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IMPORTANCE: Immunocompromised status is a risk factor for severe SARS-CoV-2 infection. Little is known about how systemic corticosteroid dose and concurrent use of immunosuppressants are associated with COVID-19 outcomes. OBJECTIVE: To assess the association between corticosteroid dose/duration and concurrent immunosuppressant use on COVID-19 hospitalisation and death in the era of COVID-19 vaccinations. DESIGN: This is a retrospective cohort study using a deidentified insurance claims database from 1 July 2020 to 30 June 30, 2022, with the risk period starting on 1 July 2021. Impact of corticosteroid exposures and concurrent use of other immunosuppressants was assessed with attributable risk analysis and Cox regression that included COVID-19 vaccination status and time-updated dichotomous immunosuppressive medication exposures. PARTICIPANTS: There were 10 109 596 eligible patients enrolled during the risk period, each with at least 365 days of continuous enrolment prior to 1 July 2021. EXPOSURES: Systemic corticosteroids, disease-modifying antirheumatic drugs (DMARDs), tumour necrosis factor-alpha inhibitors (TNFis) and other immunosuppressive drug categories. MAIN OUTCOMES: Incidence rate ratios and hazard ratios for COVID-19 hospitalisation and death. RESULTS: Corticosteroids were prescribed to 1 379 049 (13.6%) of 10 109 596 individuals. After adjustment, corticosteroids were associated with an increased risk of COVID-19 hospitalisation (HR: 5.40; 95% CI 5.27 to 5.53; p

INTRODUCTION: Presbyopia, difficulty in seeing close-ups, affects a billion people globally. Mobile financial services (MFS) have been mandated since January 2021 for Bangladesh government social safety net payments, including old age allowance (OAA) and widow allowance (WA). We report the protocol for the Transforming Households with Refraction and Innovative Financial Technology randomised trial assessing the impact on the use of online banking of providing presbyopic safety net beneficiaries with reading glasses, and brief smartphone and mobile banking app training. METHODS AND ANALYSES: Eligible participants (n=484) are OAA (men aged 65-70 years; women aged 62-70) or WA recipients (women aged 48-60) with presbyopia as their only vision problem, passing a smartphone-based test of numeracy, cognition and dexterity, and not currently owning a smartphone or independently using MFS. All participants receive smartphones loaded with a mobile banking app and a transaction-tracking app and are randomised 1:1 to receive immediate free near-vision glasses and half-day training for smartphone and banking app use (intervention), or glasses and training 12 months later (control). The primary outcome is the mean quarterly number of mobile bank transactions over the 12-month follow-up period, comparing study groups, with and without adjustment. Secondary outcomes include food security, healthcare access and social connectedness. ETHICS AND DISSEMINATION: The protocol was approved by ethics committees at Queens University Belfast (reference #MHLS22_69) and BRAC James P Grant School of Public Health (reference #IRB-21 August22-028). The trial is conducted in accordance with the Declaration of Helsinki and national regulations in Bangladesh, and results will be published in open-access, peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT05510687; ClinicalTrials.gov.

IntroductionThe increasing burden of non-communicable diseases, such as hypertension, diabetes and dyslipidaemia, presents key challenges to achieving optimal HIV care outcomes among ageing people living with HIV. These diseases are often comorbid and are exacerbated by psychosocial and structural inequities. This interaction among multiple health conditions and social factors is referred to as a syndemic. In the USA, there are substantial disparities by social position (ie, racial, ethnic and socioeconomic status) in the prevalence and/or control of non-communicable diseases and HIV. Intersecting stigmas, such as racism, classism and homophobia, may drive these health disparities by contributing to healthcare avoidance and by contributing to a psychosocial syndemic (stress, depression, violence victimisation and substance use), reducing success along the HIV and non-communicable disease continua of care. Our hypothesis is that marginalised populations experience disparities in non-communicable disease incidence, prevalence and control, mediated by intersectional stigma and the psychosocial syndemic.Methods and analysisCollecting data over a 4 year period, we will recruit sexual minority men (planned n=1800) enrolled in the MACS/WIHS Combined Cohort Study, a long-standing mixed-serostatus observational cohort in the USA, to investigate the following specific aims: (1) assess relationships between social position, intersectional stigma and the psychosocial syndemic among middle-aged and ageing sexual minority men, (2) assess relationships between social position and non-communicable disease incidence and prevalence and (3) assess relationships between social position and HIV and non-communicable disease continua of care outcomes, mediated by intersectional stigma and the psychosocial syndemic. Analyses will be conducted using generalised structural equation models using a cross-lagged panel model design.Ethics and disseminationThis protocol is approved as a single-IRB study (Advarra Institutional Review Board: Protocol 00068335). We will disseminate results via peer-reviewed academic journals, scientific conferences, a dedicated website, site community advisory boards and forums hosted at participating sites.

ObjectiveThe vast majority of the 300 000 pregnancy-related deaths every year occur in South Asia and sub-Saharan Africa. Increased access to quality antepartum and intrapartum care can reduce pregnancy-related morbidity and mortality worldwide. We used a population-based cross-sectional cohort design to: (1) examine the sociodemographic risk factors and structural barriers associated with pregnancy care-seeking and institutional delivery, and (2) investigate the influence of residential distance to the nearest primary health facility in a rural population in Mali.MethodsA baseline household survey of Malian women aged 15-49 years was conducted between December 2016 and January 2017, and those who delivereda baby in the 5 years preceding the survey were included. This study leverages the baseline survey data from a cluster-randomised controlled trial to conduct a secondary analysis. The outcomes were percentage of women who received any antenatal care (ANC) and institutional delivery; total number of ANC visits; four or more ANC visits; first ANC visit in the first trimester.ResultsOf the 8575 women in the study, two-thirds received any ANC in their last pregnancy, one in 10 had four or more ANC visits and among those that received any ANC, about one-quarter received it in the first trimester. For every kilometre increase in distance to the nearest facility, the likelihood of the outcomes reduced by 5 percentage points (0.95; 95% CI 0.91 to 0.98) for any ANC; 4 percentage points (0.96; 95% CI 0.94 to 0.98) for an additional ANC visit; 10 percentage points (0.90; 95% CI 0.86 to 0.95) for four or more ANC visits; 6 percentage points (0.94; 95% CI 0.94 to 0.98) for first ANC in the first trimester. In addition, there was a 35 percentage points (0.65; 95% CI 0.56 to 0.76) decrease in likelihood of institutional delivery if the residence was within 6.5 km to the nearest facility, beyond which there was no association with the place of delivery. We also found evidence of increase in likelihood of receiving any ANC care and its intensity increased with having some education or owning a business.ConclusionThe findings suggest that education, occupation and distance are important determinants of pregnancy and delivery care in a rural Malian context.Trial registration numberNCT02694055.

Background: Adolescent pregnancy is associated with adverse outcomes, and although there has been a global decline in the incidence of teenage pregnancies and neonatal deaths, the absolute number remains significant. This study aimed to evaluate temporal trends in live births and neonatal deaths from adolescent mothers, as well as to identify the effect of adolescent pregnancy on neonatal death. Methods: This is a population-based study of all live births from mothers residing in Sao Paulo state, Brazil, between 2004 and 2020. The Prais-Winsten model was used to analyze annual trends for live births from adolescent mothers, neonatal mortality rates, and the percentage of neonatal deaths within specific demographic groups. The Kaplan–Meier survival curve evaluated the time to neonatal death. A Poisson regression model was utilized to identify maternal and neonatal characteristics associated with the risk of neonatal death. Results: The present study encompassed a total of 9,870,181 live births, with 14.4% occurring to adolescent mothers. There were 75,504 neonatal deaths, with 14,159 (18.8%) of those occurring in the neonates born to adolescent mothers. The annual percentage change in live births to adolescent mothers decreased by -3.03% (95%CI: -4.12% to -1.93%). The neonatal mortality rates showed a declining trend within both adolescent and non-adolescent mothers. Infants born to adolescent mothers had a higher probability of neonatal death and an earlier age of death when compared to non-adolescent mothers' infants. Poisson multiple regression analysis indicated an elevated risk of neonatal death for seven tested variables (adolescent mothers, inadequate prenatal care, multiple gestation, non-hospital delivery, low birth weight, male sex and congenital anomalies) and a reduction on risk of death for neonates born from cesarean section. Conclusions: The study showed a reduction in live births to adolescent mothers and neonatal deaths among adolescent mothers from 2004 to 2020 in the state of Sao Paulo. Was also shown a risk association between been born to adolescent mothers and neonatal death. [ABSTRACT FROM AUTHOR]

