Population-based epidemiology

  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    在没有有效疾病监测能力的地区,无法很好地监测和了解SARS-CoV-2的传播。人口年轻的国家将出现不成比例的大量无症状或无症状感染,进一步阻碍感染的检测。在马里等资源有限的情况下,由训练有素的医疗专业人员在全国范围内进行的血清监测可能受到限制。以非侵入性方法广泛采样人群的新方法将允许以降低的成本进行大规模监测。
    在这里,我们评估了在实验室和马里的五个野外地点收集自然血液喂养的蚊子以测试人类抗SARS-CoV-2抗体。
    在喂食后至少10小时内,通过基于珠子的免疫测定在蚊子血粉中容易检测到针对多种SARS-CoV-2抗原的免疫球蛋白G抗体[平均灵敏度为0.92(95%CI0.78-1)和平均特异性为0.98(95%CI0.88-1)],这表明,大多数在清晨在室内收集的血液喂养的蚊子(可能在前一天晚上喂食)是用于分析的可行样本。我们发现,在大流行期间,对四种SARS-CoV-2抗原的反应性从大流行前的水平上升。2020年10月和11月,所有地点通过蚊子采样的血液的粗血清阳性率为6.3%,到2021年2月,总体增长到25.1%,城市用地最多的达到46.7%,与基于独立静脉血液的血清监测估计一致。
    我们已经证明,使用蚊子血,在人类叮咬蚊子很普遍的地区,可以在全国范围内对人类疾病(媒介传播和非媒介传播)进行血清监测,提供信息,成本效益高,和非侵入性采样选项。
    UNASSIGNED: The spread of SARS-CoV-2 cannot be well monitored and understood in areas without capacity for effective disease surveillance. Countries with a young population will have disproportionately large numbers of asymptomatic or pauci-symptomatic infections, further hindering detection of infection. Sero-surveillance on a country-wide scale by trained medical professionals may be limited in a resource-limited setting such as Mali. Novel ways of broadly sampling the human population in a non-invasive method would allow for large-scale surveillance at a reduced cost.
    UNASSIGNED: Here we evaluate the collection of naturally blood-fed mosquitoes to test for human anti-SARS-CoV-2 antibodies in the laboratory and at five field locations in Mali.
    UNASSIGNED: Immunoglobulin-G antibodies to multiple SARS-CoV-2 antigens were readily detected in mosquito bloodmeals by bead-based immunoassay through at least 10 h after feeding [mean sensitivity of 0.92 (95% CI 0.78-1) and mean specificity of 0.98 (95% CI 0.88-1)], indicating that most blood-fed mosquitoes collected indoors during early morning hours (and likely to have fed the previous night) are viable samples for analysis. We found that reactivity to four SARS-CoV-2 antigens rose during the pandemic from pre-pandemic levels. The crude seropositivity of blood sampled via mosquitoes was 6.3% in October and November 2020 across all sites, and increased to 25.1% overall by February 2021, with the most urban site reaching 46.7%, consistent with independent venous blood-based sero-surveillance estimates.
    UNASSIGNED: We have demonstrated that using mosquito bloodmeals, country-wide sero-surveillance of human diseases (both vector-borne and non-vector-borne) is possible in areas where human-biting mosquitoes are common, offering an informative, cost-effective, and non-invasive sampling option.
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  • 文章类型: Journal Article
    尿石症(美元)历来影响老年男性,但是研究表明,最近女性人数有所增加,导致几乎相同的性别发病率。美元发病率每10年翻一番,随着儿童不成比例的增加,青春期,年轻成人(AYA)妇女。妇女的美元结石成分通常是磷灰石(磷酸钙),在较高的尿液pH中形成,低尿柠檬酸盐,和大量的尿尿酸,而男性会产生更多的草酸钙结石。这种流行病学趋势的原因尚不清楚。
    这个角度用加拿大省和北美机构的数据展示了美元的范围,对这些发现的解释,并提供了减少这一趋势的潜在解决方案。我们描述了美元的经济影响。
    在安大略省,美元的整体手术干预措施显着增加了46%。发病率从2002年的47.0/100,000上升到2016年的68.7/100,000人口。在一个单一的美国机构中,从2015年到2019年,美元年度独特患者总数从10,612增加到17,706,而持有美元的女性比例远高于预期。在10-17岁的患者中,50.1%是女孩;18-34岁年龄组为57.5%,35-44岁年龄组为53.6%。肥胖的作用,饮食,荷尔蒙,环境因素,感染,和抗生素,以及经济影响,正在讨论。
    我们确认了女性美元的显着增长。我们为这种性别差异提供了潜在的解释,包括微生物学和病理生理学方面。我们还概述了创新的解决方案-可能需要超越典型的预防和治疗建议的步骤。
    UNASSIGNED: Urinary stone disease (USD) historically has affected older men, but studies suggest recent increases in women, leading to a near identical sex incidence ratio. USD incidence has doubled every 10 years, with disproportionate increases amongst children, adolescent, and young adult (AYA) women. USD stone composition in women is frequently apatite (calcium phosphate), which forms in a higher urine pH, low urinary citrate, and an abundance of urinary uric acid, while men produce more calcium oxalate stones. The reasons for this epidemiological trend are unknown.
