Teachers' perceptions of teacher-student relations in their school are linked to their job satisfaction, but whether positive teaching-related emotion constitutes a statistical indirect association between them, and whether school leadership context alters it, remains unclear. Using Teaching and Learning International Survey (TALIS) 2024 data for Shanghai (China), this study analyzed the OECD scales for teacher-student relations, joy of teaching, job satisfaction, and principal relational leadership in 1,338 teachers from 205 schools. A conditional process regression adjusted for teacher demographic and career characteristics; point estimates used the final teacher weight, and sampling variance was estimated from 100 Fay balanced repeated replication weights. Perceived school-wide teacher-student relations were positively associated with job satisfaction, and the indirect association through joy of teaching was supported. Principal relational leadership did not significantly alter the conditional direct association, whereas its interaction with joy of teaching was positive; this interaction was not reproduced when the constructs were scored as simple item means, so the moderation result is reported as exploratory. The pattern is consistent with the work environment-emotion-work attitude linkage proposed by Affective Events Theory. Conclusions are restricted to lower-secondary teachers in Shanghai and offer leads for longitudinal and intervention research.
Heart rate and cardiac dynamics can be monitored using several physiological signals, each with its own biophysical basis and signal characteristics. However, while individual properties of electrocardiogram (ECG), phonocardiogram (PCG), seismocardiogram (SCG), photoplethysmogram (PPG), and piezoplethysmogram (PiPG) are documented, systematic cross-modal comparisons remain scarce. This study aims to consolidate both the time and frequency domain features of these widely accessible technologies to provide practical guidelines for signal processing and multimodal integration. We simultaneously recorded ECG, PCG, SCG, PPG, and PiPG under standardized resting conditions and aligned all modalities on the ECG R-peak. Results highlight clear consistencies (e.g., reproducible morphology and spectra for ECG, PPG, and PiPG) as well as higher variability in PCG and SCG due to sensor coupling and anatomical factors. Temporal latencies relative to the ECG confirm known physiological conduction delays, while frequency analysis identifies modality-specific bands: ~ 30 Hz for PCG, 11-14 Hz for SCG, and 1-2 Hz for PPG/PiPG. Bandwidth analysis further emphasizes differences in spectral richness across modalities. By presenting these benchmarks in a unified framework, this work addresses the current gap between isolated characterizations and integrated signal knowledge. The outcome is a reference dataset and interpretation map that can guide filtering strategies, feature extraction, and the design of multimodal cardiac monitoring systems.
Human papillomavirus (HPV) comprises more than 230 genotypes; its oncogenic potential is a major concern, particularly in tourism-influenced regions. The present study was conducted to assess HPV prevalence and temporal changes in genotype distribution after an eight-year interval in subjects who were suspected of sexually transmitted infections (STIs). Professional physicians referred samples from 2,673 subjects to the main molecular diagnostic labs in North, Razavi, and South Khorasan provinces, as well as from a diverse group of tourists. The findings showed that HPV was detected in 1,185 (55.86%) females and 400 (72.46%) males (p = 0.01). HPV infection was most frequent in the 21-30 and 31-40 year-old groups, at 35.6% and 39.7%, respectively. Most cases clustered around five to six genotypes. The six most frequent genotypes included HPV-6 (56.62%; 77/136), HPV-16 (40.44%; 55/136), HPV-54 (36.03%; 49/136), HPV-43 (29.41%; 40/136), HPV-51 (29.41%; 40/136), and HPV-52 (28.68%; 39/136). Importantly, three prevalent genotypes (16, 51 and 52) are classified as HR-HPV. Compared with eight years ago, the percentage of HPV prevalence strongly increased by more than 28%, primarily in genital discharge samples. The most notable change (0.4% vs 5.1%) occurred in the proportion of individuals with more than four genotypes, i.e., currently 11.7 times higher than eight years ago. The greatest shift in genotype prevalence has occurred between HPV-16 and HPV-51 over the past few years. Moreover, compared to the previous study, minimal changes (0.90%) in prevalence and genotypes have been observed in South Khorasan, the highest in North and Razavi Khorasan provinces (14.5%) and also in tourist groups (3.2%). Therefore, the impact of transient populations and more likely changes in socioeconomic and cultural status in these areas, along with the progressive trends in HPV infection, should prompt health authorities to focus more on establishing HPV diagnostic facilities, screening, vaccination, and increasing public knowledge.
