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Background: Upper extremity injuries are common in baseball spanning from youth through professional leagues, especially in preseason. Although there are some arbitrary guidelines for number of throws during practices and games, there is no current information on workload during preseason in baseball pitchers. Hypothesis/Purpose: The purpose of this study was to quantify the number of throws and workload, as defined by angular velocity, during preseason training in a collegiate baseball season. Study Design: Descriptive Epidemiology Study Methods: Nine baseball pitchers wore an inertial measurement unit on the forearm during all preseason training. Movements were captured at 100Hz and classified as a throw when the forearm velocity was greater than 800°/second. Peak angular velocity was exported for each throw and total workload was calculated as the median angular velocity multiplied by total throws for each day. Chronic workload was calculated as the rolling 28 days average workload and acute workload was calculated as the average seven-day workload. Acute to chronic workload ratio (ACWR) was calculated for each week. A repeated measures ANOVA with pairwise comparisons was used to compare throws, acute workload, and ACWR between weeks. Cohen's d effect sizes were calculated for all significant differences. Results: The pitchers averaged 1990.6 ± 881.7 throws throughout preseason at an average angular velocity of 1686.2 ± 334.9 m/s. Acute workload was reduced in Week 4 compared to Week 2 (p=0.018, d=1.73) and week 3 (p=0.007, d =2.30). ACWR was above 1.27 on weeks 1,2,3, and 5. ACWR was significantly reduced in week 4 (0.79) compared to week 3 (1.50; p=0.021, d =0.71). Conclusion: ACWR was above 1.27 for four of the six weeks of preseason, suggesting that there may be a need to reduce workload and progressively build during the preseason. Clinicians should consider monitoring workload during preseason throwing to decrease risk of chronic overuse injuries. Level of Evidence: 2c [ABSTRACT FROM AUTHOR]

Background: Epidemiological research suggests that altered levels of cytokine are associated with pathophysiology and the development of major depressive disorder (MDD). Based on earlier study, IL-1β rs16944 and rs1143627 polymorphisms may increase the risk of depression. Here, we aimed to evaluate the correlation between these polymorphisms and MDD susceptibility among the population in Bangladesh. Methods: Blood samples were collected from 100 MDD patients and 70 matched controls. Study participants were evaluated by DSM-5 criteria and PCR-RFLP method were applied for genotyping. Results: The IL1β rs1143627 and rs16944 polymorphisms were found to have a significant association with the risk of MDD. In case of rs1143627 CT heterozygous genotype (OR = 2.22, 95% CI = 1.08–4.55, p-value = 0.029) and combined CT+TT (OR = 2.35, 95% CI = 1.15–4.79, p-value = 0.019) genotype was strongly associated with the increased risk of MDD in comparison to CC common genotype. Moreover, the over-dominant model indicated a 2.15-fold higher risk for MDD development (OR = 2.15, 95% CI = 1.05–4.40, p-value = 0.036). On the other hand, the IL1β rs16944 polymorphisms revealed that the TC+CC combined genotype in the dominant model showed a 2.06-fold increased risk for MDD development compared to the TT common homozygote (OR = 2.06, 95% CI = 1.06–3.99, p-value = 0.032). Conclusion: Studies suggests that IL1β rs16944 and rs1143627 polymorphisms are associated with an increased risk of MDD. These findings will provide us with valuable insights into the pathophysiology of MDD. [ABSTRACT FROM AUTHOR]

Background: Epidemiologic data on the number of cleft lip and/or palate (orofacial cleft (OFC)) births in Switzerland are currently sparse. However, this knowledge is essential for better understanding the etiologies underlying the various cleft phenotypes and providing expectant parents with the best possible healthcare planning and counseling. Methods: This is the first descriptive study to report data on the prevalence of the various cleft types, their sex, and regional distributions in Switzerland. Data for the years 1998–2021 were obtained from the Swiss Federal Statistical Office. Due to the notable initial underreporting of cleft cases from 1998 to 2006, this period was omitted from the final analyses. Results: Between 2007 and 2021, the prevalence of all Swiss OFC cases per 10,000 live births was 12.5, with a stable trend. Cleft lip was the least common anomaly. Except for cleft palate, which was more common in females, males were generally more affected by OFC than females. There was no discernible regional trend for any of the malformations, even though the prevalence differed throughout the seven Swiss regions. Conclusions: This study presents the first descriptive epidemiologic profiles for OFCs in Switzerland and emphasizes the importance of nationwide OFC registries with an accurate and reliable reporting system for the benefit of current and future patients with clefts, their parents or caregivers, and society as a whole. [ABSTRACT FROM AUTHOR]

Objectives: This study identified profiles of outpatient physician follow-up care and other practice features, mostly after detection of incident mental disorders (MD), and associated these profiles with patient characteristics and subsequent adverse outcomes. Methods: A cohort of 170,957 patients age 12 + with a new or recurrent MD detected in 2019-20 was investigated based on data from the Quebec Integrated Chronic Disease Surveillance System. Latent class analysis was performed to identify follow-up care profiles, mostly within one year of MD detection. Bivariate analyses tested associations between profiles and patient characteristics; logistic regressions examined relationships between profiles and adverse outcomes after one year. Results: Five profiles were identified: Profiles 2 and 5 (64%) offered low mental health (MH) outpatient follow-up care, while the others dispensed higher MH follow-up care. Profiles differed in patient characteristics and related outcomes. Labelled "Follow-up care by usual psychiatrist", Profile 1 (1% of sample) included younger patients with the most health and social issues. Profile 2 (50%), "Low MH follow-up care but high prior consultations for physical reasons", mostly integrated older patients with chronic physical illnesses. Profile 3 (11%), "Follow-up care by general practitioners (GP) and psychiatrists", referred to physicians other than the usual ones (e.g., walk-in practice) and encompassed patients with severe MD conditions. Profile 4 (23%), "High follow-up care by usual GP and prior consultations for physical reasons", showed the typical characteristics of patients treated in primary care (more common MD, women, less materially and socially deprived). Profile 5 (15%), "Low MH follow-up care and prior consultations for physical reasons", integrated more younger men, materially deprived patients, and with substance-related disorders (SRD) or co-occurring MD-SRD. More Profile 1 and 3 patients lived in university regions – those of Profile 4 were the least numerous in such regions. More Profile 5 patients lived in metropolitan and rural areas. Risk of death was higher in Profiles 5, 2, 3, and risk of frequent ED use and hospitalization higher in Profiles 1, 3, and 5 – patients with severe health and social issues. Conclusion: The study confirmed the need to improve prompt, adequate and continuous follow-up care for patients with incident MD. [ABSTRACT FROM AUTHOR]

OBJECTIVEJn Tiirkiye, anti-tobacco legislation (Law No. 4207 on the Prevention and Control of Harms of Tobacco Products) aims to ensure a "tobacco-free" life for current and future generations. Thus, there are observations of violations in the hospitality sector. In this study, we aimed to observe the status of hospitality venues' violation of the law in 11 different cities in Tiirkiye. MATERIAL AND METHODS: This descriptive study examined 772 hospitality venues in Ankara, Burdur, Diyarbakir, Giresun, Hatay istanbul, izmir, Kars, Kayseri, Samsun, and Zonguldak between August 1 and October 10, 2023. The Google Forms survey, Microsoft Excel, and IBM SPSS Statistics (Version 23) programs were used for data collection, entry, and analysis. A logistic regression model was used to understand the associations between non-compliance and the characteristics of the venues. RESULTS: During the observation of indoor spaces, tobacco products were used in 282 venues (37.1%). Non-compliance in bars, pubs, traditional coffee houses, and hookah cafes was statistically significantly higher than in the other venue types [odds ratio (OR)= 3.031,95% confidence interval (Cl): 1.699 to 5.408, P < 0.001 ]. The presence of a retractable roof and/or side wall (OR=5.362, 95% Cl: 3.51 8 to 8.1 73, p < 0.001), later hour observations (OR= 2.120, 95% Cl: 1.399 to 3.212, p < 0.001), and the existence of outdoor venues where smoking is permitted (OR= 3.165, 95% Cl: 2.1 70 to 4.61 7, p < 0.001) also increased indoor violations. CONCLUSION: The findings provided scientific evidence that violations of Turkish anti-tobacco legislation exist in hospitality venues. The public authorities are advised to play their vital role in preventing violations in indoor spaces. [ABSTRACT FROM AUTHOR]

Background: Abortions in India are increasing despite the laws to legalize them. Many abortions are conducted through unsafe practices and are underreported. To determine the prevalence of abortions in women of a reproductive age group in a rural area of Delhi and to determine associated factors. Methodology: A cross-sectional study was conducted among married women in the reproductive age group residing in Barwala village, Delhi/NCR. An interview schedule was used to interview 315 women, and information was obtained for socio-demography, use of contraceptives, medical history, and history of abortions. Chi-square and Fisher's exact test were used for analyzing the association of abortions with other variables. Results: Of all 315 women, 47% had a history of one or more abortions. Of all pregnancies (n = 953), 25.6% ended in abortions (n = 244). Of the total number of abortions reported, 60.7% (n = 148) were induced, while 39.3% (n = 96) were spontaneous. Of induced abortions, only 35% were safe, while 65% were unsafe abortions. Age of mother, age at marriage, history of contraception use, and gender of first child were significantly associated with abortions. However, no significant association was found with socio-economic status, education, and occupation of women and their spouses. Only 1.3% women knew that abortions are legal in India. Conclusion: A high proportion of women are going for induced abortions, of which a greater proportion is that of unsafe abortions. There is also lack of knowledge about the legalisation of abortions in India. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) is highly consequential to global health among chronic diseases. Due to a limited researches that have examined relationships between liver enzymes and DM, this study aimed to investigate the link between elevated liver enzymes and diabetes among Prospective Epidemiological Research Studies in Iran (PERSIAN) Guilan cohort study (PGCS) population. Methods: This cross-sectional study was conducted on 10519 individuals. The demographic and clinical information of the participants was recorded. The changes in alanine aminotransferases (ALT) and aspartate aminotransferases (AST), alkaline phosphatase (ALP), and γ-glutamyltransferase (GGT) were evaluated. IBM SPSS Version 21 was used to analyze the data, with a significance level < 0.05. Results: The frequency of diabetes was 24.1% and was more prevalent in women than men (27.4% vs. 20.2%, p< 0.001). After removing all confederates, patients with elevated ALT, AST, GGT, and ALP levels were 1.27, 1.27, 1.52, and 1.46 times more likely to have diabetes, respectively. The likelihood of developing diabetes rose in correlation with the number of elevated liver enzymes, up to almost 1.77-fold among subjects with three or four increased liver enzymes. Conclusion: Patients diagnosed with diabetes exhibited significantly increased levels of liver enzymes compared to those without diabetes. Also, impairment of three or four liver enzymes demonstrated a positive correlation with an elevated likelihood of DM. This indicates the importance of considering the liver status in the management of the DM population. [ABSTRACT FROM AUTHOR]

