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Aim: To explore the relationship between proinflammatory diet, habitual salt intake and the onset of type 2 diabetes. Methods: This prospective study was conducted among 171 094 UK Biobank participants who completed at least one 24‐h dietary questionnaire and were free of diabetes at baseline. Participants were followed up until 1 March 2023 for type 2 diabetes incidence, with diagnosis information obtained from linked medical records. An Energy‐adjusted Diet Inflammatory Index (E‐DII) was calculated based on 28 food parameters. Habitual salt intake was determined through the self‐reported frequency of adding salt to foods. The associations between E‐DII, habitual salt intake and type 2 diabetes incidence were tested by the Cox proportional hazard regression model. Results: Over a median follow‐up period of 13.5 years, 6216 cases of type 2 diabetes were documented. Compared with participants with a low E‐DII (indicative of an anti‐inflammatory diet), participants with a high E‐DII (indicative of a proinflammatory diet) had an 18% heightened risk of developing type 2 diabetes. The association between E‐DII and type 2 diabetes tends to be linear after adjustment for major confounders. Participants with a proinflammatory diet and always adding salt to foods had the highest risk of type 2 diabetes incidence (hazard ratio 1.60, 95% confidence interval 1.32‐1.94). Conclusions: Our findings indicate that a proinflammatory diet and higher habitual salt intake were associated with an increased risk of type 2 diabetes. These results support the public health promotion of an anti‐inflammatory diet and reducing salt intake to prevent the onset of type 2 diabetes. [ABSTRACT FROM AUTHOR]

Aims: To determine the magnitude of the association between abdominal adiposity and low‐grade inflammation in persons with recently diagnosed type 2 diabetes (T2D) and to determine to what extent this association is mediated by low physical activity level, hyperinsulinaemia, hyperglycaemia, dyslipidaemia, hypertension, and comorbidities. Materials and Methods: We measured waist circumference, clinical characteristics, and inflammatory markers i.e. tumour necrosis factor‐alpha (TNF‐α), interleukin‐6 (IL‐6), and high‐sensitivity C‐reactive protein (hsCRP), in >9000 persons with recently diagnosed T2D. We applied multiple mediation analysis using structural equation modelling, with adjustment for age and sex. Results: Waist circumference as a proxy for abdominal adiposity was positively associated with all inflammatory markers. Hence, a one‐standard deviation (SD) increase in waist circumference (SD = 15 cm) was associated with a 22%, 35%, and 46% SD increase in TNF‐α (SD = 1.5 pg/mL), IL‐6 (SD = 4.4 pg/mL), and hsCRP (SD = 6.9 mg/L), respectively. The level of hyperinsulinaemia assessed by fasting C‐peptide was quantitatively the most important mediator, accounting for 9%–25% of the association between abdominal adiposity and low‐grade inflammation, followed by low physical activity (5%–7%) and high triglyceride levels (2%–6%). Although mediation of adiposity‐induced inflammation by greater comorbidity and higher glycated haemoglobin levels reached statistical significance, their impact was minor (1%–2%). Conclusions: In persons with recently diagnosed T2D, there was a clear association between abdominal adiposity and low‐grade inflammation. A considerable part (20%–40%) of this association was mediated by other factors, with hyperinsulinaemia as a potentially important driver of adiposity‐induced inflammation in T2D. [ABSTRACT FROM AUTHOR]

Aim Materials and Methods Results Conclusions The trial (NCT04016974) investigated the pharmacokinetics, pharmacodynamics, safety and tolerability of oral semaglutide, the first orally administered glucagon‐like peptide‐1 analogue for type 2 diabetes, in healthy Chinese subjects.This single‐centre, multiple‐dose, placebo‐controlled trial randomized 32 healthy Chinese adults to once‐daily oral semaglutide (3 mg escalating to 14 mg) or placebo for 12 weeks. Blood samples were collected regularly during treatment and follow‐up. The primary endpoint was the area under the semaglutide concentration–time curve over a dosing interval (0‐24 h) at steady state (AUC0‐24h,sema,SS). Secondary pharmacokinetic endpoints included the maximum observed semaglutide plasma concentration at steady state (Cmax,sema,SS). Supportive secondary pharmacodynamics endpoints included changes in body weight and fasting plasma glucose.Treatment with all oral semaglutide doses showed dose‐dependent increases in semaglutide exposure in healthy Chinese subjects at steady state, determined by AUC0‐24h,sema,SS (233, 552 and 1288 h·nmol/L for 3, 7 and 14 mg of oral semaglutide, respectively) and Cmax,sema,SS. Oral semaglutide treatment was associated with significant reductions in body weight (p = .0001) and fasting plasma glucose (p = .0011) versus placebo at the end of treatment. The safety and tolerability of oral semaglutide were consistent with the known profile of glucagon‐like peptide‐1 receptor agonists, with no severe or blood‐glucose–confirmed symptomatic hypoglycaemic events, serious adverse events or deaths. The most frequent adverse events were gastrointestinal disorders.At steady state, oral semaglutide exposure was dose dependent and close to dose proportionality in healthy Chinese subjects. This is consistent with previous clinical pharmacology results for oral semaglutide. [ABSTRACT FROM AUTHOR]

Background: End stage ankle osteoarthritis (OA) is debilitating. Surgical management consists of either ankle arthrodesis (AA) or a total ankle replacement (TAR). The purpose of this study is to assess the trends in operative intervention for end stage ankle OA in an Australian population. Methods: This is a retrospective epidemiological study of 15,046 surgeries. Data were collected from publicly available national registries including the Australian Medicare Database and Australian Orthopaedic Association National Joint Replacement Registrar from 2001 to 2020. Results: There was a significant increase in all ankle surgeries performed across the period of interest. AA remained the more commonly performed procedure throughout the course of the study (11,946 cases, 79.4%) and was never surpassed by TAR (3100, 20.6%). The overall proportions demonstrated no significant changes from 2001 to 2020. Conclusion: The incidence of ankle surgeries continues to increase with the ageing and increasingly comorbid population of Australia. Despite demonstrating no significant overall change in the ratio of TAR and AA in our study population and period, there are noticeable trends within the timeframe, with a recent surge favouring TAR in the last 5 years. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Is there a difference in the time interval between the first and second live births among individuals with and without recurrent pregnancy loss (RPL)? SUMMARY ANSWER Primary RPL (two or more pregnancy losses before the first live birth) is associated with a shorter time interval between the first and second live births compared with individuals without RPL, but this association is reversed in patients with secondary RPL (RPL patients with no or one pregnancy loss before the first live birth). WHAT IS KNOWN ALREADY There is limited information regarding the ability to have more than one child for patients with RPL. Previous studies have investigated the time to live birth and the live birth rate from the initial presentation to clinical providers. Most of the previous studies have included only patients treated at specialized RPL clinics and thus may be limited by selection bias, including patients with a more severe condition. STUDY DESIGN, SIZE, DURATION We conducted a population-based retrospective cohort study of 184 241 participants who delivered in British Columbia, Canada, and had at least two recorded live births between 2000 and 2018. The aim was to study the differences in the time interval between the first and second live births and the prevalence of pregnancy complications in patients with and without RPL. Additionally, 198 319 individuals with their first live birth between 2000 and 2010 were studied to evaluate cumulative second live birth rates. PARTICIPANTS/MATERIALS, SETTING, METHODS Among individuals with at least two recorded live births between 2000 and 2018, 12 321 patients with RPL and 171 920 participants without RPL were included. RPL was defined as at least two pregnancy losses before 20 weeks gestation. Patients with primary RPL had at least two pregnancy losses occurring before the first live birth, while patients with secondary RPL had no or one pregnancy loss before the first live birth. We compared the time interval from the first to second live birth in patients with primary RPL, those with secondary RPL, and participants without RPL using generalized additive models to allow for a non-linear relationship between maternal age and time interval between first and second live births. We also compared prevalence of pregnancy complications at the first and second live births between the groups using non-parametric Kruskal–Wallis H test and Fisher's exact test for continuous and categorical variables, respectively. We assessed the cumulative second live birth rates in patients with primary RPL and those without RPL, among participants who had their first live birth between 2000 and 2010. Cox proportional hazards model was used to estimate and compare hazard ratios between the two groups using a stratified modelling approach. MAIN RESULTS AND THE ROLE OF CHANCE The adjusted time interval between the first and second live births was the longest in patients with secondary RPL, followed by individuals without RPL, and the shortest time interval was observed in patients with primary RPL: 4.34 years (95% CI: 4.09–4.58), 3.20 years (95% CI: 3.00–3.40), and 3.05 years (95% CI: 2.79–3.32). A higher frequency of pregnancy losses was associated with an increased time interval between the first and second live births. The prevalence of pregnancy complications at the first and second live births, including gestational diabetes, hypertensive disorder of pregnancy, preterm birth, and multiple gestations was significantly higher in patients with primary RPL compared with those without RPL. The cumulative second live birth rate was significantly lower in patients with primary RPL compared with individuals without RPL. LIMITATIONS, REASONS FOR CAUTION This study may be limited by its retrospective nature. Although we adjusted for multiple potential confounders, there may be residual confounding due to a lack of information about pregnancy intentions and other factors, including unreported pregnancy losses. WIDER IMPLICATIONS OF THE FINDINGS The results of this study provide information that will help clinicians in the counselling of RPL patients who desire a second child. STUDY FUNDING/COMPETING INTEREST(S) This study was supported in part by a grant from the Canadian Institutes of Health Research (CIHR): Reference Number W11-179912. M.A.B. reports research grants from CIHR and Ferring Pharmaceutical. He is also on the advisory board for AbbVie, Pfizer, and Baxter. The other authors report no conflict of interest. TRIAL REGISTRATION NUMBER NCT04360564. [ABSTRACT FROM AUTHOR]

