Population Studies Research Articles

Pulmonary Arterial Hypertension (PAH) Group 1: Overview, Workup, Risk Stratification, and Current (and Future) Treatment Approaches

Abstract: Risk assessment (or risk stratification) and both current and future therapies for pulmonary arterial hypertension (PAH) will be discussed in part B. Risk assessment is key in the initial evaluation and follow-up of persons with PAH. Risk assessment provides information on disease severity and mortality, which, over time, have been incorporated into the application of PAH therapies. After the initial risk assessment, a 4-strata approach is recommended at subsequent follow- up evaluations by the 2022 ERS/ESC pulmonary hypertension (PH) guidelines as described initially in COMPERA 2.0. This method appears to have increased sensitivity to changes in risk from baseline to follow-up and to changes in long-term mortality risk. Current PAH therapies target the prostacyclin, endothelin, and nitric oxide pathways. A sequential approach to therapy has been recommended since publication of the 2009 guidelines and, in the most recent iteration incorporates the 4-strata approach at follow-up. Additional therapy is recommended when intermediate- high or high-risk status is present. New therapies are under active investigation that include targeting novel pathways. Sotatercept, a fusion protein that binds to and sequesters select transforming growth factor β superfamily ligands, is the most promising novel therapy at this time. A recent phase 3, randomized, double-blind, placebo-controlled study in group 1 PAH patients showed a statistically significant improvement in 6-minute walk distance and additional studies of this drug in PH populations are ongoing. Progress in phenotyping this heterogeneous disease is being made, and as PAH therapies continue to evolve, the use of personalized treatment regimens may be possible in the care of this complex, and highly morbid and mortal disease.

Genetic Complexities of Cerebral Small Vessel Disease, Blood Pressure, and Dementia.

Vascular disease is a treatable contributor to dementia risk, but the role of specific markers remains unclear, making prevention strategies uncertain. To investigate the causal association between white matter hyperintensity (WMH) burden, clinical stroke, blood pressure (BP), and dementia risk, while accounting for potential epidemiologic biases. This study first examined the association of genetically determined WMH burden, stroke, and BP levels with Alzheimer disease (AD) in a 2-sample mendelian randomization (2SMR) framework. Second, using population-based studies (1979-2018) with prospective dementia surveillance, the genetic association of WMH, stroke, and BP with incident all-cause dementia was examined. Data analysis was performed from July 26, 2020, through July 24, 2022. Genetically determined WMH burden and BP levels, as well as genetic liability to stroke derived from genome-wide association studies (GWASs) in European ancestry populations. The association of genetic instruments for WMH, stroke, and BP with dementia was studied using GWASs of AD (defined clinically and additionally meta-analyzed including both clinically diagnosed AD and AD defined based on parental history [AD-meta]) for 2SMR and incident all-cause dementia for longitudinal analyses. In 2SMR (summary statistics-based) analyses using AD GWASs with up to 75 024 AD cases (mean [SD] age at AD onset, 75.5 [4.4] years; 56.9% women), larger WMH burden showed evidence for a causal association with increased risk of AD (odds ratio [OR], 1.43; 95% CI, 1.10-1.86; P = .007, per unit increase in WMH risk alleles) and AD-meta (OR, 1.19; 95% CI, 1.06-1.34; P = .008), after accounting for pulse pressure for the former. Blood pressure traits showed evidence for a protective association with AD, with evidence for confounding by shared genetic instruments. In the longitudinal (individual-level data) analyses involving 10 699 incident all-cause dementia cases (mean [SD] age at dementia diagnosis, 74.4 [9.1] years; 55.4% women), no significant association was observed between larger WMH burden and incident all-cause dementia (hazard ratio [HR], 1.02; 95% CI, 1.00-1.04; P = .07). Although all exposures were associated with mortality, with the strongest association observed for systolic BP (HR, 1.04; 95% CI, 1.03-1.06; P = 1.9 × 10-14), there was no evidence for selective survival bias during follow-up using illness-death models. In secondary analyses using polygenic scores, the association of genetic liability to stroke, but not genetically determined WMH, with dementia outcomes was attenuated after adjusting for interim stroke. These findings suggest that WMH is a primary vascular factor associated with dementia risk, emphasizing its significance in preventive strategies for dementia. Future studies are warranted to examine whether this finding can be generalized to non-European populations.

