High Prevalence Research Articles

The association between parity and type 2 diabetes mellitus: a cross-sectional, community-based study.

Limited published data exist on the association between parity (number of deliveries) and diabetes mellitus (DM). This study was conducted to evaluate the association between parity and type 2 DM (T2DM) among Sudanese women. A multistage sampling survey was conducted in four villages in the River Nile State, Sudan, between July and September 2022. The World Health Organization's three-level stepwise questionnaire was adopted to collect women's sociodemographic characteristics (age, sex, height, weight, marital status, parity, education level, occupation, detailed obstetric history, and family history of T2DM). Multivariate analyses were performed. A total of 397 women were recruited. Their median (interquartile range) age was 45.0 (33.0‒55.7) years. A total of 154 women (38.8%) were nulliparous, whereas 93 (23.4%), 70 (17.6%), and 80 (20.2%) had para 1‒3, 4 or 5, and more than 5, respectively. A total of 112 (28.2%) women had T2DM. In multivariate analysis, older age (adjusted odds ratio, AOR, 1.04, 95%, confidence interval, CI, 1.02‒1.06), high parity (AOR, 1.1, 95% C, 1.01‒1.20), and a family history of DM (AOR, 3.26, 95% CI, 1.98‒5.38) were associated with T2DM. Compared with the nulliparity, para 1‒3 (AOR, 2.33; 95% CI, 1.17‒4.61), para 4 or 5 (AOR, 2.12; 95% CI, 1.04‒4.30), and para > 5 (AOR, 2.16; 95% CI, 1.09‒4.27) were at higher risk of T2DM. In women aged < 50 years, high parity (AOR, 1.22; 95% CI, 1.06‒1.44) was associated with T2DM. Compared with the nulliparous women, para 4 or 5 (AOR, 3.47; 95% CI, 1.16‒10.34) and para > 5 (AOR, 4.63; 95% CI, 1.54‒13.87) were associated with T2DM, whereas para 1‒3 was not associated with T2DM. In the women aged ≥ 50 years, parity and parity groups were not associated with T2DM. There is a high prevalence of T2DM among Sudanese women. Parity and high parity are significant predictors of T2DM among these women in this part of Sudan.

Development, Content Validation and Usability of a Chatbot for Disseminating Scientific Information About Cannabis Among Young Adults

ABSTRACT Despite the high prevalence of cannabis consumption, there is limited information about cannabis based on scientific evidence available and targeted toward young adults, especially considering accessible language and ease of access. The present study aimed to develop the proof of concept of a chatbot for the dissemination of evidence and scientific information about cannabis, focused on a young adult audience. The proof of concept involved stages of literature review, conversation flow development, content evaluation through a panel of experts (n = 10) and usability analysis using a sample of potential users (young adults, n = 10). The chatbot developed presents information on epidemiology, toxicology, acute and chronic effects of cannabis use, information on cannabis use disorder, and the use of cannabinoids for medicinal purposes. The content evaluation through the Health Education Content Validation Instrument concluded that the tool was considered to have a good structure and content (Content Validity Index > 0,78; overall score = 9.0/10.0). The tool also proved to be functional and highly usable according to the analysis with the System Usability Scale (overall usability score = 9.2/10.0). Digital strategies such as chatbots can help in health education and scientific communication within stigmatized areas, such as the consumption of psychoactive substances.

Prescription Practices and Usage of Antimicrobials in a Tertiary Teaching Hospital in Rwanda: A Call for Antimicrobial Stewardship

