High Proportion Of Individuals Research Articles

Intentional self-harm and death by suicide in body dysmorphic disorder:A nationwide cohort study

Body dysmorphic disorder (BDD) is thought to be associated with considerable suicide risk. This nationwide cohort study quantified the risks of intentional self-harm - including non-suicidal self-injuries and suicide attempts - and death by suicide in BDD. Individuals with a validated ICD-10 diagnosis of BDD in the Swedish National Patient Register, registered between January 1, 1997 and December 31, 2020, were matched with 10 unexposed individuals from the general population on birth year, sex, and county of residence. Conditional Poisson regression models estimated incidence rate ratios (IRR) and 95% confidence intervals (CIs) for intentional self-harm and stratified Cox proportional hazards models estimated hazard ratios (HRs) and 95% CIs for death by suicide. Models adjusted for sociodemographic variables and lifetime psychiatric comorbidities. Among 2,833 individuals with BDD and 28,330 unexposed matched individuals, 466 (16.45%) and 1,071 (3.78%) had at least one record of intentional self-harm during the study period, respectively (IRR=3.37; 95% CI, 3.02-3.76). In the BDD cohort, about two thirds (n=314; 67%) had their first recorded self-harm event before their first BDD diagnosis. A total of 17 (0.60%) individuals with BDD and 27 (0.10%) unexposed individuals died by suicide (HR=3.47; 95% CI, 1.76-6.85). All results remained robust to additional adjustment for lifetime psychiatric comorbidities. A higher proportion of individuals with BDD who died by suicide had at least one previous record of intentional self-harm, compared to unexposed individuals (52.94% vs. 22.22%; p=0.0363). BDD was associated with a three-fold increased risk of intentional self-harm and death by suicide.

Prevalence of Selected Ophthalmic Diseases Using a Smartphone-Based Fundus Imaging System in Quang Tri and Thai Nguyen, Vietnam

Objectives: This study investigated the prevalence of ophthalmic diseases in Quang Tri and Thai Nguyen, Vietnam, utilizing a smartphone-based fundus imaging (SBFI) system.Methods: This cross-sectional study included nearly 10,000 patients who visited community health centers between July and August 2019. All participants underwent visual acuity testing and fundus imaging. We collected demographic data and medical histories, and fundus images were captured using the EYELIKE system. Data were compiled on an online platform, allowing clinicians from other regions to make diagnoses.Results: The study revealed significant variations in visual acuity and the prevalence of ophthalmic diseases between the two regions. Quang Tri had a higher proportion of individuals with good eyesight compared to Thai Nguyen. In Quang Tri, nearly 50% of the population had media haze, while in Thai Nguyen, about one-third of the population was affected. The prevalence of glaucomatous optic nerve and age-related macular degeneration was approximately 1% higher in Quang Tri than in Thai Nguyen. These findings provide valuable insights into the eye health status of these regions, indicating that eye health in Quang Tri was poorer than in Thai Nguyen.Conclusions: The prevalence rates of ophthalmic conditions in this study were within the expected ranges compared to those in other Asian countries, though they were somewhat low. The SBFI method, being simpler and more efficient than the Rapid Assessment of Avoidable Blindness, offers a promising approach for measuring and estimating the prevalence of ophthalmic diseases.

Relative and absolute inequalities in cerebrovascular disease mortality rates: exploring the influence of socioeconomic status and urbanization levels in Taiwan

Background/ObjectiveLimited evidence exists regarding the socioeconomic inequalities in cerebrovascular disease (CBD) mortality at different urbanization levels. Therefore, this study was conducted to assess the socioeconomic inequalities and urbanization levels in township-based CBD mortality in Taiwan.MethodsSocioeconomic variables, including the percentages of low-income households, individuals with a university education and above, and tax payments, were measured at the township level from 2011 to 2020. Urbanization was also determined by the national survey and divided into seven levels. Age-standardized mortality rate (ASMR) of CBD was calculated using a Geographic Information System (GIS) in 358 townships. The effects of socioeconomic variables and urbanization levels on relative and absolute inequalities in township-based CBD mortality rates were examined.ResultsSignificant differences in ASMR of CBD were observed across all socioeconomic status indicators over the years. Higher proportions of low-income households were associated with higher ASMR of CBD. Conversely, there were negative correlations between higher proportions of individuals with a university education and above and tax payments with ASMR of CBD. The regression analysis indicated significant impacts of relative and absolute socioeconomic inequalities on ASMR of CBD. Additionally, a moderation effect of socioeconomic variables and urbanization on CBD mortality rates was observed, with rural areas showing sensitivity to these factors.ConclusionAlthough ASMR of CBD showed significant decreases over time, socioeconomic inequalities in CBD mortality rates persist. Interventions targeting socioeconomic inequalities in health outcomes, especially in rural areas, are needed to address this issue.

