Metabolic Syndrome Status Changes and Cognitive Functioning: Insights from the Lifelines Cohort Study.

BACKGROUND: Metabolic syndrome is associated with increased risk of dementia. Yet, findings on how longitudinal development of metabolic syndrome status affects cognition remain controversial. OBJECTIVES: This study examines whether individuals with different changes in metabolic syndrome status differ in cognitive functioning. Additionally, the prevalence of metabolic syndrome within the Lifelines population-based study is investigated. DESIGN: 14609 Lifelines participants (mean age 60.8, 56.4% women) were divided into four groups based on their metabolic syndrome status changes between 2007-2013 (1) and between 2014-2017 (2): without metabolic syndrome (N=10863; absent at 1 and 2), de novo metabolic syndrome (N=1340; absent at 1 and present at 2), remitting metabolic syndrome (N=825; present at 1 and absent at 2), and persistent metabolic syndrome (N=1581; present at 1 and 2). ANCOVA models were employed to assess group differences in psychomotor function, visual attention, visual learning, and working memory assessed using the Cogstate Brief Battery. RESULTS: Accounting for education, age, sex, and time between examinations, groups did not statistically differ in any of the four cognitive outcomes. The prevalence of metabolic syndrome within the Lifelines population increased with age and differed among men and women. CONCLUSION: Performance in psychomotor function, visual attention, visual learning, and working memory measured by the Cogstate Brief Battery did not differ between individuals with different changes in metabolic syndrome. The length of metabolic syndrome exposure was unknown, making our results exploratory and calling for future studies addressing this gap.

Implementation research on registering cancer cases in primary health centres of Puducherry through community health workers.

Background & objectives Hospital-based cancer registry does not represent the true burden of cancer in the community. Initiating a Primary Health Centre (PHC)-based cancer registry may better estimate population-level data for cancer cases in an area. This study aimed to set up a system for facilitating a PHC-based cancer registry and to assess the registration status of cancer cases in various PHCs of Puducherry. The facilitating and limiting factors while setting up this registry were also assessed. Methods A quasi-experimental study with an embedded mixed-method design was conducted in 31 PHCs/Community Health Centres (CHCs) from March 2021 to November 2022. The interventions were implemented in all PHCs/CHCs of Puducherry with the involvement of the State Non-Communicable Diseases (NCD) cell. The line list of cancer cases from the Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) Hospital-based cancer registry was shared with all PHCs/CHCs. Sensitization sessions for all Community Health Workers (CHWs) were conducted, and feedback on cancer registration status was given to the State NCD cell. Focus group discussion (FGD)/Key informant interview (KII) was undertaken to understand strengths, challenges, and suggestions. The logic model was used to understand the various indicators while setting up this PHC-based cancer registry. Results Over a one-year intervention period, 1270 cancer cases were registered at Puducherry's PHCs/CHCs, 1203 (88%) from the shared list and 67(5%) from other facilities. However, only 53 per cent of the expected living cases were captured in the various PHCs. Major limitations for registration were the COVID-19 pandemic, stigma, inadequate manpower, infrastructure issues, and privacy concerns during screening. Interpretation & conclusions It was feasible to set up a PHC-based cancer registry in all PHCs of Puducherry. However, registration of cancer cases was suboptimal, as population-based screening of cancer cases, as recommended in the National Programme for Prevention & Control of Non-Communicable Diseases (NP-NCD) programme, was weak due to the COVID-19 pandemic. Once this is strengthened, the PHC-based cancer registry will better represent the population.

Obstetric and neonatal outcomes in women with Ankylosing spondylitis - an evaluation of a population database.

