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Objective: To explore the correlation between the risk of ischemic stroke and related risk factors in a health examination population. Methods: This was a retrospective study. A total of 300 subjects undergoing health examination in the physical examination center of Baoding NO.1 Central Hospital were selected from January 2023 to December 2023, and divided into the normal group (Group-N) and the risk group according to the criteria of cerebral hemodynamic integral value(CVHI). The risk group was further subdivided into three groups, including the high-risk group(Group-H), the medium-risk population(Group-M), and the low-risk group(Group-L), with 75 subjects in each group. The general data, including BMI, smoking, and the incidence of hypertension, diabetes, and hyperlipidemia, were analyzed and compared between the two groups. Results: Multivariable logistic regression analysis was conducted using stroke risk factors as the dependent variables after assignment, and it was found that BMI, smoking, hypertension, diabetes, hyperlipidemia, and hyperuricemia were independent risk factors for ischemic stroke (P<0.05); the incidence of obesity and overweight, smoking, hypertension, hyperlipidemia, and hyperuricemia were significantly increased in Group-H compared with those in groups M, L, and N, with statistically significant differences(P<0.05). The chi square test showed statistically significant differences in the stroke risk factors among different age groups (P<0.05). Conclusion: The incidence of ischemic stroke risk factors varies among different age groups in the health examination population, and is related to poor lifestyle and underlying diseases. [ABSTRACT FROM AUTHOR]

We conducted a comprehensive evaluation of COVID-19 vaccine effectiveness in reducing mortality rates in a country with a low vaccination coverage. A retrospective cohort study analysed data from 1,048,574 adult (≥ 18) patients spanning from March 2020 to April 2022, using data from the national digital medical record repository. Univariate analysis and logistic regression calculated odds ratios and their significance. Propensity score matching was utilised to strengthen the statistical results. Among the 1,048,574 patients diagnosed with COVID-19, 73% (n = 780,718) were unvaccinated, and 27% (n = 267,856) were reported as fully vaccinated. Unadjusted statistical analyses revealed a significant reduction in mortality rates among the vaccinated cohort (1,608 deaths; 0.6%) compared to the unvaccinated group (40,985 deaths; 5.2%) [OR 0.1090 (95%CI 0.1037 to 0.1146), p < 0.0001]. This outcome was consistent across all subgroups, including patient sex, age group, in-hospital setting, vaccine type, SARS-CoV-2 variant, and high-risk patient groups (i.e. with a solid malignancy, cardiovascular disease, chronic pulmonary disease or diabetes mellitus). Logistic regression revealed that the highest fatal risk was in non-vaccinated males aged >63. Propensity score matching substantiated the observed reduction in mortality rates across the entire vaccinated cohort and within all patient subgroups. Individuals infected with SARS-CoV-2 face an elevated risk of premature mortality. Vaccination, especially when utilising mRNA-based platforms, significantly mitigates this risk, particularly among high-risk populations. [ABSTRACT FROM AUTHOR]

ObjectiveTo investigate the prevalence and influencing factors of clustering of adverse lifestyle behaviors in populations at high risk of cardiovascular disease (CVD) in Hebei province, thus providing a reference for the prevention and control of CVD in the local population. MethodsInformation on 29 721 residents aged 35 – 75 years who were considered at high risk of CVD was collected from the datasets of the CVD Early Detection and Comprehensive Intervention Project, which was conducted in 11 sites in Hebei province from 2018 to 2021. The clustering and influencing factors of five adverse lifestyle behaviors among the residents were analyzed. ResultsOf the 29 721 residents surveyed, 27 430 (92.29%) reported having at least two or more adverse lifestyle behaviors associated with CVD risk and the numbers (percentages) of reporters were 8 132 (27.36%) for smoking, 3 493 (11.75%) for alcohol consumption, 22 236 (74.82%) for overweight/obesity, 6 725 (22.63%) for high-salt diet, and 15 100 (50.81%) for physical inactivity, respectively. A total of 18 357 (61.76%) of the residents reported the clustering of adverse lifestyle behaviors (with two or more of the five behaviors) and the subgroups of reporting higher clustering of the adverse lifestyle behaviors were those being males (9 745 [79.74%] reporting the clustering), aged 45 – 54 years (4 932, 63.94%), with primary education or below (9 254, 64.70%), with agricultural household registration (15 321, 67.26%), and with annual household income of ≤ 25 000 Chinese yuan (13 836, 66.41%), and being farmers (13 795, 67.72%). Multivariate unconditional logistic regression analysis revealed that being aged 45 – 64 years and having an agricultural household registration were risk factors for clustering of adverse lifestyle behaviors, but being female, having a junior high school education and above, having an annual household income of more than 25 000 Chinese yuan, being a laborer/private/commercial service worker/retired person/housewife/unemployed/and having other occupation were protective factors against the clustering for the residents. ConclusionAdverse lifestyle behaviors are prevalent and particularly clustered among residents at high CVD risk aged 35 – 75 years in Hebei province, and the clustering of adverse lifestyle behaviors was significantly influenced by gender, age, education, household registration, annual household income, and occupation in the population.

HCV infection poses a global health threat, with significant morbidity and mortality. This study examines HCV trends in a large Italian region from 2015 to 2022, considering demographic changes, evolving clinical profiles, treatment regimens and outcomes, including the impact of the COVID‐19 pandemic. This multicentre retrospective study analysed demographics, clinical histories and risk factors in 6882 HCV patients. The study spanned before and after the direct‐acting antiviral (DAA) era, and the COVID‐19 period, focusing on treatment outcomes (SVR12, non‐SVR12 and patients lost to follow‐up). Statistical methods included ANOVA, multinomial logistic regression, Kruskal–Wallis test and chi‐square analysis, and were conducted adhering to the intention‐to‐treat (ITT) principle. The cohort, mainly Italian males (average age 58.88), showed Genotype 1 dominance (56.6%) and a high SVR12 rate (97.5%). The pandemic increased follow‐up losses, yet SVR12 rates remained stable, influenced by factors like age, gender, cirrhosis and comorbidities. Despite COVID‐19 challenges, the region sustained high SVR12 rates in HCV care, emphasising the importance of sustained efforts in HCV care. Continuous screening and targeted interventions in high‐risk populations are crucial for achieving WHO elimination targets. The study highlights the resilience of HCV care during the pandemic and provides insights for future public health strategies. [ABSTRACT FROM AUTHOR]

Background: The α‐Gal syndrome (AGS) is characterized by the presence of specific IgE‐antibodies to the carbohydrate galactose‐α‐1,3‐galactose (α‐Gal). Sensitization to α‐Gal has been associated with tick bites and individuals exposed to ticks have an elevated risk of sensitization. The aim of this study was to analyze IgG and IgE antibody responses to α‐Gal in a high‐risk cohort of forestry employees (FE) in Luxembourg. Methods: Questionnaires and serum samples of FE from Luxembourg (n = 219) were retrospectively analyzed. α‐Gal specific IgE was quantified by ImmunoCAP, α‐Gal specific IgG and subclasses IgG1–4 were determined by ELISA. Additionally, sera from population‐based controls (n = 150) and two groups of food‐allergic patients, patients with AGS (n = 45) and fish‐allergic patients (n = 22) were assessed for IgG antibody responses to α‐Gal and cod extract. Results: Twenty‐one percent of FE was sensitized to α‐Gal (sIgE ≥ 0.1 kUA/L). Both sensitized and non‐sensitized FE exhibited high levels of α‐Gal specific IgG, IgG1 and IgG3 compared with controls, indicating a stimulation of IgG responses by recurrent tick bites, independent of the sensitization status. AGS patients had the highest levels of IgG1 and IgG2 antibodies, whereas the profile of fish‐allergic patients was similar to the profile of the controls for which anti‐α‐Gal responses were dominated by IgG2 antibodies. α‐Gal sIgG4 levels were either very low or undetectable in all groups. Conclusion: Our study provides evidence for a continuous stimulation of α‐Gal related immune responses by repeated tick bites, translating into highly elevated levels of IgG1 antibodies directed against α‐Gal. [ABSTRACT FROM AUTHOR]

