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Objectives: Extracorporeal cardiopulmonary resuscitation (eCPR) is a promising treatment that could improve survival for refractory out-of-hospital (OHCA) patients. Healthcare systems may choose to start eCPR in the prehospital setting to optimize time to eCPR initiation and decrease low-flow time. We used geospatial modeling to evaluate different eCPR catchment strategies for a forthcoming prehospital eCPR program in Houston, Texas. Methods: We studied OHCAs treated by the Houston Fire Department from 2013 to 2021. We included OHCA patients aged 18–65 years old with an initial shockable rhythm that did not have prehospital return of spontaneous circulation (ROSC). Based on the geolocation that each OHCA occurred, we used geospatial modeling to identify eCPR candidates using four mapping strategies based on distance/drive time from the eCPR center: 1) 15-minute drive time, 20-minute drive time, 10-mile drive distance, and 15-mile drive distance. Results: Of 18,501 OHCAs during the study period, 881 met the eCPR inclusion criteria. Compared to non-eCPR candidates, eCPR candidates were younger (median age 52.3 years vs 62.7 years, p < 0.01) and had a higher proportion of males (76.6% v 59.8%, p < 0.01). Of eCPR candidate OHCAs, OHCAs occurred more frequently during the weekdays and the daytime, with 5:00 PM being the most common time. Using geospatial modeling and based on drive time, 219 OHCAs (24.9% of 881) were within a 15-minute drive, and 454 (51.5%) were within a 20-minute drive. Using drive distance, 383 eCPR candidates (43.5%) were within 10 miles, and 703 (79.8%) were within 15 miles. Conclusions: Using geospatial modeling, we demonstrated a process to estimate potential eCPR patient volumes for a geographic region. Geospatial modeling represents a viable strategy for healthcare systems to delineate eCPR catchment areas. [ABSTRACT FROM AUTHOR]

Elder mistreatment disproportionately affects racial and ethnic minority older adults, particularly Chinese older adults in the U.S. who face increased risks due to cultural disparities, intergenerational conflicts, and socioeconomic disparities. This study investigated the longitudinal association of elder mistreatment with cognitive functioning among Chinese older adults in the Greater Chicago area (N = 2,811). Self-reported elder mistreatment and cognitive performance were assessed across four waves of the study. Latent growth curve modeling analysis showed that respondents reporting previous mistreatment instances at baseline exhibited better initial functioning status (B = 0.07, p <.05); however, those reporting mistreatment incidents at three follow-ups showed a faster cognitive decline compared to those without such reports (B = −0.04, p <.05). Recent and potentially cumulative experiences of elder mistreatment have a negative effect on cognitive decline. Sociocultural contexts need to be considered when addressing elder mistreatment issues within the Chinese minority community. [ABSTRACT FROM AUTHOR]

A very small proportion of all chemicals in commerce have occupational exposure limits (OELs) based on quantitative risk assessments which require estimates of exposure-response relationships (XRs). For only 18 of the 94 chemicals declared by NIOSH to be carcinogens were human XRs reported in or calculable from published reports. For the 18 carcinogens, 96 such XRs could be derived (corresponding to chemicals with multiple associated cancer end-points and/or multiple source studies). Twenty-four of 96 XR estimates came directly from reported statistical models (on continuous cumulative exposure), 45 were derived from summary study-population attributes, and 27 came from categorical analyses. Using the 96 XRs, OEL conferring one-per-thousand excess lifetime risk were calculated. OSHA's OEL, permissible exposure limits (PEL) were then compared to OEL derived from the 96 XRs. For 88 of the 96 calculated OELs (for which a corresponding PEL exists) all but 10 fell below the current PEL. Thirty-four OEL estimates were 10- to 100-fold below the PEL and 21 were greater than 100-fold below the PEL. This same pattern was observed using the different methods for deriving XRs. These findings can guide priorities in setting standards and the method is not limited to carcinogens. [ABSTRACT FROM AUTHOR]

Hemodialysis treatment negatively change people's daily lives, which can be minimized by improving the social determinants of health. This study aims to learn the leisure activities of individuals on hemodialysis and analyze the differences in the proportions of social determinants of health. This is a cross-sectional, census, analytical study with 1024 individuals on hemodialysis in a metropolitan region of southeastern Brazil. The most practiced domains of leisure are the idle and contemplative (41.7%), social (37.1%), and intellectual (32.5%). The population can be described as men (56.7%), aged between 30 and 59 years (51.6%), with less than eight years of schooling (51.6%), with an income of up to two minimum wages (56.2%). Men practice more physical activities (p <.001) and women tend to practice manual activities (p =.027). Lower education and lower income also indicate higher proportions of individuals not engaged in leisure. Understanding and acting on the social determinants of health would minimize health inequities, whereas expanding leisure practices would improve the well-being of people undergoing treatment. [ABSTRACT FROM AUTHOR]

An increasing number of women are conceiving through assisted reproductive technology; however, few studies have investigated their mental health after successful conception. This study investigated the changes in depressive symptoms in women using assisted reproductive technology and the association between the mode of conception and perinatal depressive symptoms. A longitudinal observational study was conducted from 2015 to 2019, 542 pregnant women completed questionnaires on depressive symptoms at eight timepoints during the prepregnancy, pregnancy and first-year postpartum periods. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. A generalized estimating equation regression model was employed for repeated measures. In the assisted reproductive technology group, depressive symptoms were more prevalent during early pregnancy and at 1 month postpartum than before pregnancy, and more prevalent before pregnancy and at 1 month after childbirth than in the spontaneous conception group. No significant association was identified between the mode of conception and depressive symptoms during the antenatal or postnatal period. The lack of full-time employment and prepregnancy depressive symptoms were associated with antenatal depressive symptoms. Primipara status and depressive symptoms during prepregnancy and pregnancy were associated with depressive symptoms during the first-year postpartum. Assisted reproductive technology was not a risk factor for depressive symptoms during the pregnancy and postpartum periods, whereas primipara status, lack of full-time employment and prepregnancy depressive symptoms were negative predictors. Therefore, targeted mental health interventions should address these specific factors to effectively support maternal mental health. [ABSTRACT FROM AUTHOR]

This study retrospectively compared the effect of holding the 2022 FIFA World Cup™ (WC) mid-season (season 2022/23) on injury rates and patterns in French Ligue 1 soccer clubs. Epidemiological data in 17 clubs were prospectively recorded by their physicians. Time-loss injuries (injuries leading to a player being unable to fully participate in play over the following 72-hour period) were compared with those reported during a regular season (2021–22). In the WC season, an increase of approximately 23% (training + match-play) was observed for both the total number of injuries and knee, ankle and muscle injuries combined. Incidences for match-play injury overall and for the knee, ankle and muscle regions combined and the hamstrings and calf regions specifically also rose significantly (range: p < 0.05-p < 0.01). These results suggest that injury occurrence and patterns in French L1 soccer clubs were substantially affected during the 2022/23 season when a mid-season WC was held. [ABSTRACT FROM AUTHOR]

