Screening Of High-risk Groups Research Articles

Establishing the Prevalence of Osteomalacia in Arab Adolescents Using Biochemical Markers of Bone Health.

Nutrition-acquired osteomalacia is a bone mineralization disorder associated with dietary calcium and/or solar vitamin D deficiency, risk factors considered common in the Middle Eastern region. Establishing less invasive, cheap, and widely available diagnostic markers for this underdiagnosed entity is essential, in particular for screening in high-risk groups. This study assessed the prevalence of biochemical osteomalacia in Arab adolescents. In this cross-sectional study performed between September 2019 and March 2021, adolescents aged 12-17 years from 60 different secondary and preparatory year schools in Riyadh, Saudi Arabia were included. Anthropometrics and fasting blood samples were collected. Biochemical osteomalacia was defined as any two of the following four serum markers of hypomineralization, namely low 25 hydroxyvitamin D (25OHD < 30 nmol/L), high alkaline phosphatase (ALP), low calcium (Ca), and/or inorganic phosphorous (Pi). A total of 2938 Arab adolescents [1697 girls; mean age (years) 14.8 ± 1.8; 1241 boys; mean age 15.1 ± 1.6] were recruited. Vitamin D deficiency was noted in 56.2% (n = 953) of girls and 27.1% (n = 336) of boys (p < 0.001). The overall prevalence of biochemical osteomalacia was 10.0% (n = 295/2938) and was higher in girls than boys (14.7% vs. 3.6%, p < 0.001). The prevalence of low serum Ca and/or Pi was also higher in girls than in boys (24.2% vs. 12.5%, respectively, p < 0.001), as well as elevated ALP (5.1% vs. 1.5%, p < 0.001). Overall, girls were 4.6 times (95% CI 3.3-6.4) more likely to have biochemical osteomalacia than boys. Screening of apparently healthy Arab adolescents revealed a high prevalence of deranged mineralization markers suggestive of biochemical osteomalacia, which was significantly more common in girls than boys and was likely associated with Arab traditional clothing and diet. The proposed combination of typically altered mineralization markers for the diagnosis of osteomalacia is, at best, suggestive until further comparisons with established diagnostic tools (histological analysis of bone biopsies) are conducted.

Mesothelin Gene Variants Affect Soluble Mesothelin-Related Protein Levels in the Plasma of Asbestos-Exposed Males and Mesothelioma Patients from Germany.

Malignant mesothelioma (MM) is a severe disease mostly caused by asbestos exposure. Today, one of the best available biomarkers is the soluble mesothelin-related protein (SMRP), also known as mesothelin. Recent studies have shown that mesothelin levels are influenced by individual genetic variability. This study aimed to investigate the influence of three mesothelin (MSLN) gene variants (SNPs) in the 5'-untranslated promoter region (5'-UTR), MSLN rs2235503 C > A, rs3764246 A > G, rs3764247 A > C, and one (rs1057147 G > A) in the 3'-untranslated region (3'-UTR) of the MSLN gene on plasma concentrations of mesothelin in 410 asbestos-exposed males without cancer and 43 males with prediagnostic MM (i.e., with MM diagnosed later on) from the prospective MoMar study, as well as 59 males with manifest MM from Germany. The mesothelin concentration differed significantly between the different groups (p < 0.0001), but not between the prediagnostic and manifest MM groups (p = 0.502). Five to eight mutations of the four SNP variants studied were associated with increased mesothelin concentrations (p = 0.001). The highest mesothelin concentrations were observed for homozygous variants of the three promotor SNPs in the 5'-UTR (p < 0.001), and the highest odds ratio for an elevated mesothelin concentration was observed for MSLN rs2235503 C > A. The four studied SNPs had a clear influence on the mesothelin concentration in plasma. Hence, the analysis of these SNPs may help to elucidate the diagnostic background of patients displaying increased mesothelin levels and might help to reduce false-positive results when using mesothelin for MM screening in high-risk groups.