Context The relation of magnesium (Mg) intake with depression was previously investigated by meta-analyses. However, due to limited data, a dose–response analysis was not performed. Objective Considering the recently published articles, a systematic review and dose–response meta-analysis was conducted to summarize the relation of dietary Mg intake with depression in adults. Data Sources Medline (PubMed), ISI Web of Science, Scopus, and Google Scholar were comprehensively searched up to August 2023. Data Extraction Observational studies that reported the relation of dietary Mg intake and depression in adults were included and their data were extracted. Data Analysis A total of 63 214 participants from 10 cross-sectional and 3 cohort studies were included in the current study. Pooling 15 effect sizes from 12 studies (including 50 275 participants) revealed that individuals with the highest Mg intake had a 34% lower risk of depression, compared with those with the lowest Mg intake (RR: 0.66; 95% CI: 0.57, 0.78). Moreover, the linear dose–response analysis revealed that each 100-mg/d increment in Mg intake was associated with a 7% reduced risk of depression (RR: 0.93; 95% CI: 0.90, 0.96). Additionally, based on nonlinear dose–response analysis, increasing Mg intake from 170 to 370 mg/d was associated with a reduced risk of depression. Analyses were also conducted on 9 studies (49 558 participants) with representative populations, and similar results were found in the meta-analysis (RR: 0.71; 95% CI: 0.61, 0.83) and linear (RR: 0.93; 95% CI: 0.90, 0.96) and nonlinear dose–response analysis. Conclusion The current study shows an inverse dose–dependent association between dietary Mg intakes and risk of depression in both a general and representative population of adults in a dose–response manner. Systematic Review Registration PROSPERO registration no. CRD42024506570. [ABSTRACT FROM AUTHOR]

Context Several studies have investigated the relationship between serum vitamin D and dyslipidemia in children and adolescents, but the findings have been contradictory. Objective The current systematic review and dose–response meta-analysis investigated the serum vitamin D – dyslipidemia relationship in children and adolescents. Data Sources ISI Web of Science, Scopus, MEDLINE (PubMed), EMBASE databases, and Google Scholar, were searched up to December 2022. Data Extraction Observational studies that investigated the odds of dyslipidemia in categories of serum vitamin D levels in children were included, and their data were extracted. Data Analysis Pooling of 17 effect sizes from 15 studies (39 342 participants) showed that subjects with higher serum vitamin D had 27% lower odds of hypertriglyceridemia (odds ratio [OR] = 0.73; 95% confidence interval [CI]: 0.60, 0.88). A meta-analysis of 18 effect sizes from 16 studies (39 718 participants) illustrated that highest vs lowest serum vitamin D was related to 22% lower odds of low high-density lipoprotein cholesterol (HDL-c) (OR = 0.78; 95% CI: 0.66, 0.91). Also, a nonlinear association between serum vitamin D and odds of abnormal lipid profile was found: elevating values of 25-hydroxyvitamin D from 35 nmol/L to 55 nmol/L was associated with a decreasing trend in odds of hypertriglyceridemia, hyper low-density lipoprotein cholesterolemia, hypercholesterolemia, and hypo HDL-cholesterolemia. However, no significant linear association was observed. Based on the Grading of Recommendations, Assessment, Development and Evaluations (GRADE), the certainty of all evidence was rated as high. Conclusion This meta-analysis revealed that the level of 25-hydroxyvitamin D was inversely related to odds of abnormal serum triglycerides and HDL-c in children and adolescents. Increasing serum vitamin D from 35 nmol/L to 55 nmol/L was associated with a decreasing trend in the odds of abnormal serum triglycerides, HDL-c, low-density lipoprotein cholesterol, and total cholesterol in children. Systematic Review Registration PROSPERO registration no. 42023400787. [ABSTRACT FROM AUTHOR]

Background: Spinal cord stimulators (SCSs) are used to reduce pain and improve quality of life in patients with complex regional pain syndrome (CRPS). However, many patients opt for device removal after SCS implantation due to diminished effect or complications. There is limited research on the actual duration of SCS use in CRPS patients, and no nationwide population-based studies exist. This study aimed to estimate the real-world duration of SCS use in CRPS patients and examine the influencing factors on the duration of SCS use by analyzing the National Healthcare Insurance Database. Methods: Adult patients (age = 18) with CRPS who underwent permanent SCS implantation between 2014 and 2021 were included. The authors analyzed the median duration of SCS implantation and evaluated the impacts of age, sex, hospital type, and insurance type. Results: Of 408 potential patients, 373 patients were included. The median duration of SCS use was 4.4 (95% confidence interval [CI]: 4.0-4.8) years. Male patients retained SCSs longer than female patients (4.7 vs. 4.0 years, P = 0.014), and veterans' healthcare beneficiaries showed the longest duration of SCS use (median 6.9 [95% CI: 4.6-7.8] years). Age and hospital type did not affect the duration of SCS use (P = 0.381 and P = 0.122, respectively). Conclusions: The median SCS use duration in CRPS patients was 4.4 years. Considering the high cost and invasiveness of SCS, patients should be informed about the expected duration of SCS use, alongside potential risks and benefits. [ABSTRACT FROM AUTHOR]

The Chikungunya virus (CHIKV) presents substantial public health challenges in the Eastern Mediterranean Region (EMR), with its prevalence and interaction with other arboviruses (ABVs) remaining poorly understood. This systematic review and meta-analysis aimed to assess the prevalence of CHIKV and its association with other ABVs, such as dengue virus (DENV), Rift Valley fever virus (RVFV), malaria, and yellow fever virus (YFV), in the EMR. We systematically searched databases including PubMed, Embase, Web of Science, Scopus, Cochrane Library, CINAHL, PsycINFO, and ScienceDirect to identify epidemiological studies that report CHIKV prevalence and provide odds ratios (ORs) for CHIKV compared to other ABVs. Data analysis was performed using a random-effects model. Heterogeneity was evaluated using the χ2 test and I 2 statistic. The GRADE approach was used to evaluate the quality of the studies while the AXIS tool, NOS tool, and AHRQ checklist assessed the risk of bias. The meta-analysis revealed a significant prevalence of CHIKV in the EMR. However, the studies exhibited heterogeneity, indicating variability in the results. A comparison of CHIKV with other ABVs did not show any statistically significant differences in prevalence. The meta-analysis found a notable prevalence of CHIKV in the EMR. The results also indicated that the prevalence of CHIKV is comparable to that of other ABVs in the region. These findings provide an overview of the burden of CHIKV in the EMR. [ABSTRACT FROM AUTHOR]

Introduction: Accurate estimates of intra-individual variability are necessary for proper design of clinical trials and epidemiological studies where the stress biomarkers cortisol and dehydroepiandrosterone sulfate (DHEA-S) are measured for dyads of persons with dementia (PWDs) and their family caregivers (FCGs). The aim is to determine the number of consecutive sampling days required to detect effect differences in clinical trials, and to accurately estimate regression coefficients in epidemiological studies where stress biomarkers are exposure variables in regression models with future disease as outcome. Methods: Clinical trial data from dyads of PWDs and their FCGs were used. Salivary cortisol and DHEA-S samples were collected five days a week, for eight consecutive weeks. From this data, we created formulas and graphical tools for the number of required sampling days needed to detect effect differences, and we calculated number of days needed for regression coefficients to be estimated with5% of baseline level with>20 dyads per group. When stress biomarkers are used in epidemiological studies at least six consecutive sampling days are required. Conclusion: Based on a large number of consecutive measurements of stress biomarkers we calculated the sufficient numbers of sampling days for clinical trials and for epidemiological studies to produce credible results. Our findings will aid researchers in the study design phase.