    UNASSIGNED: This perspective presents the extent of USD with data from a Canadian Province and a North American institution, explanations for these findings and offers potential solutions to decrease this trend. We describe the economic impact of USD.
    UNASSIGNED: There was a significant increase of 46% in overall surgical interventions for USD in Ontario. The incidence rose from 47.0/100,000 in 2002 to 68.7/100,000 population in 2016. In a single United States institution, the overall USD annual unique patient count rose from 10,612 to 17,706 from 2015 to 2019, and the proportion of women with USD was much higher than expected. In the 10-17-year-old patients, 50.1% were girls; with 57.5% in the 18-34 age group and 53.6% in the 35-44 age group. The roles of obesity, diet, hormones, environmental factors, infections, and antibiotics, as well as the economic impact, are discussed.
    UNASSIGNED: We confirm the significant increase in USD among women. We offer potential explanations for this sex disparity, including microbiological and pathophysiological aspects. We also outline innovative solutions - that may require steps beyond typical preventive and treatment recommendations.
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  • 文章类型: Journal Article
    目的肺功能检查对呼吸系统疾病的诊断至关重要,如慢性阻塞性肺疾病(COPD),但通常不会在日本进行年度健康检查,这阻碍了呼吸系统疾病的早期诊断。方法同意在高田体检期间参加山形-高田研究的个人(山形县,日本)在2011年进行了审查。我们采访了669名参与者(49.0%男性;平均年龄,67.7岁)关于他们的呼吸道症状和吸烟习惯,并在研究期间进行了肺功能测试。结果根据肺功能检查结果,141名参与者有肺功能障碍,115例患有阻塞性肺功能障碍。呼吸功能障碍的风险,特别是阻塞性呼吸功能障碍,通过参考用于早期COPD诊断的问卷工具进行检查。年龄之间的关联,吸烟史,呼吸道症状,和阻塞性呼吸功能障碍进行评估。≥50岁的参与者占17.6%,≥60岁的参与者占19.5%。30.3%有吸烟史,32.8%有呼吸道症状。此外,多因素参与者发生阻塞性呼吸功能障碍的概率较高.结论通过按年龄和吸烟习惯抽取个体并通过呼吸道症状问卷,有望有效识别阻塞性肺功能障碍患者。尽管在健康检查期间不能对所有个体进行肺功能检查。
    Objective Pulmonary function tests are essential for diagnosing respiratory diseases, such as chronic obstructive pulmonary disease (COPD), but are typically not performed in Japan during annual health checkups, which hinders the early diagnosis of respiratory diseases. Methods Individuals who agreed to participate in the Yamagata-Takahata study during medical checkups in Takahata (Yamagata Prefecture, Japan) in 2011 were examined. We interviewed 669 participants (49.0% men; mean age, 67.7 years old) regarding their respiratory symptoms and smoking habits and performed pulmonary function tests during the study. Results Based on pulmonary function test results, 141 participants had pulmonary dysfunction, and 115 had obstructive pulmonary dysfunction. The risk of respiratory dysfunction, particularly obstructive respiratory dysfunction, was examined by referring to a questionnaire tool for an early COPD diagnosis. The associations between age, the smoking history, respiratory symptoms, and obstructive respiratory dysfunction were evaluated. Obstructive respiratory dysfunction was found in 17.6% of participants ≥50 years old and 19.5% ≥60 years old, 30.3% had a smoking history, and 32.8% had respiratory symptoms. Furthermore, the participants with multiple factors had a higher probability of obstructive respiratory dysfunction. Conclusion Subjects with obstructive pulmonary dysfunction are expected to be efficiently identified by extracting individuals by age and smoking habit and through a respiratory symptom questionnaire, although pulmonary function tests cannot be performed for all individuals during health checkups.
