Análisis demográfico de la Cirugía Plástica en Argentina / Demographic analysis of Plastic Surgery in Argentina

En un país geográficamente vasto, dividido en 24 jurisdicciones (23 provincias y un distrito federal), con características diferentes, desde el Comité de Estadísticas de la Sociedad Argentina de Cirugía Plástica se decidió averiguar la distribución demográfica de la especialidad y de las subespecialidades. Para tal fin se realizó una encuesta anónima entre los 1142 miembros de la Sociedad Argentina de Cirugía Plástica (nota: actualización abril 2023). Fueron en total 11 preguntas respondidas por 239 miembros SACPER (20,92% del total de los miembros). Además de las preguntas de los procedimientos, hemos agregado datos como grupo etario, sexo y región del país en el que ejercen su profesión y tipos de entidades laborales para las cuales trabajan. En las últimas dos preguntas, se les solicitó a los socios que nos informen, según su conocimiento y criterio, si evidencian déficit de alguna/s subespecialidades reconstructivas en la región donde ejercen su profesión. Esta encuesta de análisis demográfico de la cirugía plástica en Argentina tuvo como objetivo informarnos la distribución por región de los diferentes procedimientos estéticos, miniinvasivos y reconstructivos que realizan los cirujanos plásticos argentinos, características de las entidades laborales donde ejercen la profesión y tipo de cirugía reconstructiva identificada por los colegas como deficitaria en su lugar de ejercicio profesional. Se lograron obtener interesantes datos sobre la distribución entre las tres principales actividades de la especialidad, distribución geográfica, características laborales y déficit de subespecialidades reconstructivas. Los datos obtenidos a través de la encuesta, y vertidos en este artículo, pueden ser usados en el presente y en el futuro por la Sociedad Argentina de Cirugía Plástica, por sus regionales, por autoridades sanitarias nacionales o locales y por los actuales cirujanos plásticos en formación para orientarlos en cuáles subespecialidades elegir y donde ejercerlas a partir del déficit informado por los colegas, o por cualquier cirujano plástico que desee usar los datos en futuras publicaciones, conferencias o divulgaciones científicas

In a geographically vast country, divided into 24 jurisdictions (23 provinces and a federal district), with different characteristics, the Statistics Committee of the Argentine Society of Plastic Surgery decided to find out the demographic distribution of the specialty and subspecialties. For this purpose, an anonymous survey was carried out among the 1,142 members of the Argentine Society of Plastic Surgery (note: update April 2023). There was a total of eleven questions answered by 239 SACPER members (20.92% of the total members). In addition to the procedural questions, we have added data such as age group, sex and region of the country in which they practice their profession and types of labor entities for which they work. In the last two questions, the partners were asked to inform us, according to their knowledge and criteria, if they evidence a deficit in any reconstructive subspecialties in the region where they practice their profession. This survey of demographic analysis of plastic surgery in Argentina, aimed to inform us about the distribution by region of the different aesthetic, mini-invasive and reconstructive procedures performed by Argentine plastic surgeons, characteristics of work entities where they practice the profession and type of reconstructive surgery identified by colleagues as deficient in their place of professional practice. Interesting data were obtained on the distribution between the three main activities of the specialty, geographical distribution, work characteristics and deficit of reconstructive subspecialties. The data obtained through the survey and presented in this article can be used in the present and in the future by the Argentine Society of Plastic Surgery, by its regional offices, by national or local health authorities and by current plastic surgeons in training. to guide them in which subspecialties to choose and where to practice them based on the deficit reported by colleagues, or by any plastic surgeon who wishes to use the data in future publications, conferences or scientific report

Consumer food environment assessment and its association with socioeconomic factors in a midsize city in Brazil / Avaliação do ambiente alimentar do consumidor e suas associações com fatores socioeconômicos em uma cidade brasileira de médio porte

ABSTRACT Objective To assess the consumer food environment and its associations with socioeconomic factors in a midsize Brazilian city. Methods An ecological study that assessed the consumer food environment through audits in a stratified and proportional sample of food stores. The ESAO-S and the ESAO-R instruments were used. Access to healthy food was assessed using the Healthy Food Store Index and the Healthy Meal Restaurant Index. Socioeconomic and demographic characteristics and the Health Vulnerability Index were obtained from the 2010 Demographic Census. Statistical analyses were performed using the IBM®SPSSNo-Break®No-Break software. Result A total of 280 food stores were assessed. Only 47.1% of food stores for home consumption had fruits, vegetables, or legumes. High availability of ultra-processed food was identified, such as sugar-sweetened beverages (85.0%) and chocolate sandwich cookies (77.8%). The prices of some unprocessed foods and the availability of snacks were different according to socioeconomic characteristics. In food stores for immediate consumption, low availability of healthy options was identified, and, in most of them, natural juices had higher prices than sugar-sweetened beverages (87.1%). The mean Healthy Food Store Index score was 5.1 (SD=3.6), and the Healthy Meal Restaurant Index was 2.4 (SD=1.2). Conclusion These findings allow us to expand the knowledge about the consumer food environment, helping to implement public policies related to food supply.

