Populations For Epidemiologic Studies Research Articles

Most babies born at a French hospital before 26 weeks survived with good outcomes.

The aim of this French study was to determine the neonatal morbidity, mortality and neurodevelopmental outcomes when infants born at the limit of viability reached 2 years of corrected age. We then compared the results with national and international cohorts. This study focused on 294 French infants born from 22 to 25 weeks of gestation in a single tertiary perinatal centre from January 2010 to December 2019. We used data on neonatal mortality and morbidity to calculate the survival rates of infants without moderate to severe neurodevelopmental and sensory deficits at 2 years of corrected age. These outcomes were compared with data from contemporary epidemiological studies of similar populations. Nearly two-thirds (60.5%) of the infants survived to discharge, with varying rates based on their gestational ages, and 57.3% had no severe neonatal morbidity. The vast majority (90.4%) of the 166 alive and available at 2 years of corrected age were free of moderate to severe neurodevelopmental impairment. Our survival rates exceeded a national French cohort study, but were closely aligned with international cohorts. These findings highlight the importance of incorporating local data into ethical decision-making about life-saving treatment for infants at the limit of viability.

Impacts of iodoacetic acid on reproduction: current evidence, underlying mechanisms, and future research directions.

In light of the undeniable and alarming fact that human fertility is declining, the harmful factors affecting reproductive health are garnering more and more attention. Iodoacetic acid (IAA), an emerging unregulated drinking water disinfection byproduct, derives from chlorine disinfection and is frequently detected in the environment and biological samples. Humans are ubiquitously exposed to IAA daily mainly through drinking water, consuming food and beverages made from disinfected water, contacting swimming pools and bath water, etc. Mounting evidence has indicated that IAA could act as a reproductive toxicant and bring about multifarious adverse reproductive damage. For instance, it can interfere with gonadal development, weaken ovarian function, impair sperm motility, trigger DNA damage to germ cells, perturb steroidogenesis, etc. The underlying mechanisms predominantly include cytotoxic and genotoxic effects on germ cells, disturbance of the hypothalamic-pituitary-gonadal axis, oxidative stress, inhibition of steroidogenic proteins or enzymes, and dysbiosis of gut microbiota. Nevertheless, there are still some knowledge gaps and limitations in studying the potential impact of IAA on reproduction, which urgently need to be addressed in the future. We suppose that necessary population epidemiological studies, more sensitive detection methods for internal exposure, and mechanism-based in-depth exploration will contribute to a more comprehensive understanding of characteristics and biological effects of IAA, thus providing an important scientific basis for revising sanitary standards for drinking water quality.

Head and neck cancer incidence is rising but the sociodemographic profile is unchanging: a population epidemiological study (2001–2020)

BackgroundIncreasing incidence of head and neck cancers (HNCs), driven by rising rates of oropharynx cancer (OPC), has been recorded around the world. This study examined trends in HNC and subsites (oral cavity, oropharynx, and larynx cancers) in Scotland focusing on assessing whether the sociodemographic profile has changed over the past 20 years.MethodsScottish Cancer Registry data (2001–2020) including European Age Standardised Rates of HNC and subsites were analysed in multivariate Poisson regression by age, sex, area-based socioeconomic status, and year of diagnosis (with interaction tests).ResultsOverall HNC and oral cavity cancer (OCC) incidence remained relatively stable. OPC incidence rates increased by 78%, while larynx cancer incidence declined by 27%. Over time, there were marginal shifts to a slightly older age profile for HNC (p = 0.001) and OCC (p = 0.001), but no changes in OPC (p = 0.86) and larynx cancer (p = 0.29). No shift in the sex profile of HNC was observed except for minor increases in female OCC rates (p = 0.001), and the socioeconomic distribution remained unchanged across all HNC subsites.ConclusionsThere have been no significant changes in the sociodemographic profile of HNC in Scotland over the last 20 years, despite the changing trends in HNCs with dramatically increasing incidence rates in OPC and reducing larynx cancer. This information can be used to target or stratify HNC prevention and control.

A Historical Survey of Key Epidemiological Studies of Ionizing Radiation Exposure.