Endometrial cancer is the most common gynecological malignancy in high-income countries and the sixth most common cancer in women. Overall incidence has risen in the last few decades as a consequence of the increase in the prevalence of its risk factors, mainly obesity and the aging of the population, and although diagnoses have increased across all age groups, the incidence rates have doubled in women under the age of 40 years. The survival rates of endometrial cancer are highly dependent on its stage at diagnosis, bringing to the fore the importance of early diagnosis. The aim of a screening strategy in this type of tumor should be to detect the disease in the pre-invasive or early stage (before developing myometrial invasion), which would improve cure rates, reduce the morbidity associated with aggressive treatment and offer uterus-sparing management options for younger women. The ideal screening tool in this scenario would be a minimally invasive, inexpensive and easy-to-perform test or auto-test, which could be implemented in a routine gynecologic checkup of patients at-risk or in the general adult population. In this comprehensive review, we aim to define the populations at higher risk of developing endometrial cancer, to assess the performance of current diagnostic tools when used in a screening setting and to discuss the accuracy of new molecular screening strategies. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) is one of the most common chronic respiratory diseases, which seriously threatens people's life, health and quality of life, and imposes a heavy burden on the patients as well as their families and society. Strengthening health education and management for people at high risk of developing COPD and implementing reasonable and effective preventive measures are important means of preventing and controlling COPD, which can not only reduce the risk of developing COPD in high-risk groups, but also reduce unnecessary medical consumption and save social resources. This article reviews the progress of health management in COPD high-risk population. [ABSTRACT FROM AUTHOR]

BACKGROUND: School-based gardening and nutrition education interventions report improvements in dietary intake, notably through fruit and vegetables. However, gardening, cooking, and nutrition randomized controlled trials are limited in evaluating dietary quality, and none have examined processed food consumption to date. OBJECTIVES: The study examined the effects of Texas Sprouts (TX Sprouts), a gardening, cooking, and nutrition education intervention, compared with control on unprocessed and ultra-processed food (UPF) consumption in predominately low-income Hispanic children. METHODS: TX Sprouts was a school-based cluster randomized controlled trial that consisted of 16 elementary schools randomly assigned to either the TX Sprouts intervention (n = 8 schools) or control (delayed intervention; n = 8 schools) over 3 y (2016-2019). TX Sprouts schools received an outdoor teaching garden and 18 1-h lessons taught by trained educators throughout the school year. Dietary intake data via 2 24-h dietary recalls were collected on a random subsample (n = 468) at baseline and postintervention. All foods and beverages were categorized using the NOVA food classification system (e.g., unprocessed, processed, ultra-processed). Generalized linear mixed effects modeling tested changes in percent calories and grams of NOVA groups between the intervention and control estimates with schools as random clusters. RESULTS: Of the sample, 63% participated in the free and reduced-price lunch program, and 57% were Hispanic, followed by non-Hispanic White (21%) and non-Hispanic Black (12%). The intervention, compared to the control, resulted in an increase in consumption of unprocessed foods (2.3% compared with -1.8% g; P < 0.01) and a decrease in UPF (-2.4% compared with 1.4% g; P = 0.04). In addition, Hispanic children in the intervention group had an increase in unprocessed food consumption and a decrease in UPF consumption compared to non-Hispanic children (-3.4% compared with 1.5% g; P < 0.05). CONCLUSIONS: Study results suggest that school-based gardening, cooking, and nutrition education interventions can improve dietary intake, specifically increasing unprocessed food consumption and decreasing UPF consumption. This trial was registered at clinicaltrials.gov as NCT02668744.

Geyi Wen,1,&ast; Jinliang Meng,1,&ast; Puxian Peng,2,&ast; Yanyan Xu,1 Ruiqi Wang,1 Wenlong Cui,2 Aihan Wen,2 Guohong Luo,2 Yunhui Zhang,1 Songyuan Tang2 1Department of Pulmonary and Critical Care Medicine, the First People’s Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, People’s Republic of China; 2Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yunhui Zhang, Department of Pulmonary and Critical Care Medicine, the First People’s Hospital of Yunnan Province, No. 157 Jinbi Road, Xishan District, Kunming, Yunnan, 650032, People’s Republic of China, Email yunhuizhang3188@126.com Songyuan Tang, Institute of Health Studies, School of Public Health, Kunming Medical University, 1168 West Chunrong Road, Yuhua Street, Chenggong District, Kunming, Yunnan, 650500, People’s Republic of China, Email tsythailand@hotmail.comPurpose: Chronic obstructive pulmonary disease (COPD) is a significant disease impacting health and quality of life. Yunnan Province, a major tobacco producer, lacks comprehensive COPD studies. The purpose of this study is to describe the epidemic situation of COPD in Yunnan province and explore its influencing factors.Methods: This study is a cross-sectional research conducted in a representative sample of adults aged 20 and older from 13 prefectures and cities in Yunnan Province, China. COPD was diagnosed using post-bronchodilator pulmonary function tests. Demographics were analyzed with descriptive statistics. The influencing factors of COPD were examined by using the multivariate logistic regression models.Results: Our study found that high-risk individuals for COPD accounted for 20.30% of the screened population aged 20 and above, with a COPD prevalence of 27.18% among this high-risk group. Male had a higher prevalence (33.01%) than did female (16.35%; p< 0.001 for sex difference). Additionally, the proportion of severe and extremely severe COPD cases in Yunnan Province was higher than the national average and other provinces. After considering the potential confounding variables, male (OR=2.291, 95% CI: 1.584– 3.313), age (OR=1.501, 95% CI: 1.338– 1.685), underweight (OR=1.747, 95% CI: 1.225– 2.491), previous smoking (OR=1.712, 95% CI: 1.182– 2.478), passive smoking (OR=1.444, 95% CI: 1.159– 1.800), and a history of respiratory system diseases in childhood (OR=2.010, 95% CI: 1.346– 3.001) were significantly associated with an increased risk of COPD. Conversely, being overweight (OR=0.636, 95% CI: 0.489– 0.828), and residing in high-altitude counties (OR=0.445, 95% CI: 0.263– 0.754) were negatively correlated with the risk of COPD.Conclusion: There is significant prevalence of COPD (27.18%) among high-risk population aged 20 and above in Yunnan Province, China. Apart from male, smoking, BMI and other known risk factors for COPD. We found that high-altitude residence had a lower prevalence of COPD. There is no significant difference in COPD prevalence between Han and ethnic minority populations.Keywords: chronic obstructive pulmonary disease, epidemiological characteristics, influencing factors, high-risk population, China

ObjectivesTo investigate the prevalence of high cancer risk and its influencing factors among women aged 35 – 64 years in the agricultural and herding areas of Hinggan League, Inner Mongolia Autonomous Region, and to provide evidence for local breast cancer prevention and control in the population. MethodsFace-to-face interview with a self-designed questionnaire, clinical examination, and breast cancer screening were conducted from January to December 2022 among 5 000 women aged 35 – 64 years recruited by random sampling in the agricultural and herding areas of six prefectures/counties/banners of Hinggan League, Inner Mongolia Autonomous Region. High risk for breast cancer was assessed using the Gail model according to the determinants listed in the Guidelines and Specifications for Breast Cancer Diagnosis and Treatment of China Anti Cancer Association – 2021. Multivariate non-conditional logistic regression model was used to analyze the main factors influencing the high risk of breast cancer among the participants. ResultsOf the 49 831 valid participants, 13 334 (26.76%) were classified as being at high risk for breast cancer. The multivariate non-conditional logistic regression analysis showed that the participants with the following characteristics were more likely to be at high risk for breast cancer: age 45 – 64 years, Mongolian ethnicity, education of middle school and above, menopausal status, family history of breast cancer, history of breast surgery or biopsy, and breast skin changes on palpation; whereas belonging to other ethnic minorities, living with family members, and previous breast examination were protective factors against being at high risk for breast cancer. ConclusionThe proportion of individuals at high risk of breast cancer was relatively low among women aged 35 – 64 years in the agricultural and herding areas of Hinggan League, Inner Mongolia Autonomous Region. Age, ethnicity, education level, whether living with family members, menopausal status, family history of breast cancer, ever having had a breast examination, history of breast surgery or biopsy, and breast skin changes on palpation are the main influencing factors for having a high risk of breast cancer among women.

Objective To conduct a visual analysis of the current research status on high-risk populations for stroke and explore research hotspots and future trends. Methods Literature related to high-risk populations for stroke was retrieved from the China National Knowledge Infrastructure (CNKI) and Web of Science core databases up to April 2023. CiteSpace6. 2 software was utilized for knowledge map analysis based on article authors, institutions,country, and keywords. Results A total of 1 479 articles were included, comprising 1 169 in Chinese and 310 in English. In addition to topic-related keywords, the high-frequency keywords domestically were risk factors, screening, and hypertension, etc. Internationally, the high-frequency keywords were risk factors, cerebral infarction, and atrial fibrillation, etc. Conclusion The research field of high-risk populations for stroke has a high level of prior research interest. Future attention should be given to the development and utilization of tools for monitoring or predicting stroke risk factors, shifting research focus from population surveys to individual preventive healthcare management. [ABSTRACT FROM AUTHOR]

Objective: From a preventive perspective, this study reviewed the literature on protective factors against depressive symptoms in high-risk children and adolescents. Methods: We conducted a thorough search of the PubMed, APA, EMCare, and Embase databases for studies published between 1946 and August 25, 2023. We included only longitudinal studies that analyzed protective factors for depressive symptoms in high-risk children or adolescents, excluding cross-sectional studies, reviews, and pre-clinical studies. Results: A total of 29 studies with 62,405 participants were analyzed and 38 protective factors were identified. Positive individual characteristics, family factors, peer relationships, school-related aspects, neighborhood characteristics, and intrinsic religiosity were associated with improved depression outcomes. Conclusion: These findings have important implications for preventive strategies in this population. Addressing protective factors can help prevent depression and enhance lifetime mental health.

