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Objective: To describe sex differences in concussion characteristics in US Service Academy cadets. Design: Descriptive epidemiology study. Setting: Four US service academies. Participants: 2209 cadets (n = 867 females, n = 1342 males). Independent Variable: Sex. Outcome Measures: Injury proportion ratios (IPR) compared the proportion of injuries by sex (females referent) for injury situation, certainty of diagnosis, prolonged recovery, recurrent injuries, mental status alterations, loss of consciousness (LOC), posttraumatic amnesia (PTA), retrograde amnesia (RGA), motor impairments, delayed symptom presentation, and immediate reporting. Main Results: Concussions from varsity/intercollegiate sports [IPR of 1.73, 95% confidence interval (CI) 1.43–2.10] and intramurals (IPR of 1.53, 95% CI 1.02–2.32) accounted for a larger proportion in males, whereas concussions outside of sport and military activities accounted for a smaller proportion among males (IPR of 0.70, 95% CI 0.58–0.85). The proportion of concussions with prolonged recovery was lower among males (IPR of 0.69, 95% CI 0.60–0.78), while concussions with altered mental status (IPR of 1.23, 95% CI 1.09–1.38), LOC (IPR of 1.67, 95% CI 1.17–2.37), PTA (IPR of 1.94, 95% CI 1.43–2.62), and RGA (IPR of 2.14, 95% CI 1.38–3.31) accounted for a larger proportion among males. A larger proportion of concussions that were immediately reported was observed in males (IPR of 1.15, 95% CI 1.00–2.31). Proportions of other characteristics (e.g., recurrent injuries) were not different between sexes. Conclusions: A higher proportion of concussions occurred outside of sport and military training for female cadets, who also displayed proportionally longer recovery times than males, despite males demonstrating a higher proportion of LOC, PTA, and RGA. Possible factors may include different mechanisms of injury outside of sport and military training, different biopsychosocial states associated with sex or injury context, and delayed injury reporting when outside of an observed environment, possibly secondary to perceived stigma about reporting injuries. [ABSTRACT FROM AUTHOR]

The enormous societal and individual consequences of mental health disorders and detrimental health behaviours in the general population are of paramount concern. Many argue that 'prevention is the best cure', pushing for the implementation of early (preventive) interventions. Key questions regarding early interventions include which population segment to target for screenings and what information these screenings should focus on. In line with previous efforts, this study aimed to identify which population segment holds the majority (≥ 80 %) of different economically costly outcomes in society, and whether child abuse before the age of 16 years predicts being part of that population segment. Epidemiological cohort study. This study used the Netherlands Mental Health Survey and Incidence Study-2, a Dutch epidemiological cohort study including 6646 adults aged 18–64 years at baseline, spanning four timepoints from 2007 to 2018. Cumulative distributions were computed to identify high-cost population segments of economically costly outcomes in adulthood (i.e., mental and physical health [behaviours], unemployment and work absenteeism). Child abuse was examined as a potential predictor of these segments and the risk of multiple high-cost population segment membership was investigated by conducting Poisson regressions. A 20 % population segment carried between 42 % and 100 % of economically costly outcomes. Being exposed to more child abuse predicted being in a high-cost population segment, albeit with small effect sizes. Being exposed to more child abuse also predicted belonging to multiple high-cost population segments across different economically costly outcomes. The study findings have implications for policy makers. Emphasis should be placed on prevention aimed at identifying potential members of multiple high-cost population segments. [ABSTRACT FROM AUTHOR]

The objective of this study was to analyse the global, regional, and national burdens of ischaemic heart disease (IHD) in adults aged 15–49 years and its attributable risk factors from 1990 to 2019. Epidemiological study. Data were obtained from the Global Burden of Disease (GBD) Study 2019. The estimated annual percentage change was used to evaluate temporal trends in incidence, deaths, and disability-adjusted life years (DALYs) of youth IHD. We selected IHD-associated risk factors, including five environmental/occupational factors, 16 behavioural risks, and five metabolic factors. We computed the age-standardised rates and percentage of age-standardised DALY rates attributable to these factors of youth IHD. Globally, there were 2.26 million cases of incidence, 0.63 million deaths, and 30.58 million DALYs in 2019. The age-standardised incidence, death, and DALY rates decreased from 1990 to 2019, whereas the absolute number of incidences, deaths, and DALYs increased significantly. Globally, approximately 94.1% of age-standardised DALY rates from IHD in youths aged 15–49 years are attributable to risk factors listed in the GBD 2019 dataset. The leading global and regional risk factors for youth IHD in 2019 were high low-density lipoprotein cholesterol (68.9%), high systolic blood pressure (51.2%), high body mass index (33.1%), smoking (30.5%), and ambient particulate-matter pollution (25.4%). The burden of IHD among young people is still heavy, and metabolic risk factors are the leading drivers of IHD. Therefore, formulating relevant policies to control and treat cardiovascular risk factors is an effective measure to reduce the IHD burden in youth. [ABSTRACT FROM AUTHOR]

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

This critical review considers the status of 21st-century epidemiological theories of disease distribution, updating to 2024 prior analyses published up through 2014, and discusses the implications of these theories for research, practice, and pedagogy. Three key trends stand out: (a) the continued dominance of individualistic biomedical and lifestyle theories; (b) growth and elaboration of social epidemiological alternatives; and (c) the ongoing inattention to epidemiologic theories of disease distribution in the training of epidemiologists and public health professionals and in current efforts to improve the rigor of epidemiological research and causal inference. In a context of growing global political polarization, climate crisis, broader environmental and ecological crises, and stubbornly persistent health inequities within and between nations, producing actionable knowledge relevant to improving the people's health and advancing health justice will require much greater engagement with social epidemiologic theories of disease distribution in research, pedagogy, and practice. At issue is critically engaging with the embodied truths manifested in the stories bodies tell in population patterns of health, disease, and well-being. [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]

Objective: To describe the epidemiology of hamstring tears in National Collegiate Athletic Association (NCAA) sports. Design: Descriptive epidemiology study. Athletic trainers from NCAA schools reported injuries to the NCAA Injury Surveillance Program. Setting: A convenience sample of NCAA hamstring tear injuries during the 2014/2015 through 2018/2019 academic years. Patients (or Participants): NCAA student-athletes. Independent Variables: Sport, sex, event type, season segment, injury history, and activity at the time of injury. Main Outcome Measures: Injury counts, rates, and proportions were used. Results: Two thousand ninety-six hamstring tears from 8 474 400 athlete-exposures (AEs) were reported (2.47 per 10 000 AEs). Rates were highest in Men's Soccer (5.97 per 10 000 AEs) and Women's Soccer (3.13 per 10 000 AEs), among all Men's and Women's sports, respectively. Competition-related rates in Men's and Women's sports were highest in 2015 to 2016 then followed a decreasing pattern across the remainder of the study period. Among sex-comparable sports, rates were higher in men's (compared with women's) Baseball/Softball, Soccer, and Track and Field. The prevalence of recurrent injuries was comparable among men's (14.8%) and women's (11.5%) sports. Time loss hamstring tears were more prevalent in Men's sports than Women's sports [injury proportion ratio 5 1.33; 95% confidence interval, (1.21, 1.47)]. Conclusions: Overall, hamstring tear rates were higher across all Men's sports compared with Women's sports. Rates across event type were comparable in several sports; and so, adjustments to practice are needed considering that practice environments are more modifiable than competitions. Indeed, improving hamstring tear prevention programs to reduce the burden of this injury in NCAA athletes remains critical. [ABSTRACT FROM AUTHOR]

The aim of this literature review was to identify and provide a summary update on the validity and applicability of the most promising dietary biomarkers reflecting the intake of important foods in the Western diet for application in epidemiological studies. Many dietary biomarker candidates, reflecting intake of common foods and their specific constituents, have been discovered from intervention and observational studies in humans, but few have been validated. The literature search was targeted for biomarker candidates previously reported to reflect intakes of specific food groups or components that are of major importance in health and disease. Their validity was evaluated according to 8 predefined validation criteria and adapted to epidemiological studies; we summarized the findings and listed the most promising food intake biomarkers based on the evaluation. Biomarker candidates for alcohol, cereals, coffee, dairy, fats and oils, fruits, legumes, meat, seafood, sugar, tea, and vegetables were identified. Top candidates for all categories are specific to certain foods, have defined parent compounds, and their concentrations are unaffected by nonfood determinants. The correlations of candidate dietary biomarkers with habitual food intake were moderate to strong and their reproducibility over time ranged from low to high. For many biomarker candidates, critical information regarding dose response, correlation with habitual food intake, and reproducibility over time is yet unknown. The nutritional epidemiology field will benefit from the development of novel methods to combine single biomarkers to generate biomarker panels in combination with self-reported data. The most promising dietary biomarker candidates that reflect commonly consumed foods and food components for application in epidemiological studies were identified, and research required for their full validation was summarized. [ABSTRACT FROM AUTHOR]