Background: Sports-related injuries remain a significant problem for collegiate baseball players. Although some studies reported the epidemiology of sports-related injuries among collegiate baseball players, the latest information on sport-related injuries should be provided. Purpose: To examine the current trends of sports-related injuries among collegiate baseball players in the Pacific 12 (PAC-12) Conference. Study Design: Descriptive epidemiology study. Methods: Demographic and injury data were obtained from a database of the PAC-12 Health Analytics Program between 2016 and 2021. Injury incidence, type, mechanism, and outcome were analyzed. The annual incidence of injuries was defined as the number of injuries per total players for 1 year. Detailed reports of the 20 most common specific diagnoses were generated. Results: A total of 1434 sports-related injuries occurred in 6 years, with the number increasing from 2016 (n = 75; incidence, 8.5 per 100 player-years) to 2021 (n = 378; incidence, 43 per 100 player-years). Most of the injuries occurred in pitchers (33.6%), were acute (76.6%), resulted in missed time (68.8%), and were new injuries (86.9%). In addition, most injuries were caused by noncontact events (53.2%) and occurred during in-season games (39.9%) and practice (47.4%). Only 1.3% of sports-related injuries did not result in a return to the previous activity level. Rotator cuff tendon injuries were the most common specific diagnoses (n = 98), followed by ulnar collateral ligament (UCL) injuries (n = 63), hamstring muscle strains (n = 60), ankle ligament sprains (n = 46), and hand/wrist fractures (n = 40). UCL injuries had the highest proportion of surgical interventions (41.3% of all UCL injuries) and the longest days to clearance (167 ± 197 days) among the 20 most common diagnoses. Conclusion: The number of sports-related injuries among PAC-12 collegiate baseball players has increased by approximately 5 times over the past 6 years. Rotator cuff tendon injuries followed by UCL injuries, hamstring muscle strains, ankle ligament sprains, and hand/wrist fractures are the most common specific diagnoses among this cohort of collegiate baseball players. Of the 20 most common specific diagnoses, UCL injuries most often require surgical interventions and had the longest return to playtime. [ABSTRACT FROM AUTHOR]

Background: Previous research has reported higher rates of both injury and illness among Paralympic athletes compared with Olympic athletes during the Winter Olympic and Paralympic Games, but no studies have directly compared injury and illness incidence between Olympic and Paralympic athletes competing in a Summer Games. Purpose: To compare injury and illness rates between Olympic and Paralympic Team USA athletes competing in the Tokyo 2020 Olympic and Paralympic Games. Study Design: Descriptive epidemiology study. Methods: All injuries and illnesses that occurred among the Team USA athletes competing in the Tokyo 2020 Summer Olympic or Paralympic Games were documented. A total of 701 Team USA athletes (53.6% female) competed in the Tokyo 2020 Summer Olympic Games, across 34 different sports. For the Tokyo 2020 Summer Paralympic Games, a total of 245 athletes (51.6% female) competed across 20 sports. Incidence rates (IRs) per 1000 athlete-days were calculated according to sex, sport, anatomic location, and illness type. IR ratios (IRRs) were calculated to compare IRs between male and female athletes and between Olympic and Paralympic athletes. Results: Overall, there were no differences in injury incidence (IRR, 1.18; 95% CI, 0.84-1.68) or illness incidence (IRR, 0.68; 95% CI, 0.41-1.15) between Olympic and Paralympic athletes. Male Paralympic athletes were less likely to sustain an illness compared with female Paralympic athletes (IRR, 0.35; 95% CI, 0.11-0.90). Conclusion: There were no differences in injury or illness rates between Olympic and Paralympic Team USA athletes competing at the Tokyo 2020 Summer Games, contrary to previous comparisons among winter sport athletes. These results challenge the prevailing notion that Summer Paralympic athletes are at greater injury and illness risk, suggesting that factors beyond Olympic or Paralympic Games participation influence health concerns. [ABSTRACT FROM AUTHOR]

Background: Contamination of sterilized surgical instruments is not a typically suspected source of increased infection rate, especially if no abnormalities in the sterilization process are detected. Purpose/Hypothesis: The purpose of this study was to report increased infection rates after knee ligament reconstructions due to undetectable sterilization process errors leading to residual moisture, not limited to a specific surgical tool. It was hypothesized that (1) residual moisture on surgical tools due to autoclave overloading would not be detected by autoclave self-diagnostics, chemical and biological tests, or organoleptic assessment and (2) this kind of contamination may elevate infection rates, especially in knee intra-articular reconstruction procedures. Study Design: Case series; Level of evidence, 4. Methods: A retrospective analysis of increased postoperative knee infection rate between January 2013 and January 2015 was performed. The inclusion criteria were all articular procedures. The exclusion criteria were joint arthroplasties, fractures, and open joint wounds. Criteria defining postoperative joint infections were as follows: (1) pain and effusion relapse and loss of achieved range of motion; (2) opaque/cloudy fluid on arthrocentesis; (3) fever >37.5°C lasting ≥3 days; and (4) ≥2-fold elevation in C-reactive protein levels, with symptoms onset within 21 days postoperatively. A negative culture result did not exclude a postoperative joint infection diagnosis and treatment. The data were summarized, and the infection rates of given subgroups were compared with a 2-tailed Fisher exact test. A risk ratio (RR) with 95% CIs was calculated. Results: Out of 533 orthopaedic procedures screened for inclusion, 4 joint arthroplasties, 7 fractures, and 2 open joint wounds were excluded. The remaining 520 articular procedures were included in the study—118 knee cruciate ligament reconstructions, 130 knee nonreconstruction arthroscopies, and 272 knee extra-articular/other joints arthroscopic and sports procedures. A total of 21.2% of knee intra-articular ligament reconstructions were complicated by postoperative joint infections, compared with 1.5% of knee nonreconstruction arthroscopies (RR, 13.8 [95% CI, 3.3-56.9]; P <.001) and 0.4% of knee extra-articular/other joints arthroscopic and sports procedures (RR, 57.6 [95% CI, 7.9-420.4]; P <.001). The source of the increased infection rate was identified as residual moisture on surgical tools due to autoclave overloading. This residual moisture was not detected by autoclave self-diagnostics, chemical and biological tests, or organoleptic assessment. After reducing the insert of surgical tools in the autoclave, the infection rate in the next 2 years after knee reconstructive procedures returned to <1% (P <.001). Conclusions: Our study demonstrated that residual moisture after the sterilization process may be an underestimated source of postoperative joint infections, undetectable in routine procedures and tests. Overcrowding of surgical equipment in the autoclave may be a root cause of this residual moisture identified. This kind of contamination may elevate the infection rate, especially in knee intra-articular reconstruction procedures. [ABSTRACT FROM AUTHOR]

Previous studies have reported inconsistent findings regarding paternal addiction to cigarettes, alcohol, and opium with psychological distress in youths. This study examined the association between paternal addiction to cigarettes, alcohol, and opium and the psychological distress of youths in southeast Iran. This cross-sectional study was conducted on 895 youths (aged 15–35) from the baseline phase of the Rafsanjan Youth Cohort Study (RYCS) whose fathers also participated in the Rafsanjan Cohort Study (RCS). The RYCS is a part of the RCS, a branch of prospective epidemiological research studies in Iran (PERSIAN). Smoking, alcohol consumption, and opium usage in youths and their fathers were assessed using a self-reported questionnaire. Psychological distress was assessed using the Kessler Psychological Distress Scale (K6 and K10). Fathers who used opium were more likely to have youth with psychological distress based on the K6 score (OR:1.37, CI:1.01–1.86) and K10 score (OR:1.34, CI: 1.01–1.80). The duration of opium consumption lower than or equal to the median was associated with increased odds of having a youth with psychological distress based on the K6 or K10 scores (OR:1.62, CI:1.14–2.31, OR:1.44, CI:1.01–2.03 respectively), but there was no significant association with duration above the median. In addition, consuming opium more than the median dosage increased the chance of having a psychologically distressed youth up to 1.47 times based on the K6 score (OR 1.47, CI 1.01–2.14) and 1.55 times based on the K10 score (OR 1.55, CI:1.08–2.22). Smoking cigarette duration lower than or equal to the median increased the chance of having a psychologically distressed youth to 1.52 times more based on the K6 score (OR 1.52, CI 1.07–2.15). There was no significant association between paternal alcohol consumption and the odds of having a psychologically distressed youth. Parental addiction to opium can lead to an increase in psychological distress in youths in the absence however of a consistent dose and duration relationship. [ABSTRACT FROM AUTHOR]

Background: Multimorbidity is common in patients with atrial fibrillation (AF), yet comorbidity patterns are not well documented. Methods: The prevalence of 18 chronic conditions (6 cardiometabolic, 7 other somatic, 5 mental health) was obtained in patients with new-onset AF from 2013-2017 from a 27-county region and controls matched 1:1 on age, sex, and county of residence. For AF patients and controls separately, clustering of conditions and co-occurrence beyond chance was estimated (using the asymmetric Somers' D statistic), overall and for ages <65, 65-74, 75-84, and ≥85 years. Results: Among 16,509 patients with AF (median age 76 years, 57% men), few (4%) did not have any of the 18 chronic conditions, whereas nearly one-quarter of controls (23%) did not have any chronic conditions. Clustering of cardiometabolic conditions was common in both AF patients and controls, but clustering of other somatic conditions was more common in AF. Although the prevalence of most condition pairs was higher in AF patients, controls had a larger number of condition pairs occurring together beyond chance. In persons aged <65 years, AF patients more frequently exhibited concordance of condition pairs that included either pairs of somatic conditions or a combination of conditions from different condition groups. In persons aged 65-74 years, AF patients more frequently had pairs of other somatic conditions. Conclusion: Patterns of co-existing conditions differed between patients with AF and controls, particularly in younger ages. A better understanding of the clinical consequences of multimorbidity in AF patients, including those diagnosed at younger ages, is needed. [ABSTRACT FROM AUTHOR]

