing inaccurate or biased information and issues regarding data privacy are addressed. The review draws attention to the limited existing literature on the use of AI chatbots in nursing and emphasizes the need for expanding research in this area. Future studies are suggested to focus on identifying the necessary training and support resources for nurses to effectively utilize this technology. This study underscores an important ethical and professional point for nurses, reminding them not to overlook the significance of human touch and emotional connection while evaluating the advantages offered by technology.

Research progress on dental materials for preventing root caries / 口腔疾病防治

@#The high incidence and untreated rate of root caries, a common and frequently occurring oral disease with challenging treatment in elderly individuals, is the main cause of tooth loss among elderly people, as rapid development results in pulpitis and periapical periodontitis or residual crown and root, which has been regarded as one of the common chronic oral diseases seriously affecting the quality of life of elderly people. Thus, early intervention and prevention are important. Traditional dental materials for preventing root caries have been widely used in clinical practice; however, they have the disadvantages of tooth coloring, remineralization and low sterilization efficiency. A series of new dental materials for preventing root caries have gradually become a research hotspot recently, which have the advantages of promoting the mineralization of deep dental tissue, prolonging the action time and enhancing adhesion. Future caries prevention materials should be designed according to the characteristics of root surface caries and the application population and should be developed toward simplicity, high efficiency and low toxicity. This review describes current research regarding anti-caries prevention material application, serving as a theoretical underpinning for the research of root caries prevention materials, which is important for both promotion in the effective prevention of root caries and improvement in the status of oral health and the quality of life among old people.

Links between life-course SES and frailty trajectory moderated by community environment resources: Person-environment Fit perspective.

INTRODUCTION: Drawing from the life course and person-environment fit perspectives, this study examined whether life-course SES disadvantages during childhood, adulthood and old- age influence frailty development in late- life and how community environment resources moderated the association between life-course SES disadvantages and frailty trajectories over a seven-year follow-up period. METHODS: Data from 11,675 participants aged ≥ 50 years at baseline who participated in the four waves (2011-2018) of the China Health and Retirement Longitudinal Survey (CHARLS) were used. Life-course SES disadvantages were self-reported, and community environment resources (basic infrastructure and voluntary organizations) were ascertained from informed officials in the community. Frailty development was measured at each wave by the Frailty Index (FI) based on 39 potential deficits. Multilevel growth modeling was used to examine the interactive effect of life-course SES disadvantages and community environment resources on frailty development. RESULTS: Life-course SES disadvantage exerted cumulatively negative effects on frailty trajectory, and individuals with SES disadvantages in two or three life stages reported higher initial levels of and faster increases in frailty scores. Community environmental resources (basic infrastructure and voluntary organizations) had a protective effect on frailty development and buffered the negative effects of SES vulnerability experiences accumulated over the life course. Community basic infrastructure resources played an important role in slowing the progression of frailty for individuals with cumulative SES disadvantage and downward mobility. DISCUSSION: Our findings provided new evidence of person-environmental docility among older adults, documenting the role of community resources in buffering SES disparities in health during later-life.

Utility of Remote Monitoring in Patients on Automated Peritoneal Dialysis

ABSTRACT Home hemodialysis (HD) and automated peritoneal dialysis (APD) have advantages over HD in hospitals or HD centers. Home therapies are generally less expensive and give patients greater mobility and freedom for work, school, family, and recreational activities. Technological advances have made it possible to complement APD with devices for remote monitoring (RM) of the patient. With them, objective information generated in the APD device is collected and sent to repositories "in the cloud" for analysis or at the time decided by the health team. With APD+RM, it is possible to monitor therapeutic compliance, effective dialysis time, ultrafiltration volumes, inflow and outflow patterns of dialysis fluid, and patient actions to respond to alarms that indicate deviations from the parameters set by the nephrologist. The results of APD+RM show good acceptance by the patient, nephrologists, and nurses, treatment adherence has improved, hospitalizations and technique failure have decreased, and some aspects of quality of life have improved. However, there is a lack of controlled clinical trials that reliably demonstrate lower mortality and comorbidity due to specific causes.