Background: Older adults, an increasingly diverse segment of the United States population, are a priority population for prescription painkiller misuse. This study documents trends and correlates of prescription painkiller misuse among Hispanic and non-Hispanic adults ages 50 and older. Methods: A secondary analysis of adults 50 years and older across 5 cohorts using the 2015–2019 National Survey on Drug Use and Health (unweighted n = 16,181, 8.5% Hispanic, and 54% female). Logistic regression modeling with complex survey design was used to examine trends in prescription painkiller misuse. Results: Over time, the prevalence of past year painkiller misuse significantly decreased for Hispanic respondents (56.1% relative decrease, p = 0.02); elevated proportions were observed across strata of demographic characteristics. Conclusions: Variability in the prevalence of painkiller misuse may be explained by demographic characteristics. Further, these results emphasize the importance of addressing comorbid recreational marijuana use when designing interventions to address painkiller misuse for older adults. [ABSTRACT FROM AUTHOR]

The health and well-being of transgender, non-binary, and gender-diverse people is receiving increasing attention from epidemiologists and public health researchers, including those utilizing longitudinal observational cohort studies. These longitudinal studies are advantageous over cross-sectional observational study designs given their scope over several timepoints rather than one, and when exposures and outcomes are prospectively measured this improves validity of causal claims. However, within these longitudinal studies, gender is often collected inconsistently (e.g. only asked at a single timepoint), or inadequately (e.g. questions that use limiting notions of gender). Due to the temporal nature of gender, this introduces potential including misclassification error and may provide an incomplete picture of gender diversity in a sample. This article considers these methodological issues and offers evidence-based recommendations to ensure longitudinal data on trans, non-binary, and gender-diverse people is treated with epidemiological rigor, while maintaining inclusivity. [ABSTRACT FROM AUTHOR]

The present study aimed to examine the spatial characteristics of myopia and identify the socioeconomic and environmental factors influencing its prevalence. Myopia prevalence among children of school age of Han ethnicity in China was 56.6% in 2019, with the highest and lowest prevalence's in Shandong (66.8%) and Guizhou (47.3%), respectively. There was a spatial aggregation of myopia prevalence in China. Environmental factors (atmospheric PM2.5 concentration and forest coverage) and socioeconomic factors (gross domestic product per capita, per capita disposable income, hospital beds per thousand people, and Engel coefficient) have significant influences on myopia prevalence. The interaction of each factor on myopia showed nonlinear enhancement. Myopia prevalence among children of school age was spatially clustered, and environmental and socioeconomic conditions are associated with myopia prevalence. Our findings provide novel perspectives for the comprehensive prevention and control of myopia. [ABSTRACT FROM AUTHOR]

This study aimed to elucidate the causal genetic relationships between iron, copper, zinc, magnesium, and rheumatoid arthritis (RA). A two-sample Mendelian randomization (MR) analysis was conducted using the "TwoSampleMR" and "MendelianRandomization" packages in R. The random-effects inverse variance-weighted (IVW) method was used as the primary approach. We performed sensitivity analyses to test the reliability of the results. The random-effects IVW analysis revealed that there was no genetic causal relationship between iron (P = 0.429, odds ratio [OR] 95% confidence interval [CI] = 0.919 [0.746–1.133]), copper (P = 0.313, OR 95% CI = 0.973 [0.921–1.027]), zinc (P = 0.633, OR 95% CI = 0.978 [0.891–1.073]), or magnesium (P = 0.218, OR 95% CI = 0.792 [0.546–1.148]) and RA. Sensitivity analysis verified the reliability of the results. Therefore, there is no evidence to support a causal relationship between iron, copper, zinc, and magnesium intake at the genetic level and the development of RA. [ABSTRACT FROM AUTHOR]

With the outbreak of coronavirus disease 2019 (COVID-19), there has been an increasing focus on exploring the relationship between SARS-CoV-2 infection and tumors. However, there is no consensus on the association between COVID-19 and lymphoma. In this study, genome-wide association study (GWAS) summary data sets for COVID-19 and lymphoma were obtained from the OPEN GWAS website. Single nucleotide polymorphisms (SNPs) were selected as genetic instrument variants for fulling P < 5 × 10−8 and linkage disequilibrium [LD] r2 < 0.001. Both palindromic and outlier SNPs were removed. Cochran's Q test, the MR‒Egger intercept test, and leave-one-out analysis were employed to assess the sensitivity of the effect of COVID-19 on lymphoma. The results showed that COVID-19 patients with very severe respiratory symptoms have an increased risk of developing diffuse large B-cell lymphoma (IVW, OR = 1.765, 95% CI 1.174–2.651, P = 0.006). There was no association between COVID-19 with very severe respiratory symptoms and Hodgkin's lymphoma or other types of non-Hodgkin's lymphoma. No horizontal or directional pleiotropy was observed in the Mendelian randomization analysis. In conclusion, SARS-CoV-2 infection with very severe respiratory symptoms may be a potential risk factor for diffuse large B-cell lymphoma (DLBCL), and follow-up studies with larger samples are needed. [ABSTRACT FROM AUTHOR]

The purpose of this study was to analyse secular trend in handgrip strength (HGS) in adolescents using an allometric approach and identify the factors associated. The sample comprised 657 and 1004 adolescents (14 to 19 years) in 2007 and 2017/2018, respectively, of public schools in Florianópolis, Brazil. The dependent variable was HGS normalised to body mass and height. Covariance analysis was used to examine secular trends in HGS, and multiple linear regression was used to identify associated factors. The independent variables were sociodemographic, biological, and behavioural factors. Comparison of HGS between surveys indicated a negative secular trend in both sexes (p < 0.001). In boys, there was a positive association of HGS with age and FFM in both surveys. In 2017/18, there was a positive association with sexual maturation and a negative association with sitting time and fat percentage. In girls, FFM was positively associated with HGS in both surveys. In 2007, there were positive associations of HGS with age and vigorous physical activity, whereas, in 2017/18, negative associations were observed with economic level and sitting time. The findings of the present study show a decline in adolescent HGS. And behavioural changes appear to be contributing to declines in HGS. [ABSTRACT FROM AUTHOR]

This study collected data related to agricultural injuries, analyzed their causes, and suggested possible remedial actions. Few studies from developing countries have investigated this important topic. Such investigations are extremely important and are required to frame national policies. A well-designed structured form was developed to collect and evaluate data on agricultural incidents, their causes, the severity of injuries, and possible prevention methods. The authors followed a door-to-door survey methodology to collect data with the help of local village leaders. Less educated and older adults in the age group 31 to 45 years were more prone to agricultural incidents (p <.05). The mean age of the victims was 35.02 years (95% CI 32.7 to 37.3); 124 (91.18%) of the victims were men; and 21 (15.4%) of the cases were fatal. Tractor rollovers caused most of the deaths. Chaff cutters were responsible for most of the incidents that required amputation. Eighteen (45%) of the chaff-cutter incidents occurred in the evening between 3:00 PM and 6:00 PM, and 12 (30%) of these incidents occurred due to fatigue. The authors strongly recommend that rollover protective structures (ROPS) for tractors and seat belts should be made mandatory in India. Public guidelines emphasizing mandatory higher education for farmers and a model curriculum for both schools and colleges that focuses on the safety of rural populations should be developed. Special training should be provided on the safe operation of machinery and a definitive work – rest schedule should be followed to prevent fatigue and protect agricultural workers from incidents. [ABSTRACT FROM AUTHOR]