RESUMO Objetivo Avaliar o ambiente alimentar do consumidor e suas associações com fatores socioeconômicos em uma cidade brasileira de médio porte. Métodos Estudo ecológico, no qual avaliou-se o ambiente alimentar do consumidor por meio de auditorias em uma amostra estratificada e proporcional de estabelecimentos que comercializam alimentos. Utilizaram-se os instrumentos ESAO-S e ESAO-R. O acesso a alimentos saudáveis foi avaliado por meio do Healthy Food Store Index e do Healthy Meal Restaurant Index. As características socioeconômicas, demográficas e o índice de vulnerabilidade da saúde foram obtidos a partir do Censo Demográfico de 2010. As análises estatísticas foram realizadas no software IBMNo-Break®No-BreakSPSSNo-Break®No-Break. Resultados Avaliaram-se 280 estabelecimentos, onde apenas 47,1% dos comércios de alimentos para consumo em domicílio possuíam frutas, verduras ou legumes. Foi identificada uma elevada disponibilidade de alimentos ultraprocessados, como refrigerantes (85,0%) e biscoitos (77,8%). Os preços de alguns alimentos in natura e a disponibilidade de salgadinhos foram diferentes segundo as características socioeconômicas. Nos comércios de alimentos para consumo imediato, foi identificada baixa disponibilidade de opções saudáveis e, na maioria deles, os sucos naturais apresentaram preços superiores a refrigerantes (87,1%). A pontuação média do Healthy Food Store Index foi 5,1 (DP=3,6) e do Healthy Meal Restaurant Index de 2,4 (DP=1,2). Conclusão Os resultados permitem ampliar o conhecimento sobre o ambiente alimentar do consumidor, auxiliando na implantação de políticas públicas relacionadas ao abastecimento alimentar.

Enabling Hotspot Detection and Public Health Response to the COVID-19 Pandemic.

INTRODUCTION: Public-facing maps of COVID-19 cases, hospital admissions, and deaths are commonly displayed at the state, county, and zip code levels, and low case counts are suppressed to protect confidentiality. Public health authorities are tasked with case identification, contact tracing, and canvasing for educational purposes during a pandemic. Given limited resources, authorities would benefit from the ability to tailor their efforts to a particular neighborhood or congregate living facility. METHODS: We describe the methods of building a real-time visualization of patients with COVID-19-positive tests, which facilitates timely public health response to the pandemic. We developed an interactive street-level visualization that shows new cases developing over time and resolving after 14 days of infection. Our source data included patient demographics (ie, age, race and ethnicity, and sex), street address of residence, respiratory test results, and date of test. RESULTS: We used colored dots to represent infections. The resulting animation shows where new cases developed in the region and how patterns changed over the course of the pandemic. Users can enlarge specific areas of the map and see street-level detail on residential location of each case and can select from demographic overlays and contour mapping options to see high-level patterns and associations with demographics and chronic disease prevalence as they emerge. CONCLUSIONS: Before the development of this tool, local public health departments in our region did not have a means to map cases of disease to the street level and gain real-time insights into the underlying population where hotspots had developed. For privacy reasons, this tool is password-protected and not available to the public. We expect this tool to prove useful to public health departments as they navigate not only COVID-19 pandemic outcomes but also other public health threats, including chronic diseases and communicable disease outbreaks.

Características sociodemográficas y consumo de alimentosultra procesados en vegetarianos y no-vegetarianos: Un estudio transversal en la población peruana / Sociodemographic characteristics and consumption of ultra-processed foods in vegetarians and non-vegetarians: A cross-sectional study in the Peruvian population

Introducción: El consumo constante de alimentos ultraprocesados representa una amenaza para la salud, inclusopara aquellos que practican el régimen vegetariano. El objetivo de este estudio fue describir las características sociodemográficas e ingesta de alimentos ultraprocesados en vegetarianos y no vegetarianos. Métodos: Se aplicó una encuesta transversal en línea. Se consideraron 460 participantes, 87 vegetarianos y 373 no vegetarianos. El reclutamiento se llevó a cabo durante los mesesde julio y septiembre de 2020, considerando participantes de18 a 59 años, residentes de las tres regiones del Perú. Se aplicóel estadístico t student para contrastar las medias de frecuencias de consumo de alimentos ultraprocesados y patrón dietético, y mediante la prueba chi-cuadrado se contrastaron proporciones en las características sociodemográficas e ingesta de alimentos ultraprocesados según patrón dietético. Se consideró un nivel de significancia de 0,05. Se analizaron los datos mediante el software estadístico IBM SPSS versión 27. Resultados: Los vegetarianos tendían a ser mujeres (60,9%), jóvenes de 18 a 25 años (71,3%), residentes de lazona costera del Perú (83,9%), universitarios (85,1%) y con un ingreso familiar mensual que oscila entre S/ 3,970.00 aS/12,660.00 (49,2%). En general, los vegetarianos demostraron significativamente un menor consumo de piqueos, galletas, bebidas azucaradas y gaseosas y dulces en comparacióna los no vegetarianos (p <0,001). Finalmente, se observó que, en comparación con los no vegetarianos, hubo un mayorporcentaje de vegetarianos que reportaron no haber consumido nunca alimentos ultraprocesados, aunque el consumode chifles fue significativamente mayor en los vegetarianosque en los no vegetarianos.(AU)