Validation of the highly sensitive person scale for suicide screening in high-risk groups: A case-control study

Purpose: High sensitivity is among the risk factors that increase psychological burden, increasing the risk of suicide in some people. The aim of the study was to develop a Korean version of the Highly Sensitive Person (HSP) scale and investigate its psychometric properties. Diagnostic validity was evaluated to identify those with high suicidal risk.Methods: A total of 176 participants were recruited from the 12 hospital-based Crisis Response Centers across South Korea. As a case-control study, we used two groups: suicidal risk group and control group. Those with suicidal ideation or attempts were classified as suicidal risk group, and the control group sample were recruited from the Crisis Response Centers workers. Tests for internal consistency and concurrent validity with other scales were conducted.Results: Results showed strong item-total correlation and concurrent validity. Receiver operating characteristic curve analysis showed an area under the curve of 0.881. The HSP cutoff score of 13 yielded the best balance between sensitivity (74%) and specificity (87%). Construct validity was supported by a one-factor model using exploratory factor analysis.Conclusion: Overall, the current study supports the use of HSP in psychiatric settings as a valid screening tool for suicidal risk.

Association of Serum Triglyceride and Stress Urinary Incontinence in Women From the National Health and Nutrition Examination Survey: A Cross-Sectional Study

ObjectiveTo investigate the relationship between serum triglyceride levels and stress urinary incontinence (SUI) in women from the National Health and Nutrition Examination Survey. MethodsAdults who participated in the National Health and Nutrition Examination Survey from 2005 to 2018 were included in the study. Univariate and multivariate logistic regressions were used to assess the relationship between serum triglyceride levels and the incidence and severity of SUI. ResultsApproximately 7973 participants (mean, 49.9 years of age) were enrolled in the study. Of those, 3367 had SUI, and 4606 did not have SUI. An adjusted multivariate logistic regression analysis demonstrated a positive correlation between serum triglyceride levels and the incidence of SUI (ORs, 1.05; 95% CI, 1-1.11, P = .045). Besides, subgroup analyses indicated that the results were robust among women with different characteristics. Additionally, serum triglyceride levels were positively associated with the severity of SUI. ConclusionSerum triglyceride levels were closely related to the incidence and severity of SUI. Based on our findings, we suggest that serum triglycerides can be included as a risk indicator for screening high-risk groups of SUI.

The prevalence of thyroid dysfunction in Jordan: a national population-based survey

BackgroundThe objectives of this study are to assess the prevalence of clinical and subclinical hypo- and hyperthyroidism and their associated factors among Jordanian adults.MethodsIn a cross-sectional population-based survey, a representative sample that included 3753 Jordanian adults was selected from the 12 governorates that represent the three regions of the country, in the year 2017. Sociodemographic and clinical data were obtained and blood samples were collected from all participants. Thyroid stimulating hormone (TSH), free tri-iodothyronine (FT3), free thyroxine (FT4), thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) were measured to evaluate the thyroid function.ResultsThe overall prevalence of thyroid dysfunction was 11.9%. Around 76% of patients with thyroid dysfunction were previously undiagnosed. The prevalence of hypothyroidism and subclinical hypothyroidism was 3.1 and 5.3%, respectively. The prevalence of hyperthyroidism and subclinical hyperthyroidism was 1.0 and 2.5%, respectively. Female preponderance which was mainly related to hypothyroid disorders was evident. The prevalence of positive TPOAb and TgAb in the study population was 14.9 and 15.3%, respectively. The prevalence of detectable TPOAb and TgAb in the euthyroid participants was10.3 and 11.9%, respectively. Logistic regression analysis revealed that female sex, age ≥ 50 years and the presence of TgAb and TPOAb were strongly associated with hypothyroidism. Hyperthyroidism was significantly associated with the presence of TPOAb and age ≥ 50 years.ConclusionThe prevalence of unrecognized thyroid dysfunction is high among Jordanians. A public health policy of screening high risk groups particularly those ≥50 years of age is recommended.

