Pub Date : 2024-08-05DOI: 10.1101/2024.08.02.24311335
Manish Sarkar, Henning von Horsten, Dimitrije Milunov, Nathalie Barreto Lefebvre, Soham Saha
Genetic obesity such as Prader Willi syndrome (PWS) is a multifaceted condition influenced by various elements, including genetic predisposition, environmental factors, and behavioral components. This meta-analysis explored the reported efficacy of therapeutics in clinical trials for PWS by evaluating clinical endpoints reached in the course of the study and the adverse events observed for each. We looked at GLP1 receptor mediated and non-GLP1 receptor mediated therapies and compared their performance in study arms across time and standard of care. In addition, we estimated the present market shares across different obesity and diabetes assets. In conclusion, the study points to two key readouts. First, existing obesity and diabetes assets are not effective for genetic obesity such as PWS. The unmet needs remain high. Second, the market of obesity and diabetes are in a stage of expansion. A collaborative approach to therapy development for genetic obesity is required to improve the quality of life for affected individuals.
{"title":"Clinical efficacy landscaping in genetic obesity: A meta-analysis in Prader Willi syndrome (PWS)","authors":"Manish Sarkar, Henning von Horsten, Dimitrije Milunov, Nathalie Barreto Lefebvre, Soham Saha","doi":"10.1101/2024.08.02.24311335","DOIUrl":"https://doi.org/10.1101/2024.08.02.24311335","url":null,"abstract":"Genetic obesity such as Prader Willi syndrome (PWS) is a multifaceted condition influenced by various elements, including genetic predisposition, environmental factors, and behavioral components. This meta-analysis explored the reported efficacy of therapeutics in clinical trials for PWS by evaluating clinical endpoints reached in the course of the study and the adverse events observed for each. We looked at GLP1 receptor mediated and non-GLP1 receptor mediated therapies and compared their performance in study arms across time and standard of care. In addition, we estimated the present market shares across different obesity and diabetes assets. In conclusion, the study points to two key readouts. First, existing obesity and diabetes assets are not effective for genetic obesity such as PWS. The unmet needs remain high. Second, the market of obesity and diabetes are in a stage of expansion. A collaborative approach to therapy development for genetic obesity is required to improve the quality of life for affected individuals.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141941545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-04DOI: 10.1101/2024.08.02.24311428
Syeda Tasnim Tabassum Hridi, Mohammad Azmain Iktidar, Arrafi Tamjid, Punam Ghosh, Kazi Sudipta Kabir, Abdullah Al Zaber, Rifat Tasnim Babu, Maliha Mehzabeen, Aysharja Das Gupta, Sreshtha Chowdhury, Simanta Roy
Background Online education gained its popularity in the education system during the COVID-19 pandemic lockdown. The online platform, including social media, was institutionalized globally for the purpose of tutoring to keep the education process ongoing under feasible circumstances. However, the post-pandemic continuation of online education and prolonged usage of electronic devices imposed a greater risk of health issues related to sensory impairment. Our study aimed to determine the impact of online education on students' hearing status and its associated factors. Methods A cross-sectional study was conducted among 1030 students of 11th grade and above who were undergoing online education in Dhaka and Chattogram. Data were collected through the online administration of a structured questionnaire containing questions on sociodemographic status, family history of diseases, personal history of comorbidities, information related to screentime exposure, and SSQ-12 (Speech, Spatial, and Qualities of Hearing -12) scale. Descriptive statistics, Pearson’s chi-square test, two independent sample t-tests, and multiple linear regression analysis were employed to obtain the results. Result The mean SSQ score of the study participants was 7.74±1.37. In bivariate analysis, gender, family income, family history of diseases (e.g., obesity, headache, hearing problem), personal history of diseases (e.g., obesity, insomnia), device type (mobile/tablet, computer), average daily screen time with sound, and break pattern during online learning were significantly (p<0.05 for all) associated with hearing status. In multivariate analysis, being female (coefficient -0.293, p=0.001), using mobile/tablet (coefficient -0.836, p=0.001), and continuous screen use (coefficient -0.348, p=0.003) were significantly associated with poor hearing status. Conclusion This current study indicates the detrimental effect of online education on the hearing of young students in Bangladesh. Future studies should explore the long-term hearing effects of online education and guide the policy makers towards incorporating online education with better approaches secondary to in-person classes.