Background Atrial fibrillation (AF) is a common clinical arrhythmia characterized by high prevalence, high disability rate, and high treatment costs, severely affecting patients' quality of life. Currently, there is no large-scale epidemiological survey on the prevalence of AF in the Xinjiang Corps region. Objective To further understand the prevalence, associated risk factors, and standardized treatment status of AF in the Shihezi area of the Xinjiang Corps, this study aims to provide reliable data support for the prevention, management, and treatment of AF in this region. Methods A cross-sectional age-stratified random sampling survey was conducted from May 2021 to June 2023 among 63 079 permanent residents aged 18 years and above in 18 pastoral and agricultural groups and urban areas of the Shihezi area of the Xinjiang Corps. A questionnaire was used to collect baseline data, epidemiological information, awareness, and treatment status of AF. Patients were divided into an AF group (n=737) and a non-AF group (n=62 342). Multifactorial Logistic regression analysis was used to explore the influencing factors of AF occurrence. Results A total of 63 079 residents from the Shihezi area of the Eighth Division of the Xinjiang Corps were included, with an average age of (54.9±15.3) years. A total of 737 AF patients were identified, with a prevalence rate of 1.17%, and an age-adjusted prevalence rate of 1.12%. The awareness rate of AF in the screened population was only 1.62% (1 021/63 079), of which the awareness rate among diagnosed AF patients was 52.78% (389/737). The prevalence rates of AF in the 18-39, 40-49, 50-59, 60-69, 70-79, and ≥80 years age groups were 0.05% (5/9 964), 0.32% (29/9 076), 0.62% (135/21 686), 1.28% (151/11 810), 3.05% (207/6 776), and 5.57% (210/3 767), respectively. The prevalence rates of AF in males and females were 1.60% (441/27 591) and 0.83% (296/35 488), respectively. The prevalence rates of AF among Han, Hui, Uyghur, Kazakh, and other ethnic groups were 1.20% (720/60 014), 0.70% (7/1 007), 0.62% (7/1 130), 1.67% (2/120), and 1.41% (1/171), respectively. The prevalence rates of AF in urban and pastoral and agricultural areas were 0.79% (350/44 504) and 2.08% (387/18 575), respectively. There were statistically significant differences in age, gender, age group distribution, residential area, and education level between the AF and non-AF groups (P

Background: The effect of air pollution, a major global health issue, on the immune system, particularly on white blood cell (WBC) counts, remains underexplored. Methods: This study utilized data from 54,756 participants in the Korean National Health and Nutrition Examination Survey to investigate the effects of short- (day of examination and 7-day averages), mid- (30- and 90-day averages), and long-term (one-, three-, and five-year averages) air pollutant exposure on WBC counts. We assessed exposure to particulate matter (PM10, PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO). Results: Linear regression with log-transformed WBC counts, adjusted for confounders, showed that PM10 was positively associated with long-term exposure, PM2.5 was negatively associated with short- and mid-term exposures, SO2 was consistently negatively associated with short- and mid-term exposures, NO2 and CO were positive across most periods, and O3 was negatively associated with short- and mid-term exposures. Logistic regression analysis confirmed these findings, showing that short- and mid-term exposure to PM10, PM2.5, and SO2 was negatively associated with the risk of belonging to the high-WBC group, while long-term exposure to PM10, PM2.5, NO2, and CO showed positive associations with risk. Conclusions: Our findings highlight the time- and pollutant-specific associations between air pollution exposure and WBC counts, underscoring air pollution's potential impact on systemic inflammation. [ABSTRACT FROM AUTHOR]

Objectives: Using electronic health records, we derived and internally validated a prediction model to estimate risk factors for long COVID and predict individual risk of developing long COVID. Design: Population-based, retrospective cohort study. Setting: Scotland. Participants: Adults (≥18 years) with a positive COVID-19 test, registered with a general medical practice between 1 March 2020 and 20 October 2022. Main outcome measures: Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for predictors of long COVID, and patients' predicted probabilities of developing long COVID. Results: A total of 68,486 (5.6%) patients were identified as having long COVID. Predictors of long COVID were increasing age (aOR: 3.84; 95% CI: 3.66–4.03 and aOR: 3.66; 95% CI: 3.27–4.09 in first and second splines), increasing body mass index (BMI) (aOR: 3.17; 95% CI: 2.78–3.61 and aOR: 3.09; 95% CI: 2.13–4.49 in first and second splines), severe COVID-19 (aOR: 1.78; 95% CI: 1.72–1.84); female sex (aOR: 1.56; 95% CI: 1.53–1.60), deprivation (most versus least deprived quintile, aOR: 1.40; 95% CI: 1.36–1.44), several existing health conditions. Predictors associated with reduced long COVID risk were testing positive while Delta or Omicron variants were dominant, relative to when the Wild-type variant was dominant (aOR: 0.85; 95% CI: 0.81–0.88 and aOR: 0.64; 95% CI: 0.61–0.67, respectively) having received one or two doses of COVID-19 vaccination, relative to unvaccinated (aOR: 0.90; 95% CI: 0.86–0.95 and aOR: 0.96; 95% CI: 0.93–1.00). Conclusions: Older age, higher BMI, severe COVID-19 infection, female sex, deprivation and comorbidities were predictors of long COVID. Vaccination against COVID-19 and testing positive while Delta or Omicron variants were dominant predicted reduced risk. [ABSTRACT FROM AUTHOR]

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PurposeThe National Heart, Lung and Blood Institute Growth and Health Study (NGHS) prospectively collected anthropometric, biospecimens, clinical, health behaviour and psychosocial measures associated with cardiovascular disease from childhood to young adulthood. The aim of the current study was to assess the impact of stress, dysregulated eating and social genomic biomarkers on cardiometabolic risk factors among the original participants now in midlife and their children.ParticipantsBeginning in 1987-1988, NGHS recruited black and white girls (age 9-10 years) from socioeconomically diverse backgrounds from from three sites: Cincinnati, Ohio; Washington, DC; and Western Contra Costa County, California (N=2379) and followed them for 10 years. The study maintained an 89% retention rate. The current study is 30 years after the start of the original study and focused on the participants of California (n=887) and their children aged 2-17 years. We re-enrolled 624 of 852 eligible participants (73%): 49.2% black and 50.8% white. The mean age was 39.5 years. Among the 645 eligible biological children, 553 were enrolled; 49% black and 51% white, with 51.5% girls and 48.5% boys. The mean age was 9.3 years.Findings to dateLongitudinal analysis of adolescent drive for thinness predicted higher scores for drive for thinness during midlife, which was indirectly associated with greater adult body mass index through adult drive for thinness. Latent trajectory modelling of adolescent growth over 10 years found that women with persistently high weight trajectory had twice the odds of having children who met the definition for obesity compared with the persistently normal group, adjusting for adult weight.Future plansNew studies on neighbourhood socioeconomic status, food insecurity and additional biomarkers of chronic stress, microbiome and accelerated ageing (ie, telomere length and epigenetic clock) are underway. We are developing a 10-year follow-up to understand changes in ageing biomarkers of the participants and their children.Trial registration numberNCT00005132.

Epidemiologic studies of low-frequency exposures or outcomes using metabolomics analyses of neonatal dried blood spots (DBS) often require assembly of samples with substantial differences in duration of storage. Independent assessment of stability of metabolites in archived DBS will enable improved design and interpretation of epidemiologic research utilizing DBS. Neonatal DBS routinely collected and stored as part of the California Genetic Disease Screening Program between 1983 and 2011 were used. The study population included 899 children without cancer before age 6 years, born in California. High-resolution metabolomics with liquid-chromatography mass spectrometry was performed, and the relative ion intensities of common metabolites and selected xenobiotic metabolites of nicotine (cotinine and hydroxycotinine) were evaluated. In total, we detected 26,235 mass spectral features across 2 separate chromatography methods (C18 hydrophobic reversed-phase chromatography and hydrophilic-interaction liquid chromatography). For most of the 39 metabolites related to nutrition and health status, we found no statistically significant annual trends across the years of storage. Nicotine metabolites were captured in the DBS with relatively stable intensities. This study supports the usefulness of DBS stored long-term for epidemiologic studies of the metabolome. -Omics-based information gained from DBS may also provide a valuable tool for assessing prenatal environmental exposures in child health research.