Background: Antimicrobial resistance (AMR) is a global problem that results in high morbidity and mortality, particularly in low- and middle-income countries. Inappropriate use of antimicrobials is a major driver of AMR. This study aimed to evaluate the rate and quality of antimicrobial prescription and use at the University Teaching Hospital of Kigali (CHUK), a tertiary-referral teaching hospital. Methodology: A point prevalence survey (PPS) of antimicrobial prescription was conducted using the Global PPS tool, including a healthcare-acquired infection (HAI) module. Results: On the day of the PPS, 39.3% (145/369) of inpatients were prescribed at least one antimicrobial. Out of the 259 prescribed antimicrobials, 232 (89.6%) were antibacterials, of which 151 (65.1%) belonged to the watch group of the WHO AWaRe classification. The top three antibiotics prescribed were cefotaxime (87; 37.5%), parenteral metronidazole (31; 13.4%), and meropenem (23; 9.9%). Stop or review dates for the prescribed antimicrobials were documented in 27/259 prescriptions (10.4%). Surgical prophylaxis (SP) was prescribed for longer than one day in 83.3% of 61 patients. Samples for culture were sent for 27.1% (63/232) of all the patients prescribed antibiotics. Conclusion: This PPS demonstrates multiple indicators of the poor use of antimicrobials, including the high prevalence usage of watch antibiotics and prolonged surgical prophylaxis and other poor-quality indicators. Thus, there is an urgent need for intervention to improve antimicrobial stewardship.

The relationship between uncertainty and fear of disease progression among newly diagnosed cancer patients: the mediating role of intolerance of uncertainty

BackgroundOne of the most prevalent unmet needs among cancer patients is the fear of disease progression (FoP). This cross-sectional study aimed to identify the relationships among uncertainty in illness (UI), intolerance of uncertainty (IU), and FoP among newly diagnosed cancer patients and to verify the mediating role of IU in the relationship between UI and FoP.MethodsA total of 202 newly diagnosed cancer patients (male: 105, 51.98%; mean age: 47.45 ± 14.8 years; lung cancer: 49, 24.26%) were recruited by convenience sampling. The patients completed a homemade questionnaire that assessed demographic characteristics, the Fear of Progression Questionnaire-Short Form, the Mishel Uncertainty in Illness Scale, and the Intolerance of Uncertainty Scale.ResultsThe prevalence of FoP among newly diagnosed cancer patients was 87.62%, and the prevalences of high, medium, and low levels of UI were 15.84%, 73.27%, and 10.89%, respectively. The mean score on the Intolerance of Uncertainty Scale was 41.19 ± 10.11. FoP among newly diagnosed cancer patients was positively correlated with UI (r = 0.656, P < 0.001) and IU (r = 0.711, P < 0.001). Moreover, IU was positively correlated with UI (r = 0.634, P < 0.001). IU partially mediated the effect of UI on FoP, accounting for 47.60% of the total effect.ConclusionsNewly diagnosed cancer patients have a high prevalence of FoP. UI can directly or indirectly affect FoP through the mediating role of IU. Healthcare professionals can help newly diagnosed cancer patients mitigate their FoP by reducing IU in light of UI.

High Prevalence of MYD88 and CD79B Mutations in Primary Sinonasal Diffuse Large B-Cell Lymphoma: Identification of an MCD-like Subtype.

Primary sinonasal diffuse large B-cell lymphoma (PSDLBCL) is a rare aggressive lymphoma. Recently, genetic classification using Next Generation Sequencing (NGS) demonstrated that PSDLBCL largely consists of the MCD genotype, which has a poor prognosis mainly driven by MYD88 L265P and CD79B gene abnormalities. This study investigated the prevalence and clinicopathological significance of MYD88 L265P and CD79B Y196 mutations using droplet digital PCR in 55 patients with PSDLBCL, as well as the translocation of BCL2/BCL6/c-Myc with FISH. We found mutations in MYD88 L265P (29/55, 52.7%) and CD79B Y196 (20/55, 36.4%). The MCD-like subtype, defined by the mutation of MYD88 and/or CD79B, was found in 32 out of 55 cases (58.2%). This subtype largely consists of non-GCB type (31/32, 96.9%; P<0.01) and double-expressor cases (20/32, 62.5%; P=0.01) compared with the MYD88/CD79B co-wild type, with BCL6 translocation in a small subset (2/32, 6.3%) and no translocations of BCL2 (0/32) or c-Myc (0/32). The MCD-like subtype tended to relapse in specific sites such as the central nervous system, testis, and/or skin compared with the co-wild type (P=0.03), showing poorer outcomes in overall survival (P=0.02) and progression-free survival (P=0.01). In conclusion, our study highlights a high prevalence of MYD88 and CD79B mutations in PSDLBCL, identifying an aggressive MCD-like subtype with a distinct relapse pattern. This molecular subclassification can be helpful for both prognostic prediction and therapeutic strategy in patients with PSDLBCL.