Introduction: The constant consumption of ultraprocessed foods represents a threat to the health of populations, even for those who practice vegetarian regimen. Objective: The aim of this study was to describe the sociodemographic characteristics and intake of ultraprocessedfoods in vegetarians and non vegetarians. Methods: A cross sectional online survey was applied. Atotal of 460 participants were considered, 87 vegetarians and373 non vegetarians. Recruitment was carried out during themonth of July and September 2020, considering participantsaged 18 to 59 years, residents of the three regions of Peru.The Student’s ttest was used to contrast the means of thefrequency of consumption of ultra processed foods and dietary pattern, and the chisquare test was used to contrastproportions in the sociodemographic characteristics and intake of ultraprocessed foods according to dietary pattern. Asignificance level of 0.05 was considered. Results: Vegetarians tended to be women (60.9%), youngpeople aged 18 to 25 years (71.3%), residents of the coastalzone of Peru (83.9%), university students (85.1%) and witha monthly family income ranging from S/ 3,970 to S/12,660(49.2%). In general, vegetarians showed significantly lowerconsumption of snacks, cookies, sugary and carbonated beverages and sweets compared to non vegetarians (p <0.001).Finally, it was observed that, compared to non vegetarians,there was a higher percentage of vegetarians who reportednever having consumed ultra processed foods, although consumption of snack foods was significantly higher in vegetarians than in non vegetarians.(AU)

Sífilis congênita no Brasil e indicadores propostos pela Rede Cegonha no âmbito do cuidado pré-natal / Congenital syphilis in Brazil and indicators proposed by Rede Cegonha in the context of prenatal care

Em comparação aos demais países da América Latina, o Brasil tem se destacado ao longo dos anos por apresentar taxas elevadas de notificações de sífilis congênita ­ denunciando, em especial, o evidente déficit das intervenções em saúde durante os cuidados pré-natais. Em 2011, na tentativa de melhorar as condições de saúde materno-infantil no país, foi instituída a Rede Cegonha, política que orienta a implementação de um novo modelo de atenção à saúde da mulher e da criança, a organização da rede de cuidados e a redução da mortalidade materna e infantil. O objetivo desta pesquisa foi analisar a incidência de sífilis congênita nos municípios brasileiros conforme indicadores propostos pela Rede Cegonha no âmbito do cuidado pré-natal. Trata-se de um estudo com delineamento observacional, do tipo ecológico misto com caráter analítico, cuja amostra foi composta por 257 municípios com quantidade de habitantes igual ou superior a cem mil (n = 257). Realizou-se análise descritiva das variáveis dependentes e independentes e análise bivariada por Regressão de Poisson por Variância Robusta para os desfechos "incidência de sífilis congênita" e "razão entre sífilis congênita e sífilis em gestante". Na análise de tendência (2015-2019), foram estimadas médias marginais por meio de Análise de Variância (ANOVA) do tipo Split-Plot para os desfechos escolhidos conforme variáveis independentes elencadas. A análise transversal evidenciou que a incidência média de sífilis congênita foi 42% maior nos municípios com IDH até 0,785 (RM=1,42; p<0,001) e 36% maior entre populações com disponibilidade de teste rápido abaixo de 50% (RM =1,36; p<0,005). A razão entre sífilis congênita e sífilis em gestantes foi 33% maior entre municípios com proporção de pobres acima de 6,9% (RM=1,33; p<0,001) e 24% maior entre locais com menos de 50% de disponibilidade de testes rápidos (RM=1,24; p<0,001). Não foi observada significância estatística do Escore de Qualidade do Pré-natal em comparação aos desfechos. A análise de tendência apontou um forte efeito do tempo (anos) na incidência de sífilis congênita (F=0,146; p<0,001) e sobre a razão entre sífilis congênita e sífilis em gestantes (F=0,192; p<0,001). Em contrapartida, notou-se que a interação entre ano e Índice de Desenvolvimento Humano Médio (IDHM) e ano e "Escore de Qualidade do Pré-Natal" apresentaram efeitos baixos sobre os desfechos. Os achados desse estudo remetem a um cenário nacional preocupante no que concerne à prevenção e controle da sífilis congênita. Todavia, cabe ressaltar, que a disponibilidade de testes rápidos e melhores condições de vida e saúde da população, sobretudo dos aspectos socioeconômicos, estiveram associados a melhores desfechos. A presente pesquisa evidenciou os importantes traços de desigualdade na ocorrência de sífilis congênita, chamando a atenção para estratégias de redução das iniquidades em saúde e melhorias no cuidado pré-natal (AU).