Emergency department documentation of legal intervention injuries at a Washington, DC, hospital.

The U.S. Centers for Disease Control and Prevention (CDC) defines legal intervention injuries as injuries caused by law enforcement agents in the course of official duties. Public health databases utilize International Classification of Diseases, 10th Revision (ICD-10), coding to collect these data through the "Y35" family ICD-10 code. Prior studies report deficiencies in public health recording of fatal legal intervention injuries. Few studies have characterized nonfatal injuries. This study investigates emergency department (ED) capture of legal intervention injury diagnostic coding. A retrospective chart review was performed on ED encounter data from January 1, 2017, to June 30, 2019, at an academic hospital in Washington, DC. Charts were identified using a keyword search program for "police." Chart abstracters reviewed the flagged charts and abstracted those that met injury definition. Primary outcomes included injury severity, patient demographics, and documented ICD-10 codes. One sample proportion testing was performed comparing sample census ED data. A total of 340 encounters had sufficient descriptions of legal intervention injuries. A total of 259 had descriptions consistent with the patient specifier of "suspect." Hospital coders recorded 74 charts (28.6%) with the Y35 family legal intervention injury code. A total of 212 involved a Black patient. A total of 122 patients had Medicaid and 94 were uninsured. Black patients made up a higher proportion of individuals in the "suspect identified legal intervention injury" group than the total population (0.819 vs. 0.609, p < 0.01, 95% CI 0.772-0.866). Patients with Medicaid or who were uninsured made up substantial proportions as well (0.471 vs. 0.175, p < 0.01, 95% CI 0.410-0.532 for Medicaid patients and 0.363 vs. 0.155, p < 0.01, 95% CI 0.304-0.424 for the uninsured patients). A large proportion of nonfatal legal intervention injuries remain unreported. Black and low-income patients are disproportionately affected. More research is needed but benefits from interprofessional data sharing, injury pattern awareness, and diagnostic coding guidance may improve reporting.

Evaluating the level of visual acuity to minimise false-positives in different colour vision tests

ABSTRACT Clinical relevance Accurate colour vision assessment is important in clinical settings to minimise false-positive errors and enhance the reliability of diagnoses outcomes. Background Colour vision testing is valuable in assessing the visual system, particularly given the high proportion of individuals with poor vision. This study aimed to determine the minimum visual acuity level required to perform a colour-vision test without errors. Methods After fogging the right eyes of 52 healthy participants using plus lenses to 1.60 logMAR, vision was evaluated using Ishihara, Hardy – Rand – Rittler Standard Isochromatic, Waggoner Pseudo-isochromatic, City University, Waggoner Computerised, and Farnsworth D-15 tests. Participants then completed these tests at lower fogging degrees (in 0.1-logMAR intervals). The acuity at which 5% of the tested population was considered abnormal was determined. Results Significant differences were found in the average visual acuity required to perform colour vision tests without errors (p < 0.05). The Waggoner Computerized test required the highest average visual acuity among the tests utilised. The Farnsworth D-15 test yielded the highest logMAR values. No significant differences were observed between the Waggoner Pseudo-isochromatic test and Hardy – Rand – Rittler Standard Isochromatic, Ishihara, and Farnsworth D-15 tests (p > 0.05). Additionally, no significant differences were found between the Ishihara and Hardy – Rand – Rittler tests (p > 0.1) or between the Waggoner Computerized and City University tests (p = 0.11). Colour vision testing maintained an accuracy ≤ 1.0 logMAR with the Ishihara and Hardy – Rand – Rittler tests, 1.1 logMAR with the Waggoner Pseudo-isochromatic and Farnsworth D-15 tests, and 0.9 logMAR with the Waggoner Computerized and City University tests. Conclusions Insights are provided into the visual acuity thresholds required for accurate colour vision testing, which can serve as a basis for future research and provide a reference for clinical practice in this field.

