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Objetivos: La utilización por parte de la población de los recursos sanitarios se encuentra relacionada con los niveles de salud y con factores socioeconómicos. Los grupos de población con menor nivel socioeconómico tienen una mayor utilización de determinados recursos sanitarios; los servicios de urgencia podrían presentar un uso diferencial entre los distintos grupos de población. El presente estudio pretende identificar diferencias en el uso de los recursos de atención urgente entre grupos con diferentes características socioeconómicas. Material y métodos: Se realiza un estudio poblacional, en el que mediante el agrupamiento de las secciones censales de la ciudad de Santander, según variables sociodemográficas (edad, nivel de formación y nivel de empleo), se establecen áreas de la ciudad con similares características, mediante análisis de clusters. Se identifica el origen de los pacientes que consultan en el Servicio de Urgencias Hospitalarias (SUH) del Hospital Marqués de Valdecilla, y se calcula la tasa de demanda para cada una de las áreas sociodemográficas. Resultados: El análisis de clusters es capaz de identificar cuatro agrupaciones de diferentes características socioeconómicas que se ajustan a barrios de la ciudad de Santander. Se aprecia una mayor utilización del SUH en los grupos sociales más desfavorecidos y de mayor edad media (odds ratio [OR] = 1,91; intervalo de confianza [IC] del 95% 1,73-2,1) de la agrupación 1 con respecto a la 4. La proporción de ingresos es superior en las agrupaciones más favorecidas, mientras que el número de usuarios que realizan visitas repetidas proceden de agrupaciones con menor nivel socioeconómico. Conclusión: La utilización del SUH está condicionada por las características sociodemográficas del área de residencia, identificándose mayor uso entre los grupos de más bajo nivel socioeconómico.

Background: A possible role of PM 2.5 components on ovarian reserve has not been adequately unexplored., Objective: To evaluate the association between PM 2.5 components and women' ovarian reserve over critical exposure periods in northern China, where the level of air pollution is among the nation's highest., Methods: We included 15,102 women with serum anti-Müllerian hormone (AMH) measurements from the Center for Reproductive Medicine of Shandong University during 2015-2019. Concentrations of PM 2.5 and its five major components (0.1° × 0.1°), including sulfate, nitrate, ammonium, organic matter, and black carbon, were assigned to each residential address. Multivariable linear mixed effect models combined with constituent-residual models were performed to estimate the effect sizes of essential components over six short- to long-term exposure periods., Results: The strength of association was stronger during the process from primary to small antral follicle compared with other longer windows. For every interquartile range increase in PM 2.5 mass was associated with - 8.7% (95%CI: -12.3%, -4.9%) change in AMH and the effect size was greatest for sulfate. Women with the lower level of attained education and those living inland were more susceptible compared with other population subgroups., Conclusion: Exposure to specific components of air pollution during critical exposure windows is associated with a decline in ovarian reserve. These data add to the growing body of evidence that environmental factors have adverse effects on reproductive health, particularly for vulnerable population subgroups., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Stroke is the second leading cause of death in the world. It has multiple risk factors of which some, such as ambient temperature, are less well documented., Objective: We aimed to examine the association between diurnal temperature range (DTR) and stroke mortality, and to test the possible effect modification of this association according to gender, age and educational level., Methods: Daily data on weather and stroke mortality from 16 provincial capital cities in China for the years 2007-2013 were obtained, with a total of 788,783 deaths from stroke. A quasi-Poisson generalized linear regression combined with a distributed lag non-linear model was used to examine the city-specific DTR effect on stroke mortality. The pooled effects of DTR on stroke mortality were then obtained using a meta-analysis, which was based on restricted maximum likelihood estimation., Results: The DTR impacts were generally limited to a period of eight days, while significant effects during lag 0-8 days were only found in the cities of Beijing, Zhengzhou, Nanjing, Hefei, Chongqing and Changsha. The DTR effects were significantly and negatively associated with latitudes at lag 0-10 days (r s = - 0.640, P = 0.008). An increase of 1 °C in DTR was associated with pooled estimate of 0.66% (95%CI: 0.28-1.05%), 0.12% (- 0.26% to 0.51%) and 0.67% (0.26-1.07%) increases in stroke mortality at lag 0-10 days during the total, hot and cold days, respectively. The impact of DTR was much higher in southern China than in northern China [1.02% (0.62% to 1.43%) versus 0.10% (-0.27% to 0.47%) ]. For the individual characteristics, only females, the elderly aged ≥ 65 years, and those with lower educational attainment were vulnerable to DTR., Conclusions: DTR has considerable effects on risk of mortality from stroke in various cities in China, especially among the elderly, females, those with low educational level, and people living in southern China. The results can inform decisions on developing programs to protect vulnerable subpopulations from adverse impacts of DTR., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The System for Early-warning based on Emergency Data (SEED) is a pilot project to evaluate the use of emergency call data with the main complaint acute undifferentiated fever (AUF) for syndromic surveillance in India. While spatio-temporal methods provide signals to detect potential disease outbreaks, additional information about socio-ecological exposure factors and the main population at risk is necessary for evidence-based public health interventions and future preparedness strategies. The goal of this study is to investigate whether a spatial epidemiological analysis at the ecological level provides information on urban-rural inequalities, socio-ecological exposure factors and the main population at risk for AUF. Our results displayed higher risks in rural areas with strong local variation. Household industries and proximity to forests were the main socio-ecological exposure factors and scheduled tribes were the main population at risk for AUF. These results provide additional information for syndromic surveillance and could be used for evidence-based public health interventions and future preparedness strategies., (Copyright © 2014. Published by Elsevier Ltd.)