Invasive freshwater snails are less sensitive to population density than native conspecifics.

Understanding how and why some species or lineages become invasive is critically important for effectively predicting and mitigating biological invasions. Here, we address an important unanswered question in invasion biology: do key life-history traits of invasive versus native lineages within a species differ in response to key environmental stressors? We focus on the environmental factor of population density, which is a fundamental characteristic of all populations, and investigate how changes in density affect native versus invasive Potamopyrgus antipodarum (New Zealand mudsnail). P. antipodarum has invaded 39 countries and detrimentally affects invaded environments. Previous studies of native and invasive populations and from laboratory experiments have demonstrated that growth and reproduction of P. antipodarum is sensitive to population density, though whether and how this sensitivity varies across native versus invasive lineages remains uncharacterized. We quantified individual growth rate and reproduction in P. antipodarum from multiple distinct native and invasive lineages across three different population density treatments. The growth of native but not invasive lineages decreased as density increased. There was no differential effect of density treatment on embryo production of invasive versus native snails, but a significantly higher proportion of snails were reproductive in high density compared to intermediate density for invasive lineages. In native lineages, there were no significant differences in the relative frequency of reproductive snails across density treatments. While the extent to which these results from our laboratory study can be extrapolated to the more complex natural world remain unclear, our findings are consistent with a scenario where differential sensitivity to population density could help explain why some lineages become successful invaders. Our findings also align with previous studies that show that invasive P. antipodarum lineages exhibit a relatively wide range of tolerance to environmental stressors.

Characteristics of forensic psychiatric patients with a neurocognitive disorder.

Emotional and behavioural disturbances accompanying neurocognitive disorders may sometimes lead to a criminal offence. Our knowledge of this specific forensic subpopulation is lagging behind the knowledge on, and attention for, 'classic' psychiatric disorders in forensic populations. To gain knowledge on the prevalence and characteristics of individuals with neurocognitive disorders in the forensic population. This retrospective database study uses an anonymised data-set of the National Database of penitentiary psychiatric centres (PPC) (N = 8391), which collects data on all patients admitted to one of the four PPCs (mental health clinics within the prison system) in The Netherlands since May 2013. Inclusion criterion for this study was the presence of a Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) or Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic code belonging to the category of neurocognitive disorders. A DSM-IV-TR or DSM-5 diagnostic code of a neurocognitive disorder was classified in 254 out of 8391 unique individuals, resulting in a prevalence of 3.0% in the total PPC population. The most prevalent diagnosis was unspecified neurocognitive disorder (59.1%). The neurocognitive disorder group significantly differed from a random control group from the database (n = 762) on demographic, clinical and criminological variables. The prevalence of neurocognitive disorders in this real-world clinical sample is remarkably lower than in two earlier studies in similar populations. Also remarkable is the relatively high prevalence of an unspecified neurocognitive disorder. These findings lead us to hypothesise that neurocognitive disorders may be underdiagnosed in this population. Forensic psychiatric settings should evaluate whether they have sufficient expertise available in neuropsychological assessment.

Maternal hepatitis B status and Sex at birth: A cross-sectional study in a Ghanaian population