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

Background: American football is the most popular sport in the United States, with over 5.6 million people >6 years old playing the sport. Fractures in American football athletes are significant, as they compromise an athlete's performance and can also lead to prolonged recovery periods, affecting team dynamics and player careers. Analyzing these injuries is critical to evaluate preventive measures and tailor rehabilitation strategies to ensure the well-being and sustained peak performance of football athletes on and off the field. Purpose: To analyze the trend of American football fractures by body site, sex, and age in amateur athletes over a 20-year period between 2002 and 2021. Study Design: Descriptive epidemiology study. Methods: The National Electronic Injury Surveillance System (NEISS) database was queried to characterize football-related fractures and injuries from 2002 to 2021 in patients aged 0-99 years old. National injury estimates were calculated using sample weights. Chi-square analysis and one-way ANOVA were performed to compare categorical variables. Results: Of 56,809 cases of American football-related fractures over 20 years, patients aged 10 to 14 years had the highest incidence of fractures, composing 41.2% of all fractures (n = 23,389), and patients aged <18 years represented 88.8% of all fractures (n = 50,457). The median age of players when fractures occurred was 13 years. Upper extremity fractures (n = 41,863 [73.7%]) were the most common fracture reported compared with lower extremity and head, neck, and trunk fractures. Among upper extremity fractures, finger fractures had the highest prevalence (35.6%), followed by lower arm fractures (19.9%) and wrist fractures (13%). While most cases resulted in release after treatment (93.1%), 5.9% resulted in treatment and hospitalization. When analyzing trends in American football-related fractures over time, we observed the largest number of fractures in 2006 (n = 3664), while the smallest number of fractures occurred in 2020 (n = 1313). Also, a downward trend was found in American football-related fractures since 2006, with a mean of 101 fewer fractures each year. Conclusion: Our analysis showed that American football-related fractures diagnosed in the emergency department in the United States were most likely to occur in pediatric patients (10-18 years old). In addition, patients experiencing American football-related fractures were most likely to have an upper extremity fracture and not require hospitalization. The trend in American football-related fractures has been decreasing since 2006. [ABSTRACT FROM AUTHOR]

Objective: This study aims at investigating how AI-based transformers can support researchers in designing and conducting an epidemiological study. To accomplish this, we used ChatGPT to reformulate the STROBE recommendations into a list of questions to be answered by the transformer itself. We then qualitatively evaluated the coherence and relevance of the transformer's outputs. Study design: Descriptive study. Methods: We first chose a study to be used as a basis for the simulation. We then used ChatGPT to transform each STROBE checklist's item into specific prompts. Each answer to the respective prompt was evaluated by independent researchers in terms of coherence and relevance. Results: The mean scores assigned to each prompt were heterogeneous. On average, for the coherence domain, the overall mean score was 3.6 out of 5.0, and for relevance it was 3.3 out of 5.0. The lowest scores were assigned to items belonging to the Methods section of the checklist. Conclusions: ChatGPT can be considered as a valuable support for researchers in conducting an epidemiological study, following internationally recognized guidelines and standards. It is crucial for the users to have knowledge on the subject and a critical mindset when evaluating the outputs. The potential benefits of AI in scientific research and publishing are undeniable, but it is crucial to address the risks, and the ethical and legal consequences associated with its use. [ABSTRACT FROM AUTHOR]

Intimate partner or marital/spousal rape is a phenomenon with unique characteristics and dynamics. Furthermore, it is an under-explored, under-defined, under-reported, and widely tolerated phenomenon. Gender-based violence and intimate partner violence are the main topics of the present study. The study aimed at exploring the trends in reported intimate partner and marital/spousal rape, within the wider context of reported domestic violence during the years 2020 and 2021 in Greece. Statistical analysis has not indicated positive correlation between the rate of reported domestic violence per year and the rate of reported domestic rape per year, with the former following an upward trend and the latter maintaining an almost steady course. Similarly, the rate of reported victims of intimate partner rape per year remained almost stable within in the 2 years. Importantly however, in 2021, the rate of reported victims of marital rape per year increased remarkably compared to 2020. In 2021, the rates of reported domestic violence per month and reported domestic rape per month indicated remarkable increase over the period May to December 2021. Notwithstanding, the rates mentioned above remained almost stable over the year 2020, showing an upward trend during the summer months. In August 2020 and 2021 the abovementioned rates reached their peak. In both years, the vast majority of victims of domestic rape were females, mostly between 30 and 45 years of age. The present study indicated an increase in rates of reported domestic violence and reported domestic rape per month after the lockdowns, especially after the second long-lasting lockdown that ended in May 2021. This increase, however, might be only apparent. Further research is needed to study the epidemiology of intimate partner and marital rape over a much longer timespan to provide further insight into the dynamics surrounding a public health concern. [ABSTRACT FROM AUTHOR]

Background: There are limited data on the epidemiology of anterior cruciate ligament (ACL) ruptures in elite adult soccer players, especially in the Russian Premier League (RPL). There is an increased risk of injury due to a combination of additional risk factors such as playing in extremely high and low temperatures, frequent long flights, and regular play on natural and artificial surfaces. Purpose: To study the epidemiology of ACL ruptures and determine the patterns associated with their occurrence in RPL soccer players. Study Design: Descriptive epidemiology study. Methods: All ACL ruptures requiring surgery sustained by players competing in the RPL across 12 competitive seasons between 2010 and 2022 were analyzed. All required data were collected from media analysis and confirmed by club doctors. Results: A total of 85 players sustained 100 injuries during 12 competitive seasons. A total of 96.5% of players returned to competitive play. The injury incidence in RPL and during participation of RPL teams in European Cups were 0.4760 and 0.5622 per 1000 playing hours, respectively. When analyzing the outcomes of the primary ACL surgery (a total of 76 operations), the following data were obtained: in 11 cases (14.5%), there was a reinjury on the ipsilateral knee joint and in 4 cases (5.3%) on the contralateral knee joint. The mean return–to-play time after all operations was 284 ± 116 days. The time of return to play after primary reconstruction was 289 ± 136 days, 278 ± 91 days after reconstruction on the contralateral knee and 271 ± 51.5 days after the first ACL revision reconstruction on the ipsilateral knee joints. Conclusion: RPL ACL injury epidemiology is similar to that in the other leagues from around the world, although there are factors that can potentially influence the number of these injuries. [ABSTRACT FROM AUTHOR]

Background: Concussions make up a significant proportion of sports injuries. This study aimed to describe the mechanisms of injury and associated symptoms of pediatric patients diagnosed with concussions (age range, 4-17 years) from contact sports. Hypothesis: Mechanisms of injury would differ based on sex and age, with female athletes and younger athletes aged 4 to 11 years sustaining fewer concussions from player-to-player contact. Study Design: Descriptive epidemiology study. Methods: The National Electronic Injury Surveillance System was queried for all contact sport concussions presented to United States emergency departments. The sports analyzed included basketball, football, soccer, hockey, rugby, and lacrosse. Descriptive data, mechanisms of injury, and associated symptoms were analyzed for each sport. Differences in the number of concussions sustained by year and sport, the severity of the injury, and associated symptoms were compared using chi-square test, and differences in proportion were calculated for mechanisms of injury stratified by sex and age. Results: A total of 12,602 youth athletes sustained concussions between 2012 and 2021. Most patients were male (78.5%), with a mean age of 13.48 years. Football concussions were the most common, with 45.32% of the concussions. The mechanism of injury was largely sport-specific, with player-to-player contact the most common overall. Older male athletes were more likely to have concussions from player-to-player contact, whereas younger athletes were more impacted by head-to-ground mechanisms. Symptom presentation was not sport-specific, and headache and dizziness were the most common presentation at 41.2% and 26.2%, respectively. Conclusion: The most important overall mechanism of injury was player-to-player contact, especially in older male youth athletes, whereas younger athletes were more likely to be concussed due to head-to-ground injuries. [ABSTRACT FROM AUTHOR]