Pretransplant Blinatumomab Improves Outcomes in B Cell Acute Lymphoblastic Leukemia Patients Who Undergo Allogeneic Hematopoietic Cell Transplantation

BackgroundBlinatumomab, a bispecific monoclonal antibody, effectively controls refractory B cell acute lymphoblastic leukemia (ALL) and promotes measurable residual disease (MRD) negativity. This study investigated the impact of pretransplant blinatumomab on allogeneic hematopoietic cell transplantation (HCT) outcomes in B cell ALL patients. MethodsWe analyzed the effect of pretransplant blinatumomab on transplant outcomes of 117 adults undergoing allogeneic HCT for B cell ALL at Princess Margaret Hospital, Toronto, between 2010 and 2021. Outcomes assessed included overall survival (OS), graft-versus-host disease and relapse-free survival (GRFS), cumulative incidences of relapse (CIR), and nonrelapse mortality (NRM). ResultsThe median follow-up was 36 months. Thirty-one participants (26.5%) received blinatumomab. Blinatumomab group had higher proportions of individuals with high disease risk index, primary induction failure and was more likely to receive dual T cell depletion with antithymocyte globulin and post-transplant cyclophosphamide. Two-year OS, GRFS, NRM, and CIR in the blinatumomab and nonblinatumomab groups were, respectively: 65.4% versus 45.6% (P = .05), 42.2% versus 17.3% (P = .01), 3.2% versus 43.0% (P = .007) and 34.4% versus 14.4% (P = .02). Blinatumomab was associated with a lower incidence of day-100 grade 2 to 4 and grade 3 to 4 acute graft-versus-host disease (aGVHD): 27.5% versus 56.7% (P = .009), and 10.9% versus 34.7% (P = .04), respectively. Multivariate analysis confirmed the association between pretransplant blinatumomab and improved OS and NRM. ConclusionsPretransplant blinatumomab is associated with improved OS and lower risk of NRM in B cell ALL patients undergoing allogeneic HCT, likely reflecting lower burden of treatment-related toxicity in this population. Larger prospective trials are warranted to validate our findings.

Dispensaries and Medical Marijuana Certifications and Indications: Unveiling the Geographic Connections in Pennsylvania, USA.

Pennsylvania opened its first medical marijuana (MMJ) dispensary in 2018. Qualifying conditions include six conditions determined to have no or insufficient evidence to support or refute MMJ effectiveness. We conducted a study to describe MMJ dispensary access in Pennsylvania and to determine whether dispensary proximity was associated with MMJ certifications and community demographics. Using data from the Pennsylvania Department of Health, we geocoded MMJ dispensary locations and linked them to US Census Bureau data. We created dispensary access measures from the population-weighted centroid of Zip Code Tabulation Areas (ZCTAs): distance to nearest dispensary and density of dispensaries within a 15-min drive. We evaluated associations between dispensary access and the proportion of adults who received MMJ certification and the proportion of certifications for low evidence conditions (amyotrophic lateral sclerosis, epilepsy, glaucoma, Huntington's disease, opioid use disorder, and Parkinson's disease) using negative binomial modeling, adjusting for community features. To evaluate associations racial and ethnic composition of communities and distance to nearest dispensary, we used logistic regression to estimate the odds ratios (OR) and 95% confidence intervals (CI), adjusting for median income. Distance and density of MMJ dispensaries were associated with the proportion of the ZCTA population certified and the proportion of certifications for insufficient evidence conditions. Compared to ZCTAs with no dispensary within 15 min, the proportion of adults certified increased by up to 31% and the proportion of certifications for insufficient evidence decreased by up to 22% for ZCTAs with two dispensaries. From 2018 to 2021, the odds of being within five miles of a dispensary was up to 20 times higher in ZCTAs with the highest proportions of individuals who were not White (2019: OR: 20.14, CI: 10.7-37.8) and more than double in ZCTAs with the highest proportion of Hispanic individuals (2018: OR: 2.81, CI: 1.51-5.24), compared to ZCTAs with the lowest proportions. Greater dispensary access was associated with the proportions of certified residents and certifications for low evidence conditions. Whether these patterns are due to differences in accessibility or demand is unknown. Associations between community demographics and dispensary proximity may indicate MMJ access differences.