In this article we review the history of key epidemiological studies of populations exposed to ionizing radiation. We highlight historical and recent findings regarding radiation-associated risks for incidence and mortality of cancer and non-cancer outcomes with emphasis on study design and methods of exposure assessment and dose estimation along with brief consideration of sources of bias for a few of the more important studies. We examine the findings from the epidemiological studies of the Japanese atomic bomb survivors, persons exposed to radiation for diagnostic or therapeutic purposes, those exposed to environmental sources including Chornobyl and other reactor accidents, and occupationally exposed cohorts. We also summarize results of pooled studies. These summaries are necessarily brief, but we provide references to more detailed information. We discuss possible future directions of study, to include assessment of susceptible populations, and possible new populations, data sources, study designs and methods of analysis.

Longitudinal Molecular and Serological Evidence of SARS-CoV-2 Infections and Vaccination Status: Community-Based Surveillance Study (CONTACT).

This prospective, longitudinal, community-based study,EpidemiologiCal POpulatioN STudy of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Lake CounTy, Illinois(CONTACT), investigated coronavirus disease 2019 (COVID-19) immunity, occupational risks related to SARS-CoV-2 exposure, and long-term immunoglobulin G (IgG) seroconversion kinetics. At baseline and follow up (3, 6, and 9months), non-hospitalized adult participants provided nasal and blood serum specimens for molecular [reverse transcription polymerase chain reaction (RT-PCR)] and serological (IgG) testing (4 November 2020-30 October 2021). At baseline, 6.4% (65/1008) had evidence of current/prior SARS-CoV-2 infection. At 3, 6, and 9months, positive PCR tests were obtained from 0.4% (3/781), 0.4% (3/733), and 0% (0/673) of participants, respectively. Positive IgG occurred at baseline and 3, 6, and 9months in 4.5% (45/1008), 6.0% (48/799), 5.4% (39/733), and 2.8% (19/673) of participants, respectively. Of participants positive for IgG at baseline, 28 had a negative IgG test at a follow-up visit; of those 28, 21 had their first negative IgG test within 6months. Participants were more likely to retain positive IgG if they were 18-29years of age, were male, or had medium-high/high-risk occupations. A high vaccination rate (70% received ≥ 1 dose by 9months) was observed. Influence of occupational status or characteristics on transmission and IgG, and COVID-19 vaccination trends, are shown. This study expands on prior studies assessing COVID-19 immunity and IgG seroconversion by including both RT-PCR and serologic testing and longitudinal follow-up of study participants. We observed decreased infection rates over the 9month follow-up period as well as a decline in IgG persistency after 6months. The findings from this community-based study regarding vaccinate rates, infection rates by PCR, and IgG persistency over time can help improve our understanding of COVID-19 immunity, occupational risks related to SARS-CoV-2 exposure, and the kinetics of long-term IgG seroconversion, which is important to help guide local and national mitigation strategies. NCT04611230.

Evaluation of risks of cardiovascular disease from radiation exposure linked to computed tomography scans in the UK

Epidemiological studies of patient populations have shown that high doses of radiation increase risks of cardiovascular disease (CVD). Results from a recent meta-analysis of 93 epidemiological studies covering a wide range of doses provided evidence of a causal association between radiation exposure and CVD, and indicated excess relative risk per Gy for maximum dose below 500 mGy or delivered at low dose rates. These doses cover the range of organ doses expected from multiple diagnostic computed tomography (CT) scans. Dose-effect factors for the excess absolute risk of mortality from CVD following radiation exposure were derived from the meta-analysis. The present study uses these factors to estimate excess risks of mortality for various types of CVD, including cerebrovascular disease (CeVD), from CT scans of the body and head, assuming that the meta-analytic factors were accurate and represented a causal relationship. Estimates are based on cumulative doses to the heart and brain from CT scans performed on 105 574 patients on 12 CT scanners over a period of 5½ years. The results suggest that the excess number of deaths from CeVD could be 7 or 26 per 100 000 patients depending whether threshold brain doses of 200 mGy or 50 mGy, respectively are assumed. These results could have implications for head CT scans. However, the results rely on the validity of risk factors derived in the meta-analysis informing this assessment and which include significant uncertainties. Further incidence studies should provide better information on risk factors and dose thresholds, particularly for CeVD following head CT scans.