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  • 文章类型: Preprint
    在没有有效疾病监测能力的地区,无法很好地监测和了解SARS-CoV-2的传播。人口年轻的国家将出现不成比例的大量无症状或无症状感染,进一步阻碍了人群感染的检测。在马里等资源有限的情况下,由训练有素的医疗专业人员在全国范围内进行血清监测的范围可能有限。以非侵入性方法广泛采样人群的新方法将允许以降低的成本进行大规模监测。在这里,我们评估了在实验室和马里的五个野外地点收集的自然采血蚊子以测试人类抗SARS-CoV-2抗体。在喂食后至少10小时内,通过基于珠子的免疫测定,发现免疫球蛋白G抗体很容易在蚊子血粉中检测到,具有高灵敏度(0.900±0.059)和特异性(0.924±0.080),分别,表明大多数以血液为食的蚊子是在清晨在室内收集的(因此,可能在前一天晚上喂食)是用于分析的可行样本。我们发现,在大流行期间,对四种SARS-CoV-2抗原的反应性从大流行前的水平上升。与马里的其他血清监测研究一致,2020年10月/11月,所有地点通过蚊子采样的血液的粗血清阳性率为6.3%,整体上升至25.1%,距离巴马科最近的小镇在2021年2月达到46.7%。蚊子血粉是常规免疫测定的可行目标,因此,在人类叮咬蚊子很普遍的地区,可以在全国范围内对人类疾病(媒介传播和非媒介传播)进行血清监测,并且是一个信息丰富的,成本效益高,非侵入性采样选项。
    The spread of SARS-CoV-2 cannot be well monitored and understood in areas without capacity for effective disease surveillance. Countries with a young population will have disproportionately large numbers of asymptomatic or pauci-symptomatic infections, further hindering detection of infection in the population. Sero-surveillance on a country-wide scale by trained medical professionals may be limited in scope in resource limited setting such as Mali. Novel ways of broadly sampling the human population in a non-invasive method would allow for large-scale surveillance at a reduced cost. Here we evaluate the collection of naturally bloodfed mosquitoes to test for human anti-SARS-CoV-2 antibodies in the laboratory and at five field locations in Mali. Immunoglobulin-G antibodies were found to be readily detectable within the mosquito bloodmeals by a bead-based immunoassay at least through 10 hours post-feeding with high sensitivity (0.900 ± 0.059) and specificity (0.924 ± 0.080), respectively, indicating that most blood-fed mosquitoes collected indoors during early morning hours (and thus, have likely fed the previous night) are viable samples for analysis. We find that reactivity to four SARS-CoV-2 antigens rose during the pandemic from pre-pandemic levels. Consistent with other sero-surveillance studies in Mali, crude seropositivity of blood sampled via mosquitoes was 6.3% in October/November 2020 over all sites, and increased to 25.1% overall, with the town closest to Bamako reaching 46.7% in February of 2021. Mosquito bloodmeals a viable target for conventional immunoassays, and therefore country-wide sero-surveillance of human diseases (both vector-borne and non-vector-borne) is attainable in areas where human-biting mosquitoes are common, and is an informative, cost-effective, non-invasive sampling option.