Background: In males, the relationship between pubertal timing and depression is understudied and less consistent than in females, likely for reasons of unmeasured confounding. To clarify this relationship, a combined epidemiological and genetic approach was chosen to exploit the methodological advantages of both approaches. Methods: Data from 2026 males from a nationwide, representative study were used to investigate the non-/linear relationship between pubertal timing defined by the age at voice break and depression, considering a multitude of potential confounders and their interactions with pubertal timing. This analysis was complemented by Mendelian randomization (MR), which is robust to inferential problems inherent to epidemiological studies. We used 71 single nucleotide polymorphisms related to pubertal timing in males as instrumental variable to clarify its causal relationship with depression based on data from 807 553 individuals (246 363 cases and 561 190 controls) by univariable and multivariable MR, including BMI as pleiotropic phenotype. Results: Univariable MR indicated a causal effect of pubertal timing on depression risk (inverse-variance weighted: OR 0.93, 95%-CI [0.87–0.99)], p = 0.03). However, this was not confirmed by multivariable MR (inverse-variance weighted: OR 0.95, 95%-CI [0.88–1.02)], p = 0.13), consistent with the epidemiological approach (OR 1.01, 95%-CI [0.81–1.26], p = 0.93). Instead, the multivariable MR study indicated a causal relationship of BMI with depression by two of three methods. Conclusions: Pubertal timing is not related to MDD risk in males. [ABSTRACT FROM AUTHOR]

The research of Mendel, born two centuries ago, still has many direct implications for our everyday clinical work. He introduced the terms "dominant" and "recessive" characters and determined their 3:1 ratio in the offspring of heterozygous "hybrid" plants. This distribution allowed calculation of the number of the phenotype-determining "elements," i.e., the alleles, and has been used ever since to prove the monogenic origin of a disorder. The Mendelian inheritance of monogenic kidney disorders is still of great help in distinguishing them from those with multifactorial origin in clinical practice. Inheritance of most monogenic kidney disorders fits to Mendel's observations: the equal contribution of the two parents and the complete penetrance or the direct correlation between the frequency of the recessive character and the degree of inbreeding. Nevertheless, beyond the truth of these basic concepts, several observations have expanded their genetic characteristics. The extreme genetic heterogeneity, the pleiotropy of the causal genes and the role of modifiers in ciliopathies, the digenic inheritance and parental imprinting in some tubulopathies, and the incomplete penetrance and eventual interallelic interactions in podocytopathies, reflect this expansion. For all these reasons, the transmission pattern in a natural setting may depend not only on the "character" but also on the causal gene and the variant. Mendel's passion for research combined with his modest personality and meticulous approach can still serve as an example in the work required to understand the non-Mendelian universe of genetics. [ABSTRACT FROM AUTHOR]

This study aims to investigate the association between Body Mass Index (BMI) and sex hormone levels utilizing a cross-sectional study design alongside Mendelian randomization (MR) analysis. A cross-sectional study was performed based on National Health and Nutrition Examination Survey (NHANES) 2013–2016. Additionally, a two-sample MR analysis was performed, utilizing Single Nucleotide Polymorphisms (SNPs) associated with BMI identified in a genome-wide association study (GWAS) comprising 339224 individuals. Data on outcomes, including total testosterone (TT, 199569 samples), estradiol (E 2 , 17134 samples), and sex hormone binding globulin (SHBG, 185211 samples), were sourced from the United Kingdom Biobank (UKB). In cross-sectional analysis involving 4092 males, multivariable linear regression demonstrated that each unit increase in BMI was positively correlated with an elevated risk of testosterone deficiency (TD), increased E 2 levels, and a reduced TT, SHBG, free androgen index and TT/E 2. Subsequent quartile division of BMI revealed, through multivariable logistic regression, that higher BMI quartiles were associated with a greater TD risk, elevated E 2 levels, and reduced TT, SHBG, and TT/E 2 levels compared to quartile 1 (P for trend <0.001). In the MR analysis, a causal effect was established, with each unit increase in BMI being associated with decreased TT (β = −0.17; 95 % CI −0.24 to −0.09) and SHBG (β = −0.13; 95 % CI −0.21 to −0.05) levels. Our findings unveil a causal link between BMI and reduced TT and SHBG levels in males. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the level of awareness of skin cancer among the Prospective Epidemiological Research Studies in Iran (PERSIAN) Guilan cohort study (PGCS) population. Methods: This cross-sectional study was conducted on 625 participants of PGCS in Guilan, Iran, in 2022. The demographic and clinical information of the participants was recorded, and individuals with a history of skin cancer were excluded from the study. The awareness about skin cancer was collected using a questionnaire containing 26 questions with a cutoff score of 13 as an average score. All data were analyzed using IBM SPSS Version 21, considering a significance level < .05. Results: Out of 625 participants, 41.84% weremale. About 218 (32.9%) participants had a level of awareness about skin cancer higher than the average, in which 169 (25.5%), 276 (41.7%), 18 (2.8%), and 134 (20.2%) of participants had a higher-than-average score in epidemiology, causes, clinicalmanifestations, and prevention and treatment fields, respectively. The findings illustrated that the awareness score about skin cancer was significantly different based on gender, source of information on causes, and scope of clinical manifestations (p < .05). Also, the level of education and visiting a doctor could significantly affect the level of awareness (p < .05). Conclusion: The PGCS population had low awareness of skin cancer. Identifying knowledge gaps can guide the development of targeted educational resources. Dermatology nurses can play a key role in creating and implementing health education programs that promote early detection of cancer symptoms, starting with increasing knowledge about early warning signs. [ABSTRACT FROM AUTHOR]

Ankle-foot injuries are ubiquitous in the US military, with Achilles tendinopathy a common condition that affects function and health-related quality of life. To evaluate the burden and associated factors of Achilles tendinopathy. Descriptive epidemiology study. The Defense Medical Epidemiological Database was used to identify relevant health care encounters. All active duty and reserve military members who served between 2006 and 2015 (officers = 2 149 887; enlisted = 9 503 995). Multiyear prevalence of Achilles tendinopathy care episodes was calculated and compared by military rank, service branch, and year. Unadjusted and adjusted assessments of injury burden were calculated. Officers incurred 37 939 episodes at a prevalence of 17.65 per 1000 servicemembers (male officers = 18.20 per 1000 servicemembers, female officers = 14.80 per 1000 servicemembers). Among enlisted personnel, 116 122 episodes of Achilles tendinopathy occurred in 12.22 per 1000 servicemembers (male enlisted = 12.07 per 1000 servicemembers, female enlisted = 13.22 per 1000 servicemembers). All officer specialties had a higher burden of Achilles tendinopathy episodes than the ground and naval gunfire officers (prevalence ratio [PR] = 1.04–1.43) except for aviation, which demonstrated a lower burden (PR = 0.65). Among enlisted occupations, maritime or naval specialties had a lower burden of Achilles tendinopathy than infantry (PR = 0.82) and all other specialties except for aviation, which had a higher burden (PR = 1.07–1.71). Multiple associated factors were identified: sex, age, rank, military occupation, and service branch. Achilles tendinopathy was ubiquitous in the US military, with a progressive increase in prevalence during the study epoch. Sex, age, rank, military occupation, and service branch were identified as associated factors. These findings highlight the need for both prophylactic interventions and identification of the populations with the greatest need. [ABSTRACT FROM AUTHOR]