BACKGROUND: Ankylosing Spondylitis (AS) is a systemic chronic rheumatic disease characterized by involvement of the axial skeletal and sacroiliac joints. Although this disease is not rare amongst women of reproductive age, data regarding pregnancy outcomes have demonstrated conflicting results. We therefore aimed to compare pregnancy and perinatal outcomes between women who suffered from AS to those who did not. METHODS: A retrospective cohort study using the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS). Included in the study were all pregnant women who delivered or had a maternal death in the US between 2004 and 2014. Women with an ICD-9 diagnosis of AS before or during pregnancy were compared to those without. Pregnancy, delivery, and neonatal outcomes were compared between the two groups using multivariate logistic regression models adjusting for potential confounders. RESULTS: A total of 9,096,788 women were inclusion in the analysis. Amongst them, 383 women (3.8/100,000) had a diagnosis of AS and the rest were controls. Women with AS, compared to those without, were more likely to be older; Caucasian; from higher income quartiles; suffer from thyroid disorders, and have multiple pregnancies (p < 0.001, all). After adjusting for confounders, patients in the AS group, compared to those without, had a higher rate of cesarean delivery (CD) (aOR 1.47, 95% CI 1.14-1.91, p = 0.003); gestational diabetes (aOR 1.55, 95% CI 1.02-2.33, p = 0.038); and placenta previa (aOR 3.6, 95% CI 1.6-8.12, p = 0.002). Regarding neonatal outcomes, patients with AS, compared to those without, had a higher rate of small-for-gestational-age (SGA) neonates (aOR 2.19, 95% CI 1.22-3.93, p = 0.009); and intrauterine fetal death (IUFD) (aOR 3.46, 95% CI 1.11-10.83, p = 0.033). CONCLUSION: Women diagnosed with AS have an increased risk of obstetric complications, including CD, as well as an increased risk of SGA and IUFD.

Association between cardiometabolic index and kidney stone from NHANES: a population-based study.

Purpose: The Cardiometabolic Index (CMI) is a novel marker of visceral obesity and dyslipidemia. Our study aimed to explore the association between CMI and kidney stones among US adults. Methods: This cross-sectional study was conducted among adults with complete records of CMI and kidney stones information from the 2011 to 2018 National Health and Nutrition Examination Survey (NHANES). Inverse probability treatment weighting (IPTW) was used to balance the baseline characteristics of the study population. The independent relationship between CMI and kidney stones was evaluated using IPTW-adjusted multivariate logistic regression, restricted cubic splines (RCS), and subgroup analysis. Results: A total of 9,177 participants, with an average CMI of 0.72 (0.99), were included in this study. The IPTW-adjusted logistic regression revealed that CMI was an independent risk factor for kidney stones. The adjusted odds ratio (OR) for kidney stones were 1.39 (95% CI: 1.24 - 1.56, P < 0.001) for the second CMI tertile and 1.31 (95% CI: 1.17 - 1.47, P < 0.001) for the third CMI tertile, compared with the first CMI tertile. A linear relationship between CMI levels and kidney stone risk was observed in the RCS analysis. Subgroup analysis showed that the association between CMI levels and kidney stone risk remained stable across groups. Conclusions: A positive association between CMI level and the risk of kidney stones was observed among US adults in our study. Further large-scale prospective studies are needed to validate our findings.

Trends in Melanoma Mortality in Serbia: A 22-Year Population-Based Study.

Background: We aimed to investigating the sex-specific and age-specific melanoma mortality trends observed on the territory of Serbia between 2000 and 2021. Methods: This population-based study used data from the Statistical Office of the Republic of Serbia database during the period 2000-2021. The calculation of the gender and age-standardized rates (ASR) was performed. We used a regression analysis complete with linear trend model. Results: The mean ASR was 1.77 per 100,000 people, meaning that male mortality rates (2.24 per 100,000) was higher than female mortality rates (1.34 per 100,000). During the observation period, a rising trend in mortality from melanoma skin cancer was reported. Observed by gender, the change of melanoma mortality trend was significant in men (P=0.021), but not in women (P=0.747). The annual growth rate of ASRs values was 1.43%. A increase in the melanoma mortality rate was observed since 2000 by 2.44% annually in males and by 2.79% annually in females. Mortality rates were increasing in both sexes as they aged, and the greatest number of deaths was recorded in the group of those aged 80 yr or above (16.25 per 100,000 for men; 10.45 per 100,000 for women). Conclusion: Our study findings underline the importance of launching more effective public health awareness campaigns to educate people about the dangers of melanoma and its symptoms' detection along with establishing a diagnosis at an early stage of the disease, especially among male patients and those at an advanced age.