This study evaluated how Monkey jack pulp extract (MJPE) impacted the raw Pangasius (Pangasianodon hypophthalmus) fish balls physicochemical quality, microbiological safety, oxidative, and storage stability while being refrigerated. Fish balls were made with several antioxidants, including control (T0), butylated hydroxytoluene (BHT, T1), ascorbic acid (AA, T2), and MJPE at increasing concentrations (T3 and T4), and kept for 10 days at 4°C. On days 1, 5, and 10, changes in pH, cooking loss, color characteristics (L*, a*, b*, chroma, and hue angle), heme iron content, antioxidant activity (DPPH), lipid oxidation (TBARS), and total viable count (TVC) were assessed. All samples showed quality decrease with increasing storage time. However, antioxidants treated samples showed significantly (P < 0.05) higher stability than the control treated samples in every storage day. T4 successfully inhibited pH rise, decreased cooking loss, maintained higher heme iron levels, and preserved color characteristics rather than other treatments. Additionally, T4 showed higher DPPH scavenging capacity (ranged 72.44% to 65.79%), whereas the control showed the lower DPPH value (ranged 56.57% to 33.39%). TBARS value showed the lowest (0.31 to 0.41 mg MDA/kg sample) in T4 and the highest (0.49 to 0.67 mg MDA/kg sample) in the control. MJPE considerably reduced bacterial growth (0.80 to1.68 Log10 CFU/mL) compared to control and synthetic antioxidants treated samples. In terms of keeping the quality and enhancing the shelf life, MJPE demonstrated significantly improved antioxidant and antimicrobial effects compared to BHT and AA (P < 0.05). MJPE showed significant potential as a natural preservative for fish-based products by improving their physicochemical, microbiological, and oxidative stability during refrigerated storage.
BACKGROUND:Despite extensive knowledge of erythropoiesis, the role of interleukin enhancer binding factor 3 (ILF3) in β-thalassemia remains unclear. The aim of this study was to investigate the expression pattern and functional role of ILF3 during erythroid differentiation in β-thalassemia. METHODS:(1) Single-cell transcriptomic profiles were constructed based on the GSE133181 dataset (3 healthy controls and 3 β-thalassemia patients). The differential expression of ILF3, transcriptional programs of erythroid subsets, pathway activity, and differentiation trajectory were analyzed. (2) ILF3 was knocked out in K562 cells using sgRNA. Cell proliferation was detected by CCK-8 assay, and apoptosis was measured by Annexin V-APC single staining. RESULTS:(1) ILF3 was downregulated in the β-thalassemia group, and the proportion of erythroid cells was significantly enriched in ILF3+ cells. (2) ILF3+ erythroid cells highly expressed maturation-related genes and were enriched in cell cycle and metabolic synthesis pathways, while ILF3- cells highly expressed stress-related genes and activated inflammatory stress pathways. (3) Trajectory analysis suggested early arrest of erythroid differentiation in β-thalassemia, with consistently low ILF3 expression throughout the disease group. (4) Knockout of ILF3 promoted apoptosis in K562 cells. CONCLUSION:ILF3 is downregulated in β-thalassemia, and its deficiency may contribute to erythroid differentiation arrest and ineffective hematopoiesis by inducing apoptosis and potentially enhancing inflammatory stress.