High Prevalence of Sarcocystis in a Collapsed Black Rat (Rattus rattus) Population from the Florida Keys.

We collected and screened black rats (Rattus rattus) in Key Largo, Florida, USA, to determine the potential role of disease or parasites in the collapse of the local population. Rats appeared healthy, but 94% (n=15/16) tested positive for Sarcocystis sp. The partial 18S rRNA gene sequence was 98.7-99.7% similar to a strain of Sarcocystis zuoi that is now considered a strain of the newly described Sarcocystis kani within the larger S. zuoi species complex that contains numerous new species. These Sarcocystis spp. use Asian snakes as definitive hosts and rodents, shrews, or tree shrews as intermediate hosts. Pythons are the definitive host for several Sarcocystis spp. in Asia, including a related parasite (Sarcocystis singaporensis) that has been used as a biologic control agent for Rattus spp. in southeast Asia. It is probable that increasing numbers of invasive Burmese pythons (Python bivittatus) in the Florida Keys are contributing to the spread of this parasite in addition to imposing predation pressure on both rodents and native snakes. As such, further surveillance and molecular and morphologic characterization of parasites from rodents and snakes in south Florida should be prioritized.

Use of a Health Fair to Promote Health Equity of the Hispanic Community in Metro Detroit

This study analyzes the demographics, general health characteristics, and barriers to healthcare of the Metro Detroit Hispanic community through a health fair survey. Data was collected using a descriptive, 25-question self-reported survey in English and Spanish administered to 19 health fair attendees. Of total respondents, 92% identified as Hispanic and 76% Spanish-speaking. Descriptive analysis was conducted on several variables, including prevalence of medical conditions, health behaviors, and barriers to care. Participants reported a high prevalence of serious chronic conditions including diabetes (29%) and hypertension (29%). Significant barriers included a lack of medical insurance (72%), no primary care physician (67%), and language (24%). Other notable barriers were medication and food insecurity (50% and 67%, respectively). Our findings illustrate the power of a health fair in reaching a local, underserved Hispanic population, and underscore the need for targeted efforts in improving Hispanic health equity and access in Metro Detroit.

Two birds, one stone: minimum wage and child labor

PurposeThis paper investigates the impact of quasi-exogenous and substantial increases in the minimum wage on child labor outcomes in Türkiye. The study aims to provide empirical evidence on how minimum wage policies affect child labor outcomes in a developing country context, with a focus on gender and age differences. It seeks to understand whether minimum wage increases lead to a reduction in child labor and whether the impact is different for various demographic groups.Design/methodology/approachThe research employs a difference-in-differences methodology using data from the 2012 and 2019 Child Labor Force Survey in Türkiye. The treatment group consists of children from households with minimum wage earners, while the control group comprises children from other households. Various labor market outcomes are analyzed, and robustness checks are performed.FindingsOur findings indicate that while the overall effect of minimum wage increases on child labor is statistically insignificant, there are notable heterogeneous impacts across different demographic groups and employment sectors. Specifically, we observe a significant reduction in the employment probability of girls under the age of 15 and unpaid family workers. Additionally, the likelihood of younger children being wage earners decreases, and the minimum wage increase reduces employment in the agriculture and services sectors for certain subgroups. The impact is also more limited for children in single-adult-worker households.Social implicationsThese results underscore the varying effects of minimum wage policies on child labor and highlight the importance of considering demographic and sectoral differences in policy formulation. Policymakers should complement such policies with income-generating programs and targeted education initiatives to address child labor issues more comprehensively and sustainably.Originality/valueThis study fills a critical gap in the limited international literature on the causal effects of minimum wage policies on child labor incidence. One notable exception, Menon and van der Meulen Rodgers (2018) have explored the impact of minimum wage on child labor in India using regional variation, our study uniquely analyzes the effects at the household level in Türkiye. This approach provides valuable insights into how minimum wage changes affect child labor outcomes in a developing economy context with a high prevalence of minimum wage earners. It also contributes to the broader economic understanding of child labor and household income dynamics.