Lung cancer survival trends and prognostic factors: A 26-year population-based study in Girona Province, Spain.

BACKGROUND: Lung cancer (LC) is Europe's primary cause of cancer-related mortality largely due to its historically low survival rates. The aim of this study was to analyze 26-year survival trends in the province of Girona, Spain, and to identify key prognostic factors. METHODS: Population-based study of LC cases collected between 1994 and 2019, with follow-up until December 31, 2021. Variables included date of diagnosis, sex, age, histology, and tumor stage (the latter since 2010). Diagnosis dates were categorized into three periods (1994-2002, 2003-2011, and 2012-2019). Multivariate flexible parametric models, incorporating age as a non-linear, time-varying covariate, were used to analyze net survival (NS) and trends. Annual absolute change in survival (AAC_S) was calculated using 3-year NS. RESULTS: The analysis of 9,113 LC cases showed a NS improvement between the first and last period (7.1 months (95 %CI: 6.5;7.6) to 8.5 months (95 %CI: 7.9;9.1)). Squamous cell carcinoma (NSC-SCC) showed the greatest improvement with an AAC_S of 0.32 % (95 % CI: 0.21; 0.43), while survival for non-small cell lung cancer not otherwise specified declined (AAC_S of -0.19 % (95 %CI: -0.26; -0.12)). Prognostic analysis of the 3,642 cases (2010-2019) indicated a lower LC death risk for adenocarcinoma and NSC-SCC compared to LC not otherwise specified (HR 0.52 and 0.62, respectively). Increasing tumor stage correlated with higher LC mortality risk (1.8-, 4.0-, and 10.1-fold increase for stage II, III, and IV, respectively, compared to stage I). CONCLUSIONS: LC survival has notably improved, particularly for NSC-SCC. Survival is influenced by sex, age, date of diagnosis, tumor histology and especially by stage, underscoring comprehensive data collection's importance.

Hearing loss and its relation to longitudinal changes in white matter microstructure in older adults: The Rotterdam Study.

Hearing loss is considered a potentially modifiable risk factor for dementia. The sensory deprivation theory postulates that hearing loss adversely affects cognition in older adults through structural brain changes, but longitudinal studies are scarce. To find evidence for a possible detrimental effect of hearing loss on white matter microstructure, we carried out a longitudinal study in the population-based Rotterdam Study. A total of 1877 participants with a median age at baseline of 56.4 years (IQR: [52.2-60.0]) underwent audiometry and had longitudinal diffusion imaging data available with a mean follow-up of 4.0 years. A lower level of hearing acuity was associated with worse white matter microstructure in the left uncinate fasciculus and superior longitudinal fasciculus at baseline. Poorer hearing acuity was also associated with faster microstructural deterioration over time in the left superior longitudinal fasciculus. The strongest effects were observed for low-frequency hearing thresholds, while the high-frequency thresholds showed the weakest associations. These results suggest that hearing loss may contribute to the age-related decline in brain structure, consistent with the sensory deprivation theory.

Extrapolating Sentinel Surveillance Information to Estimate National COVID Hospital Admission Rates: A Bayesian Modeling Approach.

The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) was established in March 2020 to monitor trends in hospitalizations associated with SARS-CoV-2 infection. COVID-NET is a geographically diverse population-based surveillance system for laboratory-confirmed COVID-19-associated hospitalizations with a combined catchment area covering approximately 10% of the US population. Data collected in COVID-NET includes monthly counts of hospitalizations for persons with confirmed SARS-CoV-2 infection who reside within the defined catchment area. A Bayesian modeling approach is proposed to estimate US national COVID-associated hospital admission rates based on information reported in the COVID-NET system. A key component of the approach is the ability to estimate uncertainty resulting from extrapolation of hospitalization rates observed within COVID-NET to the US population. In addition, the proposed model enables estimation of other contributors to uncertainty including temporal dependence among reported COVID-NET admission counts, the impact of unmeasured site-specific factors, and the frequency and accuracy of testing for SARS-CoV-2 infection. Based on the proposed model, an estimated 6.3 million (95% uncertainty interval (UI) 5.4-7.3 million) COVID-19-associated hospital admissions occurred in the United States from September 2020 through December 2023. Between April 2020 and December 2023, model-based monthly admission rate estimates ranged from a minimum of 1 per 10,000 population (95% UI 0.7-1.2) in June of 2023 to a highest monthly level of 16 per 10,000 (95% UI 13-19) in January 2022.