Individual satisfaction is associated with increased retention in HIV/AIDS care services and adherence to treatment. This study assessed factors associated with individual satisfaction at the initiation of antiretroviral therapy and compared the proportions of satisfaction at the initiation of antiretroviral therapy and after three months of follow-up. Face-to-face interviews were carried out among 398 individuals of three HIV/ AIDS healthcare services in Belo Horizonte, Brazil. Variables included sociodemographic and clinical characteristics, perception about healthcare services, and domains of quality of life. Individuals that rated the quality of healthcare services as good or very good were classified as satisfied. A logistic regression analysis of the association between independent variables and individual satisfaction was performed. The proportion of individual satisfaction with healthcare services was 95.5% at the initiation of antiretroviral therapy and 96.7% after three months and these changes were not statistically significant (p = 0.472). The physical domain of quality of life was found to be associated with satisfaction at the initiation of antiretroviral therapy (OR = 1.38; CI = 1.11–1.71; p = 0.003). Training and supervision of health professionals for addressing the needs of individuals with lower levels of physical domain of quality of life may improve satisfaction with HIV/ AIDS care. [ABSTRACT FROM AUTHOR]

Outdoor PM2.5 was sampled in Pretoria, 18 April 2017 to 28 February 2020. A case-crossover epidemiology study was associated for increased PM2.5 and trace elements with increased hospital admissions for respiratory disorders (J00-J99). The results included a significant increase in hospital admissions, with total PM2.5 of 2.7% (95% CI: 0.6, 4.9) per 10 µg·m−3 increase. For the trace elements, Ca of 4.0% (95% CI: 1.4%−6.8%), Cl of 0.7% (95% CI: 0.0%−1.4%), Fe of 3.3% (95% CI: 0.5%−6.1%), K of 1.8% (95% CI: 0.2–3.5) and Si of 1.3% (95% CI: 0.1%−2.5%). When controlling for PM2.5, only Ca of 3.2% (95% CI: 0.3, 6.1) and within the 0–14 age group by 5.2% (95% CI: 1.5, 9.1). Controlling for a co-pollutant that is highly correlated with PM2.5 does reduce overestimation, but further studies should include deposition rates and parallel sampling analysis. [ABSTRACT FROM AUTHOR]

Heat stress-related kidney injury has drawn public health attention. This study explored the temporal relationships between impaired kidney function and preceding outdoor heat exposure Taiwan. Data of participants collected through a health screening program was used to assess the association between chronic kidney disease (CKD) and average ambient temperature with various time lag structures. A total of 1,243 CKD cases and 38,831 non-CKD participants were included in the study. After adjusting for demographic, socioeconomic, lifestyle factors, and comorbidities, CKD was positively associated with the ambient temperature within 1–9 months. The 9-month average ambient temperature yielded the highest odds ratio of CKD (OR = 1.22; 95% CI = 1.09–1.37). Furthermore, females and farmers were found to be more vulnerable to CKD risk after outdoor heat exposure. These findings suggest that the prevention of heat stress-related kidney injury should consider relevant time frames and focus on vulnerable populations. [ABSTRACT FROM AUTHOR]

There is a dearth of research assessing the prevalence of eating disorders in publicly insured populations. While evidence shows that eating disorders affect people of all racial, ethnic, and socioeconomic backgrounds, research has neglected to focus on the rate at which they occur among those who have public health insurance. The present study indexes the prevalence of clinically significant disordered eating in a case series of 165 adults in a publicly insured sample at an outpatient general psychiatry clinic in Los Angeles, California. Results illustrate that 46 (27.8%) participants screened positive for clinically significant disordered eating with no significant differences relating to age or gender in those who screened positive versus those who did not (p >.05). This markedly elevated frequency of disordered eating presentations underscores the need for improved clinician training and education around disordered eating and eating disorder assessment as a whole. In addition, there is a critical need to study publicly insured populations so as to mitigate stereotypes about who has eating disorders and improve the likelihood of diagnosis and care. [ABSTRACT FROM AUTHOR]

Observational and Mendelian randomization (MR) studies have established links between dyslipidemia and select cancer susceptibilities. However, there is a lack of comprehensive exploration of causal relationships spanning diverse cancer types. Here, we conducted a two-sample MR analysis to elucidate the causative connections between 9 blood lipid metabolic profiles (namely, adiponectin, leptin, lipoprotein A, apolipoprotein A1, apolipoprotein B, cholesterol, triglycerides, LDL-cholesterol, and HDL-cholesterol) and 21 site-specific cancer risks. Our findings reveal genetically predicted adiponectin levels to be associated with a reduced ovarian cancer risk, while genetically determined leptin increases bladder cancer risk but decreases prostate cancer risk. Lipoprotein A elevates risk of prostate cancer while diminishing risk of endometrial cancer, while apolipoprotein A1 heightens risks of breast and cervical cancers. Furthermore, elevated levels of cholesterol are positively correlated with kidney cancer, and triglycerides demonstrate a positive association with non-melanoma skin cancer but a negative association with breast cancer. Protective effects of genetically predicted LDL-cholesterol on endometrial cancer and adverse effects of HDL-cholesterol on breast cancer are also observed. Our study conclusively establishes that blood lipid metabolic profiles exert causal effects on cancer susceptibility, providing more robust evidence for cancer prevention and prompting contemplation regarding the future health of the human populace. [ABSTRACT FROM AUTHOR]

The unique characteristics of rural areas and agricultural work can contribute to the genesis of diseases, including mental disorders such as depression. To estimate the prevalence of and factors associated with depression symptoms in Brazilian farmers. A cross-sectional epidemiological study involving 784 farmers of the state of Espírito Santo/Brazil was carried out. Depression was identified using the Mini-International Neuropsychiatric Interview. Hierarchical logistic regression was used to assess the associated factors. The prevalence of depression symptoms among farmers was 16.8% (n = 132). Of those experiencing symptoms, 6.1% (n = 48) we're currently experiencing a depressive episode, and 10.7% (n = 84) a recurrent depressive episodes. The associated factors were: female gender (OR 1.63; 95% CI 1.04–2.54), not owning the land (OR 1.79; 95% CI 1.11–2.89), professional dissatisfaction (OR 1.99; 95% CI 1.18–3.35), previous pesticide poisoning (OR 2.87; 95% CI 1.45–5.67), complex multimorbidity (OR 1.95; 95% CI 1.15–3.31) and occurrence of previous depressive episodes (OR 9.83; 95% CI 4.39–21.99). A high prevalence of depression symptoms was identified among rural workers. Sociodemographic, occupational, clinical, and professional dissatisfaction factors were associated with a higher risk of depression symptoms in this population. [ABSTRACT FROM AUTHOR]

Longitudinal data arise frequently in many economic studies and epidemiological research. In this paper, we investigate the partially linear additive model for longitudinal data in the framework of quantile regression. To incorporate the within-subject correlation, we develop an estimation procedure using quadratic inference function (QIF) and polynomial spline approximation for unknown nonparametric functions. The theoretical properties of the resulting estimators are established, where the nonparametric functions achieve the optimal convergence rate and the parametric components are asymptotically normal even when the number of parameters in the linear part is diverging. We also propose a variable selection procedure based on penalization. Since the objective function is discontinuous, a practical estimation procedure is proposed using induced smoothing and we prove that the smoothed estimator is asymptotically equivalent to the original estimator. The proposed methods are evaluated via simulation studies and a real data application. [ABSTRACT FROM AUTHOR]