The STAR collaborative nonsuicidal self-injury study: methods and sample description of the face-to-face sample

BackgroundNonsuicidal self-injury (NSSI) is highly prevalent in adolescents and young adults worldwide. It is linked to a broad variety of mental disorders and an increased suicide risk. Despite its high prevalence, research on the underlying mechanisms and on potential risk and resilience factors for maintaining or quitting NSSI remains scarce. This manuscript presents an overview of the “Self-injury: Treatment-Assessment-Recovery” (STAR) collaboration, which aimed to address these gaps.MethodsWe investigated the natural course of NSSI as well as its social, psychological, and neurobiological predictors (observational study; OS). OS data collection occurred at four timepoints (baseline [T0], 4 [post, T1], 12 [follow-up (FU), T2], and 18 [FU, T3] months after baseline) for the NSSI group, which was compared to a healthy control (HC) group at T0 only. Online self-report was used at all timepoints, while semi-structured interviews (face-to-face (f2f)) were conducted at T0 and T3. At T0 only, we conducted ecological momentary assessment and neurobiological investigations. Here, we present the general methodology and sample characteristics of the completed OS including the f2f subprojects, while other subprojects are not within the scope of this paper.Sample descriptionThe OS sample consists of 343 participants at T0 (180 NSSI, 163 HC). Mean age in the NSSI group (T0) was 18.1 years (SD = 2.09, range: 15–25), gender-related data is available for 166: 156 = female, 7 = male, 3 = transgender, 10 = not disclosed). In the HC group, mean age (T0) was 19.1 years (SD = 2.35, range: 15–25) (142 = female, 21 = male). At T1, 128 (71.11%) of the NSSI participants completed the questionnaires, at T2 125 (69.44%) and at T3 104 (57.78%). In the fMRI subproject, 126 adolescents participated (NSSI = 66, HC = 60, 100% female; mean age (T0): NSSI = 18.10 years, SD = 2.21; HC = 19.08, SD = 2.36).ConclusionUnderstanding predictors is of utmost importance for adequate diagnosis and intervention for NSSI. Our OS applied a multimodal investigation of social, psychological, and neurobiological parameters and is the largest sample of adolescents with NSSI to date including follow-up assessments. As health care providers require specific knowledge to develop new treatments, we believe that our in-depth assessments can potentially enhance care for youths engaging in NSSI.

Insights into Helicobacter pylori macrolide resistance: a comprehensive systematic review and meta-analysis

BackgroundHelicobacter pylori infection is a primary global health concern. However, the widespread use of antibiotics, particularly macrolides such as clarithromycin, has increased resistance among H. pylori strains. This study aimed to investigate the prevalence of macrolide resistance in H. pylori in different world regions.MethodsThis systematic literature search was performed using the appropriate search syntax after searching PubMed, Embase, Web of Science, and Scopus databases between May 2015 and December 2023. Statistical analysis was performed using Pooled and random effects model in R and the metafor package.ResultsA total of 7,768 articles were retrieved. After a thorough evaluation, 155 studies (by 178 reports) were finally eligible for inclusion in this systematic review and meta-analysis. According to the results, the majority of studies (178 reports from 43 countries) assessed clarithromycin susceptibility, with a pooled prevalence of 33.3% and high heterogeneity between studies (I2 = 98.57%, p &amp;lt; 0.001). The rate of erythromycin resistance was moderate (22.8%, 10 reports), while azithromycin resistance was 34.4% (4 reports). Subgroup analysis revealed significant differences in the prevalence of resistance based on geographic location, continent, and year of publication. Clarithromycin resistance increased from 29.1% (2015–2019) to 36.5% (2020–2023).ConclusionThis study highlights the critical challenges of macrolide resistance in treating H. pylori infection. The high prevalence and geographic variation underscore the need for tailored treatment strategies based on regional resistance patterns. Furthermore, continuously monitoring resistance trends and investigating contributing factors are essential to optimize treatment.Systematic review registrationhttps://www.crd.york.ac.uk/prospero; CRD42024557749.