A symptomatic approach to tuberculosis screening for high-risk groups in Malaysia: Cost-effectiveness and budget impact analysis

BackgroundOne of the crucial areas of eliminating TB is the early detection of cases through the screening programme. This study's focal point is to measure the relative cost-effectiveness and budget impact of the symptomatic approach compared to the existing approach of TB screening (consisted of both symptomatic and asymptomatic screening) among high-risk groups in Malaysia. MethodThe Cost-Effectiveness Analysis (CEA) was measured using a decision tree model and the outcome is presented in terms of cost per TB case detected and the ICER. Analysis was conducted using secondary data collected from the Disease Control Division, Sabah and Sarawak State Health Departments. The robustness of the model is determined by Deterministic and Probabilistic Sensitivity Analysis. Subsequently, Budget impact over 5 years period, from 2018 to 2022 was estimated for both approaches. ResultsThe symptomatic approach was more cost-effective than the existing approach with ICER of MYR 424.71. The cost of conducting Sputum for Acid Fast Bacilli (SAFB) was found as the key driver for ICER. Budget Impact Analysis showed that switching from the existing approach towards the symptomatic approach would result in a cost-saving of MYR 65.5 million over 5 years. However, this would lead to 4473 TB cases being undetected over the same duration. ConclusionThis study suggests that the policymakers have to weigh the trade-off between cost-saving and TB case detection. This cost-saving can be channelled to new TB intervention programme with a higher chance of TB case detection. Nevertheless, any decision made must be in concordance to the objectives of the country’s TB programme.

Disease burden of chronic obstructive pulmonary diseases in China from 1990 to 2019

Objective: To examine the trend of the burden on chronic obstructive pulmonary diseases (COPD) and epidemiologic transition on related risk factors among the Chinese population from 1990 to 2019. Methods: Based on the data from the Global Burden of Disease 2019 Study, we used the indicator numbers such as disability-adjusted life year (DALY), years of life lost (YLD), years lived with disability (YLL), and prevalence rate to describe the changes of COPD burden stratified by different sex and age groups from 1990 to 2019. We applied population attribution faction (PAF) to analyze the burden attributed to risk factors and epidemiological transition. Results: In 2019, the age-standard rate for DALY, YLD, and YLL and prevalence rate for COPD were 1 102.77/100 000 population,862.37/100 000 population, 240.40/100 000 population, and 2 404.41/100 000. Both age-standardized DALY and YLL rates for COPD in males were higher than in females, except for the YLD rate in females. COPD's top five risk factors were particulate matter pollution, smoking, occupational particulate matter, gases, and fumes, low temperature, and secondhand smoke. Smoking surpassed environmental particulate pollution in 1994 and became the first factor causing the disease burden of COPD. Since then, the order of risk factors has not changed. The PAF of environmental particulate pollutants increased by 1.78% annually, from 15.22% in 1990 to 25.37%, and the PAF of household air pollution from solid fuels decreased by 5.59% annually, from 40.30% in 1990 to 7.59%. Conclusions: From 1990 to 2019, the per person health loss caused by COPD in China showed an overall downward trend. The PAF of relevant risk factors has also changed, the importance of environmental factors is relatively declined, and the status of smoking and other related risk behaviors has become increasingly prominent. The prevention and control of COPD can focus on screening high-risk groups (≥40 years old, smoking, heavy air pollution, having occupational exposure), smoking cessation, and environmental treatment.

Epidemiologic and socioeconomic factors impacting hepatitis B virus and related hepatocellular carcinoma.

Chronic Hepatitis B is a highly prevalent disease worldwide and is estimated to cause more than 800000 annual deaths from complications such as cirrhosis and hepatocellular carcinoma (HCC). Although universal hepatitis B vaccination programs may have reduced the incidence and prevalence of chronic hepatitis B and related HCC, the disease still imposes a significant healthcare burden in many endemic regions such as Africa and the Asia-Pacific region. This is especially concerning given the global underdiagnosis of hepatitis B and the limited availability of vaccination, screening, and treatment in low-resource regions. Demographics including male gender, older age, ethnicity, and geographic location as well as low socioeconomic status are more heavily impacted by chronic hepatitis B and related HCC. Methods to mitigate this impact include increasing screening in high-risk groups according to national guidelines, increasing awareness and health literacy in vulnerable populations, and developing more robust vaccination programs in under-served regions.