Maternal carrier status of hepatitis B has been associated with excess sons while maternal immunity to it has been associated with excess daughters at birth. However, the proportion of males at birth (sex ratio) is relatively low in Sub-Saharan Africa despite the relatively high prevalence of hepatitis B. However, no known study has tested this hypothesis in the Ghanaian population; hence the aim of the study. The study was cross-sectional between January and September 2023 at the Tamale Central Maternal and Child Health unit. The study involved 380 mothers of whom mothers with daughters (MD) were 145 (38.2 %) while the rest were mothers with sons (MS). The mothers were aged between 18 and 43 years and were sampled within one week of delivery to singleton births. Maternal venous blood samples were collected and tested for hepatitis B surface antigen (HBsAg), surface antibody (HBsAb), envelop antigen (HBeAg) envelope antibody (HBeAb) and core antibody (HBcAb) using immunochromatographic technique and total testosterone (TT), using ELISA. There was no significant difference in the serum total testosterone level between MD and MS (0.32 ± 0.13 vs 0.32 ± 0.27, P = 0.991). Moreover, while the mothers were seropositive for HBsAg (10.5 %), HBsAb (35.5 %), HBeAg (0.0 %), HBeAb (5.3 %) and HBcAb (11.8 %), there was no significant association between sex at birth and maternal hepatitis B status for HBsAg (ꭓ2: 0.531, P = 0.472), HBsAb (ꭓ2: 2.655, P = 0.140), HBeAb (ꭓ2: 0.251, P = 0.633) and HBcAb (ꭓ2: 0.101, P = 1.000). Maternal hepatitis B status may not be associated with the offspring sex at birth in the studied population from Ghana.

Ocular trauma study in rural indian population – clinical features and visual outcomes based on ocular trauma score

Aim: The study was aimed to assess the clinical features of ocular trauma and to classify and compare mechanical ocular injuries. Materials and Methods: This retrospective study was done on 299 patients with ocular injuries from January 2018 to May 2019. We reviewed case record forms for visual acuity (VA) and anterior segment findings. Fundus findings and intraocular pressure values were also noted. When indicated, radiological examinations such as computed tomography, magnetic resonance imaging, B-scan, and X-ray orbit were performed. The SPSS 11.0 package was used for data analysis. Results: Of the 299 instances in this study, 104 (34.78%) were in the 30–45 age group. The impact on males was 4.8 times greater than that on females. The most frequent cause among the 102 participants (34.11%) was industrial work. Out of 216 cases of closed-globe injuries, more than half, i.e., 113 cases (52.31%), were in zone I. Conclusion: Ocular trauma is more common among young males, with industrial work being the most common cause. A unilateral, closed-globe injury was more common compared to bilateral and open injuries. In open-globe injuries, zone II was more commonly affected, while in closed injuries, zone I was more common. Visual impairment was more severe in open-globe injuries. With regard to the prediction of final VA, our results were comparable to the ocular trauma score study, thus affirming its utility.

Metabolomic profiling of blood and seminal plasma in the small-spotted catshark (Scyliorhinus canicula): A comparative study of aquarium and wild populations in the Valencia region

In chondrichthyans, despite males in ex situ conservation programs exhibiting good sperm quality, offspring production is confined to specific species. This study hypothesizes that the aquarium's environmental footprint may contribute to this loss of reproductive capacity. Consequently, the research initially focused on comparing the blood metabolomic profiles of the Small-Spotted Catshark (Scyliorhinus canicula) in both an aquarium environment at Oceanogràfic of Valencia and in wild populations along the Valencia Region coast (Spain). Furthermore, the study compared the blood metabolomic profiles with those of seminal plasma. This comparison aimed to identify potential variations in seminal plasma composition and its relationship with in vitro seminal characteristics. Samples were collected from S. canicula present in the aquarium (n = 7) and wild captured individuals (n = 12). Despite conventional semen quality assessments showing no significant disparities in semen volume and sperm concentration, considerable differences were observed in sperm motility and viability rates. Specifically, aquarium specimens showed slightly reduced metrics. The untargeted metabolic study in blood revealed significant differences between aquarium and wild individuals, with 158 semi-polar and 233 non-polar differential metabolites. A parallel analysis of seminal plasma similarly revealed substantial differences, with 2 semi-polar and 74 non-polar differential metabolites. Additionally, the analysis showed 104 semi-polar and 188 non-polar metabolites shared between the blood and seminal plasma of both animal groups. A further targeted analysis of 28 metabolites in blood identified significantly lower concentrations of phenylalanine, tyrosine, lysine, taurine, arginine, N-acetyl-L-glutamate, and creatinine in aquarium sharks. In seminal plasma samples, aquarium animals exhibited elevated levels of 7-Dehydrodesmosterol but reduced levels of phenylalanine, pantothenic acid (Vit B5), and spermine. In conclusion, these findings highlight alterations in both the blood and seminal plasma metabolomic profiles between aquarium-housed and wild animals, demonstrating the impact of the aquarium's environmental footprint, which could partly explain the reduced reproductive success of sharks in captivity.

