Germline genetic testing in patients with advanced prostate cancer (PCa) is underutilized and hypothesized to be impacted by socioeconomic and demographic factors. This single institution, retrospective study assessed the association of income and social vulnerability with genetic referrals and testing. The Henry Ford Health (HFH) tumor registry was queried for new diagnoses of stage III, IV PCa from 2017 to 2022. 1385 patients were eligible and 186 patients (13.43%) received a referral, while 1199 (86.57%) patients did not. Median household income (gMHI) and social vulnerability index (SVI) were assigned based on census tract level geocoding and analyzed by tertiles. Univariable and multivariable logistic regression analyses were performed assessing referral for genetic counseling and completion of genetic testing as outcomes. In the multivariable analysis, associations between age, stage and gMHI were analyzed. Black and stage IV patients were more likely to receive genetics referral than White and stage III patients, respectively (20.3% vs 10.6%, p < 0.0001; 25.5% vs 7.3%, p < 0.0001). Multivariable analysis showed that middle gMHI tertile patients had 53% lower unadjusted OR for genetic referral than lowest gMHI tertile patients (OR = 0.47, 95% CI [0.29, 0.75]; p = 0.0017). There was no significant difference in the odds of referral between the highest and lowest gMHI tertiles (OR = 1.22, 95% CI [0.83, 1.79]; p = 0.3175). No other significant associations were found between gMHI, SVI and genetic counseling referrals or completion of testing. Adjusted comparisons showed significant associations between increased referral or testing rate and decreasing age and more advanced stage (OR = 0.97, 95% CI [0.95, 1.00]; p = 0.0218), (OR = 2.84, 95% CI [1.70, 4.74]; p = 0.0001). Although socioeconomic factors have been hypothesized as barriers to genetic testing, we found no evidence of an association in our patient population. Instead, the lowest gMHI tertile patients were equally as likely to complete genetic testing as highest gMHI tertile patients, indicating socioeconomic barriers can be overcome. Clinical factors including age and stage did independently predict completion of testing, supporting referral for testing based on clinical characteristics.

Dietary modification is a crucial component of chronic kidney disease (CKD) management, but the complexity of renal diets leads to significant adherence challenges. Understanding the patient's perspective is vital for developing effective, patient-centred interventions that improve adherence and health outcomes. This scoping review aimed to map the available evidence on the reported preferences of patients with CKD regarding nutrition-related health outcomes, and to identify the perceived barriers and facilitators that hinder or support the achievement of these outcomes. Studies were included if they involved adult patients with CKD and explored their perspectives on nutrition-related outcomes, barriers, or facilitators to dietary management. Qualitative, quantitative, and mixed-methods studies published in English were eligible. A systematic search was conducted in June 2025 across four electronic databases (MEDLINE, CINAHL, Embase, and Cochrane Database of Systematic Reviews), supplemented by hand-searching reference lists of included articles. Data were extracted independently using a custom data extraction tool. The identified barriers and facilitators were thematically mapped and categorised according to the World Health Organization Multidimensional Adherence Model (WHO-MAM). Four studies met the inclusion criteria. A primary finding was the lack of evidence directly addressing patients' preferred nutrition-related health outcomes. However, preferences could be inferred; patients value reassurance, emotional support, and receiving practical, individualised, and culturally relevant advice. Perceived barriers included: (A) unhelpful, paternalistic communication from healthcare teams; (B) patient factors like feeling overwhelmed and confused; (C) socioeconomic factors such as conflicting cultural norms and social pressures; and (D) therapy-related factors like generic, non-culturally specific advice. Key facilitators included: (A) helpful, empathetic, and collaborative communication styles; (B) patient factors like self-monitoring and psychosocial support; (C) socioeconomic factors such as leveraging cultural health beliefs; and (D) therapy-related factors like health literacy-sensitive materials and dietitian support. There is a significant gap in the literature regarding the nutrition-related health outcomes that CKD patients prioritise. The findings highlight that the patient-healthcare provider relationship is a pivotal factor influencing adherence. Clinical practice should shift towards a more patient-centred, collaborative, and culturally sensitive model of care. Future research should use qualitative methods to directly investigate patient preferences to inform the co-design of effective dietary interventions.