Ying-Xue Sun,1,&ast; Tian Tang,1,&ast; Jin-Yu Zou,1,&ast; Qian-Qian Yue,1 Li-Feng Hu,1 Tong Peng,1 Xin-Ru Meng,1 Ge-Hui Feng,1 Li-Li Huang,1 Ying Zeng1– 3 1Department of International and Humanistic Nursing, School of Nursing, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China; 2Hunan Province Key Laboratory of Tumor Cellular & Molecular Pathology, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China; 3Hunan Engineering Research Center for Early Diagnosis and Treatment of Liver Cancer, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ying Zeng, Department of International and Humanistic Nursing, School of Nursing, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China, Tel +86 17773486339, Fax + 86 0734-8281344, Email zengying2003@126.comBackground: Colorectal, and gastric cancers have the second, and fourth mortality rates worldwide, respectively. Endoscopic screening is a crucial diagnostic tool for colorectal, and gastric cancers. Effective interventions can improve adherence to endoscopic screening in high-risk populations, which is important for cancer prevention and mortality reduction. This study aimed to identify interventions that could improve adherence to endoscopic screening for cancer in high-risk populations.Methods: Combination keywords including colorectal cancer, gastric cancer, screening adherence, and interventions were used to search for articles in PubMed, Web of Science, Cochrane Library, and MEDLINE Complete. The review methodology was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-SCR).Results: A total of 12 articles were included in this review: 9 randomized controlled trials(RCT) and 3 quasi-experimental studies(QEDs). Among the extracted studies, 11 were about colorectal cancer, and 1 was about gastric cancer. Most studies used lecture-based or Information Technology-based health education interventions. Narrative interventions have proven to be novel and effective approaches for promoting adherence to endoscopic screening. Health education interventions included cancer epidemiology, cancer risk factors, warning symptoms, and screening methods.Conclusion: All interventions involved were effective in increasing individual knowledge of cancer-related endoscopic screening, willingness to undergo screening, and screening behaviors. These findings provide a reference for designing endoscopy-related cancer screening interventions.Keywords: colorectal cancer, gastric cancer, screening adherence, high-risk population

Background: The level of awareness of peripheral artery disease (PAD) in Saudi Arabia, especially among populations at high risk, is not currently well known. Therefore, our objective was to assess the existing level of awareness among patients who are at high risk of PAD, as well as their comprehension of the disease. Method: An interview-based cross-sectional study included 1035 participants with risk factors for PAD and collected data on demographics and knowledge domains related to PAD. Results: The statistical analysis was performed using t-tests and ANOVA. Overall, participants exhibited poor knowledge, with a mean score of 5.7 out of 26. The highest scores were observed in the risk factor and preventive measure domains, with means of 1.8 out of 7 and 1.8 out of 6, respectively. The factors associated with higher knowledge scores included older age, male gender, higher education, healthcare profession, interviews in vascular settings, previous awareness of PAD, and prior cardio-cerebrovascular interventions. Conclusion: This study underscores the inadequate knowledge of PAD among high-risk individuals. Targeted educational initiatives are essential to bridge this knowledge gap, potentially reducing the burden of PAD-related complications and improving patient outcomes. Efforts should focus on raising awareness about PAD, particularly among high-risk populations. [ABSTRACT FROM AUTHOR]

Metformin exerts a good efficacy for gestational diabetes mellitus (GDM) treatment by regulating gluconeogenesis and insulin resistance, while no consensus about its preventive effect on GDM is reached yet. Thus, this meta-analysis aimed to comprehensively investigate the prophylactic administration of metformin in pregnant women at high risk of GDM. Databases (EMBASE, PubMed, Cochrane, CNKI, Wanfang, CQVIP) were searched to screen papers concerning the GDM prevention using metformin in women at high risk of GDM (polycystic ovary syndrome (PCOS), obese, and pregestational insulin resistance patients) until January 2023. Our study showed that five cohort studies and fifteen randomized controlled trials (RCTs) involving 3911 women were included. Pooled analysis showed that prophylactic metformin treatment (vs. control treatment) greatly reduced GDM rate (relative risk (RR) = 0.59, 95% confidence intervals (CI): 0.43–0.80). Subgroup analyses also revealed that prophylactic metformin treatment (vs. control treatment) decreased the GDM rate in the following patients' types: (1) in Asians (RR = 0.31, 95% CI: 0.23–0.41), (2) in PCOS patients (RR = 0.42, 95% CI: 0.26–0.68), and (3) in patients receiving high dose of metformin (mean dose > 1000 mg) (RR = 0.59, 95% CI: 0.42–0.83). Concerning the quality of involved studies, the overall risk of bias was low. Egger's test implied that no publication bias existed in the findings. Moreover, sensitivity analysis suggested the pleasing robustness of the results. In conclusion, prophylactic metformin reduces GDM incidence in high-risk pregnant women, indicating its early-application benefits. [ABSTRACT FROM AUTHOR]

High‐risk populations are the predominant populations affected by hepatitis C virus (HCV) infection, and there is an urgent need for efficient and cost‐effective HCV testing strategies for high‐risk populations to identify potential undiagnosed HCV‐infected individuals. This study compared several commonly used testing strategies and conducted effectiveness and cost analysis to select the appropriate testing strategy for diagnosing HCV infection in high‐risk populations. Among the 2093 samples from high‐risk populations in this study, 1716 were HCV negative, 237 were current HCV infection, 137 were past HCV infection, and three were acute early HCV infection. It was found that out of 237 patients with HCV current infection, Strategy A could detect 225 cases, with a missed detection rate of 5.06%, and the total cost was 33 299 RMB. In addition, Strategy B could detect 237 cases of current HCV infection, and the HCV missed detection rate was 0.00%, and the total cost was 147 221 RMB. While 137 cases of past HCV infection could be distinguished by strategy C, but 14 cases with current HCV infection were missed, with an HCV‐positive missed detection rate of 5.91%, and the total cost for Strategy C was 43 059 RMB. In conclusion, in high‐risk populations, the HCV positivity rate is typically higher. If feasible, the preferred approach is to directly conduct HCV RNA testing, which effectively minimizes the risk of missing cases. However, in situations with limited resources, it is advisable to initially choose a highly sensitive method for anti‐HCV screening, followed by HCV RNA testing on reactive samples. [ABSTRACT FROM AUTHOR]

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ObjectiveTo investigate the high-risk detection rate and aggregation of cardiovascular diseases（CVD） in 8 districts of Shanghai and influencing factors， and to provide scientific references for prevention and control of CVD.MethodsBased on the Cardiovascular Disease Screening and Management Program in Shanghai from 2016 to 2021， 104 685 participants aged 35 to 75 in 8 districts of Shanghai were selected for analysis. χ2 test and multivariate logistic regression were used for statistical analysis of the influencing factors of CVD and aggregation of CVD.ResultsThe proportion of high-risk CVD individuals in the population was 19.17%， including the high-risk individuals with hypertension （8.65%）， dyslipidemia （6.33%）， CVD history （5.58%）， and WHO assessed risk ≥20% types （2.69%）， respectively. Old age， overweight and obesity， central obesity， smoking， drinking， farmers， unmarried， and low family income were the risk factors of CVD， while high education level was the protective factor. In the participants， 16 323 people （81.34%） were classified as CVD high-risk groups； The number of aggregation of 1， 2 and ≥3 high risk types of CVD were 16 323（81.34%）， 3 236（16.13%）， 509（2.54%）， respectively. Old age， low education level， low annual family income， farmers， unmarried， smoking， drinking， overweight， obesity and central obesity were associated with the risk of aggregation of high risk types of CVD， and the correlation strength increased with the increase of aggregation types.ConclusionThe prevention and control of CVD in Shanghai should focus on the hypertension， elderly， overweight， obesity， central obesity， smoking， drinking， low educated， low family income， farmers and unmarried people， and targeted intervention measures should be taken to reduce the risk of CVD among residents.