Association between blood pressure and new onset of chronic kidney disease in non-diabetic Japanese adults: A population-based longitudinal study from 1998 to 2023

Background and aimsHypertension is a risk factor for developing chronic kidney disease (CKD). Studies of adult participants in the USA reported that hypertension increased the risk of developing CKD even in the non-diabetic population. However, studies in non-diabetic populations are limited and additional studies in other races are required. This study aimed to examine the relationship between hypertension and the development of CKD in non-diabetic Asian adults. Methods and resultsIn this longitudinal study, non-diabetic Japanese adults who took annual checkups from 1998 to 2023 were included. CKD was defined as <60 mL/min/1.73 m2, and hypertension was classified into four levels according to the guidelines of the American College of Cardiology/American Heart Association. The Weibull accelerated failure time model was selected because the proportional hazards assumption was violated. Of the 7363 (men: 40.3%) people in the final cohort, 2498 (men: 40.1%) developed CKD after a mean follow-up of 7.99 years. Elevated blood pressure (BP) and hypertension stage 2 had a 9% (95% confidence interval [CI]: 1%–16%) and 11% (95% CI: 5%–17%) shorter survival time to CKD onset, respectively, than normal BP. Hypertension stage 1 also had a shorter survival to CKD onset by point estimate, but all 95% CIs crossed 1 in all models. ConclusionsIn a relatively healthy Asian population without diabetes, controlling BP to an appropriate range reduces the risk of developing CKD.

Enhancing the specificity of 17-hydroxy progesterone cut-off value for cosyntropin stimulation testing. A retrospective study of Sri Lankan population

Enhancing the specificity of 17-hydroxy progesterone cut-off value for cosyntropin stimulation testing. A retrospective study of Sri Lankan population

A parsec-scale Galactic 3D dust map out to 1.25 kpc from the Sun

Context. High-resolution 3D maps of interstellar dust are critical for probing the underlying physics shaping the structure of the interstellar medium, and for foreground correction of astrophysical observations affected by dust. Aims. We aim to construct a new 3D map of the spatial distribution of interstellar dust extinction out to a distance of 1.25 kpc from the Sun. Methods. We leveraged distance and extinction estimates to 54 million nearby stars derived from the Gaia BP/RP spectra. Using the stellar distance and extinction information, we inferred the spatial distribution of dust extinction. We modeled the logarithmic dust extinction with a Gaussian process in a spherical coordinate system via iterative charted refinement and a correlation kernel inferred in previous work. In total, our posterior has over 661 million degrees of freedom. We probed the posterior distribution using the variational inference method MGVI. Results. Our 3D dust map has an angular resolution of up to 14′ (Nside = 256), and we achieve parsec-scale distance resolution, sampling the dust in 516 logarithmically spaced distance bins spanning 69 pc to 1250 pc. We generated 12 samples from the variational posterior of the 3D dust distribution and release the samples alongside the mean 3D dust map and its corresponding uncertainty. Conclusions. Our map resolves the internal structure of hundreds of molecular clouds in the solar neighborhood and will be broadly useful for studies of star formation, Galactic structure, and young stellar populations. It is available for download in a variety of coordinate systems online and can also be queried via the publicly available dustmaps Python package.