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  • 文章类型: Journal Article
    背景:在当地背景下了解2019年冠状病毒病(COVID-19)的流行病学对于未来的大流行准备和COVID-19病例量的潜在增加都是有价值的,特别是由于变异菌株。
    方法:我们的工作使我们能够在2020年3月1日至2021年12月15日在艾伯塔省完成一项针对COVID-19检测呈阳性的患者的基于人群的研究。我们完成了一个多中心,使用阿尔伯塔省的次要数据源进行基于人群的回顾性描述性研究,加拿大。我们确定了所有成年患者(≥18岁)进行了实验室测试,随后对COVID-19呈阳性(仅包括第一例COVID-19事件)。我们确定COVID-19测试呈阳性,性别,年龄,合并症,居住在长期护理(LTC)设施中,住院时间,住院时间(LOS),和死亡率。从COVID-19阳性测试中随访患者60天。
    结果:在2020年3月1日至2021年12月15日之间,在艾伯塔省确定了255,037名成年人患有COVID-19。大多数确诊病例发生在60岁以下(84.3%);然而,大多数死亡(89.3%)发生在60岁以上的人群中.检测阳性的总住院率为5.9%。作为LTC的居民,在COVID-19检测阳性的60天内,死亡率高达24.6%。COVID-19患者中最常见的合并症是抑郁症。在所有患者中,17.3%的男性和18.6%的女性在COVID-19检测阳性后进行了计划外的门诊就诊。
    结论:COVID-19与广泛的医疗保健利用有关。LTC居民在COVID-19大流行期间受到了重大影响,相关死亡率很高。应做进一步的工作,以更好地了解COVID-19感染后与相关医疗保健利用相关的经济负担,从而为医疗保健系统的资源分配提供信息,规划,和预测。
    BACKGROUND: Understanding the epidemiology of Coronavirus Disease of 2019 (COVID-19) in a local context is valuable for both future pandemic preparedness and potential increases in COVID-19 case volume, particularly due to variant strains.
    METHODS: Our work allowed us to complete a population-based study on patients who tested positive for COVID-19 in Alberta from March 1, 2020 to December 15, 2021. We completed a multi-centre, retrospective population-based descriptive study using secondary data sources in Alberta, Canada. We identified all adult patients (≥ 18 years of age) tested and subsequently positive for COVID-19 (including only the first incident case of COVID-19) on a laboratory test. We determined positive COVID-19 tests, gender, age, comorbidities, residency in a long-term care (LTC) facility, time to hospitalization, length of stay (LOS) in hospital, and mortality. Patients were followed for 60 days from a COVID-19 positive test.
    RESULTS: Between March 1, 2020 and December 15, 2021, 255,037 adults were identified with COVID-19 in Alberta. Most confirmed cases occurred among those less than 60 years of age (84.3%); however, most deaths (89.3%) occurred among those older than 60 years. Overall hospitalization rate among those who tested positive was 5.9%. Being a resident of LTC was associated with substantial mortality of 24.6% within 60 days of a positive COVID-19 test. The most common comorbidity among those with COVID-19 was depression. Across all patients 17.3% of males and 18.6% of females had an unplanned ambulatory visit subsequent to their positive COVID-19 test.
    CONCLUSIONS: COVID-19 is associated with extensive healthcare utilization. Residents of LTC were substantially impacted during the COVID-19 pandemic with high associated mortality. Further work should be done to better understand the economic burden associated with related healthcare utilization following a COVID-19 infection to inform healthcare system resource allocation, planning, and forecasting.
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  • 文章类型: Journal Article
    背景:结肠直肠癌(CRC)是西班牙最常诊断的癌症。西班牙没有记录癌症生存中的社会经济不平等。我们旨在研究西班牙南部CRC患者的社会经济不平等与总死亡率和生存率之间的关系。
    方法:我们进行了一项基于人群的多水平队列研究,包括2011-2013年期间的儿童权利公约案件。研究时间至事件结局是死亡,主要暴露是CRC患者的社会经济状况,由西班牙剥夺指数在人口普查区水平评估。我们使用了混合效应柔性风险模型,包括人口普查区作为随机截获,通过剥夺得出总体生存估计。
    结果:在3589例CRC患者和12,148人年风险(pyr)中,964例患者在随访结束前死亡。剥夺死亡率显示最贫困群体的死亡率最高(96.2/1000pyr,95%CI:84.0-110.2)。在适应性爱之后,年龄,癌症阶段,和居住面积,最贫困者的超额死亡风险高于贫困者60%(超额死亡风险比:1.6,95%CI:1.1~2.3).
    结论:我们发现剥夺与CRC超额死亡率和生存率之间存在一致的关联。这些不平等背后的原因需要进一步调查,以改善所有社会群体的平等癌症结果。
    BACKGROUND: Colorectal cancer (CRC) is the most frequently diagnosed cancer in Spain. Socioeconomic inequalities in cancer survival are not documented in Spain. We aim to study the association of socioeconomic inequalities with overall mortality and survival among CRC patients in southern Spain.