Background: How common it is with the presence of human papillomavirus (HPV) in the healthy and diseased oral cavity is largely unknown for Africans. In this cross-sectional study we assessed the prevalence of oral HPV and the risk factors associated with HPV contraction including sexual practice in the urban and rural Zambian population. Methods: Urban (N = 188) and rural (N = 211) Zambian adults aged 21 years and older living in Ndola and Mansa, respectively, were interviewed about demographical data, oral and coital sexual history and tobacco and alcohol use. Participants were orally examined and underwent a buccal swab test for 12 high-risk HPVs (HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59) and two low-risk HPVs (HPV6 and 11) with real-time PCR. Results: Alcohol consumption was higher in urban participants than rural participants, i.e., 34.1% and 16.6%, respectively, consumed alcohol once a week or more (p = 0.001). Ever-smokers constituted 38.8% of urban and 32.2% of rural participants (p = 0.363). Engaging in orogenital sex was uncommon, however, more common in urban than rural participants (13.3% and 4.3%, respectively, p = 0.003). Only three participants were positive for HPV (HPV16, 35, and 45, respectively). Conclusions: Urban participants displayed higher sexual risk behaviour than rural participants. However, the prevalence of oral HPV infection in Zambia was low, which contrasts to the high incidence of cervical cancer reported for the country. [ABSTRACT FROM AUTHOR]

Simple Summary: Colon cancer is an increasing health concern, especially for Asian Americans. Our study analyzed recent data to understand colon cancer prevalence and risk factors in Asian Americans across different states and counties. We found that colon cancer prevalence among Asian Americans increased significantly between 2017 and 2021, and the highest rates were seen in Arkansas, Rhode Island, and New Hampshire. Speaking only English and having health insurance were associated with a higher prevalence of colon cancer, possibly due to greater access to screening. Communities with greater socioeconomic resources had lower rates of colon cancer, likely due to better access to early screenings. These findings highlight the importance of preventive efforts to address the increased colon cancer rates in the Asian American population. Future studies should examine geographic and community-level factors contributing to these disparities. Background: Colon cancer (CC) is a significant public health concern. With Asian Americans (AAs) representing a rapidly growing demographic in the United States, our study examined CC prevalence among AAs. Methods: The study merged the 2017–2021 Medical Expenditure Panel Survey and County Health Ranking. Our analysis calculated age-adjusted CC rates and examined its prevalence across states. Regression analyses were conducted to study county-level risk factors of CC. Results: The CC age-adjusted rate among AAs increased by five-fold, from 155 per 100,000 in 2017 to 753 per 100,000 in 2021. State-level disparities revealed the highest CC prevalence in Arkansas, Rhode Island, and New Hampshire. Not speaking other languages and having insurance were significantly associated with higher CC rates, suggesting barriers to preventions and greater use of screening (p < 0.05). County-level analysis identified lower CC prevalence in regions with a greater socioeconomic advantage (p < 0.05). Socioeconomic advantage seemed to facilitate higher screening rates, which then translated into higher CC rates. Conclusions: Our findings underscore the need for early preventions to address rising CC rates among AAs. Future research should also explore geographic factors to better understand the disparities in CC risk. [ABSTRACT FROM AUTHOR]

Simple Summary: Anaplastic thyroid cancer (ATC) is among the most aggressive human cancers, with a very poor prognosis. Over the last decades, several experimental and clinical findings have been accumulated supporting the therapeutic role of aspirin/acetylsalicylic acid (ASA) against different human neoplasms, including thyroid cancer. Here, we show that treatment with ASA inhibits the proliferation and survival of a panel of three ATC-derived cell lines cultured in vitro. It can also hamper cell migration and invasion in two of the three cell lines and strongly impair their capability of forming 3D masses within a solid milieu. Moreover, we demonstrated that ASA reduces the intracellular activity of a biochemical pathway known to be involved in ATC cell replication. In conclusion, the findings reported here warrant further investigations to fully evaluate the potential therapeutic value of aspirin in ATC patients. Background: several experimental findings and epidemiological observations indicated that aspirin/acetylsalicylic acid (ASA) may be endowed with anticancer effects against a variety of human malignancies, including thyroid carcinomas. Among these, undifferentiated/anaplastic thyroid carcinoma (ATC) is one of the most aggressive and lethal human cancers, refractory to all currently available therapies. Methods: we here evaluated in a preclinical setting the effects of ASA on a panel of three ATC-derived cell lines: the CAL-62, the 8305C, and the 8505C. Results: the data obtained demonstrated the ability of ASA to inhibit, in a dose- and time-dependent manner, the proliferation of all ATC cell lines investigated, with IC50 values comprised between 2.0 and 4.3 mM. Cell growth was restrained with the same efficacy when the ASA treatment was applied to three-dimensional soft-agar cultures. In addition, ASA significantly reduced migration and invasion in two of the three ATC cell lines. We finally investigated the effects of ASA on the MAPK and PI3K/Akt signaling pathways, which are often altered in ATC. The results showed that the phosphorylation status of the Akt1/2/3 kinases was significantly reduced following ASA treatment, while ERK1/2 phosphorylation was either unaffected or slightly upregulated. Conclusions: our findings support epidemiological evidence on the anticancer potential of ASA. On this basis, further investigations should be carried out to assess the usefulness of ASA as adjuvant therapy in patients affected by ATC. [ABSTRACT FROM AUTHOR]

Lexical dynamics, just as epidemiological dynamics, represent spreading phenomena. In both domains, constituents (words, pathogens) are transmitted within populations of individuals. In linguistics, such dynamics have been modeled by drawing on mathematical models originating from epidemiology. The basic reproductive ratio is a quantity that figures centrally in epidemiological research but not so much in linguistics. It is defined as the average number of individuals that acquire a constituent (infectious pathogen) from a single individual carrying it. In this contribution, we examine a set of lexical innovations, i.e., words that have spread recently, in four different languages (English, German, Spanish, and Italian). We use and compare different ways of estimating the basic reproductive ratio in the lexical domain. Our results show that the basic reproductive ratio can be somewhat reliably estimated by exploiting estimates of lexical age of acquisition and prevalence but that the derivation based on diachronic corpus data comes with certain challenges. Based on our empirical results, we argue that the basic reproductive ratio can inform about the stability of newly emerging words and about how often such words are successfully propagated in linguistic contact events. Our analysis shows that an average lexical innovation that has spread in the previous two centuries has been passed on by each individual only to a handful of contacts. [ABSTRACT FROM AUTHOR]

Background: COVID‐19 has posed substantial challenges to healthcare systems globally, emphasizing the need for robust epidemiological tracking, particularly in regions like Saudi Arabia where distinct variations in case rates necessitate specialized public health strategies. Aims and Objectives: This study aims to identify the most effective model for predicting COVID‐19 trends by analyzing daily time‐to‐event case data across six Saudi regions. The goal is to enhance resource allocation and intervention strategies by gaining a deeper understanding of the epidemic's dynamics and developing a reliable method for early detection of trend changes to prompt timely public health actions. Research Gap: Previous studies have predominantly utilized simpler statistical models such as log‐normal, Gamma, and Weibull distributions, which often fall short in accurately describing the complex behaviors of COVID‐19 case distributions, particularly during peak times and periods of periodicity. This study addresses these shortcomings by employing advanced trigonometrically enhanced models. Methodology: To model daily time‐to‐event COVID‐19 case data from various regions in Saudi Arabia spanning 2020 to 2023, we employed the new trigonometric Weibull distribution from the new trigonometric‐generated P‐class of distributions. Our methodological approach included a comprehensive model validation process, utilizing a comparative analysis across seven distinct estimation techniques. Maximum likelihood estimation proved to be the most effective overall. We also adapted specific classical estimation techniques to fit the unique epidemiological characteristics of each region: Cramer von Mises estimation for Abu 'Urwah, Al‐Aridah, and Al Bada'I; Anderson–Darling estimation for Abha; maximum product spacing estimation for Ad Dammam; and maximum likelihood estimation for Abu 'Arish. This tailored approach allowed for a detailed analysis of regional data, enhancing the accuracy and relevance of our modeling outcomes. Conclusions: The new trigonometric Weibull distribution effectively modeled daily COVID‐19 cases across various regions in Saudi Arabia, demonstrating superior fit and capturing complex epidemic dynamics. This study highlights the new trigonometric Weibull distribution distribution's capability to detect significant trends and periodic fluctuations, enhancing public health response strategies. Its successful application underscores the value of advanced trigonometric models in epidemiological research and pandemic management. [ABSTRACT FROM AUTHOR]

The increasingly widespread application of next-generation sequencing (NGS) in clinical diagnostics and epidemiological research has generated a demand for robust, fast, automated, and user-friendly bioinformatics workflows. To guide the choice of tools for the assembly of full-length viral genomes from NGS datasets, we assessed the performance and applicability of four open-source bioinformatics pipelines (shiver—for which we created a user-friendly Dockerized version, referred to as dshiver; SmaltAlign; viral-ngs; and V-pipe) using both simulated and real-world HIV-1 paired-end short-read datasets and default settings. All four pipelines produced consensus genome assemblies with high quality metrics (genome fraction recovery, mismatch and indel rates, variant calling F1 scores) when the reference sequence used for assembly had high similarity to the analyzed sample. The shiver and SmaltAlign pipelines (but not viral-ngs and V-Pipe) also showed robust performance with more divergent samples (non-matching subtypes). With empirical datasets, SmaltAlign and viral-ngs exhibited an order of magnitude shorter runtime compared to V-Pipe and shiver. In terms of applicability, V-Pipe provides the broadest functionalities, SmaltAlign and dshiver combine user-friendliness with robustness, while the use of viral-ngs requires less computational resources compared to other pipelines. In conclusion, if a closely matched reference sequence is available, all pipelines can reliably reconstruct viral consensus genomes; therefore, differences in user-friendliness and runtime may guide the choice of the pipeline in a particular setting. If a matched reference sequence cannot be selected, we recommend shiver or SmaltAlign for robust performance. The new Dockerized version of shiver offers ease of use in addition to the accuracy and robustness of the original pipeline. [ABSTRACT FROM AUTHOR]