Investigating the Critical Period for Alcohol or Other Drug-Related Presentations Following Access to Residential Substance Use Treatment: a Data Linkage Study

AbstractIndividuals who access residential treatment for substance use disorders are at a greater risk of negative health and substance-use outcomes upon exiting treatment. Using linked data, we aimed to identify predictive factors and the critical period for alcohol or other drug (AOD)-related events following discharge. Participants include 1056 individuals admitted to three residential treatment centres in Queensland, Australia from January 1 2014 to December 31 2016. We linked participants’ treatment data with administrative data from hospitals, emergency departments, AOD services, mental health services and the death registry up to December 31 2018. We used survival analysis to examine presentations for AOD-related events within two-years of index discharge. A high proportion of individuals (57%) presented to healthcare services for AOD-related events within 2 year of discharge from residential treatment, with the first 30 days representing a critical period of increased risk. Completing residential treatment (aHR = 0.49 [0.37–0.66], p &lt; .001) and high drug-abstaining self-efficacy (aHR = 0.60 [0.44–0.82], p = .001) were associated with a reduced likelihood of AOD-related events. Individuals with over two previous residential treatment admissions (aHR = 1.31 [1.04–1.64], p = .029), identifying as Indigenous Australian (aHR = 1.34 [1.10–1.63], p &lt; .001), alcohol as a primary substance (aHR = 1.58 [1.30–1.92], p &lt; .001), and receiving a Disability Support Pension (aHR = 1.48 [1.06–2.06], p = 0.022) were at a greater likelihood. The high proportion of individuals that present to health and drug services for AOD-related events, especially in the first 30 days post-discharge, highlights the need for continued support following discharge from substance use treatment.

Factors associated with older adults' cognitive decline 6 months after gamma-variant SARS-CoV-2 infection.

Cognitive deficits are commonly reported after COVID-19 recovery, but little is known in the older population. This study aims to investigate possible cognitive damage in older adults 6 months after contracting COVID-19, as well as individual risk factors. This cross-sectional study involved 70 participants aged 60-78 with COVID-19 6 months prior and 153 healthy controls. Montreal Cognitive Assessment-Basic (MoCA-B) screened for cognitive impairment; Geriatric Depression Scale and Geriatric Anxiety Inventory screened for depression and anxiety. Data were collected on demographics and self-reports of comorbid conditions. The mean age of participants was 66.97 ± 4.64 years. A higher proportion of individuals in the COVID group complained about cognitive deficits (χ2 = 3.574; p = 0.029) and presented with deficient MoCA-B scores (χ2 = 6.098, p = 0.014) compared to controls. After controlling for multiple variables, all the following factors resulted in greater odds of a deficient MoCA-B: COVID-19 6-months prior (OR, 2.44; p = 0.018), age (OR, 1.15; p < 0.001), lower income (OR, 0.36; p = 0.070), and overweight (OR, 2.83; p = 0.013). Further analysis pointed to individual characteristics in COVID-19-affected patients that could explain the severity of the cognitive decline: age (p = 0.015), lower income (p < 0.001), anxiety (p = 0.049), ageusia (p = 0.054), overweight (p < 0.001), and absence of cognitively stimulating activities (p = 0.062). Our study highlights a profile of cognitive risk aggravation over aging after COVID-19 infection, which is likely mitigated by wealth but worsened in the presence of overweight. Ageusia at the time of acute COVID-19, anxiety, being overweight, and absence of routine intellectual activities are risk factors for more prominent cognitive decline among those infected by COVID-19.