Compared to other Latin American countries, Brazil has stood out over the years for presenting high rates of congenital syphilis notifications ­ denouncing, in particular, the evident deficit of health interventions during prenatal care. In 2011, in an attempt to improve maternal and child health conditions in the country, the "Rede Cegonha" programm was created, a policy that guides the implementation of a new model of health care for women and children, the organization of the care network and the reduction of maternal and child mortality. The objective of this research was to analyze the incidence of congenital syphilis in Brazilian cities according to indicators proposed by "Rede Cegonha" in the context of prenatal care. This is an observational ecological study, whose sample consisted of 257 municipalities with a number of inhabitants equal to or greater than one hundred thousand (n = 257). Descriptive analysis of dependent and independent variables and bivariate analysis by Poisson Regression by Robust Variance were performed for the outcomes "incidence of congenital syphilis" and "ratio between congenital syphilis and syphilis in pregnant women". In the trend analysis (2015- 2019), marginal means were estimated using Split-Plot Analysis of Variance (ANOVA) for the outcomes chosen according to the independent variables. The cross-sectional analysis showed that the mean incidence of congenital syphilis was 42% higher in municipalities with HDI up to 0.785 (RM=1.42; p<0.001) and 36% higher among populations with availability of a rapid test below 50% (RM = 1.36; p<0.005). The ratio between congenital syphilis and syphilis in pregnant women was 33% higher among municipalities with a proportion of poor people above 6.9% (RM=1.33; p<0.001) and 24% higher among locations with less than 50% availability of rapid tests (RM=1.24; p<0.001). There was no statistical significance of the "Prenatal Quality Score" compared to the outcomes. Trend analysis showed a strong effect of time (years) on the incidence of congenital syphilis (F=0.146; p<0.001) and on the ratio between congenital syphilis and syphilis in pregnant women (F=0.192; p<0.001). In contrast, it was verified that the interaction between year and Human Development Index (HDI) and year and "Prenatal Quality Score" had low effects on outcomes. The findings of this study refer to a worrying national scenario with regard to the prevention and control of congenital syphilis. However, it is noteworthy that the availability of rapid tests and better living conditions and health of the population, especially regarding socioeconomic aspects, were associated with better outcomes. The present research highlighted the important features of inequality in the occurrence of congenital syphilis, drawing attention to strategies to reduce health inequities and improve prenatal care (AU).

Analysis of COVID-19 vaccine non-intent by essential vs non-essential worker, demographic, and socioeconomic status among 101,048 US adults.

As of May 2021, over 286 million coronavirus 2019 (COVID-19) vaccine doses have been administered across the country. This data is promising, however there are still populations that, despite availability, are declining vaccination. We reviewed vaccine likelihood and receptiveness to recommendation from a doctor or nurse survey responses from 101,048 adults (≥18 years old) presenting to 442 primary care clinics in 8 states and the District of Columbia. Occupation was self-reported and demographic information extracted from the medical record, with 58.3% (n = 58,873) responding they were likely to receive the vaccine, 23.6% (n = 23,845) unlikely, and 18.1% (n = 18,330) uncertain. We found that essential workers were 18% less likely to receive the COVID-19 vaccination. Of those who indicated they were not already "very likely" to receive the vaccine, a recommendation from a nurse or doctor resulted in 16% of respondents becoming more likely to receive the vaccine, although certain occupations were less likely than others to be receptive to recommendations. To our knowledge, this is the first study to look at vaccine intent and receptiveness to recommendations from a doctor or nurse across specific essential worker occupations, and may help inform future early phase, vaccine rollouts and public health measure implementations.

Adverse Childhood Experiences and Subsequent Chronic Diseases Among Middle-aged or Older Adults in China and Associations With Demographic and Socioeconomic Characteristics.