Public awareness, procedural knowledge, and reporting intention for child abuse involving children with disabilities in Malaysia.

Parental socioeconomic status and other sociodemographic determinants of health disparities among children and adolescents in Austria.

Clinical trial participation in kidney, bladder, and prostate malignancies in the United States: Sociodemographic distribution and impact on survival.

Obesity and type 2 diabetes mellitus are closely interconnected global epidemics driven by shared metabolic, environmental, and socioeconomic factors. Excess adiposity promotes insulin resistance through adipose tissue dysfunction, chronic inflammation, and ectopic fat deposition, ultimately contributing to β-cell failure and hyperglycemia. Pregnancy represents a unique metabolic state in which physiological insulin resistance may unmask underlying metabolic vulnerability, increasing risks of gestational diabetes, hypertensive disorders, and adverse maternal and neonatal outcomes. Maternal obesity and diabetes also contribute to long-term cardiometabolic risk and the intergenerational transmission of metabolic disease. Integrated strategies emphasizing preconception care, lifestyle interventions, optimized glycemic management, and coordinated postpartum cardiometabolic follow-up are critical to improving maternal and offspring health outcomes.

Diabetes is a prevalent chronic condition often accompanied by comorbidities such as obesity, hypertension, and arthritis, influenced by both individual behaviors and broader socioeconomic factors. This study aims to analyze diabetes trends and associated chronic conditions across U.S. states from 2011 to 2021, and to develop a predictive model to estimate diabetes prevalence using selected health, demographic, and socioeconomic indicators. We compiled a comprehensive dataset by integrating multiple U.S. public health sources, yielding 90 features representing chronic disease rates, demographics, and socioeconomic conditions. Statistical analysis and visualizations—including trend lines and geographic comparisons—were used to identify regional disparities and comorbidity patterns. For predictive modeling, we implemented a hybrid deep learning framework combining Principal Component Analysis (PCA) for feature selection with a Multi-Layer Perceptron (MLP) classifier. The model was evaluated using 5-fold cross-validation and standard performance metrics. Our visual analytics revealed significant state-level disparities in diabetes prevalence, closely associated with factors like obesity, tobacco use, and poverty. States such as Mississippi consistently exhibited higher rates of diabetes and related risk factors. The MLP-PCA model, using only the top 21 features, achieved strong predictive performance: 93.07% accuracy, 92.81% precision, 90.65% recall, and a 91.61% F1-score, with a rapid prediction time of 0.12 s. The top features included population demographics, obesity, COPD, arthritis, hypertension management, and poverty rate. By integrating data visualization and machine learning, this study offers a scalable and interpretable framework for monitoring diabetes at the population level. The implementation strategy enables early detection and supports targeted public health strategies by identifying high-risk regions and influential risk factors. Future work will incorporate time-series forecasting and additional environmental and behavioral variables to enhance prediction and inform long-term health planning. • Created a novel U.S. diabetes dataset integrating multiple public sources. • Analysed 10-year chronic disease trends using statistical and geospatial methods. • Identified regional disparities in diabetes and comorbid conditions across states. • Explored and discussed demographic, socioeconomic, and health factors influencing diabetes rates. • Developed efficient ML models using tailored feature selection strategies. • Reduced 89 features to top 10, 15, and 21 for accurate state-level predictions. • Evaluated models with 5-fold cross-validation and diverse performance metrics.

A global perspective on autoimmunity and immunodeficiency: exploring geoepidemiology trends.