Life expectancy and longevity are influenced by air pollutants and socioeconomic status, but the extend and significance are still unclear. Better understanding how the spatial differences of life expectancy and longevity are affected by air pollutants is needed for generating public health and environmental strategies since the whole of China is now threatened by deteriorated air quality. 85 major city regions were chosen as research areas. Geographically Weighted Regression (GWR) and Stepwise Regression (SR) were used to find the spatial correlations between health indicators and air pollutants, adjusted by per capita GDP(1). The results were, regions with higher life expectancy were mainly located in the east area and areas with good air quality, a regional difference of 10 μg/m(3) in ambient air SO2(2) could cause adjusted 0.28 year's difference in life expectancy, a regional difference of 10 μg/m(3) in ambient air PM10(3) could lead to a longevity ratio difference of 2.23, and per capita GDP was positively associating with life expectancy but not longevity ratio, with a regional difference of 10,000 RMB(4) associating with adjusted 0.49 year's difference in life expectancy. This research also showed the evidences that there exist spatially differences for ambient air PM10 and SO2 influencing life expectancy and longevity in China, and this influences were clearer in south China., (Copyright © 2014 Elsevier B.V. All rights reserved.)

To investigate the lag effects and seasonal differences of urban air quality change on human health, we carried out a time-series analysis of daily general practitioner consultations for allergic rhinitis (AR) in Beijing, China. In earlier publications we had assessed the relative risks of air pollutants on AR in Beijing during the period 2009-2010. This article analyzes for the same time period the lag effects of air pollutants and the seasonal effects on daily number of outpatient with allergic rhinitis; differences among age groups and gender groups were also taken into consideration. The results show that, the largest effect RRs of PM(10) were at lag01, lag0, lag01, lag01, and lag01 for the total population, male, female, young/middle aged people (20-60 years age group), and old people (more than 60 years age group), respectively. The largest associations of SO(2) were observed at lag3, lag1, lag3, lag0 and lag0 for the total population, male, female, young people/middle aged people (20-60 years age group), and old people (more than 60 years age group), respectively. The strongest effects of NO(2) were found at lag03 for the total population, female and the young/middle aged people; at lag0 for male and lag03 for elder people. RRs of the three pollutants for AR have shown a decreasing relevance from NO(2) to PM(10) to SO(2). The seasonal effect models show that PM(10), SO(2), and NO(2) had higher risk for AR in the warm season than in the cold season., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Alveolar bone quality is considered to be an important prognostic factor in dental implant stability. Although numerous methods have been described, no technique allows for reliable diagnostics. The purpose of this study was to determine if strain measurements on the shaft of a contra angle handpiece during implant bed preparation could be used for the determination of bone quality. Experiments in polyurethane foam and human cadaver bone were conducted to investigate whether strain measurements could be correlated with other diagnostic parameters, such as the surgeon's tactile sensation during drilling, implant insertion torque, implant stability, elastic modulus of bone and bone quality as assessed radiographically. Tests were also performed to determine if strain measurements could be used to distinguish various types of bone. As axial feed and contact pressure during the drilling process could not be standardized under simulated clinical conditions, substantial deviations in the time needed to complete the drilling occurred. Under controlled circumstances using polyurethane foam, this problem could be addressed by a normalization procedure, but great variations occurred in human cadaver bone. As bone quality could not be reliably determined, especially when a cortical layer was present, strain measurements on a contra angle handpiece appears to be inappropriate for this purpose., (Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