ABSTRACT Objective: This study aims to compare calibration methods for weights in the subsample of Laboratory Exams from the 2013 Brazilian National Health Survey (PNS), seeking to assess their representativeness and precision. Methods: Two alternative proposals for constructing calibrated weights were performed based on post-stratification and raking methods. A comparison between the weights provided for the Laboratory Exams subsample and the two suggested weights was conducted through parameter estimates using the 2013 PNS subsample data. Additionally, seven measures were used to assess the performance of the proposed weighting systems. Results: The alternative post-stratification and raking weights produced generalizable estimates for the target population of the 2013 PNS, while the original weights did not. The alternative methods showed similar performance to the original method, with a slight advantage for raking in some evaluation measures. Conclusion: It is recommended that basic design weights be documented and included in the public-use data files of the PNS. Furthermore, it is suggested to cross-reference information between the sample and subsample of the 2013 PNS to enable the exploration of methods such as data imputation, aiming to obtain more accurate and representative estimates. These improvements are essential to ensure the quality and usefulness of PNS data in epidemiological and public health studies.

OBJECTIVE: This study aims to show the usefulness of incorporating a community-based geographical information system (GIS) in recruiting research participants for the Asian Cohort for Alzheimers Disease (ACAD) study for using the subgroup of Korean American (KA) older adults. The ACAD study is the first large study in the USA and Canada focusing on the recruitment of Chinese, Korean and Vietnamese older adults to address the issues of under-representation of Asian Americans in clinical research. METHODS: To promote clinical research participation of racial/ethnic minority older adults with and without dementia, we used GIS by collaborating with community members to delineate boundaries for geographical clusters and enclaves of church and senior networks, and KA serving ethnic clinics. In addition, we used socioeconomic data identified as recruitment factors unique to KA older adults which was analysed for developing recruitment strategies. RESULTS: GIS maps show a visualisation of the heterogeneity of the sociodemographic characteristics and the resources of faith-based organisations and KA serving local clinics. We addressed these factors that disproportionately affect participation in clinical research and successfully recruited the intended participants (N=60) in the proposed period. DISCUSSION: Using GIS maps to locate KA provided innovative inroads to successful research outreach efforts for a pilot study that may be expanded to other underserved populations across the USA in the future. We will use this tool subsequently on a large-scale clinical genetic epidemiology study. POLICY IMPLICATION: This approach responds to the call from the National Institute on Aging to develop strategies to improve the health status of older adults in diverse populations. Our study will offer a practical guidance to health researchers and policymakers in identifying understudied and hard-to-reach specific Asian American populations for clinical studies or initiatives. This would further contribute in reducing the health and research disparity gaps among older minority populations.

Background The American Association of Clinical Endocrinologists and the American Society of Endocrinology have proposed an adiposity-based chronic disease (ABCD) model for evaluating obesity, and there has been very few studies of ABCD in China, and the efficacy of its application is unclear. Objective To understand the prevalence of ABCD and its root cause in the Chinese elderly population aged 65 years and above using ABCD, a new obesity evaluation index. Methods Five thousand five hundred and sixty-two elderly people aged 65 years and above who participated in medical checkups at 28 community health centers in Pingshan District, Shenzhen City, Guangdong Province, from January to December 2021 were selected to obtain the basic characteristics of the study subjects through questionnaires, physical examinations, and laboratory tests, and to stage the sample population according to the diagnostic criteria of the ABCD model, and calculate the prevalence rates of ABCD and the individual stage, and multifactorial Logistic regression analysis was used to explore the relationship between ABCD staging and different cardiometabolic risk factor risks. Results The prevalence of ABCD in this study was 71.0%, and the prevalence of stage 0, 1, and 2 were 4.8% (267/5 562) , 32.5% (1 808/5 562) , and 33.7% (1 874/5 562) , respectively. The results of multifactorial Logistic regression analysis showed that, using ABCD normal as the reference group, diabetes mellitus, hypertension, high triacylglycerol, low HDL-C, high LDL-C, and cigarette smoking, in addition to high total cholesterol and alcohol consumption, were associated with the stage of ABCD (P

Introduction Hearing loss among military personnel is a well-known challenge, reported as the second most common VA service-connected disability. Although most hearing loss occurs gradually, a subset occurs suddenly and significantly impacts quality of life and military readiness and is considered as a medical emergency. This study aims to evaluate the incidence of sudden hearing loss among different subpopulations within the military system to better identify at-risk groups. Materials and Methods This study was a retrospective population-based study reviewing all cases of diagnosed sudden hearing loss between January 1, 2016 and December 31, 2021 within active duty service members in the U.S. DoD. Statistical analysis of multiple subpopulations was performed. Results There were 2,650 cases of sudden hearing loss diagnosed in active duty service members during the study period, with an average incidence of 32.9 cases per 100,000 people per year, compared with 5 to 27 cases per 100,000 people per year reported in civilian populations. Senior officers demonstrated significantly increased rates of sudden hearing loss with 103.9 cases per 100,000 people per year, likely as a result of increased age, as did Air Force personnel with 45.1 cases per 100,000 people per year. There was no difference in incidence based on military occupational specialty, though service members located overseas were noted to have decreased incidence compared with those stationed within the USA. There was no significant difference during the years before coronavirus-19 pandemic (2016-2019) compared to the years following the start of the pandemic (2020-2021). Conclusions Sudden hearing loss appears to occur more frequently in military personnel than in the civilian population. The increased incidence in senior officers is likely driven by increased age, though further evaluation into the discrepancies between reported incidence of hearing loss among enlisted service members and officers is warranted. Although military occupational specialty did not demonstrate any significant difference in incidence, for thus far unknown reasons those in the Air Force demonstrated increased rates of sudden hearing loss. Although other potentially at-risk groups were identified, focused efforts to better understand contributing factors to elevated incidence in senior officers and Air Force personnel will help to better mitigate the incidence and effects of sudden hearing loss. [ABSTRACT FROM AUTHOR]

Syphilis is considered a Sexually Transmitted Infection (STI), of global epidemiological importance due to its magnitude and repercussions on the health of the population. Among pregnant women, the occurrence of syphilis causes harm, including to the fetus. The increased incidence of syphilis in pregnant women remains a worrying situation throughout Brazil. In this sense, the study aimed to describe confirmed cases and find out the incidence rate of syphilis in pregnant women in Brazil, from 2017 to 2022, based on data available in SINAN and SINASC (DATASUS). Of the total confirmed cases reported, the highest percentages were found in pregnant women with incomplete primary education (31%), aged between 20 and 39 years (74%) and of mixed race (55.1%). The latent form was the most prevalent clinical form (49.3%). The incidence rate increased progressively, from 18.1/1000 LB (2017) to 30.8/1000 LB (2022). Syphilis in pregnant women still ranks as one of the main public health problems in Brazil, affecting the health of thousands of pregnant women annually, with a progressive increase in the incidence rate in recent years. It is necessary to reorient health planning actions to intensify strategies for tackling the problem in question. [ABSTRACT FROM AUTHOR]

This cross-sectional study assessed data from Brazil’s 2019 National Student Health Survey to investigate associations between cyberbullying and sociodemographic, family, mental health, and behavioural factors among Brazilian schoolchildren. Multivariate analysis by Poisson regression found 13.2% prevalence of cyberbullying, which was higher among adolescents who felt nobody cared about them (PR=1.47; 1.36-1.59); felt sad (PR=1.5; 1.4-1.7); reported that life was not worth living (PR=1.71; 1.59-1.84); had no friends (PR=1.68; 1.50-1.87); suffered parental aggression (PR=1.54; 1.45-1.65); missed classes without permission (PR=1.13; 1.06-1.20); used tobacco (PR=1.19; 1.10-1.30); alcoholic beverages (PR=1.16; 1.08-1.25); or illicit drugs (PR=1.14; 1.04-1.25); or had sexual intercourse (PR=1.23; 1.14-1.33). Prevalence was lower among boys (PR=0.85; 0.80-0.91); those 16-17 years old (PR=0.88; 0.82-0.95); and who reported having parental supervision in their free time (PR=0.78; 0.73-0.83). Cyberbullying has a high prevalence, highlighting the importance of monitoring this practice and establishing prevention measures in schools. [ABSTRACT FROM AUTHOR]