Adolescents with a history of childhood maltreatment are vulnerable to body dissatisfaction and associated psychopathology such as eating disorders. The aim of this study was to expand the understanding of the association between childhood maltreatment and body dissatisfaction in adolescents and young adults. In an epidemiological cohort study, N = 1,001 participants aged 14–21 years from Dresden, Germany, completed self-report measures on childhood maltreatment, body image, and self-esteem. Lifetime mental disorders were assessed in standardized clinical interviews. Data analyses included multiple regression and mediation analyses. More than one-third of the participants reported experiences of childhood maltreatment (37.4%), in which emotional neglect and abuse were the most frequent subtypes. Individuals with a history of childhood maltreatment showed significantly less satisfaction with their physical appearance than participants without such adverse experiences. In a single mediator model, self-esteem emerged as potential mediator in the association between child maltreatment and body (dis)satisfaction. Experiences of childhood maltreatment may be considered as risk factor for the development of body dissatisfaction in adolescents, and the role of potential mediator variables such as self-esteem warrants further prospective research. [ABSTRACT FROM AUTHOR]

Having an intellectual disability increases the likelihood for exhibiting impairments in vision, hearing, and balance. The intersection of these issues has yet to be described in a large cohort. By hosting the largest public health database for individuals with intellectual disability, Special Olympics (SO) offers ∼120,000 assessments completed at competitions between 2007 and 2018. Of SO athletes assessed for vision (N = 52,521), hearing (N = 35,073), and balance (N = 31,446), 74%, 28%, and 51% demonstrated a deficit, respectively. Thirteen percent of athletes presenting to three assessments (N = 7,887) showed concurrent impairments. The high prevalence of sensory and balance impairments at younger ages (M = 28.8, SD = 14.15) compared to the general population highlights disparities faced by the intellectual disability community and should guide public health policy for improved screening and counselling. [ABSTRACT FROM AUTHOR]

This study examined whether Heritage Language Learners (HLLs) of English display profile effects in their performance on knowledge- and processing-dependent measures relative to the standardised mean scores of monolingual speakers. The study also investigated the influence of several experiential factors on HLL performance. Participants were 59 Arabic-speaking HLLs from six to nine years old. The children completed a battery of linguistic tests in their L1 and L2, as well as cognitive measures of short-term and working memory and non-verbal intelligence. Significantly lower standardised scores were observed for HLLs as compared to the standardised mean scores on all Arabic/English language tasks except L2 word reading. HLLs scored at or above age-level expectations on cognitive measures except the Arabic nonword repetition task. Stepwise regression analyses examining variance in HLLs' performance, age and richness of environment consistently explained HLLs' performance in L1 Arabic, but different factors accounted for HLLs' performance in English depending on the task. Age was the only variable that consistently explained variance in performance on the cognitive measures. The results suggest that processing-dependent measures may be less sensitive to difference in language experience than traditional knowledge-based measures such as standardised measures of language and vocabulary. [ABSTRACT FROM AUTHOR]

Inconsistent findings have emerged from epidemiological research investigating the association between vitamin B6 and the risk of gastric cancer. To obtain a more precise assessment, we conducted a comprehensive search of published data and performed a meta-analysis. PubMed, Web of Science, EMBASE and Cochrane Library databases were systematically searched. A total of 12 studies (5 prospective cohort and 7 case–control studies) involving 5,692 cases and 814,157 participants were included in the meta-analysis. The results showed that high intake of vitamin B6 may reduce the odds of gastric cancer (OR = 0.83, 95% CI: 0.73–0.95, p=0.006). However, this association was only observed in the case– control studies (OR = 0.68, 95% CI: 0.51–0.89, p=0.006) but not in the cohort studies (RR = 1.01, 95% CI: 0.94–1.08, p=0.819). Additionally, the negative association between vitamin B6 intake and gastric cancer risk was found in the United States of America (OR = 0.71, 95% CI: 0.62–0.82, p=10−4), but not in Europe (OR = 0.88, 95% CI: 0.74–1.05, p=0.169) or the other regions (OR = 0.86, 95% CI: 0.66–1.13, p=0.280). In conclusion, there is not sufficient evidence to assume that vitamin B6 intake is associated with gastric cancer risk, which needs further confirmation. [ABSTRACT FROM AUTHOR]

The aim of this 10-year study was to investigate whether and how temperature modifies the association between daily ambient PM10, NO2, SO2 air pollution and daily respiratory disease mortality in Cape Town. A time-stratified case-crossover epidemiological design was applied. Susceptibility by sex and age groups (15–64 years and ≥65 years) was also investigated. On days with medium Tapp levels, NO2 displayed a stronger association with respiratory mortality than PM10 or SO2. Females appeared to be more susceptible to NO2 at medium Tapp levels to males. The 15-64-year-old age group seemed to be more vulnerable to NO2 and PM10 at medium Tapp levels compared to the elderly (≥65 years). At high Tapp levels, females were more susceptible to PM10. The 15-64-year-old group were more vulnerable to NO2 and SO2. The results can be used in present-day early warning systems and in risk assessments to estimate the impact of increased air pollution and temperature. [ABSTRACT FROM AUTHOR]

This study assessed for the first time the oral and dental health of ultra-trail athletes. We also confirmed and quantified the scale of their exposure to oral health risk factors. This was a cross-sectional study using data from a survey among runners who enlisted in the 2020 edition of the UT4M races (Ultra-Trail des 4 Massifs). The dental health of 84% of the participants was "good" or "very good". The nutritional intake during effort comprised foods liable to induce tooth decay (energy bars (55%), sugar-rich gels and fruit confectionary (40%)) and snacking was frequent (39%). More than 3/5 of runners saw a dentist for preventive check-ups. The more runners participate in races the more likely they are to have oral hygiene strategies during competitions (aOR = 1.85, p ≤ 0.05). The oral health of ultra-trail runners is better than that of the average French adult population. Regular dental hygiene and preventive dental consultations appear to counterbalance the risks that we evidenced. [ABSTRACT FROM AUTHOR]

Prior studies report conflicting results about the association between lithium use and all-cause mortality. In addition, data are scarce on this association among older adults with psychiatric disorders. In this report, we sought to examine the associations of lithium use with all-cause mortality and specific causes of death (i.e., due to cardiovascular disorder, non-cardiovascular disease, accident, or suicide) among older adults with psychiatric disorders during a 5-year follow-up period. In this observational epidemiological study, we used data from 561 patients belonging to a Cohort of individuals with Schizophrenia or Affective disorders aged 55-years or more (CSA). Patients taking lithium at baseline were first compared to patients not taking lithium, and then to patients taking (i) antiepileptics and (ii) atypical antipsychotics in sensitivity analyses. Analyses were adjusted for socio-demographic (e.g., age, gender), clinical characteristics (e.g., psychiatric diagnosis, cognitive functioning), and other psychotropic medications (e.g. benzodiazepines). There was no significant association between lithium use and all-cause mortality [AOR=1.12; 95%CI=0.45-2.79; p=0.810] or disease-related mortality [AOR=1.37; 95%CI=0.51-3.65; p=0.530]. None of the 44 patients taking lithium died from suicide, whereas 4.0% (N=16) of patients not receiving lithium did. These findings suggest that lithium may not be associated with all-cause or disease-related mortality and might be associated with reduced risk of suicide in this population. They argue against the underuse of lithium as compared with antiepileptics and atypical antipsychotics among older adults with mood disorders. [ABSTRACT FROM AUTHOR]