Geographic variation in the probability of being born with and retaining contrasting tail tip colour (tail luring) in the common lancehead Bothrops jararaca

In snakes which are known to be ambush predators, tail luring, in which the movement of a snake’s tail resembles that of a worm or insect larva and is used to attract prey, has emerged as a complementary hunting strategy. In certain species, some individuals may present a conspicuously bright colour at the tail tip which eventually disappears with age. Some authors argue that the bright colour enhances the resemblance of the snake’s tail with a potential food item, increasing the success of capture. Here, we tested the influence of geographic variation, sex, and environmental factors on the probability that common lanceheads Bothrops jararaca (Wied-Neuwied 1824) from southeastern Brazil were born with this contrasting tail tip and whether snakes retain this trait throughout adulthood. None of the predictors affected the probability of births with a contrasting tail tip. However, a higher proportion of individuals from the coastal populations retained this trait into adulthood. The absence of difference in the probability of being born with this trait indicates that there are other factors influencing tail tip colour, such as phylogenetic correlates, rather than intrinsic or environmental factors. A higher proportion of ectothermic prey in the diet of coastal populations may explain why this population retains tail-luring throughout adulthood.

Abstract WMP9: Comparative Analysis of Endovascular Treatment Outcomes in Acute Large Vessel Occlusion Strokes: Intracranial Atherosclerotic vs. Non- Intracranial Atherosclerotic Occlusions

Introduction: Intracranial atherosclerotic disease (ICAD) is a common cause of ischemic stroke worldwide. We assessed the clinical outcomes of endovascular treatment in acute large vessel occlusion (LVO) strokes caused by ICAD and compared them with large vessel occlusion strokes not associated with intracranial atherosclerosis (non-ICAD LVO). Methods: Our study comprised 1390 adult patients diagnosed with LVO stroke that underwent endovascular therapy at Rhode Island Hospital from July 2015 to March 2023 and data collected retrospectively. Among these, 68 patients exhibited Intracranial Atherosclerotic Disease Large Vessel Occlusion (ICADLVO), while 1322 individuals were categorized as non-ICADLVO. In the ICADLVO group, 23 out of 68 patients underwent angioplasty, whereas 38 patients received stenting. We aim to compare treatment outcomes, including recurrent in-hospital large vessel occlusion, disability, and mortality between these two distinct groups, while also assessing demographic characteristics and medical risk factors. T-Test, Chi square and fisher’s exact tests were used for the comparison of groups. Results: The study findings highlight significant differences between the ICADLVO group and the non-ICADLVO group. The ICADLVO group had younger age (mean 66.6 ± 12.64 vs. 71.92 ± 14.56, p &lt; 0.001) , higher proportion of individuals with Asian ethnicity (5.2% vs. 0.8%, p = 0.019), higher incidence of prior strokes (43.3% vs. 23.9%, p=0.000), higher prevalence of smokers (35.6% vs. 22.7%, p = 0.022), and a lower association with known atrial fibrillation (23.9% vs. 42.3%, p=0.003) compared to the non-ICADLVO group. Additionally, the ICADLVO group had a higher occurrence of recurrent large vessel occlusion during hospitalization (11.8% vs. 4%, p = 0.008). This analysis finds no significant difference in good 90-dayfunctional outcome (mRS &lt;= 2) between the ICADLVO and NON-ICADLVO groups (OR = 0.62, 95% CI 0.34-1.13, p=0.118). Conclusion: Our study showed a higher incidence of recurrent large vessel occlusion during hospitalization in the ICADLVO group following endovascular therapy. However, we did not observe any statistically significant differences in long-term outcomes, including measures of disability and mortality.

The role of psychological interventions in improving quality of life and reducing symptoms in patients with rheumatologic conditions: systematic review

The long-term condition known as rheumatoid arthritis (RA) severely reduces bodily, emotional, and psychological functioning. Hence, the need of psychological interventions is important to improve the quality of life and reduce symptoms. For instance, this review aimed to explain the role psychological interventions in reducing symptoms and improving quality of life in rheumatoid arthritis patients. A thorough search was carried out in November 2023, mostly using PubMed, in compliance with PRISMA criteria. The search was limited to English-language research that looked at the effect of psychological interventions on rheumatoid arthritis patients. To guarantee the quality and applicability of the evaluated research, certain inclusion and exclusion criteria were developed. A wide spectrum of research from various countries and areas was included in the study, without any focus on a specific age. A discernible pattern indicated a high proportion of individuals with effect of psychological interventions in long term condition. According to the findings of the current investigation, there is confirmed evidence to prove the positive effect of psychological interventions on rheumatoid conditions.