A comprehensive study of genetic regulation and disease associations of plasma circulatory microRNAs using population-level data.

BACKGROUND: MicroRNAs (miRNAs) are small non-coding RNAs that post-transcriptionally regulate gene expression. Perturbations in plasma miRNA levels are known to impact disease risk and have potential as disease biomarkers. Exploring the genetic regulation of miRNAs may yield new insights into their important role in governing gene expression and disease mechanisms. RESULTS: We present genome-wide association studies of 2083 plasma circulating miRNAs in 2178 participants of the Rotterdam Study to identify miRNA-expression quantitative trait loci (miR-eQTLs). We identify 3292 associations between 1289 SNPs and 63 miRNAs, of which 65% are replicated in two independent cohorts. We demonstrate that plasma miR-eQTLs co-localise with gene expression, protein, and metabolite-QTLs, which help in identifying miRNA-regulated pathways. We investigate consequences of alteration in circulating miRNA levels on a wide range of clinical conditions in phenome-wide association studies and Mendelian randomisation using the UK Biobank data (N = 423,419), revealing the pleiotropic and causal effects of several miRNAs on various clinical conditions. In the Mendelian randomisation analysis, we find a protective causal effect of miR-1908-5p on the risk of benign colon neoplasm and show that this effect is independent of its host gene (FADS1). CONCLUSIONS: This study enriches our understanding of the genetic architecture of plasma miRNAs and explores the signatures of miRNAs across a wide range of clinical conditions. The integration of population-based genomics, other omics layers, and clinical data presents opportunities to unravel potential clinical significance of miRNAs and provides tools for novel miRNA-based therapeutic target discovery.

Age-specific distribution of oculometric parameters and myopia in children aged 8-12y.

AIM: To describe the distribution of ocular biometrics and to evaluate its associations with refractive error and to assess the contribution from ocular parameters to refractive error among Chinese myopic children. METHODS: This cross-sectional study evaluated subjects aged 8-12y. Keratometry, ocular biometry, and cycloplegic autorefraction were performed on each subject. Spherical equivalent refraction (SER) and ocular biometrics were assessed as a function of age and gender. The Pearson correlation analysis between SER and ocular biometrics was carried out. Multiple linear regression was performed to analyze the association between SER and ocular parameters. RESULTS: A total of 689 out of 735 participants (321 boys, 48.1%) were analyzed, with a mean SER of -2.98±1.47 diopter (D). Axial length (AL), anterior chamber depth (ACD), corneal radius of curvature (CR), horizontal visible iris diameter (HVID), central corneal thickness (CCT) and lens power (LP) showed normal distribution. The AL, AL/CR ratio, ACD and CR increased from 8 to 12y of age, while SER and LP decreased, HVID and CCT remained stable. There was no difference in gender. SER decreased by 0.929 D for every 1 mm increase in AL and decreased by 1.144 D for every 0.1 increase in AL/CR ratio. The Pearson correlation coefficient between SER and AL was -0.538 (P<0.01) and -0.747 (P<0.01) between SER and AL/CR ratio. For the SER variance, AL explained 29.0%, AL/CR ratio explained 55.7%, while AL, CR, ACD and LP explained 99.3% after adjusting for age and gender. CONCLUSION: The AL, CR, ACD and LP are the most important determinants of myopic refractive error during myopia progression.

Population-based overall and net survival of childhood leukemia at 1-, 5-, and 10-years of follow-up in three regions of Colombia.