Shade of Innovative Food Processing Techniques: Potential Inducing Factors of Lipid Oxidation.

With increasing environmental awareness and consumer demand for high-quality food products, industries are strongly required for technical innovations. The use of various emerging techniques in food processing indeed brings many economic and environmental benefits compared to conventional processes. However, lipid oxidation induced by some "innovative" processes is often "an inconvenient truth", which is scarcely mentioned in most studies but should not be ignored for the further improvement and optimization of existing processes. Lipid oxidation poses a risk to consumer health, as a result of the possible ingestion of secondary oxidation products. From this point of view, this review summarizes the advance of lipid oxidation mechanism studies and mainly discloses the shade of innovative food processing concerning lipid degradation. Sections involving a revisit of classic three-stage chain reaction, the advances of polar paradox and cut-off theories, and potential lipid oxidation factors from emerging techniques are described, which might help in developing more robust guidelines to ensure a good practice of these innovative food processing techniques in future.

Phage Therapy-Challenges, Opportunities and Future Prospects.

The increasing drug resistance of bacteria to commonly used antibiotics creates the need to search for and develop alternative forms of treatment. Phage therapy fits this trend perfectly. Phages that selectively infect and kill bacteria are often the only life-saving therapeutic option. Full legalization of this treatment method could help solve the problem of multidrug-resistant infectious diseases on a global scale. The aim of this review is to present the prospects for the development of phage therapy, the ethical and legal aspects of this form of treatment given the current situation of such therapy, and the benefits of using phage products in persons for whom available therapeutic options have been exhausted or do not exist at all. In addition, the challenges faced by this form of therapy in the fight against bacterial infections are also described. More clinical studies are needed to expand knowledge about phages, their dosage, and a standardized delivery system. These activities are necessary to ensure that phage-based therapy does not take the form of an experiment but is a standard medical treatment. Bacterial viruses will probably not become a miracle cure-a panacea for infections-but they have a chance to find an important place in medicine.

[The application of telemedicine technologies under medical care provision to crew members on shipboard].

The impact of development of technique and technology as result of scientific and technological progress in modern society tremendously affected population life of people in its various areas. One of these technologies is telemedicine. The telemedicine technologies permit to ensure accessibility of highly qualified medical care to travelers, ship crew members and persons located at remote objects. The actuality of application of telemedicine technologies is excessively high in conditions of providing medical care to ship crew members working hundreds miles away from nearest medical care station. The article considers application of telemedicine technologies in world-wide practice. The legal norms of applying telemedicine in the Russian Federation were analyzed. The results of scientific research of telemedicine application on shipboard are analyzed and both advantages and disadvantages of technology under study are determined. The ways of resolving existing problems are proposed to minimize risks associated with application of telemedicine technologies on shipboard.

Methods and research progress in the construction of animal models of osteosarcopenia: a scoping review.