Early developments of psychiatric epidemiology in Chile: a local history with global implications

Abstract This viewpoint discusses a conference paper titled: “Epidemiological research on mental morbidity in Chile”, which summarizes a handful of studies from 1950s in Chile covering conditions such as alcoholism, psychosis, epilepsy, and neurosis. These were the first psychiatric epidemiological population studies conducted in the Southern hemisphere, but they are largely unknown globally. We argue that the Chilean studies have important implications for modern psychiatric epidemiology, as well as for related fields such as global mental health and mental health services research. This piece starts by describing the general sociopolitical context and presenting the main methodological features of the studies. It focuses then on three specific implications for the field: 1) promoting decoloniality in psychiatric epidemiology; 2) ensuring methodological rigor and feasibility; and 3) informing the development of mental health policy and services.

Effect of Environmental Temperature in Lowlands on Lung Health: A Literature Review

Lowlands, with their hot and humid climates, present health challenges especially on the respiratory system. High ambient temperatures can worsen lung conditions, especially for people with asthma or chronic obstructive pulmonary disease (COPD). In the context of climate change and increased air pollution, it is important to understand the impact of environmental temperature on lung health in lowlands. The study aimed to review the existing literature to evaluate these effects, focusing on the mechanisms underlying this relationship and the long-term effects of high temperature exposure on lung function. The method used was a systematic literature review, which included relevant studies from scientific journals on the relationship between environmental temperature and lung health, as well as epidemiological studies in lowland populations. The article search technique in this study is through web access to Mendeley, and Science Direct. The results showed that high temperatures could trigger exacerbations of lung diseases, increase pollutant particles, and decrease lung function, as well as increase the risk of respiratory infections and decrease quality of life. In conclusion, high temperatures in lowlands have a significant impact on lung health, requiring mitigation efforts, and further research to understand the underlying biological mechanisms and develop effective intervention strategies.

Influence of Air Pollution Exposures on Cardiometabolic Risk Factors: a Review.

The increasing prevalence of cardiometabolic risk factors (CRFs) contributes to the rise in cardiovascular disease. Previous research has established a connection between air pollution and both the development and severity of CRFs. Given the ongoing impact of air pollution on human health, this review aims to summarize the latest research findings and provide an overview of the relationship between different types of air pollutants and CRFs. CRFs include health conditions like diabetes, obesity, hypertension etc. Air pollution poses significant health risks and encompasses a wide range of pollutant types, air pollutants, such as particulate matter (PM), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O2). More and more population epidemiological studies have shown a positive correlation between air pollution and CRFs. Although various pollutants have diverse effects on specific cellular molecular pathways, their main influence is on oxidative stress, inflammation response, and impairment of endothelial function. More and more studies have proved that air pollution can promote the occurrence and development of cardiovascular and metabolic risk factors, and the research on the relationship between air pollution and CRFs has grown intensively. An increasing number of studies are using new biological monitoring indicators to assess the occurrence and development of CRFs resulting from exposure to air pollution. Abnormalities in some important biomarkers in the population (such as homocysteine, uric acid, and C-reactive protein) caused by air pollution deserve more attention. Further research is warranted to more fully understand the link between air pollution and novel CRF biomarkers and to investigate potential prevention and interventions that leverage the mechanistic link between air pollution and CRFs.