COMPREHENSIVE TREATMENT PROGRAM FOR BRONCHIAL ASTHMA IN CHILDREN WITH A HISTORY OF PERINATAL CENTRAL NERVOUS SYSTEM PATHOLOGY

Bronchial asthma remains a pressing issue in pediatrics, with high prevalence and a continuous increase in morbidity among children. It has been found that most children with bronchial asthma have a history of perinatal central nervous system (CNS) damage. Despite progress in the diagnosis and treatment of bronchial asthma, the mechanisms by which perinatal CNS lesions influence asthma development are varied, and existing treatment regimens for such children are not always highly effective. This highlights the need for improved treatment methods for children with bronchial asthma who also suffer from the consequences of perinatal CNS injury. KEYWORDS: bronchial asthma, central nervous system, perinatal injury, neurostimulation, morphofunctional indicators, Semax.

Cannabidiol Modulates Neuroinflammatory Markers in a PTSD Model Conducted on Female Rats

Post-traumatic stress disorder (PTSD) is a debilitating neuropsychiatric condition closely linked to neuroinflammation, with a higher prevalence in women. Cannabidiol (CBD), a non-psychoactive cannabinoid, has shown promise as a potential treatment for PTSD. In this study, we used a PTSD model in which female rats were subjected to a severe foot shock followed by contextual situational reminders (SRs). Testing was conducted one month after exposure. The rats received daily CBD injections for three weeks during the SRs, from days 7 to 28. Two days after the final SR, the rats underwent five extinction trials, followed by the forced swim test (FST). After a five-day rest period, the rats were sacrificed, and brain tissues from the medial prefrontal cortex (mPFC) and ventral subiculum (vSUB) were analyzed for inflammatory markers. Chronic CBD treatment reversed impairments in fear extinction caused by shock and SR. It also reduced learned helplessness in the FST and decreased the upregulation of mPFC-il1β induced by shock and SRs. Additionally, exposure to shock and SRs downregulated mPFC-il6 while upregulating vSUB-il6. CBD treatment further downregulated il6 expression in the vSUB compared to the vehicle groups. Our findings show that CBD effectively inhibited the development of PTSD-like behaviors and suppressed neuroinflammation in the mPFC.

User preferences for an mHealth app to support HIV testing and pre-exposure prophylaxis uptake among men who have sex with men in Malaysia.

Recent estimates report a high incidence and prevalence of HIV among men who have sex with men (MSM) in Malaysia. Mobile apps are a promising and cost-effective intervention modality to reach stigmatized and hard-to-reach populations to link them to HIV prevention services (e.g., HIV testing, pre-exposure prophylaxis, PrEP). This study assessed attitudes and preferences toward the format, content, and features of a mobile app designed to increase HIV testing and PrEP uptake among Malaysian MSM. We conducted six online focus groups between August and September 2021 with 20 MSM and 16 stakeholders (e.g., doctors, nurses, pharmacists, and NGO staff) to query. Transcripts were analyzed in Dedoose software to identify thematic content. Key themes in terms of app functions related to stylistic preferences (e.g., design, user interface), engagement strategies (e.g., reward systems, reminders), recommendations for new functions (e.g., enhanced communication options via chat, discussion forum), cost of services (e.g., PrEP), and legal considerations concerning certain features (e.g., telehealth, patient identification), minimizing privacy and confidentiality risks. Our data suggest that a tailored HIV prevention app would be acceptable among MSM in Malaysia. The findings further provide detailed recommendations for successfully developing a mobile app to improve access to HIV prevention services (e.g., HIV testing, PrEP) for optimal use among MSM in Malaysia.