Purpose: To test the hypothesis that central drusen location is strongly linked with known Age‐related Macular Degeneration (AMD) risk factors and risk of incident late AMD. Methods: The Alienor study is a prospective population‐based cohort study of residents of Bordeaux, France, followed from 2009 to 2017. On retinal photographs, we defined central drusen as at least one soft drusen (>63 μm) within 500 μm from fovea and pericentral drusen as at least one drusen 500–3000 μm from fovea, in the absence of any central drusen. Late AMD (atrophic and/or neovascular) was diagnosed using multimodal imaging. In total, 481 eyes were included in the analysis: 160 central and 321 pericentral. We investigated associations with systemic (age, sex, smoking, medical prescriptions, plasma concentrations of lipids and nutrients, UV exposure, blood pressure), ocular (retinal thickness, cataract extraction) and genetic risk scores (GRS). Results: In multivariate logistic regression central drusen were associated with smoking (OR, 2.95 for smoking more than 20 pack‐years, p = 0.02), HDL‐cholesterol (OR, 1.57 for 1 standard deviation (SD) increase, p = 0.0048), pulse pressure (OR, 0.77 for 1 SD increase, p = 0.04), Age‐Related Maculopathy Susceptibility 2 (ARMS2) GRS (OR, 1.42; 95% CI, 1.11–1.83) and complement GRS (OR, 1.55; 95% CI, 1.15–2.10). In Cox modelling, the central location of drusen (at baseline or during the follow‐up) was associated with a 4.41‐fold increased risk (95% CI,1.98–9.81) for an incident late AMD. Conclusion: Central drusen were strongly associated with AMD risk factors and incident late AMD, suggesting that it represents a key marker for AMD progression. [ABSTRACT FROM AUTHOR]

Introduction: Keratinocyte, basal cell, and squamous cell carcinomas are the main types of non-melanoma skin cancer (NMSC). Although they do not represent a high risk of mortality, these neoplasms have a significant impact on public health, causing aesthetic and functional damage, especially in areas constantly exposed to the sun, such as the head, neck, and face. Surgery is an established approach in the treatment of NMSC. The present study aims to outline an epidemiological profile of patients undergoing surgery for the treatment of NMSC by the plastic surgery service of the Hospital das Clínicas of the Federal University of Minas Gerais (UFMG). Method: A descriptive epidemiological study was carried out at the Borges da Costa Outpatient Clinic of the Hospital das Clínicas of UFMG between March and August 2023. A form was developed for data collection, covering variables relevant to the epidemiological analysis. Results: The sample of 26 patients had a mean age of 69 years, with a predominance of white patients (88.4%). The lesions were most frequent on the nose (53.8%), lateral middle third of the face (20.5%), and forehead (12.8%). Regarding the margin, 55.8% had free margins, 41.1% had compromised margins, and 2.9% had narrow margins. Conclusion: The results highlight the need to systematize the care flow for patients with NMSC, aiming at a more effective compilation and evaluation. In addition, the epidemiological peculiarities of the patients treated could be identified and evaluated through the proposed form, providing insights for improvements in the care and management of non-melanoma skin cancer in the hospital.

Interest in using internet search data, such as that from the Google Health Trends Application Programming Interface (GHT-API), to measure epidemiologically relevant exposures or health outcomes is growing due to their accessibility and timeliness. Researchers enter search term(s), geography, and time period, and the GHT-API returns a scaled probability of that search term, given all searches within the specified geographic-time period. In this study, we detailed a method for using these data to measure a construct of interest in 5 iterative steps: first, identify phrases the target population may use to search for the construct of interest; second, refine candidate search phrases with incognito Google searches to improve sensitivity and specificity; third, craft the GHT-API search term(s) by combining the refined phrases; fourth, test search volume and choose geographic and temporal scales; and fifth, retrieve and average multiple samples to stabilize estimates and address missingness. An optional sixth step involves accounting for changes in total search volume by normalizing. We present a case study examining weekly state-level child abuse searches in the United States during the coronavirus disease 2019 pandemic (January 2018 to August 2020) as an application of this method and describe limitations.

AimsExposure to endocrine-disrupting chemicals (EDCs) during critical neurodevelopmental windows has been associated with the risk of autistic traits. This systematic review of epidemiological studies examined the association between maternal exposure to EDCs during pregnancy and the risk of autism spectrum disorder (ASD) in the offspring.MethodsWe searched PubMed, Web of Science, Scopus, and Google Scholar from inception to November 17, 2022, for studies investigating the association between prenatal exposure to EDCs and outcomes related to ASD. Two independent reviewers screened studies for eligibility, extracted data, and assessed the risk of bias. The review was registered in PROSPERO (CRD42023389386).ResultsWe included 27 observational studies assessing prenatal exposure to phthalates (8 studies), polychlorinated biphenyls (8 studies), organophosphate pesticides (8 studies), phenols (7 studies), perfluoroalkyl substances (6 studies), organochlorine pesticides (5 studies), brominated flame retardants (3 studies), dioxins (1 study), and parabens (1 study). The number of examined children ranged from 77 to 1,556, the age at the assessment of autistic traits ranged from 3 to 14 years, and most studies assessed autistic traits using the Social Responsiveness Scale. All but one study was considered to have a low risk of bias. Overall, there was no association between maternal exposure to specific ECDs during pregnancy and the occurrence of autistic traits in offspring.ConclusionsFindings from the epidemiological studies evaluated here do not support an association between prenatal exposure to ECDs and the likelihood of autistic traits in later in life. These findings should not be interpreted as definitive evidence of the absence of neurodevelopment effects of EDCs affecting ASD risk, given the limitations of current studies such as representative exposure assessment, small sample sizes, inadequacy to assess sexually dimorphic effects, or the effects of EDC mixtures. Future studies should carefully address these limitations.

Abstract Objective This cross‐sectional study aimed to determine the epidemiology of olfactory and gustatory dysfunctions related to COVID‐19 in China. Methods This study was conducted by 45 tertiary Grade‐A hospitals in China. Online and offline questionnaire data were obtained from patients infected with COVID‐19 between December 28, 2022, and February 21, 2023. The collected information included basic demographics, medical history, smoking and drinking history, vaccination history, changes in olfactory and gustatory functions before and after infection, and other postinfection symptoms, as well as the duration and improvement status of olfactory and gustatory disorders. Results Complete questionnaires were obtained from 35,566 subjects. The overall incidence of olfactory and taste dysfunction was 67.75%. Being female or being a cigarette smoker increased the likelihood of developing olfactory and taste dysfunction. Having received four doses of the vaccine or having good oral health or being a alcohol drinker decreased the risk of such dysfunction. Before infection, the average olfactory and taste VAS scores were 8.41 and 8.51, respectively; after infection, they decreased to 3.69 and 4.29 and recovered to 5.83 and 6.55 by the time of the survey. The median duration of dysosmia and dysgeusia was 15 and 12 days, respectively, with 0.5% of patients having symptoms lasting for more than 28 days. The overall self‐reported improvement rate was 59.16%. Recovery was higher in males, never smokers, those who received two or three vaccine doses, and those that had never experienced dental health issues, or chronic accompanying symptoms. Conclusions The incidence of dysosmia and dysgeusia following infection with the SARS‐CoV‐2 virus is high in China. Incidence and prognosis are influenced by several factors, including sex, SARS‐CoV‐2 vaccination, history of head‐facial trauma, nasal and oral health status, smoking and drinking history, and the persistence of accompanying symptoms.