A Comparative Study of Sleep Parameters in Adult Survivors of Childhood Acute Lymphoblastic Leukemia and Healthy Peers: Insights from Accelerometer Data

Background. Sleep problems are among the common late side effects of treatment that can occur in survivors of childhood acute lymphoblastic leukemia. At present, the objective evaluation of sleep in the natural environment using actigraphy rather than self-assessment of research participants or the more demanding polysomnography is increasingly coming to the forefront in population epidemiological studies. The main objective of this cross-sectional study is to objectively characterize selected sleep parameters with respect to gender in adult survivors of childhood acute lymphoblastic leukemia (ALS) in their natural environment and to compare them with a control group (CG) sampled from a healthy population. Another partial aim of the study is to determine the fulfillment of recommendations in the areas of sleep (SL) and sleep efficiency (SE). Methods. 20 ALS and 20 CGs aged 18–30 years participated in the survey. The ALS were diagnosed on average 15.5 years ago. Selected sleep parameters were measured instrumentally by means of an Axivity AX3 accelerometer worn on the wrist for seven days in a natural environment. Results. No significant differences were found between the ALS and CG groups for the selected sleep parameters. The total time in bed for the ALS was 405.5 min/day compared to 428.2 min/day for the CG ( p = 0.37 ), sleep for the ALS was 372.7 min/day compared to 382.9 min/day for the CG ( p = 0.34 ), and SE for the ALS was 88.0% compared to 88.5% for the CG ( p = 0.99 ). No significant gender differences were found. The sleep recommendation of >420 min/day was met by 15% for the ALS and 19% for the CG; SE > 85% was achieved by 80% for the ALS and 80% for the CG. Conclusion. The results of our study suggest that ALS may achieve the same values as the healthy population in selected sleep parameters.

DEHP and DBP, common phthalates, induce glucose metabolism disorders in rats via oxidative damage of PI3K/Akt/GLUT4 signaling

Phthalic acid esters (PAEs) are environmental endocrine disruptors thought to interfere with glucose metabolism in humans. Most of the related research has focused on population epidemiological studies, with the underlying mechanisms remaining unresolved. Using an in vivo animal model, we examined the effects of oral administration of two commonly used PAEs [di(2-ethylhexyl) phthalate (DEHP) and dibutyl phthalate (DBP)] on glucose homeostasis and insulin secretion. DEHP (750 mg/kg, 1/40 LD50), DBP (500 mg/kg, 1/40 LD50), and DEHP (750 mg/kg) + DBP (500 mg/kg) exert an influence on glucose metabolism and elicit a reduction in insulin sensitivity in rats. Furthermore, these substances induce detrimental effects on the structure and functionality of pancreatic β-cells. DEHP and/or DBP triggered an increase in plasma malondialdehyde (MDA) and reduction in superoxide dismutase (SOD) activity; a reduction in the phosphorylation of phosphatidyl inositol 3 kinase (PI3K) and phospho-protein kinase B (p-Akt473) proteins; an increase in the relative expression of Bax, Caspase-8, cleaved-Caspase-9, and cleaved-Caspase-3; and a reduction in the relative expression of Bcl-2-related Bax in pancreatic tissue and of gastrocnemius glucose transporter 4 (GLUT4) in the gastrocnemius muscle. Based on these findings, these PAEs can disrupt glucose metabolism, possibly via oxidative damage of the PI3K/Akt/GLUT4 pathway; this damage induces pancreatic β-cell apoptosis, affects pancreatic β-cell function, and affects glucose metabolism and insulin resistance in rats. To the best of our knowledge, this study was the first to show that the combined effect of the two PAEs affects glucose metabolism and insulin resistance in rats that is significantly higher than the effects of each PAE. Thus, safety standards and studies do not consider this effect as a significant oversight when blending PAEs. We assert that this must be addressed and corrected for establishing more impactful and safer standards.

Estimating heritability explained by local ancestry and evaluating stratification bias in admixture mapping from summary statistics