Demographic, Clinical, and Antiretroviral Regiment Treatment Characteristics of HIV/AIDS Patients at the Regional General Hospital of Central Papua

The incidence of HIV infections in Papua is currently on the rise, primarily due to restricted access to antiretroviral treatment and insufficient support and care. Additionally, there is a lack of awareness among residents in rural or mountainous areas about HIV/AIDS infection, as provided by healthcare professionals. Until now, research data have been scarce on the demographic characteristics, clinical features, and treatment approaches for HIV/AIDS patients in the interior regions of Papua. This data is crucial for devising strategies aimed at enhancing healthcare services for individuals affected by HIV/AIDS.Consequently, this study endeavors to gain insights into the demographic characteristics, clinical features, and treatment modalities for HIV/AIDS patients at the Regional General Hospital of the Central Papua Region. It employs an observational descriptive approach, utilizing medical records of HIV/AIDS patients who visited the Central Papua Regional Government Hospital in June 2023. The findings indicate that, based on demographic data, the majority of patients were, on average, ≤25 years old (60.8%), male (52.5%), married (56.7%), and the highest number of HIV/AIDS cases were among secondary education graduates (40.8%). The majority were employed (67.5%) with incomes below the minimum wage threshold (69.2%). All heterosexual patients exhibited behavioral risk factors, and 4.2% had comorbidities such as hypertension. Tuberculosis was the most common opportunistic infection (17.5%). The highest proportion of individuals with HIV/AIDS were in stage II (66.7%). The predominant antiretroviral treatment regimen was a fixed-dose combination (FDC) containing Tenofovir 300mg, Lamivudine 300mg, and Efavirenz 600mg. The duration of use of ARV therapy in people with HIV / AIDS is at most 1 month.

Public perception on human exposure risk: A case study on endocrine disrupting compounds in the environment

Humans are exposed to environmental risks owing to the broad usage of endocrine disrupting compounds (EDCs). However, the subjective evaluation of risk levels and characteristics, as well as the variation in risk processing, have not been thoroughly examined. The objective was to understand the public's perception of the risk associated with human exposure to environmental EDCs and identify any variations in risk perception. In this pioneering study conducted within the distinctive social and cultural context of Malaysia, a developing nation, a quantitative analysis approach was employed to assess the subjective evaluation of risk levels and characteristics among the public while developing a risk perception model. Data gathered from surveys and questionnaires were analyzed to gather information on the public's perception of environmental and health issues pertaining to pesticides, hormones, plastics, medicines, and cosmetics. The analysis revealed that the majority of the public assessed the level of human exposure to environmental risks based on experiential processing, which was influenced by cognitive and affective variables. Interestingly, a higher proportion of individuals in the community had a low risk perception of environmental EDCs, surpassing the overall risk perception by 19.3%. Furthermore, the public showed significant awareness of environmental and health issues related to pesticides, hormones, and plastics but had a lesser inclination to acknowledge the vulnerability of humans to risks associated with medicines and cosmetics. These findings suggest that the public is likely to be exposed to environmental EDCs based on their current perceived risks, and that sociopsychological factors play a significant role in shaping perceptions and judgments. This understanding can inform the development of targeted risk management strategies and interventions to mitigate the potential harm caused by environmental EDCs.

Geospatial analysis and participant characteristics associated with colorectal cancer screening participation in Alberta, Canada: a population-based cross-sectional study

BackgroundColorectal cancer (CRC) is a leading cause of death in Canada and early detection can prevent deaths through screening. However, CRC screening in Alberta, Canada remains suboptimal and varies by sociodemographic and health system characteristics, as well as geographic location. This study aimed to further the understanding of these participant and health system characteristics associated with CRC screening in Alberta and identify clusters of regions with higher rates of overdue or unscreened individuals.MethodsWe included Albertans aged 52 to 74 as of December 31, 2019 (index date) and we used data from administrative health data sources and linked to the Alberta Colorectal Cancer Screening Program database to determine colorectal cancer screening rates. We used multivariable multinomial logistic regression analysis to investigate the relationship between sociodemographic, health system characteristics and participation in CRC screening. We used optimized Getis-Ord Gi* hot-spot analysis to identify hot and cold-spots in overdue for and no record of CRC screening.ResultsWe included 919,939 Albertans, of which 65% were currently up to date on their CRC screening, 21% were overdue, and 14% had no record of CRC screening. Compared to Albertans who were currently up to date, those who were in older age groups, those without a usual provider of care, those who were health system non-users, and those living in more deprived areas were more likely to have no record of screening. Areas with high number of Albertans with no record of screening were concentrated in the North and Central zones.ConclusionsOur study showed important variation in colorectal cancer screening participation across sociodemographic, health system and geographical characteristics and identified areas with higher proportions of individuals who have no record of screening or are under-screened in Alberta, Canada.