ObjectiveTo detect individuals at high risk of cardiovascular disease (CVD) and to explore influencing factors of the risk among 35 – 75-year-old residents in Hebei province for prevention and treatment of CVD in the population. MethodsTotally 140 632 permanent residents aged 35 – 75 years were recruited with stratified random cluster sampling in 11 districts/counties/prefectures covered by the CVD high-risk population screening and comprehensive intervention program across Hebei province. Face-to-face interview with a questionnaire designed by domestic researchers, physical examination, and detections of serum lipids and fasting blood glucose were conducted among the participants from September 2016 through November 2020. The CVD risk was evaluated based on any of the followings: history of cardiovascular and cerebrovascular diseases, hypertension, dyslipidemia and with 10-year risk of ≥ 20% for CVD assessed according the ‘risk prediction charts’ published by World Health Orgaization. The detection rate of individuals at high risk of CVD and influencing factors of CVD risk were analyzed. ResultsAmong the 137 115 participants (97.50% of all residents surveyed) with eligible responses, 33 297 (24.3%) were assessed as being at high CVD risk. The results of multivariate unconditional logistic regression analysis showed that aged 50 years and above, living in rural areas, smoking, hypertension, diabetes, dyslipidemia, and obesity were risk factors of having a high-risk of CVD, while, being female and with the education of junior middle school were protective factors against CVD risk among 35 – 75 years old residents in Hebei province. ConclusionThe proportion of individuals at high risk of CVD is relatively high and the risk is mainly influenced by gender, age, education, living residence, hypertension, diabetes, dyslipidemia, and obesity among 35 – 75-year-old residents in Hebei province.

ObjectiveA high-risk group of diabetes in a community in Shanghai was followed up for 2 years. The level of blood glucose control was monitored， the incidence and risk factors of the high-risk group were analyzed， and the incidence and risk factors distribution in the community were studied. The results will provide a basis for the community to formulate strategies for early prevention and treatment of diabetes in Shanghai.MethodsA total of 580 subjects were collected， according to the criteria of high-risk groups of diabetes. Among them， 77 people whose blood glucose had reached the diagnostic criteria for diabetes entered the patient group， and the rest 503 people entered the high-risk group. Corresponding intervention methods such as outpatient follow-up and health education were given， and blood glucose monitoring was repeated at the 12th month and 24th month after enrollment. Blood glucose control， new-onset diabetes and the effect of intervention were analyzed.ResultsThe patients’ venous fasting blood glucose level at the 12th and 24th month was significantly lower than that at the baseline survey， and there was no significant change in body mass index （BMI） and waist circumference. Subjects in patient group were older and had a higher proportion of a history of impaired glycemic regulation， family history of diabetes， hypertension， and hyperlipidemia than those in high-risk group. In the high-risk group of 503 cases， 74 （14.7%） were new-onset diabetics during the follow-up period， A higher proportion of new-onset diabetics were male， BMI， a combined history of impaired glucose regulation and gestational diabetes history of gestational diabetes mellitus （women only） was a contributing factor to the onset of diabetes.ConclusionHigh-risk groups are more susceptible to diabetes； patients in the diabetes group have better control of fasting blood glucose levels during the 2-year follow-up period， and outpatient follow-up combined with comprehensive interventions helps diabetic patients to control blood glucose.

IntroductionStudies on human T-lymphotropic virus 1/2 (HTLV-1/2) infection are scarce in incarcerated population. Therefore, this study estimated the prevalence of HTLV-1/2 infection among prisoners of the major penitentiary complex of Goiás State, Central-West Brazil, comparing it with available data from other Brazilian regions.MethodsA cross-sectional study was conducted with 910 prisoners of the major penitentiary complex in the State of Goiás, Central-West Brazil. All participants were interviewed, and their serum samples were tested for anti-HTLV-1/2 using an enzyme-linked immunosorbent assay (ELISA; Murex HTLV-I + II, DiaSorin, Dartford, UK). Seropositive samples were submitted for confirmation by a line immunoassay (INNO-LIA HTLV I/II, Fujirebio, Europe N.V., Belgium).ResultsThe majority of participants were males (83.1%), between 25 and 39 years old (56.1%; mean age: 31.98 years), self-reported brown ethnicity (56.2%) and reported 9 years or less of formal education (41.4%). Most reported using non-injectable illicit drugs and various sexual behaviors that present risk for sexually transmitted infections (STIs). The prevalence of anti-HTLV-1/2 was 0.33% (95% CI: 0.07–0.96), HTLV-1 (0.22%) and HTLV-2 (0.11%). The two HTLV-1 seropositive prisoners reported high-risk sexual behaviors, and the HTLV-2 seropositive individual was breastfed during childhood (> 6 months) by her mother and three other women.ConclusionThese data revealed a relatively low seroprevalence of HTLV-1/2 in prisoners in Central-West Brazil, and evidence of HTLV-1 and HTLV-2 circulation in the major penitentiary complex of Goiás State. Given the prevalence of high-risk sexual behaviors, there is a crucial need to intensify education and health programs in prisons to effectively control and prevent HTLV-1/2 and other STIs.

Introduction: Sexually transmitted infections (STIs) present significant global and national health challenges, particularly in India. Objective: This study investigates the prevalence and characteristics of STIs among attendees at the Suraksha clinic in the Apex Regional STD Centre, Safdarjung Hospital. Methods: Retrospective data from January 2018 to December 2022 were statistically analyzed using Excel and SPSS. The study includes the examination for diagnosis of various STIs, such as syphilis, HIV, gonorrhea, chlamydiasis, trichomoniasis, candidiasis, bacterial vaginosis (BV), chancroid and genital herpes. . Gender distribution and syndromic diagnoses, including Vaginal/Cervical Discharge and Genital ulcers, were also considered. Referrals to Integrated Counseling and Testing Centres for HIV testing were analyzed. Results: The results reveal a substantial burden of STIs, with 3.06% showing reactivity to syphilis , 1.74% testing positive for HIV, 3.36% for Gonorrhoea, 11.78% for Chlamydiasis, 1.05% for Trichomoniasis, 26.24% for Candidiasis, 9.97% for Bacterial Vaginosis (BV), 7.80% for Chancroid, 11.64% for Herpes genitalis , and 4.01% for other non STI infections. Attendees' interactions included 34.36% of referrals to Integrated Counseling and Testing Centres for HIV testing. The gender distribution showed 58.92% male and 40.94% female attendees. Conclusion: Syndromic diagnoses, including Vaginal/Cervical Discharge (21.22%) and Genital Warts (8.00%), highlight prevalent conditions, necessitating routine screening, early detection, and targeted interventions for effective disease control and prevention. These findings underscore the significance of integrated screening, patient education, and proactive strategies to safeguard public health in the face of rising STI rates.

Background: Various predictive models have been published to identify outpatients with inadequate colonic cleansing who may benefit from intensified preparations to improve colonoscopy quality. The main objective of this study was to compare the accuracy of three predictive models for identifying poor bowel preparation in outpatients undergoing colonoscopy. Methods: This cross-sectional study included patients scheduled for outpatient colonoscopy over a 3-month period. We evaluated and compared three predictive models (Models 1–3). The quality of colonic cleansing was assessed using the Boston Bowel Preparation Scale. We calculated the area under the curve (AUC) and the corresponding 95% confidence interval for each model. Additionally, we performed simple and multiple logistic regression analyses to identify variables associated with inadequate colonic cleansing and developed a new model. Results: A total of 649 consecutive patients were included in the study, of whom 84.3% had adequate colonic cleansing quality. The AUCs of Model 1 (AUC = 0.67, 95% CI [0.63–0.70]) and Model 2 (AUC = 0.62, 95% CI [0.58–0.66]) were significantly higher than that of Model 3 (AUC = 0.54, 95% CI [0.50–0.58]; p < 0.001). Moreover, Model 1 outperformed Model 2 (p = 0.013). However, the new model did not demonstrate improved accuracy compared to the older models (AUC = 0.671). Conclusions: Among the three compared models, Model 1 showed the highest accuracy for predicting poor bowel preparation in outpatients undergoing colonoscopy and could be useful in clinical practice to decrease the percentage of inadequately prepared patients. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a major global public health concern. Although the incidence of TB in China is declining, the country continues to face many challenges regarding TB control. This study aimed to develop an active case finding (ACF) strategy for high-risk populations in areas with high TB burden and evaluate the effectiveness of the ACF strategy for early TB detection in patients to reduce TB transmission. This was a descriptive study. From May to October 2019, active TB screening was conducted in Zhejiang Province, China. Overall, 24 high-burden townships were chosen as study sites. Residents aged ≥65 years, suffering from diabetes, diagnosed with HIV/AIDS, or with a history of TB were mobilized for screening. Chest radiography was performed for all participants in the community. Sputum specimens were collected for sputum smear tests and cultures at county-level TB-designed hospitals. A professional medical team performed the final diagnoses. Overall, 130,643 residents were included, accounting for 8.85% of the total population in the selected areas. After screening, 89 confirmed cases and 419 suspected cases were identified. The detection rates for suspected and confirmed cases were 320.72/100,000 and 68.12/100,000, respectively. Individuals with a history of TB accounted for a large proportion of detected cases, and the detection rate was higher among males than in females. This study identified 10.5% of reported cases in the selected areas in 2019. In Zhejiang province, compared with the previous year, the rates of TB notification in 2019 and 2020 declined by 7.0% and 7.4%, respectively, compared with the previous year. However, the TB notification rate in 2019 was almost the same as that in 2018 (a decline of 2.5%) but sharply declined in 2020 (14.4%) in the screened areas. Our findings suggest that the ACF strategy may have helped to maintain the downward trends in TB notification rates by detecting patients with TB and suspected cases in the short term. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has caused severe worldwide health concerns since its first description as the SARS-COV-2 virus in December 2019. The wide dissemination of this virus, together with the lack of treatment, prompted vaccine development within a short period of time to elicit a protective immunity against COVID-19. Due to their rapid development, potential subsequent side effects of COVID-19 vaccines were overlooked, which might lead to many health concerns. This is especially true for patients at a greater risk of harm from COVID-19, such as pregnant women, children, and patients with pre-existing chronic diseases. In this review, we provide a summary of common to rare side effects of administrated COVID-19 vaccines in a Middle Eastern population. We have found that the distinction between side effects from COVID-19 vaccines in terms of frequency and severity is attributed to the differences in study populations, gender, and age. Pain at the injection site, fever, headache, fatigue, and muscle pain were the most common reported side effects. Vaccinated subjects with previous COVID-19 infection exhibited an equivalent neutralizing response after just one dose compared to two doses of vaccine. Consequently, individuals who experienced more side effects had significantly higher antibody levels. This indicates that having better immunity correlates with higher antibody levels, leading to a higher frequency of vaccine side effects. Individuals with underlying comorbidities, particularly having known allergies and with illnesses such as diabetes and cancer, might be more prone to post-vaccination side effects. Studies of a high-risk population in Middle Eastern countries are limited. Future studies should be considered to determine longterm side effects, side effects after booster doses, and side effect differences in cases of heterologous and homologous vaccination for better understanding and proper handling of high-risk populations and patients who experience these side effects. [ABSTRACT FROM AUTHOR]