African zebu cattle (Bos indicus) exhibit remarkable adaptations to extreme thermal conditions, yet the genomic basis of this resilience remains incompletely characterized. Ethiopia provides a unique natural setting in which closely related zebu populations have adapted divergently to dry-hot (DHETZ) and humid-hot (HHETZ) climates. In this study, we reanalyzed publicly available whole-genome sequencing datasets from 46 Ethiopian zebu cattle from five populations and compared them with Asian zebu, Sudanese zebu, African taurine, and European taurine breeds. By integrating genome-wide SNP analysis, population genetic structure assessment, and multiple selection scans (iHS, Hp, XP-EHH, and XP-CLR), we identified distinct and shared selection signatures between DHETZ and HHETZ. We detected 33.7 million and 34.2 million biallelic autosomal SNPs in DHETZ and HHETZ, respectively. Ethiopian zebu clustered closely with Sudanese zebu but showed clear divergence from Asian zebu and taurine breeds. DHETZ and HHETZ exhibited very low genetic differentiation (FST = 0.0063), consistent with their shared ancestry; however, each group displayed unique selection signals. In DHETZ, iHS and Hp detected 298 and 113 candidate regions, respectively, whereas in HHETZ, they detected 244 and 138 regions, respectively. Cross-population XP-EHH and XP-CLR analyses identified 163 and 227 divergent regions between DHETZ and HHETZ, respectively. Integration of the four selection scans identified 19 high-confidence candidate regions in DHETZ and 13 in HHETZ. DHETZ showed strong selection in genes involved in oxidative stress regulation, protein folding, mitochondrial function, and vascular remodeling, including SESN2, DNAJC8, GRPEL2, ABLIM3, and AFAP1L1. In contrast, HHETZ displayed signatures in genes associated with immune responses, energy metabolism, and angiogenesis inhibition, including MYD88, PRKACA, PRKACB, and WIF1. Several genes, including VEGFC, TNIP3, and DMXL2, were under selection in both groups, suggesting conserved mechanisms of thermotolerance and reproductive adaptation. The shared VEGFC signal and the HHETZ-specific WIF1 signal may indicate a distinct vascular regulatory mechanism in the dry-hot and humid-hot environments. Our results reveal a dual pattern of genomic adaptation in Ethiopian zebu cattle and provide candidate loci for future validation and climate-resilient livestock breeding.
Liquid organic fertilizers (LOF) are used to supply additional nutrients to crops. However, LOF are expensive to use regularly. In this research, a smart fertigation treatment (S), where LOF was applied based on lettuce plant growth, was compared to a manual treatment (M) in a greenhouse. Digital sensors with IoT capability were installed in S and M treatments. The sensor in S treatment was interfaced to a solid-state relay connected to a pump, to automatically regulate LOF application. Digital sensors in both treatments measured canopy area (CA) of plants once every three days using image analysis and remotely exchanged data. In the M treatment, LOF was applied every third day to plants, whereas the LOF application was regulated by the sensor in S treatment to happen only when CA of plants was lower by 10% than those in the M treatment. Results indicated no differences in fresh weight (33.4 vs. 32.3 g·plant-1) and leaf area (770.2 and 772.6 cm-2) of plants between two treatments. Nutrient concentration in the root zone, measured as electrical conductivity of substrate, was significantly higher (21-69%) in M than S treatment. The number of fertigation events and cost of LOF applied were approximately four times higher in M than S treatment. This resulted in higher fertilizer-use-efficiency in S (1.159 kg ∙ m-2 ∙ $-1) than M (0.168 kg ∙ m-2 ∙ $-1) treatment. These results indicate that the smart fertigation method can optimize LOF application (i.e., reduce wastage and costs) while maintaining crop growth.