Background: Osteosarcopenia(OS) is a significant health concern resulting from the ageing process. Currently, as the population grows older, the prevalence of OS, a disease that entails the synchronous degeneration of muscles and bones, is mounting. This poses a serious threat to the health of the elderly while placing an enormous burden on social care. In order to comprehend the pathological mechanism of OS and develop clinical drugs, it is pertinent to construct an efficient animal model of OS. To investigate the modeling techniques of diverse experimental models of OS and elucidate their respective benefits and drawbacks, with the purpose of furnishing a theoretical foundation to advance experimental research on OS. Methods: We searched PubMed, Embase database, China Knowledge Network, Wanfang data platform and Vipshop journal platform databases from 2000 through to September 1, 2023. We included animal studies on sarcopenia or osteoporosis or osteosarcopenia or sarcopenia-osteoporosis, modeling methods for osteosarcopenia. Two independently screened study abstracts and full reports and complete data extraction. Results: Eventually, Of 112, 106 citations screened. 4938 underwent full-text review and 38 met the inclusion criteria. we reviewed and analyzed the literature and categorized the animal models of OS into the following five categories: Aging OS models; Hormonal deficiency model of OS;Chemical injection to induce OS;Disuse OS models and Genetic engineering OS models. Conclusion: This review outlines animal modeling approaches for OS, providing a comprehensive summary of their advantages and disadvantages. The different models were evaluated and selected based on their respective strengths and weaknesses to enable higher quality research outcomes in various research directions. The most widely used and established approach is considered to be the ageing and chemical injection OS model, which has the advantages of excellent reproducibility and low cost. The translational potential of this article: To gain a profound comprehension of the pathological mechanism of OS and to devise efficacious clinical treatments, it is imperative to establish a viable laboratory animal model of OS. This article surveys various modeling techniques assessing their benefits, drawbacks and areas of applicability while predominantly employing mice as the primary model animal. Additionally, the evaluation indicators of OS models are briefly described.

Utility of remote monitoring in patients on automated peritoneal dialysis.

Home hemodialysis (HD) and automated peritoneal dialysis (APD) have advantages over HD in hospitals or HD centers. Home therapies are generally less expensive and give patients greater mobility and freedom for work, school, family, and recreational activities. Technological advances have made it possible to complement APD with devices for remote monitoring (RM) of the patient. With them, objective information generated in the APD device is collected and sent to repositories "in the cloud" for analysis or at the time decided by the health team. With APD+RM, it is possible to monitor therapeutic compliance, effective dialysis time, ultrafiltration volumes, inflow and outflow patterns of dialysis fluid, and patient actions to respond to alarms that indicate deviations from the parameters set by the nephrologist. The results of APD+RM show good acceptance by the patient, nephrologists, and nurses, treatment adherence has improved, hospitalizations and technique failure have decreased, and some aspects of quality of life have improved. However, there is a lack of controlled clinical trials that reliably demonstrate lower mortality and comorbidity due to specific causes.

Stent-Assisted Coil Embolization of Ruptured Aneurysms in the Acute Stage: Advantages and Disadvantages.

Objective: In the acute stage of ruptured cerebral aneurysms, limited devices are available, making the treatment difficult. We aimed to evaluate the outcomes of the coil embolization with stenting for the ruptured cerebral aneurysms in the acute stage. Methods: We assessed 22 cases treated with stenting among 134 of 169 consecutive patients with subarachnoid hemorrhages undergoing an endovascular treatment between April 2014 and December 2021, of which 134 underwent an embolization during the acute stage. A stent was used in the patients wherein the treatment with the balloon-assisted or double catheter technique was difficult. Stenting was performed under the loading of two or more antiplatelet agents. Results: The mean age of the patients was 68.9 years, of which five were male and 14 (63.6%) had severe grade (World Federation of Neurosurgeons grade IV, V). The aneurysm site was the anterior communicating artery in four cases, internal carotid artery in nine, middle cerebral artery in two, vertebrobasilar artery in six, and posterior cerebral artery in one. The aneurysm shape was saccular in 13 cases, dissection in seven, and fusiform in two. Stents were used for wide-neck aneurysms in 12 cases, vascular preservation in seven, and rescue in three. The mean maximum diameter was 9.6 mm. The mean neck size was 6.4 mm. Complete occlusion and neck remnant were found in eight and seven cases, respectively. The perioperative complication rate was 45.5% (thromboembolism in five cases, stent occlusion in two, re-bleeding in two, and cerebral hemorrhage in one). The outcomes included modified Rankin Scale 0-2 in seven cases, 4-5 in five, and 6 in nine. Stent-related death occurred in one case. The rate of morbidity and mortality was 18.2%. Although stents were used in the acute stage of rupture, they were used for the right reasons. However, a high rate of complications occurred: two cases of re-bleeding, in which an incomplete occlusion was a factor. Conclusion: Stent placement in patients with the acute ruptured cerebral aneurysms should be carefully determined and efforts should be made to reduce the embolic and hemorrhagic complications. However, it may be an effective treatment option when other options could be extremely difficult.