Background and aims Design, setting and participants Measurements Findings Conclusions Varenicline is one of the most effective smoking cessation treatments. Its supply in England was disrupted in July 2021 due to nitrosamine impurities found by its supplier, Pfizer. This study measured the impact of this disruption on smoking cessation in England.The study used repeated cross‐sectional surveys conducted monthly, from June 2018 to December 2022. Set in England, it comprised a total of 3024 adults who reported smoking during the past year and had made at least one serious attempt to quit in the past 6 months.Generalized additive models analyzed the association of the varenicline supply disruption with the trend in self‐reported varenicline use in the most recent quit attempt. We used these results to estimate the population‐level impact of the disruption on smoking cessation.Before July 2021, the proportion of past 6‐month quit attempts using varenicline was stable at approximately 3.9% [risk ratio (RR)trend = 1.034, 95% confidence interval (CI) = 0.823–1.298]. The trend in varenicline use has changed sharply since the supply disruption (RRΔtrend = 0.297, 95% CI = 0.120–0.738), with prevalence falling by 69.3% per year since; from 4.1% in June 2021 to 0.8% in December 2022. Convergently, National Health Service general practitioner prescribing data reported that just 0.1% of prescriptions for smoking cessation treatments in December 2022 were for varenicline. Assuming that varenicline does not return to the market, we estimate that this could result in ~8400 fewer people stopping smoking for at least 6 months, ~4200 fewer long‐term ex‐smokers and ~1890 more avoidable deaths each year.In England, the disruption in supply of varenicline since 2021 has coincided with a substantial fall in the use of varenicline in attempts to quit smoking. [ABSTRACT FROM AUTHOR]

Large-scale copy number variants (CNVs) are structural alterations in the genome that involve the duplication or deletion of DNA segments, contributing to genetic diversity and playing a crucial role in the evolution and development of various diseases and disorders, as they can lead to the dosage imbalance of one or more genes. Massively parallel sequencing (MPS) has revolutionized the field of genetic analysis and contributed significantly to routine clinical diagnosis and screening. It offers a precise method for detecting CNVs with exceptional accuracy. In this context, a non-invasive prenatal test (NIPT) based on the sequencing of cell-free DNA (cfDNA) from pregnant women's plasma using a low-coverage whole genome MPS (WGS) approach represents a valuable source for population studies. Here, we analyzed genomic data of 12,732 pregnant women from the Slovak (9,230), Czech (1,583), and Hungarian (1,919) populations. We identified 5,062 CNVs ranging from 200 kbp and described their basic characteristics and differences between the subject populations. Our results suggest that re-analysis of sequencing data from routine WGS assays has the potential to obtain large-scale CNV population frequencies, which are not well known and may provide valuable information to support the classification and interpretation of this type of genetic variation. Furthermore, this could contribute to expanding knowledge about the central European genome without investing in additional laboratory work, as NIPTs are a relatively widely used screening method. [ABSTRACT FROM AUTHOR]

Aim Materials and Methods Results Conclusions To prospectively assess the association of smoking timing with the risk of type 2 diabetes (T2D) and examine whether smoking amount or genetic susceptibility might modify the relationship.A total of 294 815 participants without diabetes from the UK Biobank, including non‐smokers and smokers with data on the time from waking to first cigarette, were included. Cox proportional hazards models were used to evaluate the association between smoking timing and the risk of incident T2D.During a median follow‐up time of 12 years, a total of 9937 incident cases of T2D were documented. Compared with non‐smokers, a shorter time from waking to first cigarette was significantly associated with a higher risk of incident T2D (P for trend < .001). In the fully adjusted model, the hazard ratios (HRs) (95% confidence interval) associated with smoking timing were 1.46 (1.17–1.81) for more than 2 hours, 1.51 (1.21–1.87) for 1–2 hours, 1.58 (1.34–1.85) for 30–60 minutes, 1.86 (1.57–2.21) for 5–15 minutes and 2.01 (1.60–2.54) for less than 5 minutes. We found that even among those who reported being light smokers, those with the shortest time from waking to first cigarette had a 105% higher risk of T2D with an HR of 2.05 (1.52–2.76), which was comparable with heavy smokers. The genetic risk score for T2D did not modify this association (P‐interaction = .51).Our findings indicate that shorter time from waking to first cigarette is significantly associated with a higher risk of incident T2D. [ABSTRACT FROM AUTHOR]

Background: Fertility‐sparing surgery (FSS) is an alternative choice of young patients who have not completed their family planning and still have fertility needs. The aims of this study were to compare the outcomes of early‐stage epithelial ovarian cancer (EOC) patients undergoing FSS and radical comprehensive staging surgery (RCS), and the suitability of FSS. Methods: A total of 1297 patients aged between 20 and 44 years with newly diagnosed early‐stage EOC were recruited from the Taiwan Cancer Registry database between 2009 and 2017. Site‐specific surgery codes were used to distinguish patients in FSS group or RCS group. Cancer‐specific survival (CSS) was evaluated using Kaplan–Meier method with log‐rank test and Cox regression model. Results: There were 401 and 896 patients in FSS and RCS group. Patients in FSS group were with younger age and mostly had Stage I disease. In contrast, patients in RCS group were older. There were more Stage II, high‐grade (Grade 3) disease, and adjuvant chemotherapy in RCS group. Stage and tumor grade were two independent factors correlating with CSS and the type of surgery showed no effect on CSS (HR: 1.09, 95% CI: 0.66–1.77, p = 0.73) in multivariable analysis. In multivariable analysis, the clear cell carcinoma group who underwent FSS demonstrated better CSS compared to those in the RCS group (HR: 0.28, 95% CI: 0.06–0.82, p = 0.04). A total of 17 women who underwent FSS developed second malignancies of the uterine corpus or contralateral ovary. Conclusion: FSS can be a safe alternative procedure in selected young patients of Stage I EOC who have fertility desire. Endometrial biopsy before or during FSS and regular surveillance to detect recurrence are mandatory for ovarian cancer patients undergoing FSS. [ABSTRACT FROM AUTHOR]

Background and purpose: Influenza vaccination is associated with a longer‐term protective effect against stroke; however, it has a short‐term inflammatory response which may increase short‐term risk of stroke. The aim was to investigate the association between influenza vaccination and short‐term risk of stroke in adults. Methods: Administrative data were obtained from the Alberta Health Care Insurance Plan for all adults in Alberta, Canada, from September 2009 to December 2018. The hazard of any stroke (acute ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage and transient ischaemic attack) within 3, 7, 14, 21 and 30 days of influenza vaccination compared to unexposed time was analysed using Andersen−Gill Cox models, with adjustment for age, sex, anticoagulant use, atrial fibrillation, chronic obstructive pulmonary disease, diabetes, hypertension, income quintile, and rural or urban home location. Results: In the entire cohort consisting of 4,141,209 adults (29,687,899 person‐years), 1,769,565 (42.7%) individuals received at least one vaccination. In total 38,126 stroke events were recorded with 1309 occurring within 30 days of a vaccination event. Influenza vaccination was associated with a significantly reduced hazard of stroke within 3 days (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.73–0.93), 7 days (HR 0.87, 95% CI 0.80–0.95), 14 days (HR 0.87, 95% CI 0.81–0.93), 21 days (HR 0.85, 95% CI 0.80–0.91) and 30 days (HR 0.66, 95% CI 0.65–0.68). Conclusions: An increased early risk associated with vaccination was not observed. The risk of stroke was reduced at all time points within 30 days after influenza vaccination. [ABSTRACT FROM AUTHOR]

Aim: Socio‐economic status (SES) influences diabetes onset, progression and treatment. In this study, the associations between SES and use of hospital care were assessed, focusing on hospitalizations, technology and cardiovascular complications. Materials and Methods: This was an observational cohort study comprising 196 695 patients with diabetes (all types and ages) treated in 65 hospitals across the Netherlands from 2019 to 2020 using reimbursement data. Patients were stratified in low, middle, or high SES based on residential areas derived from four‐digit zip codes. Results: Children and adults with low SES were hospitalized more often than patients with middle or high SES (children: 22%, 19% and 15%, respectively; p <.001, adults: 28%, 25% and 23%; p <.001). Patients with low SES used the least technology: no technology in 48% of children with low SES versus 40% with middle SES and 38% with high SES. In children, continuous subcutaneous insulin infusion (CSII) and real‐time continuous glucose monitoring (rtCGM) use was higher in high SES {CSII: odds ratio (OR) 1.54 [95% confidence interval (CI) 1.35‐1.76]; p <.001; rtCGM OR 1.39 [95% CI 1.20‐1.61]; p <.001} and middle SES [CSII: OR 1.41 (95% CI 1.24‐1.62); p <.001; rtCGM: OR 1.27 (95% CI 1.09‐1.47); p =.002] compared with low SES. Macrovascular (OR 0.78 (95% CI 0.75‐0.80); p <.001) and microvascular complications [OR 0.95 (95% CI 0.93‐0.98); p <.001] occurred less in high than in low SES. Conclusions: Socio‐economic disparities were observed in patients with diabetes treated in Dutch hospitals, where basic health care is covered. Patients with low SES were hospitalized more often, used less technology, and adults with high SES showed fewer cardiovascular complications. These inequities warrant attention to guarantee equal outcomes for all. [ABSTRACT FROM AUTHOR]