Hepatitis E virus (HEV) infection is one of the most common causes of acute viral hepatitis. Most patients with HEV infection are asymptomatic and the virus can be spontaneously eliminated. Pregnant women, the elderly, immunocompromised populations, patients with chronic liver disease, and individuals in close contact with HEV-infected animals are at a high risk for HEV infection. The recombinant hepatitis E vaccine HEV 239 is the only approved hepatitis E vaccine, with both short- and long-term protective efficacy. This vaccine has a favorable safety profile with few adverse events, and the high-risk populations should be given the priority to receive such vaccination. Immunocompromised individuals may develop chronic HEV infection. Ribavirin and interferon are currently the most commonly used antiviral drugs for the treatment of HEV infection； however, it still needs to develop safe and effective novel antiviral drugs for patients with contraindications to ribavirin or interferon or those who have no response to such therapy. [ABSTRACT FROM AUTHOR]

Abstract Aims Psychotic-like experiences (PLEs), especially for persistent PLEs, are highly predictive of subsequent mental health problems. Hence, it is crucial to explore the psychopathological associations underlying the occurrence and persistence of PLEs. This study aimed to explore the above issues through a longitudinal dynamic network approach among PLEs and psychological and psychosocial factors. Methods A total of 3,358 college students completed two waves of online survey (from Oct 2021 to Oct 2022). Socio-demographic information was collected at baseline, and PLEs, depressive and anxiety symptoms, and adverse life events were assessed in both waves. Cross-lagged panel network analyses were used to establish networks among individuals with baseline PLEs as well as those without. Results At baseline, 455(13.5%) students were screened positive for PLEs. Distinct dynamic network structures were revealed among participants with baseline PLEs and those without. While ‘psychomotor disturbance’ had the strongest connection with PLEs in participants with baseline PLEs, ‘suicide/self-harm’ was most associated with PLEs in those without. Among all three subtypes of PLEs, bizarre experiences and persecutory ideation were the most affected nodes by other constructs in participants with baseline PLEs and those without, respectively. Additionally, wide interconnections within the PLEs construct existed only among participants without baseline PLEs. Conclusions The study provides time-variant associations between PLEs and depressive symptoms, anxiety symptoms, and adverse life events using network structures. These findings help to reveal the crucial markers of the occurrence and persistence of PLEs, and shed high light on future intervention aimed to prevent and relieve PLEs.

The COVID-19 pandemic has caused severe worldwide health concerns since its first description as the SARS-COV-2 virus in December 2019. The wide dissemination of this virus, together with the lack of treatment, prompted vaccine development within a short period of time to elicit a protective immunity against COVID-19. Due to their rapid development, potential subsequent side effects of COVID-19 vaccines were overlooked, which might lead to many health concerns. This is especially true for patients at a greater risk of harm from COVID-19, such as pregnant women, children, and patients with pre-existing chronic diseases. In this review, we provide a summary of common to rare side effects of administrated COVID-19 vaccines in a Middle Eastern population. We have found that the distinction between side effects from COVID-19 vaccines in terms of frequency and severity is attributed to the differences in study populations, gender, and age. Pain at the injection site, fever, headache, fatigue, and muscle pain were the most common reported side effects. Vaccinated subjects with previous COVID-19 infection exhibited an equivalent neutralizing response after just one dose compared to two doses of vaccine. Consequently, individuals who experienced more side effects had significantly higher antibody levels. This indicates that having better immunity correlates with higher antibody levels, leading to a higher frequency of vaccine side effects. Individuals with underlying comorbidities, particularly having known allergies and with illnesses such as diabetes and cancer, might be more prone to post-vaccination side effects. Studies of a high-risk population in Middle Eastern countries are limited. Future studies should be considered to determine long-term side effects, side effects after booster doses, and side effect differences in cases of heterologous and homologous vaccination for better understanding and proper handling of high-risk populations and patients who experience these side effects.

Objective To explore the potential classification and characteristics of unhealthy lifestyle behaviors in high -risk population of stroke. Methods From August to September 2022, a questionnaire survey was conducted among 500 high-risk stroke patients aged 40 and over in a community of Guangdong Province by convenience sampling method, including general demographic data, unhealthy lifestyle behaviors and knowledge of stroke prevention and treatment. Latent class analysis and unordered multinomial logistic regression analysis were used to explore the potential class distribution characteristics and influencing factors of unhealthy lifestyle characteristics in high-risk groups. Results The high-risk groups could be divided into three potential categories: "basically healthy lifestyle groupn (Cl, 67.20%), "sedentary-lack of exercise group" (C2, 21.60%), and aunhealthy lifestyle -prominent smoking group" (C3, 11.20%). Compared with abasically healthy lifestyle group'; people aged 40 to 59 years old were more likely to be classified as asedentary-lack of exercise groupn (OR =2.160, 95%CI: 1.249-3.734, P < 0.05), and tliose with high score of prevention and treatment knowledge were more likely to be classified as "sedentary-lack of exercise group" compared with aunhealthy lifestyle -prominent smoking group" (OR =0.935, 95%CI: 0.887-0.985, P<0.05). Compared with the "basically healthy lifestyle group笃 men (OR =29.682, 95%CI: 9.758-90.283, P <0.05), living alone (OR=2.727, 95%CI: 1.117-6.656, P<0.05), and non-hypertension (OR=2.51 & 95%CI: 1312-4.831, P < 0.05) group were more likely to be classified as aunhealthy lifestyle-prominent smoking group". Conclusion Attention should be paid to the heterogeneity of lifestyle characteristics of stroke high -risk groups, and targeted intervention measures should be given to different types of high-risk groups. [ABSTRACT FROM AUTHOR]

Lung cancer screening with low-dose computer tomography (CT) has been shown to reduce the lung cancer mortality in high-risk individuals by 20%. Despite the proven mortality benefit, the utilization of lung cancer screening among high-risk populations remains low. This study explores the prevalence of high-risk population for developing lung cancer among hospitalized women and evaluates the screening behavior toward other common cancers during a hospital stay. This is a cross-sectional study in which 248 cancer-free hospitalized women aged 50–75 years who reported current or prior smoking were enrolled during hospital admission at an academic center. A bedside survey was conducted to collect socio-demographic, cancer screening behavior, and medical comorbidities for the study patients. Unpaired t-test and Chi-square tests were used to compare characteristics and common cancer screening behavior by lung cancer risk stratification. Forty-three percent of the hospitalized women were at intermediate to high-risk for developing lung cancer risk. Intermediate to high-risk women were more likely to be older, Caucasian, retired, or with a disability, and had higher comorbidity burden as compared to the low-risk group. Women at low and intermediate to high risk were equally non-adherent with breast (35% vs 31%, p = 0.59) and colorectal (32% vs 24%, p = 0.20) cancers screening guidelines. Only 38% of women from the intermediate to the high-risk group had a CT chest within the last year. The study's findings suggest that almost half of the hospitalized women who report current or past smoking are at high-risk for developing lung cancer. [ABSTRACT FROM AUTHOR]