This review aimed, as part of a larger FIFA project aiming to steer women's football research, to scope literature on any level of competitive football for women, to understand the current quantity of research on women's football injuries. The study reviewed all injury-related papers scoped by a recent scoping review mapping all published women's football research with an updated search performed on 23 February 2021. Eligibility criteria assessment followed the recent scoping review with injury-specific research focus. A total of 497 studies were scoped. Most studies contained an epidemiological (N = 226; 45%) or risk factors assessment (N = 105; 21%). Less assessed areas included financial burden (N = 1; <1%) and injury awareness (N = 5; 1%). 159 studies (32%) assessed injuries of the whole body. The most common single location assessed in the literature was the knee (N = 134, 27%), followed by head/face (N =108, 22%). These numbers were, however, substantially lowered, when subdivided by playing level and age-group. The volume of research focuses especially on descriptive research and specific body locations (head/face and knee). Although information can be taken from studies in other sports, more football-specific studies to support management and prevention of injuries are warranted. [ABSTRACT FROM AUTHOR]

The purpose of the study was to report the injury rates and characteristics (body location, type, mechanism, and severity) of musculoskeletal injuries in Kyorugi, Poomsae, and Shibum. A total of 137 Korean collegiate Taekwondo players – Kyorugi (n = 44), Poomsae (n = 46), and Shibum (n = 47) – were prospectively studied in 2019. Injury rates per 1,000 athlete-exposures (AEs) and time-exposures (TEs) during training and competition were calculated. Additionally, body location, type, mechanism, and severity of injury were analysed. The highest injury rate was recorded in Poomsae (172.0/1,000 AEs and 79.5/1,000 TEs) followed by Kyorugi (47.1/1,000 AEs and 25.9/1,000 TEs) and Shibum (57.5/1,000 AEs and 17.0/1,000 TEs). The frequently injured body location was the thigh (Kyorugi = 17%; Poomsae = 25%; Shibum = 18%). The common injury types were muscle cramps/spasms in Kyorugi (33%) and Poomsae (59%), and sprain in Shibum (41%). The common injury mechanisms were gradual onset in Kyorugi (40%) and Shibum (49%), and non-contact trauma in Poomsae (91%). Regarding the severity, the number of days from the injury onset to recovery > 1 week were higher in the order of Kyorugi (78%), Shibum (54%), and Poomsae (28%). Our data provide preliminary evidence that different injury prevention strategies should be applied to each modality of Taekwondo. [ABSTRACT FROM AUTHOR]

To identify the epidemiological patterns of pediatric out-of-hospital cardiac arrests (OHCA) in Queensland, Australia and to investigate associations between patient variables and prehospital outcome. Included were pediatric (>4 days–18 years) OHCA patients attended by paramedics in the state of Queensland (Australia) between January 2009 and December 2019. Patient and arrest characteristics were described. Factors associated with return of spontaneous circulation (ROSC) on hospital arrival were investigated. A total of 1,612 pediatric patients were included; 611 were deceased prior to paramedic arrival and 1,001 received resuscitation attempts by paramedics. Approximately one quarter (26.8%) of resuscitation-attempted patients achieved ROSC on hospital arrival. Most arrests (49.7%) were due to medical causes. Arrests due to trauma had the lowest rate of ROSC on hospital arrival (9.6%), whereas those due to drug overdose had the highest rate (40%). Patients in rural areas had a lower rate of ROSC on hospital arrival than those in metropolitan areas (20.7% vs 32.5%, p < 0.001). The median response interval to all OHCA patients was 8 minutes. Trauma was considerably more prevalent in rural areas than in metropolitan areas, while all other etiologies were comparable. Older pediatric age groups had higher rates of ROSC on hospital arrival than infants, particularly early adolescents (39.4% vs. 14.9%, p = 0.001). Etiology, age, bystander witness, shockable initial rhythm, and geographic locality factors were independently associated with ROSC on hospital arrival. Approximately a quarter of pediatric prehospital OHCA achieved ROSC on hospital arrival. Prehospital outcome differs according to patient cohort and is associated with diverse patient demographic variables. [ABSTRACT FROM AUTHOR]

Epidemiological studies show that depressive and substance use disorders are salient risk factors for suicidal behavior. In residential centers in Mexico City, 75.72% of the patients are diagnosed with comorbidity of substance use and psychiatric disorders; however, the specific prevalence of depression and suicidal behavior in this population has not been reported. This study aims to inform the comorbidity of depression and suicidal behavior in crystal users in residential centers in the state of Aguascalientes, Mexico. A brief survey was applied to measure substance use patterns, suicidal behavior, and depression symptoms using the Depression Scale of the Center of Epidemiological Studies (CES-D-R). The sample included 343 participants. The results show that of the 23.3% of participants who reported depressive symptoms, 65% showed suicidal ideation, 46% suicide planning, and 43% suicidal attempt. These results show the importance of implementing components that address depression and suicidal behavior in interventions for substance use. Currently, no specialized interventions are developed to treat substance use disorders with crystal methamphetamine and, at the same time, treat others mental problems like depression and suicidal behavior. We conclude that the development of this intervention is necessary and urgent. [ABSTRACT FROM AUTHOR]

This study investigated time-loss injury occurrence and patterns between the first season (2020/21, S2) completed during the Covid-19 pandemic (longer pre-season following cancellation of the 2019/20 season but shorter duration) and a regular season (2018/19, S1) in French Ligue 1 and 2 professional soccer clubs. Epidemiological data were prospectively recorded in a national injury database by each club's physician. In all clubs combined, the mean number of injuries per club was 31.5 and 36.6 in S2 and S1, respectively (−13.9%). Overall match injury incidence (per 1000 hours) in all clubs combined was lower in S2 versus S1 (22.23 vs 25.96, p < 0.01). In Ligue 1 clubs alone, match-play incidences for injury overall (24.92 vs 29.42), muscle strains (10.59 vs 13.24) and strains specifically in the hamstring region (4.52 vs 6.22) were lower in S2 versus S1 (all p < 0.05). No differences in the incidence of match injuries affecting the ankle and knee regions were observed. Changes in the 2020/21 season structure and duration owing to the Covid-19 pandemic seem not to have had a negative effect on injury occurrence and patterns in French professional soccer clubs. [ABSTRACT FROM AUTHOR]

Substance use is one of the most important global issues that have become a worldwide psychological, social, and familial problem among older adults, but epidemiologic studies remain sparse especially in developing countries. The current study aims to examine the prevalence and related factors for substance use among older adults in Tehran, Iran. The sample consisted of 1280 community-dwelling individuals aged over 60 years. A linear logistic regression model and bivariate analyses were done to test the relationship between substance use and related explanatory variable. The prevalence of current substance use (past 30 days) was 11.3% (95% CI: 10.98, 11.61); such a way that opium was the most commonly used drug (74.3%), followed by alcohol (20.83%). The main reason for substance use was pain relief (66.01%). Substance use was more among men, the most elderly, those with low educational levels, and those who have musculoskeletal disorders. In addition, there was a significant relationship between social networks, perceived health status, and income level with substance use. Policies aimed to improve access to health and rehabilitation services, re-building support networks, and developing health literacy can lead to a reduced rate of substance use among older adults. [ABSTRACT FROM AUTHOR]

