Population Subgroups Research Articles

Deep Vein Thrombosis After Earthquake: A Systematic Review and Meta-analysis.

Among natural disasters, earthquake is associated with heavy fatalities and financial damages, causing considerable mortality. The complications resulting from getting trapped in rubble, secondary traumas, obligation to reside in temporary shelters, along with other factors such as limited mobility, stress, and dehydration, predispose earthquake survivors to Deep Vein Thrombosis (DVT). The aim of the present study is to investigate the rate of DVT after an earthquake using a systematic review and meta-analysis. To perform the present study, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used. The protocol of this review study has been registered in the International Perspective Register of Systematic Review (PROSPERO) with the code of CRD42021290375. Credible data resources including PubMed, Scopus, Web of Science, Science Direct, Google Scholar, Magiran, SID, and Embase were used for extracting relevant studies. Random effect model was used to perform the meta-analysis. I2 was ritualized to investigate heterogeneity across the studies. Publication bias of studies was evaluated using the Begg test. In this study, 267 primary studies were identified and extracted. After removing the duplicate ones and the screening, eventually 12 final studies were chosen for the meta-analysis. Based on the meta-analysis results, the total rate of DVT was 9.07% (95% confidence interval [CI]: 7.32-10.81; I2 = 97.9%; P = 0<0.001). Analysis of DVT in the subgroups of the general population and patient survivors were 11.43% (95% CI: 9.06-13.79; I2 = 98%; P = 0<0.001) and 2.51% (95% CI: 0.04-4.63; I2 = 77.7%; P = 0.001). Also, based on the Begg test, the publication bias in the chosen studies was not considerable. DVT rate in earthquake survivors is higher compared with other disasters, and over time it finds a growing trend. After earthquake, the focus of rescue and health-care teams is on individuals with observable injuries and damages. Because DVT is first asymptomatic but has fatal consequences, including pulmonary embolism and sudden death, it should be incorporated in health's status assessment of earthquake-stricken people as well as screening and diagnostic programs of health-care providers.

Transition to retirement impact on risk of depression and suicidality: results from a longitudinal analysis of the Survey of Health, Ageing and Retirement in Europe (SHARE).

Depression is among the main contributors to older adults' mental health burden. Retirement, one of the major life transitions, has been claimed to influence mental health substantially. Following up on a previous meta-analysis, the study aims to assess from a longitudinal perspective short- and long-term impacts of transitioning to retirement on depression risk and suicidality in older adults across Europe. We conducted a longitudinal study using data from the Survey of Health, Ageing and Retirement in Europe (SHARE), collected between 2004 and 2020 in 27 European countries plus Israel. To estimate relative risks (RR) and 95% confidence intervals (95% CIs) for depression and suicidality at seven time intervals before and after retirement, we fitted adjusted generalized estimating equation models for repeated measures. We included 8,998 individuals employed at baseline and retired at follow-up (median follow-up time: 9years; maximum: 16years). Compared to the year of retirement, the risk of depression was 11% lower in the following year (RR 0.89; 95% CI 0.81-0.99), 9% lower after 2years (RR 0.91; 95% CI 0.82-1.00) and after 3years (RR 0.91; 95% CI 0.81-1.01). Significant estimates remained among females, married individuals, those with an intermediate or higher level of education, former manual workers and those who retired at or before their country's median retirement age. A significant increase in depressive symptoms emerged from the tenth year after retirement among former non-manual workers (RR 1.21; 95% CI 1.05-1.40) and late retirees (RR 1.37; 95% CI 1.16-1.63). No heterogeneity emerged among strata. As for suicidality, we reported an increase in risk only 5years or more after retirement, namely +30% 5-9years after retirement (RR 1.30; 95% CI 1.04-1.64) and +47% 10 or more years after retirement (RR 1.47; 95% CI 1.09-1.98). Sensitivity analyses excluding subjects who reported a diagnosis of depression over the study period and those retirees who declared to receive a disability pension confirmed the results obtained in the overall analysis. Longitudinal adjusted data suggest an independent effect of retiring associated with a reduction in depression and suicidality risk in the short run, with its effect decreasing in the long run. Such trends are particularly evident among selected subgroups of elderly populations. If greater flexibility in pensionable age may help prevent depression late in life, the transition to retirement is to be accompanied by targeted health promotion interventions. In an ageing society, welfare policies should be evaluated, considering their long-term impact on mental health.