The heritability explained by local ancestry markers in an admixed population (hγ2) provides crucial insight into the genetic architecture of a complex disease or trait. Estimation of hγ2 can be susceptible to biases due to population structure in ancestral populations. Here, we present heritability estimation from admixture mapping summary statistics (HAMSTA), an approach that uses summary statistics from admixture mapping to infer heritability explained by local ancestry while adjusting for biases due to ancestral stratification. Through extensive simulations, we demonstrate that HAMSTA hγ2 estimates are approximately unbiased and are robust to ancestral stratification compared to existing approaches. In the presence of ancestral stratification, we show a HAMSTA-derived sampling scheme provides a calibrated family-wise error rate (FWER) of ∼5% for admixture mapping, unlike existing FWER estimation approaches. We apply HAMSTA to 20 quantitative phenotypes of up to 15,988 self-reported African American individuals in the Population Architecture usingGenomics and Epidemiology (PAGE) study. We observe hˆγ2 in the 20 phenotypes range from 0.0025 to 0.033 (meanhˆγ2= 0.012± 9.2×10-4), which translates to hˆ2 ranging from 0.062 to 0.85 (mean hˆ2= 0.30± 0.023). Across these phenotypes we find little evidence of inflation due to ancestral population stratification in current admixture mapping studies (mean inflation factor of 0.99± 0.001). Overall, HAMSTA provides a fast and powerful approach to estimate genome-wide heritability and evaluate biases in test statistics of admixture mapping studies.

Dose estimates and their uncertainties for use in epidemiological studies of radiation-exposed populations in the Russian Southern Urals.

Many residents of the Russian Southern Urals were exposed to radioactive environmental pollution created by the operations of the Mayak Production Association in the mid- 20th century. There were two major releases: the discharge of about 1x1017 Bq of liquid waste into the Techa River between 1949 and 1959; and the atmospheric release of 7.4 * 1016 Bq as a result an explosion in the radioactive waste-storage facility in 1957. The releases into the Techa River resulted in the exposure of more than 30,000 people who lived in riverside villages between 1950 and 1961. The 1957 accident contaminated a larger area with the highest exposure levels in an area that is called the East Urals Radioactive Trace (EURT). Current epidemiologic studies of the exposed populations are based on dose estimates obtained using a Monte-Carlo dosimetry system (TRDS-2016MC) that provides multiple realizations of the annual doses for each cohort member. These dose realizations provide a central estimate of the individual dose and information on the uncertainty of these dose estimates. In addition, the correlation of individual annual doses over realizations provides important information on shared uncertainties that can be used to assess the impact of shared dose uncertainties on risk estimate uncertainty.This paper considers dose uncertainties in the TRDS-2016MC. Individual doses from external and internal radiation sources were reconstructed for 48,036 people based on environmental contamination patterns, residential histories, individual 90Sr body-burden measurements and dietary intakes. Dietary intake of 90Sr resulted in doses accumulated in active bone marrow (or simply, marrow) that were an order of magnitude greater than those in soft tissues. About 84% of the marrow dose and 50% of the stomach dose was associated with internal exposures. The lognormal distribution is well-fitted to the individual dose realizations, which, therefore, could be expressed and easily operated in terms of geometric mean (GM) and geometric standard deviation (GSD). Cohort average GM for marrow and stomach cumulative doses are 0.21 and 0.03 Gy, respectively. Cohort average dose uncertainties in terms of GSD are as follows: for marrow it is 2.93 (90%CI: 2.02-4.34); for stomach and the other non-calcified tissues it is 2.32 (90% CI: 1.78-2.9).

FastHaN: a fast and scalable program for constructing haplotype network for large-sample sequences.

Haplotype networks can be used to demonstrate the genealogical relationships of DNA sequences within species, and thus are widely applied in population genetics, molecular ecology, epidemiology and evolutionary studies. However, existing programs become computationally infeasible as the sample size increases. Here, we present fastHaN, an efficient and scalable program suitable for constructing haplotype networks for large samples. On a data set with the haplotype length of 30 kb, the Median Joining Network (MJN) algorithm implemented by fastHaN is 3000 times faster than PopART and 70 times faster than NETWORK in single-threaded mode. The implementation of the Templeton-Crandall-Sing (TCS) algorithm is 100 times faster than PopART and 5800 times faster than the TCS software. Moreover, fastHaN also enables multi-threaded mode with scalability. The source code is freely available on https://github.com/ChenHuaLab/fastHaN/. A web-based version is also available on https://ngdc.cncb.ac.cn/haplotype/.