Background: Childhood leukemia (CL) is the most common type of childhood cancer worldwide and in Colombia. Thanks to therapeutic innovations and improved access, the survival of children and adolescents with leukemia has increased considerably worldwide, especially in high-income countries. In Colombia, a middle-income country, survival has also been observed to increase in big cities. However, the survival rate in intermediate cities is still unknown. Objective: This study aimed to assess short- and long-term survival rates of children with leukemia coming from three intermediate Colombian cities as well as to compare overall survival (OS) rates versus relative survival (RS) rates of this population of children. Methods: Data from population-based cancer registries in three Colombian cities (Bucaramanga metropolitan area, Manizales and Pasto) were analyzed. OS and RS of up to 10 years were estimated for children who were diagnosed with leukemia at ages 0-18 years between 1998 and 2018 and followed up for vital status. RS was calculated using the Pohar-Perme method. We performed a separate survival analysis by gender and by period of diagnosis (before and after 2010). Results: We included data from 507 children and adolescents diagnosed with leukemia. RS at 1, 5 and 10 years after diagnosis were similar between the populations for the respective timeframes (RS Bucaramanga 86.5%, 66.9% and 52.5%; Manizales 81.1%, 62.8% and 61.1%; Pasto 81.7% at 1 year, 66.2% at 5 years and 59.4% at 10 years). OS and RS were very similar for all estimates and periods. There were no clear differences in RS between genders across the three population-based cancer registries and there was an improvement in RS after 2010, particularly in Bucaramanga and Pasto. Conclusion: Our study reports similar 5-year survival rates for CL in these Colombian cities compared to rates documented in other Latin American countries and larger Colombian cities. These are far below what is reported in high-income settings. This highlights opportunities for improvement in the Colombian health system, where numerous barriers persist in terms of suspicion, diagnosis and continuity of treatment for CL.

The regional cancer spectrum in Uganda: a population-based cancer survey by sub-regions (2017-2020).

Background: Accurate estimation of the burden of cancer in developing countries is a major public health concern for cancer prevention and control because of the limited coverage of population-based cancer registries (PBCRs). The cancer registration coverage status of Uganda was 11.90% and was not uniformly distributed in all regions of Uganda. This population-based survey was conducted to assess the burden of cancer in all the sub-regions of Uganda by site, sex and age group to accurately determine the cancer profile of Uganda by sub-region for a tailored intervention to mitigate cancer risk factors and burden. Methods: This study used existing administrative units of Uganda from which 55 districts emerged, forming 10 sub-regions as satellite population-based cancer registry study sites. Data on newly diagnosed cancer cases were retrospectively collected for the period 2017-2020 using a cancer notification form, entered into CanReg5 Software, exported to spreadsheets and univariate analysis was performed to determine the cancer spectrum, their proportions and crude rates by site, sex, age group and geographical location. Results: A total of 25,576 cancer cases were registered, up to 14,322 (56%) were in females and, male cancers were 11,254 (44%). The top five female cancers in all the sub-regions included cervical cancer (43%, n = 6,190), breast (22%, n = 3,200), esophagus (5.6%, n = 800), ovary (5.2%, n = 746), Kaposi Sarcoma (KS) (4.7%, n = 666) and other less common cancers (18.5%, n = 2,720). In males, the top five cancers included prostate cancer 25.1 % (n = 2,820), esophagus 15.1% (n = 1,704), KS 12.4% (n = 1,395), liver 8.8% (n = 989) and stomach 4.8% (n = 539), with other less common male cancers accounting for 33.8% (n = 3,807).In all the sub-regions of Uganda, cancers of the esophagus, liver and KS are common in both males and females, but the number of males with these cancers is twice that of their female counterparts. In Rwenzori, Kigezi and Bugishu sub-Regions, there seems to be an increased risk of developing other skin cancers in females, while stomach cancers have been reported in both males and females. Most of the other sub-regions register emerging cases of only ovarian cancer in females. In children, the top three cancers included lymphoma, 33.9% (n = 653); soft tissue sarcomas, 20.8% (n = 400); malignant bone tumors, 15.8% (n = 305); myeloid-type leukemia, 13.8% (n = 265); and the other less common childhood cancers combined, 15.7% (n = 303). The proportion of childhood cancers is higher in the male child compared to the female at a ratio of 1.3:1. Conclusions: The sub-regional cancer spectrum in Uganda ranges from cervical cancer to breast, esophageal, ovarian and KS in females. Male cancers include prostate, esophageal, KS, liver and stomach cancers. Although the cancer profile is similar in most sub-regions of Uganda, except Ankole subregions with mountainous topography (Rwenzori, Kigezi, Bugisu), there has been significant variation in cancer profile, especially for males, where Non-Hodgkins Lymphomas is one of the cancers reported for Uganda by PBCRs in Gulu, and Kampala has been replaced by stomach cancers as one of the common male cancers in the sub-regions. These findings emphasize the need for the establishment and support of additional regional PBCRs and periodic population-based cancer surveys to accurately determine the burden of cancer, inform the establishment of regional cancer centers and guide national and sub-national cancer control programs in Uganda. Cancer surveillance systems using PBCRs should be part of the national cancer control program. Periodic population-based cancer surveys should also be conducted as part of Uganda's demographic and health surveys in areas without PBCRs to inform the country comprehensively and accurately on the cancer burden to design robust cancer mitigation measures.