Transarterial Embolization for Musculoskeletal Pain Management: AJR Expert Panel Narrative Review.

Musculoskeletal embolization has emerged in recent years as a treatment for chronic joint pain, as the inflammatory cascade responsible for such pain has become better understood. Studies have demonstrated a complex interplay between joint inflammation and synovial hypervascularity that causes growth of new unmyelinated nerve fibers responsible for pain. Embolization targets joint hypervascularity, to disrupt the inflammatory cycle and provide pain relief. The standard treatment algorithm for chronic joint pain is well-established and entails escalating therapeutic options that include exercise, self-management programs, analgesic medications, intra-articular injections, and finally surgical replacement or release. Genicular artery embolization (GAE), targeting abnormal vasculature around the knee joint, is the most heavily studied musucloskeletal embolization procedure, reflecting the high worldwide prevalence and increasing incidence of knee osteoarthritis. GAE is now supported by multiple prospective studies, including randomized control trials comparing GAE versus sham treatment. Embolization has also extended outside of the knee joint to include the shoulder (treatment of adhesive capsulitis or secondary stiff shoulder), elbow (medial/lateral epicondylitis), hip (osteoarthritis, great trochanteric pain syndrome), and ankle (plantar fasciitis). This AJR Expert Panel Narrative Review discusses the current status of transarterial embolization for musculoskeletal pain management, focusing on treatment of knee osteoarthritis and chronic shoulder pain.

Modified cognitive behavioral therapy approach reduces loudness discomfort levels for an autistic child with hyperacusis: case report

IntroductionHyperacusis is common among the autistic population, with a lifetime prevalence estimated at up to 60% compared to 17.1% in those without autism. For autistic children, avoidance behaviors and distress associated with hyperacusis significantly disrupt participation in everyday routines including academic, social and leisure activities. Although hyperacusis is a significant problem for children with autism and their families, there is little research on effective interventions. This report describes the clinical case of an 11-year-old boy with autism who received a modified cognitive behavioral therapy (CBT) approach to address symptoms of hyperacusis.Case presentationPatient A is an 11-year-old boy with autism and hyperacusis. He and his parents report difficulties tolerating loud or high-pitched sounds including whistling, fireworks, traffic and high-pitched musical instruments (e.g., the ocarina and flute). When hearing these sounds during everyday activities (e.g., celebrations and social events) he will often ask strangers to stop, cover his ears, or avoid/run away from the source of sound. A modified CBT approach was combined with exposure therapy, and sensory-based self-regulation strategies to improve tolerance and decrease distress when hearing whistling. Treatment outcomes include improved loudness discomfort levels in audiology evaluations, improved auditory domain scores on the Sensory Profile questionnaires, lower self-reported subjective units of distress scale (SUDS) ratings in response to bothersome sounds, and decreased use of noise canceling headphones during daily activities. The client and his parents also reported generalization of these improvements with other sounds (e.g., fireworks).ConclusionThe patient described in this case report showed measurable improvements in his ability to tolerate whistling, a bothersome sound encountered regularly in his daily life. Considering the high prevalence rate of hyperacusis in autism and its impact on children and family routines, stress and daily living, the development and testing of an effective treatment approach for hyperacusis is needed. The treatment plan for this case arose from the collaboration between professionals in occupational therapy, applied behavior analysis, audiology, and clinical psychology. Future studies are encouraged to determine the efficacy of this combined approach for other children with autism and hyperacusis.

Primary hyperoxaluria type 3: from infancy to adulthood in a genetically unique cohort.