Establishing a Prediction Model by Machine Learning for Accident-Related Patient Safety

Patient safety has always been an important issue when improving the quality of medical care. The first step when preventing accidents is to screen for the high-risk groups that are prone to accidents. A patient safety reporting system is one of the best tools for such screening. We used machine learning techniques to analyze events involving falling and establish a risk prediction model. The results are then fed back to medical organizations with the aim of raising their quality of medical care. Bayesian network, artificial neural network, logistic regression, and decision tree-based chi-square automatic interaction detection were applied to analyze a database covering a 14-month period from November 2012 to December 2013, and the area under the ROC curve (AUC) values were 0.940, 0.979, 0.981, and 0.971, respectively. Next, data from January to February 2013 was verified by the model showing the highest discrimination ability, namely, logistic regression, and the AUC and F -measure values were 0.944 and 0.871, respectively. Our results demonstrate that a high level of performance was obtained when using a machine learning model for fall prediction among newly admitted patients. Machine learning can thus be applied to provide the most appropriate decision-aided prediction model when screening high-risk groups that are prone to accidents within hospitals.

Ultrasound Evaluation of Subclavian Artery and Internal Thoracic Artery Before Coronary Artery Bypass Grafting as Part of Preoperative Vascular Assessment

Noninvasive diagnostic imaging of subclavian artery (SCA) and internal thoracic artery (ITA) is crucial to the patients planning to use ITA for coronary artery bypass grafting (CABG). The guidelines have not yet provided guidance on screening high-risk groups. The present study aimed to evaluate the contribution of ultrasonography in the assessment of SCA and ITA, especially for the patients referred for CABG who planned to use ITA graft. Patients diagnosed with multivessel coronary heart disease were enrolled and some of them planned CABG. Bilateral SCAs and ITAs were routinely evaluated by color Doppler ultrasound (CDUS) before operation. The luminal diameter and the peak systolic velocity of the proximal and distal parts of SCA and ITA were measured. Depending on the Doppler waveform, the lumen narrowing rate was calculated. The final analysis was carried out in 572 patients. Thirty-five patients had moderate (50%-69%), severe (70%-99%) stenosis or occlusion in the SCA (left-sided in 21 and right-sided in 14). One patient had severe proximal stenosis in left ITA and one patient had no flow in left ITA due to the occlusion in left SCA. One patient had anatomic variation of isolated right aortic arch with aberrant left SCA. All of those cases were confirmed with multidetector computed tomography angiography. CDUS could be used for the evaluation of SCA and ITA before CABG as part of presurgical vascular assessment and provide an import basis for the imaging diagnosis and surgical plan.

Opportunistic Eye Screening Among First-Degree Relatives of Glaucoma Patients at a Suburban Tertiary Center in Malaysia.

Background and objectiveThe majority of glaucoma patients are asymptomatic and are usually diagnosed at an advanced stage of the disease. This study aimed to assess the outcomes of glaucoma screening among known first-degree relatives of primary glaucoma patients.Materials and methodsThis study involved primary angle-closure glaucoma (PACG), primary open-angle glaucoma (POAG), and juvenile open-angle glaucoma (JOAG) patients who attended the glaucoma clinic at the Hospital Universiti Sains Malaysia between January 2014 and December 2015. First-degree relatives of the patients underwent a preliminary eye-screening evaluation, including visual acuity (Snellen chart), intraocular pressure (IOP) measurement (air-puff tonometry), and non-mydriatic fundus photography. Patients with visual acuity worse than 6/12, IOP measuring more than 21 mmHg or a difference of more than 3 mmHg between the eyes, and a vertical cup-disc ratio (VCDR) of 0.7 or higher were given a comprehensive eye examination.ResultsSeventy indexed glaucoma patients were recognized, and 368 first-degree relatives were identified. Forty-five relatives underwent the preliminary screening. Of these, 29 showed normal findings (62%), one had corneal pathology (2%), and 16 (36%) underwent a complete eye examination after failing the initial screening. Among the indexed JOAG group, five relatives (11%) were diagnosed as having JOAG; two were treated medically, while the remaining three required surgical intervention.ConclusionOpportunistic glaucoma screening of high-risk groups, especially JOAG is a feasible and cost-effective way to detect early glaucoma and prevent irreversible blindness. However, improvement in our healthcare system, including the involvement of multicentre clinics in other states in screening initiatives, is required to promote and facilitate the response to screening opportunities.

Impact of Occupational Risks of Medical Staff on Willingness to Occupational Mobility in COVID-19 Pandemic.