Kasper Bonnesen,1,2 Morten Schmidt1– 3 1Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; 2Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; 3Department of Cardiology, Aarhus University Hospital, Aarhus, DenmarkCorrespondence: Kasper Bonnesen, Aarhus University, Olof Palmes Allé 43– 45, 8200 Aarhus N, Denmark, Tel +45 87 16 72 12, Email bonnesen@clin.au.dkPurpose: Hypertension is an important risk factor in cardio-epidemiological research, but data quality remains a concern. We validated different registry-based definitions of hypertension.Patients and Methods: The cohort included all first-time responders of the Danish National Health Surveys (2010, 2013, or 2017). Prescription-defined hypertension was defined as ≥ 1 or ≥ 2 filled prescriptions of antihypertensive specific drugs in ≥ 1 or ≥ 2 different antihypertensive drug classes within 90, 180, or 365 days before survey response. Hospital-diagnosed hypertension was defined from hypertension diagnoses within five years before the survey response. Considering self-reported hypertension as the reference, we calculated the positive predictive value (PPV), the negative predictive value (NVP), the sensitivity, and the specificity of prescription-defined and hospital-diagnosed hypertension.Results: Among 442,490 survey responders, 127,247 (29%) had self-reported hypertension. For prescription-defined hypertension with 365-day lookback, the PPV was highest for ≥ 2 prescriptions in ≥ 2 drug classes (94%) and lowest for ≥ 1 prescription in ≥ 1 drug class (85%). The NPV was highest for ≥ 1 prescription in ≥ 2 drug classes (94%) and lowest for ≥ 1 prescription in ≥ 2 drug classes (80%). The sensitivity was highest for ≥ 1 prescription in ≥ 1 drug class (79%) and lowest for ≥ 2 prescriptions in ≥ 2 drug classes (30%). The specificity was ≥ 94% for all algorithms. The PPV and specificity did not change noteworthy with length of lookback period, whereas the NPV and the sensitivity generally were higher for longer lookback. The algorithm ≥ 1 prescription in ≥ 2 drug classes with 365-day lookback was among the best balanced across all measures of validity (PPV=88%, NPV=94%, sensitivity=75%, specificity=96%). For hospital-diagnosed hypertension, the PPV was 90%, the NPV was 76%, the sensitivity was 22%, and the specificity was 99%.Conclusion: Compared with self-reported hypertension, the algorithms for prescription-defined and hospital-diagnosed hypertension had high predictive values and specificity, but low sensitivity.Keywords: epidemiologic studies, epidemiology, hypertension, predictive value of tests, sensitivity and specificity, validation study

Introduction: Dental implants are widely employed as dependable replacements for lost teeth. However, it is crucial to establish, solely through prospective cohort studies, whether a history of periodontitis indeed constitutes a significant risk factor for implant failure. Methods: A systematic literature search was conducted in October 2022 in several electronic databases with subsequent manual updates. Only original prospective cohort studies evaluating the implant (loss) rate ≥1 year after implant loading were included. Logarithmic risk ratio and weighted mean differences were calculated. Study results were summarized using random effects meta‐analyses evaluated by trial sequential analyses. The Newcastle‐Ottawa scale evaluated study bias and the GRADE approach assessed the certainty/quality of the evidence. Results: A total of 14 publications reporting on 12 prospective cohort studies were included. Low evidence certainty/quality evidence due to the absence of randomized clinical trials revealed significantly greater odds of failure in patients with a history of periodontitis at follow‐ups both after ≤5 years (RR = 1.62; 95% CI: 1.71–2.37; p = 0.013) and >5 years (RR = 2.26; 95% CI: 1.12–4.53; p = 0.023). The incidence of peri‐implantitis (RR = 4.09; 95% CI: 1.93–8.58; p < 0.001) and the weighted mean (WM) of marginal bone loss (WM difference = 0.75 mm; 95% CI: 0.18–1.31; p < 0.05) were statistically significantly greater in the periodontally compromised group, whereas there was no significant difference between the two groups for peri‐implant probing depth. Conclusion: A history of periodontitis can be considered a significant risk factor for incident implant failure, peri‐implantitis, and greater marginal bone loss. [ABSTRACT FROM AUTHOR]

Introduction The global disease burden may be exacerbated by exposure to passive smoking (SHS), with the workplace being a primary location for such exposure. Numerous epidemiological studies have identified SHS as a risk factor for diseases affecting various systems, including cardiovascular, respiratory, immune, endocrine, and nervous systems. The conventional observational study has certain methodological constraints that can be circumvented through a Mendelian randomization (MR) study. Our MR study intends to investigate the causal link between workplace exposure to SHS and the potential associated diseases. Aim and Methods Summary statistics data involving European participants were sourced from three databases: the UK Biobank, the FinnGen study, and the European Bioinformatics Institute. Genetic variants linked with exposure to SHS in the workplace were identified as instrumental variables. The MR was carried out using inverse variance weighted (IVW), MR-Egger, and weighted median methods. Sensitivity tests were also undertaken within the MR to evaluate the validity of the causality. Results According to the IVW model, genetically determined atrial fibrillation (AF) and stroke (p = 6.64E−04 and 5.68E−07, odds ratio = 2.030 and 2.494, 95% confidence interval = 1.350 to 3.051 and 1.743 to 3.569) were robustly associated with exposure to SHS in the workplace. Suggestive associations were found between workplace SHS and myocardial infarction (MI), asthma, and depression. Conclusions The MR study demonstrates that exposure to SHS in the workplace is a significant risk factor for AF and stroke in European individuals. Whether workplace exposure to SHS influences other diseases and the causality between them requires further exploration. Implications This study explored the causality between exposure to SHS in the workplace and potential associated diseases in multiple systems, including MI, AF, stroke, lung cancer, asthma, allergic disease, type 2 diabetes, and depression, using an MR study. The MR study can circumvent the methodological constraints of observational studies and establish a causal relationship. The two-sample MR analysis provides evidence supporting the causal association of frequent workplace SHS with AF and stroke. Individuals exposed to SHS in the workplace may also have a heightened risk of MI, asthma, and depression. However, whether SHS affects other diseases and the causality between them requires further investigation. To our knowledge, this is the first two-sample MR study to determine the causal relationship between SHS and potential diseases. Exposure to SHS in the workplace is a prevalent issue and may contribute to a global disease burden. The reduction of exposure following the introduction of smoke-free laws has led to a decrease in the admission rate for cardiac events and an improvement in health indicators. It is crucial to further advance smoke-free policies and their implementation. [ABSTRACT FROM AUTHOR]

Background We investigated mortality in workers of the world's largest chrysotile mine and enrichment factories located in the town of Asbest, Russian Federation. Methods This historical cohort study included all workers employed for at least 1 year between 1975 and 2010 and follow-up until the end of 2015. Cumulative exposure to dust was estimated based on workers' complete occupational history linked to dust measurements systematically collected from the 1950s. Exposure to chrysotile fibers was estimated using dust-to-fiber conversion factors. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated as mortality rate ratios in Poisson regression models. Results A total of 30 445 (32% women) workers accumulated 721 312 person-years at risk and 11 110 (36%) died. Of the workers, 54% had more than 30 years since their first exposure. We found an exposure-response between cumulative dust and lung cancer mortality in men. No clear association with dust exposure but a modest increase in the highest category of fiber exposure was seen for lung cancer in women. Mesothelioma mortality was increased (RR = 7.64, 95% CI = 1.18 to 49.5, to at least 80 fibers per cm3 years and RR = 4.56, 95% CI = 0.94 to 22.1, to at least 150 mg/m3 years [dust]), based on 13 deaths. For colorectal and stomach cancer, there were inconsistent associations. No associations were seen for laryngeal or ovarian cancer. Conclusion In this large-scale epidemiological study in the world's largest active asbestos mine, we confirmed an increased risk of mesothelioma with high fiber exposure and an increasing mortality for lung cancer in men with increasing dust exposure. Less clear-cut increased lung cancer mortality was seen in the women. Continued mortality follow-up is warranted. [ABSTRACT FROM AUTHOR]

Introduction: The German Central Health Study Hub is a service that was initially developed at short notice during the COVID-19 pandemic. Since then, it has been expanded in scope, content, active users and functionality. The service is aimed at two main audiences: data provider and data consumers. The former want to share research data from clinical, public health and epidemiological studies and related documents according to the FAIR criteria for research data, and the latter want to find and ultimately reuse relevant research data in the above areas. Methods: The service connects both groups via graphical and programmatic interfaces. A sophisticated information model is employed to describe and publish various research data objects while obeying data protection and fulfilling FAIR requirements. The service is being developed in a demand-driven manner with extensive user interaction. Results: A free-to-use service, built on open-source software (Dataverse, MICA, Keycloak), accessible via a web-browser. In close collaboration with users several features (ranging from collection to group items to combined data capture via API and UI) were created. The adoption of the service increases continuously and results in over 1,970 research data objects in June 2024. Conclusion: The service fills a marked gap and connects both user groups, yet it still needs to be improved in various dimensions (features, content, usage). The impact on the community needs to be further assessed. Despite recent legislative changes (GDNG, EHDS), the system improves the findability of sensitive data, provides a blueprint for similar systems and shows how to create a useful and userfriendly service together with users. [ABSTRACT FROM AUTHOR]