There is limited information on the prevalence and etiology of urolithiasis, although it is considered a common condition in chelonians. Several hypotheses regarding urolith formation in chelonians have been proposed, but none has been tested by epidemiological research. The objective of this study was to evaluate the prevalence of urolithiasis in a large number of chelonians and to evaluate the association between housing and dietary conditions and urolithiasis in African spurred tortoises (Centrochelys sulcata). Records of all client-owned chelonians that underwent radiographs at two institutions were extracted. Univariable and multivariable logistic regression models were built to explore associations between the presence of urolithiasis and husbandry variables. Prevalence of urolithiasis was 4.4% (95% confidence interval [CI]: 3.3–5.9%; 46/1,033) among all chelonians. Terrestrial chelonians had 64 times the odds (odds ratio [OR]: 64.2; 95% CI: 15.4–266.6; P < 0.001) of presenting urolithiasis compared with aquatic chelonians. African spurred tortoises had 22 times the odds (OR: 22.3; 95% CI: 7.7–64.5; P < 0.001) of presenting urolithiasis compared with other terrestrial chelonians. African spurred tortoises living in a confined indoor area had 3 times the odds of presenting urolithiasis compared with the tortoises living outdoors (OR: 3.01; 95% CI: 1.06–8.55; P = 0.038), and African spurred tortoises that were not fed any fruit had 0.31 times the odds of presenting urolithiasis compared with the tortoises fed fruit (OR: 0.31; 95% CI: 0.10–0.99; P = 0.049). Certain chelonians in captivity are at higher risk than others of suffering urolithiasis. African spurred tortoises in a confined indoor area had the highest risk of developing urolithiasis. As a precaution, avoiding fruit should be considered in the diet of African spurred tortoises. [ABSTRACT FROM AUTHOR]

Background: While prevention protocols have been implemented, skiing-related musculoskeletal injuries and concussions continue to present to emergency departments in the United States. Previous literature has suggested the pediatric population may constitute up to 40% of skiing-related injuries. Purpose: To assess injury trends and the underlying mechanisms of skiing injuries in pediatric patients seen at emergency departments in the United States. Study Design: Descriptive epidemiology study. Methods: The National Electronic Injury Surveillance System (NEISS) was queried for pediatric (age ≤18 years) skiing injuries between January 1, 2012, and December 31, 2022. Injury mechanism, location, disposition, and diagnosis were recorded, and the statistical sample weight assigned by NEISS by hospital was used to calculate national estimates (NEs). Injury trends were evaluated with linear regression analysis. Results: Overall, 2951 pediatric skiing injuries were included (NE = 123,386). The mean age of the patients was 12.4 ± 3.5 years, with 61.3% of the injuries occurring in male patients. Impact with the ground was the most common injury mechanism (NE = 87,407; 70.8%). Fractures were the most common diagnosis (NE = 38,527, 31.2%), followed by strains/sprains (NE = 22,562, 18.3%), contusions/abrasions (NE = 16,257, 13.2%), and concussions (NE = 12,449, 10.1%). The lower leg was the most common fracture site (NE = 9509, 24.7%), followed by the shoulder (NE = 7131, 18.5%) and lower arm (NE = 5876, 15.3%). Analysis of annual injuries revealed no significant trend between 2012 and 2022 (P =.17), with fluctuations apparent throughout the study period. Significant decreases were seen in strains/sprains (P <.01) and contusions/abrasions (P <.01), but not in concussions (P =.57) or fractures (P =.70). Conclusion: Impacts with the snow/ground made up 70.8% of all injuries. Fractures were the most common injury diagnosis, followed by strains/sprains, with the lower leg being most frequently fractured. While strains/sprains and contusions/abrasions showed a significant decline, there were no significant trends in fractures and concussions between 2012 and 2022. [ABSTRACT FROM AUTHOR]

Background: Pickleball is one of the fastest-growing sports in the United States, with more than an 11-fold increase in injuries from 2010 to 2019. Purpose: To (1) determine the prevalence and demographic variables associated with pickleball-related fractures among patients evaluated at emergency departments in the United States between 2002 and 2022 and (2) identify variables influencing patient disposition status. Study Design: Descriptive epidemiology study. Methods: The US Consumer Product Safety and Commission's publicly available database, the National Electronic Injury Surveillance System (NEISS), was used in this study. Analyses consisted of descriptive statistics for fracture prevalence and demographic variables as well as univariate analysis for disposition status (discharged home vs hospital admission). Results: A total of 397 pickleball-related fractures were recorded between 2002 and 2022, which indicated a 90-fold increase in our study period. Based on weighted national average of NEISS sampling, this equated to approximately 5400 fractures annually. Players who sustained pickleball fractures were primarily aged >60 years (n = 344 [87%]; P <.001) and female (n = 273 [69%]; P <.001). Most fractures involved the upper extremity (n = 262 [66%]; P <.001), with the most common ones involving the radius (n = 79 [30%]), humerus (n = 22 [8%]), and ulna (n = 8 [3%]). Fractures were due most commonly to falls (n = 365 [92%]; P <.001) and occurred in the winter months (n = 142 [36%]; P <.001). There was a significant difference in disposition status, with most patients discharged (n = 320 [81%] vs n = 77 [19%] for hospital admission; P <.001). Univariate analysis revealed that age >60 years, male sex, and fractures to the trunk and lower extremity all led to significantly increased odds of being admitted (odds ratios: 2.27, 2.31, 2.89, and 13.8, respectively). Conclusion: Between 2002 and 2022, there was a 90-fold increase in pickleball-related fractures. Most fractures were of the upper extremity after a fall in women aged >60 years. Despite female fracture predominance, men were 2.3 times more likely to be admitted after sustaining a fracture. [ABSTRACT FROM AUTHOR]

Purpose: The present research aimed to compare the different types of fractures to those caused by e-scooter use as well as reveal the severity of e-scooter injuries via an epidemiological analysis of fractures over the course of 6 months. Methods: This retrospective study assessed medical records of patients with fractures or dislocations admitted to a Turkish level three trauma centre emergency orthopaedic department between June 2021 and January 2022. Using a two-group design, the first group encompassed all fractures and dislocations treated, while the second focused on e-scooter-related cases. Comparative analysis covered fracture patterns and factors within the e-scooter group, like demographics, injury mechanism, and timing. Surgical need and types were explored for e-scooter injuries. Results: Among 4481 upper extremity fractures, finger fractures (27.47%) and distal radius fractures (25.37%) were common, while e-scooter-related cases exhibited radius and ulna shaft fractures (23.07%). Of 2400 lower extremity fractures, toe fractures (30.2%) and metatarsal fractures (19.66%) predominated, with e-scooter-related injuries largely featuring metatarsal fractures (30%). The surgery rate in all patients was 8.92%, whereas the surgery rate specifically for e-scooter injuries was 48.2%. Significantly greater occurrence of lower extremity fractures was evident in e-scooter-related injuries compared to upper extremities (p = 0.011). Collisions involving stationary or moving objects were linked to injuries in the lower extremities, whereas falls were primarily associated with injuries in the upper extremities. Treatment included surgery (48.2%) and conservative management (52.8%), with ORIF (35.7%) and CRIF (10.7%) utilised. Conclusion: E-scooter-related fractures and dislocations are typically more severe, often requiring surgery, compared to other fractures during the same period. The study emphasises the link between injury type and increased risk of lower extremity fractures or dislocations. [ABSTRACT FROM AUTHOR]

Purpose: Health care databases are a valuable source for epidemiological research on amyotrophic lateral sclerosis (ALS) if diagnosis codes are valid. We evaluated the validity of the diagnostic codes for ALS in the Danish National Patient Registry (DNPR). Patients and Methods: We obtained data from the DNPR for all adult (> 17 years) patients registered with ALS in Denmark between 1987 and 2022 (median population of 4.2 million during the study period). We randomly selected adult patients living in the North Denmark Region and Central Denmark Region (median population 1.4 million), with a primary discharge diagnosis code of ALS, diagnosed at three departments of neurology. We retrieved and reviewed medical records and estimated the positive predictive value (PPV) of the ALS diagnosis. Results: Over 36 years, we identified 5679 patients. From the validation cohort of 300 patients, we were able to retrieve 240 (80%) medical records, and 215 ALS diagnoses were confirmed. The overall positive predictive value was 89.6% (95% confidence interval (CI): 85.1– 92.8). The highest PPV was achieved for diagnoses registered for patients aged ≥ 70 years (93.8; 95% CI: 86.2– 97.3) compared to patients < 60 years (83.4; 95% CI: 73.3– 90.7). Conclusion: We found a high PPV of primary diagnostic codes for ALS from Danish departments of neurology, demonstrating high validity. Thus, the DNPR is a well–suited data source for large-scale epidemiological research on ALS. [ABSTRACT FROM AUTHOR]