Perfil sociodemográfico y descripción del síntoma de presentación en mujeres con cáncer de mama en un estudio de base poblacional: implicaciones y papel de las enfermeras

ObjectiveTo describe the frequency and typology of the presenting symptom of women diagnosed of breast cancer in Spain and their socio-demographic profile. MethodsDescriptive study nested in a population epidemiological study (MCC-SPAIN) in 10 Spanish provinces. Between 2008 and 2012, 836 histologically confirmed incident cases of breast cancer were recruited who reported some symptom prior to diagnosis in a direct computerized interview. For the comparison of 2 discrete variables, the Pearson Chi square test was used. ResultsThe most frequent presenting symptom among women who reported at least one symptom was noticing a «lump in the breast» (73%), followed far behind by noticing «changes in the breast» (11%). The frequency of the presenting symptom showed some geographic heterogeneity as well as with menopausal status. No association was observed between the type of presenting symptom and the rest of the sociodemographic variables explored, except for the educational level in which women with a higher educational level tended to proportionally report other symptoms different from the «lump in the breast» more frequently than less educated. Postmenopausal women reported noticing changes in the breast (13%) more frequently than premenopausal women (8%), although without reaching statistical significance (P=.056). ConclusionsThe most frequent presenting symptom is «breast lump», followed by «breast changes». There could be sociodemographic heterogeneity in the type of presenting symptom to be taken into account by nurses in their socio-sanitary interventions.

A Short Review on Carcinogenicity

Humans are exposed to a variety of different and persistent DNA-damaging agents, some of which have been identified as carcinogens. DNA damage can occur from exposure to exogenous agents, but damage from endogenous processes is more common. That is, epidemiological studies of migrant populations from low-cancer-risk areas to high-cancer-incidence countries suggest the role of environmental factors and/or lifestyle as important players in the etiology of cancer. As a result, it can be assumed that carcinogens found in the environment or our diet are to blame. Carcinogen exposure is associated with various forms of DNA damage, including single-strand breaks, double-strand breaks, chemical DNA cross-links, oxidative stress, and DNA-DNA or DNA-protein breaks. This review focuses on DNA damage caused by the following carcinogens: polycyclic aromatic hydrocarbons, heterocyclic aromatic amines, mycotoxins, ultraviolet light, ionizing radiation, aristolochic acid, nitrosamines, and particulate matter. In addition, we discuss several cancers for which molecular epidemiological evidence suggests that these agents are etiological risk factors. The complex role that carcinogens play in the pathophysiology of cancer development remains unclear, but DNA damage remains central to this process.

Sociodemographic profile and description of the presenting symptom in women with breast cancer in a population-based study: Implications and role for nurses

ObjectiveTo describe the frequency and typology of the presenting symptom of women diagnosed of breast cancer in Spain and their socio-demographic profile. MethodsDescriptive study nested in a population epidemiological study (MCC-SPAIN) in 10 Spanish provinces. Between 2008 and 2012, 836 histologically confirmed incident cases of breast cancer were recruited who reported some symptom prior to diagnosis in a direct computerized interview. For the comparison of 2 discrete variables, the Pearson Chi square test was used. ResultsThe most frequent presenting symptom among women who reported at least one symptom was noticing a “lump in the breast” (73%), followed far behind by noticing “changes in the breast” (11%). Geographic heterogeneity was observed in the frequency of the presenting symptom, as well as with menopausal status. No association was observed between the type of presenting symptom and the rest of the sociodemographic variables explored, except for the educational level in which women with a higher educational level tended to proportionally report other symptoms different from the “lump in the breast” more frequently than less educated. Postmenopausal women reported noticing changes in the breast (13%) more frequently than premenopausal women (8%), although without reaching statistical significance (P = .056). ConclusionsThe most frequent presenting symptom is “breast lump”, followed by “breast changes”. There could be sociodemographic heterogeneity in the type of presenting symptom to be taken into account by nurses in their socio-sanitary interventions.