A Classification Bias and an Exclusion Bias Jointly Overinflated the Estimation of Publication Biases in Bilingualism Research.

A publication bias has been argued to affect the fate of results in bilingualism research. It was repeatedly suggested that studies presenting evidence for bilingual advantages are more likely to be published compared to studies that do not report results in favor of the bilingual advantage hypothesis. This work goes back to the original claim and re-examines both the dataset and the classification of the studies that were employed. We find that the exclusion of published works such as doctoral dissertations, book chapters, and conference proceedings from the original dataset significantly inflated the presumed publication bias. Moreover, the estimation of the publication bias was affected by a classification bias that uses a mega-category that consists of both null and negative outcomes. Yet finding evidence for a bilingual disadvantage is not synonymous with obtaining a result indistinguishable from zero. Consequently, grouping together null and negative findings in a mega-category has various ramifications, not only for the estimation of the presumed publication bias but also for the field's ability to appreciate the insofar hidden correlations between bilingual advantages and disadvantages. Tracking biases that inflate scientific results is important, but it is not enough. The next step is recognizing the nested Matryoshka doll effect of bias-within-bias, and this entails raising awareness for one's own bias blind spots in science.

Not one, but many: developing a multi-indication pricing model for medicines in Belgium.

Back ground: Current pricing and reimbursement models that focus on one indication at a time are not suited to address the market access of multi-indication medicines. Therefore, the aim of this study is to co-create with Belgian stakeholders a multi-indication pricing model and procedural pathway, to identify conditions for implementation, and to illustrate the multi-indication pricing model with a case study. Methods: Different multi-indication pricing models were identified from the literature, case studies and pilots in other countries. Semi-structured interviews were conducted with 21 representatives from the National Institute for Health and Disability Insurance, insurance funds, clinicians, patients, the policy cell of the Minister of Health, pharmaceutical industry and academia. These provided insight in the opinions of stakeholders about possible multi-indication pricing models and their feasibility in the Belgian context. Agreement on the preferred multi-indication pricing model and procedural pathway was reached in a multi-stakeholder round table. Results: The international review generated four main multi-indication pricing models that vary in terms of whether a uniform price or differential prices are applied, whether prices are adjusted for the volume and/or value of the medicine in each indication, and whether a proactive or retroactive dynamic pricing approach is used. However, Belgian stakeholders preferred a fifth model, which sets a single price as the volume- and value-weighted average price across all indications at launch. Over time, the price is adapted based on volume and value of the medicine in real-life practice for each indication. To implement this model, a legal framework, horizon scanning and early dialogue, data infrastructure, an evidence plan for the medicine, technical expertise and governance model need to be developed. Conclusion: Although the multi-indication pricing model preferred by Belgian stakeholders raises the administrative burden, it allows for the price of a medicine to vary during the lifecycle based on its initial and real-life performance in multiple indications.

Polymath: to be or not to be?

Is it best to achieve excellence in one or multiple fields? Is it better to be a medical doctor reading only medical textbooks all your life or is it better to also tour around the world as a concert pianist and investigate the mysteries of the brain by conducting research projects? As a medical doctor, classical pianist, and neuroscientist, I discuss the advantages, disadvantages, opportunities, and challenges of pursuing multiple careers, drawing from my own experience and from polymaths of the past.

Research Progress on the Development of Porcine Reproductive and Respiratory Syndrome Vaccines.