Introduction: Brucellosis, a globally prevalent disease, affects both humans and animals, with notable significance in Iran. While the severity and mortality of this disease are rare, it poses a substantial economic burden due to reduced productivity and livestock abortion. Torbat Jam city has a high prevalence of brucellosis in the region, necessitating an investigation into its epidemiological aspects. Objectives: The present study aimed to investigate the epidemiology of brucellosis in Torbat Jam city. Materials and Methods: This study examined 5366 cases of brucellosis in the city of Torbat Jam from 2017 to 2022. A comprehensive checklist encompassing variables, such as age, gender, place of residence, occupation, season, history of contact with infected animals, consumption of unpasteurized dairy products, and vaccination history was used for data collection. The t-test was used to compare the means of two groups, while the chi-square test was employed to assess the relationship between categorical variables and grouped numerical variables. A significance level of 0.05 was considered in this study. Results: A total of 5366 cases of Malta fever were analyzed in this study, with male patients comprising 50.40% and female patients accounting for 49.60% of the cases. The mean age of the patients during the study period was 33.18±18.81 years. Brucellosis onset occurred at an average age of 35.39±18.03 years in males and 30.96±19.01 years in females, with a statistically significant difference (P value <0.01). The youngest reported case of brucellosis was 1 year old, while the oldest was 101 years old. The highest disease occurrence (60.8%) was observed in the age group of 15-50 years, with a higher prevalence observed in both genders within this age group. Conclusion: The city of Torbat Jam is considered a high-risk area in terms of brucellosis prevalence. Factors such as rural living, contact with animals and consumption of unpasteurized dairy products significantly contribute to the disease’s spread in these regions. The results underscore the insufficient public awareness regarding brucellosis transmission and prevention, highlighting the urgent need for educational programs to enhance knowledge and awareness among individuals in these areas. [ABSTRACT FROM AUTHOR]

One of the priorities in family and community care is the epidemiological surveillance of the care needs and dysfunctionality present in populations of highly complex chronic patients (HCCPs) using standardised nursing languages. The aim of this study is to establish the prevalence of care needs and dysfunctionality among HCCPs in a specific health area by municipalities and geographical areas (metropolitan, north, and south) while verifying correlations with sociodemographic, financial, and health characteristics. This is an epidemiological, observational, descriptive, cross-sectional study carried out with a sample of 51,374 HCCPs, whose data were grouped into 31 municipalities. Data were collected on the following variables: sociodemographic, financial, health, functional status (health patterns), and care needs (nursing diagnoses). The mean age of the HCCPs was 73.41 (1.45) years, of which 56.18 (2.86)% were women. The municipalities in the northern area have a significantly higher proportion of older patients, HCCPs, lower incomes, and higher unemployment rates. The southern area had higher proportions of non-Spanish nationals and professionals in the hotel and catering industry, and the metropolitan area had a higher proportion of employed individuals and higher levels of education. Northern municipalities had a higher prevalence of illnesses and anxiolytic and anti-psychotic treatments. Dysfunctionality frequencies did not differ significantly by area. However, a higher prevalence of 13 nursing diagnoses was observed in the north. A high number of correlations were observed between population characteristics, dysfunctionality, and prevalent diagnoses. Finally, the frequencies of dysfunctionality in the population and the most common care needs were mapped by municipality. This research sought to ascertain whether there was an unequal distribution of these two aspects among HCCPs in order to gain a deeper epidemiological understanding of them from a family and community perspective using standardised nursing languages. This study was not registered. [ABSTRACT FROM AUTHOR]

Background. Brain stroke is the second most common cause of death and the first cause of disability in Iran. Most stroke-related deaths occur in low- and middle-income countries. This epidemiological study was conducted due to insufficient studies and generally with a small sample size in the country, aiming at identifying the main risk factors for stroke in East Azarbaijan province. Methods. This cross-sectional study was performed using data gathered from 5430 patients with a definite diagnosis of brain stroke registered in the Tabriz Stroke Registration System (TSR) between February 2015 and June 2021 in the referral hospitals of East Azerbaijan. Analyses were performed using STATA software (version 17). Descriptive statistics were calculated, and a chi-square test was run. It is worth mentioning that any P<0.05 was considered statistically significant. Results. The epidemiological profile of the main risk factors was presented in the framework of clinical trials and findings, clinical risk factors, and behavioral risk factors associated with brain stroke. The mean age of the patients was 69.52±15.72 years; 47.15% were female and 52.85% were male. The most common risk factors include: having high blood pressure (67.81%), snoring (32.06%), diabetes mellitus (22.23%), familial history of stroke (18.78%), ischemic heart disease (17.55%), aspiration pneumonia (15.32%), smoking (13.65%), atrial fibrillation (10.15%), and hyperlipidemia (8.42%). Ischemic brain stroke (68.20%) was more common than hemorrhagic brain stroke (31.80%). Smoking was significantly higher in men than women (P<0.001). The prevalence of hypertension (P<0.001), atrial fibrillation (P=0.001), and hyperlipidemia (P<0.001) was significantly higher in women than men. There was a direct and significant relationship between atrial fibrillation and age (P<0.001) and female gender (P=0.001). Conclusion. The main risk factors for brain stroke include high blood pressure, snoring, diabetes mellitus, ischemic heart disease, aspiration pneumonia, smoking, atrial fibrillation, and hyperlipidemia, respectively. Hypertension is the most common risk factor among patients, so screening for asymptomatic cases is recommended. Educating people about common clinical manifestations can help expedite their early referral and treatment. [ABSTRACT FROM AUTHOR]

Context: Health care utilization and the occurrence of non-time-loss (NTL) lateral ankle sprains is not well documented in collegiate athletes but could provide better estimates of injury burden and inform clinician workload. Design: Descriptive epidemiologic study. Methods: Lateral ankle sprain injury occurrence for Division I collegiate student-athletes in a conference with 32 sports representing 732 team seasons was collected during the 2018–2019 through 2020–2021 academic years. Injuries were designated as acute or overuse, and time-loss (TL) or NTL. Associated health care utilization, including athletic training services (AT services), and physician encounters were reported along with anatomical structures involved and season of occurrence. Results: A total of 1242 lateral ankle sprains were reported over the 3 years from 732 team seasons and 17,431 player seasons, resulting in 12,728 AT services and 370 physician encounters. Most lateral ankle sprains were acute-TL (59.7%), which were associated with the majority of AT services (74.1%) and physician encounters (70.0%). Acute-NTL sprains represented 37.8% of lateral ankle sprains and were associated with 22.3% of AT services and 27.0% of physician encounters. On average, there were 12.7 (5.8) AT services per acute-TL sprain and 6.0 (3.6) per acute-NTL sprain. Most sprains involved "ankle lateral ligaments" (45.6%), and very few were attributed to overuse mechanisms (2.4%). Conclusions: Lateral ligament sprains are a common injury across many sports and result in substantial health care utilization from ATs and physicians, including NTL lateral ankle sprains. Although TL injuries were the majority of sprains, a substantial proportion of sprains were NTL and accounted for a considerable proportion of health care utilization. [ABSTRACT FROM AUTHOR]

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

Background: Most neurological diseases have no curative treatment; therefore, focusing on prevention is key. Continuous research to uncover the protective and risk factors associated with different neurological diseases is crucial to successfully inform prevention strategies. eHealth has been showing promising advantages in healthcare and public health and may therefore be relevant to facilitate epidemiological studies. Objective: In this study, we performed a Delphi consensus exercise to identify the key screening tests to inform the development of a digital neurological examination tool for epidemiological research. Methods: Twelve panellists (six experts in neurological examination, five experts in data collection—two were also experts in the neurological examination, and three experts in participant experience) of different nationalities joined the Delphi exercise. Experts in the neurological examination provided a selection of items that allow ruling out neurological impairment and can be performed by trained health workers. The items were then rated by them and other experts in terms of their feasibility and acceptability. Results: Ten tests and seven anamnestic questions were included in the final set of screening items for the digital neurological examination. Three tests and five anamnestic questions were excluded from the final selection due to their low ratings on feasibility. Conclusion: This work identifies the key feasible and acceptable screening tests and anamnestic questions to build an electronic tool for performing the neurological examination, in the absence of a neurologist. [ABSTRACT FROM AUTHOR]