Aim: To characterize the impact of the COVID‐19 pandemic on diabetes diagnosis using data from Alberta's Tomorrow Project (ATP), a population‐based cohort study of chronic diseases in Alberta, Canada. Materials and Methods: The ATP participants who were free of diabetes on 1 April 2018 were included in the study. A time‐segmented regression model was used to compare incidence rates of diabetes before the COVID‐19 pandemic, during the first two COVID‐19 states of emergency, and in the period when the state of emergency was relaxed, after adjusting for seasonality, sociodemographic factors, socioeconomic status, and lifestyle behaviours. Results: Among 43 705 ATP participants free of diabetes (65.5% females, age 60.4 ± 9.5 years in 2018), the rate of diabetes was 4.75 per 1000 person‐year (PY) during the COVID‐19 pandemic (up to 31 March 2021), which was 32% lower (95% confidence interval [CI] 21%, 42%; p < 0.001) than pre‐pandemic (6.98 per 1000 PY for the period 1 April 2018 to 16 March 2020). In multivariable regression analysis, the first COVID‐19 state of emergency (first wave) was associated with an 87.3% (95% CI −98.6%, 13.9%; p = 0.07) reduction in diabetes diagnosis; this decreasing trend was sustained to the second COVID‐19 state of emergency and no substantial rebound (increase) was observed when the COVID‐19 state of emergency was relaxed. Conclusions: The COVID‐19 public health emergencies had a negative impact on diabetes diagnosis in Alberta. The reduction in diabetes diagnosis was likely due to province‐wide health service disruptions during the COVID‐19 pandemic. Systematic plans to close the post‐COVID‐19 diagnostic gap are required in diabetes to avoid substantial downstream sequelae of undiagnosed disease. [ABSTRACT FROM AUTHOR]

Noonan syndrome is a group of diseases with a similar clinical picture, consisting of 16 diseases caused by mutations in 15 genes. According to the literature, approximately half of all cases are attributed to Noonan syndrome type 1, NSML, caused by mutations in the PTPN11 gene. We analyzed 456 unrelated probands using a gene panel NGS, and in 206 cases, the cause of the disease was identified. Approximately half of the cases (107) were caused by variants in the PTPN11 gene, including three previously undescribed variants, one of which was classified as VOUS, and the other two as LP causative complex alleles. Frequent variants of the PTPN11 gene characteristics for Russian patients were identified, accounting for more than 38% (c.922A>G p.Asn308Asp, c.417G>C p.Glu139Asp, c.1403C>T p.Thr468Met) of all cases with mutations in the PTPN11 gene. A comparative characterization of frequent variants of the PTPN11 gene in different populations is shown. The most common features of Noonan syndrome in the studied sample were facial dysmorphisms and cardiovascular system abnormalities. A lower representation of patients with growth delay was observed compared to previously described samples. [ABSTRACT FROM AUTHOR]

Background: The adoption of direct oral anticoagulants (DOACs) has changed practice in prevention of stroke in atrial fibrillation (AF). We used Irish data national data on stroke and anticoagulation therapy over 9 years to investigate changes in anticoagulation practice and potential consequences on stroke prevalence and thrombolysis. Methods: AF, anticoagulation, thrombolysis, and stroke data from the Irish National Audit of Stroke (INAS) 2013–2021 were reviewed. The proportion of patients with ischemic stroke (IS) and intracerebral hemorrhage (IH) with known AF admitted on anticoagulation was determined. Effects on age distribution in the population and thrombolysis practice were assessed. Results: AF data were available on 34,630 of 35,241 individuals (98.3%) included in INAS; median age was 74 years and 56% were male. AF was found in 10,016 (28.9%, 9059 IS, 957 IH). 6313 had known AF prior to stroke (63.1%). The proportion all total IS due to AF decreased by 15.3% (31.3%−26.5%, chi-square = 24.6, p < 0.0001). The proportion of IH did not change significantly (21.6%–20.2%, chi-square = 1.8, p = 0.18). Over the 9 years, 3875 (38.6%) of the subjects with AF were recorded as receiving anticoagulants at admission. In 2013, 4.4% of AF-associated strokes were admitted on a DOAC and 21.4% on warfarin; by 2021, 44.1% were receiving a DOAC and 6.2% warfarin. There was a strong inverse correlation between the proportion of anticoagulated stroke patients and the total proportion of AF-associated strokes over time (r = −0.82, p = 0.006). In contrast, no correlation was found between increasing DOAC usage and IH (r = 0.14, p = 0.71). Increased anticoagulation usage correlated with a reduction in patients ⩾ 80 years (r = −0.83, p = 0.006) and also correlated with a relative reduction of 30.1% in subjects thrombolysed <4 h from onset (r = −0.89, p = 0.001) Conclusion: DOACs have led to increased use of anticoagulation, but warfarin use fell by two-thirds. There has been a reduction in the proportion of AF-associated IS without a noticeable increase in IH. Increased anticoagulation correlated with reduced numbers of strokes in those >80 years and in the proportion of patients thrombolysed. [ABSTRACT FROM AUTHOR]

Polyetheretherketone (PEEK) is of interest as implant material for cementless tibial total knee arthroplasty (TKA) components due to its potential advantages. One main advantage is that the stiffness of PEEK closely resembles the stiffness of bone, potentially avoiding peri-prosthetic stress-shielding. When introducing a new implant material for cementless TKA designs, it is essential to study its effect on the primary fixation. The primary fixation may be influenced by patient factors such as age, gender, and body mass index (BMI). Therefore, the research objectives of this finite element (FE) study were to investigate the effect of material (PEEK vs. titanium) and patient characteristics on the primary fixation (i.e., micromotions) of a cementless tibial tray component. A total of 296 FE models of 74 tibiae were created with either PEEK or titanium material properties, under gait and squat loading conditions. Overall, the PEEK models generated larger peak micromotions than the titanium models. Differences were seen in the micromotion distributions between the PEEK and titanium models for both the gait and squat models. The micromotions of all tibial models significantly increased with BMI, while gender and age did not influence micromotions. [ABSTRACT FROM AUTHOR]

The UK government is consulting on banning disposable e-cigarettes. This study aimed to describe trends in disposable e-cigarette use among adults in Great Britain since 2021 and establish who would currently be affected by a ban on disposables. Nationally-representative monthly cross-sectional survey. We analysed data from 69,973 adults surveyed between January 2021 and August 2023. We estimated monthly time trends in the weighted prevalence of current disposable e-cigarette use among adults and by sociodemographic characteristics and smoking status. From January 2021 to August 2023, the prevalence of disposable e-cigarette use grew from 0.1 % to 4.9 %. This rise was observed across all population subgroups but was most pronounced among younger adults (e.g. reaching 15.9 % of 18-year-olds compared with 1.3 % of 65-year-olds), those who currently smoke (16.3 %), and those who stopped smoking in the past year (18.2 %). Use among never smokers remained relatively rare (1.5 %), except among 18- to 24-year-olds (7.1 %). Use was significantly higher in England than Wales or Scotland (5.3 % vs. 2.0 % and 2.8 %) and among less (vs. more) advantaged social grades (6.1 % vs. 4.0 %), those with (vs. without) children (6.4 % vs. 4.4 %), and those with (vs. without) a history of mental health conditions (9.3 % vs. 3.1 %). A ban on disposable e-cigarettes would currently affect one in 20 adults in Great Britain (approximately 2.6 million people). The proportion who would be affected would be greatest among young people, including the 316,000 18-24 year-olds who currently use disposables but who have never regularly smoked tobacco, which may discourage uptake of vaping in this group. However, a ban would also affect 1.2 million people who currently smoke and a further 744,000 who previously smoked. It would also have a disproportionate impact on disadvantaged groups that have higher rates of smoking and typically find it harder to quit. [ABSTRACT FROM AUTHOR]

Aim: To examine the association between 1‐hour plasma glucose (PG) concentration and markers of non‐alcoholic fatty liver disease (NAFLD) assessed by transient elastography (TE). Methods: We performed TE in 107 metabolically well‐characterized non‐diabetic White individuals. Controlled attenuation parameter (CAP) was used to quantify liver steatosis, while liver stiffness marker (LS) was used to evaluate fibrosis. Results: Controlled attenuation parameter correlated significantly with 1‐hour PG (r = 0.301, P < 0.01), fasting insulin (r = 0.285, P < 0.01), 2‐hour insulin (r = 0.257, P < 0.02), homeostasis model assessment index of insulin resistance (r = 0.252, P < 0.01), high‐density lipoprotein cholesterol (r = −0.252, P < 0.02), body mass index (BMI; r = 0.248, P < 0.02) and age (r = 0.212, P < 0.03), after correction for age, sex and BMI. In a multivariable linear regression analysis, 1‐hour PG (β = 0.274, P = 0.008) and fasting insulin levels (β = 0.225, P = 0.029) were found to be independent predictors of CAP. After excluding subjects with prediabetes, 1‐hour PG was the sole predictor of CAP variation (β = 0.442, P < 0.001). In a logistic regression model, we observed that the group with 1‐hour PG ≥ 8.6 mmol/L (155 mg/dL) had a significantly higher risk of steatosis (odds ratio 3.98, 95% confidence interval 1.43‐11.13; P = 0.008) than individuals with 1‐hour PG < 8.6 mmol/L, after correction for potential confounders. No association was observed between 1‐hour PG and LS. Conclusion: Our data confirm that 1‐hour PG ≥ 8.6 mmol/L is associated with higher signs of NAFLD, even among individuals with normal glucose tolerance, categorized as low risk by canonical diagnostic standards. TE is a safe low‐impact approach that could be employed for stratifying the risk profile in these patients, with a high level of accuracy. [ABSTRACT FROM AUTHOR]