To examine whether education level influences screening, monitoring, and treatment of hypercholesterolemia. Epidemiological cohort study. Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre. Cholesterol blood test results ordered by general practitioners in Greater Copenhagen were retrieved from 2000-2018. Using the International Standard Classification of Education classification, the population was categorized by length of education in three groups (basic education; up to 10 years, intermediate education; 11-12 years, advanced education; 13 years or more). The database comprised 13,019,486 blood sample results from 653,903 patients. Frequency of lipid measurement, prevalence of statin treatment, age and comorbidity at treatment initiation, total cholesterol threshold for statin treatment initiation, and achievement of treatment goal. The basic education group was measured more frequently (1.46% absolute percentage difference of total population measured [95% CI 0.86%–2.05%] in 2000 and 9.67% [95% CI 9.20%–10.15%] in 2018) over the period compared to the intermediate education group. The advanced education group was younger when receiving first statin prescription (1.87 years younger [95% CI 1.02–2.72] in 2000 and 1.06 years younger [95% CI 0.54–1.58 in 2018) compared to the intermediate education group. All education groups reached the treatment goals equally well when statin treatment was initiated. Higher education was associated with earlier statin prescription, although the higher educated group was monitored less frequently. There was no difference in reaching treatment goal between the three education groups. These findings suggest patients with higher education level achieve an earlier dyslipidemia prevention intervention with an equally satisfying result compared to lower education patients. Little is known about the role of social inequality as a possible barrier for managing hypercholesterolemia in general practice. Increasing education level was associated to less frequent measurement and less frequent statin treatment. Patients with higher education level were younger, and less comorbidity at first statin prescription. Education level had no effect on frequency of statin treatment-initiated patients reaching the treatment goal was found. [ABSTRACT FROM AUTHOR]

Persistent human papillomavirus (HPV) infection has been associated with the development of cervical cancer. To reduce the incidence of cervical cancer and promote awareness of HPV, a government-sponsored epidemiological study was conducted from 2015 to 2018 in Zhengzhou City. A total of 184,092 women aged 25–64 years were included, of which 19,579 were infected with HPV, reflecting a prevalence of 10.64 percent (19,579/184,092). The HPV genotypes found were classified as high-risk (13 genotypes) and low-risk (8 genotypes). Single and multiple infections were detected in 13,787 (70.42 percent) and 5,792 (29.58 percent) women, respectively. The five most common high-risk genotypes detected, listed in descending order, were HPV52 (2.14 percent; 3,931/184,092), HPV16 (2.04 percent; 3,756/184,092), HPV58 (1.42 percent; 2,607/184,092), HPV56 (1.01 percent; 1,858/184,092), and HPV39 (0.81 percent; 1,491/184,092). Meanwhile, the most common low-risk genotype was HPV53 (0.88 percent; 1,625/184,092). The prevalence of HPV gradually increased with age, with the highest occurring in women aged 55–64 years. The prevalence of single-type HPV infection decreased with age, whereas that of multiple-type HPV infection increased with age. This study indicates a high burden of HPV infection in women in Zhengzhou City. [ABSTRACT FROM AUTHOR]

Pesticide dust concentrations in homes have been previously associated with occupational and home/garden use of pesticides, hygiene practices, and other factors. This study evaluated the relationship between self-reported use of 2,4-dichlorophenoxyacetic acid (2,4-D) and house dust concentrations and these factors in the Biomarkers of Exposure and Effect in Agriculture (BEEA) Study, a molecular epidemiologic study of farmers in Iowa and North Carolina. The vacuum dust from the homes of 35 BEEA participants was analyzed for the presence of 2,4-D. Participants provided detailed information on occupational and home/garden pesticide use during the past 12 months and reported household characteristics via questionnaires. Linear regression models were used to examine the association between 2,4-D concentrations and four exposure metrics for occupational use in the last 12 months (yes/no, days since last use, days of use, intensity-weighted days of use), home/garden use (yes/no), as well as several household characteristics. 2,4-D was detected in all homes and was used occupationally by 54% of the participants. In a multi-variable model, compared to homes with no occupational or home/garden 2,4-D use reported in the past 12 months, concentrations were 1.6 (95% confidence interval (CI): 0.5, 4.9) times higher in homes with low occupational 2,4-D use (intensity-weighted days < median) and 3.1 (95% CI: 1.0, 9.8) times higher in homes of participants with high use (≥median intensity-weighted days) (p-trend = 0.06). Similar patterns were observed with other occupational metrics. Additionally, 2,4-D dust concentrations were non-significantly elevated (relative difference (RD) = 1.8, 95% CI: 0.5, 6.2) in homes with home/garden use and were significantly lower in homes that did not have carpets (RD = 0.20, 95% CI: 0.04, 0.98). These analyses suggest that elevated 2,4-D dust concentrations were associated with several metrics of recent occupational use and may be influenced by home/garden use and household characteristics. [ABSTRACT FROM AUTHOR]

Dietary intakes portray what someone consumes throughout a day, which also offer important insight for carrying out the intercession programs to avoid several chronic diseases. Precise tools and techniques of assessing nutritional intakes are necessary for monitoring the dietary condition of patients for clinical and epidemiological research on the relationships between health and diet. Measuring the exact dietary intakes is regarded as an open issue in the health and nutrition fields. Thereby, this work develops a new dietary assessment model implemented with four main phases like '(1) pre-processing, (2) segmentation, (3) feature extraction and (4) classification'. The input image is first subjected to pre-processing, which includes median filtering to decrease noise. The pre-processed image is then used in segmentation, which is performed using modified K-means clustering. Then comes feature extraction, which involves extracting colour, shape and texture-based features. Following that, the collected features are classified using an optimised CNN. Furthermore, the weights of CNN are fine-tuned using Self-Adaptive Cat Swarm Optimisation (SA-CSO), which is an upgraded version of the CSO algorithm, to improve the accuracy of the created approach. [ABSTRACT FROM AUTHOR]

This study aimed to verify the moderation of sociodemographic factors in the association of weight status with physical activity of 2347 students, both male and female, aged between 11 and 15 years. This study is a cross-sectional correlational descriptive epidemiological survey. We collected body mass measurements, height, gender, age, work, housing, type of residence, parent's education, economic class, and physical activity level. Poisson regression with 95% confidence intervals was used for the association analyses. 33.2% of the students were overweight, and 52.3% were considered active, the highest proportion being boys (64.1%). Overweight girls who do not work (PR = 1,29; CI95% = 1,09–1,53), normal-weight girls who work (PR = 1,83; CI95% = 1,31–2,57), and overweight girls who have a father with ≥ 8 years of education (PR = 1,47; CI95% = 1,14–1,91) were more likely to be active. However, normal-weight girls aged 13 to 15 years were less likely to be active (PR = 0,59; CI95% = 0,48–0,73). We conclude that age, work, and father's education variables influenced the relationship between weight status and adolescents' level of physical activity. Future research needs to understand the relationship between weight status and physical activity and the moderating role of sociodemographic factors to identify the characteristics of Brazilian adolescents and what leads them to be inactive. [ABSTRACT FROM AUTHOR]