Importance: Associations between adverse childhood experiences (ACEs) and chronic diseases among middle-aged or older Chinese individuals have not been well documented. In addition, whether demographic and socioeconomic characteristics modify any such associations has been underexplored. Objectives: To examine associations between ACEs and subsequent chronic diseases and to assess whether age, sex, educational level, annual per capita household expenditure level, and childhood economic hardship modify these associations. Design, Setting, and Participants: This population-based cross-sectional study used data from the China Health and Retirement Longitudinal Study (CHARLS), a survey of residents aged 45 years or older in 28 provinces across China; specifically, the study used data from the CHARLS life history survey conducted from June 1 to December 31, 2014, and a CHARLS follow-up health survey conducted from July 1 to September 30, 2015. The study population included 11 972 respondents aged 45 years or older who had data on at least 1 of 14 specified chronic diseases and information on all 12 of the ACE indicators included in this study. Data analysis was performed from December 1 to 30, 2020. Exposures: Any of 12 ACEs (physical abuse, emotional neglect, household substance abuse, household mental illness, domestic violence, incarcerated household member, parental separation or divorce, unsafe neighborhood, bullying, parental death, sibling death, and parental disability), measured by indicators on a questionnaire. The number of ACEs per participant was summed and categorized into 1 of 5 cumulative-score groups: 0, 1, 2, 3, and 4 or more. Main Outcomes and Measures: Hypertension, dyslipidemia, diabetes, heart disease, stroke, chronic lung disease, asthma, liver disease, cancer, digestive disease, kidney disease, arthritis, psychiatric disease, and memory-related disease were defined by self-reported physician diagnoses or in combination with health assessment and medication data. Multimorbidity was defined as the presence of 2 or more of these 14 chronic diseases. Logistic regression models were used to assess associations of the 12 ACEs with the 14 chronic diseases and with multimorbidity. Modification of the associations by demographic and socioeconomic characteristics was assessed by stratified analyses and tests for interaction. Results: Of the 11 972 individuals included (mean [SD] age, 59.85 [9.56] years; 6181 [51.6%] were females), 80.9% had been exposed to at least 1 ACE and 18.0% reported exposure to 4 or more ACEs. Compared with those without ACE exposure, participants who experienced 4 or more ACEs had increased risks of dyslipidemia, chronic lung disease, asthma, liver disease, digestive disease, kidney disease, arthritis, psychiatric disease, memory-related disease, and multimorbidity. The estimated odds ratios (ORs) ranged from 1.27 (95% CI, 1.02-1.59) for dyslipidemia to 2.59 (95% CI, 2.16-3.11) for digestive disease. A dose-response association was also observed between the number of ACEs and the risk of most of the chronic diseases (excluding hypertension, diabetes, and cancer) (eg, chronic lung disease for ≥4 ACEs vs none: OR, 2.01; 95% CI, 1.59-2.55; P < .001 for trend) and of multimorbidity (for individuals among the overall study population with ≥4 ACEs vs none: OR, 2.03; 95% CI, 1.70-2.41; P < .001 for trend). The demographic or socioeconomic characteristics of age, sex, educational level, annual per capita household expenditure level, or childhood economic hardship were not shown to significantly modify the associations between ACEs and multimorbidity. Conclusions and Relevance: In this population-based, cross-sectional study of adults in China, exposure to ACEs was associated with higher risks of chronic diseases regardless of demographic and socioeconomic characteristics during childhood or adulthood. These findings suggest a need to prevent ACEs and a need for a universal life-course public health strategy to reduce potential adverse health outcomes later in life among individuals who experience them.

Changing Demographics, Temporal Trends in Waitlist, and Posttransplant Outcomes After Heart Transplantation in the United States: Analysis of the UNOS Database 1991-2019.

BACKGROUND: We sought to investigate temporal trends in patient characteristics, waitlist, and posttransplant outcomes after heart transplantation in the United States. METHODS: Using data from the United Network of Organ Sharing, we identified adults listed for heart transplantation between 1991 and 2019. Patients were divided into 4 eras based on the 3 time points in which changes were made to the patient selection/allocation policy (Era 1=January 1991-January 1999; Era 2=January 1999-July 2006; Era 3=July 2006-October 2018; and Era 4=October 2018-March 2020), and patient characteristics, waitlist, and posttransplant outcomes were evaluated for each era. RESULTS: Between 1991 and 2019, 95 179 patients were added to the heart transplantation waitlist. Compared with Era 1, patients listed in Era 4 were older (mean age: 50 versus 52 years) and with higher risk comorbidities (eg, 10% versus 28.8% diabetes, 23.3% versus 35.6% obese). Over the study period, 22 738 patients died or were permanently delisted for deterioration on the waitlist while 61 687 were transplanted. Compared with the preceding era, there was significant decrease in death or deterioration in the last 2 eras (sub-hazard ratio, 0.67 [95% CI, 0.65-0.70] for Era 3 versus Era 2 and sub-hazard ratio, 0.65 [95% CI, 0.58-0.73] for Era 4 versus 3). Across the years, 27.1% to 40.5% of those on the waitlist were transplanted. Among those transplanted, there was increase in the rates of in-hospital stroke (2.8% in Era 1 to 3.7% in Era 4), renal failure requiring dialysis (7.2%-17.1%), and length-of-stay (14-17days), P<0.001. However, this did not negatively impact short-term survival when compared with the preceding era (1-year graft survival from Era 1 to Era 4=84.1%, 86.4%, 90.4%, and 89.7%, respectively). CONCLUSIONS: There have been significant changes in the characteristics of patients listed for heart transplantation. Although transplant volume has increased, the wide supply-demand gap persisted. The last two changes in the allocation policy achieved their primary objective of reducing waitlist mortality.

Demographic, clinical characteristics and treatment outcomes of immune-complex membranoproliferative glomerulonephritis and C3 glomerulonephritis in Japan: A retrospective analysis of data from the Japan Renal Biopsy Registry.