Background: This study reviewed migraine prevalence and disability gathered through epidemiologic survey studies in the United States conducted over the past three decades. We summarized these studies and evaluated changing patterns of disease prevalence and disability. Methods: We conducted a systematic review of US studies addressing the prevalence, disability, and/or burden of migraine, including both episodic migraine (EM) and chronic migraine (CM). A Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) protocol was used in conjunction with the PubMed search engine. Eligible studies were published before February 2022, were conducted in the United States, included representative samples, and used a case definition of migraine based on the International Classification of Headache Disorders (ICHD). The primary measure of disease burden was the Migraine Disability Assessment Scale (MIDAS). The MIDAS measures days lost due to migraine over 3 months in three domains and defines groups with moderate (Grade III) or severe disability (Grade IV) using cut‐scores. Results: Of the 1609 identified records, 26 publications from 11 US population‐based studies met eligibility criteria. The prevalence of migraine in the population has remained relatively consistent for the past 30 years: ranging from 11.7% to 14.7% overall, 17.1% to 19.2% in women, and 5.6% to 7.2% in men in the studies reviewed. CM prevalence is 0.91% (1.3% among women and 0.5% of men) in adults and 0.8% in adolescents. The proportion of people with migraine and moderate‐to‐severe MIDAS disability (Grades III–IV), has trended upward across studies from 22.0% in 2005 to 39.0% in 2012, to 43.2% in 2016, and 42.4% in 2018. A consistently higher proportion of women were assigned MIDAS Grades III/IV relative to men. Conclusion: The prevalence of migraine in the United States has remained stable over the past three decades while migraine‐related disability has increased. The disability trend could reflect changes in reporting, study methodology, social and societal changes, or changes in exacerbating or remediating factors that make migraine more disabling, among other hypotheses. These issues merit further investigation. Plain Language Summary: We reviewed 11 population‐based studies that adhered to the International Classification of Headache Disorders to examine the prevalence and burden of migraine in the United States. While the prevalence of migraine has remained stable at ~12% of adults for the past 30 years (with higher rates in women), the burden of migraine, including disability and impact on work, academics, and social life, appears to be increasing. The escalating burden of migraine may result from factors like increased headache frequency or changes in study methodology, indicating a need for more population studies. [ABSTRACT FROM AUTHOR]

Background: Nearly 8 million high school students in the United States participate in sports each year. With the lack of recent population data, an update to previous studies on US high school athletes is needed. Purpose: To update the epidemiology of sports injuries in high school athletes in the United States. Study Design: Descriptive epidemiology study. Methods: The data from the National Health School Sports-Related Injury Surveillance Study, including 100 nationally representative high schools, were obtained for 9 high school sports (boys' football, soccer, basketball, wrestling, and baseball and girls' soccer, basketball, volleyball, and softball) between the 2015 and 2019 academic years. Injury rates were calculated as the ratio of injuries per 1000 athlete exposures (AEs), defined as 1 athlete participating in 1 practice or competition. Data on injured body area, injury type (sprains/strains, concussions, contusions, and fractures), time loss, and need for surgery were also obtained. Rate ratios (RRs) with 95% CIs and P values were calculated. Results: Athletic trainers reported 15,531 injuries during 6,778,209 AEs, with an overall rate of 2.29 injuries per 1000 AEs. Injury rates were highest in football (3.96), girls' soccer (2.65), and boys' wrestling (2.36). The overall injury rate was lower in girls' sports (1.86) compared with boys' sports (2.52) (RR, 0.74 [95% CI, 0.71-0.76]; P <.001) and was higher in competition compared with practice (RR, 3.39 [95% CI, 3.28-3.49]; P <.001). The most commonly injured body areas were the head/face (24.2%), ankle (17.6%), and knee (14.1%). Sprains/strains (36.8%) and concussions (21.6%) were the most common diagnoses. Overall, 39.2% and 34% of injuries resulted in a time loss of <1 week and 1 to 3 weeks, respectively. Surgery was required in 6.3% of injuries, with wrestling (9.6%), girls' basketball (7.6%), and boys' baseball (7.4%) being the sports with the highest proportion of injuries needing surgery. Conclusion: Study findings demonstrated that boys' football, girls' soccer, and boys' wrestling had the highest injury rates, with boys' sports overall having higher injury rates than girls' sports. Sprains/strains and concussions were the most common diagnoses. Few injuries required surgery. [ABSTRACT FROM AUTHOR]

Background: Elbow ulnar collateral ligament (UCL) reconstruction (UCLR) is the gold standard for operative treatment of UCL tears, with renewed interest in UCL repairs. Purpose: To (1) assess trends in rates of UCLR and UCL repair and (2) identify predictors of complications by demographic, socioeconomic, or surgical center volume factors. Study Design: Descriptive epidemiology study. Methods: Patients who underwent UCLR or UCL repair at New York State health care facilities between 2010 and 2019 were retrospectively identified; concomitant ulnar nerve procedures among the cohort were also identified. Surgical center volumes were classified as low (<99th percentile) or high (≥99th percentile). Patient information, neighborhood socioeconomic status quantified using the Area Deprivation Index, and complications within 90 days were recorded. Poisson regression analysis was used to compare trends in UCLR versus UCL repair. Multivariable regression was used to determine whether center volume, demographic, or socioeconomic variables were independent predictors of complications. Results: A total of 1448 UCL surgeries were performed, with 388 (26.8%) concomitant ulnar nerve procedures. UCLR (1084 procedures; 74.9%) was performed more commonly than UCL repair (364 procedures; 25.1%), with patients undergoing UCL repair more likely to be older, female, and not privately ensured and having undergone a concomitant ulnar nerve procedure (all P <.001). With each year, there was an increased incidence rate ratio for UCL repair versus UCLR (β = 1.12 [95% CI, 1.02-1.23]; P =.022). The authors identified 2 high-volume centers (720 UCL procedures; 49.7%) and 131 low-volume centers (728 UCL procedures; 50.3%). Patients undergoing UCL procedures at high-volume centers were more likely to be younger and male and receive workers' compensation (all P <.001). UCL repair and ulnar nerve-related procedures were both more commonly performed at low-volume centers (P <.001). There were no significant differences in 3-month infection, ulnar neuritis, instability, arthrofibrosis, heterotopic ossification, or all-cause complication rates between low- and high-volume centers. The only significant predictor for all-cause complication was Medicaid insurance (OR, 2.91 [95% CI, 1.20-6.33]; P =.011). Conclusion: A rising incidence of UCL repair compared with UCLR was found in New York State, especially among female patients, older patients, and nonprivate payers. There were no differences in 3-month complication rates between high- and low-volume centers, and Medicaid insurance status was a predictor for overall complications within 90 days of operation. [ABSTRACT FROM AUTHOR]

Background & Objective: The etiology of endometriosis is unknown and many hormonal, inflammatory, genetic and environmental factors are effective in the formation of endometriosis. The present study investigated the epidemiology of endometriosis in patients referred to ShohadayeTajrish Hospital in six years. Materials & Methods: This descriptive study performed on endometriosis Iranian women who referred to ShohadayeTajrish Hospital between 2016 and 2022. The sample size of this study was determined using the census method, and 711 patients. For analysis, SPSS version 22 was used, and results were reported as mean ± SD. Results: Finally, 711 patients enrolled in this study and the average age of patients was 34.69± 7.53 years and the mean age of onset of disease was 29.97±4.61 years. More than 55% of patients had a healthy weight and normal body mass index. 17.72 percent of patients had a history of infertility in their life's. Conclusion: Endometriosis patients' life in many aspects, including their job, lifestyle, education, marital status and health care is affected. [ABSTRACT FROM AUTHOR]

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• Systematic review article to the STROBE-M guidelines. • Prevalence of diseases in waste pickers. • Waste pickers the American, African, and Asian Continents. • Occupational health of waste pickers. Waste pickers, who work with the collection of recyclable materials in search of a source of income, are subject to various risks and diseases that are very well researched. The aim of this systematic review was therefore to identify and analyze the results of epidemiological research on waste pickers over the last 20 years as well as to investigate the geographical distribution and quality of these studies. The studies were selected from the literature by creating search keys with representative keywords in different databases. This systematic review exceptionally includes research qualified according to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. In total, 61 epidemiological studies with waste pickers were found in 15 different countries, with the largest number of studies carried out in the American continent compared to the African and Asian, respectively. Regarding the quality, 91.80 % were classified as excellent and 8.20 % as good. Although the results show a significant number of epidemiological studies with waste pickers, demonstrating scientific evidence, that there is still a lack of research focusing on waste pickers in different work scenarios, from different health perspectives and in different parts of the world, and it is not possible to highlight the trends in health research for this profession. [ABSTRACT FROM AUTHOR]