The increasing global burden of obesity and its metabolic complications necessitates a detailed understanding of specific metabolic phenotypes. This study investigates the 25-year trends in the prevalence of eight metabolic phenotypes that are categorized by body mass index (BMI) and metabolic health status, among Iranian adults from 2000 to 2025. This retrospective analysis utilized data from four national and sub-national cross-sectional studies based on the World Health Organization (WHO) STEPwise approach to non-communicable disease (NCD) risk factors surveillance (STEPS), conducted in Iran from 2007, 2011, 2016, and 2021. Adults aged 25-65 were classified into eight phenotypes based on BMI categories (underweight, normal weight, overweight, obese) and metabolic health status (healthy/unhealthy), defined using the National Cholesterol Education Program's and Adult Treatment Panel III (NCEP-ATP III) criteria. A smoothing spline model was applied to estimate trends from 2000 to 2025. A total of 55,204 adults were included in this study. From 2000 to 2025, the prevalence of metabolically unhealthy overweight (MUOW) increased from 19.16% to 26.20%, and metabolically unhealthy obese (MUOb) from 15.07% to 21.67%, while metabolically healthy normal weight (MHNW) declined from 26.82% to 13.67%. For both genders, there was a constant increase in MUOW and MUOb, with the percentage of MUOb being nearly twice as high in females compared to males (In 2000: 19.37% vs. 10.30%, In 2025: 26.16% vs. 14.86% among females vs. males). The prevalence of MUOW (In 2000: 20.69% vs. 16.99%, among urban and rural areas, respectively, and In 2025: 26.72% vs. 23.14% among urban and rural areas, respectively) and MUOb (In 2000: 15.54% vs. 11.75%, among urban and rural areas, respectively, and In 2025: 23.26% vs. 18.76% among urban and rural areas, respectively) increased, with urban areas showing higher percentages than rural areas. Across age groups, MUOW and MUOb consistently rose over the years, peaking in the 45-54 and 55-64 age groups, while the 25-34 age group had the highest percentage of MHNW. Across provinces, MUOW and MUOb increased, while metabolically healthy underweight (MHUW), MHNW, metabolically healthy obese (MHOb), metabolically unhealthy underweight (MUUW), and metabolically unhealthy normal weight ( MUNW) decreased, with metabolically healthy overweight (MHOW) showing a slight rise. From 2000 to 2025, a significant increase in metabolically unhealthy phenotypes, particularly MUOW and MUOb, was observed among Iranian adults, driven by a decline in metabolically healthy phenotypes. This trend underscores the need for targeted public health interventions, especially for older adults, women, and urban populations. Regional differences reflect varying cultural and socioeconomic factors. The online version contains supplementary material available at 10.1007/s40200-025-01805-3.

High-Impact Chronic Pain Incidence Among U.S. Adults: A Brief Report Focused on Socioeconomic Factors.

How representative are electronic health records? A record linkage study using individual-level census data.

Contrasting cancer inequalities in Europe: Patterns of geographical variations in cancer mortality by country and sex.

This study provides novel evidence on perceptions and use of alcohol-free and low-alcohol (NoLo) products among mid-life women, a group underrepresented in alcohol research. A cross-sectional survey of 497 women aged 40-65 was co-developed with stakeholders to ensure relevance and acceptability. The survey assessed understanding of alcohol by volume (ABV) definitions (low-alcohol ≤1.2%; alcohol-free ≤0.05%), patterns of NoLo use, attitudes, and perceived helpfulness for harm reduction. Most respondents misunderstood ABV terms, with 64% assuming "alcohol-free" meant 0% ABV. Nearly half had used NoLo products in the past year, with uptake more common among participants with higher education levels and, more tentatively, with higher income, raising equity concerns. Bayesian regression identified taste motives as strong positive predictors of NoLo use, while enhancement motives (drinking for pleasure) were negative predictors. Around 75% rated NoLo substitution as helpful for reducing alcohol intake. In adjusted Bayesian regression, enhancement motives and AUDIT scores showed predominantly negative associations with perceived helpfulness, and taste motives showed no clear effect indicating that determinants of use and beliefs about helpfulness may differ. Acceptability varied by context: celebratory scenarios were rated most appropriate, while during pregnancy or in the workplace were least acceptable. Factor analysis revealed three sub-scales of NoLo perceptions; recent users reporting higher social and health benefits and fewer associations with alcohol-related cues. Findings underscore the need for policy to prioritise clear ABV labelling, inclusive messaging, and equitable access to appealing NoLo options that emphasise taste, social usability, and health benefits to maximise harm-reduction impact.