Statins are widely prescribed for cardiovascular risk reduction, yet concerns remain regarding their effects on skeletal muscle. Evidence on the longitudinal relationship between statin use and muscle mass remains inconsistent, particularly in population-based settings. Therefore, this study investigated the longitudinal association between statin use and changes in total and region-specific skeletal muscle mass in a population-based adult cohort. This single-center retrospective cohort study analyzed adults with repeated health examinations from 2021 to 2023. Skeletal muscle mass was assessed using bioelectrical impedance analysis, including upper limb lean mass (ULM), lower limb lean mass (LLM), appendicular lean mass (ALM), and skeletal muscle index (SMI). Statin use was determined from medical records and self-reported medication histories. Linear mixed-effects models with random intercepts helped evaluate longitudinal changes in muscle mass according to statin use. Models were sequentially adjusted for age and sex, and further for body mass index and diabetes mellitus. Among 2,300 participants, 334 (14.5%) were continuous statin users, who were older and had a higher prevalence of metabolic comorbidities than non-users. In unadjusted analyses, statin users exhibited significantly greater declines in LLM and ALM than non-users. These differences remained significant after adjustment for age and sex. However, after further adjustment for body mass index and diabetes mellitus, associations between statin use and changes in all muscle mass indices were no longer significant. No significant differences were observed for ULM or SMI in any model. In this longitudinal cohort, statin use was not independently associated with accelerated skeletal muscle mass decline after adjustment for key metabolic confounders. These findings suggest that underlying metabolic and clinical characteristics, rather than statin exposure, may play a more important role in longitudinal muscle mass changes.
Acromastigum A. Evans is revised in East Indochina. The distribution of six species is documented, including one species whose occurrence is not supported by available materials. One new-to-science species from the species-poor subgenus Acromastigum is described from the Lâm Viên Plateau of the Central Highlands of Vietnam. The report of Acromastigum curtilobum for Thailand is based on incorrect identification and should be referred to A. herzogii. Acromastigum echinatum and A. laevigatum are observed for the first time in Cambodia. A large number of new localities of A. herzogii have been found in Vietnam, where the species distribution extends from North Vietnam through the Annamite Range to the Lâm Viên Plateau. This species is the most common representative of the genus in East Indochina. Morphological and molecular data reveal a more natural relationship of A. herzogii and A. stellare to subg. Inaequilatera than to subg. Acromastigum, as previously suggested. These two subgenera are also distinct in their rhizoid distribution, which was not noted in previous research. Overall, Acromastigum is an uncommon component of plant communities in East Indochina and has never been found with either sporophytes or fertilized archegonia, suggesting its high sensitivity to disturbances in forest communities.
BACKGROUND:High AUROC is often taken as evidence that a transcriptomic classifier is promising, but rank discrimination can conceal fixed-threshold failure after cohort or platform transfer. METHODS:We benchmarked four GEO whole-blood cohorts: GSE65682 for discovery, GSE95233 for external microarray validation, GSE154918 for cross-platform RNA-seq validation, and GSE28750 for non-infectious inflammation stress testing. We compared logistic-regression workflows using training-derived standard scaling, training-derived robust scaling, sample-wise rank normalization with training-derived scaling, and robust scaling using unsupervised external-cohort reference statistics. Internal performance used five-fold cross-validation with fold-contained imputation and scaling. External uncertainty used 2,000 stratified bootstrap replicates. RESULTS:Internal discrimination was very high for all strategies, but external validation revealed threshold collapse for training-derived standard and robust scaling. In GSE154918, both had balanced accuracy 0.50 at the 0.5 threshold despite very high AUROC, equivalent to random classification at that fixed threshold. The strict-inductive sample-rank strategy preserved fixed-threshold performance across external cohorts (balanced accuracy 0.95-1.00). Robust external-cohort adaptation also performed well (0.95-1.00) but uses unlabeled external-cohort distribution statistics and is therefore reported as adaptation rather than fixed single-sample transfer. Calibration and regularization sensitivity did not rescue the failing training-derived scaling strategies. In the sepsis-versus-non-infectious-inflammation stress test, robust external-cohort adaptation had the highest observed balanced accuracy (0.80, 95% CI 0.61-0.95), but its difference from sample-rank normalization was uncertain in paired bootstrap analysis. CONCLUSIONS:High AUROC can mask fixed-threshold failure in sepsis transcriptomic classifiers. In this benchmark, strict-inductive sample-rank normalization was the most stable fixed external strategy, while robust external-cohort scaling was best interpreted as unsupervised cohort adaptation whose reliability depends on external reference-sample availability.