{"title":"Online education and its relation to hearing status among higher-secondary students in Bangladesh: A cross-sectional survey","authors":"Syeda Tasnim Tabassum Hridi, Mohammad Azmain Iktidar, Arrafi Tamjid, Punam Ghosh, Kazi Sudipta Kabir, Abdullah Al Zaber, Rifat Tasnim Babu, Maliha Mehzabeen, Aysharja Das Gupta, Sreshtha Chowdhury, Simanta Roy","doi":"10.1101/2024.08.02.24311428","DOIUrl":"https://doi.org/10.1101/2024.08.02.24311428","url":null,"abstract":"Background Online education gained its popularity in the education system during the COVID-19 pandemic lockdown. The online platform, including social media, was institutionalized globally for the purpose of tutoring to keep the education process ongoing under feasible circumstances. However, the post-pandemic continuation of online education and prolonged usage of electronic devices imposed a greater risk of health issues related to sensory impairment. Our study aimed to determine the impact of online education on students' hearing status and its associated factors. Methods A cross-sectional study was conducted among 1030 students of 11th grade and above who were undergoing online education in Dhaka and Chattogram. Data were collected through the online administration of a structured questionnaire containing questions on sociodemographic status, family history of diseases, personal history of comorbidities, information related to screentime exposure, and SSQ-12 (Speech, Spatial, and Qualities of Hearing -12) scale. Descriptive statistics, Pearson’s chi-square test, two independent sample t-tests, and multiple linear regression analysis were employed to obtain the results. Result The mean SSQ score of the study participants was 7.74±1.37. In bivariate analysis, gender, family income, family history of diseases (e.g., obesity, headache, hearing problem), personal history of diseases (e.g., obesity, insomnia), device type (mobile/tablet, computer), average daily screen time with sound, and break pattern during online learning were significantly (p<0.05 for all) associated with hearing status. In multivariate analysis, being female (coefficient -0.293, p=0.001), using mobile/tablet (coefficient -0.836, p=0.001), and continuous screen use (coefficient -0.348, p=0.003) were significantly associated with poor hearing status. Conclusion This current study indicates the detrimental effect of online education on the hearing of young students in Bangladesh. Future studies should explore the long-term hearing effects of online education and guide the policy makers towards incorporating online education with better approaches secondary to in-person classes.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141941417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-03DOI: 10.1101/2024.08.02.24311171
Jennifer Schlezinger, Anila Bello, Kelsey M Mangano, Kushal Biswas, Paridhiben P Patel, Emily H Pennoyer, Thomas MS Wolever, Wendy J Heiger-Bernays, Dhimiter Bello
Extensive use of per- and polyfluoroalkyl substances (PFAS) has resulted in their ubiquitous presence in human blood. PFAS exposures have been associated with multiple adverse human health effects including increased risk of liver damage, elevated serum lipids, impaired vaccine response, adverse birth outcomes and cancer. Biomonitoring studies have focused on measuring long-chain PFAS, but these are being replaced by shorter chain PFAS and PFAS with alternative structures, resulting in incomplete understanding of human exposures. Here, we take advantage of serum samples collected as part of a clinical trial testing the efficacy of a dietary fiber intervention to reduce serum cholesterol to investigate exposure to legacy and replacement PFAS chemicals in Canadian participants. Serum samples were collected from 72 participants in 2019-2020 at baseline and after 4 weeks of the intervention and were analyzed for 17 PFAS species. The highest geometric mean concentrations of PFAS measured at baseline corresponded to PFOSA (7.1 ng/ml), PFOS (4.2, ng/ml), PFOA (1.8 ng/ml) and PFHxS (1.3 ng/ml). Short chain PFAS including PFBuA, PFHxS and/or PFHpA were detected in 100% of participants and GenX was detected in 70% of participants. Analyses of associations between PFAS serum concentrations and biomarkers of adverse health outcomes showed the PFBuA, PFHxA, PFDA and PFOSA were associated with higher serum gamma-glutamyl transferase concentrations but not with measures of serum total or low-density lipoprotein cholesterol. Comparison of PFAS concentrations at baseline and after a 4-week follow-up showed that total PFAS concentrations decreased in both the control and cholesterol intervention groups. However, the suite of PFAS of concern identified by the United States National Academies of Sciences, Engineering, and Medicine, significantly decreased only in the cholesterol intervention group. This observation suggests that a dietary fiber intervention may reduce PFAS body burden, but future intervention studies need to control for PFAS exposure sources and extend beyond 4 weeks. Overall, the results show that exposures to short-chain and alternative PFAS are common in this Canadian population.