The reclassification of membranoproliferative glomerulonephritis (MPGN) into immune-complex MPGN (IC-MPGN) and C3 glomerulopathy (C3G) based on immunofluorescence findings in kidney biopsies has provided insights into these two distinct diseases. C3G is further classified into dense deposit disease and C3 glomerulonephritis (C3GN) based on electron micrographic findings. Although these diseases have poor outcomes, limited Japanese literature confined to small, single-center cohorts exist on these diseases. We retrospectively analyzed 81 patients with MPGN type I and III from 15 hospitals in the Japan Renal Biopsy Registry to compare demographic, clinical characteristics and treatment outcomes of patients with IC-MPGN to those with C3GN. Of the 81 patients reviewed by immunofluorescence findings in kidney biopsies, 67 patients had IC-MPGN and 14 patients had C3GN. Age at diagnosis and systolic and diastolic pressure were higher and proteinuria and impaired renal function were significantly more prevalent in patients with IC-MPGN than those with C3GN. About 80% of the patients in both groups were treated with immunosuppressive therapy. At last follow-up (median 4.8 years), complete remission rate of proteinuria was significantly higher in patients with C3GN (64.3%) than in those with IC-MPGN (29.9%; P = 0.015). The renal survival rate was lower in patients with IC-MPGN when compared to C3GN (73.1% vs. 100%; log-rank, P = 0.031). Systolic blood pressure and renal function at baseline were independent predictors of progression to end-stage kidney disease. The overall prognosis of patients with C3GN is more favorable than for patients with IC-MPGN.

Genetic analyses reveal demographic decline and population differentiation in an endangered social carnivore, Asiatic wild dog.

Deforestation and agricultural intensification have resulted in an alarming change in the global land cover over the past 300 years, posing a threat to species conservation. Dhole is a monophyletic, social canid and, being an endangered and highly forest-dependent species, is more prone to the loss of favorable habitat in the Anthropocene. We determined the genetic differentiation and demographic history of dhole across the tiger reserves of Maharashtra using the microsatellite data of 305 individuals. Simulation-based analyses revealed a 77-85% decline in the major dhole sub-populations. Protected areas have provided refuge to the historically declining dhole population resulting in clustering with strong genetic structure in the remnant dhole population. The historical population decline coincides with the extreme events in the landscape over the past 300 years. The study highlights the pattern of genetic differentiation and diversity of a highly forest-dependent species which can be associated with the loss of forest cover outside tiger reserves. It also warrants attention to develop conservation plans for the remnant surviving population of dholes in India.

Prediction of individual COVID-19 diagnosis using baseline demographics and lab data.

The global surge in COVID-19 cases underscores the need for fast, scalable, and reliable testing. Current COVID-19 diagnostic tests are limited by turnaround time, limited availability, or occasional false findings. Here, we developed a machine learning-based framework for predicting individual COVID-19 positive diagnosis relying only on readily-available baseline data, including patient demographics, comorbidities, and common lab values. Leveraging a cohort of 31,739 adults within an academic health system, we trained and tested multiple types of machine learning models, achieving an area under the curve of 0.75. Feature importance analyses highlighted serum calcium levels, temperature, age, lymphocyte count, smoking, hemoglobin levels, aspartate aminotransferase levels, and oxygen saturation as key predictors. Additionally, we developed a single decision tree model that provided an operable method for stratifying sub-populations. Overall, this study provides a proof-of-concept that COVID-19 diagnosis prediction models can be developed using only baseline data. The resulting prediction can complement existing tests to enhance screening and pandemic containment workflows.

Spatial pattern of the ecological environment in Yunnan Province.

Ecological science focuses on the structure and function of the natural environment. However, the study of ecological environments primarily focuses on single-element research and lacks a comprehensive perspective. To examine ecological environmental trends on different scales, the present paper selected Yunnan Province as the study area. Chemical oxygen demand, rocky desertification, forest coverage, natural disaster data and spatial analysis methods were used to obtain the ecological environmental characteristics of each county and construct a comprehensive evaluation method of the ecological environment. The present paper revealed that the environmental capacity in Yunnan Province was at a moderate level, the ecological environment fragility was remarkable, the significance of the ecological environment was very high, natural disasters occurred frequently, and spatial differentiation between ecological environments was obvious. The province may be divided into three functional areas: the comprehensive-balanced area, the efficiency-dominated area and the environment-dominated area. Central Yunnan was a key development zone and the main area for the manufacturing and service industries, which were built as a modern industrial system in Yunnan Province. The ecological environment in northwestern Yunnan and southern Yunnan is of high significance, and this region was an ecological environment protection area that was important area for the construction of the modern agricultural system in Yunnan Province. To achieve sustainable development of the ecological environment, the spatial characteristics of the ecological environment must be determined at the county scale.

Genetic diversity, population structure and historical demography of the two-spined yellowtail stargazer (Uranoscopus cognatus).