Primary hyperoxaluria type 3 (PH3) is a rare autosomal recessive disorder caused by bi-allelic genetic variants in the 4 hydroxy-2 oxoglutarate aldolase (HOGA-1) gene. We report the natural history of PH3 in a 16-patient cohort, 15 from a unique genetically isolated population. This retrospective single-center study followed PH3 patients between 2003 and 2023 with demographic, clinical, radiographic, genetic, and biochemical parameters. Genetic population screening was performed in four villages to determine carrier frequency and identify couples at risk in a genetically isolated population. Sixteen patients with biallelic (or homozygous) pathogenic variants (PV) in HOGA-1 (c.944_946 del, c.119C > A, c.208C > T) were included in the study, 15 Druze and one Jewish, aged 0-63years at diagnosis (4 adults and 12 pediatric patients). All symptomatic patients had clinical or imaging signs of nephrolithiasis. One developed chronic kidney disease (CKD) stage 5; biopsy showed focal mesangial sclerosis and chronic tubulo-interstitial changes with few oxalate deposits. Two other patients had CKD stage 2 (eGFR 87 and 74mL/min/1.73m2) upon their last visit. The remaining cohort showed preserved kidney function until the latest follow-up. Of 1167 healthy individuals screened, 90 carriers were found, a rate of 1:13 in the genetically unique cohort screened. A high prevalence of PH3 patients was found among a unique cohort, but probably still underdiagnosed due to relatively mild disease course. The carrier rate is high. There is no specific therapy for PH3, but early diagnosis can prevent redundant diagnostic efforts and provide early treatment for kidney stone disease. Even in our homogeneous cohort, kidney stone disease severity and CKD degree were variable, supporting a suspected contribution of yet unknown genetic or environmental factors.

Analysis of the epidemiological trends of Tuberculosis in China from 2000 to 2021 based on the joinpoint regression model

BackgroundChina is ranked third globally in terms of burden and has a moderately high to high prevalence of tuberculosis (TB). This study meticulously investigated the notification rates of TB and assessed the epidemic in China from 2000 to 2021. The aim of the study was to provide robust supporting data that is crucial for enhancing TB prevention and control strategies.MethodsExtensive data regarding TB notification rates in China between 2000 and 2021 was collected. The joinpoint regression model was subsequently utilized to assess the temporal trends in the notification rates of TB, which were analyzed through the annual percentage change (APC) and the average annual percentage change (AAPC).ResultsDuring the study period (2000–2021), the standardized notification rates of TB in China ranged from 38.89/100,000 to 101.15/100,000, with a significant annual average decrease of 4.43% (P < 0.05). Before the COVID-19 pandemic, a marked acceleration in this decline was observed from 2006 to 2015, with an APC of 4.62% (P < 0.05). Stratified by age and sex, the age group with the most significant annual decline in overall standardized notification rates of TB among males in China was < 15 years old, followed by 55–64 years old, and the group with the least decrease was 25–44 years old. Similarly, the age group with the most significant annual decline in standardized notification rates of TB among females was < 15 years old.ConclusionsThe epidemic of TB in China exhibited a downward trajectory between 2000 and 2021. However, it is imperative to prioritize the attention given to males and older adults, and to promote specific and effective prevention and control strategies for these populations.

Developing an implementation blueprint: Lessons learned from integrating electronic patient-reported outcomes in HIV clinics in Alabama.