Porcine reproductive and respiratory syndrome (PRRS) is a highly contagious disease in the pig industry, but its pathogenesis is not yet fully understood. The disease is caused by the PRRS virus (PRRSV), which primarily infects porcine alveolar macrophages and disrupts the immune system. Unfortunately, there is no specific drug to cure PRRS, so vaccination is crucial for controlling the disease. There are various types of single and combined vaccines available, including live, inactivated, subunit, DNA, and vector vaccines. Among them, live vaccines provide better protection, but cross-protection is weak. Inactivated vaccines are safe but have poor immune efficacy. Subunit vaccines can be used in the third trimester of pregnancy, and DNA vaccines can enhance the protective effect of live vaccines. However, vector vaccines only confer partial protection and have not been widely used in practice. A PRRS vaccine that meets new-generation international standards is still needed. This manuscript provides a comprehensive review of the advantages, disadvantages, and applicability of live-attenuated, inactivated, subunit, live vector, DNA, gene-deletion, synthetic peptide, virus-like particle, and other types of vaccines for the prevention and control of PRRS. The aim is to provide a theoretical basis for vaccine research and development.

Models of traumatic brain injury-highlights and drawbacks.

Traumatic brain injury (TBI) is the leading cause for high morbidity and mortality rates in young adults, survivors may suffer from long-term physical, cognitive, and/or psychological disorders. Establishing better models of TBI would further our understanding of the pathophysiology of TBI and develop new potential treatments. A multitude of animal TBI models have been used to replicate the various aspects of human TBI. Although numerous experimental neuroprotective strategies were identified to be effective in animal models, a majority of strategies have failed in phase II or phase III clinical trials. This failure in clinical translation highlights the necessity of revisiting the current status of animal models of TBI and therapeutic strategies. In this review, we elucidate approaches for the generation of animal models and cell models of TBI and summarize their strengths and limitations with the aim of exploring clinically meaningful neuroprotective strategies.

The mediating effect of allostatic load on the association between life course socioeconomic disadvantage and chronic pain: a prospective finding from the National Survey of Midlife Development in the United States.

Background: Socioeconomic disadvantages (SEDs) are associated with chronic pain (CP) and allostatic load (AL). Few prospective population-based studies have examined the relationship between life course SED, CP interference, and CP widespreadness, and there is no prospective population-based study on whether AL mediates the association between SED and CP. Objective: In this study, we investigated whether the prospective effect of SED on CP at Midlife in the United States (MIDUS) 3 is consistent with the accumulation of risk model and social mobility model, using the National Survey of MIDUS (n = 593). To prepare for the mediation analysis, we tested (1) whether SED would be prospectively associated with AL in the MIDUS 2 biomarker project, (2) whether AL would be prospectively associated with CP, and (3) whether childhood, as a critical period, moderated the association between AL and CP. In addition, the mediating effect of AL on the association between SED and CP was examined. Method: SED was measured using cumulative scores and disadvantage trajectories derived from latent class trajectory modeling (LCTM). After multiple imputations, analyses were conducted using multinomial logistic regression for CP and negative binomial regression for AL, respectively. Finally, mediation analyses and moderated mediation analyses were performed. Results: LCTM identified three SED trajectories, namely, constant low, high to low, and medium to high. The results showed that proximal cumulative SED was associated with high-interference CP. Furthermore, compared with the group with constant low SED, the group with medium-to-high SED was significantly associated with high-interference pain and experienced pain in at least three different sites. Cumulative SED and deteriorating SED trajectories were associated with higher AL, consistent with previous studies. Furthermore, childhood SED moderated the effect of AL on CP widespreadness and unexpectedly demonstrated a protective effect, while other associations between AL and CP were not significant. Subsequent mediation analysis did not yield statistically significant evidence. Conclusions: People who experienced more recent SED or increasing disadvantage throughout their lives were more likely to suffer from CP, and this association was not mediated by physiological system dysregulation caused by chronic stress. Therefore, measures to alleviate AL may not be effective in protecting socioeconomically disadvantaged populations from CP.