Benthic species, though ecologically important, are vulnerable to genetic loss and population size reduction due to impacts from fishing trawls. An assessment of genetic diversity and population structure is therefore needed to assist in a resource management program. To address this issue, the two-spined yellowtail stargazer (Uranoscopus cognatus) was collected within selected locations in the Indo-West Pacific (IWP). The partial mitochondrial DNA cytochrome c oxidase subunit 1 and the nuclear DNA recombination activating gene 1 were sequenced. Genetic diversity analyses revealed that the populations were moderately to highly diversified (haplotype diversity, H = 0.490-0.900, nucleotide diversity, π = 0.0010-0.0034) except sampling station (ST) 1 and 14. The low diversity level, however was apparent only in the matrilineal marker (H = 0.118-0.216; π = 0.0004-0.0008), possibly due to stochastic factors or anthropogenic stressors. Population structure analyses revealed a retention of ancestral polymorphism that was likely due to incomplete lineage sorting in U. cognatus, and prolonged vicariance by the Indo-Pacific Barrier has partitioned them into separate stock units. Population segregation was also shown by the phenotypic divergence in allopatric populations, regarding the premaxillary protrusion, which is possibly associated with the mechanism for upper jaw movement in biomechanical feeding approaches. The moderate genetic diversity estimated for each region, in addition to past population expansion events, indicated that U. cognatus within the IWP was still healthy and abundant (except in ST1 and 14), and two stock units were identified to be subjected to a specific resource management program.

Demographic analysis of an Israeli Carpobrotus population.

Carpobrotus species are harmful invaders to coastal areas throughout the world, particularly in Mediterranean habitats. Demographic models are ideally suited to identify and understand population processes and stages in the life cycle of the species that could be most effectively targeted with management. However, parameterizing these models has been limited by the difficulty in accessing the cliff-side locations where its populations are typically found, as well as accurately measuring the growth and spread of individuals, which form large, dense mats. This study uses small unmanned aerial vehicles (drones) to collect demographic data and parameterize an Integral Projection Model of an Israeli Carpobrotus population. We validated our data set with ground targets of known size. Through the analysis of asymptotic growth rates and population sensitivities and elasticities, we demonstrate that the population at the study site is demographically stable, and that reducing the survival and growth of the largest individuals would have the greatest effect on reducing overall population growth rate. Our results provide a first evaluation of the demography of Carpobrotus, a species of conservation and economic concern, and provide the first structured population model of a representative of the Aizoaceae family, thus contributing to our global knowledge on plant population dynamics. In addition, we demonstrate the advantages of using drones for collecting demographic data in understudied habitats such as coastal ecosystems.

Demographic, clinical and laboratory characteristics for differential diagnosis of peripheral lymphadenopathy (LAP) and the etiologic distribution of LAP in adults; a multicenter, nested case-control study including 1401 patients from Turkey.

Peripheral lymphadenopathy (LAP) is an important and common abnormal finding of the physical exam in general medical practice. We aimed to reveal the LAP etiology and demographic, clinical and laboratory variables that may be useful in the differential evaluation of LAP. This multicenter, nested case-control study including 1401 patients between 2014 and 2019 was conducted in 19 tertiary teaching and research hospitals from different regions in Turkey. The ratio of infectious, malign and autoimmune/inflammatory diseases was 31.3%, 5% and 0.3%, respectively. In 870 (62%) of patients had nonspecific etiology. Extrapulmonary tuberculosis (n: 235, 16.8%) was the most frequent cause of LAP. The ratio of infective etiology of LAP was significantly lower in patients older than 65 years-old compared to younger patients with the rate of 66.67% and 83.84%, respectively (p 0.016, OR 0.386, 95% Cl 0.186-0.803). The probability of malign etiology was higher both in patients who are older than 45 years-old (p < 0.001, OR 3.23, 95% Cl 1.99-5.26) and older than 65 years-old (p 0.002, OR 3.36, 95% Cl 1.69-6.68). Age, localization and duration of LAP, leukocytosis, anemia, thrombocytopenia, CRP and sedimentation rate were important parameters to differentiate infections. Size of lymph node and splenomegaly in addition to the parameters above were useful parameters for differentiating malign from benign etiology. Despite the improvements in diagnostic tools, reaching a definite differential diagnosis of lymphadenopathy is still challenging. Our results may help clinicians to decide in which cases they need an aggressive workup and set strategies on optimizing the diagnostic approach of adulthood lymphadenopathy.

Biases in Demographic Modeling Affect Our Understanding of Recent Divergence.