Aim: To assess temporal trends of chronic kidney disease (CKD) attributable to type 2 diabetes (T2D) globally and in five sociodemographic index (SDI) regions. Materials and Methods: We extracted the population data and CKD burden attributable to T2D from the Global Burden of Disease Study 2019. We evaluated the trends of disability‐adjusted life years (DALYs), mortality, prevalence and incidence through age‐period‐cohort modelling, and calculated net drifts (overall annual percentage changes), local drifts (annual percentage changes in each age group), longitudinal age curves (fitted longitudinal age‐specific rates), period relative risks (RRs) and cohort RRs. Results: From 1990 to 2019, the global burden of CKD attributable to T2D showed increasing trends in general. The burden of CKD attributable to T2D was highest in the middle SDI region and lowest in the low SDI region. Age effects increased with age, and peaked at the ages of 75‐79 and 80‐84 years for incidence and prevalence, respectively. Period RRs in the burden of CKD attributable to T2D increased, with the high SDI being the most remarkable in DALYs and mortality, and the middle SDI being the most notable in incidence. Cohort RRs showed unfavourable trends in incidence and prevalence among recent cohorts. Conclusions: After a lengthy period of multi‐initiative diabetes management, the high‐middle SDI region exhibited improvement. However, unresolved issues and improvement gaps were still remarkable. Future efforts to reduce the burden of CKD attributable to T2D in the population should prioritize addressing the unfavourable patterns identified. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) has exposed critical care supply shortages worldwide. This study aimed to investigate the association between regional critical care capacity and the incidence of invasive mechanical ventilation following novel COVID-19 during the pandemic in Japan, a country with a limited intensive care unit (ICU) bed capacity of a median of 5.1 ICU beds per 100,000 individuals. Methods: This population-based cohort study used data from the CRoss Icu Searchable Information System database and publicly available databases provided by the Japanese government and Japanese Society of Intensive Care Medicine. We identified patients recently diagnosed with COVID-19, those who received invasive mechanical ventilation, and those who received extracorporeal membrane oxygenation (ECMO) between February 2020 and March 2023. We analyzed the association between regional critical care capacity (ICU beds, high-dependency care unit (HDU) beds, resource-rich ICU beds, and intensivists) and the incidence of invasive mechanical ventilation, ECMO, and risk-adjusted mortality across 47 Japanese prefectures. Results: Among the approximately 127 million individuals residing in Japan, 33,189,809 were recently diagnosed with COVID-19, with 12,203 and 1,426 COVID-19 patients on invasive mechanical ventilation and ECMO, respectively, during the study period. Prefecture-level linear regression analysis revealed that the addition of ICU beds, resource-rich ICU beds, and intensivists per 100,000 individuals increased the incidence of IMV by 5.37 (95% confidence interval, 1.99–8.76), 7.27 (1.61–12.9), and 13.12 (3.48–22.76), respectively. However, the number of HDU beds per 100,000 individuals was not statistically significantly associated with the incidence of invasive mechanical ventilation. None of the four indicators of regional critical care capacity was statistically significantly associated with the incidence of ECMO and risk-adjusted mortality. Conclusions: The results of prefecture-level analyses demonstrate that increased numbers of ICU beds, resource-rich ICU beds, and intensivists are associated with the incidence of invasive mechanical ventilation among patients recently diagnosed with COVID-19 during the pandemic. These findings have important implications for healthcare policymakers, aiding in efficiently allocating critical care resources during crises, particularly in regions with limited ICU bed capacities. Registry and the registration no. of the study/trial The approval date of the registry was August 20, 2020, and the registration no. of the study was lUMIN000041450. [ABSTRACT FROM AUTHOR]

Introduction Material and methods Results Conclusions Previous studies have established a history of shoulder dystocia as an important risk factor for shoulder dystocia, but studies on shoulder dystocia by severity are scarce. It is unknown if shoulder dystocia tends to be passed on between generations. We aimed to assess the recurrence risk of shoulder dystocia by severity in the same woman and between generations on both the maternal and paternal side. We also assessed the likelihood of a second delivery and planned cesarean section after shoulder dystocia.This was a population‐based cohort study, using data from the Medical Birth Registry of Norway. To study recurrence in the same mother, we identified 1 091 067 pairs of first and second, second and third, and third and fourth births in the same mother. To study intergenerational recurrence, we identified an individual both as a newborn and as a mother or father in 824 323 mother‐offspring pairs and 614 663 father‐offspring pairs. We used Bayesian log‐binomial multilevel regression to calculate relative risks (RR) with 95% credible intervals.In subsequent deliveries in the same woman the unadjusted RR of recurrence was 7.05 (95% credible interval 6.39–7.79) and 2.99 (2.71–3.31) after adjusting for possible confounders, including current birthweight. The RRs were higher with severe shoulder dystocia as exposure or outcome. With severe shoulder dystocia as both exposure and outcome, unadjusted and adjusted RR was 20.42 (14.25–29.26) and 6.29 (4.41–8.99), respectively. Women with severe and mild shoulder dystocia and those without had subsequent delivery rates of 71.1, 68.9 and 69.0%, respectively. However, the rates of planned cesarean section in subsequent deliveries for those without shoulder dystocia, mild and severe were 1.3, 5.2 and 16.0%, respectively. On the maternal side the unadjusted inter‐generational RR of recurrence was 2.82 (2.25–3.54) and 1.41 (1.05–1.90) on the paternal side. Corresponding adjusted RRs were 1.90 (1.51–2.40) and 1.19 (0.88–1.61), respectively.We found a strong recurrence risk of shoulder dystocia, especially severe, in subsequent deliveries in the same woman. The inter‐generational recurrence risk was higher on the maternal than paternal side. Women with a history of shoulder dystocia had more often planned cesarean section. [ABSTRACT FROM AUTHOR]

To characterize the ocular inflammatory side effects associated with immune checkpoint inhibitor (CPI) treatment in a Northern California population. Retrospective case series. Patients receiving CPI within an integrated healthcare delivery system. All patients within Kaiser Permanente Northern California receiving CPI between January 1, 2012 and November 1, 2018 were identified. Medical records of those seen in the ophthalmology clinic at least once were retrospectively reviewed. Type and duration of ocular inflammation, indication for and exposure to CPI, time from exposure to diagnosis of ocular inflammation. 31 cases of ocular inflammation were identified in 5061 patients (0.61%) receiving CPI. Mean ± SD age was 67 ± 11.9 (range 38–89). Mean time from exposure to diagnosis was 6.8 ± 5.5 months (range 0.5–17). 87% of cases were bilateral, and 43% of cases were chronic. Average ophthalmology follow-up was 16 ± 18 months (range 0–71). 16/31 (52%) had anterior uveitis, 7/31 (23%) had serous retinal detachment or panuveitis resembling Vogt-Koyanagi-Harada syndrome, 4/31 (13%) had papillitis, and 6/31 (19%) had diplopia or ocular motility defect. There was one case each (3.2%) of melanoma associated retinopathy, corneal edema, granulomatous lacrimal gland enlargement, and choroidal neovascularization. Ocular inflammation is a rare immune associated side effect of CPI treatment, the most common manifestation of which is anterior uveitis. [ABSTRACT FROM AUTHOR]

Aims: To quantify the incremental health and economic burden associated with cognitive impairment (CI) among non‐institutionalized people with diabetes ≥65 years in the United States. Materials and Methods: Using 2016‐2019 Medical Expenditure Panel Surveys data, we identified participants ≥65 years with diabetes. We used propensity score weighting to quantify the CI‐associated incremental burden on health‐related quality of life measured by the 12‐item Short Form Survey (SF‐12), including the mental component summary score, physical component summary score and health utility. We also compared the annual health service utilization and expenditures on ambulatory visits, prescriptions, home care, emergency room (ER), hospitalizations and total annual direct medical expenditures. Results: We included 5094 adults aged ≥65 with diabetes, of whom 804 had CI. After propensity score weighting, CI was associated with a lower mental component summary score (−8.4, p <.001), physical component summary score (−5.2, p <.001) and health utility (–0.12, p <.001). The CI group had more ambulatory visits (+4.4, p =.004) and prescriptions (+9.9, p <.001), with higher probabilities of having home care (+11.3%, p <.001) and ER visits (+8.2%, p =.001). People with CI spent $5441 (p <.001) more annually, $2039 (p =.002) more on prescriptions, $2695 (p <.001) more on home care and $118 (p <.001) more on ER visits. There is no statistically significant difference in the utilization and expenditure of hospitalizations. Conclusion: CI was associated with worse health‐related quality of life, higher health service utilization and expenditures. Our findings can be used to monitor the health and economic burden of CI in non‐institutionalized older persons with diabetes. [ABSTRACT FROM AUTHOR]

Aim: To explore the impact of type 2 diabetes (T2D), glycaemic control and use of glucose‐lowering medication on clinical outcomes in hospitalized patients with COVID‐19. Materials and Methods: For all patients admitted to a hospital in the Capital Region of Denmark (1 March 2020 to 1 December 2021) with confirmed COVID‐19, we extracted data on mortality, admission to intensive care unit (ICU), demographics, comorbidities, medication use and laboratory tests from the electronic health record system. We compared patients with T2D to patients without diabetes using Cox proportional hazards models adjusted for available confounding variables. Outcomes were 30‐day mortality and admission to an ICU. For patients with T2D, we also analysed the association of baseline haemoglobin A1c (HbA1c) levels and use of specific glucose‐lowering medications with the outcomes. Results: In total, 4430 patients were analysed, 1236 with T2D and 2194 without diabetes. The overall 30‐day mortality was 19% (n = 850) and 10% (n = 421) were admitted to an ICU. Crude analyses showed that patients with T2D both had increased mortality [hazard ratio (HR) 1.37; 95% CI 1.19‐1.58] and increased risk of ICU admission (HR 1.28; 95% CI 1.04‐1.57). When adjusted for available confounders, this discrepancy was attenuated for both mortality (adjusted HR 1.13; 95% CI 0.95‐1.33) and risk of ICU admission (adjusted HR 1.01; 95% CI 0.79‐1.29). Neither baseline haemoglobin A1c nor specific glucose‐lowering medication use were significantly associated with the outcomes. Conclusion: Among those hospitalized for COVID‐19, patients with T2D did not have a higher risk of death and ICU admission, when adjusting for confounders. [ABSTRACT FROM AUTHOR]