Supplemental Material for Network Analysis of COVID-19-Related PTSD and Depressive Symptoms Among Chinese General Population and Comorbidity Subgroup

Supplemental Material for Network Analysis of COVID-19-Related PTSD and Depressive Symptoms Among Chinese General Population and Comorbidity Subgroup

The frequency of rs2231142 in ABCG2among Asian subgroups: implications for personalized rosuvastatin dosing.

Statins are widely used medications for the primary and secondary prevention of cardiovascular diseases. Statin-induced musculoskeletal symptoms are the primary adverse drug events contributing to poor adherence to lipid-lowering therapy. Rosuvastatin is characterized by interindividual differences in systemic exposure among different patient population subgroups. The missense variant Q141K within ABCG2, highly prevalent in some Asian subgroups, results in decreased transporter efflux function and increased exposure to rosuvastatin. We aim to highlight the implications of ABCG2 genotype in prescribing rosuvastatin and the ramifications of interpopulation differences in Q141K frequencies in the starting dose of rosuvastatin in majorAsian subgroups, using the most recent genetic-based guidelines. The high frequency of Q141K in Filipinos could warrant a lower starting rosuvastatin dose versus non-Filipinos. The Q141K genotype frequencies in Asian subgroups suggest significant interpopulation differences, reinforcingthe needto move beyond race-based to genotype-based rosuvastatin dosing.

Trend and Future Perspective of Modern Contraceptive Prevalence, Unmet Need, and Demand Satisfied for Modern Methods for All 38 Districts of Bihar State in India: Application of Family Planning Estimation Tool at District Level

Background: Estimating couples in need and demand of contraceptives for a country helps policy makers for better planning, budget allocation and implement a focused program to achieve the desired goals, especially at district level. In Bihar, the state with India’s highest population density and lowest socioeconomic standing. The family planning indicators have been estimated and projected at the national and state levels in most attempts, while estimation at the district level has rarely been attempted. Methods: We have used a statistical model that can generate estimates and projections of rates and trends of indicators related to access to reproductive health at the national and sub-national levels. Avenir Health has packaged this model in the form of a user-friendly web application, the Family Planning Estimation Tool (FPET), which can be operated by local stakeholders with little external support. We present here annual estimates and projections of rates and trends of the modern contraceptive prevalence rate, unmet need, and demand satisfied for modern family planning methods at state level and its 38 districts from 1991 to 2030 with application of FPET. Findings: There is a large amount of heterogeneity between the districts; only three districts have high modern contraceptive prevalence rate (mCPR > 54%) and high met demand with a modern contraception of more than 74 percent in 2021; whereas five districts have low mCPR of less than 40 percent in 2021. It is estimated that 11 districts out of 38 districts are likely to reach met demand with a modern method greater than 74 percent by 2030. Overall Bihar requires additional 3.6 million users of modern contraceptives from 2021 to reach 74 percent of demand satisfied with modern contraceptive methods by 2030. But the findings estimate that approximately 3 million additional MWRA will be using modern contraceptive methods during 2021 and 2030 in Bihar. Indeed, the estimates suggest that the increase in the mCPR needed to achieve 74 percent or more demand satisfied with modern methods by 2030 in Bihar, four districts, namely, Kisanganj, Katihar, Gopalganj and Saran should be focused and prioritized followed by another five districts, namely, Siwan, Arwal, Purba Champaran, Sitamarhi, and Sheohar as these districts will be at the bottom of the table with less than 70 percent of demand satisfied with modern methods by 2030. Conclusion: The identification of districts that are performing better or worse helps decentralized planning effectively. The analysis can be generalized to other states and districts as well as other types of population subgroups.

Is information on social rights accessible to cancer patients?