With the introduction of the Hospital Readmissions Reduction Program, hospitals have been under pressure to reduce their readmission rates by providing quality post-discharge care and avoiding financial penalties. Although some readmissions are expected and planned, the majority are not, and these additional costs have created a financial strain on the federal government and the hospital systems. Decreasing readmission rates is pivotal to the ever-increasing healthcare costs in the United States and the population's overall health. Readmission rates are highest in Medicare and Medicaid patients, high-risk populations, and low socioeconomic communities due to additional challenges they face once leaving the hospital. One intervention that could decrease these rates is incorporating telehealth in transition care management. Telehealth has shown to be a sustainable and effective method to provide post-discharge care to patients with a higher risk of readmission using different forms of technology. With comprehensive telehealth training, successful remote medical and social guidance can be an option to help reduce admissions in high-risk populations. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is a major malignancy threatening the health of people in China and screening could be effective for preventing the occurrence and reducing the mortality of CRC. We conducted a multicenter, prospective clinical study which recruited 4,245 high‐risk CRC individuals defined as having positive risk‐adapted scores or fecal immunochemical test (FIT) results, to evaluate the clinical performance of the multitarget fecal immunochemical and stool DNA (FIT‐sDNA) test for CRC screening. Each participant was asked to provide a stool sample prior to bowel preparation, and FIT‐sDNA test and FIT were performed independently of colonoscopy. We found that 186 (4.4%) were confirmed to have CRC, and 375 (8.8%) had advanced precancerous neoplasia among the high CRC risk individuals. The sensitivity of detecting CRC for FIT‐sDNA test was 91.9% (95% CI, 86.8–95.3), compared with 62.4% (95% CI, 54.9–69.3) for FIT (P < 0.001). The sensitivity for detecting advanced precancerous neoplasia was 63.5% (95% CI, 58.3–68.3) for FIT‐sDNA test, compared with 30.9% (95% CI, 26.3–35.6) for FIT (P < 0.001). Multitarget FIT‐sDNA test detected more colorectal advanced neoplasia than FIT. Overall, these findings indicated that in areas with limited colonoscopy resources, FIT‐sDNA test could be a promising further risk triaging modality to select patients for colonoscopy in CRC screening. [ABSTRACT FROM AUTHOR]

Abstract Objective To explore the status quo and influencing factors for health-promoting lifestyle in the rural populace with high risk of cardiovascular and cerebrovascular diseases, and to provide reference for developing primary prevention strategies for cardiovascular and cerebrovascular diseases. Method Questionnaire-based survey of 585 cases of high-risk cardiovascular and cerebrovascular population in 11 administrative villages in Fuling of Lishui city was conducted using the Health Promoting Lifestyle Profile-II (HPLP II), Perceived Social Support from Family Scale (PSS-Fa), General Health Questionnaire (GHQ-12), and other questionnaire tools. Results The total score of the health-promoting lifestyle in the rural populace with high risk of cardiovascular disease is 125.55 ± 20.50, which is at an average level, and the mean scores of each dimension in descending order are—nutrition, interpersonal support, self-actualization, stress management, health responsibility, and exercise. Monofactor analysis revealed that age, education level, marriage, monthly per capita household income, physical activity based on the International Physical Activity Questionnaire (IPAQ), family support function, carotid intima-media thickness, and blood pressure were influencing factors for the health-promoting lifestyle in the rural populace with high risk of cardiovascular and cerebrovascular diseases (P

ObjectiveTo analyze the results of colonoscopy screening on colorectal cancer among high risk individuals assessed from permanent residents of Shenzhen city during 2017 – 2019 for providing evidence to the optimization of strategies on the screening. MethodsTotally 6 2 60 permanent adult residents (aged 40 – 74 years) were assessed as having high risk of colorectal cancer based on the survey results of Major Cancer Early Diagnosis and Treatment Project in Urban Population conducted in Shenzhen city from May 2017 through August 2019. Of the high-risk individuals, 2 622 received colonoscopy examination and the data on 1 371 examinees with complete information of questionnaire interview and clinical examination were analyzed. ResultsThe compliance rate of colonoscopy examination was 41.88% for all the high-risk individuals identified in the project-based survey. Among the 1 371 colonoscopy examinees included in the analysis, the detection rate was 0.22% (3 cases) for colorectal cancer, 11.09% (152) for precancerous lesion, 34.50% (473) for benign polyps, 6.27% (86) for inflammatory bowel disease, 2.77% (38) for benign polyps combined with inflammatory lesion, and 10.80% (148) for other colorectal diseases, respectively. For the 1 371 examinees, the detection rate of precancerous lesions and benign polyps differed significantly by gender, age, body mass index, and salty food preference, while gender and salty food preference were also significantly related to the detection rate of other colon diseases (all P < 0.05); the detection rate of benign polyps combined with inflammatory lesion was influenced significantly by the frequency of fruit and meat consumption (both P < 0.05); and the detection rate of inflammatory bowel disease was significantly associated with tea drinking (P < 0.05). ConclusionIn urban Shenzhen, the compliance rate of colonoscopy examination is relatively high but the detection rate of various pathological lesions is low and influenced by multiple demographic and individual characteristics among the adult residents at high risk of colorectal cancer. The results suggest that both the scheme of colorectal cancer screening and the identification of high risk individuals need to be optimized for early diagnosis and treatment of the disease.

Objective To analyze the epidemiological characteristics of high-risk populations for chronic kidney diseases (CKD) based on the screening data of community health centers in Jing'an and Minhang Districts of Shanghai from 2016 to 2018. Methods The screening data of high-risk CKD population in community health service centers in Jing'an and Minhang Districts of Shanghai were collected. The differences in the detection rate of CKD among high-risk population with different gender, age and disease history were compared and the influencing factors were analyzed. Results The detection rate of CKD in high-risk population in community was 14.71%, and those with early CKD (stage 1 and 2) accounted for the majority (84.57%). The detection rate of CKD was higher in the female high-risk group than the male group (Chi-square=202.158, P < 0.01), and in the elderly group than the non-elderly group (Chi-square=16.294, P < 0.01). The subjected high-risk individuals had complicated medical history, and those (61.77%) having a history of hypertension ranked first in number. The detection rate of CKD was higher in the patients with hypertension than those without (Chi-square=67.837, P < 0.01), and in those without diabetes than those with (Chi-square=13.978, P < 0.01). Based on the 6 risk factors (gender, age 65 and above, hypertension, diabetes, hyperuricemia and family history of kidney disease), the highest detection rate was found among the 392 patients with 4 risk factors, with 84 patients (21.43%) having CKD. Conclusion Gender, age, hypertension and diabetes mellitus are the risk factors of CKD, the detection rate of CKD is higher in female population and older people with hypertension but not diabetes.

Gastric adenocarcinoma is one of the most frequent and deadly cancers worldwide. However, its incidence is variable, being higher in eastern countries where screening the general population is recommended. On the other hand, in low to intermediate-risk countries, screening the general population may not be cost-effective, and therefore, it is necessary to be aware of high-risk populations that may benefit from adequate screening and surveillance. It is not always easy to identify these individuals, leading to a late diagnosis of gastric adenocarcinoma. In this review, the authors intend to summarize the data required to identify the population at risk of sporadic or familial gastric adenocarcinoma and the beginning of screening and its surveillance, with the final aim of increasing early detection of gastric adenocarcinoma and decreasing morbimortality. The authors highlight the importance to be aware of the several hereditary syndromes and MAPS recommendations and apply screen and surveillance protocols. The high-risk syndromes to gastric adenocarcinoma are gastric adenocarcinoma and proximal polyposis of the stomach, hereditary diffuse gastric cancer, and familial intestinal gastric cancer.

Objective To study the compliance to endoscopic screening and its influencing factors among high-risk population of upper gastrointestinal cancer (UGC) in urban Beijing and to provide evidence for developing appropriate health management strategies. MethodsWith cluster sampling, we recruited 73 240 permanent residents aged 40 – 69 years from designated communities of Beijing Cancer Early Diagnosis and Treatment Project in six urban districts of Beijing and conducted a face-to-face questionnaire survey on demographic and UGC-related information among the residents from September 2016 to March 2020. The residents assessed as at high-risk of UGC were advised to have endoscopic screening in designated hospitals. The acceptance of the endoscopic screening and its influencing factors among the high-risk people were analyzed. ResultsValid responses were collected from all the participants and 23.0% (n = 16 862) of them were assessed as at high-risk of UGC. Of the high-risk participants, 11.9% (n = 2 004) received endoscopic screening. The results of unconditional multivariate logistic regression analysis showed that the high-risk participants with following characteristics were more likely to have a high compliance to endoscopic screening: aged over 50 years, with the education of senior high/technical secondary school and above, suffering from psychic trauma or depression, with upper gastrointestinal disease history, with family history of cancer, having hot food preference in daily diet, and being exposed to a little or much kitchen fume when cooking at home; while the high-risk participants being current smoker and having regular physical exercise were more likely to have low compliance to endoscopic screening. ConclusionAmong high UGC risk population in urban Beijing, the overall compliance to endoscopic screening was poor and the compliance was influenced mainly by age, education, psychic trauma or depression, history of upper gastrointestinal diseases, family history of cancer, current smoking, regular physical activity, hot food preference in daily diet and kitchen fumes exposure at home.