PurposeMedical staff are a crucial resource in the battle against the COVID-19 pandemic but are vulnerable to both SARS-CoV-2 infection and negative psychological outcomes. This study evaluated medical staff’s occupational risks, professional identity, and occupational mobility intention during the pandemic.Patients and MethodsThe questionnaire was anonymous. All respondents were Chinese medical personnel.ResultsOur findings suggest that the professional risks faced by medical professionals can enhance their professional mobility willingness and weaken their professional identity. They cannot only directly enhance their professional mobility willingness but also indirectly strengthen their professional mobility willingness through professional identity. The objective support and subjective support obtained by medical professionals cannot only alleviate the negative impact of occupational risk on professional identity alone but also jointly, and in the process of their joint mitigation, the former has been internalized and absorbed, while the latter has a stronger mitigation effect. The objective support and subjective support obtained by medical professionals can neither alone nor jointly alleviate the direct and positive impact of occupational risk on the willingness of occupational mobility.ConclusionThe occupational risks faced by medical personnel can improve their willingness to move professionally and weaken their occupational identity. Early screening of high-risk groups for turnover intention among health care workers and more psychosocial health care and physical protection are needed during the COVID-19 pandemic in China.

Dyslipidemia and risk of prostate canсer in patients with urologic diseases

Aim. To assess the impact of homeostasis parameters on risk of prostate cancer.Materials and Methods. The study included 108 patients with urologic diseases and with (n = 54) or without (n = 54) prostate cancer. Median age in both groups was 67 (interquartile range 64-73) years. Clinicopathological data and blood test results have been collected from outpatient and inpatient records. In particular, we measured serum levels of total testosterone and prostate-specific antigen.Results. Risk factors for prostate cancer include increased total cholesterol (p = 0.023), low-density lipoprotein cholesterol (p = 0.035), total triglycerides (p = 0.048), and total testosterone (p = 0.002). High levels of total testosterone directly correlated with the tumor stage (r = 0.56). The concentration of prostate-specific antigen correlated with the lipid parameters and remained a reliable diagnostic criterion (p = 0.002).Conclusion. The association of hyper/dyslipidemia with prostate cancer provides an opportunity to improve its prevention by routine lipid screening in high-risk groups.

A COVID-19 mortality prediction model for Korean patients using nationwide Korean disease control and prevention agency database

The experience of the early nationwide COVID-19 pandemic in South Korea led to an early shortage of medical resources. For efficient resource allocation, accurate prediction of the prognosis or mortality of confirmed patients is essential. Therefore, the aim of this study was to develop an accurate model for predicting COVID-19 mortality using epidemiolocal and clinical variables and for identifying a high-risk group of confirmed patients. Clinical and epidemiolocal variables of 4049 patients with confirmed COVID-19 between January 20, 2020 and April 30, 2020 collected by the Korean Disease Control and Prevention Agency were used. Among the 4049 total confirmed patients, 223 patients died, while 3826 patients were released from isolation. Patients who had the following risk factors showed significantly higher risk scores: age over 60 years, male sex, difficulty breathing, diabetes, cancer, dementia, change of consciousness, and hospitalization in the intensive care unit. High accuracy was shown for both the development set (n = 2467) and the validation set (n = 1582), with AUCs of 0.96 and 0.97, respectively. The prediction model developed in this study based on clinical features and epidemiological factors could be used for screening high-risk groups of patients and for evidence-based allocation of medical resources.

Factors associated with dyslipidemia and its prevalence among Awash wine factory employees, Addis Ababa, Ethiopia: a cross-sectional study