Should Familial Hypercholesterolaemia Be Included in the UK Newborn Whole Genome Sequencing Programme?

The UK National Health Service (NHS) has recently announced a Newborn Genomes Programme (NGP) to identify infants with treatable inherited disorders using whole genome sequencing (WGS). Here, we address, for familial hypercholesterolaemia (FH), the four principles that must be met for the inclusion of a disorder in the NGP. Principle A: There is strong evidence that the genetic variants causing FH can be reliably detected. Principle B: A high proportion of individuals who carry an FH-causing variant are likely to develop early heart disease if left undiagnosed and not offered appropriate treatment. Principle C: Early intervention has been shown to lead to substantially improved outcomes in children with FH. Principle D: The recommended interventions are equitably accessible for all. FH meets all the Wilson and Jungner criteria for inclusion in a screening programme, and it also meets all four principles and therefore should be included in the Newborn Genomes Programme.

The Association Between Short Sleep Duration and Metabolic Syndrome: A Case-Control Study.

Short sleep duration and quality are increasingly common in the Middle East and North Africa (MENA) region and has been linked to metabolic syndrome, which increases the risk of cardiovascular disease and diabetes. This study aimed to examine the link between short sleep duration and metabolic syndrome. We conducted a case-control study using data from Qatar Biobank, with 1000 participants categorized into two groups: less than 7 hours of sleep (n=500) and 7 or more hours of sleep (n=500). Metabolic syndrome was defined using WHO criteria, and logistic regression analysis adjusted for age and gender. There was a higher proportion of individuals with MetS in the short sleep duration group compared to the normal sleep duration group (22.8% vs 15.8%, respectively). The multivariable regression showed that short sleep duration was associated with metabolic syndrome (OR 1.91, 95% CI: 1.14-3.20, P=0.014) and having 1-2 components of metabolic syndrome (OR 1.91, 95% CI: 1.14-3.20, P=0.014), particularly in males (OR: 2.30, 95% CI: 1.07-4.94, P=0.032). Being overweight (OR 2.17, 95% CI: 1.30-3.63, P=0.003) was also associated with a shorter sleep duration. BMI was identified as the main contributor to the association between short sleep duration and metabolic syndrome, while diabetes played a minor role. Short sleep duration was associated with metabolic syndrome in Qatar, particularly in males.

Association between brown sugar intake and decreased risk of cancer in the Amami islands region, Japan.

Although excess white sugar intake imposes various health burdens, brown sugar is high in minerals, polyphenols, and polycosanol. However, few epidemiological studies have assessed brown sugar intake for health benefit. People in the Amami islands region, with a relatively high proportion of individuals with longevity, consume brown sugar as a type of refreshment. This cohort study was conducted in Amami to clarify the association of brown sugar intake with mortality risk and cancer incidence. Participants were recruited from the general population of Amami as part of the Japan Multi-Institutional Collaborative Cohort Study. The number of eligible participants was 5004 (2057 men and 2947 women). During the median follow-up period of 13.4 years, 274 deaths and 338 cases of cancer were observed. HRs and 95% CIs were estimated using the Cox proportional hazard model, after adjusting for sugar-related and other variables. After adjusting for their related confounding factors, brown sugar intake was associated with decreased HRs and a decreasing trend for all-site and stomach cancer incidence (p = 0.001 and 0.017, respectively) in women and men, and for breast cancer incidence (p = 0.034) in women. Additionally, a decreasing trend in the HRs for lung cancer incidence was observed among never and ex-smokers (p = 0.039). Decreased HRs for overall death, cancer, and cardiovascular disease were not apparent. Brown sugar intake was associated with decreased risk of all-site, stomach, and breast cancer incidences in the Amami population.