Lifestyle physical activity (PA) and nutrition are known to be effective interventions in preventing and managing obesity-related comorbidities among adult populations but less so among children and adolescents. We examined the effectiveness of lifestyle interventions in children from minority ethnic populations in Western high-income countries (HICs). Our systematic review included 53 studies, involving 26,045 children from minority ethnic populations who followed lifestyle intervention programmes lasting between 8 weeks and 5 years with the aim of preventing and/or managing childhood obesity and associated comorbidities, including adiposity and cardiometabolic risks. The studies were heterogenous in terms of lifestyle intervention components (nutrition, PA, behavioural counselling) and settings (community vs. schools and after-school settings). Our meta-analysis included 31 eligible studies and showed no significant effects of lifestyle interventions when they focused on body mass index (BMI) outcomes (pooled BMI mean change = −0.09 (95% CI = −0.19, 0.01); p = 0.09). This was irrespective of the intervention programme duration (<6 months vs. ≥6 months), type (PA vs. nutrition/combined intervention) and weight status (overweight or obese vs. normal weight) as all showed nonsignificant effects in the sensitivity analysis. Nonetheless, 19 of the 53 studies reported reductions in BMI, BMI z-score and body fat percentage. However, the majority of lifestyle interventions adopting a quasi-design with combined primary and secondary obesity measures (11 out of 15 studies) were effective in reducing the obesity comorbidities of cardiometabolic risks, including metabolic syndrome, insulin sensitivity and blood pressure, in overweight and obese children. Preventing childhood obesity in high-risk ethnic minority groups is best achieved using combined PA and nutrition intervention approaches, which jointly target preventing obesity and its comorbidities, especially the outcomes of diabetes, hypertension and cardiovascular disease. Therefore, public health stakeholders should integrate cultural and lifestyle factors and contextualise obesity prevention strategies among minority ethnic groups in Western HICs. [ABSTRACT FROM AUTHOR]

Objective: To understand the dietary intake of high-risk population with hypertension in Haikou, and to analyze the relationship between dietary intake and blood pressure, especially the relationship between sodium intake and blood pressure, so as to provide a scientific basis for salt reduction. Methods: A multi-stage cluster sampling was used from July to December 2021 to collect 3-4 community service centers from each of the four districts in Haikou. A total of 15 community service centers were collected, and 295 permanent residents aged 55-74 were recruited from 15 community service centers, with 20 eligible subjects from each community. The subjects underwent general physical examination and laboratory tests, and a dietary survey was conducted using the self-developed Android phone APP "Nutrition Assistant" (registration number: 2021SR1547832). SPSS 21.0 was used for t test, χ² test and multiple regression analysis. Results: In Haikou, 69.4% of the subjects had energy intake above energy requirement, and 44.8% had fat intake above the acceptable range of macronutrients. There were only differences in energy, carbohydrate, vitamin B 6 and sodium intake (t=-2.174, -1.990, 2.333, -5.442, P=0.031, 0.048, 0.021, <0.001, respectively). There were significant differences in BMI, family history of chronic diseases, systolic blood pressure and diastolic blood pressure (F value or χ² value=4.260, 19.045, 139.916, 36.864, P value=0.015, <0.001, <0.001, <0.001, respectively). Multiple regression analysis analysis showed that 24h sodium excretion was significantly correlated with systolic and diastolic blood pressure (t = 12.964, P<0.001), and for every 1 mmol increase in sodium excretion, systolic and diastolic blood pressure increased by 0.135 mmhg and 0.068 mmhg, respectively. Conclusion: The dietary intake of the middle-aged and elderly people at high risk of hypertension in the Haikou community was unbalanced, and the intake of sodium salt was strongly correlated with blood pressure, so it is necessary to continue to promote salt reduction as one of the key ways to prevent and control hypertension. [ABSTRACT FROM AUTHOR]

Abstract Colorectal cancer (CRC) is a major malignancy threatening the health of people in China and screening could be effective for preventing the occurrence and reducing the mortality of CRC. We conducted a multicenter, prospective clinical study which recruited 4,245 high‐risk CRC individuals defined as having positive risk‐adapted scores or fecal immunochemical test (FIT) results, to evaluate the clinical performance of the multitarget fecal immunochemical and stool DNA (FIT‐sDNA) test for CRC screening. Each participant was asked to provide a stool sample prior to bowel preparation, and FIT‐sDNA test and FIT were performed independently of colonoscopy. We found that 186 (4.4%) were confirmed to have CRC, and 375 (8.8%) had advanced precancerous neoplasia among the high CRC risk individuals. The sensitivity of detecting CRC for FIT‐sDNA test was 91.9% (95% CI, 86.8–95.3), compared with 62.4% (95% CI, 54.9–69.3) for FIT (P

Jingnuo Ding, Weifeng Zhao Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, Suzhou, JiangSu Province, 215000, People’s Republic of ChinaCorrespondence: Weifeng Zhao, Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Gusu District, Suzhou, JiangSu Province, 215000, People’s Republic of China, Tel +86 13360518767, Email zhaoweifeng@suda.edu.cnAbstract: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors of the digestive system and has a 5-year overall survival rate of 14.1%. Many HCC patients are diagnosed at an advanced stage, and thus early screening is essential for reducing the mortality of HCC. In addition to commonly used detection indicators such as serum alpha-fetoprotein (AFP), lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3) and abnormal prothrombin (protein induced by vitamin K absence II, PIVKA-II), liquid biopsy techniques have been demonstrated to have diagnostic value in HCC detection. Compared with invasive procedures, liquid biopsy can detect circulatory metabolites of malignant neoplasms. Liquid biopsy techniques can detect circulating tumor cells, circulating tumor DNA, circulating RNA and exosomes and have been used in the early screening, diagnosis and prognostic evaluation of HCC. This paper reviews the molecular biological characteristics and application of different liquid biopsy techniques, and aim to highlight promising biomarkers that may be feasible options for early-stage HCC evaluation to improve early screening in populations at high risk for HCC.Keywords: liquid biopsy techniques, hepatocellular carcinoma, high-risk population

Objective To investigate the application value of serum auto-antibody detection combined with low-dose spiral computed tomography (LDCT) in early lung cancer screening. Methods From 12568 medical examination crowd (7453 males and 5115 females), 1324 people with high-risk cases of lung cancer in our medical examination center were divided randomly into three groups (LDCT, serum auto-antibody, and serum auto-antibody combined with LDCT groups). All people in this research were screened by chest X-ray. Follow-up was conducted for one year, and the positive screening and diagnosis rates of early lung cancer screening were compared between these groups of high-risk people with lung cancer. Results The positive screening and diagnostic rates of high-risk lung cancer in the serum auto-antibody combined with LDCT group was significantly higher those that in other two groups (P < 0.001). The specificity and sensitivity of serum auto-antibody combined with LDCT group were 89.1% and 88.4%, respectively; the area under the ROC curve was 0.863. Conclusion Serum auto-antibody detection combined with low-dose spiral CT can significantly improve the positive screening rate of lung cancer in high-risk populations, providing a strong theoretical support for lung cancer screening pathway.