To explore the mechanisms underlying Gen Z consumers' willingness to continue using slow fashion apparel, this study constructs a conceptual model based on SOR theory. The model considers personal and social fashion consciousness as stimulus variables, aesthetic, emotional, social, and green values as organism variables, and willingness to continue using as the response variable. Data were collected through a questionnaire based on a 7-point Likert scale, yielding 311 valid responses. SPSS and JASP were used to assess reliability and validity and examine direct and mediation effects. The results indicate that personal fashion consciousness, social value, and green value are all significantly and positively associated with willingness to continue using slow fashion apparel. Personal fashion consciousness is positively associated with perceived aesthetic and emotional values, whereas social fashion consciousness is positively associated with perceived social and green values. Furthermore, social and green values mediate the relationship between social fashion consciousness and willingness to continue using slow fashion apparel. However, the mediating effects of aesthetic and emotional values are not significant. This study suggests that in the context of sustainable consumption, value-related factors may better explain long-term use behavior than aesthetic experiences alone. These findings suggest that slow fashion brands should support individual expression and sustainability-related meanings and enhance Gen Z consumers' perceptions of green and social value, thereby encouraging continued use of slow fashion apparel and promoting sustainable fashion development.
BACKGROUND:Shared decision making (SDM) integrates the expertise of healthcare providers with the values and preferences of patients. The Multifocal Approach to Sharing in Shared Decision-Making (MAPPIN'SDM) based on a six-step SDM model, has shown robust reliability and validity in diverse settings. This study aimed to validate the Korean version (K-MAPPIN'SDM) and assess its applicability in Korean clinical practice. METHODS:The K-MAPPIN'SDM was developed through a translation and cultural adaptation process including forward translation, synthesis, blind back translation, semantic equivalence review, and multidisciplinary evaluation for accuracy in the Korean context. The instrument was piloted with six physicians and 288 patients involved in SDM. For construct validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. Psychometric evaluation included Pearson's correlation, Guttman split-half coefficient, and Cronbach's alpha. Criterion validity was assessed using the 9-Item Shared Decision-Making Questionnaire (SDM-Q-9), SDM-Q-Doc, and Communication Assessment Tool (CAT). RESULTS:The final K-MAPPIN'SDM was successfully developed through a scientifically rigorous and culturally sensitive translation and validation process. EFA and CFA supported a one-factor model for both versions of K-MAPPIN'SDM, though model fit was better for the patient version. Internal consistency of the K-MAPPIN'SDM was high (Cronbach's α = 0.94 for healthcare provider version; 0.87 for patient version). Guttman coefficients were 0.90 and 0.73, respectively. The provider version correlated strongly with SDM-Q-Doc (r = 0.88, p < .001); the patient version correlated with SDM-Q-9 (r = 0.58, p < 0.001) and CAT (r = 0.47, p < .001). CONCLUSIONS:The K-MAPPIN'SDM is a psychometrically sound tool for assessing SDM. This scale has the potential to be widely used to assess SDM in Korea. K-MAPPIN'SDM can serve as a tool to assess current state of SDM implementation from diverse perspectives in Korea and provide framework for training healthcare providers in SDM practices.
OBJECTIVE:This study aimed to evaluate short-term physiological and psychological changes associated with participation in a community-based Kurort Health Walking program conducted in a forest environment. PATIENTS AND METHODS:This study was conducted as part of a public health program in Saikai City, Nagasaki, Japan. A total of 90 participants who attended certified Kurort Health Walking courses between March 2024 and March 2025 were included. Physiological parameters, including systolic and diastolic blood pressure and pulse rate, and psychological status were assessed before and after the walking session. Autonomic nervous activity was evaluated using heart rate variability indices, including the low-frequency/high-frequency ratio and high-frequency power, measured at four time points before, during, and after the walk. Mood states were assessed using validated questionnaires. RESULTS:Systolic and diastolic blood pressure decreased significantly after the walking session (p < 0.001). Neither the low-frequency/high-frequency ratio nor high-frequency power showed significant changes across the measurement points. Negative mood states decreased significantly, whereas positive mood states, including vigor, friendliness, pleasure, and relaxation, increased, and anxiety decreased after walking (p < 0.001). CONCLUSION:Participation in the community-based Kurort Health Walking program was associated with short-term changes in physiological and psychological measures. However, because this study did not include a control group, the independent contributions of the forest environment, physical activity, and other contextual factors could not be distinguished.