Introduction NFDI4Health is a consortium funded by the German Research Foundation to make structured health data findable and accessible internationally according to the FAIR principles. Its goal is bringing data users and Data Holding Organizations (DHOs) together. It mainly considers DHOs conducting epidemiological and public health studies or clinical trials. Methods Local data hubs (LDH) are provided for such DHOs to connect decentralized local research data management within their organizations with the option of publishing shareable metadata via centralized NFDI4Health services such as the German central Health Study Hub. The LDH platform is based on FAIRDOM SEEK and provides a complete and flexible, locally controlled data and information management platform for health research data. A tailored NFDI4Health metadata schema for studies and their corresponding resources has been developed which is fully supported by the LDH software, e.g. for metadata transfer to other NFDI4Health services. Results The SEEK platform has been technically enhanced to support extended metadata structures tailored to the needs of the user communities in addition to the existing metadata structuring of SEEK. Conclusion With the LDH and the MDS, the NFDI4Health provides all DHOs with a standardized and free and open source research data management platform for the FAIR exchange of structured health data. [ABSTRACT FROM AUTHOR]

Background: Periodontitis and benign prostatic hyperplasia (BPH) are all common chronic diseases with higher incidence in middle-aged and old men. Several studies have indicated a potential association between periodontitis and BPH, although the findings remain inconclusive. However, there is no mendelian randomization (MR) studies to assess this association. Methods: The 40 men who had received health check-ups were included in an epidemiological study. Genetic data of BPH (13118 cases and 72799 controls) and periodontitis (3046 cases and 195395 controls) from FinnGen project was used to perform two-sample MR analysis. The inverse-variance weighted (IVW) model was identified as the primary analytical method, with MR Egger, weighted median, simple mode, and weighted mode serving as additional approaches. Results: The epidemiological analysis demonstrated a lack of statistically significant differences in the prevalence of clinical BPH between severe periodontitis group and non-severe periodontitis group. Similarly, no statistically significant differences were found in the prevalence of severe periodontitis among individuals with clinical BPH compared to those without. Additionally, Among the five models utilized in MR analysis, including the IVW model, no evidence of a causal link between periodontitis and BPH was observed. Conclusion: The findings from our epidemiological investigation and MR analysis do not provide support for a causal relationship between periodontitis and BPH. [ABSTRACT FROM AUTHOR]

Introduction Shoulder injuries account for approximately 8% to 24% of all musculoskeletal injuries in the military. Recently, a change was made to service-specific physical fitness tests. Knowledge of relative shoulder labral injury rates before and after this change would help guide future directions and preventive strategies. However, we found no previous literature evaluating the rates of labral injury among United States Military branch personnel by enlistment status (enlisted versus officer), gender, age, or race. Materials and Methods In this retrospective epidemiological study, we queried the Defense Medical Epidemiology Database for International Classification of Disease, Tenth Revision (ICD-10) code S43.43 (superior glenoid labrum lesion) to determine the total number of patients with a shoulder labral injury from 2016 to 2019. Results were assessed for demographic associations of shoulder labral injury with branch, service occupation, rank, gender, race, and age. Queries were limited to first-time occurrences and ambulatory data only. Results Overall, our study found the incidence of shoulder labral injuries to be largely conserved each year from 2016 to 2019 (3.22–3.35/1000/year). Incidence of labral injury was highest in males, White service members, the junior enlisted, the Army service branch, ages 20 to 29, and enlisted non-combat personnel. Conclusions With knowledge of injury patterns in specific military populations, initiatives may be taken to identify at-risk service members with the goal of informing future preventive strategies. [ABSTRACT FROM AUTHOR]

Background: An outbreak of Salmonella Infantis was associated with the consumption of shredded pork products at multiple restaurants in Ontario between July 2021 and October 2021. The outbreak involved 36 case-patients from six public health units. The implicated shredded pork products were obtained from an unlicensed source. This is the largest reported outbreak of Salmonella Infantis linked to restaurant food exposures in Ontario, with complexities related to the investigation of unlicensed foods. This article aims to describe the epidemiological, food safety and laboratory investigations that led to the identification and removal of the source of the outbreak from implicated restaurants, including the challenges encountered while investigating an outbreak related to an unlicensed source of food. Methods: Epidemiological and laboratory analyses were conducted to identify the source of the outbreak. Food safety investigations were conducted to ascertain the origin and distribution of the implicated food. Results: Whole-genome sequencing identified the outbreak strain from the isolates of 36 casepatients across six public health units in Ontario. Seven case-patients (19%) were hospitalized. No deaths were reported. The outbreak was linked to shredded pork products (i.e., rinds or skins) that were distributed by an unlicensed meat processor and consumed at various restaurants that served Southeast Asian fusion cuisine concentrated in the Greater Toronto Area. The product was removed from implicated restaurants. Conclusion: Historically, foods from unlicensed sources have been implicated in multiple large outbreaks and continue to be of significant public health risk. The outbreak investigation emphasized the threat of food from unlicensed sources to the public’s health and the importance of additional public health interventions to prevent outbreaks linked to unlicensed sources. [ABSTRACT FROM AUTHOR]

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Objective To analyze the pulmonary ventilation function and influencing factors in residents in some area of Tianjin and provide a basis for the precise prevention and control of chronic obstructive pulmonary disease (COPD) in Tianjin. Methods A total of 5693 permanent residents aged 35 years and above in Heping District, Jinnan District and Baodi District of Tianjin were randomly selected from June to December 2022. The basic information, smoking history, treatment and China COPD Screening Questionnaire (COPD-SQ) were collected. According to the COPD-SQ result, the subjects were divided into the COPD low-risk group (COPD-SQ score<16 points, 4 648 cases) and the COPD high-risk group (COPD-SQ score>16 points, 1 045 cases). The physical examination and the pulmonary ventilation function testing were completed. Multivariate Logistic regression was used to analyze independent risk factors for COPD disease. Results The included subjects with the body quality index 25.1 (23.0, 27.6) kg/m² were 56 (48, 64) years old, including 2 393 (42.0%) men, 1 381 (24.3%) smokers and 650 (11.4%) proposed COPD. Only 18 patients were received standard treatment, accounting for 2.8% of the patients with suspected COPD. Compared with the COPD low-risk group, the proportion of males and smokers, age, waist-to-hip ratio, blood pressure and proposed COPD were higher in the COPD high-risk group. BMI, peripheral percutaneous oxygen saturation, FVC percentage of predicted value, FEV1 percentage of predicted value, FEV1 percentage of FVC, PEF percentage of predicted value, MMEF percentage of predicted value, and PEF50 percentage of predicted value were lower (all P＜0.05). The proportion of smokers and proposed COPD in Heping District, Jinnan District and Baodi District had statistical significance (P＜0.05). The multivariate Logistic regression analysis showed that independent risk factors of COPD morbidity included gender, smoking and age (P<0.05). Conclusion The smoking rate of residents aged 35 and above in some area of Tianjin is high. Age, smoking status and gender are associated with the incidence of COPD. [ABSTRACT FROM AUTHOR]

Heart failure (HF) management in type 1 diabetes (T1D) is particularly challenging due to its increased prevalence and the associated risks of hospitalization and mortality, driven by diabetic cardiomyopathy. Sodium–glucose cotransporter-2 inhibitors (SGLT2-is) offer a promising avenue for treating HF, specifically the preserved ejection fraction variant most common in T1D, but their utility is hampered by the risk of euglycemic diabetic ketoacidosis (DKA). This review investigates the potential of SGLT2-is in T1D HF management alongside emergent Continuous Ketone Monitoring (CKM) technology as a means to mitigate DKA risk through a comprehensive analysis of clinical trials, observational studies, and reviews. The evidence suggests that SGLT2-is significantly reduce HF hospitalization and enhance cardiovascular outcomes. However, their application in T1D patients remains limited due to DKA concerns. CKM technology emerges as a crucial tool in this context, offering real-time monitoring of ketone levels, which enables the safe incorporation of SGLT2-is into treatment regimes by allowing for early detection and intervention in the development of ketosis. The synergy between SGLT2-is and CKM has the potential to revolutionize HF treatment in T1D, promising improved patient safety, quality of life, and reduced HF-related morbidity and mortality. Future research should aim to employ clinical trials directly assessing this integrated approach, potentially guiding new management protocols for HF in T1D. [ABSTRACT FROM AUTHOR]

This cross-sectional study evaluates whether internet searches for abortion medications increased following the leak of a draft Supreme Court of the United States ruling that would overturn the 1973 Roe v Wade decision.