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

Objective: To investigate the distribution pattern of animal bites in Mirjaveh, Iran from 2015 to 2020. Methods: The data on animal bites were collected from the Department of Infectious Diseases, the provincial health center. Monthly climatic data on precipitation and temperature during the study period were also collected. The correlation between incidence and temperature, precipitation rate, land type, and altitude was also analyzed. Results: The results showed that men were more affected by animal bites than women (76.4%, P<0.001), and the highest incidence rate occurred in the age group of 5-19 years. The incidence rate of animal bites was found to be correlated with temperature and altitude. An increase in temperature was associated with a rise in the incidence rate of animal bites. The number of animal bites increased until 2019, possibly due to an increase in the number of dogs in the area. Conclusions: Targeted interventions should be implemented to reduce the incidence of animal bites, particularly among children, housewives, and students. Improving access to appropriate treatments, increasing public awareness of the hazards of animal bites, and increasing the number of vaccinated dogs in the area are essential strategies to be considered. [ABSTRACT FROM AUTHOR]

Background: Surfing is an increasingly popular sport with a high propensity for both traumatic and atraumatic injuries. Purpose: To analyze the trends, etiologies, and diagnoses of lower extremity orthopaedic-related surfing injuries presenting to United States (US) emergency departments (EDs) within a 21-year study period. Study Design: Descriptive epidemiology study. Methods: The National Electronic Injury Surveillance System database was queried for data on lower extremity surfing injuries presenting to US EDs from January 1 to December 31, 2022. Data collected included year, injury mechanism, injury location, diagnosis, and disposition. The raw data were used to calculate national estimates (NEs) based on each hospital’s assigned statistical sample weight. Linear regressions were performed to analyze annual trends. Results: A total of 776 lower extremity surfing injuries were included (NE = 49,218 injuries). The mean age of the patients was 29.4 ± 13.6 years. The most common injured areas were the foot (NE = 17,411; 35.4%), lower leg (NE = 8673, 17.6%), and knee (NE = 8139; 16.5%). The most common mechanism of injury was impact with board (NE = 17,144; 34.8%), and the most common fracture locations were the lower leg (NE = 1195; 29.5%), ankle (NE = 1594; 24.5%), and foot (NE = 1495; 23.0%). There were statistically significant decreases in weighted estimates for lower extremity surfing injuries by 108 per year (P < .001), for lacerations by 76 per year (P < .001), and for sprains by 18 per year (P = .01). Impact-with-board injuries decreased by 59 injuries per year (P < .001) and constituted 63.5% of lacerations and 12.1% of fractures. Only 3.9% of patients were admitted for hospitalization. Conclusion: There was a decreasing trend in lower extremity surfing injuries presenting to US EDs during the 21-year study period. [ABSTRACT FROM AUTHOR]

Background: The epidemiology of musculoskeletal injuries at the Australian Open, Wimbledon, and US Open tennis tournaments has been investigated in recent studies; however, there is no published literature on the incidence of musculoskeletal injuries at the French Open. Purpose: To describe the incidence, location, and type of musculoskeletal injuries in tennis players during the French Open tournament from 2011 to 2022. Study Design: Descriptive epidemiology study. Methods: A review was performed of all injuries documented by a multidisciplinary medical team during the French Open from 2011 to 2022. All musculoskeletal injuries that occurred during the main draw of the female and male singles or doubles matches were included. Descriptive statistics were used to summarize the data. Injury locations were grouped into regions as well as into upper limb, trunk, and lower limb. Results: In total, there were 750 injuries in 687 tennis players, resulting in a mean of 62.5 injuries per tournament; however, there were no obvious trends in injury incidence over the time frame evaluated. The number of injuries in female and male players was similar (392 vs 358, respectively). The most common injury regions were the thigh/hip/pelvis (n = 156), ankle/foot (n = 114), and spine (n = 103). The most common injury types were muscle-related (n = 244), tendon-related (n = 207), and joint-related (n = 163), and the most affected muscles were the adductors (n = 45), rectus abdominis (n = 38), and lumbar muscles (n = 25). Conclusion: Over the 12-year period from 2011 to 2022 female and male players experienced similar numbers of musculoskeletal injuries, with most injuries occurring in the lower limbs compared with the upper limbs and trunk. [ABSTRACT FROM AUTHOR]

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Purpose: This study aimed to analyze the epidemiological characteristics of hip fracture in all age groups in Shanghai, and to evaluate the hospitalization cost of patients with hip fracture. Methods: A total of 1,332 hip fracture patients admitted to a tertiary general hospital between January 2015 and May 2020 in Shanghai were included. Age, sex, diagnosis, cause of injury and site, fracture type, comorbidities, length of stay, treatment, outcomes (at discharge) and hospitalization expenses were recorded. The epidemiological characteristics of hip fracture were analyzed by using SPSS 26.0 software. Results: The average age of hip fracture was 77.24 ± 12.66 years, and 69.0% of the patients were female. Overall, 886 patients had femoral neck fracture, and 446 patients suffered from intertrochanteric fracture. Most of the fractures caused by falls at the same level and falls from a height occurred in those aged 81–90 years; and traffic accident injuries mostly took place in patients aged 50–60. Among the 1,302 hip fracture patients who underwent surgical treatment, hip replacement was the major choice for femoral neck fracture, accounting for 49.2%. Internal fixation was the main treatment choice for intertrochanteric fracture, making up 97.8%. The median length of hospital stay lasted 8 days and at cost of hospitalization was ¥49,138.18 RMB. Conclusion: This epidemiological study found that patients with hip fracture had certain distribution characteristics in age, sex, type of fracture, injury season, cause of injury, mode of operation, length of stay, cost, and so on. Proper medical management, social preventive measures, and prevention of falls are needed to reduce the risk of hip fracture and the socioeconomic burden. [ABSTRACT FROM AUTHOR]

Oral Mucosal Lesions (OMLs) are conditions of the oral mucosa that cause alterations in their presentation and pain in the affected patient, highlighting their importance for study. The aim of this research is to determine the prevalence of oral lesions in the Ecuadorian Austro. Descriptive statistics were used to associate variables, yielding statistically significant findings based on oral lesions, sex, and geographical environment. This study was conducted under the appropriate bioethical permissions. The results obtained correspond to the prevalence of lesions by province. Morona Santiago displays a rate of 17% for abscesses, surpassing the provinces of Azuay (13.50%) and Cañar (10.67%). However, gingivitis for pathology, Azuay stands out with 13.17%, while Cañar and Morona Santiago present 10.50% and 8.33%, respectively. There is also a predominant occurrence of abscesses in rural areas (41.17%) compared to urban ones (26.33%). Regarding sex, girls show a higher percentage of abscesses (41.17%) compared to boys who have a clear tendency to present GUM lesions (22.33%). The data indicates that in the studied provinces, geographical environment and sex are key variables to understand the distribution of oral lesions. These findings encourage us to continue pursuing this type of research, which contributes to improving the quality of life for children. [ABSTRACT FROM AUTHOR]

Objective: To explore how sports injury epidemiological outcomes (i.e., prevalence, average prevalence, incidence, burden, and time to first injury) vary depending on the response rates to a weekly online self‐reported questionnaire for athletes. Methods: Weekly information on athletics injuries and exposure from 391 athletics (track and field) athletes was prospectively collected over 39 weeks (control group of the PREVATHLE randomized controlled trial) using an online self‐reported questionnaire. The data were used to calculate sports injury epidemiological outcomes (i.e., prevalence, average prevalence, incidence, burden, and time to first injury) for sub‐groups with different minimum individual athletes' response rates (i.e., from at least 100%, at least 97%, at least 95%, ... to at least 0% response rate). We then calculated the relative variation between each sub‐group and the sub‐group with a 100% response rate as a reference. A substantial variation was considered when the relative variation was greater than one SD or 95% CI of the respective epidemiological outcome calculated in the sub‐group with a 100% response rate. Results: Of 15 249 expected weekly questionnaires, 7209 were completed and returned, resulting in an overall response rate of 47.3%. The individual athletes' response rates ranged from 0% (n = 51) to 100% (n = 100). The prevalence, average weekly prevalence, and time to first injury only varied substantially for the sub‐groups below a 5%, 10% and 18% minimum individual response rate, respectively. The incidence and injury burden showed substantial variations for all sub‐groups with a response rate below 100%. Conclusions: Epidemiological outcomes varied depending on the minimum individual athletes' response rate, with injury prevalence, average weekly prevalence, and time to first injury varying less than injury incidence and injury burden. This highlights the need to take into account the individual response rate when calculating epidemiological outcomes, and determining the optimal study‐specific cut‐offs of the minimum individual response rate needed. [ABSTRACT FROM AUTHOR]