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Objective: To investigate the factors associated with hypercholesterolemia in older adults residing in a small municipality in northeastern Brazil. Methods: This is a population‐based cross‐sectional epidemiological study conducted with 232 older adults (women: 58.60%; men: 41.40%) in Aiquara, Bahia, Brazil. Independent variables included socioeconomic, behavioral, and health‐related factors. The outcome was self‐reported hypercholesterolemia (yes or no). Poisson regression with a robust estimator was used to calculate Prevalence Ratios (PR) and their respective 95% Confidence Intervals (CI) in the inferential analysis. Gross models were initially developed, followed by a hierarchical multiple explanatory model (Level 1: socioeconomic variables; Level 2: behavioral aspects; Level 3: health conditions). Results: The observed prevalence of hypercholesterolemia was 34.50% (men: 21.90%; women: 43.40%). Additionally, a higher probability of hypercholesterolemia was observed in women (PR: 1.94; 95% CI: 1.27–2.97); participants with high sedentary behavior (PR: 1.47; 95% CI: 1.03–2.09); those with abdominal obesity (PR: 1.65; 95% CI: 1.06–2.57); and those with diabetes mellitus (PR: 1.54; 95% CI: 1.04–2.29). Conclusion: The main results showed that female sex, high sedentary behavior, abdominal obesity, and diabetes mellitus were positively associated with hypercholesterolemia in the older population of the study. [ABSTRACT FROM AUTHOR]

Background: Because of growing concerns regarding repeated head trauma, in 2016, the United States Soccer Federation (USSF) banned headers for athletes aged ≤10 years and limited athletes aged 11 to 13 years to practicing headers for 30 minutes per week. Purpose: To assess whether the USSF header policy was associated with fewer soccer-related concussions after the 2015 season. Study Design: Descriptive epidemiology study. Methods: A retrospective cohort from the National Electronic Injury Surveillance System database was assessed. Age, sex, and injury type were extracted for all soccer-related emergency department visits between January 1, 2012, and December 31, 2023. Univariate and multiple regression analyses were used to assess concussions as a percentage of all soccer-related injuries based on sex, age group (6-9, 10-13, and 14-17 years), and year. The following time frames were assessed: 2012-2015, 2016-2019, and 2020-2023. Results: The proportion of concussions decreased from 8.2% of all soccer-related injuries in 2012-2015 to 6.1% in 2020-2023 (P <.01). The relative risk reduction for soccer-related concussions presenting to an emergency department in 2020-2023 compared with 2012-2015 was 25.6%. Overall, the proportion of concussions among 10- to 13-year-old and 14- to 17-year-old players was higher than for 6- to 9-year-old players (6.6% and 8.9% vs 4.9%, respectively; P <.01). Despite having a lower frequency of soccer-related injuries overall, female players had a greater proportion of concussions than male players (9.6% vs 6.2% of all soccer-related injuries; P <.01). In the multiple regression analysis, injuries that occurred in 2020-2023 were associated with lower odds of concussion compared with 2012-2015 (odds ratio [OR], 0.75 [95% CI, 0.69-0.81]). Compared with 6- to 9-year-old and male players, the 10- to 13-year-old (OR, 1.30 [95% CI, 1.16-1.45]), 14- to 17-year-old (OR, 1.79 [95% CI, 1.61-1.99]), and female players (OR, 1.53 [95% CI, 1.43-1.63]) were associated with higher odds of concussion. Conclusion: A 25.6% reduction in the relative risk of presenting to the emergency department with a soccer-related concussion was found when comparing 2020-2023 (after USSF header policy implementation) with 2012-2015 (before policy implementation). The USSF youth soccer header policy may improve player safety by reducing head impacts in the pediatric population. [ABSTRACT FROM AUTHOR]

Background: The mean age of volleyball athletes has increased over the past decade, raising concerns about musculoskeletal injuries. There is no literature on how different mechanisms of injury (MOI) affect different adult age groups. Purpose: To evaluate epidemiologic trends, diagnoses, and mechanisms of volleyball-related upper extremity injuries within different adult age groups. Study Design: Descriptive epidemiology study. Methods: Data from the National Electronic Injury Surveillance System for volleyball-related upper extremity injuries in patients aged between 19 and 79 years, between January 1, 2013, and December 31, 2022, were analyzed. Data included body parts, diagnosis, MOI, and disposition. Calculations used corresponding hospital sample weights for national estimates (NEs). Patients were divided into either 20-39, 40-59, or 60+ years age groups. Linear regressions were used to analyze annual trends, chi-square tests were used to analyze categorical variables, and the Holm P value adjustment method was utilized in post hoc analysis. Results: A weighted NE of 41,164 volleyball-related upper extremity injuries occurred in the study period. The mean age was 35.8 ± 14 years, and male patients constituted 49.4% of all patients. The most injured body parts of all age groups were fingers (33.2%), shoulders (28.9%), and wrists (16%). The most common identifiable MOI were impacts with the floor (24%), impacts with the ball (18.7%), and spikes/serves (6.9%). The 20-39 age group experienced shoulder dislocations at the greatest rate of all age groups (NE = 3362 [37%]) and sustained injuries from spike/serve movements at the greatest rates (NE = 2214 [8.2%]; P <.01). Of the 3362 shoulder dislocations in the 20-39 age group, 1445 (43%) were during spikes/serves. The 60+ age group had the greatest rates of sprains/strains (NE = 1353 [41.1%]). Additionally, the 60+ age group suffered from injuries secondary to impacts on the floor (NE = 1242 [37.7%]) and impacts with the ball (NE = 769 [23.4%]) at the greatest rates (P <.01). Conclusion: Our study demonstrated that adult populations are at risk for volleyball-related upper extremity injuries, specifically affecting the finger, wrist, and shoulder. MOI among age groups differed, as younger adults more often sustained injuries from dynamic movements, whereas older adults sustained injuries from trauma. [ABSTRACT FROM AUTHOR]

Background: Wrestling is among the most common youth sports in the United States, with about 260,000 high school participants annually. There is a lack of literature investigating wrestling injury profiles and mechanisms of injuries. In the past 15 years, urgent care utilization has increased, and National Federation of State High School Associations (NFHS) concussion protocols have been developed and implemented. Purpose/Hypothesis: The purpose of this study was to analyze causes, diagnoses, body parts, and trends associated with wrestling injuries presenting to US emergency departments. It was hypothesized that there would be (1) decreased overall injuries presenting to emergency departments because of increased urgent care utilization and (2) decreased concussions because of the NFHS rule implementation and revision. Study Design: Descriptive epidemiology study; Level of evidence, 3. Methods: Youth wrestling injuries presenting to US emergency departments between January 1, 2013, and December 31, 2022, were queried from the National Electronic Injury Surveillance System database. The data included date of presentation, age, sex, race, body part, injury diagnosis, disposition, and a brief injury narrative. National estimates (NE) were calculated using the associated statistical weight of the reporting hospital. Linear regressions were performed to investigate the relationship between year and NE for overall injuries, diagnoses, body parts, mechanisms of injury, and other subanalyses. Statistical significance was set at P <.05. Results: A total of 8628 (NE = 296,502) wrestling injuries met the inclusion criteria for this study. The mean age at presentation was 14.3 ± 2.6 years (range, 3 to 18 years). The shoulder (NE = 43,207 [14.6%]), head (NE = 40,875 [13.8%]), and knee (NE = 30,218 [10.2%]) were the most injured body parts. The most common diagnoses were strain/sprain (NE = 91,924 [31%]), other/not stated (NE = 53,736 [18.1%]), and fracture (NE = 52,261 [17.6%]). Common mechanisms of injury included not specified (NE = 148,169 [50%]), impact with mat (NE = 61,557 [20.8%]), and abnormal rotation/strain (NE = 37,449 [12.6%]). Overall injuries (P =.01) (coefficient: –1763 [95% CI, –2963 to −563]) and concussions (P =.01) (coefficient: –178 [95% CI, –302 to −55]) statistically significantly decreased. Conclusions: Our study showed a trend in the decrease in overall injuries and concussions in high school wrestlers. Strains/sprains were the most common diagnoses with the shoulder being the most common site. Youth wrestlers would benefit from future research analyzing risks associated with these injuries as well as advances in protective gear. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease is the leading cause of death among women, but sex-specific risk factors are incompletely understood. In this study, we aimed to assess the associations between the type of menopause, and age at natural menopause with the odds of cardiovascular disease (CVD), and coronary heart disease (CHD). Methods: This cross-sectional study is a part of data from the Rafsanjan Cohort Study (RCS) which is a branch of the Prospective Epidemiological Research Studies in Iran (PERSIAN). A sample of 1767 postmenopausal women were included. The diagnosis for CVD and CHD was based on self-report questionnaires. Menopause age was categorized as < 40, 40–44, 45–49, and ≥ 50. Also, the menopause types were classified as natural and induced menopause (surgery or chemotherapy). The association was evaluated by logistic regressions. Results: The menopause age < 40 years had higher odds of CVD compared to women with menopause age > 40 years (OR: 2.66; 95%CI 1.29–5.48). Women with induced menopause had higher odds of CVD compared to women with natural menopause (OR = 1.44, 95% CI 1.04–1.98). In terms of the odds of CHD, the results showed that the odds of CHD increased in menopause age < 40 years and induced menopause compared to reference groups (OR: 2.49, 95% CI 1.15–5.37, OR = 1.48; 95% CI 1.06–2.07, respectively). Conclusion: Premature menopause and induced menopause should be considered as important risk factors for CVD, and CHD. Health policymakers should pay more attention to the type of menopause and the age of menopause in postmenopausal women to predict the risk of CVD and preventive strategies. [ABSTRACT FROM AUTHOR]