NRDE2 deficiency impairs homologous recombination repair and sensitizes hepatocellular carcinoma to PARP inhibitors

To identify novel susceptibility genes for hepatocellular carcinoma (HCC), we performed a rare-variant association study in Chinese populations consisting of 2,750 cases and 4,153 controls. We identified four HCC-associated genes, including NRDE2, RANBP17, RTEL1, and STEAP3. Using NRDE2 (index rs199890497 [p.N377I], p= 1.19×10-9) as an exemplary candidate, we demonstrated that it promotes homologous recombination (HR) repair and suppresses HCC. Mechanistically, NRDE2 binds to the subunits of casein kinase 2 (CK2) and facilitates the assembly and activity of the CK2 holoenzyme. This NRDE2-mediated enhancement of CK2 activity increases the phosphorylation of MDC1 and then facilitates the HR repair. These functions are eliminated almost completely by the NRDE2-p.N377I variant, which sensitizes the HCC cells to poly(ADP-ribose) polymerase (PARP) inhibitors, especially when combined with chemotherapy. Collectively, our findings highlight the relevance of the rare variants to genetic susceptibility to HCC, which would be helpful for the precise treatment of this malignancy.

A Systematic Review on the Role of Antibiotics and Analgesics in Systemically Ill Patients Undergoing Tooth Extraction.

Antibiotics are commonly prescribed as a preventive measure, particularly post-tooth extraction, aiming to minimize the risk of infection. Preemptive analgesia functions by disrupting the nervous system's ability to encode pain stimuli, thus preventing the formation of pain memory. Dentists often recommend analgesics and antibiotics either as adjuncts or sole treatments for various dental conditions, offering both efficacy and cost-effectiveness. A comprehensive literature search was conducted across multiple databases, including PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Science Direct, and Lilac, using MeSH terms relevant to the role of antibiotics and analgesics in systemically ill patients undergoing tooth extraction. Out of 178 articles screened, 83 underwent full-text assessment for eligibility, and six were selected for qualitative analysis. The review process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, ensuring methodological rigor and transparent reporting. Across diverse study populations, the role of antibiotics and analgesics consistently demonstrated a statistically significant impact. Hence, the utilization of analgesics and antibiotics plays a pivotal role in preventing infection following tooth extraction in systemically ill patients, thereby promoting optimal oral hygiene and overall health.

Eating Behaviors and Adiposity Indicators - Observations from the 2016/17 Examination of the Population Study of Women in Gothenburg.

To determine the cross-sectional association between eating behavior in terms of the three-factor eating questionnaire (TFEQ) and adiposity measures. The TFEQ-R21 was administered to 573 women aged 38 and 50 who participated in the population study of women in Gothenburg 2016/17. Three domains, emotional eating (EE), uncontrolled eating (UE), and cognitive restraint (CR) were examined as outcomes as well as predictors of adiposity outcomes. Multiple linear and logistic regression models were adjusted for age, education, lifestyle factors, and dieting behavior. All TFEQ domains were positively associated with dieting. EE and UE were associated with higher consumption of sweets and CR with lower consumption of sweets. Wellbeing was negatively associated with EE and UE. In mutually adjusted models, EE and CR but not UE were positively associated with BMI, waist circumference (WC), waist-to-hip ratio, waist-to-height ratio, and skinfold. One standard deviation higher EE was associated with obesity, BMI ≥ 30 kg/m2, OR = 1.62 (1.26, 2.10), and abdominal fatness, WC > 88 cm, OR = 1.57 (1.26, 1.95). Former and current dieting were positively associated with these outcomes, too, but UE and CR were not associated in mutually adjusted models. This study shows that emotional eating behavior is associated with adiposity in a population of middle-aged women, over a large range of values for body fatness, and independent of dieting behavior. The results imply that treatment of obesity should include psychological support to restrict the risk for emotional eating in response to states of negative mood.

Metastatic pattern and prognosis in patients with lung adenosquamous carcinoma: A surveillance, epidemiology, and end results-based population study