To investigate the effects of aerosol pollen on human health, we carried out a time-series analysis of daily general practitioner consultations for allergic rhinitis (AR) in Beijing. The objective of this study was to assess the possible effects of pollen on clinic visits for allergic rhinitis in Beijing during the pollen season. We found a strong association between the concentration of pollen in ambient air and the number of consultations for allergic rhinitis. Females had significantly more outpatient visits than males when the levels of pollen increased. Young people (20-60 years old) had had significantly more outpatient visits than older people (over 60 years old) when the levels of pollen increased. After adjusting for air pollutants, the relative risks of pollen on daily number of outpatient for AR were increased., (Copyright © 2011 Elsevier B.V. All rights reserved.)

To investigate the effects of urban air quality change on health, we carried out a time-series analysis of daily general practitioner consultations for allergic rhinitis (AR) in Beijing, China. Non-parametric generalized additive model (GAM) was used to analyze the highly non-linear or non-monotonic exposure-response relationship between three air pollutants (namely PM₁₀, SO₂ and NO₂) and daily outpatient visits for AR, after controlling for long term trends, the 'day of the week' effect and confounding meteorological factors. The objective of this study was to assess the possible effects of air pollutants on outpatient visits caused by AR in Beijing during the period 2009-2010. Our work indicates that strong associations exist between daily concentration of the three air pollutants and the daily number of outpatients for AR., (Copyright © 2011 Elsevier B.V. All rights reserved.)

The evidence for the efficiency of clinical methods used to assess the quality of alveolar bone in terms of a density measure prior to and during dental implant surgery is limited. The aim of this paper is to describe the biomechanical background which can be used as a basis for determining the bone quality by measuring the elastic properties of the bone and to design a novel device for the determination of the bone quality during dental implant surgery. Applying material mechanical equations for porous and cellular structured models, the elastic material properties (modulus of elasticity) of cellular and cortical bone as porous structures were approximated over the whole range of relative bone mineral density of trabecular and cortical bone. Based on a circular disc with a central hole reflecting a horizontal cross-section of an implant socket, the mechanical effects of expanding the central hole were studied. Subsequently, the clinical situation of a socket prepared for the placement of a dental implant (depth: 10 mm; diameter 3.5 mm) was simulated using three-dimensional (3D) finite element analysis. A loading device (thickness: 3.5 mm) was placed in the trabecular part of the socket and expanded, while the resulting pressure was recorded and used for the calculation of an elastic modulus. Finite element analysis revealed that it was possible to estimate the bone quality by applying the measurement technique proposed. Maximum deviations of 6% of the experimentally determined elastic modulus from the setpoint elastic modulus were found. Measuring the internal pressure in a drill hole, e.g., in an implant socket caused by a defined expansion of a rotational symmetric loading device, could be used for establishing a clinically meaningful test system for the objective classification of alveolar bone., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

The aim of this study was to investigate the amount of damage to the lingual nerve by mandibular block anaesthesia alone. For this purpose the records of 12,104 patients in whom mandibular block anaesthesia was administered without any type of surgery were reviewed. The reason for treatment in those patients was, in 72.4% fillings and crown preparations, in 27.13% periodontal procedures and in 0.30% other treatment. The records showed a lingual sensory disturbance in 18 out of 12,104 patients (0.15%). In 17 out of these 18 patients the tongue sensation recovered after a period of 6 months. Only in one patient (0.008%) was there a slight sensory diminution of the tongue, even after one year.