Background Previous research suggests that alcohol consumption is associated with high age at menopause. Yet, knowledge about the dose–response relationship is inconsistent. Thus, we studied the pattern of the association of pre-menopausal alcohol consumption with age at natural menopause. Methods We performed a retrospective population-based study using self-reported data from 280 497 women aged 50–69 years attending the Norwegian breast cancer screening programme (BreastScreen Norway) during 2006–15. Associations of weekly alcohol consumption between the age of 20 and 49 years with age at menopause were estimated as hazard ratios (HRs) using Cox proportional hazard models with restricted cubic splines to allow for non-linear associations. We adjusted for year and place of birth, number of childbirths, educational level, body mass index and smoking habits. Results Mean age at natural menopause was 51.20 years (interquartile range: 49–54 years). The adjusted HR of reaching menopause was highest for women with no alcohol consumption (reference) and the HR decreased by alcohol consumption up to 50 grams per week (adjusted HR 0.87; 95% CI: 0.86–0.88). Above 50 grams, there was no further decrease in the HR of reaching menopause (P for non-linearity of <0.001). Conclusions Women who did not consume alcohol were youngest at menopause. The lack of a dose–response association among alcohol consumers implies virtually no relation of alcohol consumption with age at menopause. Our findings may suggest that characteristics of the women who did not consume alcohol, not accounted for in the data analyses, explain their younger age at menopause. [ABSTRACT FROM AUTHOR]

Purpose: Low back pain is a significant health problem with a high prevalence. Studies of smaller cohorts of low back pain patients have indicated increased body sway. The present paper tests the hypothesis of an association between low back pain and postural sway in a large randomly selected population. Methods: The current study used the fifth examination (2011–2015) of The Copenhagen City Heart Study where 4543 participated. The participants answered a self-administered questionnaire regarding pain, physical activity, smoking, alcohol consumption, education, and other lifestyle factors. Measurement of postural body sway was performed using the CATSYS system. Results: Totally 1134 participants (25%) reported to have low back pain. Subjects with low back pain had higher sway area and sway velocity than subjects without. Conclusion: When using multivariate statistical analysis, confounding factors such as male gender, higher age, larger body height, low education level, smoking, and low activity level explained the association between low back pain and postural sway. [ABSTRACT FROM AUTHOR]

Introduction: Frailty and atrial fibrillation (AF) are common aging problems and increasing globally. The association(s) between frailty and AF has been inconclusive. The purpose of this prospective population-based cohort was to investigate the associations between frailty and incident AF in older men and women. Methods: In total 839 participants, women (n = 458) and men (n = 381), aged 61–74 years from the Kuopio Ischaemic Heart Disease Risk Factor Study were included (March 1, 1998, to December 31, 2001). At the baseline, frailty prevalence was 49.3% (n = 414), and non-frailty 50.7% (n = 425) of the total population. Frailty was ascertained with the presence of 3–5 and prefrailty 1–2 of the following criteria: weight loss (highest 20% over 7 years), self-reported tiredness, weakness (measured by handgrip strength), slow walking speed (walking pace), and low physical activity (lowest 20%). AF events were obtained by record linkages from the national computerized hospitalization registry in Finland up to December 31, 2019. Multivariate Cox proportional hazard regression estimated the hazard ratio (HR) of incident events, adjusted for potential confounders. Results: During the mean follow-up of 14.2 years, 288 AF cases (169 women; 119 men) occurred. After adjustment for possible confounders, the HRs (95% confidence intervals [CIs]) for AF was 1.46 (1.48–1.85) in the frail population, compared to the non-frail group. The association was observed only among older frail women (multivariable-adjusted HR 1.78, 95% CI [1.28–2.48]) (p for interaction = 0.04). No statistically significant associations were observed between frailty and future AF incident among men (multivariable-adjusted HRs 1.12, 95% CI (0.77–1.63)). Conclusions: In this population-based epidemiological cohort, the risk of developing AF was increased in women affected by frailty at baseline but not in men. [ABSTRACT FROM AUTHOR]

The aim of the study was to provide an overview on the relation between vision and generic health‐related quality of life (HRQoL) in general populations worldwide. We conducted a systematic review to identify articles that have evaluated the relation of binocularly measured distance visual acuity (VA) and HRQoL in adults at population level around the world. Used search terms were related to visual acuity, vision loss, visual impairment and HRQoL. We identified 780 articles, of which 12 satisfied the eligibility criteria. The studies were conducted in the USA, Europe, Asia and Australia. Generic HRQoL was measured using EQ‐5D, 15D, SF‐36, SF‐12 and/or WHOQoL. Nine studies reported a trend between decreasing VA and deteriorating HRQoL of at least some degree. Vision loss was mostly associated with dimensions related to physical health and capability, including self‐care, mobility and usual activities. Mental dimensions – vitality and social functioning in particular – were also affected, although the results were inconsistent. Six studies compared the impact of different medical conditions on HRQoL, all of which reported that the impact of visual impairment was equal or stronger compared with other major medical conditions. In conclusion, generic HRQoL instruments are sensitive to detect the relation between vision and HRQoL, as they cover dimensions influenced by vision. Declining vision is associated with reduced functioning, which leads to dependence and isolation – both major factors in an individual's well‐being. This phenomenon showed surprising similarity around the world and therefore emphasises the global burden of vision loss at both individual and societal level and encourages its prevention and treatment. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the prevalence of overweight/obesity and associated complications from a large, cross‐sectional, nationwide database in China. Materials and Methods: Data were obtained from 519 Meinian health check‐up centres across 243 cities. Eligible participants were aged ≥18 years, with a routine check‐up in 2019 (N = 21 771 683) and complete height, weight, sex and region data. The unadjusted prevalence rates of overweight/obesity were calculated by age, sex and region. In addition, the nationwide prevalence rates of overweight and obesity were standardized according to the 2010 China census by age group and sex. The prevalence of obesity‐related complications by body mass index (BMI) groups was calculated using logistic regression. Results: There were 15 770 094 eligible participants (median age 40 years; mean BMI 24.1 kg/m2; 52.8% male). By Chinese BMI classification, 34.8% were overweight and 14.1% were obese. Overweight and obesity were more prevalent in male than female participants (standardized: overweight 40.2% vs. 27.4%; obesity 17.6% vs. 9.6%, respectively). The prevalence of assessed complications was higher in participants with overweight/obesity versus those with normal BMI (P < 0.001 for trends). The most prevalent complications in participants with overweight/obesity were fatty liver disease, prediabetes, dyslipidaemia and hypertension. The number of complications increased with higher BMI. Conclusions: Overweight/obesity and related complications are highly prevalent in this population. These data may better inform management and prevention public health strategies in China. [ABSTRACT FROM AUTHOR]

Aim: To examine disparities in glucose‐lowering drug (GLD) usage between migrants and native Danes with type 2 diabetes (T2D). Materials and Methods: In a nationwide, register‐based cross‐sectional study of 253 364 individuals with prevalent T2D on December 31, 2018, we examined user prevalence during 2019 of (i) GLD combination therapies and (ii) individual GLD types. Migrants were grouped by origin (Middle East, Europe, Turkey, Former Yugoslavia, Pakistan, Sri Lanka, Somalia, Vietnam), and relative risk (RR) versus native Danes was computed using robust Poisson regression to adjust for clinical and socioeconomic characteristics. Results: In 2019, 34.7% of native Danes received combination therapy, and prevalence was lower in most migrant groups (RR from 0.78, 95% confidence interval CI 0.71‐0.85 [Somalia group] to 1.00, 95% CI 0.97‐1.04 [former Yugoslavia group]). Among native Danes, the most widely used oral GLD was metformin (used by 62.1%), followed by dipeptidyl peptidase‐4 inhibitors (13.3%), sodium‐glucose cotransporter‐2 inhibitors (11.9%) and sulphonylureas (5.2%), and user prevalence was higher in most migrant groups (RR for use of any oral GLD: 0.99, 95% CI 0.97‐1.01 [Europe group] to 1.09, 95% CI 1.06‐1.11 [Sri Lanka group]). Furthermore, 18.7% of native Danes used insulins and 13.3% used glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs), but use was less prevalent in migrants (RR for insulins: 0.66, 95% CI 0.62‐0.71 [Sri Lanka group] to 0.94, 95% CI 0.89‐0.99 [Europe group]; RR for GLP‐1RAs: 0.29, 95% CI 0.22‐0.39 [Somalia group] to 0.95, 95% CI 0.89‐1.01 [Europe group]). Conclusions: Disparities in GLD types and combination therapy were evident between migrants and native Danes. Migrants were more likely to use oral GLDs and less likely to use injection‐based GLDs, particularly GLP‐1RAs, which may contribute to complication risk and mortality among this group. [ABSTRACT FROM AUTHOR]

METHODS This was a whole population study, assessing the impact of the COVID-19 pandemic on the number of people with a new diagnosis of type 2 diabetes in England. Impact of the COVID-19 pandemic on new diagnoses of type 2 diabetes in England Keywords: observational study; population study; type 2 diabetes EN observational study population study type 2 diabetes 3424 3429 6 10/05/23 20231101 NES 231101 BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has been associated with a reduction in new diagnoses of type 2 diabetes, with an estimated 60 000-70 000 missed or delayed diagnoses across the UK from March to December 2020.[[1]] Using population-based National Audit data, we aimed to: (a) compare observed with expected numbers and incidence rates of new type 2 diabetes diagnoses in England from April 2020 to March 2022 to assess whether new diagnoses in 2021/2022 made up for the reduced number earlier in the pandemic; and (b) assess whether patient characteristics in newly diagnosed people were different prepandemic versus postpandemic onset. While we have seen excess cases of new diagnoses of type 2 diabetes in those aged younger than 30 years, in older age groups, missed diagnoses seem to remain an ongoing issue, raising concerns about the heightened risk of microvascular and macrovascular complications because of suboptimally managed vascular risk factors in the undiagnosed elderly people. [Extracted from the article]