Brazilian legislation provides for rights for cancer patients in order to assist with their treatment and mitigate the expenses they face during their illness. This study aimed to calculate the proportion of individuals undergoing cancer treatment at a Brazilian Unified National Health System (SUS) referral center who reported being aware of 15 specific legal rights, according to the population subgroup eligible to request each right. All adult cancer patients starting treatment at the Juiz de Fora Women's Association for Preventing and Fighting Cancer Hospital (ASCOMCER), Minas Gerais State, from March to July 2022, were interviewed (n = 62). About 60% of these patients had incomplete primary education or were illiterate, around 75% lived in households with a per capita income below one minimum wage, and 91.9% received treatment from the SUS. For nine of the 15 selected rights, the proportion of eligible patients was higher than 10%, ranging from 17.7% for "Withdrawal from the Severance Pay Fund (FGTS)" to 100% for "priority in the processing of procedures". However, the only one of these rights known to at least 50% of eligible patients was "sickness benefit" (70.6%). The respective proportions were below 5% in three rights, including "exemption from property tax", "exemption from income tax on retirement, pension, and retirement", and "priority in the processing of cases". Cancer patients need to have their comprehensive care strengthened. Therefore, it is crucial to enhance the availability of information regarding the benefits cancer patients may receive from a democratic state that respects the rule of law.

Factor X deficiency: a comment on two recent case studies

Abstract Hereditary factor X deficiency (HFXD) is a rare genetic bleeding disorder, affecting approximately 1 in 1,000,000 individuals globally, and resulting in abnormally low activity of clotting factor X (FX). Diagnosis may occur early in life, particularly in patients with a family history of the disorder or severe deficiency, or later in life for those with mild-moderate deficiency. Regardless of age at diagnosis, this disorder can significantly impact the lives of patients, as well as those of caregivers and/or family members. Alongside a wide historical array of HFXD treatments, including supportive care with blood transfusions, FX replacement with fresh frozen plasma or prothrombin complex concentrates, specific replacement has been made possible with the isolation and concentration of human plasma-derived FX for therapeutic use, offering the potential for a streamlined prophylactic regimen and improved quality of life and wellbeing. Two recent case studies describe the diagnosis and management of children with HFXD in India and the Philippines, both of whom were diagnosed in infancy following severe bleeding episodes. They share important similarities but highlight key differences in the experience of diagnosis and management of HFXD. Together they illustrate the lack of a specific target population subgroup for this rare but serious bleeding disorders, and the importance of checking FX levels (among other clotting factors) when prothrombin time (PT) and partial thromboplastin time (PTT) are prolonged.

Assessment of levels and trends of HIV infections among different subgroup populations of Gujarat State - Prioritization of the districts.

In India, HIV prevalence varies by region and high-risk groups. General population rates have decreased in high prevalence states through HIV Sentinel Surveillance among pregnant women, while low-moderate prevalence states show variable trends. Gujarat, in western India, has mixed HIV prevalence according to 2017 Sentinel Surveillance data. To study the level and trend of HIV positivity among pregnant women and high-risk groups (HRGs) across different districts of the state of Gujarat from year 2012-13 to 2016-17. To review the possible determinants of the HIV epidemic across the selected districts in the state of Gujarat. Data from the National AIDS Control Organization (NACO) spanning 2012-17 was analyzed for HIV trends in Gujarat. This included combined HIV testing data from pregnant women at Integrated and Counseling Testing Centers, blood unit testing data from selected districts, and HIV testing among high-risk populations through Targeted Intervention sites. HIV cases in Kheda district declined post-2013-14 among pregnant women (0.38% to 0.21% in 2016-17), and in general ICTC clients (5.53% to 0.264% in 2017-18). MSM seropositivity dropped from 1.15% (2014-15) to 0.74% (2016-17), FSWs from 0.7% (2014-15) to 0.29% (2015-16). Contrastingly, blood donors exhibited an increasing trend, rising from 0.15% (2012-13) to 0.24% (2016-17). In Mehsana, ANC mother seropositivity rose to 0.6% (2013-14), fell to 0.32% (2015-16), and rose again to 0.48% (2016-17). General ICTC clients declined from 1.2% (2012-13) to 0.53% (2016-17). FSWs had 0.25% seropositivity (2015-16), while MSM saw a drop from 0.44% (2014-15) to 0.23% (2016-17). Blood donors' trend was inconsistent. Sabarkantha's pregnant women seropositivity dipped from 0.59% (2012-13) to 0.20% (2014-15), rising to 0.25% (2017-18). General ICTC client seropositivity decreased from 5.34% (2012-13) to 1.17% (2017-18). While declines in HIV prevalence are evident among certain groups such as pregnant women and general ICTC clients, there are fluctuations in seropositivity among high-risk populations like MSM, FSWs, and blood donors. These insights emphasize the need for targeted interventions and ongoing monitoring to effectively address the evolving HIV landscape in these districts.