Gender-Specific Differences in Prevalence and Association of Cardio-Metabolic Parameters and Hyperuricemia: A Population-Based Cross-Sectional Study, Nakhon Nayok, Thailand.

Background: Although the prevalence of HUA is increasing, epidemiologic studies on HUA in the middle-aged and elderly population are limited. The present study aimed to calculate the prevalence and evaluate the sex-related associations between metabolic parameters and hyperuricemia (HUA) among middle-aged and elderly adults. Methods: This was a population-based cross-sectional study from 2018 to 2019 in rural areas of Nakhon Nayok Province, Thailand. We enrolled 780 subjects aged 40 yr and over for health check-ups and examination surveys. The age-standardized prevalence of HUA was estimated by the direct method. A multiple logistic regression was performed to identify the potential risk factors associated with HUA. Results: The prevalence of HUA were 30.9% (42% in males vs. 20% in females). Elderly adults were associated with a 35% increase in the risk of HUA. Obesity was found to be strongly associated with an increased prevalence of HUA in both sexes. Hypertriglyceridemia (51% increase in males vs. 23% increase in females), and high fasting glucose (90% increase in males vs. 49% increase in females) were also associated risk factors for HUA in both sexes. However, low high-density lipoprotein was only associated with a 67% increase in the risk of HUA in females. Conclusion: The age-standardized prevalence of HUA among females is relatively lower than in males. This study also revealed that obesity is strongly associated with HUA in both sexes.

Pregnancy-Associated Maternal Mortality Within One Year After Childbirth: Population-Based Cohort Study.

OBJECTIVE: The objective of this study is to assess associations between pregnancy complications and pregnancy-associated maternal mortality (PAM) within 1 year after childbirth. DESIGN: Population-based cohort study. SETTING: Norway, 1967-2020. POPULATION: 1 237 254 mothers with one or more singleton pregnancies registered in the Medical Birth Registry, 1967-2019 and followed in the Cause of Death Registry to 2020. METHODS: Logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for maternal education, age, year of first childbirth and chronic medical conditions. MAIN OUTCOME MEASURES: PAM by lifetime history of pregnancy complications: placental abruption, preeclampsia, preterm birth, perinatal death, small for gestational age (< 2.5 percentile), gestational diabetes and gestational hypertension. RESULTS: Crude OR for PAM was 4.24 (95% CI 3.53-5.10), if complications occurred in the last pregnancy, whereas 2.52 (2.08-3.06) if complications occurred in the first pregnancy, compared to mothers without complications in any pregnancy. Adjusted ORs for PAM when complications occurred in the last pregnancy were, for placental abruption 3.75 (1.20-11.72), preeclampsia: 4.42 (3.17-6.15), preterm birth: 4.32 (3.25-5.75), perinatal death: 24.18 (16.66-35.08), small for gestational age: 2.90 (1.85-4.54), gestational diabetes: 1.43 (0.63-3.25) and pregnancy hypertension: 2.05 (1.12-3.74) compared to mothers without complications. The OR for PAM increased slightly by increasing the number of complicated pregnancies but the trend was stronger for increasing number of complications in the last pregnancy (e.g., during 1999-2019: one complication; 4.14 [2.79-6.13], two complications; 11.50 [6.81-19.43]). CONCLUSION: Complications in the last pregnancy were more strongly associated with PAM than those in the first pregnancy.