Objective: To explore the status quo and influencing factors for health-promoting lifestyle in the rural populace with high risk of cardiovascular and cerebrovascular diseases, and to provide reference for developing primary prevention strategies for cardiovascular and cerebrovascular diseases. Method: Questionnaire-based survey of 585 cases of high-risk cardiovascular and cerebrovascular population in 11 administrative villages in Fuling of Lishui city was conducted using the Health Promoting Lifestyle Profile-II (HPLP II), Perceived Social Support from Family Scale (PSS-Fa), General Health Questionnaire (GHQ-12), and other questionnaire tools. Results: The total score of the health-promoting lifestyle in the rural populace with high risk of cardiovascular disease is 125.55 ± 20.50, which is at an average level, and the mean scores of each dimension in descending order are—nutrition, interpersonal support, self-actualization, stress management, health responsibility, and exercise. Monofactor analysis revealed that age, education level, marriage, monthly per capita household income, physical activity based on the International Physical Activity Questionnaire (IPAQ), family support function, carotid intima-media thickness, and blood pressure were influencing factors for the health-promoting lifestyle in the rural populace with high risk of cardiovascular and cerebrovascular diseases (P < 0.05). Multiple stepwise regression analysis showed that monthly per capita household income, family support function, physical activity based on the IPAQ, and education level were positively correlated with the level of the health-promoting lifestyle. Conclusion: The health-promoting lifestyle level of the rural populace with high risk of cardiovascular and cerebrovascular diseases needs to be improved. When assisting patients to improve their health-promoting lifestyle level, it is imperative to pay attention to improving patients' physical activity level, emphasizing the influence of the family environment on patients, and focusing on patients with economic difficulties and low education level. [ABSTRACT FROM AUTHOR]

Abstract Background This study aimed to evaluate the feasibility of using the HIV self-test in high-risk Iranian groups (MSM, FSWs, and TGs). Methods This study was a mixed study designed as a quantitative–qualitative study conducted between October 1, 2020, and June 22, 2021, in Tehran and Karaj, Iran. The sample size needed for this study generally was 1000 people, including FSWs, MSM, and transgender individuals. Convenience and snowball sampling methods were used to collect the samples. Results A total of 930 eligible respondents were enrolled in the study, of whom 456 (49%) were female and 49 (5.3%) were transgender (98% of TGs were male to female), and their mean age was 33.63 years (10.54 SD). The feasibility of using HIV self-tests in Iranian high-risk groups was significantly high. The majority of participants (97%) did not have any confidentiality problems while preparing or performing the test. In general, feasibility was assessed based on five questions. The overall feasibility score was 6.33 (0.824 SD). Taking tests, reading HIV test results, finding a safe place to do the test, and accessing HIV self-tests showed a high average. Conclusion HIV self-testing was highly acceptable and feasible among high-risk populations, so routine HIV testing was efficiently possible.

Abstract Background The pandemic of coronavirus disease 2019 (COVID-19) has changed human behavior in areas such as contact patterns and mask-wearing frequency. Exploring human–human contact patterns and mask-wearing habits in high-risk groups is an essential step in fully understanding the transmission of respiratory infection-based diseases. This study had aims to quantify local human–human (H–H) contacts in high-risk groups in representative provinces of China and to explore the occupation-specific assortativity and heterogeneity of social contacts. Methods Delivery workers, medical workers, preschoolers, and students from Qinghai, Shanghai, and Zhejiang were recruited to complete an online questionnaire that queried general information, logged contacts, and assessed the willingness to wear a mask in different settings. The “group contact” was defined as contact with a group at least 20 individuals. The numbers of contacts across different characteristics were assessed and age-specific contact matrices were established. A generalized additive mixed model was used to analyze the associations between the number of individual contacts and several characteristics. The factors influencing the frequency of mask wearing were evaluated with a logistic regression model. Results A total of 611,287 contacts were reported by 15,635 participants. The frequency of daily individual contacts averaged 3.14 (95% confidence interval: 3.13–3.15) people per day, while that of group contacts was 37.90 (95% CI: 37.20–38.70). Skin-to-skin contact and long-duration contact were more likely to occur at home or among family members. Contact matrices of students were the most assortative (all contacts q-index = 0.899, 95% CI: 0.894–0.904). Participants with larger household sizes reported having more contacts. Higher household income per capita was significantly associated with a greater number of contacts among preschoolers (P 50,000–99,999 = 0.033) and students (P 10,000–29,999 = 0.017). In each of the public places, the frequency of mask wearing was highest for delivery workers. For preschoolers and students with more contacts, the proportion of those who reported always wearing masks was lower (P

Qiyun Jiang,1,2 Dan Gong,1,2 Huiqi Li,3 Donglan Zhang,4 Suzhen Hu,5 Qinghua Xia,6 Hong Yuan,7 Peng Zhou,6 Yiying Zhang,7 Xing Liu,8 Mei Sun,1,2 Jun Lv,1,2 Chengyue Li1,2 1Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, People’s Republic of China; 2Research Institute of Health Development Strategies, Fudan University, Shanghai, People’s Republic of China; 3School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; 4Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, USA; 5Department of Medical Affairs, Liaocheng People’s Hospital, Liaocheng, People’s Republic of China; 6Department of Chronic Disease Prevention and Control, Changning District Center for Disease Control and Prevention, Shanghai, People’s Republic of China; 7Department of Chronic Disease Prevention and Control, Jiading District Center for Disease Control and Prevention, Shanghai, People’s Republic of China; 8Department of Epidemiology, School of Public Health, Fudan University, Shanghai, People’s Republic of ChinaCorrespondence: Chengyue Li; Jun Lv, Department of Health Policy and Management, School of Public Health, Fudan University, P.O. Box 177, 130 Dong’an Road, Shanghai, 200032, People’s Republic of China, Tel +86-21-33561022 ; +86-21-33563953, Fax +86-21-33563380, Email lichengyue@fudan.edu.cn; lujun@shmu.edu.cnPurpose: This study aimed to develop a screening tool based on a risk scoring approach that could identify individuals at high risk for hypertension in Shanghai, China.Methods: A total of 3147 respondents from the 2013 Shanghai Chronic Disease and Risk Factor Surveillance were randomly divided into the derivation group and validation group. The coefficients obtained from multivariable logistic regression were used to assign a score to each variable category. The receiver operating characteristic (ROC) curve was used to find the optimal cut-off point and to evaluate the screening performance.Results: Age, family history of hypertension, having diabetes, having dyslipidemia, body mass index, and having abdominal obesity contributed to the risk score. The area under the ROC curve was 0.817 (95% CI: 0.797– 0.836). The optimal cut-off value of 20 had a sensitivity of 83.4%, and a specificity of 64.3%, demonstrating good performance.Conclusion: We developed a simple and valid screening tool to identify individuals at risk for hypertension. Early detection could be beneficial for high-risk groups to better manage their conditions and delay the progression of hypertension and related complications.Keywords: Eastern China, high-risk population, hypertension, risk scoring method, screening tool

Abstract Background Health belief is an important factor affecting lung cancer screening in high-risk population, but the research based on Chinese cultural background is still insufficient. Therefore, we adapted the English version of the Lung Cancer Screening Health Belief Scales (LCSHB) into the Chinese version (LCSHB-C) and examined its psychometric characteristics. Methods After obtaining authorization from the original author, the LCSHB-C was adapted based upon Brislin's translation model. Using a variety of community-based recruitment methods, a total of 353 participants were recruited in Fuzhou, Fujian province, China to complete the questionnaires. We combined the classical test theory and item response theory to examine the psychometric properties of the LCSHB-C. Results The Cronbach’s alpha for the four subscales ranged from 0.83 ~ 0.93. The content validity index for the four subscales was ranged from 0.87 ~ 1.0. Confirmatory factor analysis supported each subscale structure model fit well. Rasch analysis results further validated the reliability and validity of the four subscales. The person reliability and separation index of each subscale ranged from 0.77 to 0.87 and 1.83 to 2.63, respectively. Conclusions The LCSHB-C is a reliable and valid instrument used to measure health beliefs related to lung cancer screening among those high-risk for lung cancer in China, which facilitates the development of lung cancer screening programs and promotes the "three early prevention strategies" of lung cancer (i.e.,early detection, early diagnosis and early treatment).

BackgroundStroke is an acute cerebrovascular disease with high mortality and disability. This study aimed to investigate the trend of stroke prevalence from 1989 to 2015 in China, explore the transition of high-risk population and high-risk factors, and provide some evidence to develop more targeted stroke intervention strategies.Material and methodsWe derived the baseline data from China Health and Nutrition Survey (CHNS). Participants responded to face-to-face interviews and examinations containing demographic information, behavioral health information, disease history, and physical examination. We applied chi-square test, shapley value decomposition model, and decision tree model to evaluate the changes of high-risk population and high-risk factors of stroke.ResultsAcross 42,419 middle-aged and elderly residents, the prevalence of stroke was decreasing from 1989 to 2015. Hypertension was the leading risk factor of stroke, while its contribution rate was weakened with the increasing of medicine taking rate. As the second risk factor of stroke, the contribution of age decreased either. Meanwhile, the contribution rate of historical health factors, lifestyle factors, and regional factors, such as body mass index, diabetes, and living area to the impact of stroke was increasing. In addition, the first high-risk population of stroke changed from hypertension patients aged 75 years and above to without spouse residents living in stroke belt such as Beijing and Liaoning. The second risk population of stroke transformed from male hypertensive patients under 75 years old into male hypertensive patients living in urban. The third high-risk group turned from the elderly aged 75 and above into the female patients with hypertension and diabetes.ConclusionsThis study demonstrated that the high-risk population and high-risk factors of stroke changed in China and revealed the direction and internal mechanism of transition of stroke. Targeted stroke intervention strategies should be renewed. Health education for the high-risk population of stroke should be carried out, healthy living habits need be advocated, and the use of antihypertensive drugs for the hypertensive patients should be standardized.