온도 지표에 따른 도시와 농촌의 열사망 위험도 격차

Heat impact on human health is a global concern due to climate change which has been accelerating. Recently, previous studies have contended that it is necessary to consider different vulnerabilities to heat by temperature metrics and urbanicity when setting the heat alarming system; however, the current heat alarm system in Korea is based on the maximum temperature solely. Therefore, this study aimed to examine whether the heat-related mortality risks differ by the urban and rural areas with sub-population groups, using two temperature metrics, the daily minimum temperature and the maximum temperature.BR We collected 229 nationwide district-level (sigungu) daily time-series data including the minimum temperature, the maximum temperature, and the all-cause mortality during the summer season (June ~ Sep) of the study period (2011 ~ 2017). Using the two-stage time series analysis with a distributed lag non-linear model (DLNM), we estimated heat-mortality risk estimates based on the minimum and maximum temperatures, individually. The risk estimates were pooled with meta-regression by urban and rural area. BR The maximum temperature is associated with mortality risk in both urban and rural areas. However, the minimum temperature has a significant impact on mortality only in the urban area. In addition, heat-related mortality risks differed by the sup-population (sex and age group), regions, and temperature metrics.BR In conclusion, heat-mortality risk between urban and rural areas differs by temperature metrics and characteristics of sub-populations. The results suggest that more elaborated heat definitions and heat alarming systems should be established to increase the efficiency of the alarming system and address unequal vulnerability to heat.

Unsupervised cluster analysis reveals distinct subgroups in healthy population with different exercise responses of cardiorespiratory fitness

Background/ObjectiveConsiderable attention has been paid to interindividual differences in the cardiorespiratory fitness (CRF) response to exercise. However, the complex multifactorial nature of CRF response variability poses a significant challenge to our understanding of this issue. We aimed to explore whether unsupervised clustering can take advantage of large amounts of clinical data and identify latent subgroups with different CRF exercise responses within a healthy population. Methods252 healthy participants (99 men, 153 women; 36.8 ± 13.4 yr) completed moderate endurance training on 3 days/week for 4 months, with exercise intensity prescribed based on anaerobic threshold (AT). Detailed clinical measures, including resting vital signs, ECG, cardiorespiratory parameters, echocardiography, heart rate variability, spirometry and laboratory data, were obtained before and after the exercise intervention. Baseline phenotypic variables that were significantly correlated with CRF exercise response were identified and subjected to selection steps, leaving 10 minimally redundant variables, including age, BMI, maximal oxygen uptake (VO2max), maximal heart rate, VO2 at AT as a percentage of VO2max, minute ventilation at AT, interventricular septal thickness of end-systole, E velocity, root mean square of heart rate variability, and hematocrit. Agglomerative hierarchical clustering was performed on these variables to detect latent subgroups that may be associated with different CRF exercise responses. ResultsUnsupervised clustering revealed two mutually exclusive groups with distinct baseline phenotypes and CRF exercise responses. The two groups differed markedly in baseline characteristics, initial fitness, echocardiographic measurements, laboratory values, and heart rate variability parameters. A significant improvement in CRF following the 16-week endurance training, expressed by the absolute change in VO2max, was observed only in one of the two groups (3.42 ± 0.4 vs 0.58 ± 0.65 ml⋅kg−1⋅min−1, P = 0.002). Assuming a minimal clinically important difference of 3.5 ml⋅kg−1⋅min−1 in VO2max, the proportion of population response was 56.1% and 13.9% for group 1 and group 2, respectively (P<0.001). Although group 1 exhibited no significant improvement in CRF at group level, a significant decrease in diastolic blood pressure (70.4 ± 7.8 vs 68.7 ± 7.2 mm Hg, P = 0.027) was observed. ConclusionsUnsupervised learning based on dense phenotypic characteristics identified meaningful subgroups within a healthy population with different CRF responses following standardized aerobic training. Our model could serve as a useful tool for clinicians to develop personalized exercise prescriptions and optimize training effects.