BackgroundLung adenosquamous carcinoma (ASC) is a rare tumor with high invasive and metastatic potential. Few studies have explored metastatic patterns in patients with advanced-stage ASC. MethodsPatients diagnosed with ASC in the Surveillance, Epidemiology, and End Results database from 2010 to 2015 were selected. Descriptive statistics were obtained to characterize the metastatic sites of the study participants. The Kaplan–Meier method was applied to compare survival curves among patients with different metastatic patterns. Cox regression analysis was performed to evaluate risk factors for metastasis. ResultsA total of 858 eligible patients with ASC were enrolled; the mean age was 71.5 years (standard deviation ± 7.8 years). There was a slightly higher proportion of male patients (54.0 %). A total of 63.2 % of patients harbored single-site metastasis (median OS: 5 months), 23.6 % of patients had two-site metastasis (median OS: 4 months), and approximately 10 % of patients harbored three or more sites metastasis (median OS: 3 months). Bone (56.9 %) was the most frequent site of metastasis (median OS: 4 months), followed by lung metastasis (37.6 %, median OS: 5 months), liver metastasis (22.1 %, median OS: 5 months), and brain metastasis (21.4 %, median OS: 4 months). Chemotherapy decreased the risk of death by 70 % (HR = 0.296, 95 % CI 0.241–0.363), 70 % (HR = 0.302, 95 % CI 0.224–0.406), 78 % (HR = 0.218, 95 % CI 0.151–0.314), and 70 % (HR = 0.302, 95 % CI 0.231–0.396) in patients harboring bone, liver, brain and lung metastases, respectively. The brain increased the risk of death by 50 % (HR = 1.501, 95 % CI 1.209–1.865), 64 % (HR = 1.644, 95 % CI 1.126–2.402), and 128 % (HR = 2.284, 95 % CI 1.653–3.157) in patients harboring bone, liver and lung metastases, respectively. ConclusionPatients with advanced-stage ASC have unfavorable outcomes. Early detection and aggressive treatment can improve patients outcomes.

BSEC Method for Unveiling Open Clusters and its Application to Gaia DR3: 83 New Clusters

Open clusters (OCs) are common in the Milky Way, but most of them remain undiscovered. There are numerous techniques, including some machine-learning algorithms, available for the exploration of OCs. However, each method has its limitations and therefore, different approaches to discovering OCs hold significant values. We develop a comprehensive approach method to automatically explore the data space and identify potential OC candidates with relatively reliable membership determination. This approach combines the techniques of Hierarchical Density-Based Spatial Clustering of Applications with Noise, Gaussian mixture model, and a novel cluster member identification technique, color excess constraint. The new method exhibits efficiency in detecting OCs while ensuring precise determination of cluster memberships. Because the main feature of this technique is to add an extra constraint (EC) for the members of cluster candidates using the homogeneity of color excess, compared to typical blind search codes, it is called Blind Search-Extra Constraint (BSEC) method. It is successfully applied to the Gaia Data Release 3, and 83 new OCs are found, whose color–magnitude diagrams (CMDs) are fitted well to the isochrones. In addition, this study reports 621 new OC candidates with discernible main sequence or red giant branch. It is shown that BSEC technique can discard some false negatives of previous works, which takes about three percentage of known clusters. It shows that as an EC, the color excess (or two-color) constraint is useful for removing fake cluster member stars from the clusters that are identified from the positions and proper motions of stars, and getting more precise CMDs, when differential reddening of member stars of a cluster is not large (e.g., ΔE(G BP − G RP) < 0.5 mag). It makes the CMDs of 15% clusters clearer (in particular for the region near turnoff) and therefore is helpful for CMD and stellar population studies. Our result suggests that the color excess constraint is more appropriate for clusters with small differential reddening, such as globular clusters or older OCs, and clusters that the distances of member stars cannot be determined accurately.