Systematic review and meta-analysis of cardiovascular disease risk among hypertensive patients in Africa.

Tobacco use is a leading cause of preventable disease and death worldwide. In Russia, despite tobacco-control measures, adolescent tobacco use remains a significant public health concern. This study aimed to assess the prevalence and predictors of tobacco use among adolescents aged 13-15 years in the Russian Federation using data from the Global Youth Tobacco Survey (GYTS). The present study was a cross-sectional study based on secondary analysis of data from the 2021 Russian Federation GYTS. Descriptive statistics, bivariate analysis, and multivariable logistic regression were used to evaluate sociodemographic and attitudinal factors associated with adolescent tobacco use. The findings showed that the prevalence of adolescent tobacco use was 16.3% among 13-year-olds, to 21.4% among 14-year-olds, and 29.6% among 15-year-olds (p<0.001). Male adolescents had a higher prevalence of tobacco use than females (22.7% vs. 20.8%, p=0.009). Tobacco use prevalence also increased by school level, reaching 29.0% among ninth-grade students, compared with 17.2% and 20.7% among seventh- and eighth-grade students, respectively (p<0.001). Weekly spending was strongly associated with tobacco use, with prevalence rising to 36.0% among adolescents spending 1000 rubles or more per week. In multivariable analysis, adolescents spending 1000 rubles or more per week had over twice the odds of tobacco use (adjusted odds ratio [OR]: 2.03; 95% confidence interval [CI]: 1.75-2.46; p<0.001). Positive tobacco use expectancies were also strongly associated with tobacco use, with adjusted ORs reaching 10.79 among adolescents who agreed that they might enjoy tobacco use. The findings of this study highlight that adolescent tobacco use in Russia continues to be a significant public health issue, characterized by an increasing prevalence with age, an emergence of a relatively small sex difference in prevalence, and strong associations with socioeconomic factors and positive tobacco use expectancies.

A pan-European assessment of multi-sector drivers of human hantavirus risk: climate, biodiversity, and socio-economic factors as key determinants.

Health gaps by sexual orientation and gender identity among Japanese millennial generation: A decomposition analysis.

Modeling the role of environmental and socioeconomic factors in endemic SFTS risk using a multicomponent framework.

Prediction of specific cardiovascular outcomes may facilitate precision medicine in hypertension. We aimed to explore risk factor heterogeneity for acute coronary syndrome (ACS), stroke and heart failure in treatment-eligible hypertensive patients. In this population-based cohort study in Västerbotten, Sweden, middle-aged patients with treatment-eligible hypertension were included. Association between traditional cardiovascular risk factors and ACS, stroke and heart failure was studied. Multinomial logistic regression was performed to determine standardized odds ratios. Over a 10-year period, there were 1190 cardiovascular events in 12 238 participants. Risk factor associations were mainly of the same direction but differed in magnitude across cardiovascular outcomes. Total cholesterol was significantly associated with ACS, but not with heart failure and stroke. Smoking and male sex were more strongly associated with ACS than with heart failure and stroke. BMI and socioeconomic factors were significantly associated with heart failure, but not with ACS and stroke. Diabetes and DBP had stronger associations with stroke compared to ACS and heart failure. We found clinically important differences in the association between different risk factors and ACS, stroke and heart failure in treatment-eligible hypertensive patients. The current model was insufficient to guide treatment decisions but should stimulate further research into risk factor heterogeneity between cardiovascular disease outcomes.

Geographic disparities in suicide mortality in South Korea (2012–2023): Socioeconomic protective factors associated with suicide cold spots