Satisfaction with Health Care Services in the Adult Population of the Federation of Bosnia and Herzegovina during the COVID-19 Pandemic.

Background and Objectives: Patient satisfaction with health care can influence health care-seeking behavior in relation to both minor or major health problems or influence communication and compliance with medical advice, which is especially important in emergencies such as the COVID-19 pandemic. Thus, it is important to continually monitor patient satisfaction with provided care and their dynamics. The aim of this study was to assess patient satisfaction with health care during the COVID-19 pandemic in the adult population of the Federation of Bosnia and Herzegovina (FB&H) and compare it with levels of satisfaction in the same population before the COVID-19 pandemic. Materials and Methods: A representative, population-based survey was implemented in the adult population of the FB&H using the EUROPEP instrument, which measures satisfaction with health care using 23 items. The sample included 740 respondents who were 18 years or older residing in the FB&H and was implemented in December 2020. All data were collected using a system of online panels. The survey questions targeted the nine months from the beginning of the pandemic to the time of data collection, i.e., the period of March to December 2020. Results: The mean composite satisfaction score across all 23 items of the EUROPEP tool was 3.2 points in all age groups; the ceiling effect was 22% for the youngest respondents (18-34 years old), 23% for 35-54 years old, and 26% for the oldest group (55+), showing increasing satisfaction by age. The overall composite score for both females and males was 3.2. The ceiling effect was higher in those with chronic disease (29% vs. 23% in those without chronic disease). The composite mean score for respondents residing in rural vs. urban areas was 3.2 with a ceiling effect of 22% in rural and 24% in urban residents. When comparing mean composite scores surveyed at various points in time in the FB&H, it was found that the score increased from 3.3 to 3.5 between 2011 and 2017 and dropped again to 3.3 in this study. Despite these observations in the overall trends of satisfaction scores, we note that no statistically significant differences were observed between most of the single-item scores in the stratified analysis, pointing to the relative uniformity of satisfaction among the analyzed population subgroups. Conclusions: The rate of satisfaction with health care services in the FB&H was lower during the COVID-19 pandemic compared to 2011 and 2017. Furthermore, while an increasing trend in satisfaction with health care was observed in the FB&H during the years prior to 2020, the COVID-19 pandemic may have contributed to the reversal of this trend. It is important to further monitor the dynamics of patient satisfaction with health care, which could serve as a basis for planning, delivering, and maintaining quality services during the COVID-19 pandemic and other emergencies.

Effect of Curcuma longa on T lymphocytes in rats induced to prostate cancer

Worldwide, prostate cancer is the second most diagnosed type of cancer in the male population, as well as the fifth leading cause of death. Therefore, it is necessary to look for alternatives for its prevention and treatment. Objective: to determine the effect of the pulverized rhizome of Curcuma longa on T lymphocytes in an animal model of prostate cancer. Methodology: It is an experimental study, 30 male rats Holtzman from 10 to 12 weeks of age were used, with an average weight of 200 to 250 g. Prostate cancer induction was performed by administration of testosterone, progesterone, and N-nitroso-N-methylurea (NMU) at doses of 100 mg/kg, 50 mg/kg, and 50 mg/kg, respectively. The pulverized rhizome of Curcuma longa was administered in aqueous solution at doses of 200, 400 and 600 mg/kg. Determination of CD4+ and CD8+ T cells was analyzed by BD FACSCalibur flow cytometry using FlowJo software. Results: Curcuma longa at different doses significantly improved the percentage of CD4+ and CD8+ T lymphocytes in the animals that received the treatments, increasing the population subgroups by 50 to 100%. Likewise, a better effect on the inhibition of tumor growth was presented at the dose of 600 mg/kg. Conclusion: an increase in T lymphocytes by Curcuma longa was evidenced at all the doses tested, presenting better results at the dose of 600 mg/kg.