The SRG/eROSITA All-Sky Survey

Clusters of galaxies can be used as powerful probes to study astrophysical processes on large scales, test theories of the growth of structure, and constrain cosmological models. The driving science goal of the SRG/eROSITA All-Sky Survey is to assemble a large sample of X-ray clusters with a well-defined selection function to determine the evolution of the mass function and, hence, the cosmological parameters. We present here a catalog of 12 247 optically confirmed galaxy groups and clusters detected in the 0.2–2.3 keV as extended X-ray sources in a 13 116 deg2 region in the western Galactic half of the sky, which eROSITA surveyed in its first six months of operation. The clusters in the sample span the redshift range 0.003 &lt; z &lt; 1.32. The majority (68%) of these clusters, 8361 sources, represent new discoveries without known counterparts in the literature. The mass range of the sample covers three orders of magnitude from 5 × 1012 Msun to 2 × 1015Msun. We construct a sample for cosmology with a higher purity level (~95%) than the primary sample, comprising 5259 securely detected and confirmed clusters in the 12791 deg2 common footprint of eRASS1 and the DESI Legacy Survey DR10. We characterize the X-ray properties of each cluster, including their flux, luminosity and temperature, the total mass, gas mass, gas mass fraction, and mass proxy YX. These are determined within two apertures, 300 kpc, and the overdensity radius R500, and are calculated by applying a forward modeling approach with a rigorous X-ray background treatment, K-factor, and the Galactic absorption corrections. Population studies utilizing log N-log S, the number of clusters detected above a given flux limit, and the luminosity function show overall agreement with the previous X-ray surveys after accounting for the survey completeness and purity through the selection function. The first eROSITA All-Sky Survey provides an unprecedented sample of galaxy groups and clusters selected in the X-ray band. The eRASS1 cluster catalog demonstrates the excellent performance of eROSITA for extended source detection, consistent with the pre-launch expectations for the final all-sky survey, eRASS:8.

Subacute Thyroiditis Following COVID-19 and COVID-19 Vaccination

ObjectiveCOVID-19 infection and immunizations have been implicated in developing a range of thyroid diseases, including subacute thyroiditis (SAT). This study aimed to evaluate the association between COVID-19 infection and/or COVID-19 vaccination with SAT. MethodsA population of 3 million adults insured by Clalit Health Services was evaluated from March 2020 to September 2022. Patients with a new diagnosis of SAT were identified and matched in a 1:10 ratio to a control group. Each control was assigned an index date that was identical to that of their matched case, defined as the date of SAT diagnosis. Multivariate conditional logistic regression models were used to evaluate the association between COVID-19 infection, vaccine, and thyroiditis. ResultsA total of 3221 patients with SAT were matched with 32 210 controls. Rates of COVID-19 vaccination (first, second, or third dose) and COVID-19 infection were evaluated prior to the date of SAT diagnosis (disease group) or index date (control group) to detect a possible association. No difference was detected between the groups in relation to vaccinations at the 30 days, 60 days, and 90 days of time points (P = .880/0.335/0.174, respectively). No difference was found between groups in relation to COVID-19 infection at these time points (P = .735/0.362/0.956, respectively). There was higher use of medications for the treatment of thyroiditis, including nonsteroidal anti-inflammatory drugs (28.6% vs 7.9%, P < .01), steroids (10.3% vs 1.8%, P < .01), and beta-blockers (18.3% vs 5.4%, P < .01). ConclusionBased on this large population study, no association was found between COVID-19 infection and/or the COVID-19 vaccine and SAT.

MAFLD and glomerular hyperfiltration in subjects with normoglycemia, prediabetes and type 2 diabetes: Across-sectional population study.

Metabolic dysfunction-associated fatty liver disease (MAFLD, 2020 diagnostic criteria) and glomerular hyperfiltration share common risk factors, including obesity, insulin resistance, impaired glucose tolerance, diabetes, dyslipidemia, and hypertension. To assess the prevalence of MAFLD and its association with glomerular hyperfiltration and age-related worsening of kidney function in subjects with normoglycemia, prediabetes and type 2 diabetes mellitus (T2DM). We analysed data recorded during occupational health visits of 125,070 Spanish civil servants aged 18-65years with a de-indexed glomerular filtration rate (GFR) estimated with the chronic-kidney-disease-epidemiological (CKD-EPI) equation (estimated glomerular filtration rate [eGFR]) ≥60mL/min. Subjects were categorised according to fasting plasma glucose levels <100mg/dL (normoglycemia), ≥100 and ≤125mg/dL (prediabetes), or ≥126mg/dL and/or antidiabetic treatment (T2DM). The association between MAFLD and glomerular hyperfiltration, defined as a de-indexed eGFR above the age- and gender-specific 95th percentile, was assessed by multivariable logistic regression. In the whole study group, MAFLD prevalence averaged 19.3%. The prevalence progressively increased from 14.7% to 33.2% and to 48.9% in subjects with normoglycemia, prediabetes and T2DM, respectively (p<0.001 for trend). Adjusted odds ratio (95% CI) for the association between MAFLD and hyperfiltration was 9.06 (8.53-9.62) in the study group considered as a whole, and 8.60 (8.03-9.21), 9.52 (8.11-11.18) and 8.31 (6.70-10.30) in subjects with normoglycemia, prediabetes and T2DM considered separately. In stratified analyses, MAFLD amplified age-dependent eGFR decline in all groups (p<0.001). MAFLD prevalence increases across the glycaemic spectrum. MAFLD is significantly associated with hyperfiltration and amplifies the age-related eGFR decline.