The rapid rise of cyanotoxins production poses a serious threat to global freshwater ecosystems and has become an important issue of global public health. In Africa, a continent facing serious environmental problems, including poisoning by cyanotoxins, knowledge of the presence and distribution of these toxins remains limited. The primary objective of our review is to assess the occurrence and distribution of cyanotoxins, particularly microcystins (MCs), in African freshwater ecosystems. We aim to analyze the limited but existing literature on this subject, focusing specifically on studies published between 2001 and 2023. Recognizing the scarcity of research on this topic in Africa, we strive to elucidate the emerging patterns of toxin variants and their correlation with environmental variables, such as water temperature and nutrient concentrations. Our investigation reveals MCs as the predominant cyanobacterial secondary metabolites detected across the majority of African freshwater environments where cyanotoxins have been documented. Furthermore, their concentrations have exceeded the World Health Organization's (WHO) provisional guideline for lifetime human exposure through drinking water, which is set at 1 µg L−1, as indicated by data in Table 1. Highly significant positive relationships were found between toxin-producing cyanobacteria and environmental factors, in particular water temperature and nutrient concentrations. Given the associated exposure risks in Africa, we recommend frequent monitoring of water quality, the development of guidelines based on international best practice, toxicity tests, and epidemiological investigations to understand the health risks and impacts of cyanotoxin exposure. These measures are essential to both protect the well-being of humans and to ensure the sustainability of African aquatic ecosystems. [ABSTRACT FROM AUTHOR]

Simple Summary: The purpose of this pediatric cancer research investigation was to assess how radiation therpay in the first primary malignannt neoplasm predispose to Second Primary Thyroid Maligancy (SPTM), as well as therapeutics and mortality associated with SPTM. This study applied a retrospective cohort design, as non-experiment translational epidemiologic investigation, utilizing the USA National Cancer Institute, Surveillance Epidemiology and End Results (SEER) data in the assessment of risk determinants and predisposing factors in SPTM, as well as racial differentials in SPTM cumulative incidence and mortality. Specifically, radiation utilization in first primary malignancy among children predisposed to SPTM, indicative of the need to assess exposure effect of other carcinogens prior to radiation therapy in first primary malignant neoplasm, hence SPTM marginilaization. Objective: To assess racial and sex variances in second primary thyroid malignancy (SPTM) cumulative incidence and temporal trends and the radiation exposure effect in pediatric SPTM. Materials and Methods: A retrospective cohort study, a non-experimental epidemiologic design, was used to assess the cumulative incidence (CmI) and temporal trends as well as the exposure effect of radiation in SPTM among children, 0–19 years, in the Surveillance, Epidemiology, and End Results (SEER) registry, National Cancer Institute (NCI), USA. Percent change (PC) and annual percent change (APC) were used to examine CmI rates and temporal trends, while chi-square statistics and binomial regression models were used to examine variable distribution by race and to determine the exposure effect of radiation on SPTM as well as mortality, respectively. Results: The frequency of pediatric thyroid cancer was (n = 3457) between 1973 and 2013/14, while the PC was 151.2 for all races but 99.8 among whites. Of all pediatric thyroid cancers diagnosed during this period, SPTM accounted for 3% (n = 99). Compared to whites, blacks/AA were 60% less likely to present with SPTM, adjusted risk ratio, aRR = 0.40, 99% CI 0.06–2.47, while other races were 18% more likely to develop SPTM, aRR = 1.18, 99% CI 0.48–2.87. Additionally, females relative to males were 63% less likely to be diagnosed with SPTM, aRR = 0.37, 99% CI 0.22–0.61. With respect to urbanicity, compared to children in rural areas, those in urban areas were 21% less likely to develop SPTM, aRR = 0.79, 99% CI, 0.12–5.35, while children in metropolitan areas were 40% less likely to develop SPTM, aRR = 0.60, 99% CI, 0.10–3.59. Although imprecise, there was a 5% increased risk of SPTM, with radiation as an exposure effect, aRR = 1.05, 99% CI 1.01–1.75. Conclusions: There are increasing temporal trends in pediatric SPTM with blacks relative to whites having observed lower incidence, despite an increasing percent change among blacks/AA, indicative of the disproportionate burden of this malignant neoplasm. SPTM risk was higher among males and in rural areas, while radiation as a risk for SPTM was clinically and biologically meaningful, albeit an observed statistically insignificant inference due to sampling variability, requiring intervention mapping in radiation exposure margination among children. [ABSTRACT FROM AUTHOR]

BACKGROUND: In environmental epidemiology, we use an array of tools from various, related disciplines to answer key questions about environmental exposures in relation to health outcomes. Typically, we ask questions related to what, who, where, when, and how. We value these questions because they contribute to novel scientific discovery and our understanding of disease etiology linked to environmental exposures. In addition, these questions help us better understand who might be at highest risk of exposure and subsequent risk of disease. Although necessary for the goals of environmental epidemiology, these questions are insufficient for addressing environmental health disparities. Specifically, these questions may be able to help us describe exposure–health outcome associations but are limited in their ability to move beyond identification to intervening on observed disparities to achieve environmental health equity. OBJECTIVES: We sought to emphasize the need to value and routinely add the key question of “Why?” in environmental epidemiological studies. In asking this additional critical question, we can identify and incorporate the structural determinants and drivers of environmental exposure disparities and determine whether these factors are linked to existing and historically recalcitrant health disparities. Further, we can design effective studies that build on existing frameworks to address the fundamental causes of environmental health disparities. DISCUSSION: This commentary underscores the need to routinely incorporate “why” questions in the practice of environmental epidemiology. By asking and addressing “Why?” we can employ better, more solution-oriented study designs, improve data collection, and enhance our ability to collaborate with diverse study populations through trust-building and community-engaged research. Incorporating these approaches will move environmental epidemiology forward from mostly documenting to actively addressing environmental health disparities. [ABSTRACT FROM AUTHOR]

Baseball pitching requires fast and coordinated motions of the whole body to reach high ball speeds, putting considerable strain on the musculoskeletal system, particularly the shoulder and elbow. To describe musculoskeletal symptoms and the functional status of the shoulder and elbow in male high school baseball pitchers. Descriptive epidemiology study. Dutch baseball talent academies. One hundred twenty-five male high school baseball pitchers aged 12 to 18 years who participated in 1 of the 6 Dutch baseball talent academies and the Dutch National U-18 team were recruited and enrolled. Musculoskeletal symptoms, functional status of the shoulder and elbow were registered for each player every 6 months over 2 consecutive baseball seasons through self-assessment questionnaires, including the Kerlan-Jobe Orthopaedic Clinic (KJOC) and the Western Ontario Shoulder Instability Index (WOSI) questionnaires. Five hundred seventy musculoskeletal (MSS) symptoms in 93 of the 125 players were reported. The average 6-month prevalence for symptoms of the throwing shoulder was 37% (95% CI = 33%–41%), and for the elbow 37% (95% CI = 31%–42%), followed by the lower back with 36% (95% CI = 26%–45%). The baseball pitchers who experienced only shoulder symptoms had an average KJOC score of 80.0 (95% CI = 75.3–84.7) points, whereas those with only elbow symptoms reported a score of 90.2 (95% CI = 89.2–95.3). On the WOSI questionnaire, baseball pitchers scored an average of 421.2 (95% CI = 200.1–642.4) points. In a cohort of Dutch high school baseball pitchers, one-third reported shoulder and elbow symptoms on the throwing side, with reduced functional status and lower back symptoms. Future efforts should focus on developing preventive strategies through early symptom detection, aiming to prevent symptom progression and, ultimately, the development of severe injuries. [ABSTRACT FROM AUTHOR]

Background: Hematological alterations have been observed in diabetes, with some studies showing controversial associations between specific hematologic parameters and type 2 diabetes mellitus (T2DM). Objectives: This study aims to determine the association between hematological indices, specifically white blood cell (WBC) count, red cell distribution width (RDW), and platelet distribution width (PDW), and the presence of T2DM in an Iranian population, using data from the Bandare-Kong non-communicable diseases (BKNCD) cohort. Methods: Data from the BKNCD cohort, which includes 4063 individuals aged 35 - 70 years, was used in this study. After excluding participants with conditions that could interfere with the analysis, 2318 subjects remained for final evaluation. Results: Among the 2318 individuals, T2DM was present in 530 (22.9%). Binary logistic regression analysis revealed that the odds of T2DM increased by approximately 7% for every 109/L increase in WBC count, after adjusting for variables such as occupation, age, body mass index, sex, place of residence, education, smoking, marital status, systolic and diastolic blood pressure (DBP), and physical activity (adjusted odds ratio (aOR) = 1.066, 95% confidence interval (CI) = 1.003; 1.133, P = 0.039). Additionally, elevated PDW was associated with a 63% increase in the odds of T2DM (aOR = 1.625,95% CI 1.159; 2.279, P = 0.005), while increased RDW was associated with decreased odds of T2DM (aOR= 0.801,95% CI 0.716; 0.895, P< 0.001). Conclusions: Elevated PDW and WBC counts in T2DM patients in this study suggest an inflammatory state and hypercoagulability. However, the paradoxically decreased RDW maybe linked to poor glycemic control in these patients. [ABSTRACT FROM AUTHOR]

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Abdominal musculature injuries comprise the third most prevalent time-loss injury across professional baseball. Despite increased awareness and prevention attempts in the recent decade, the trends of these abdominal injury numbers in Major League Baseball (MLB) are not fully understood. Purposes: To update the trends in oblique and intercostal injuries, analyze the impact of these injuries based on time out of play, and identify factors that correlate with increased injury severity to help with recovery time prognostication for the sports medicine community. Study Design: Descriptive epidemiology study. Methods: Using the MLB Health and Injury Tracking System, the authors identified all abdominal and core musculature injuries that resulted in time out of play in MLB and Minor League Baseball (MiLB) between the 2011 and 2021 seasons. These were filtered for injuries that resulted in ≥1 days missed (DM) during spring training, the regular season, and postseason. A Student t test was utilized to assess for significant differences for all normally distributed values. Regression analysis was utilized for determining change over time. For all statistical comparisons, the threshold for alpha was set to P <.05. Results: During the study period between 2011 and 2021, there were 4560 total abdominal injuries among 3401 athletes. When filtered for in-season, time-loss injuries defined as spring training, regular season, and postseason, there were 2890 injuries. Of these, 1928 were oblique injuries, 453 were intercostal injuries, and 115 were rectus injuries. The number of oblique injuries each season increased for all of baseball (P <.001), as well as for MLB (P =.009) and MiLB (P =.012) individually. Of the 1928 oblique injuries, 498 (26%) oblique injuries occurred at the MLB level and 1430 (74%) occurred at the MiLB level. Batting and pitching-related injuries comprised 860 (45%) and 729 (38%) oblique injuries, with a total of 18,455 DM and 20,891 DM, respectively. This corresponded to a mean of 22 DM for batting injuries and 29 DM for pitching injuries (mean difference, 7.2; 95% CI, 5.27-9.13; P <.001). Conclusion: This decade-long study on professional baseball revealed a significant increase in abdominal oblique injuries across MLB and MiLB, with the largest number of injuries observed in the 2021 season. Meanwhile, there was a significant decrease in intercostal injuries across professional baseball during these years. Such injuries continue to pose challenges, leading to substantial DM per injury and affecting players from various positions. [ABSTRACT FROM AUTHOR]