Trends and disparities in diabetes and prediabetes among adults in the United States, 1999–2018

ObjectiveThe aims of the study were to describe the up-to-date trend of total, diagnosed, and undiagnosed diabetes and prediabetes, assess their associated disparities among population subgroups, and examine their relationship with sociodemographic factors among adults in the United States. Study designThis was a cross-sectional study from a nationally representative sample of US adults (aged ≥20 years) who participated in the National Health and Nutrition Examination Survey. MethodsDiagnosed diabetes was defined as a self-reported previous diagnosis of diabetes by a physician or any other health professionals (other than during pregnancy). Undiagnosed diabetes was defined as elevated levels of fasting plasma glucose (≥126 mg/dL) or HbA1c (≥6.5%). Total diabetes included those who had either diagnosed or undiagnosed diabetes. Prediabetes was defined as an HbA1c level of 5.7%–6.4% or a fasting plasma glucose level of 100–125 mg/dL. All estimates were age standardized to the 2010 US census population for age groups 20–44, 45–64, and 65+ years. All analyses accounted for the complex survey design. Logistic regressions were used to conduct the analyses. ResultsA total of 21,600 (mean, 47.2 years [SD, 14.7]) individuals were analyzed. From 1999 to 2018, the age-standardized prevalence increased significantly from 9.17% to 14.7% (difference, 5.52%; 95% confidence interval [CI], 2.69%–8.35%; P-trend <0.001) for total diabetes, increased from 6.15% to 11.0% (difference, 4.79%; 95% CI, 2.27%–7.32%; P-trend<0.001) for diagnosed diabetes and remained stable from 3.01% to 3.73% (difference, 0.72%; 95% CI, −0.47% to 1.91%; P-trend = 0.19) for undiagnosed diabetes. The age-standardized prevalence of prediabetes increased significantly from 29.5% to 48.3% (difference, 18.8%; 95% CI, 13.3%–24.4%; P-trend<0.001). Disparities persisted with higher prevalence among adults with obesity and populations that have been marginalized, including racial and ethnic minorities, low income, less educated Americans, and those living in food-insecure household. ConclusionsThe prevalence of diabetes and prediabetes increased significantly from 1999 to 2018 among US adults. There are substantial and persistent disparities among racial and ethnic minorities, populations experiencing socio-economic disadvantages, and adults with obesity.

The Impact of Ambient Temperature on Cardiorespiratory Mortality in Northern Greece

It is well-established that exposure to non-optimum temperatures adversely affects public health, with the negative impact varying with latitude, as well as various climatic and population characteristics. This work aims to assess the relationship between ambient temperature and mortality from cardiorespiratory diseases in Eastern Macedonia and Thrace, in Northern Greece. For this, a standard time-series over-dispersed Poisson regression was fit, along with a distributed lag nonlinear model (DLNM), using a maximum lag of 21 days, to capture the non-linear and delayed temperature-related effects. A U-shaped relationship was found between temperature and cardiorespiratory mortality for the overall population and various subgroups and the minimum mortality temperature was observed around the 65th percentile of the temperature distribution. Exposure to extremely high temperatures was found to put the highest risk of cardiorespiratory mortality in all cases, except for females which were found to be more sensitive to extreme cold. It is remarkable that the highest burden of temperature-related mortality was attributed to moderate temperatures and primarily to moderate cold. The elderly were found to be particularly susceptible to both cold and hot thermal stress. These results provide new evidence on the health response of the population to low and high temperatures and could be useful to local authorities and policy-makers for developing interventions and prevention strategies for reducing the adverse impact of ambient temperature.