BackgroundDyslipidemia is a highly prevalent and modifiable risk factor for atherosclerotic cardiovascular diseases. Though the problem is significant in Ethiopia, available data in this regard is very poor among alcoholic beverage industrial workers. This study aimed to assess factors associated with dyslipidemia and its prevalence among Awash wine factory employees in Addis Ababa, Ethiopia.MethodsA cross-sectional study was conducted among 335 randomly selected employees of Awash wine factory, Addis Ababa, Ethiopia from January to February 2021. Data was collected by a face-to-face interview technique using the WHO STEPwise approach. Data were entered and analyzed using Epi Info 7 and SPSS version 26, respectively. Both bivariable and multivariable logistic regression analyses were performed to identify factors associated with dyslipidemia. All statistical tests were declared significant at p-value < 0.05.ResultsThe overall prevalence of dyslipidemia was 67.8% (95% CI 62.5–72.7%). Elevated total cholesterol, elevated triglycerides, reduced high-density lipoprotein, and elevated low-density lipoprotein was found in 25.4%, 33.4%, 50.7%, and 21.5% of participants, respectively. Dyslipidemia was significantly associated with age group 30–39 years (AOR = 2.51; 95% CI 1.16–5.44, p = 0.019), ≥ 40 years (AOR = 6.45; 95% CI 2.01–20.71, p = 0.002), current alcohol consumption (AOR = 3.37; 95% CI 1.70–6.66, p < 0.001), eating vegetables < 2 days per week (AOR = 2.89; 95% CI 1.54–5.43, p = 0.001), sitting duration of > 4 h per day (AOR = 1.96; 95% CI 1.03–3.74, p = 0.041), and raised waist circumference (AOR = 4.56; 95% CI 2.07–10.08, p < 0.001).ConclusionsHigh prevalence of dyslipidemia was found among Awash wine factory employees in Addis Ababa. Periodic screening of high-risk groups along with effective health promotion and education which encourages a healthy lifestyle is essential.

Analysis of Carotid Ultrasound Screening of High-Risk Groups of Stroke Based on Big Data Technology.

In order to understand detection of carotid atherosclerosis in the screening of high-risk stroke populations in a certain area of China, we have analyzed related risk factors of CAS. In accordance with the requirements of the “2015 Technical Plan for the Screening and Intervention Projects for High-Risk Stroke Populations,” a cluster sampling method was used to select 4532 (number of screened persons from 2015 to 2021) permanent residents over 41 years old (一) in Shaheying Town, Liulin Town, Chenggu County, Hanzhong City, Shaanxi Province, and Da'an Town, Ningqiang County, and nearby communities are selected as the screening targets. We screened out high-risk groups of stroke based on big data technology and understood the detection of CAS. According to the screening results of big data technology, it was divided into two groups: CAS group and non-CAS group. The basic information, medical history, personal lifestyle, physical examination, and laboratory examination results of the two groups were classified and counted. The measurement data such as age and waist circumference of the two groups were tested by two independent samples, and the count data of gender, stroke history, hypertension, and other data were tested by the χ2 test of the four-table data, and the logistic regression model was used to analyze the risk factors for CAS of population at high risk of stroke. The results proved the following: (1) Among the 4532 screeners, 865 cases were screened out of the high-risk population of stroke, with an average age of (58.5 ± 8.3) years, mainly 59 to 68 years old, accounting for 43.8%, and the male-to-female ratio was 1.6 : 1. (2) The detection rates of CAS, intimal thickening, plaque formation, and stenosis among high-risk groups of stroke were 55.5%, 10.2%, 52.2%, and 32.6%, respectively. (3) Among the high-risk groups of stroke, CAS patients have a history of stroke, the proportion of hypertension, age, total cholesterol, and low-density lipoprotein cholesterol levels that are higher than those in the non-CAS group, and the difference is statistically significant. (4) Logistic regression analysis shows that age, diabetes, and low-density lipoprotein cholesterol are independent risk factors for CAS in the high-risk population of stroke in this area.

Presentation and Patterns of Celiac Disease in Indian Subcontinent: A Literature Review

Gluten, in genetically susceptible individuals induces an immune mediated enteropathy called Celiac disease (CD). It is an established cause of malabsorption, with the worldwide prevalence being 1% in the general population. It is found across all age groups, from infants to the elderly with 20% patients being diagnosed in the seventh decade of life. It has varying clinical presentations ranging from silent asymptomatic forms which are diagnosed during screening to life threatening forms with severe malabsorption to atypical presentations, with the symptom spectrum extending beyond the gastrointestinal tract which are more common in adults. High index of suspicion, robust screening and testing, followed by strict adherence to gluten free diet is a must to curb and cure the disease. Patients tend to face difficulties not only during diagnosis, but also with compliance and availability of a gluten free diet, in addition to significant economic and psychosocial burden, which is more predominant in developing countries. Screening of high-risk groups like first-degree relatives of celiac disease, patients with severe malnutrition, other autoimmune diseases, refractory anaemia and irritable bowel syndrome should be done to enhance case detection. In low middle income countries, judicious resource utilisation takes precedence, hence, tackling a multifactorial disease such as celiac disease becomes challenging. Repeated follow ups, awareness among patients and doctors, encouragement, availability of testing and dietary counselling is necessary for management of the disease in such settings. Improving sanitation and feeding practices may also play role in decreasing incidence, considering childhood GI infections are a well-established risk factor. Increased availability of serological tests (IgA/IgG anti-tTG, anti -EMA and anti-DGP), biopsy, genetic testing and other newer modalities under research have improved the diagnostic accuracy. Poor compliance increases the risk of GI malignancy, non-Hodgkin’s lymphoma, Hepatocellular carcinoma and MALToma. Hence adherence is a must to prevent complications. A wide variety of treatment modalities are being evaluated to bring into force alternative strategies for management. Only providing gluten free diet is often not sufficient for improvement of nutritional status in patients with CD. Hence, micronutrient supplementation should also be encouraged to meet the unmet needs.