Background: In 2022, Major League Baseball (MLB) implemented the universal designated hitter (DH) rule, thus allowing the pitcher to focus solely on defense while the DH, who bats for the pitcher, focuses solely on offense. Purpose/Hypothesis: The purpose of our study was to determine if implementation of the universal DH rule affected the incidence of injuries in MLB pitchers when compared with before implementation. It was hypothesized that the shift to the universal DH rule would be associated with a decrease in the rate of offense-related pitcher injuries. Study Design: Descriptive epidemiology study. Methods: Using publicly available data, we identified injuries sustained by MLB pitchers during the 2021 (before the DH rule change) and 2022 (after the rule change) regular seasons. Pitchers placed on the injured list for non–gameplay related reasons were excluded. Statistical analysis was performed with the chi-square and independent t tests. Results: The injury incidence rate decreased significantly from before to after the rule change for MLB pitchers overall (from 6.58 to 5.60 injuries/1000 athlete game-exposures [AGE]; P =.02) and for National League pitchers (from 7.62 to 6.26 injuries/1000 AGE; P =.04). No significant changes were seen in American League pitchers (P =.20). Injury locations that decreased from before to after the rule change were the thigh (from 0.52 to 0.21 injuries/1000 AGE; P =.003) and the hand/finger/wrist (from 0.63 to 0.30 injuries/1000 AGE; P =.01). Total time lost decreased from 9471 days before the rule change to 8857 days after the rule change (P =.00001). Conclusion: Implementation of the universal DH rule was associated with a decrease in pitcher injuries overall and within the National League. Injuries to the thigh and hand/finger/wrist also decreased overall and within the National League. Furthermore, total days lost decreased from before to after the rule change. These findings may be due to the elimination of offensive gameplay requirements for pitchers, which highlights a positive consequence of the universal DH rule, but further studies are needed. [ABSTRACT FROM AUTHOR]

Background: Ulnar collateral ligament (UCL) injuries have been on the rise for the past 3 decades. Current epidemiological studies on the incidence of UCL injuries have been limited to state or regional data. Purpose: To utilize a large national claims database to determine the rates of UCL injuries and UCL surgical procedures over the past decade (2010-2019) and whether there has been a change in UCL surgical procedure patterns in the United States. Study Design: Descriptive epidemiology study. Methods: The PearlDiver patient claims database was used to identify UCL injuries occurring from 2010 and 2019 that were sustained by male patients between 10 and 34 years of age. The study cohort was divided into 5 age groups (10-14, 15-19, 20-24, 25-29, and 30-34 years). Primary outcomes included the number of patients in each age group who sustained a UCL injury, the number of patients in each age group who underwent surgery, and the mean time from injury to surgery. Results: A total of 19,348 UCL injuries occurred between 2010 and 2019, and 13% required a surgical intervention. Most of the injuries (54%) occurred in the 15- to 19-year group. Patients in the 20- to 24-year group were more likely to undergo surgery versus the 15- to 19-year group. Results demonstrated a trend toward delayed surgical interventions in patients in the 20- to 24-year group in the latter part of the decade. Conclusion: Data suggested that male patients <20 years account for the majority of UCL injuries, while male patients aged between 20 and 24 years are most likely to undergo surgery. Despite a number of targeted injury-prevention strategies and rule changes in sports, the UCL injury rate remained high. Therefore, there is a clear and present need to continue to develop UCL injury-prevention strategies for the younger population. [ABSTRACT FROM AUTHOR]

Background: It is unclear how levels of sport participation have changed among adolescents in the United States (US) in recent years, particularly considering evidence of increasing sport professionalization and attrition. Purpose: To evaluate the differences and trends in single- and multiple-team sport participation among US high school students between 1999 and 2019. Study Design: Descriptive epidemiology study. Methods: Using the Youth Risk Behavior Surveillance System of the US Centers for Disease Control and Prevention, a biannual representative survey of US high school students, data on self-reported sport participation (no participation, single team, multiple teams) within the previous year were evaluated. Differences in sport participation prevalence between 1999 and 2019 were assessed in sex strata by grade, race/ethnicity, and US region. Weighted trends using the National Center for Health Statistics Guidelines for Analysis of Trends and logistic regression models were employed for analyses. Results: The study sample over the 20-year period (N = 149,404) was 49.8% female; the majority were in ninth grade (27.7% female, 28.7% male), were non-Hispanic White (56.1% female, 56.8% male), and resided in the Southern US (57.6% female, 57.4% male). Among girls, 27.2% (95% CI, 25.8-28.6) reported multiple sports team participation in 1999, while 21.3% (95% CI, 20.1-22.6) reported the same in 2019. Among boys, 39.5% (95% CI, 38.4-40.7) reported multiple sports team participation in 1999 versus 29.1% (95% CI, 27.7-30.6) in 2019. Analyses of trends indicated that girls experienced increasing trends in single-sport team participation (β = 0.04, SE = 0.01, P <.001). Among boys, there were increasing trends in no sport participation (β = 0.06, SE = 0.01, P <.001), while multiple-sport team participation decreased over the 20-year period (β = −0.10, SE = 0.01, P <.001). Disparities in trends were observed among female and male groups by race/ethnicity, grade, and region. Conclusion: Sport participation over a 20-year period in the US decreased significantly for boys and increased for single-sports teams among girls. Sport specialization may be contributing some of the observed trends, though limitations in the data require additional research to confirm these hypotheses. Tailored efforts to increase sport participation among both sexes is needed. [ABSTRACT FROM AUTHOR]

Background: Achilles tendon ruptures are common and potentially career-ending injuries for National Basketball Association (NBA) players. Many studies have reviewed the impact of Achilles tendon ruptures on return to play (RTP) and performance, but there are no studies on their economic significance. Purpose/Hypothesis: This study aimed to analyze the economic and performance consequences of Achilles tendon ruptures usingthe cost of recovery (COR) for NBA franchises as well as preinjury salary/career success. It was hypothesized that players with higher preinjury salaries or performance would have an increased COR, higher rates of RTP, and more career success after their injury. Study Design: Descriptive epidemiology study. Methods: Publicly available data of NBA players who sustained an Achilles tendon rupture between 1990 and 2023 were analyzed. Data were retrospectively gathered by R software code to include players' ages, positions, salaries, pre- and postinjury player efficiency rating, time missed after injury, and RTP. Performance impact was measured by advanced statistics: player efficiency rating, Win Shares per 48 Minutes, and Value Over Replacement Player. Two groups of 3 cohorts were created: All-Star, Starter, and Reserve versus group A (<$3,999,999), group B (≥$3,999,999 to ≤$8,999,999), and group C (>$8,999,999). Analysis of variance with post hoc Tukey tests for continuous data and Fisher exact tests for categorical data was used. Significance levels were set at P <.05. Results: A total of 37 players met the inclusion criteria and played between the years of 1992 through 2019. The mean COR that NBA teams faced was $4 million per player. The cumulative economic loss from Achilles tendon ruptures in the NBA between 1992 and 2019 was $117,578,851. Overall RTP was 78.38%, and 31.03% of players who returned to play were out of the NBA within 3 years. RTP to the highest playing level was highest in group B (45.5%), followed by group A (40%) then group C (12.5%). The COR of All-Star players, Starter players, and Reserve players averaged $5.7 million, $3.4 million, and $3 million, respectively. Conclusion: This study investigated the financial and performance implications of Achilles tendon ruptures among NBA athletes. Most players struggled to restore their preinjury performance, except for Reserve players. The findings provide valuable insights into the complexities of COR and postinjury performance. [ABSTRACT FROM AUTHOR]

Background: The time that adolescents spend using screens is associated with an elevated body mass index (BMI) and decreased physical activity, with gender being an important determinant. There is evidence that an elevated BMI can affect oral health. Aim: To analyze gender differences in physical activity levels and screen time, as well as screen use and BMI, and their associations with DMFT. Methods: Physical activity levels, screen time, and their relationship with the oral health status and BMI were studied in 468 schoolchildren aged 12 to 15 years. To analyze the differences in the numerical data, an analysis of the mean by the Student t-test or a one-way analysis of variance followed by the Bonferroni post hoc analysis was used. Moreover, to analyze the differences in the categorical data, the chi-square test was used. Results: Boys were more active (59.9%) than girls (40.1%) (p < 0.001) in terms of the means of transportation that they used to travel to school. It was observed that boys spent more mean hours playing outdoors than girls (boys: 1.38 ± 0.04 vs. girls: 1.24 ± 0.04; p = 0.040). The mean number of hours engaged in sports activities outside school was higher for boys than girls (boys: 2.22 ± 0.06 vs. girls: 1.77 ± 0.73; p ≤ 0.001). The mean number of hours spent using electronic devices during the weekend was higher in boys than girls (boys: 2.89 ± 0.08 vs. girls 2.44 ± 0.09; p ≤ 0.001). Children with a DMF > 0 had a higher mean BMI than those with a DMFT = 0 (DMFT > 0; 21.95 ±4.80 vs. DMFT = 0; 20.77 ± 3.67; p = 0.003). Conclusions: An increased number of hours spent in front of a computer correlates with a higher BMI. Sex seems to be a determining factor when it comes to engaging in active activities. Caries is more frequent in children with a higher BMI. [ABSTRACT FROM AUTHOR]