Device-measured physical activity and sedentary time in a national sample of Luxembourg residents: the ORISCAV-LUX 2 study

BackgroundExisting information about population physical activity (PA) levels and sedentary time in Luxembourg are based on self-reported data.MethodsThis observational study included Luxembourg residents aged 18-79y who each provided ≥4 valid days of triaxial accelerometry in 2016-18 (n=1122). Compliance with the current international PA guideline (≥150 min moderate-to-vigorous PA (MVPA) per week, irrespective of bout length) was quantified and variability in average 24h acceleration (indicative of PA volume), awake-time PA levels, sedentary time and accumulation pattern were analysed by linear regression. Data were weighted to be nationally representative.ResultsParticipants spent 51% of daily time sedentary (mean (95% confidence interval (CI)): 12.1 (12.0 to 12.2) h/day), 11% in light PA (2.7 (2.6 to 2.8) h/day), 6% in MVPA (1.5 (1.4 to 1.5) h/day), and remaining time asleep (7.7 (7.6 to 7.7) h/day). Adherence to the PA guideline was high (98.1%). Average 24h acceleration and light PA were higher in women than men, but men achieved higher average accelerations across the most active periods of the day. Women performed less sedentary time and shorter sedentary bouts. Older participants (aged ≥55y) registered a lower average 24h acceleration and engaged in less MVPA, more sedentary time and longer sedentary bouts. Average 24h acceleration was higher in participants of lower educational attainment, who also performed less sedentary time, shorter bouts, and fewer bouts of prolonged sedentariness. Average 24h acceleration and levels of PA were higher in participants with standing and manual occupations than a sedentary work type, but manual workers registered lower average accelerations across the most active periods of the day. Standing and manual workers accumulated less sedentary time and fewer bouts of prolonged sedentariness than sedentary workers. Active commuting to work was associated with higher average 24h acceleration and MVPA, both of which were lower in participants of poorer self-rated health and higher weight status. Obesity was associated with less light PA, more sedentary time and longer sedentary bouts.ConclusionsAdherence to recommended PA is high in Luxembourg, but half of daily time is spent sedentary. Specific population subgroups will benefit from targeted efforts to replace sedentary time with PA.

Genome-wide Interaction Study with Smoking for Colorectal Cancer Risk Identifies Novel Genetic Loci Related to Tumor Suppression, Inflammation, and Immune Response.

Tobacco smoking is an established risk factor for colorectal cancer. However, genetically defined population subgroups may have increased susceptibility to smoking-related effects on colorectal cancer. A genome-wide interaction scan was performed including 33,756 colorectal cancer cases and 44,346 controls from three genetic consortia. Evidence of an interaction was observed between smoking status (ever vs. never smokers) and a locus on 3p12.1 (rs9880919, P = 4.58 × 10-8), with higher associated risk in subjects carrying the GG genotype [OR, 1.25; 95% confidence interval (CI), 1.20-1.30] compared with the other genotypes (OR <1.17 for GA and AA). Among ever smokers, we observed interactions between smoking intensity (increase in 10 cigarettes smoked per day) and two loci on 6p21.33 (rs4151657, P = 1.72 × 10-8) and 8q24.23 (rs7005722, P = 2.88 × 10-8). Subjects carrying the rs4151657 TT genotype showed higher risk (OR, 1.12; 95% CI, 1.09-1.16) compared with the other genotypes (OR <1.06 for TC and CC). Similarly, higher risk was observed among subjects carrying the rs7005722 AA genotype (OR, 1.17; 95% CI, 1.07-1.28) compared with the other genotypes (OR <1.13 for AC and CC). Functional annotation revealed that SNPs in 3p12.1 and 6p21.33 loci were located in regulatory regions, and were associated with expression levels of nearby genes. Genetic models predicting gene expression revealed that smoking parameters were associated with lower colorectal cancer risk with higher expression levels of CADM2 (3p12.1) and ATF6B (6p21.33). Our study identified novel genetic loci that may modulate the risk for colorectal cancer of smoking status and intensity, linked to tumor suppression and immune response. These findings can guide potential prevention treatments.