Longitudinal association of dietary habits and the risk of cardiovascular disease among Iranian population between 2001 and 2013: the Isfahan Cohort Study

There has been a steady rise in the incidence of cardiovascular disease (CVD) in the Iranian population. The aim of this study is to investigate the association between Global Dietary Index (GDI) and CVD risk among the Iranian adult population. This study was conducted based on Isfahan Cohort Study, a longitudinal study that collected data between 2001 and 2013 on 6405 adults. Dietary intakes were assessed by a validated food frequency questionnaire to calculate GDI. All participants were followed every two years by phone call to ask about death, any hospitalization, or cardiovascular events to examine CVD events. The Average age of participants was 50.70 ± 11.63 and the median of GDI score was 1 (IQR: 0.29). A total of 751 CVD events (1.4 incidence rate, per 100 person-year) occurred during 52,704 person-years of follow-up. One-unit GDI increase was associated with a higher risk of MI by 72% (HR: 1.72; 95% CI 1.04–2.84), stroke by 76% (HR: 1.76; 95% CI 1.09–2.85) and CVD by 30% (HR: 1.48; 95% CI 1.02–2.65). In addition, a one-unit GDI increase was associated with a higher risk of coronary heart disease more than 2 times (HR: 2.32; 95% CI 1.50–3.60) and CVD mortality and all-cause mortality over than 3 times [(HR: 3.65; 95% CI 1.90–7.01) and (HR: 3.10; 95% CI 1.90–5.06), respectively]. Higher GDI had a significant relationship with the increased risk of CVD events and all-cause mortality. Further epidemiological studies in other populations are suggested to confirm our findings.

Manifestation of infantile scurvy in a skeleton from the high medieval village of Trutmanice (South Moravia, Czech Republic).

The study describes the pathological findings recorded on the human remains of a 3 to 4-year-old child found in the burial site of Trutmanice (Czech Republic), dated to the 13th-15th century. The human remains were examined using standard macroscopic osteological and paleopathological methods, supplemented by radiographic examination. Although the preservation of the bones limited the analysis, multiple pathological changes were observed mainly on the skull: cribra orbitalia, small pores and fine deposits of newly formed bone tissue, hypertrophic diploë, grooves indicating rich branching of meningeal arteries on the intracranial surface of the cranial vault. A very fine periostotic deposition of newly formed bone tissue was also observed at the distal end of the diaphysis of the right tibia and both distal ends of the femora. The radiographs of the femora showed white lines of Frankel, scurvy lines, and Wimberger's rings. The observed pathological changes were possibly consistent with scurvy based on differential diagnosis. Reports about cases of juvenile scurvy from rural areas within the context of landlocked countries of Central Europe are rare. While scurvy is now more frequently reported in the paleopathological literature, evidence for scurvy within one of the most natural agricultural areas in the Czech lands remains rare. We recommend using radiographic examination to complement the diagnosis of scurvy in future paleopathological and epidemiological studies of past populations.

Aptidão física de acordo com o nível de atividade física em pessoas idosas: uma análise transversal

Abstract Introduction Aging is marked by physiological changes and a decrease in physical activity. These aspects can have repercussions, namely declining functionality and increasing likelihood of adverse events. Objective To compare performance in physical fitness tests of sufficiently and insufficiently active older people. Methods Epidemiological population study, cross-sectional, carried out with 209 older people (58.4% women) from Aiquara/BA. Sociodemographic information was obtained by means of interviews. Physical fitness was measured by means of the following tests: handgrip strength, chair stand, arm curl, timed up and go, sit and reach and step in place. The level of physical activity was checked by the International Physical Activity Questionnaire (<150 min/week physical activity = insufficiently active). Comparisons were made using the Student t-test or Mann-Whitney U-test, according to the distribution of normality determined by the Kolmogorov-Smirnov test (p ≤ 0.05). Results We found that 51.70% of the participants were insufficiently active (men: 66.66%; women: 40.98%). In addition, insufficiently active participants of both sexes performed less well in the handgrip strength, chair stand, arm curl, timed up and go and step in place tests (p < 0.05). Moreover, insufficiently active men showed lower performance in the sit and reach test than sufficiently active men (p < 0.05). Conclusion Insufficiently active older women and men have lower muscle strength/resistance, dynamic balance/agility and cardiorespiratory endurance. Furthermore, insufficiently active men show less flexibility than those sufficiently active.