People living with HIV are disproportionately affected by depression, anxiety, and substance use which impede engagement with HIV treatment services and can increase risks of HIV-related morbidity and mortality. Capturing timely, accurate patient data at point of care is recommended to inform clinical decision-making and retain patients on the HIV care continuum. Currently, there is limited use of validated screening tools for substance use and mental health at the point of care in HIV clinics, even though people with HIV (PWH) have a high prevalence of these comorbidities. Even fewer clinics screen in a manner that encourages disclosure of stigmatized substance use, depression, and anxiety. Electronic patient-reported outcomes (ePROs) are an evidence-based modality to overcome such limitations by eliciting responses directly from patients via tablet, smartphone, or computer. To date, there is limited consensus on how to implement ePROs into non-academic settings and enhance uptake. Our team sought to address this gap by examining the implementation of ePROs, previously implemented in an academic clinic, to enhance screening and treatment of mental health (MH) and substance use at five Ryan White HIV/AIDS Program-funded clinics in Alabama. The ePROs were delivered through a multi-component intervention titled HIV + Service delivery and Telemedicine through Effective Patient Reported Outcomes (+STEP), which also provides targeted training to frontline clinicians, and resources for MH and substance use treatment for PWH without access to care. The objective of this study is to provide an implementation blueprint that can be tested and utilized in other HIV clinics to integrate ePROs and increase evidence-based screening for depression, anxiety, and substance use among PWH, as well as outline lessons learned from implementation to date. The findings from this study provide practical steps and advice based on our experience in implementing electronic patient-reported outcomes in HIV clinics in the US Deep South.

Influence of self-reported physical exercise on musculoskeletal pain among Chinese medical students.

From January to April 2020, the COVID-19 pandemic affected eastern China, leading medical students to adopt home protection measures that significantly altered their physical activity and lifestyle habits. This study aimed to assess the prevalence of musculoskeletal pain (MSP) among medical students during home protection and to analyze the influence of demographic factors, physical exercise habits during normal school life, home protection data on MSP. This research provides a foundation for developing interventions to reduce MSP among medical students. A cross-sectional survey was conducted at Nanjing Medical University in Jiangsu Province from January to April 2020, utilizing the Nordic Musculoskeletal Questionnaire (NMQ) to measure MSP. Multivariate logistic regression identified factors influencing MSP. A total of 859 students participated, with a 40.2% prevalence of MSP during home protection. Multivariate analysis showed that female sex (OR: 1.648; 95% CI: 1.157-2.347), irregular physical exercise during school (OR: 1.648; 95% CI: 1.157-2.347), and less than or equal to six hours of sleep per day during home protection (OR: 1.474; 95% CI: 1.020-2.131) were significant risk factors. The high prevalence of MSP underscores the need for interventions that focus on gender-specific risks, promote regular physical exercise, and ensure adequate sleep.

Characterization of baseline symptoms and functional impairments in a large cohort of outpatients attending a long covid rehabilitation clinic in the United Kingdom

Objective: In response to the high prevalence and morbidity associated with long COVID (LC), outpatient rehabilitation programmes were created across jurisdictions. We aimed to characterize baseline symptoms and impairments of patients attending outpatient LC rehabilitation. Design: This study was a retrospective quality-improvement analysis. Subjects/Patients: Patients attending outpatient LC rehabilitation at the Oxfordshire Post-Covid Service. Methods: Data included age/sex and 6 questionnaires performed at baseline: Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Dyspnoea-12 (D12), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Assessment-7 (GAD-7), Visual Analogue Scale (VAS) of self-rated health, and the Work And Social Adjustment Scale (WSAS). All scores were dichotomized (indicating presence/absence of clinically significant pathology). Potential differences between age (&lt;/≥ 50 years) and sex were assessed using χ2 tests. Results: A total of 422 patients were included (mean/standard deviation [SD] age = 47.1/13.2;132/31.3% male). A total of 76% had significant fatigue (FACIT-F), 69% had breathlessness (D12), 55% had depression (PHQ-9), 34% had anxiety (GAD-7), 41% self-reported poor health (VAS), and 57% had work/social life dysfunction (WSAS). D12 scores differed between age groups (older &gt; younger, χ2 = 3.19/p = 0.048), with no differences observed on other scales. Conclusion: In this preliminary study, a high proportion of LC outpatients had significant impairments across domains. The findings of this study reaffirm the need for high-quality, multidisciplinary LC rehabilitation, and may be used to help build a standardized set of outcome measures moving forward.