Background: The metabolic syndrome (MetS) comprises metabolic irregularities, including hypertension and central obesity, which are influenced by genetic, metabolic, environmental, and dietary factors. As diet and lifestyle are risk factors for MetS, it is important to know which diet quality index better predicts MetS. The aim of this study is to compare the ability of different diet quality indices in predicting MetS and to identify the most effective one. Methods: This cross-sectional study involved 5,206 participants aged 35 to 70 engaged in the Prospective Epidemiological Research Study in Iran (PERSIAN) cohort. Assessment of one year's food intake via a validated 134-item semi-quantitative food frequency questionnaire (FFQ) facilitated the calculation of adherence to five diet quality indices: Dietary Approaches to Stop Hypertension (DASH), Mediterranean, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND), Dietary Inflammatory Index (DII), and Diet Quality Indices (DQI). While bivariate Pearson correlation and binary logistic regression aided in identifying the strongest correlation and predictor for MetS among the indices. Results: This study showed a significant association between adhering to the DASH diet score, Mediterranean diet score, MIND diet score, DII score, and DQI score, and the odds of developing MetS (OR: 0.94, (95% CI: 0.93–0.95), OR: 0.85, (95% CI: 0.81–0.89), OR: 0.84, (95% CI: 0.80–0.89), OR: 1.22, (95%CI: 1.11–1.34), OR: 0.95, (95%CI 0.94–0.96) respectively). Therefore, with each unit increase in DASH diet score, Mediterranean diet score, MIND diet score, DII score, and DQI score, the odds of MetS was reduced by 5.4%, 14.5%, 15.6%, 22%, 5%, respectively. All the indices were correlated with the intake of most of the micronutrients, with the strongest correlations being observed in the DII. DASH diet score aligned with the most favourable MetS biomarker risk, while DII score primarily associated with MetS and could be considered as a predictor for MetS. Conclusion: The present study's findings reveal that between all these five diet quality indices, the DASH diet score correlates strongly with a favourable biomarker risk profile, while the DII score is predominantly linked to MetS. [ABSTRACT FROM AUTHOR]

Background: Cannabis use has been causally linked to violent behaviors in experimental and case studies, but its association with homicide victimization has not been rigorously assessed through epidemiologic research. Methods: We performed a case-control analysis using two national data systems. Cases were homicide victims from the National Violent Death Reporting System (NVDRS), and controls were participants from the National Survey on Drug Use and Health (NSDUH). While the NVDRS contained toxicological testing data on cannabis use, the NSDUH only collected self-reported data, and thus the potential misclassification in the self-reported data needed to be corrected. We took a data fusion approach by concatenating the NSDUH with a third data system, the National Roadside Survey of Alcohol and Drug Use by Drivers (NRS), which collected toxicological testing and self-reported data on cannabis use for drivers. The data fusion approach provided multiple imputations (MIs) of toxicological testing results on cannabis use for the participants in the NSDUH, which were then used in the case-control analysis. Bootstrap was used to obtain valid statistical inference. Results: The analyses revealed that cannabis use was associated with 3.55-fold (95% CI: 2.75–4.35) increased odds of homicide victimization. Alcohol use, being Black, male, aged 21–34 years, and having less than a high school education were also significantly associated with increased odds of homicide victimization. Conclusions: Cannabis use is a major risk factor for homicide victimization. The data fusion with MI method is useful in integrative data analysis for harmonizing measures between different data sources. [ABSTRACT FROM AUTHOR]

Objective To construct a land use regression (LUR) model for particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5) in Zunyi. Methods Collect and organize hourly PM2.5 monitoring data from routine air quality monitoring stations from January 1, 2020 to December 31, 2020, as well as geographic information data such as land use, roads, population density, altitude, and meteorological factors in Zunyi. Conduct multiple stepwise linear regression with PM2.5 concentration as the dependent variable and geographic information variables and meteorological factors as independent variables to construct a model. Use leave-one-out cross validation (LOOCV) to verify the performance of the model. Results The model formula is Y=72.656-0.026×altitude-0.009×NDVI-0.62×average temperature-383.512×average precipitation. The model had R2=0.74, adjusted R2=0.72, cross validation R2=0.69, RMSE=3.51, and a high spatial resolution (250 m×250 m). Conclusion The model fits well and fully reflects the influencing factors of PM2.5 spatial distribution in Zunyi. It can be used to estimate individual exposure levels and provide strong support for environmental health epidemiological research. [ABSTRACT FROM AUTHOR]

Background: In Venezuela, the predominant vaccines administered are BBIBP-CorV and Gam-COVID-Vac. Despite robust evidence from randomized clinical trials validating the effectiveness of COVID-19 vaccines in mitigating hospitalization and mortality, there is still a lack of post-authorization safety studies conducted within this demographic population. Methods: A prospective observational study from October 5, 2021 to March 31, 2022 encompassed COVID-19 vaccinated and unvaccinated patients from four sentinel hospitals in Venezuela. Patient lethality was predicted using Charlson Comorbidity index. Clinical outcomes were assessed through WHO's COVID-19 Clinical Progression Scale. Results: Out of the 175 patients assessed, 85 (48.6%) were vaccinated. The median Charlson Comorbidity index was 3 points, with no statistically significant differences observed between the groups (p = 0.2). A total of 50 (28.6%) patients died during the study period, with higher proportion of deaths in unvaccinated patients (35.6% vs. 21.2%, p = 0.035). Advanced age (OR = 1.043, 95% CI = 1.015–1.071, p = 0.002) was associated with increased death risk, whereas vaccination against COVID-19 (OR = 0.428, 95% CI = 0.185–0.99, p = 0.047), high oxygen saturation (OR = 0.964, 95% CI = 0.934–0.995, p = 0.024), and enoxaparin administration (OR = 0.292, 95% CI = 0.093–0.917, p = 0.035) were associated with decreased death risk. Conclusion: During the third and fourth waves of the pandemic, COVID-19 vaccination was associated with a 57% reduction in lethality among patients in four public hospitals in Venezuela. Key summary points: Less than half (48.6%) of the patients were vaccinated against SARS-CoV-2. At least one out of four patients died during the study period, mainly in the unvaccinated group. Advanced age was associated with a higher risk of death. Vaccination against COVID-19, high oxygen, and enoxaparin administration were factors associated with a lower risk of death. [ABSTRACT FROM AUTHOR]

Background: Previous research introduced V-PFCRC as an effective spot urinary dilution adjustment method for various metal analytes, including the major environmental toxin arsenic. V-PFCRC normalizes analytes to 1 g/L creatinine (CRN) by adopting more advanced power-functional corrective equations accounting for variation in exposure level. This study expands on previous work by examining the impacts of age and sex on corrective functions. Methods: Literature review of the effects of sex and age on urinary dilution and the excretion of CRN and arsenic. Data analysis included a Data Set 1 of 5,752 urine samples and a partly overlapping Data Set 2 of 1,154 combined EDTA blood and urine samples. Both sets were classified into age bands, and the means, medians, and interquartile ranges for CRN and TWuAs in uncorrected (UC), conventionally CRN-corrected (CCRC), simple power-functional (S-PFCRC), sex-aggregated (V-PFCRC SA), and sex-differentiated V-PFCRC SD modes were compared. Correlation analyses assessed residual relationships between CRN, TWuAs, and age. V-PFCRC functions were compared across three numerically similar age groups and both sexes. The efficacy of systemic dilution adjustment error compensation was evaluated through power-functional regression analysis of residual CRN and the association between arsenic in blood and all tested urinary result modes. Results: Significant sex differences in UC and blood were neutralized by CCRC and reduced by V-PFCRC. Age showed a positive association with blood arsenic and TWuAs in all result modes, indicating factual increments in exposure. Sex-differentiated V-PFCRC best matched the sex-age kinetics of blood arsenic. V-PFCRC formulas varied by sex and age and appeared to reflect urinary osmolality sex-age-kinetics reported in previous research. V-PFCRC minimized residual biases of CRN on TWuAs across all age groups and sexes, demonstrating improved standardization efficacy compared to UC and CCRC arsenic. Interpretation: Sex differences in UC and CCRC arsenic are primarily attributable to urinary dilution and are effectively compensated by V-PFCRC. While the sex and age influence on V-PFCRC formulas align with sex- and age-specific urinary osmolality and assumed baseline vasopressor activities, their impact on correction validity for entire collectives is minimal. Conclusion: The V-PFCRC method offers a robust correction for urinary arsenic dilution, significantly reducing systemic dilution adjustment errors. Its application in various demographic contexts enhances the accuracy of urinary biomarker assessments, benefiting clinical and epidemiological research. V-PFCRC effectively compensates for sex differences in urinary arsenic. Age-related increases in TWuAs are exposure-related and should be additionally accounted for by algebraic normalization, covariate models, or standard range adjustments. [ABSTRACT FROM AUTHOR]

Background Older adults are particularly vulnerable to COVID-19, due to slower immune response. Objective This study aims to investigate the epidemiological characteristics of older adults with COVID-19 in Guilan province, north of Iran. Methods This multicenter study was designed based on the medical care monitoring system (MCMC) and conducted on 42,481 older people aged ≥60 hospitalized due to COVID-19 in Guilan province from February 2020 to February 2022. Results Patients included 22,026(52%) male and 20,455(48%) female. Among the hospitalized patients, 14% died. Of the total deaths, 3,084(49%) had positive PCR results for COVID-19. The most common comorbidities among the deceased patients were cardiovascular diseases (25.3%) and diabetes (24.3%). There were significant associations between gender and age, between age and mortality, and between clinical symptoms and mortality. Conclusion Special attention should be paid to older patients with diabetes and cardiovascular diseases, especially males, during pandemics. It is important to train staff in private hospitals to be prepared for future pandemics and to use the referral system to reduce the burden of hospital admissions. [ABSTRACT FROM AUTHOR]