Risk Factors for Adults with Chronic Obstructive Pulmonary Disease in the United States, Utilizing State-Based Surveillance.

Chronic Obstructive Pulmonary Disease (COPD) is a complex and heterogeneous condition. Exposure to tobacco smoke and air pollutants are key risk factors for COPD development; however, other risk factors include race/ethnicity, sex of adults, a history of asthma, occupational exposures, and chronic respiratory infections. Data for the current study were from the 2022 Behavioral Risk Factor Surveillance Survey. Chi-squares and multinomial logistic regression analyses, adjusted with the survey's sampling weight, were used to examine how critical health indicators impacted a COPD diagnosis. Participants (N = 311,175) were adults aged 45 years and older. Adjusted multinomial regression analyses showed adults who reported asthma, current and former smoking, poor physical health, depression, less physical activity, and fatigue were more likely to report COPD. Those with COPD were more likely to be male than female. Moreover, those with COPD reported higher rates of health insurance coverage, and yet had lower income and more financial difficulty affording a doctor for health services. In a follow up regression analysis, examining racial differences in COPD for participants, American Indian adults had a higher odds of reporting COPD than the "other" race groups. Because COPD remains a leading cause of death and disability in the U.S., and racial disparities persist in respiratory outcomes, continuing to identify risk factors for vulnerable groups could assist health program planners with development of successful health messaging.

SARS-CoV-2 Antibody Seroprevalence in Gabon: Findings from a Nationwide Household Serosurvey in a Sub-Saharan Africa Country.

Seroconversion surveys of anti-SARS-CoV-2 antibodies provide accurate estimates of the prevalence of SARS-CoV-2 infections. This nationwide population-based cross-sectional serosurvey aimed to evaluate the prevalence of SARS-CoV-2 antibodies among residents in Gabon and compare the estimated cumulative number of COVID-19 cases with the officially registered number of laboratory-confirmed cases up to December 2021. Households in each province were randomly selected. Twenty-eight localities, including sixteen urban and twelve rural, were randomly selected for the study. Whole blood samples were collected in dry tubes from all study participants nationwide within 15 days. Serum samples were used to measure SARS-CoV-2-specific ELISA titers. Overall, data from 1672 households were analyzed. Out of the 3659 participants, 3175 were found to be positive for SARS-CoV-2 antibodies, resulting in a crude seroprevalence of 86.77%. Stratification of study participants by age group showed the highest seroprevalences in the 20-29 and 40-49 age groups with 91.78% (95% CI: 89.5-93.6) and 91.42% (95% CI: 88.7-93.5), respectively. Nyanga province had the lowest prevalence (72.8%), and Estuaire and Ogooué-Lolo provinces had the highest prevalence (90 and 92%). Our results suggest a high transmission rate in the Gabonese population 21 months after the first SARS-CoV-2 case in the country. This high seroprevalence estimate could indicate that the population may not have adequately implemented or appropriately adhered to the applied infection control measures.

Multi-dimensional patient-reported outcomes and quality of life at diagnosis of IBD: A population-based inception cohort study.

BACKGROUND AND AIMS: Patient-reported outcomes (PROs) are pivotal in assessing treatment efficacy and estimating the burden of inflammatory bowel diseases (IBD). We investigated PROs at the time of IBD diagnosis. METHODS: The Short Inflammatory Bowel Disease Questionnaire (SIBDQ), IBD-Disability Index (IBD-DI), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and disease activity-related PROs were assessed in the Copenhagen IBD Inception Cohort, a prospective, population-based cohort of patients newly diagnosed with IBD between May 2021 and May 2023. RESULTS: A total of 203 UC and 116 CD patients were recruited. At diagnosis, 160 (78.8%) and 99 (85.3%) patients with UC and CD, respectively, reported moderate-to-severe impairment in at least one PRO (p=0.18), with 89 (43.8%) and 74 (63.8%), respectively, reporting moderate-to-severe impairment in at least two PROs (p<0.01). Being female, the disease extent of UC, and extraintestinal manifestations were associated with impaired PROs. There were no differences found according to CD phenotype. FACIT-F, IBD-DI, and SIBDQ scores showed weak, but significant, correlations with the Mayo Endoscopic Score in UC, and the FACIT-F score with C-reactive protein (CRP). In CD, SIBDQ, IBD-DI, and FACIT-F correlated moderately with CRP and fecal calprotectin, but not with the endoscopic severity of CD. None of the PROs correlated with iron, ferritin, or vitamin D levels. Among the most prevalent symptoms reported were fatigue, abdominal pain, urgency, and passing of blood in both CD and UC. CONCLUSION: We found a substantial patient-reported disease burden in newly diagnosed IBD, underscoring the importance of vigilant PRO monitoring in clinical practice. FUNDING: This study was funded by an unrestricted grant from the Novo Nordisk Fonden.