Testing among competing demographic models of divergence has become an important component of evolutionary research in model and non-model organisms. However, the effect of unaccounted demographic events on model choice and parameter estimation remains largely unexplored. Using extensive simulations, we demonstrate that under realistic divergence scenarios, failure to account for population size (Ne) changes in daughter and ancestral populations leads to strong biases in divergence time estimates as well as model choice. We illustrate these issues reconstructing the recent demographic history of North Sea and Baltic Sea turbots (Scophthalmus maximus) by testing 16 isolation with migration (IM) and 16 secondary contact (SC) scenarios, modeling changes in Ne as well as the effects of linked selection and barrier loci. Failure to account for changes in Ne resulted in selecting SC models with long periods of strict isolation and divergence times preceding the formation of the Baltic Sea. In contrast, models accounting for Ne changes suggest recent (<6 kya) divergence with constant gene flow. We further show how interpreting genomic landscapes of differentiation can help discerning among competing models. For example, in the turbot data, islands of differentiation show signatures of recent selective sweeps, rather than old divergence resisting secondary introgression. The results have broad implications for the study of population divergence by highlighting the potential effects of unmodeled changes in Ne on demographic inference. Tested models should aim at representing realistic divergence scenarios for the target taxa, and extreme caution should always be exercised when interpreting results of demographic modeling.

The Impact of Purifying and Background Selection on the Inference of Population History: Problems and Prospects.

Current procedures for inferring population history generally assume complete neutrality-that is, they neglect both direct selection and the effects of selection on linked sites. We here examine how the presence of direct purifying selection and background selection may bias demographic inference by evaluating two commonly-used methods (MSMC and fastsimcoal2), specifically studying how the underlying shape of the distribution of fitness effects and the fraction of directly selected sites interact with demographic parameter estimation. The results show that, even after masking functional genomic regions, background selection may cause the mis-inference of population growth under models of both constant population size and decline. This effect is amplified as the strength of purifying selection and the density of directly selected sites increases, as indicated by the distortion of the site frequency spectrum and levels of nucleotide diversity at linked neutral sites. We also show how simulated changes in background selection effects caused by population size changes can be predicted analytically. We propose a potential method for correcting for the mis-inference of population growth caused by selection. By treating the distribution of fitness effect as a nuisance parameter and averaging across all potential realizations, we demonstrate that even directly selected sites can be used to infer demographic histories with reasonable accuracy.

Conservation priorities in an endangered estuarine seahorse are informed by demographic history.

Historical demographic events shape genetic diversity that remains evident in the genomes of contemporary populations. In the case of species that are of conservation concern, this information helps to unravel evolutionary histories that can be critical in guiding conservation efforts. The Knysna seahorse, Hippocampus capensis, is the world's most endangered seahorse species, and it presently survives in only three estuaries on the South African south coast. Factors that contributed to the species becoming endangered are unclear; additionally, the lack of information on whether the three populations should be managed separately because of potential long-term isolation hampers effective management efforts. In the present study, we reconstructed the seahorses' demographic history using a suite of microsatellite loci. We found that the largest population (Knysna Estuary) has colonised the other estuaries relatively recently (< 450 years ago), and that its population size is comparatively large and stable. Neither of the other two populations shows signs of long-term reductions in population size. The high conservation status of the species is thus a result of its limited range rather than historical population declines. Our findings indicate that the long-term survival of H. capensis depends primarily on the successful management of the Knysna population, although the other estuaries may serve as reservoirs of genetic diversity.

How Social Media Use at Work Affects Improvement of Older People's Willingness to Delay Retirement During Transfer From Demographic Bonus to Health Bonus: Causal Relationship Empirical Study.

BACKGROUND: With the increased older population in China and the subsequent reduced labor force, the "demographic bonus" is disappearing. The Chinese government proposed a Healthy China strategy in 2017. The transfer of the demographic bonus to a "health bonus" extended the working life of people and reduced the negative impact of the population's aging on the labor force structure. OBJECTIVE: This research focuses on the effect of older workers' social media usage at work on their work ability (related to both physical and mental health) and thus their willingness to delay retirement. METHODS: The questionnaire respondents were older than 55 years, and they obtained the questionnaire from social media, from June to July 2018. A total of 1020 valid questionnaires were collected, and SmartPLS 3.28 (SmartPLS GmbH) was used to analyze the data. Effects were analyzed using 2-tailed t tests. RESULTS: (1) Use of social media at work can improve information support (t14=13.318, P<.001), emotional support (t14=13.184, P<.001), and self-efficacy (t14=6.364, P<.001) for older people; (2) information support is the main factor affecting the self-efficacy of older workers (t14=23.304, P<.001), as compared with emotional support (t14=1.799, P=0.07); (3) the impacts of emotional support on work ability (t14=8.876, P<.001) and work stress (t14=9.545, P<.001) are generally higher than those of information support (t14=4.394, P<.001; t14=5.002, P<.001); (4) self-efficacy has an impact on work ability (t14=5.658, P<.001) and work stress (t14=4.717, P<.001); and (5) the impacts of work ability (t14=8.586, P<.001) and work stress (t14=8.579, P<.001) on retirement willingness are greater than those of emotional support (t14=2.112, P=.04) and information support (t14=4.314, P<.001). CONCLUSIONS: Our study confirms that the use of social media at work has a positive impact on older workers. Based on the findings, we have put forward proposals to extend people's working lives and help governments implement health bonus policies. In the future, we will compare the different values of willingness to delay retirement among older people in different occupations and different cultures.