To compare parent reported physician diagnosed asthma from questionnaires for epidemiological purposes, to general practitioner (GP) recorded childhood asthma. This study was embedded in the KOALA Birth Cohort Study with regular follow-up by ISAAC core questions on asthma in 2834 children in two different recruitment groups, with 'conventional' lifestyles or 'alternative' lifestyles. At age 11–13 years these data were linked to data extracted from GP records. We compared parent reported physician diagnosed asthma, asthma medication use, and current asthma with GP recorded asthma diagnosis and medication. Two different combinations of questions were used to define current asthma (i.e. ISAAC and MeDALL based definition). Among 958 children with information provided both by the parents and GPs, 98 children (10.2%) had parent reported physician diagnosed asthma, 115 children (12.0%) had a GP recorded asthma diagnosis (Cohen's kappa 0.49; 95% CI 0.40 to 0.57). Discrepant cases showed that asthma symptoms at an early age led to different labeling between parents and GP. The agreement between ISAAC based definition and MeDALL based definition was excellent (Cohen's kappa 0.82; 95% CI 0.74 to 0.88). Parent reported physician diagnosed asthma and GP recorded childhood asthma had only moderate agreement, and is possibly influenced by labeling early transient wheeze as asthma diagnosis. It is important that parent reported physician diagnosed asthma is combined with additional questions such as current asthma symptoms and asthma medication use, as used in ISAAC or MeDALL based current asthma, in order to obtain reliable information for epidemiological research. [ABSTRACT FROM AUTHOR]

The mental health of the farming community across industrialised nations has long been a major concern. Using an adapted procedure for a systematic literature review of observational epidemiological studies reporting prevalence (informed by the Joanna Briggs Institute method), this paper reviews peer-reviewed literature that explicitly compares farmer and non-farmer mental health (n = 48). In doing so, it provides a central and accessible evidence base for researchers and practitioners, and simultaneously reveals a stark lack of consensus; specifically, 54.0% of measures deployed to assess farmer mental health determined it to be the same as or even better than non-farming populations. This ambiguity sits in sharp contrast to the unequivocally worrisome farmer suicide statistics. Informed by the literature, the paper discusses potential reasons for this mismatch, including (i) farmers' progression through a different "pathway" to suicide that is not always preceded by mental illness, and (ii) a failure of current methods to accurately gauge the mental health status of farmers. The paper concludes by recommending more research into farmers' "pathway" to suicide, and highlights the need for a dedicated and multi-disciplinary programme of methods research that will afford a more culturally appropriate and effective means of understanding mental health in the farming community. [ABSTRACT FROM AUTHOR]

To investigate the factors associated with adherence to viral mitigation protocols during the COVID-19 pandemic. This epidemiological cross-sectional study examines adherence to behaviour in 4158 adults and its relationship with sources of information. Adherence to social distancing protocols (SDPs) and adherence to hygienic behaviour (HB) recommendations. Individuals aged 18–30 reported lowest adherence to SDPs and HB. Alcohol consumption was associated with lower adherence. Increased risk perception, fear of infection and altruistic attitude were associated with greater adherence. Males, single and childless individuals reported lower adherence. Extroverts and urban residents reported lower adherence to SDPs, but not HB. In contrast to earlier stages of the pandemic, voluntary social distancing was associated with greater adherence to SDPs as opposed to rule-enforced social distancing. Regarding information obtainment, increased time spent acquiring information from recognised newspapers had the strongest favourable association with adherence. Relying on information from friends and family was associated with decreased adherence to SDPs. Sensitivity analyses replicated the findings, supporting the stability and robustness of the proposed models. This study identifies factors associated with favourable and detrimental adherence behaviour along with substantial dissemination routes, presenting strategies that may be of utility towards fostering adherence to contemporaneously implemented mitigation protocols. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is an etiologically heterogeneous neurodevelopmental condition that eludes a single explanation or cure. Epidemiological studies reveal risk factors, relevant comorbidities, and behavioral correlates to reach a better understanding of ASD. To contribute such data from an understudied ASD population, this paper presents epidemiological data from a Turkish sample of individuals with ASD (n = 911, 748 boys (82.1%) and 163 girls (17.9%) between 1 and 18 years of age). Average age at diagnosis was 31.06 ± 11.88 months, and the male-to-female ratio was 4.6:1. Three in 4 individuals with ASD had obsessive behaviors, and 1 in 4 had allergic conditions, inappropriate sexual behaviors, self-harming behaviors, and harmful behaviors towards others. One in 3 received a dietary treatment for at least 3 months; almost half received vitamin supplements; the majority (70%) did not experience constipation; and 2 in 3 were picky eaters. This paper presents data on the age of diagnosis, gender ratios, accompanying behaviors, and dietary interventions in Turkish individuals with ASD, which are topics of current research interest about ASD. Such data from non-Western populations may supplement epidemiological knowledge gained from Western populations to help reach a more comprehensive understanding of this condition with many unknowns. [ABSTRACT FROM AUTHOR]

Structural competency is an emerging paradigm for both the training of health professionals and the creation of a common language addressing structural processes that determine health disparities. However, its application to the field of epidemiological design and research is absent. Based on our previous proposal of a tool for Structural and Intercultural Competency in Epidemiological Studies, the SICES guidelines, in this article we analyse the possibilities and challenges of a 'structural turn' in epidemiology. In terms of possibilities, we recognise the value of paradigms from multiple parts of the world, such as social and sociocultural epidemiology, critical epidemiology and collective health, in facilitating a structural turn in epidemiological studies. In this framework, structural competency would provide a new angle by focusing not only on what to research (e.g. inequalities), but with what skills and attitudes (e.g. cultural and epistemic humility). The challenges lie in the inclusion of reflexivity and a comprehensive view in the context of a positivist epidemiology oriented towards obtaining evidence from a biomedical, but not social, perspective. [ABSTRACT FROM AUTHOR]

Among a representative sample of adults aged 50 years and older too (i) determine the prevalence of hearing loss, (ii) evaluate probable causes and risk factors of hearing loss, and (iii) assess the association between hearing loss measured by audiometry and self-report. A population-based survey of adults aged 50 and older in Santiago, Chile using the Rapid Assessment of Hearing Loss (RAHL) survey. 538 participants completed a questionnaire, which included questions on socio-demographic and health characteristics and self-reported hearing loss. Hearing and possible cause of hearing loss was assessed using pure tone audiometry (0.5–4.0 kHz), tympanometry, and otoscopy. The prevalence of any level of hearing loss in adults aged 50 years and older was 41% (95% CI 33.2, 49.2). In terms of aetiologies, 89.3% of ears with mild or worse hearing loss were classified as sensorineural. Otoscopy was abnormal in 10.7% of subjects with impacted earwax being the most common finding (4.4%) followed by chronic otitis media (3.5%). Hearing aid usage was 16.6%. Older age, lower socioeconomic position, lack of education, and solvent exposure were significantly associated with hearing loss. Hearing loss among individuals aged over 50 years was common in Santiago, Chile. [ABSTRACT FROM AUTHOR]