    METHODS: We conducted a multilevel population-based cohort study, including CRC cases for the period 2011-2013. The study time-to-event outcome was death, and the primary exposure was CRC patients\' socioeconomic status assessed by the Spanish deprivation index at the census tract level. We used a mixed-effects flexible hazard model, including census tract as a random intercept, to derive overall survival estimates by deprivation.
    RESULTS: Among 3589 CRC patients and 12,148 person-years at risk (pyr), 964 patients died before the end of the follow-up. Mortality by deprivation showed the highest mortality rate for the most deprived group (96.2 per 1000 pyr, 95% CI: 84.0-110.2). After adjusting for sex, age, cancer stage, and the area of residence, the most deprived had a 60% higher excess mortality risk than the less deprived group (excess mortality risk ratio: 1.6, 95% CI: 1.1-2.3).
    CONCLUSIONS: We found a consistent association between deprivation and CRC excess mortality and survival. The reasons behind these inequalities need further investigation in order to improve equality cancer outcomes in all social groups.
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  • 文章类型: Journal Article
    BACKGROUND: The present study aimed to report a full overview of the incidence and epidemiology of foot fractures.
    METHODS: Population-based epidemiological cohort study including all foot fractures over 5 years. All patient charts and radiology were manually assessed.
    RESULTS: A total of 4938 patients sustained 5912 foot fractures during the study period. Patients\' mean age at the time of fracture was 36.1 (21.7 SD) years. The overall incidence of foot fractures was 142.3/100,000/year. The hind foot incidence was 13.7/100,000/year, the mid foot incidence 6.5/100,000/year, and the fore foot incidence 123.9/100,000/year. The most common mode of injury was due to low energy trauma (98.7%).
    CONCLUSIONS: This study shows an overall incidence of foot fractures to be 142.3/100,000/year. The hind foot incidence is 13.7/100,000/year, the mid foot incidence 6.5/100,000/year, and the fore foot incidence 123.9/100,000/year.
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  • 文章类型: Journal Article
    What are the overall, 30-day, 6-month, and 1-year mortality rates following distal femur fractures?
    Epidemiological cohort study. Retrospective reviews of charts and X-rays based on a search in the National Danish Health Registry.
    A total of 293 patients were treated for 302 distal femur fractures between 2005 and 2010. The mean age at the time of fracture was 44.0 years for males and 71.6 years for females. The overall mortality rates after a non-periprosthetic distal femur fracture at 30 days, six months, and one year were 5%, 15%, and 21%, respectively. The mortality rates for patients at > 60 years at 30 days, six months, and one year were 8%, 26%, and 35%, respectively. The mortality rates for patients at ≤ 60 years at 30 days, six months, and one year were 1%, 2%, and 3%, respectively. The overall mortality rates after a periprosthetic distal femur fracture at 30 days, six months, and one year were 10%, 15%, and 15%. Males were 2.6 (95% CI 1.01-6.86, P = 0.04) times more likely to die within the first year compared to women. Patients treated by conservative means shows a 2.8 (95% CI 1.41-5.54, P = 0.03) times increased likelihood of death within the first year compared to patients treated with surgery.
    The overall one year mortality rate was 21% for non-periprosthetic distal femur fractures and was elevated to 35% in patients older than 60 years. Patients presenting with a periprosthetic fracture showed a one year mortality rate of 15%.
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  • 文章类型: Journal Article
    Regional epidemiological studies for respiratory diseases have been rarely performed in Japan, because spirometry is not regularly conducted in the standard annual health checks. The Yamagata-Takahata Study is an epidemiological study utilizing regional characteristics based on the 21st Century Centers of Excellence (COE) Program and the Global COE Program. Spirometric examination and other specific measurements via blood sampling were performed for the study participants in annual health check-ups held in Takahata, a town in Yamagata Prefecture. The Yamagata-Takahata Study revealed the impact of cigarette smoking habit on pulmonary function, the impact of reduced pulmonary function on mortality, and the situation regarding COPD comorbidities in Japan. Additionally, the study identified biomarkers of decline in pulmonary function among active smokers, and the risk factors for respiratory mortality in Japan. In this review, we summarize the findings of the Yamagata-Takahata study regarding the association between lower pulmonary function and the clinical characteristics of a Japanese general population.
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