Assessment of burden of prediabetes and diabetes with oral glucose tolerance test in community-based settings of Bengaluru rural district.

Background and Objectives: Diabetes is a major public health concern in India. The majority of studies done in rural population lack systematic methodology in estimating the prevalence of diabetes mellitus. Objectives of this study were to estimate the burden of prediabetes, type 2 diabetes mellitus and its associated risk factors among adults (18-69) years in rural Bengaluru, Karnataka. Methods: A cross-sectional study was conducted among adults aged 18-69 years in three villages of Devanahalli taluk of rural Bengaluru between May and October 2019. Behavioural and metabolic risk factors related to diabetes were assessed using WHO-STEPS instrument and IDSP-NCD risk factor tool. Fasting blood glucose and OGTT test were performed, and WHO diagnostic criteria were used to diagnose diabetes mellitus. Results: Prevalence of prediabetes and type 2 diabetes (T2DM) in rural Bengaluru was found to be 6.3% and 10.9%, respectively. Behavioural risk factors related to diabetes measured in the study population were current tobacco use (32.7%), current alcohol use (9.9%), physical inactivity (46.8%) and unhealthy diet (82.3%). Metabolic risk factors measured were obesity (7.5%), central obesity (46.4%), prediabetes (6.3%) and hypertension (24.3%). More than one-thirds of diabetes and three-fourths of hypertension individuals were newly diagnosed by the population-based screening. Conclusion: The burden of diabetes and its risk factors are high due to the health transition occurring in rural population of Bengaluru. Undiagnosed diabetes mellitus and hypertension in rural population as demonstrated by this study highlight the need to strengthen the population-based screening and diagnosis of T2DM and hypertension (HTN) under the national health programme.

Prevalence of human papillomaviruses in self-collected samples among women attending antenatal care in Ethiopia: a cross-sectional study.

Cervical cancer is the second most commonly diagnosed cancer in women in Ethiopia. However, data are limited on the prevalence of human papillomavirus (HPV) genotypes. Self-sampled vaginal lavages were obtained consecutively from 783 women attending 7 health facilities across Ethiopia. Genotype prevalence was assessed by Multiplex-Papillomavirus-Genotyping which detects and individually identifies 51 genotypes and 3 subtypes. Genotype-specific prevalence was described and associations with known risk factors were analysed. The overall HPV prevalence (age range 18-45) was 33.1% (95% confidence interval (CI) 29.8-36.4). The prevalence of HPV was different in the rural and urban population with 17.6% (95%CI 11.6-23.7) and 36.8% (95%CI 33.1-40.6) (p < 0.001 chi-square test), respectively. The most common high-risk types were HPV 16 (6.6%), followed by HPV 52 (4.3%), 51 and 39 (both 2.9%). Urban women compared to rural women had a higher risk of being HPV positive (odds ratio 2.36 (95% CI 1.47-3.79; p < 0.001). Age at sexual debut ≤15 years and polygamous husband (in urban women) also increased the risk of being HPV positive nearly two-fold. The high prevalence of hr-HPV in Ethiopian women in the reproductive age group shows the need for screening programs. The nonavalent HPV vaccine covers the most prevalent hr-HPV genotypes as found in this study and can therefore be used effectively. Since antenatal care is the best-utilised health service, implementing self-sampled vaginal lavage could be an opportunity for screening in this age group. Screening algorithms and triage still need to be defined to avoid over-treatment in these women.