Aim: To investigate whether continuous HbA1c levels and HbA1c‐polygenic risk scores (HbA1c‐PRS) are significantly associated with worse brain health independent of type 2 diabetes (T2D) diagnosis (vs. not), by examining brain structure and cognitive test score phenotypes. Methods: Using UK Biobank data (n = 39 283), we tested whether HbA1c levels and/or HbA1c‐PRS were associated with cognitive test scores and brain imaging phenotypes. We adjusted for confounders of age, sex, Townsend deprivation score, level of education, genotyping chip, eight genetic principal components, smoking, alcohol intake frequency, cholesterol medication, body mass index, T2D and apolipoprotein (APOE) e4 dosage. Results: We found an association between higher HbA1c levels and poorer performance on symbol digit substitution scores (standardized beta [β] = −0.022, P =.001) in the fully adjusted model. We also found an association between higher HbA1c levels and worse brain MRI phenotypes of grey matter (GM; fully‐adjusted β = −0.026, P <.001), whole brain volume (β = −0.072, P =.0113) and a general factor of frontal lobe GM (β = −0.022, P <.001) in partially and fully adjusted models. HbA1c‐PRS were significantly associated with GM volume in the fully adjusted model (β = −0.010, P =.0113); however, when adjusted for HbA1c levels, the association was not significant. Conclusions: Our findings suggest that measured HbA1c is associated with poorer cognitive health, and that HbA1c‐PRS do not add significant information to this. [ABSTRACT FROM AUTHOR]

Objective: To investigate associations between parenting styles during childhood and diabetes in adulthood in a Japanese community. Methods: In 2011, 710 community-dwelling Japanese residents aged ≥ 40 years were assessed for the presence of diabetes and for their perceptions of the parenting style of their parents, as measured using the "care" and "overprotection" scales of the Parental Bonding Instrument. Care and overprotection scores for each parent were dichotomized by age-specific median values. Diabetes mellitus was defined as a fasting plasma glucose level of ≥ 7.0 mmol/L, a 2-h post-loaded glucose level of ≥ 11.1 mmol/L, HbA1c ≥ 6.5%, and/or the current use of insulin or oral glucose-lowering agents. The odds ratios (ORs) for prevalent diabetes were calculated using a logistic regression model. Results: The prevalence of diabetes was 14.9%. Subjects with a high paternal overprotection score had a significantly greater likelihood of prevalent diabetes than those with a low paternal overprotection score after adjusting for confounders (OR 1.71, 95% confidence interval [CI] 1.06–2.77), while there was no significant association between paternal care and diabetes. Additionally, the multivariable-adjusted ORs for the presence of diabetes were significantly higher in subjects with a low maternal care score (OR 1.61, 95%CI 1.00–2.60) or in subjects with a high maternal overprotection score (OR 1.73, 95%CI 1.08–2.80). Moreover, the subjects with a low care score and high overprotection score for both their father and mother had a significantly higher multivariable-adjusted OR of diabetes than those with a high care score and low overprotection score for both parents (OR 2,12, 95%CI 1.14–3.95). Conclusions: This study suggests that inadequate care and excessive overprotection during childhood may contribute to the development of diabetes in adulthood. [ABSTRACT FROM AUTHOR]

The symptomatic samples were taken from five districts in Yogyakarta and Central Java provinces of Indonesia to survey the genetic diversity of Begomovirus, α and β satellites. Fourteen samples tested positive by PCR for infections of tomato leaf curl New Delhi virus, pepper yellow leaf curl Indonesia virus, mungbean yellow mosaic India virus, and ageratum yellow vein China virus. For the first time, the Ageratum yellow vein alpha satellite (AYVA) was identified in Indonesia and the tomato leaf curl Java beta satellite (ToLCJaB) was detected in different hosts. The partial genome sequences of begomoviruses and complete sequences of the α and β satellites were obtained and deposited in NCBI GenBank (OP846592-OP846615). The phylogenetic study revealed that AYVA and ToLCJaB each had two separate lineages. Coherent with the other reports, the polymorphism and diversity analyses confirmed that the βC1 coding region of the ToLCJaB genome is highly conserved. The comparison of phylogroups 1 and 2 of ToLCJaB produced a high Fixation index (FST) value, indicating genetic isolation between them. This report could serve as a basis for future work on the poorly studied genetic variation of α and β satellites in Indonesia and other countries. [ABSTRACT FROM AUTHOR]

To investigate trends in the haemoglobin (Hb) level in middle-aged Swedish women from 1968 to 2017 and to examine the potential association between Hb and the use of hormonal contraceptives (HCs). A prospective observational population study of representative 38- and 50-year-old women of Gothenburg, Sweden. The population study of women in Gothenburg started in 1968–1969 and has continued since then with new examinations every 12 years, including both follow-ups and new recruited cohorts. The study consists of both physical examinations and questionnaires. Two thousand four hundred eighty-eight women aged 38 and 50 participated in the study from 1968 to 2017. Linear regression model analyses were used to analyse linear and non-linear trends in the level of Hb. Linear and logistic regression models were used to analyse possible associations between HC and Hb and possible associations between the use of HC and anaemia, respectively. Hb was measured in g/L. HC included any ongoing use of HC therapy. Covariates were smoking, body mass index (BMI), alcohol consumption and education. A non-linear U-shaped trend in mean Hb was seen in the two age groups, 38- and 50-years old. After adjusting for covariates, a significantly higher mean Hb was seen in the 2016–2017 examination compared to 1980–1981, 1992–1993 and 2004–2005. In 38-year-olds, using HC was associated with a reduced risk of anaemia (OR 0.35, 95% CI 0.13–0.75). In both age groups, the use of HC was significantly associated with having a higher Hb. Mean levels of Hb in middle-aged women of the general population seem to be increasing again after lower levels in the 1980s and 1990s. The use of HC was associated with having a higher Hb and a lower risk of anaemia in 38-year-old women. Studies of trends in haemoglobin (Hb) in Swedish women are scarce, although many factors associated with Hb levels have changed during the last decades. The use of hormonal contraceptives was associated with higher Hb and decreased risk of anaemia in younger middle-aged women. This study shows there is a non-linear (U-formed) trend in mean Hb, with increasing values since 1992. [ABSTRACT FROM AUTHOR]

Aims: To examine associations between weight loss/gain and risk of developing 13 obesity‐related complications (ORCs), stratified by baseline body mass index (BMI). Materials and Methods: In this retrospective cohort study, we included adults with obesity (>30 kg/m2) from the UK Clinical Practice Research Datalink GOLD database with weight change (−50% to +50%) between Years 1 and 4 (N = 418 774 [median follow‐up: 7 years]). Associations between weight change, baseline BMI and risk of developing ORCs during follow‐up were assessed using Cox proportional hazard models. Results: The impact of weight change on ORCs was generally dependent on baseline BMI. Four clear patterns were seen across the 13 outcomes. Pattern 1 showed greatest weight loss benefit for people with low baseline BMI (type 2 diabetes, sleep apnoea, hypertension and dyslipidaemia); Pattern 2 showed most weight loss benefit at lower baseline BMI but no significant weight loss effect at higher baseline BMI (asthma, hip/knee osteoarthritis and polycystic ovary syndrome); Pattern 3 showed benefit in most cardiovascular diseases with weight loss (chronic kidney disease, heart failure, atrial fibrillation and venous thromboembolism), but no additional benefit with >10% weight loss; Pattern 4 showed no clear relationship between weight change and unstable angina/myocardial infarction and depression. We found similar but opposite patterns for weight gain. Conclusions: Weight loss benefit is dependent on weight loss magnitude and initial BMI, and weight gain is associated with a similar risk increase. Four patterns of association were identified between degree of weight change, baseline BMI and 13 ORCs. [ABSTRACT FROM AUTHOR]

Aim: Weight bias, stigma and discrimination are pervasive in the health care system and society and may result in biased treatment of people living with obesity (PwO). We aimed to identify perceptions, attitudes and potential barriers that exist between people with obesity and health care professionals (HCPs) in Denmark. Methods: The ACTION‐DK survey was a cross‐sectional, non‐interventional, descriptive study conducted in Denmark. The cohort included 879 PwO (body mass index ≥30.0 kg/m2) based on self‐reported height and body weight, and 100 HCPs from the primary and secondary sectors who frequently encountered PwO. Results: Several discrepancies between PwO and HCPs were identified, including recognition of obesity as a chronic disease (PwO: 49% vs. HCPs: 84%) and whether PwO were responsible for their weight loss (PwO: 81% vs. HCPs: 17%). Among PwO, 46% were motivated to lose weight, but only 28% of HCPs shared this perception. Untimely initiation of obesity care consultations was also identified as a potential barrier to proper obesity care, as PwO waited 7 years, on average, from their initial decision to lose weight before having their first obesity care consultation. In addition, only 24% of PwO had a follow‐up consultation after the initial obesity care discussion. Almost half of HCPs (46%) considered weight loss medication effective, but only 10% brought up this possibility during an obesity care discussion. Conclusions: Our findings suggest that it is pivotal to improve obesity care in Denmark by ensuring a better follow‐up and alignment of the perceptions and attitudes toward obesity between PwO and HCPs. [ABSTRACT FROM AUTHOR]