Background: Transgender women in India face unique stressors associated with minority experiences, such as experiences of gender transition and participation in sex work. However, the relationship between sex work, transition and mental health outcomes is understudied in this population. Aims: This article aims to examine the association between gender transition status, sex work, family rejection and depressive symptoms among transgender women in India. Methods: Data comes from a cross-sectional epidemiological study with transgender women from three states of India; Karnataka, Maharashtra and Tamil Nadu (N = 1366). Multivariate regressions were used to examine the association between sex work status and gender transition and how gender transition, and sex work are associated with depressive symptoms. Results: 70% of the sample reported being in sex work and over 82% endorsed taking some form of gender transition service. Those who reported being in sex work were significantly more likely to have undergone breast augmentation, hormonal therapy and gender affirming surgery. Those who reported ever being married were less likely to report gender affirming surgery and were more likely to report hormonal therapy. Additionally, being in sex work, undergoing transition, leaving home because of sexual orientation, and being married were significantly associated with depressive symptoms. Discussion: Community-led organizations and other service agencies must incorporate intersectional experiences and identities, including sex work and gender transition, in their programs to further social and health justice for transgender women in India. Policy and programmatic implications are discussed. Supplemental data for this article is available online at https://doi.org/10.1080/26895269.2021.1939220 [ABSTRACT FROM AUTHOR]

Epidemiological studies focusing on the association between vitamin B12 and gastric cancer risk reported inconsistent findings. We conducted a systematic review and meta-analysis to assess the relationship. PubMed (Medline), Web of science and EMBASE databases were systematically searched. A total of nine studies involving 3,494 cases of with gastric cancer and 611,638 participants were included. The result showed that there is no significant association between vitamin B12 intake and the risk of gastric cancer (OR = 0.88, 95% CI: 0.69-1.12, P = 0.303). Nevertheless, high intake of vitamin B12 might decrease the risk of gastric cancer in Helicobacter pylori (Hp)-negative people (OR = 0.83, 95% CI: 0.62-0.99, P = 0.044), but increase the cancer risk in Hp-positive populations (OR = 1.66, 95% CI: 1.27-2.16, P = 10−4). Additionally, further analysis indicated that excessive vitamin B12 might increase the risk of non-cardia gastric cancer (OR = 1.15, 95% CI: 1.01-1.33, P = 0.006). A negative association between vitamin B12 intake and gastric cancer risk was found in nonsmokers (OR = 0.83, 95% CI: 0.71-0.96, P = 0.012) but not in smokers (OR = 1.08, 95% CI: 0.71-1.47, P = 0.619). In conclusion, although we found no convincing evidence that vitamin B12 intake is associated with the risk of gastric cancer, it is important to maintain the relative stability of vitamin B12 for people with Hp infection. [ABSTRACT FROM AUTHOR]

Delayed endolymphatic hydrops (DEH) is a rare disease, and the actual number of patients in Japan remains unknown. To investigate the number and prevalence of patients with DEH in Japan. In total, 781 departments of otolaryngology in Japan were selected for survey by stratified random sampling according to the total number of hospital beds. We sent questionnaires to the target departments and collected data regarding the number of patients with DEH who visited those departments in 2019. The overall response rate was 68.0% (531 departments). The estimate number of patients with DEH in Japan was 962, and the prevalence was calculated to be 0.8 per 100,000 population. Patients with DEH were extremely rare in Japan. This may be the first nationwide epidemiological study on the number and prevalence of patients with DEH in Japan or in the world. [ABSTRACT FROM AUTHOR]

Cancer incidence is rising rapidly in Sub-Saharan Africa (SSA). Dietary intake is an established risk factor for certain cancers but only a few epidemiological studies have been conducted in SSA. This study systematically reviewed and summarized the published literature on this issue and identified gaps that can be addressed in future research. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and literature searched was conducted until 11/2/2021. Out of the 5,457 potential references, we reviewed 19 eligible studies: 17 case-controls, two cross-sectionals and no cohort study. South Africa and Kenya conducted the majorities of the studies. The commonest studied cancers were esophageal (9/19), colorectal (4/19) and breast (4/19). Only four studies utilized a validated Food Frequency Questionnaire (FFQ). Although most studies (16/19) reported associations between dietary intake and cancer risks, they were lacking important confounders including total energy intake, multivitamin intake, body fat measures, physical-activity, smoking, and alcohol. Despite rapidly expanding cases of cancer associated with diet, the existent evidence on diet-cancer relationship is too scarce to deduce solid conclusions. There is a need for large cohorts with comprehensive datasets, validated dietary instruments while using advanced statistical analyses that can provide further insights into the imperative links between African diet and cancer risk. Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2022.2032217. [ABSTRACT FROM AUTHOR]

Despite the clinical benefits, coronary artery disease patient participation rates in cardiac rehabilitation (CR) and long-term exercise are poor. This study explored the factors related to participation in these interventions from the perspectives of post-acute myocardial infarction (AMI) patients and their significant others. Semi-structured interviews were performed with post-AMI patients (number (n) = 10) and their significant others (n = 10) following phase-III and phase-IV CR. Reflexive thematic analysis with an inductive orientation was utilised to identify themes within the dataset (ClinicalTrials.gov identifier: NCT03907293). The overarching theme of the data was a perceived need to improve health, with the participants viewing health benefits as the principal motive for participating in CR and long-term exercise training. Three further themes were identified: motivation, extrinsic influences, and CR experience. These themes captured the underlying elements of the participants' decision to take part in CR and long-term exercise training for the purpose of health improvements. An AMI collectively impacts the attitudes and beliefs of patients and their significant others in relation to CR participation, long-term exercise, and health. The factors identified in this study may inform strategies to promote patient enrollment in CR and adherence to long-term exercise. Post-AMI patients and their significant others reported that health benefits were the primary motive for participating in CR and long-term exercise, with aspects related to motivation, extrinsic influences, and CR experience underpinning the decision. Healthcare professionals should supply information about health benefits during the CR referral process, with insights into the experiences of CR graduates potentially improving the strength of recommendation. CR facilitators may promote long-term exercise adherence by assisting patients with the identification of an enjoyable exercise modality. Healthcare professionals should include significant others in the CR referral process, which may enable these individuals to support the patients' decisions. [ABSTRACT FROM AUTHOR]

Acculturation to the mainstream culture and the settlement contexts could shape cognitive function of older immigrants. Guided by ecological theory, this study examines the interaction effect between individual acculturation and ecology of family on cognitive function among older Chinese Americans. Data were derived from the Population Study of Chinese Elderly in Chicago (n = 3,019). Family types included tight-knit (high solidarity and low conflicts), unobligated-ambivalent (high solidarity and conflicts), commanding-conflicted (low solidarity and high conflicts), and detached (low solidarity and low conflicts). Acculturation was measured via language ability, media use, and ethnic social relations. Cognitive function was evaluated by global cognition, episodic memory, working memory, processing speed, and mini-mental state examination. Multiple regression analyses and interaction terms were used. Older adults in the commanding-conflicted type had the lowest cognitive function. After controlling confounding variables, higher levels of acculturation (b = 0.009, SE = 0.003, p <.01) were associated with higher levels of global cognition. Acculturation buffered the negative impact of having a commanding-conflicted relationship with children on global cognition (b = 0.070, SE = 0.016, p <.001). Language ability, media use, and ethnic social relations played a unique role in the relationships between family types and cognitive domains. Acculturation to the dominant culture is identified as a cultural asset for cognitive function in older Chinese Americans. Social services could protect cognitive function of older immigrants in the commanding-conflicted type through enhancing cultural participation. Future research could test how affective and cognitive aspects of acculturation affect health. [ABSTRACT FROM AUTHOR]