Background: The long-term health association of the leisure-time and transport-related physical activity domains of the International Physical Activity Questionnaire have not been established in Latin American settings. The authors aimed to quantify the 7-year all-cause mortality risk associated with levels of leisure-time and transport-related physical activity. Methods: Ongoing prospective cohort study conducted in 4 sites in Peru. People ≥35 years were randomly selected from the general population in each study site. The exposures were leisure-time and transport-related physical activity (International Physical Activity Questionnaire) at baseline. The outcome was all-cause mortality based on information retrieved from national records. Cox regression and sensitivity analyses were conducted. Results: There were 3601 people (mean age 55.8 y, 51.5% women). Greater levels of physical activity were associated with lower risk of all-cause mortality, an observation confirmed in sensitivity analyses. Compared with those with low levels of physical activity, leisure-time (≥500 metabolic equivalent of task minutes per week) and transport-related (500–1499 and ≥1500 metabolic equivalent of task minutes per week) physical activity were associated with 70% (95% confidence interval, 3%–90%), 43% (95% confidence interval, 18%–61%), and 42% (95% confidence interval, 8%–63%) lower all-cause mortality, respectively. Conclusions: Greater levels of leisure-time and transport-related physical activity were associated with a strong reduction in the risk of all-cause mortality across different geographical sites. [ABSTRACT FROM AUTHOR]

Serological surveillance studies of infectious diseases provide population-level estimates of infection and antibody prevalence, generating crucial insight into population-level immunity, risk factors leading to infection, and effectiveness of public health measures. These studies traditionally rely on detection of pathogen-specific antibodies in samples derived from venipuncture, an expensive and logistically challenging aspect of serological surveillance. During the COVID-19 pandemic, guidelines implemented to prevent the spread of SARS-CoV-2 infection made collection of venous blood logistically difficult at a time when SARS-CoV-2 serosurveillance was urgently needed. Dried blood spots (DBS) have generated interest as an alternative to venous blood for SARS-CoV-2 serological applications due to their stability, low cost, and ease of collection; DBS samples can be self-generated via fingerprick by community members and mailed at ambient temperatures. Here, we detail the development of four DBS-based SARS-CoV-2 serological methods and demonstrate their implementation in a large serological survey of community members from 12 cities in the East Bay region of the San Francisco metropolitan area using at-home DBS collection. We find that DBS perform similarly to plasma/serum in enzyme-linked immunosorbent assays and commercial SARS-CoV-2 serological assays. In addition, we show that DBS samples can reliably detect antibody responses months postinfection and track antibody kinetics after vaccination. Implementation of DBS enabled collection of valuable serological data from our study population to investigate changes in seroprevalence over an 8-month period. Our work makes a strong argument for the implementation of DBS in serological studies, not just for SARS-CoV-2, but any situation where phlebotomy is inaccessible. IMPORTANCE Estimation of community-level antibody responses to SARS-CoV-2 from infection or vaccination is critical to inform public health responses. Traditional studies of antibodies rely on collection of blood via venipuncture, an invasive procedure not amenable to pandemic-related social-distancing measures. Dried blood spots (DBS) are an alternative to venipuncture, since they can be self-collected by study participants at home and do not require refrigeration for shipment or storage. However, DBS-based assays to measure antibody levels to SARS-CoV-2 have not been widely utilized. Here, we show that DBS are comparable to blood as a sampling method for antibody responses to SARS-CoV-2 infection and vaccination over time measured using four distinct serological assays. The DBS format enabled antibody surveillance in a longitudinal cohort where study participants self-collected samples, ensuring the participants' safety during an ongoing pandemic. Our work demonstrates that DBS are an excellent sampling method for measuring antibody responses whenever venipuncture is impractical.

The rates of early-onset colorectal cancer (EO-CRC) have been rising by 0.5% to 2.4% annually for three decades, accounting for an estimated 12% of all colorectal cancer diagnosed in the United States in 2020. Enhancing the rigor and comprehensiveness of the epidemiology in terms of the exposures and prognostic biomarkers is essential if we are to modify risk factors and underlying mechanisms, ultimately arresting this unduly trend. This commentary serves to describe the disease trend, postulate underlying risk factors and mechanisms driving disease incidence, and proposes a call to action for cancer epidemiologists to promote increased and timely opportunities to intervene on this trend.

Sleep problems are prevalent among adolescents, especially among those diagnosed with mental health disorders. There is insufficient knowledge about sleep among adolescents within child and adolescent mental health services (CAMHS) in comparison to the general population. The data are drawn from the youth@hordaland study, a large population-based study conducted in 2012, linked to the Norwegian Patient Registry (NPR) (n = 9077). Psychiatric disorders were based on clinical diagnoses from the NPR, while insomnia, delayed sleep-wake-phase disorder (DSWPD), and other sleep problems/patterns were assessed by self-report questionnaires from youth@hordaland. The prevalence of diagnosed sleep disorders among adolescents seeking mental health services was 0.6%, yielding an estimated prevalence of 0.07% of the population. However, questionnaire-based measurement of insomnia from the youth@hordaland study indicated that insomnia was highly prevalent across disorders in comparison to a reference group of adolescents who were not within mental health care. Insomnia ranged from 29% among adolescents diagnosed with ADHD (PR = 1.79; 95% CI 1.41-2.29) to 48% among adolescents diagnosed with depression (PR = 2.53, 95% CI 2.19-2.92). All diagnostic groups had a mean sleep efficiency below (85%), indicating poor sleep quality. Insomnia, delayed sleep-phase wake disorder, and poor sleep efficiency were confirmed as transdiagnostic sleep problems across psychiatric disorders. In addition, some disorder-specific patterns emerged, such as a higher prevalence of insomnia among adolescents with depression, and DSWPS among adolescents with conduct disorder. This underscores the need for treating sleep problems in CAMHS, and transdiagnostic treatment approaches are warranted.

Abstract Cognitive disorders, including dementia, Parkinson's and Alzheimer's disease, pose significant public health issues. Preventing/delaying their onset is essential as effective medical treatments are unavailable. Nuts contain bioactive compounds, including fatty acids, macronutrients such as proteins and dietary fibers, micronutrients, and polyphenols; these act synergistically preventing age‐related diseases. Epidemiological investigations have established that high nut consumption reduces cognitive impairment risk, suggesting it is useful for cognitively impaired individuals; however, clinical data on the effects of nut consumption on cognitive function are lacking. This review summarized nut consumption effects on oxidative stress, inflammatory response, and gut microbiota. Nuts reduce oxidative stress; their active substances, including glansreginin A, proanthocyanidins, quercetin, and nut oil, have significant anti‐inflammatory effects. Furthermore, they comprise complex mixtures, which synergistically induce beneficial changes in the intestinal microbial community.

Branched chain amino acids (BCAAs) are essential for protein homeostasis, energy balance, and signaling pathways. Changes in BCAA homeostasis have emerged as pivotal contributors in the pathophysiology of several cardiometabolic diseases, including type 2 diabetes, obesity, hypertension, atherosclerotic cardiovascular disease, and heart failure. In this review, we provide a detailed overview of BCAA metabolism, focus on molecular mechanisms linking disrupted BCAA homeostasis with cardiometabolic disease, summarize the evidence from observational and interventional studies investigating associations between circulating BCAAs and cardiometabolic disease, and offer valuable insights into the potential for BCAA manipulation as a novel therapeutic strategy for cardiometabolic disease.