Variability in International Society on Thrombosis and Haemostasis-Scientific and Standardization Committee endorsed Bleeding Assessment Tool (ISTH-BAT) score with normal aging in healthy females: contributory factors and clinical significance

BackgroundBleeding assessment tools are key screening tests used in the evaluation of patients with suspected inherited bleeding disorders. The International Society on Thrombosis and Haemostasis-Scientific and Standardization Committee endorsed Bleeding Assessment Tool (ISTH-BAT) has differing reference ranges for adult males (0-3), adult females (0-5), and children (0-2), reflecting differing bleeding symptoms and exposure to hemostatic challenges in these healthy population subgroups. Age is known to markedly impact bleeding score in individuals with von Willebrand disease. However, the influence of age on bleeding score in healthy adult controls is poorly understood. ObjectivesWe aimed to assess variability in ISTH-BAT score with age among healthy control females. MethodsWe used the legacy “Merging Project” dataset of normal healthy controls upon which current ISTH-BAT normal ranges are based. We included women, totaling 646 individuals. The normal range (middle 95th percentile) of total ISTH-BAT and grouped subdomain scores between age quartiles was assessed. ResultsThe normal range of ISTH-BAT scores increased with age, ranging from 0 to 4 in the youngest quartile (age range, 18-30) to 0 to 6 in the oldest (age range, 52-88). This increased variability with aging was related both to high menorrhagia domain scores in older women and an increase in postprocedural bleeding with accumulated exposure to hemostatic challenges. ConclusionsCumulatively, our data highlight that normal aging leads to increased variability in bleeding scores in healthy adult females. Further refinement of the ISTH-BAT with age-adjusted reference ranges may improve the sensitivity and specificity of the tool among females.

Gendered morphologies and walking: Evidence from smartphone tracking data among young adults in Barcelona

AbstractIt is well established that urban form can encourage or hinder daily walking activity. Consequently, urban form has a direct impact on both spatial accessibility and the ability of achieving daily physical activity recommendations. However, the relationship between urban form and walking patterns may present relevant differences among different population subgroups, for instance in terms of gender. In order to analyse how the relationship between urban form and daily walking time might be modulated by gender, the present study aims to explore walking patterns of men and women living in different neighbourhood types in Barcelona Metropolitan Region (Spain). For this purpose, the study uses data extracted from a smartphone tracking app among a rather specific population group: young adults who commute daily to the same destination. The findings show that compact urban forms promote gender equality. The study especially sheds light on the disadvantaged position of young women living in small towns and suburbs, who walk much less than other women and any men.

Healthy, Wealthy, and Happy: The Joint Role of Health and Income in Explaining Global Life Satisfaction

Based on Gallup World Poll data, we explore the heterogeneous evolution of income, health, and well‐being within world population subgroups identified according to country, gender, age, and education, offering an integrated approach with wide geographical coverage. We provide novel evidence on the global “winners” and “losers” in life satisfaction between 2009 and 2018, showing that individuals located at the bottom of the global income distribution and those with poor health saw pronounced reductions in life satisfaction as opposed to populations with incomes falling between the 60th and the 80th centile and the healthy ones, who experienced significant improvements. Our results highlight that health is at least on a par with income in explaining life satisfaction, although there are considerable differences across world regions. In particular, health supersedes income in its relevance to life satisfaction, mostly in more affluent world regions, while the opposite holds in destitute parts of the world.

Generational shifts in attitudes and beliefs about alcohol: An age-period-cohort approach

Introduction and aimsPopulation level alcohol consumption has declined markedly in Australia in the past two decades, with distinct generational patterns. The underlying reason for this shift remains unclear and there has been little work assessing how attitudes and beliefs about alcohol have shifted in population sub-groups. Design and methodsUsing seven waves of survey data spanning 19 years (2001–2019, n = 166,093 respondents aged 14 +), we assess age, time-period and birth cohort effects on trends in four measures of alcohol attitudes (disapproval of regular alcohol use, perceptions of safe drinking levels for men and women and perception that alcohol causes the most deaths of any drug in Australia). ResultsThere were steady increases in period effects for perceived safe drinking levels (especially for men) and belief that alcohol causes the most deaths. Disapproval of regular use has been stable at the population level, but there are marked cohort differences, with early and recent cohorts more likely than others to disapprove of regular alcohol use. Discussions and conclusionsThese findings point to a broad lowering of perceived safe levels of drinking across the population alongside a sharp increase in disapproval of drinking for recent cohorts, potentially contributing to the reductions in drinking that have been reported in these cohorts.