Before examining the impact of training load on injury risk in runners, it is important to gain insight into the differences between methods that are used to measure change in training load. To investigate differences between 4 methods when calculating change in training load: (1) weekly training load; (2) acute : chronic workload ratio (ACWR), coupled rolling average (RA); (3) ACWR, uncoupled RA; (4) ACWR, exponentially weighted moving average (EWMA). Descriptive epidemiology study. This study is part of a randomized controlled trial on running injury prevention among recreational runners. Runners received a baseline questionnaire and a request to share global positioning system training data. Runners who registered for running events (distances 10–42.195 km) in the Netherlands. The primary outcome measure was the predefined significant increase in training load (weekly training loads ≥ 30% progression and ACWRs ≥ 1.5), based on training distance. Proportional Venn diagrams visualized the differences between the methods. A total of 430 participants (73.3% men; mean age = 44.3 ± 12.2 years) shared their global positioning system training data for a total of 22 839 training sessions. For the weekly training load, coupled RA, uncoupled RA, and EWMA method, respectively, 33.4% (95% CI = 32.8, 34.0), 16.2% (95% CI = 15.7, 16.6), 25.8% (95% CI = 25.3, 26.4), and 18.9% (95% CI = 18.4, 19.4) of the training sessions were classified as significant increases in training load. Of the training sessions with significant increases in training load, 43.0% from the weekly training load method were different than the coupled RA and EWMA methods. Training sessions with significant increases in training load based on the coupled RA method showed 100% overlap with the uncoupled RA and EWMA methods. The difference in the change in training load measured by weekly training load and ACWR methods was high. To validate an appropriate measure of change in training load in runners, future research on the association between training loads and running-related injury risk is needed. [ABSTRACT FROM AUTHOR]

Limited longitudinal data exist on patient-reported outcomes (PROs) after acute lateral ankle sprain (LAS). The impact of prospective hop testing on PROs at return to play (RTP) and 6 months post-RTP is unclear. To determine if high school athletes with an LAS who return to baseline physical function as measured by a single-leg hop for distance (SLHOP) have better PROs relative to individuals who return to symmetry. Cohort study. Ten high schools over 2 years. Two hundred six high school athletes who sustained an LAS were included. Baseline SLHOP testing was completed preinjury. Patient-reported outcomes were recorded at time of injury, RTP, and 6 months post-RTP. Participants were classified as symmetry (n = 134) or restorative (n = 72). Symmetry was defined as achieving an SLHOP performance within 10% of the uninjured limb at RTP. Restorative was defined as achieving an SLHOP performance within 10% of preinjury levels. The Foot and Ankle Ability Measure (FAAM)–Activities of Daily Living, FAAM-Sport, Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, and PROMIS Depression were analyzed using a 2-way nonparametric analysis of variance. The interaction term of group by time was the main comparison of interest and was interpreted if significant. Post hoc multiple comparisons were performed using the Tukey-Kramer test. The restorative group reported better FAAM scores at RTP and 6 months post-RTP (P <.05) relative to the symmetry group. There were no differences in PROMIS Anxiety scores at time of injury, RTP, or 6 months post-RTP between groups (P >.05). There were no differences in PROMIS Depression scores at time of injury between groups (P =.34), but the restorative group had worse PROMIS Depression scores at RTP (P =.03). The restorative group reported better FAAM-ADL and FAAM-Sport scores at RTP and 6 months post-RTP relative to the symmetry group. Restoring individuals to baseline physical function rather than limb symmetry may ensure better PROs after an LAS. [ABSTRACT FROM AUTHOR]

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Objective: To investigate the epidemiology of injuries and risk factors in Raipur, Chhattisgarh, India. Methods: A community-based cross-sectional study was conducted in 10 selected wards of Raipur. Data were collected from injured individuals using a structured questionnaire. Socio-demographic characteristics, injury mechanisms, medical care-seeking behavior, and outcomes were assessed. Results: 312 individuals with injuries were included, with 193 men and 119 women. Males were more likely to be injured than females (61.86% v.s. 38.14%). Younger adults aged 21-30 were at highest risk (21.5%). The most common injuries were falls (38.8%) and road traffic accidents (34.9%). Injuries occurring on-road are the most frequent, followed by, at home with a highly significant association (P <0.001). Most individuals sought medical care (90.1%), primarily in private facilities (51.3%). Conclusions: This study provides valuable insights into the epidemiology of injuries in Raipur. The findings can inform the development of evidence-based interventions to reduce the burden of injuries and improve the health and well-being of the population. [ABSTRACT FROM AUTHOR]

Objective: Atrial fibrillation (AF) is one of the most common arrhythmic disorders worldwide. This study aims to describe the prevalence of AF in various cities in Indonesia using single‐lead hand held electrocardiography linked to a smartphone‐based application. Methods: This is a cross‐sectional epidemiological study conducted at tertiary hospital of major cities in Indonesia, between January 2018 and July 2019. The AliveCor Kardia™ Mobile system device was used as a screening tool for AF and confirmed its finding with clinical diagnoses made by cardiologists. Results: A total of 9773 subjects were enrolled in this study. The prevalence of AF reported by the device and cardiologist was 3.2% and 3.5%, respectively. AF prevalences are equal in men than women. The majority of subjects (56%) are having low risk for stroke or systemic thromboembolism. Prevalence of risk factors such as heart failure, hypertension, diabetes, and history of stroke among AF patients were 50%, 22.9%, 31.9%, 13.5%, and 5.8%, respectively. Conclusion: The prevalence of AF at referral hospitals visitors based on smartphone diagnosis in Indonesia is 3.2%. [ABSTRACT FROM AUTHOR]

Objective: To investigate the factors associated with diabesity in older women. Methods: This epidemiological study used a cross‐sectional design and included 196 older women (72.70 ± 7.20 years) from Jequié, Bahia, Brazil. Diabesity was defined as having both an elevated abdominal circumference (≥88 cm) and diabetes mellitus. For the inferential analyses, we constructed crude models followed by a multiple hierarchical explanatory model, with the following levels: Level 1 (socioeconomic variables), Level 2 (behavioral aspects), and Level 3 (health conditions). Poisson regression with a robust estimator was employed, and we calculated Prevalence Ratios (PR) with 95% Confidence Intervals (CI). Results: The prevalence of abdominal obesity, diabetes mellitus, and diabesity were 79.60%, 27.80%, and 22.40%, respectively. Women who were insufficiently active had a higher likelihood of diabesity (PR: 2.04; 95% CI: 1.22–3.41), as did those who spent more time in sedentary behavior (PR: 1.81; 95% CI: 1.04–3.16), used three or more continuous medications (PR: 2.51; 95% CI: 1.29–4.89), or reported a negative self‐perception of health (PR: 2.57; 95% CI: 1.03–5.80). Conclusion: The study identified several factors associated with diabesity in older women: insufficient physical activity, prolonged sedentary behavior, polypharmacy, and negative self‐perception of health. [ABSTRACT FROM AUTHOR]

In modern medicine, studies devoted to the assessment of the parameters of residential infrastructure and the population's attitude towards them have become quite large-scale. Objectives: The aim of the study was to establish associations between individually perceived parameters of residential infrastructure and the main modifiable cardiovascular risk factors (hypertension, obesity, lipid and carbohydrate metabolism disorders) in one of the subjects of the Russian Federation. Methods: The epidemiological study "Study of the influence of social factors on chronic non-communicable diseases" started in 2015 and ended in 2023. The sample was formed by using the stratification method based on the assignment to a medical organization. The study included 1598 respondents aged 35 to 70 years (491 rural residents). The study of infrastructure parameters was conducted based on the subjective opinions of respondents using the neighborhood environment walkability scale (NEWS) questionnaire, divided into eight scales. Logistic regression analysis was used to identify associations between infrastructure parameters and cardiovascular risk factors; the odds ratio (OR) and 95% confidence interval were evaluated. Results: Individually perceived infrastructure parameters of the scale B, reflecting the accessibility of infrastructure facilities, were associated with hypertension [OR = 1.33], obesity [OR = 1.40], and abdominal obesity [OR = 1.59]. Elements of the social infrastructure of the scale C, describing the streets in the residential area, increased the likelihood of developing obesity [OR = 1.42] and visceral obesity [OR = 1.43]. The characteristics of the residential area, represented by the scale D that evaluates pedestrian infrastructure, were associated with all major cardiovascular risk factors (hypertension [OR = 1.65], obesity [OR = 1.62] and abdominal obesity [OR = 1.82], and disorders of lipid [OR = 1.41] and carbohydrate metabolism [OR = 1.44]). Conclusion: Social factors represented by various aspects of infrastructure have become important criteria for determining cardiovascular health. Environmental conditions affect cardiovascular risk factors through behavioral patterns that shape the respondent's lifestyle. Interventions in urban planning—increasing accessibility to infrastructure facilities for the population, developing a pedestrian-friendly urban environment, improving physical activity resources in areas, planning recreation areas, and landscaping—can become the most important concept for the prevention of cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Background/Objectives: Intensive care unit (ICU) e-referrals are an important indicator for exploring potential deficiencies in critical care resources. This study aimed to examine the epidemiology and patterns of ICU e-referrals across all regions of Saudi Arabia during the COVID-19 pandemic using routinely collected data from April 2020 to December 2021. Methods: This descriptive epidemiological study analyzed data from the Saudi Medical Appointments and Referrals Centre (SMARC). This study reveals novel regional ICU e-referral patterns for critical cases using national unique digital health data, adding insights beyond the existing literature. Variables included age, sex, referral timing, reason, specialty, and region of origin. Descriptive statistics and mapping of administrative areas were performed based on e-referral request rates per 10,000 population. Results: During the study period, 36,619 patients had ICU e-referral requests. The mean age was 54.28 years, with males constituting 64.81% of requests. Out-of-scope e-referrals comprised 71.44% of requests. Referrals related to medical specialties, such as cardiology and pulmonology, were the most common (62.48%). Referral patterns showed peaks in July–August 2020 and May 2021. The Northern Border and Albaha areas had the highest request rates per population, potentially reflecting a higher proportion of severe cases requiring ICU-level care compared to other regions. Conclusions: The temporal pattern and geographic distribution of ICU e-referrals mirrored previously reported critical COVID-19 cases in Saudi Arabia. Preventive measures and vaccination programs contributed to a significant decline in ICU e-referral requests, suggesting a positive impact on controlling severe COVID-19 cases. Population-adjusted analysis revealed regional disparities, highlighting the importance of considering population size in healthcare resource management and policy. [ABSTRACT FROM AUTHOR]