CARDIOVASCULAR RISK FACTORS AND ARTERIAL HYPERTENSION IN QOM (TOBA) POPULATIONS OF TWO PUBLIC INSTUTIONS IN NORTHERN ARGENTINE

Objective: To evaluate cardiovascular risk factors and control of high blood pressure in Qom (indigenous) populations of northern Argentina. Design and method: A descriptive, prospective and observational study was carried out through a survey directed at patients who attended 2 public institutions in the Province of Formosa: one carried out in the city of Formosa (Capital) and another in the town of Las Lomitas, in the interior of the province. It was carried out between the months of July and December 2023. A survey was carried out based on the risk factor variables of the Heart study and others useful for the population studied. The study was carried out under local and international ethical standards and under signed informed consent. Results: Of 34 patients surveyed (80% women), 25% were from the capital of Formosa and 75% from the rural area of Las Lomitas. Of the CVRFs, it was observed that 50% had high blood pressure (HTN) at some point, although 22% assumed that they currently had it and the rest did not know it. 97% of the population took their blood pressure at some point and 61% did so in the last year. 51% of hypertensive patients take medication regularly, using one (1) drug in 14%, two (2) drugs in 28% and three (3) drugs in 42%. Regarding the body mass index, it was observed that 55% were obese, having values above provincial and national surveys. In addition, it was found that 8% are active smokers, 23% are diabetic and the same percentage (23%) had cholesterol alterations. 2.9% had chronic renal failure and 5.9% had atrial fibrillation. Conclusions: The present study highlights adherence to treatment, the high proportion of diabetes and the lack of cholesterol controls, taking into account the percentage of obese individuals. Although the number of patients is limited, the present study retrieves valuable information to continue with future research that can improve the cardiovascular quality of life of this specific population.

A modified schedule of multiple aeroallergen ultra-rush immunotherapy in perennial allergic rhinitis: safety, efficacy, and T lymphocyte cell population studies.

This study assessed whether a modified immunotherapy schedule for allergic rhinitis could be safe and efficient. Ultra-rush immunotherapy (URIT) rapidly desensitizes patients to aeroallergens. We aimed to develop a modified URIT protocol in 3 days to achieve the target dose while observing whether it could improve this situation and decrease the time to achieve the maintenance dose. The URIT was exercised in 21 patients with perennial allergic rhinitis. Premeditations were given to the patients 3 days prior to the immunotherapy and during the 3 days injections immunotherapy: pred nisolone, ranitidine, and Airokast/montelukast. Finally, the T cell population frequencies of patients prior to and after immunotherapy, including T helper 1, T helper 2, cytotoxic T lymphocytes, and regulatory T cells, were studied using flow cytometry. During the URIT protocol, 21 patients received 291 injections. Six patients (28.6%) showed systemic reactions in our study. All systemic reactions occurred on the third day by the 1:1 dilution of the maintenance dose. These systemic reactions occurred in three patients after 13 injections, and the three remaining patients showed systemic reactions following the last injection. No systemic reaction was observed on the first and second day of the therapy, and the risk of systemic reaction with every injection was about 2%. Among the T cell populations, CD3+ and CD8+ cells decreased significantly. The findings emphasized that URIT, alongside premedication with a high dose of antihistamine, helped to achieve the maintenance dose and control clinical manifestations.