Deliberate self-harm (DSH) treated in general hospital is a well-established risk factor for suicide and other cause mortality. However, few studies have used population data to investigate the differential impact of specific psychiatric disorders on the risk of subsequent suicide, by sex and age of the patient in the context of previous DSH episodes. All patients aged 18 and older treated for DSH in general hospitals during the period 2008–2018 were identified through national registers. Cox proportional hazards regression was used to ascertain the associated risk of death by suicide, mental and behavioural disorder and other external causes. The cohort consisted of 39 479 patients of which 878 died by suicide, 461 by mental and behavioural disorders and 1037 by other external causes. Overall, schizophrenia spectrum disorders, affective disorders and personality disorders increased the risk of suicide. Large gender and age differences were identified in the risk of suicide associated with personality disorders and affective disorders. Alcohol use disorders and dementia increased the risk of dying by mental and behavioural disorders and alcohol use disorders and other substance use disorders increased the risk of death by external causes. Schizophrenia spectrum disorders, affective disorders and personality disorders increased the risk of suicide among DSH patients, but the effect varied by gender, age and history of previous DSH. Psychiatric evaluation of all DSH patients and treatment tailored to the patient's specific needs is essential to reduce the risk of premature death. [ABSTRACT FROM AUTHOR]

To identify possible predictors of executive functions of individuals with CHARGE syndrome, as these will be important targets for interventions. A population-based cross-sectional study investigating the executive functions of a representative sample of 35 Norwegians with CHARGE syndrome divided into two subgroups to handle their inherent heterogeneity. Both performance-based measures and rating scale findings were included and organized according to the 3-factor model of Miyake and colleagues. Both measures showed comprehensive executive dysfunctions within the population, which were largely unrelated to deafblindness. Working memory stood out as a strength within the executive domain and the only factor presenting results within the normal range. Verbal working memory was a particular cognitive resource for participants with deafblindness, and, unlike those without deafblindness, unrelated to sensorimotor functions. Individuals with CHARGE syndrome appear to be at risk for underdeveloped executive functions due to neurogenetic and environmental factors. Performance-based measures and ratings from caregivers gave unique and complementary knowledge and implied the need of both when investigating executive functioning in CHARGE syndrome. Participants with deafblindness presented strong verbal working memory despite their auditory impairments, indicating effective compensatory mechanisms The results also indicated an untapped cognitive potential in both subgroups. Because of their relatively advanced working memory significantly correlating with global cognition, the environment should assume equal learning potential of individuals with CHARGE syndrome regardless of their degree of sensory impairments. [ABSTRACT FROM AUTHOR]

Purpose: Knowledge of visual health in the population is necessary for designing and implementing measures to handle visual handicap. The purpose of the FORSYN (Forekomst af synshandicap og synshjælpemidler i Danmark) project was to study visual health in the Danish population 2020–2022 after implementation of the recent advances in the management of choroidal and retinal vascular disease. The present study reports visual acuity and causes of central visual loss from this study. Methods: A population‐representative sample of 10 350 citizens living within 40 kilometres from Aarhus University Hospital were invited to answer a questionnaire about quality of life related to vision, measurement of visual acuity and a non‐mydriatic examination of the eyes. The data were corrected for selection bias on the basis of demographic and socioeconomic factors so that the results could be projected to represent the adult Danish population. Results: Population‐adjusted visual acuity in ETDRS letters (mean ± SD) differed significantly (p < 0.0001) among the worse eye (84.1 ± 0.25), the better eye (88.4 ± 0.11) and binocularly (89.2 ± 0.15). Social blindness affected 0.22% (95% CI: 0.14%–0.33%) of the population and was in none of the studied persons due to exudative age‐related macular degeneration (AMD) or diabetic retinopathy. The most frequent causes of visual loss were atrophic AMD, neuro‐ophthalmic disorders and other chorioretinal diseases. Conclusions: Recent advances in the therapy of chorioretinal vascular diseases have been paralleled with a reduction in central vision loss secondary to exudative AMD and diabetic retinopathy in Denmark. The demographic development can be expected to increase the demand for treatments of vision‐threatening diseases that mainly affect older persons. [ABSTRACT FROM AUTHOR]

To examine the concurrent validity of the Anxiety Symptom-scale against two well-being scales, the Cantril Ladder (CL) and World Health Organization Well-Being Index (WHO-5), to test the algorithm defining anxiety against these scales, and identify cut-off points for the Anxiety Symptom-scale sum score. 14,405 adult respondents completing all psychometric questions in the Lolland Falster Health Study. Receiver operating characteristic analyses comparing Anxiety Symptom-scale WHO-5 and CL. 2.5% of respondents had an anxiety disorder (3% female and 2% male) according to the Anxiety Symptom-scale algorithm. The area under the curve (AUC) was 0.87 for CL and 0.90 for WHO-5 (using inverse scores), indicating high concordance with anxiety disorder as identified by the scale. A score solely ≥2 on item 10 is a relevant cut off to low wellbeing. Anxiety disorder covers a broad range on the scale's sum score, with 3 to 4 indicating low well-being in this population sample and a sensitivity of 0.85 − 0.99 against CL and WHO-5. The Anxiety Symptom-scale is a sensitive and valid instrument for the identification of patients in low well-being with symptoms of anxiety. A score ≥2 on the functional impact (Item 10) of all symptoms is a relevant indicator of anxiety associated with low well-being in this sample. A higher Anxiety Symptom-scale sum score is coherent with lower well-being, though without specific cut-off points. Further validation of the Anxiety Symptom-scale in a clinical setting is recommended. [ABSTRACT FROM AUTHOR]

Purpose: Deep learning artificial intelligence can determine the sex using only fundus photographs. However, the factors used by deep learning to determine the sex are not visible. Therefore, the purpose of the study was to determine whether the sex of an older individual can be determined by regression analysis of their color fundus photographs (CFPs). Methods: Forty-two parameters were analyzed by regression analysis using 1653 CFPs of normal subjects in the Kumajima study. The parameters included the mean values of red, green, and blue intensities; the tessellation fundus index; the optic disc ovality ratio; the papillomacular angle; and the retinal vessel angles. Finally, the L2 regularized binomial logistic regression was used to predict the sex using all the parameters, and the diagnostic ability was assessed through the leave-one-cross-validation. Results: The mean age of the 838 men and 815 women were 52.8 and 54.0 years, respectively. The ovality ratio and retinal artery angles in women were significantly smaller than that in men. The green intensity at all locations for the women were significantly higher than that of men (P < 0.001). The discrimination accuracy rate assessed by the area-under-the-curve was 80.4%. Conclusions: Our methods can determine the sex from the CFPs of the adult with an accuracy of 80.4%. The ovality ratio, retinal vessel angles, tessellation, and the green intensities of the fundus are important factors to identify the sex in individuals over 40 years old. [ABSTRACT FROM AUTHOR]

To measure the association of baseline psychological symptoms (depressive symptoms and perceived stress) with withdrawal from a cohort study. Depressive symptoms and perceived stress were obtained using validated measures during the baseline computer-assisted telephonic interview for the REasons for Geographic and Racial Differences in Stroke study a national longitudinal cohort (≥45 years, 42% Black, 55% women) recruited between 2003 and 2007. Participants who completed follow-up after September 1, 2019, were considered active. Primary outcome was time to study withdrawal. The association of psychological symptoms and time-to-withdrawal was measured using Cox proportional hazard regression models with incremental adjustments by demographic and clinical factors. Out of 29,964 participants included in the analysis, 11,111 (37.1%) participants withdrew over the follow-up period (median: 11 years). Compared to participants with low depressive symptoms, those with moderate symptoms had 5% higher risk (aHR= 1.05; 95% CI= 1.00-1.10) and those with high level of depressive had 19% higher risk (aHR= 1.19; 95% CI= 1.11-1.27) of withdrawal in fully adjusted models. No significant association between perceived stress and withdrawal risk was observed. Depressive symptoms were significantly associated with withdrawal. Prevalence of depressive symptoms at baseline is an important indicator of participant retention in large prospective cohorts. [ABSTRACT FROM AUTHOR]

Abstract Aim Method Result Conclusion This paper aimed to answer how psychometric methods based on neurotypical populations can serve as valid instruments in the assessment and diagnosis of intellectual disability in individuals with atypical development. The genetic, structural, and functional features of CHARGE make it uniquely suited to address this question.A Norwegian population of individuals with CHARGE (N = 35) underwent assessment procedures according to DSM-5 guidelines for the evaluation of an intellectual disability diagnosis. Results from cognitive testing (Wechsler Intelligence Scales) and parental evaluation of adaptive skills (Vineland Adaptive Behavioral Scale) were obtained and compared to their respective norm samples to explore any methodological inconsistencies.Significant differences emerged between the participants and the norm samples. Global cognition obtained from Wechsler revealed a bimodal distribution, suggesting a two-group sample, with the youngest children forming their own subgroup. Comparisons of the different age-groups’ performances demonstrated the lowest results among the preschoolers while the adults scored the highest. The global adaptive behavior score turned out significantly lower than the performance-based scores, thereby deflating the overall estimate of global intellectual abilities.For individuals with CHARGE, the effect of the atypicality seemed most apparent during early childhood, stabilizing and subsiding towards adulthood. The test results’ interpretability was weakest for the preschoolers progressively increasing until peaking in adulthood, emphasizing the importance of delaying the assessment and diagnosis of intellectual disability. Because of several validity issues connected to the observation-based measure, complementary testing should precede clinical evaluations when possible in the diagnostics of individuals with CHARGE. [ABSTRACT FROM AUTHOR]