Influence of disabilities on state-level disparity in dental care utilization and tooth loss: Findings from the 2020 Behavioral Risk Factor Surveillance System.

The aim of this study is to describe the prevalence of disparity in access to dental care and tooth loss between US adults with and without disabilities at the state level. This secondary analysis included data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), a cross-sectional state-run annual telephone survey of noninstitutionalized US adults aged 18 years or older. The primary predictor, having any disability, was defined as reported difficulty in hearing, vision, cognition, mobility, self-care, or independent living. The two dental outcomes used were reported time since last dental visit and missing teeth status. We conducted descriptive analysis and multinomial regression models on weighted data to report the prevalence and state-level disparity in dental outcomes between individuals with and without disability. Nationally, one in four adults reported a disability, with a disproportionately higher prevalence among females, Native Americans and lower education and income groups. The highest utilization of dental services within a year among individuals with disabilities was found in the Northwestern and Midwestern states. Western states had the highest proportion of individuals with disability to have had a recent dental visit and a complete dentition, while the Southern states had the lowest proportions. After adjusting for sociodemographic factors, 59.1% of individuals with disabilities had dental visits within a year, which is 8.0% points less than those without disabilities. Similarly, only 50.8% of individuals with a disability had complete tooth retention, which is 10.1% points less than individuals without disability. Regardless of the type of disability, adults with a disability were less likely to have visited the dentist in the past year or to have retained all of their teeth. Those with self-care disabilities had the lowest rates of both. There were clear disparities in the utilization of dental care and dentate status among adults with disabilities at the state level. The findings from this study highlighted the necessity of finding local solutions to address the gap in dental care utilization and tooth loss between those with and without disability among the US population.

Understanding Patient Preferences for Intervention in Individuals with Precursor Multiple Myeloma: The Preference Study

Background: The standard of care for patients with monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) consists of watchful waiting until progression to clinically manifest multiple myeloma. While an increasing number of clinical trials are exploring the premise that early intervention in this MGUS/SMM patient population will prevent progression to multiple myeloma, little is known about how patients might balance the risks against potential benefits of early intervention. Methods: To quantify preference for attributes of intervention in individuals with MGUS and SMM, we developed an online conjoint instrument with four attributes that we identified as being salient to clinical decision making: prevention of multiple myeloma, monthly cost, inconvenience, and risk of long-term side effects. We recruited individuals from two nationwide prospective cohorts to take the online instrument. To be eligible to participate, participants had to be age 18 or older, have a diagnosis of MGUS or SMM, and have no concurrent malignancy requiring active therapy. Logistic regression models were used to investigate the attributes that drive decisions of early treatment. In addition, we used a latent profile analysis to investigate latent classes defined by patient choices and assess patient characteristics that predict class membership. Results: Participants (n=272) were 43% male, with a mean age of 64.1 (SD: 9.7) years. Logistic regression models suggest a strong preference for choosing interventions based on a higher likelihood of multiple myeloma prevention (odds ratio [OR] per 10% change:1.86, 95% confidence interval [CI]: 1.72, 2.00) and avoidance of side effects (OR: 0.10, 95%CI: 0.08, 0.13). Latent profile analysis identified three latent profiles: the first profile defines individuals who predominantly value avoidance of side effects, the second profile characterizes individuals who value keeping costs low, and the third profile of individuals values multiple myeloma prevention above other attributes. Mean age was similar across latent profiles. A higher proportion of individuals in profile two (group prioritizing cost) did not complete college and had a household income of less than $100,000. A similar proportion of individuals with SMM prioritized avoiding side effects as they did multiple myeloma risk reduction. Conclusions: Overall, we found that low side effects and prevention of multiple myeloma are desirable intervention attributes in patients with MGUS and SMM. The prioritization of myeloma prevention vs low side effect profile was not perfectly coupled with an individual's disease burden. These findings reinforce the notion that a “one size fits all” approach to prevention and interception of multiple myeloma may not be suitable for all patients, and thus a diverse interventional portfolio may be needed to reach broad populations of patients with precursor conditions to multiple myeloma.