G-patch proteins are emerging as key regulatory cofactors of DEAH-box RNA helicases involved in pre-mRNA splicing, yet the functions of many family members remain poorly understood. Here, we characterize the conserved G-patch domain-containing protein Cwf28 from Schizosaccharomyces pombe, an essential factor with a previously unclear molecular function, and define its role within the spliceosome. Tandem affinity purification coupled with mass spectrometry revealed that Cwf28 predominantly associates with components of the Prp19 complex (NTC) and factors involved in the catalytic activation and progression of the spliceosome, placing it within catalytically active spliceosomal assemblies. Gene ontology analysis showed enrichment of the Cwf28 interactome in factors involved in spliceosome assembly, activation, and catalytic remodeling. Notably, the DEAH-box RNA helicase Cdc28, the ortholog of human DHX16 and Saccharomyces cerevisiae Prp2, was identified as the most abundant interactor. Further analysis demonstrated that Cwf28 interacts with Cdc28 via its conserved G-patch domain, and domain mapping confirmed that this interaction is G-patch domain dependent. Together, these findings identify Cwf28 as a component of catalytically active spliceosomes and suggest a potential role for Cwf28 in modulating the activity of the RNA helicase Cdc28, providing insight into conserved mechanisms underlying RNA helicase regulation during splicing.
To address the critical influence of pulse shape on the laser ablation of metallic materials, this study proposes a comprehensive methodology that integrates finite‑element numerical simulations with experimental validation. Based on the spatiotemporal energy‑distribution characteristics of Gaussian and super‑Gaussian pulses, the temperature evolution, plasma electron density, and ablation efficiency of 6061 aluminum alloy were systematically analyzed under various single‑pulse energies and spot radii. Comparison between experimental measurements and numerical predictions enables the construction of an energy‑coupling model for laser ablation and establishes a theoretical framework describing how pulse shape governs the material's thermal response and plasma dynamics. The performance of the experimental laser was benchmarked against that of a commercial laser. The results show that the maximum difference in dispersion coefficients between the two lasers is only 0.19%, and the largest discrepancy in average perforation time between the Gaussian and super‑Gaussian pulses is approximately 6 s. Owing to its more uniform energy distribution, the super‑Gaussian pulse exhibits 3-18% higher energy‑coupling efficiency and material‑removal efficiency under identical energy input. Therefore, controlling the pulse shape can significantly enhance the stability and efficiency of laser ablation, satisfy the requirements of high‑precision material processing regarding energy‑distribution uniformity and ablation consistency, and provide a theoretical foundation for applying pulse‑shaping techniques in high‑efficiency laser manufacturing.
This study investigates the effects of ground roughness, building orientation, swirl ratio, and radial position on the wind loads of hip roof buildings under tornado conditions. The simulation results (CFD) presented herein were compared with validated simulations, existing experimental data, and field measurements to validate the accuracy of the modelling approach. The most unfavorable vortex ratio affecting the hipped roof was identified through an analysis of the wind pressure coefficient under typical vortex ratios. The wind load characteristics at specific roof locations were examined by comparing radial distances. The influence of orientation angle on turbulent structures and wind pressure distribution within the wind field was investigated through comparative analysis of different aspects. This study investigates the influence of ground roughness on wind pressure and mean aerodynamic force over hipped roofs through computational analysis. Results indicate that increased surface roughness reduces the proportion of upward airflow, causing wind field characteristics to approach those of smooth surfaces. When the building orientation is 90°, the maximum negative pressure occurs at the leeward ridge junction due to minimal airflow separation and windward area. At the maximum core radius, airflow directly impacts the windward surface, inducing flow separation and vortex formation, which generates substantial vortices on the roof's leeward side. These findings provide quantifiable insights into the near-ground tornado-structure interaction, offering valuable guidance for optimizing design codes and enhancing the resilience of low-rise buildings in tornado-prone regions.