Exploring the correlation between COVID 19 and periodontal disease.

An association of periodontal disease with the severity of COVID 19 disease has been observed during COVID 19 pandemic. This article explores the various hypotheses that link the two conditions, to understand their interrelationship. Targeted research may help elucidate evidence for screening of high-risk groups and identification of therapeutic targets.

Analysis of screening results and risk factors of high-risk populations of lung cancer in Nanchang city from 2018 to 2019

Objective: To collate and analyze the screening results of high-risk lung cancer populations in communities in Nanchang from 2018 to 2019, and to explore the lung-positive nodules and risk factors for lung cancer. Methods: Data of the screening subjects in 8 administrative districts and 15 street health service centers in Nanchang city, Jiangxi province from November 2018 to October 2019 were collected, people at high risk of lung cancer was assessed, clinical screening of high-risk groups of lung cancer was conducted by low-dose helical computed tomography (LDCT), and risk factors for suspected lung cancer and lung-positive nodules were analyzed. Results: Of the 25 871 people participated in screening, 5 220 were at high risk for lung cancer and 15 374 without other malignant tumors were at high risk. There were 2 417 cases participated in clinical LDCT screening, including 193 cases of lung-positive nodules, 67 cases of suspected lung cancer, 912 cases of other lung diseases, the positive rate of lung cancer or lung-positive nodules was 10.76% (260/2 417). Univariate analysis showed that age, coarse grain intake, oil intake, housing heating, passive smoking, alcohol consumption and mental trauma were associated with positive pulmonary nodules or lung cancer (all P<0.05). Multivariate analysis showed that gender, age, housing heating, smoking and drinking were related to the occurrence of lung nodules or lung cancer (all P<0.05). Conclusions: Men are more likely to develop lung cancer or lung-positive nodules than women. The age is an independent risk factor for lung-positive nodules or lung cancer. In a certain range, age will increase the incidence of lung cancer, housing heating may be the protective factor for lung cancer, while smoking and drinking are risk factors.

Factors Associated with Turnover Intention Among Healthcare Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in China.

PurposeThis study assessed the prevalence of turnover intention and explored associated factors on turnover intention among healthcare workers during the COVID-19 pandemic in China.MethodsAn institutional-based cross-sectional study was conducted from July to February 13th to 20th, 2020, in 31 provinces of mainland China. A total of 1403 healthcare workers were recruited. Hierarchical logistic regressions were used to identify potential factors associated with turnover intention among Chinese health care workers.ResultsThe prevalence of turnover intention among healthcare workers was 10.1% during the COVID-19 pandemic in China. Results of hierarchical regression revealed that working in Grade II hospital (OR = 1.78), technician (OR = 0.30), daily working hours over 12 h (OR = 2.92), frequency of mask replacement between 4 and 8 h (OR = 3.51), refuse volunteer to frontline (OR = 1.68), patient–physician relation unchanged (OR = 1.73), depression (OR = 2.21) and lower social support (OR = 1.75) were significantly associated with the risk of turnover intention. Additionally, healthcare worker’s psychosocial syndemic (OR = 6.13) was positively associated with turnover intention.ConclusionTurnover intention is relatively prevalent among healthcare workers during the COVID-19 pandemic in China, and the factors contributing to turnover intention were complex and varied. Early screening of high-risk groups for turnover intention among healthcare workers and more psychosocial health care and physical protection are needed during the COVID-19 pandemic in China.