Background: Children in low-resource countries like Georgia often have limited access to assessment measures for mental health care services. This study adapts and validates the mental health screening tool the Strength and Difficulties Questionnaire for use in Georgian children. Methods: A total of 16 654 children were assessed by a parent and/or teacher using Georgian-adapted Strength and Difficulties Questionnaire. Receiver operating characteristic analyses were performed to assess the discriminative validity of the Strength and Difficulties Questionnaires and to establish an optimal cutoff score. Results: Data from 15 738 parents- and 13 560 teachers-administered Strength and Difficulties Questionnaire were analyzed. The internal consistency analysis showed Cronbach's alpha to be 0.625 and 0.621 for parent- and teacher-administered Strength and Difficulties Questionnaire, respectively. The area under the curve (95% CI) shows that the Strength and Difficulties Questionnaire can differentiate risk group children from typically developing peers: parent-administered questionnaires--0.629 (0.556-0.702) and teacher-administered questionnaires--0.680 (0.611-0.789). Parent-administered Strength and Difficulties Questionnaire has a cutoff value of 16 or more with 92.5% of sensitivity and teacher-administered Strength and Difficulties Questionnaire--14 or more with a sensitivity of 85.6%. Conclusion: The study finds that the Strength and Difficulties Questionnaire is a valid screening instrument and does not depend on the informant--parent or teacher. It suggests that with appropriate cultural adaptation, the SDQ can be used in the Republic of Georgia to identify children at risk for mental disorders and help guide resource allocation. [ABSTRACT FROM AUTHOR]

Objective: Breast cancer (BC) is the most common cancer type in women and may be inherited, mostly in an autosomal dominant pattern. The clinical diagnosis of BC relies on the published diagnostic criteria, and analysis of two genes, BRCA1 and BRCA2, which are strongly associated with BC, are included in these criteria. The aim of this study was to compare BC index cases with non-BC individuals in terms of genotype and diagnostic features to investigate the genotype/demographic information association. Materials and Methods: Mutational analyses for the BRCA1/BRCA2 genes was performed in 2475 individuals between 2013-2022 from collaborative centers across Turkey, of whom 1444 with BC were designated as index cases. Results: Overall, mutations were identified in 17% (421/2475), while the percentage of mutation carriers in cases of BC was similar, 16.6% (239/1444). BRCA1/BRCA2 gene mutations were detected in 17.8% (131/737) of familial cases and 12% (78/549) of sporadic cases. Mutations in BRCA1 were found in 4.9%, whereas 12% were in BRCA2 (p<0.05). Meta-analyses were performed to compare these results with other studies of Mediterranean-region populations. Conclusion: Patients with BRCA2 mutations were significantly more common than those with BRCA1 mutations. In sporadic cases, there was a lower proportion with BRCA1/BRCA2 variants, as expected, and these results were consistent with the data of Mediterranean-region populations. However, the present study, because of the large sample size, revealed more robust findings than previous studies. These findings may be helpful in facilitating the clinical management of BC for both familial and non-familial cases. [ABSTRACT FROM AUTHOR]

Aim: To assess the associations of total dietary fibre and fibre from different food sources (ie, cereal, fruit and vegetables) with the risk of diabetes. Materials and methods: The Melbourne Collaborative Cohort Study enrolled 41 513 participants aged 40 to 69 years from 1990 to 1994. The first and second follow‐ups were conducted in 1994 to 1998 and 2003 to 2007, respectively. Self‐reported diabetes incidence was recorded at both follow‐ups. We analysed data from 39 185 participants, with a mean follow‐up of 13.8 years. The relationships between dietary fibre intake (total, fruit, vegetable and cereal fibre) and the incidence of diabetes were assessed using modified Poisson regression, adjusted for dietary, lifestyle, obesity, socioeconomic and other possible confounders. Fibre intake was categorized into quintiles. Results: At total of 1989 incident cases were identified over both follow‐up surveys. Total fibre intake was not associated with diabetes risk. Higher intake of cereal fibre (P for trend = 0.003), but not fruit (P for trend = 0.3) and vegetable fibre (P for trend = 0.5), was protective against diabetes. For cereal fibre, quintile 5 versus quintile 1 showed a 25% reduction in diabetes risk (incidence risk ratio [IRR] 0.75, 95% confidence interval [CI] 0.63‐0.88). For fruit fibre, only quintile 2 versus quintile 1 showed a 16% risk reduction (IRR 0.84, 95% CI 0.73‐0.96). Adjustment for body mass index (BMI) and waist‐to‐hip ratio eliminated the association and mediation analysis showed that BMI mediated 36% of the relationship between fibre and diabetes. Conclusion: Intake of cereal fibre and, to a lesser extent, fruit fibre, may reduce the risk of diabetes, while total fibre showed no association. Our data suggest that specific recommendations regarding dietary fibre intake may be needed to prevent diabetes. [ABSTRACT FROM AUTHOR]

2 TABLE Raw incidence rates (IR) of type 1 diabetes in Piedmont (Italy) by 100 000 residents and rate ratios (RR), comparison between before and during the COVID pandemic years. Nevertheless, over the 3 years of the COVID-19 pandemic, the overall incidence of DM1 has remained ~17% higher than before the pandemic, suggesting further work to understand the link between coronaviruses and diabetes is a priority. Keywords: database research; observational; population study; study; type 1 diabetes EN database research observational population study study type 1 diabetes 3068 3070 3 09/06/23 20231001 NES 231001 BACKGROUND There have now been several reports that the incidence of type 1 diabetes (DM1) increased during the COVID-19 pandemic, particularly in young children,[[1], [3]] although some data are conflicting.[4] Overall, however, there is emerging evidence from diabetes registries that this observed increase is real. [Extracted from the article]

Background and aims: Although obesity has been confirmed as a risk factor for SARS-CoV-2 infection and its severity, the role of post-bariatric surgery (BS) variables and the infection is unclear. We, therefore, aimed to study comprehensively the relationship between the extent of weight reduction after surgery and other demographic, clinical, and laboratory variables with the rates of SARS-CoV-2 infection. Methods: A population-based cross-sectional study was performed, utilizing advanced tracking methodologies on the computerized database of a nation-wide health maintenance organization (HMO). The study population included all HMO members aged ≥18 years that had been tested at least once for SARS-CoV-2 during the study period and underwent BS at least one year before their testing. Results: Of the total 3038 individuals who underwent BS, 2697 (88.78%) were positive for SARS-CoV-2 infection and 341 (11.22%) were negative. Multivariate regression analysis demonstrated that the body mass index and the amount of weight reduction after the BS were not related to the likelihood of SARS-CoV-2 infection. Post-operative low socioeconomic status (SES) and vitamin D3 deficiency were associated with significant and independent increased rates of SARS-CoV-2 infection (odds ratio [OR] 1.56, 95% confidence interval [CI], 1.19–2.03, p < 0.001; and OR 1.55, 95% CI, 1.18–2.02, p < 0.001; respectively). Post-operative physical activity > 3 times/week was associated with a significant and independent reduced rate of SARS-CoV-2 infection (OR 0.51, 95% CI, 0.35–0.73, p < 0.001). Conclusion: Post-BS vitamin D3 deficiency, SES, and physical activity, but not the amount of weight reduction, were significantly associated with the rates of SARS-CoV-2 infection. Healthcare workers should be aware of these associations after BS and intervene accordingly. [ABSTRACT FROM AUTHOR]

Introduction: Approximately a third of cancer-related deaths are attributable to modifiable factors. Methods: As a pilot experience, a cross-sectional survey was conducted in 8,000 citizens residing in four different municipalities of the Salerno province (Sarno, Pagani, San Valentino Torio, and San Marzano sul Sarno) to investigate key lifestyle and dietary habits. Results: A total of 703 of participants (8.7%) reported a history of malignancy. Alarmingly, 30.5% declared to be a current smoker, while 78.8% did not report any kind of physical activity. Encouragingly, 64.5% declared to be abstemious, and 83.0% declared to consume fruit and vegetables every day, while 4.7% and 31.9% declared not to consume meat and fried food, respectively, at any time. Never-consumers of fruit and vegetables had higher odds of having a history of colorectal cancer (OR = 5.01; 95% CI = 1.46–17.15; p = 0.01). Conclusions: The PREVES study has served to prove the validity of an operational model allowing to integrate hospital and territorial healthcare services, which we expect to be applied at a larger scale. Key information regarding dietary and lifestyle habits of the investigated population was obtained. Larger studies conducted using more accurate approaches to investigate diet, such as 24-h recalls and food frequency questionnaires, are warranted. [ABSTRACT FROM AUTHOR]

Length-weight relationships (LWRs) and Fulton's condition factor were estimated for two flatfishes, Cynoglossus lingua Hamilton, and Cynoglossus cynoglossus (Hamilton), from the Cox's Bazar coast of Bangladesh. Sampling was done from September to November 2022 from the landing center of Bangladesh Fisheries Development Corporation. In this study, the maximum total length of C. cynoglossus (34.0 cm) is a new record for this species. The length-weight relationships for these two species were highly significant (P < 0.001) with adjusted r2 values of 0.918 and 0.927 for C. lingua and C. cynoglossus, respectively. The calculated growth coefficient (b) for C. lingua and C. cynoglossus was 2.873 and 3.359, respectively. The estimated Fulton's condition factor (Kn) was 0.42 ± 0.05 for C. lingua and 0.72 ± 0.11 for C. cynoglossus. No information about the population parameters of C. lingua from the Bay of Bengal has been reported previously in any scientific database. The maximum Kn value of C. lingua was observed in the 13.0–15.9 cm length class while that of C. cynoglossus was found in the 31.0–33.9 cm length class. Our estimated LWR and Fulton's condition factor values for these two flatfishes can be useful for management and conservation. [ABSTRACT FROM AUTHOR]