As the nerve center of power systems, power communication networks require risk assessment methods with lightweight architecture and high prediction accuracy to support reliable operation and maintenance decision-making. To overcome the limitations of conventional models-including weak temporal feature extraction, static weight assignment, and poor generalization in small-sample scenarios-this paper proposes a risk assessment method for power communication networks based on the fusion of Lightweight Temporal Attention (LTA) and Elastic Net (EN). First, a risk indicator system is constructed, and redundant features are eliminated through variance-based screening to reduce data dimensionality. The LTA module discards complex multi-head structures and computes dynamic weights solely by combining indicator-risk correlations and normalized interaction terms, enabling adaptive focusing on core time-series indicators. The EN regression is adopted to construct the prediction model, in which bi-regularization balances fitting performance and generalization ability to further improve prediction accuracy. Tests on 12-month small-sample datasets show that the MAE of the LTA-EN model is reduced by 23.4% compared with the conventional fixed-weight linear regression scheme and by 12.1% compared with the complex attention-ridge regression approach. The small-sample generalization error is decreased by 10% on average, and the core indicator recognition efficiency is improved by 40%. The model achieves an optimal tradeoff among small-sample adaptability, lightweight deployment, and high-precision prediction, and can provide efficient quantitative support for monthly risk early warning of power communication networks.
Malnutrition is a frequent complication of Crohn's disease (CD), but multidimensional nutritional data from South Asian populations remain limited. This cross-sectional study compared nutritional status between active disease and remission among 127 South Asian adults with CD attending a tertiary-care center in Dhaka, Bangladesh. Disease activity was assessed using the Crohn's Disease Activity Index (CDAI), Simple Endoscopic Score for Crohn's Disease (SES-CD), and magnetic resonance enterography (MRE). Nutritional assessment included body mass index (BMI), mid-upper arm circumference (MUAC), calf circumference (CC), triceps skinfold thickness (TSF), mid-arm muscle circumference (MAMC), the Mini Nutritional Assessment (MNA), and biochemical measurements. Protein-energy malnutrition was operationalized using the Global Leadership Initiative on Malnutrition (GLIM) framework, with BMI < 18.5 kg/m2 as the available phenotypic criterion and CD-related inflammatory and gastrointestinal burden as the etiologic criterion. Of 127 participants, 63 had active disease, and 64 were in remission. Overall, 60 participants (47.2%) met the study definition of GLIM malnutrition, with a substantially higher frequency in active disease than in remission (81.0% vs. 14.1%, P < 0.001). Participants with active disease had significantly lower BMI, MUAC, CC, sex-stratified TSF, MAMC, and MNA scores (all P < 0.001). Hemoglobin, serum iron, albumin, and zinc concentrations were also lower in active disease (all P < 0.001), whereas folate (P = 0.411) and vitamin B12 (P = 0.051) did not differ significantly. BMI correlated positively with MUAC, CC, TSF, MAMC, and MNA score (rs = 0.366-0.967; all P < 0.001), with the weakest association observed for MAMC, while correlations with biochemical markers were weaker and were generally not statistically significant after subgroup stratification. The objective disease-activity sensitivity analysis based on SES-CD and/or MRE produced the same active and remission classification as the primary analysis (100% agreement; Cohen's κ = 1.000). These findings demonstrate a substantial burden of protein-energy malnutrition in Bangladeshi adults with CD, particularly during active disease, while also showing that nutritional impairment may persist during remission. Simple anthropometric measures provide useful information on physical tissue depletion, but biochemical abnormalities should be interpreted alongside disease activity because markers such as albumin and zinc may be influenced by systemic inflammation in addition to nutritional status. A multidimensional approach combining anthropometric assessment with targeted biochemical evaluation may therefore provide a more comprehensive assessment of nutritional status in CD.