Background: The current evidence for acute management practices of sport-related concussion (SRC) is often limited to in-clinic visits, with limited studies identifying professionals in early SRC care and the association with prolonged recovery outcomes. Purpose: To describe acute SRC management practices (ie, the personnel in the initial evaluations, removal from activity) and test the association with prolonged return to sport (RTS) time. Study Design: Descriptive epidemiology study. Methods: We conducted a retrospective cohort study of 17,081 high school SRCs accrued between the 2015-2016 and 2020-2021 academic years. We reported acute management practices and RTS time as frequencies stratified by sex, sport, and event type and compared athletic trainer (AT) access in initial evaluation with chi-square tests (P <.05). Separate logistic regressions estimated odds ratios (ORs) and 95% CIs for removal from activity and prolonged RTS >21 days by acute management practices. Results: Most SRCs (n = 12,311 [72.1%]) had complete initial evaluation by an AT. Boys had an AT evaluation in 75.5% (n = 2860/3787) of practice-related and 74.8% (n = 5551/7423) of competition-related events. Girls had an AT evaluation in 61.3% (n = 1294/2110) of practice-related and 69.3% (n = 2606/3761) of competition-related events. In sex-comparable sports (n = 6501), there was no difference between boys (n = 1654/2455 [67.4%]) and girls (n = 2779/4046 [68.7%]) having an AT involved in the first evaluation (χ2 = 1.21; P =.27). Notably, 25.3% of girls' SRCs were evaluated by a coach alone, and we observed differences in personnel in initial evaluations by sport. The odds of immediate removal were higher when an AT made the initial evaluation (OR, 2.8 [95% CI, 2.54-3.08]). The odds of prolonged RTS >21 days was lower for those with an AT in the initial evaluation (OR, 0.74 [95% CI, 0.65-0.84]) adjusting for significant factors from univariate analyses, boys relative to girls (OR, 0.85 [95% CI, 0.76-0.96]), specialty care relative to PCP (OR, 2.16 [95% CI, 1.90-2.46]), specialty care relative to urgent or ready care (OR, 0.99 [95% CI, 0.82-1.22]) concussion history (OR, 1.41 [95% CI, 1.22-1.63]), and removal from activity (OR, 0.90 [95% CI, 0.78-1.05]). Conclusion: This study found variability in personnel involved in initial SRC evaluations, with higher percentages of athletes with SRCs having ATs make the initial evaluation during competitive events. There was no association between sex and AT involvement in comparable sports. There was an association between prolonged RTS and AT involvement, sex, concussion history, and location of follow-up care. [ABSTRACT FROM AUTHOR]

Introduction: The use and costs of mental health services by rural and remote Australian women are poorly understood. Objective: To examine the use of the Better Access Scheme (BAS) mental health services across geographical areas. Design: Observational epidemiology cohort study using a nationally representative sample of 14 247 women from the Australian Longitudinal Study on Women's Health born 1973–1978, linked to the Medical Benefits Schedule dataset for use of BAS services from 2006 to 2015. The number and cost of BAS services were compared across metropolitan and regional/remote areas for women using the mental health services. Findings: 31% of women accessed a BAS mental health service, 12% in rural populations. Overall, 90% of women with estimated high service need had contact with professional services (83% rural vs 92% metropolitan regions). Mean mental health scores were lower for women accessing a BAS service in remote areas compared with metropolitan, inner and outer regional areas (61.9 vs 65.7 vs 64.8 vs 64.2, respectively). Higher proportion of women in remote areas who were smokers, low/risky drinkers and underweight were more likely to seek treatment. Compared with metropolitan areas, women in inner, outer regional and remote areas accessed a lower mean number of services in the first year of diagnosis (6.0 vs 5.0 vs 4.1 vs 4.2, respectively). Actual mean overall annual costs of services in the first year of diagnosis were higher for women in metropolitan areas compared with inner, outer regional or remote areas ($733.56 vs $542.17 vs $444.00 vs $459.85, respectively). Discussion: Women in rural/remote areas not accessing services need to be identified, especially among those with the highest levels of distress. In remote areas, women had greater needs when accessing services, although a substantial proportion of women who sought help through the BAS services lived in metropolitan areas. Conclusion: Regardless of lower cost to services in rural/remote areas, geographic and economic barriers may still be major obstacles to accessing services. [ABSTRACT FROM AUTHOR]

Clostridioides difficile infection (CDI) is the main source of healthcare and antibiotic-associated diarrhea in hospital context and long-term care units, showing significant morbidity and mortality. This study aimed to analyze the epidemiological context, describing the severity and outcomes of this event in patients admitted to our hospital, thus confirming the changing global epidemiological trends in comparison with other cohorts. We conducted a single-center, observational, and retrospective study at the Hospital do Espírito Santo (HESE), Évora, in Portugal, analyzing the incidence of CDI in patients meeting eligibility criteria from January to December 2018. During this period, an annual incidence rate of 20.7 cases per 10,000 patients was documented. The studied population average age was 76.4 ± 12.9 years, 83.3% over 65. Most episodes were healthcare-acquired, all occurring in patients presenting multiple risk factors, with recent antibiotic consumption being the most common. Regarding severity, 23.3% of cases were classified as severe episodes. Recurrences affected 16.7% of participants, predominantly female patients over 80 years old, all of whom were healthcare-acquired. Mortality rate was disproportionately high among the older population. Our investigation documented an overall incidence rate of over 10.4-fold the number of cases identified in the year 2000 at the same hospital, more recently and drastically, in community-associated episodes. [ABSTRACT FROM AUTHOR]

Simple Summary: Tongue cancer typically has male predominance. However, several studies have documented an increasing number of incidences among the younger population, with female predominance, which is unusual. Current trends in tongue cancer and possible risk factors require more investigation. The global epidemiological trends in tongue cancer have shifted toward more incidences in younger and female groups. Our study confirms the same findings regarding the younger age group. However, in our locality, no significant changes have been noted regarding gender. More multi-institutional studies are recommended to explain such changes and highlight the possible risk factors so that appropriate corrective actions can be taken into consideration. The tongue is the most common site for oral cavity carcinoma. It typically has male predominance. However, several studies have documented an increasing number of incidences among the younger population, with female predominance, which is unusual. In this study, we aimed to determine current trends in tongue cancer regarding age and gender. Data from 197 tongue cancer patients were extracted from The Oncology Center, Mansoura University (OCMU) database from 2006 to 2021. The patients were divided into two time periods: (2006–2013) and (2014–2021). We computed counts and proportions of tongue cancer for demographic and tumor characteristics. The data were analyzed using SPSS. Gender showed no statistically significant difference in both groups, while the percentages of diagnosed females were 52.7% and 52%, respectively. The percentages of males were 47.3% and 48%, p-value = 0.927. There was a statistically significant difference in the number of patients aged 20 to 39 years old and ≥60 years old in both periods. The p-values were 0.039 and 0.011, respectively. Although tongue cancer is typically more common in males, our results showed no significant difference in the gender of diagnosed patients. In addition, our results showed that the number of younger patients significantly increased in the period from 2014 to 2021. However, we encourage further investigations involving larger populations. [ABSTRACT FROM AUTHOR]

Background: The impact of chronic kidney disease (CKD) on atrial fibrillation outcomes (AF) is not well understood. Methods: We conducted analyses of comorbid AF and CKD related death in the United States from 1999 to 2020 using descriptive epidemiology. Results: Age-adjusted mortality rates (AAMR) per 100,000 increased from 0.39 in 1999 to 1.65 in 2020. Non-Hispanic populations (1.01) and nonmetropolitan areas (1.08) had higher AAMRs compared to Hispanic (0.62) and metropolitan (0.97) areas. Midwestern (1.11) and Western (1.13) US regions recorded the highest AAMRs. Conclusions: These findings highlight the need for interventions to address AF death disparities in patients with CKD. [ABSTRACT FROM AUTHOR]