{"title":"Per- and Poly-fluoroalkyl Substances (PFAS) in Circulation in a Canadian Population: Their Association with Serum Liver Enzyme Biomarkers and Piloting a Novel Method to Reduce Serum PFAS","authors":"Jennifer Schlezinger, Anila Bello, Kelsey M Mangano, Kushal Biswas, Paridhiben P Patel, Emily H Pennoyer, Thomas MS Wolever, Wendy J Heiger-Bernays, Dhimiter Bello","doi":"10.1101/2024.08.02.24311171","DOIUrl":"https://doi.org/10.1101/2024.08.02.24311171","url":null,"abstract":"Extensive use of per- and polyfluoroalkyl substances (PFAS) has resulted in their ubiquitous presence in human blood. PFAS exposures have been associated with multiple adverse human health effects including increased risk of liver damage, elevated serum lipids, impaired vaccine response, adverse birth outcomes and cancer. Biomonitoring studies have focused on measuring long-chain PFAS, but these are being replaced by shorter chain PFAS and PFAS with alternative structures, resulting in incomplete understanding of human exposures. Here, we take advantage of serum samples collected as part of a clinical trial testing the efficacy of a dietary fiber intervention to reduce serum cholesterol to investigate exposure to legacy and replacement PFAS chemicals in Canadian participants. Serum samples were collected from 72 participants in 2019-2020 at baseline and after 4 weeks of the intervention and were analyzed for 17 PFAS species. The highest geometric mean concentrations of PFAS measured at baseline corresponded to PFOSA (7.1 ng/ml), PFOS (4.2, ng/ml), PFOA (1.8 ng/ml) and PFHxS (1.3 ng/ml). Short chain PFAS including PFBuA, PFHxS and/or PFHpA were detected in 100% of participants and GenX was detected in 70% of participants. Analyses of associations between PFAS serum concentrations and biomarkers of adverse health outcomes showed the PFBuA, PFHxA, PFDA and PFOSA were associated with higher serum gamma-glutamyl transferase concentrations but not with measures of serum total or low-density lipoprotein cholesterol. Comparison of PFAS concentrations at baseline and after a 4-week follow-up showed that total PFAS concentrations decreased in both the control and cholesterol intervention groups. However, the suite of PFAS of concern identified by the United States National Academies of Sciences, Engineering, and Medicine, significantly decreased only in the cholesterol intervention group. This observation suggests that a dietary fiber intervention may reduce PFAS body burden, but future intervention studies need to control for PFAS exposure sources and extend beyond 4 weeks. Overall, the results show that exposures to short-chain and alternative PFAS are common in this Canadian population.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141941523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-03DOI: 10.1101/2024.07.31.24311314
Amy E Benefield, Desiree Williams, VP Nagraj
Near-term disease forecasting and scenario projection efforts rely on the availability of data to train and evaluate model performance. In most cases, more extensive epidemiological time series data can lead to better modeling results and improved public health insights. Here we describe a procedure to augment an epidemiological time series. We used reported flu hospitalization data from FluSurv-NET and the National Healthcare Safety Network to estimate a complete time series of flu hospitalization counts dating back to 2009. The augmentation process includes concatenation, interpolation, extrapolation, and imputation steps, each designed to address specific data gaps. We demonstrate the forecasting performance gain when the extended time series is used to train flu hospitalization models at the state and national level.
{"title":"An Imputation-Based Approach for Augmenting Sparse Epidemiological Signals","authors":"Amy E Benefield, Desiree Williams, VP Nagraj","doi":"10.1101/2024.07.31.24311314","DOIUrl":"https://doi.org/10.1101/2024.07.31.24311314","url":null,"abstract":"Near-term disease forecasting and scenario projection efforts rely on the availability of data to train and evaluate model performance. In most cases, more extensive epidemiological time series data can lead to better modeling results and improved public health insights. Here we describe a procedure to augment an epidemiological time series. We used reported flu hospitalization data from FluSurv-NET and the National Healthcare Safety Network to estimate a complete time series of flu hospitalization counts dating back to 2009. The augmentation process includes concatenation, interpolation, extrapolation, and imputation steps, each designed to address specific data gaps. We demonstrate the forecasting performance gain when the extended time series is used to train flu hospitalization models at the state and national level.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141941522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02DOI: 10.1101/2024.07.30.24311217
Ashis Kumar Biswas, Sharmistha Roy
Abstract: Objective: To compare the burden of communicable and non-communicable diseases (NCDs) in the USA and globally, particularly among 15-45-year-olds. Methods: The imported data from the WHO Mortality Database portal was analyzed by SPSS. Results: The study shows the percentage of deaths from NCDs out of total deaths in the USA in 2010 and 2019 were 86.7% and 86.8% which are higher than global rates of 78.1% and 80.2%. Despite a similar death percentage out of total death, the death rate due to NCDs increased from 601.04/100,000 (2010) to 687.99/100,000 (2019) and 790.29/100,000 (2020) globally; and from 693.60/100,000 (2010) to 753.35/100000 (2019) and 795.78/100000 (2020) in the USA. On the other hand, the death rate from communicable diseases were 56.57/100000, 55.52/100000, and 129.47/100000 globally; and 44.63/100000, 43.20/100000, and 151.99/100000 in the USA in the respective years. Young adults of 15-45 years show a higher NCD death rate in the USA with an increasing trend. Conclusion: The USA has a higher NCDs dependent mortality rate relative to the global mortality rate, particularly among the 15-45 years age group. During the COVID-19 pandemic, the relative increase in the rate of communicable disease death indicates an interplay between communicable and NCDs.
{"title":"The increasing trend of Non-Communicable Diseases among young adults may invite multiple public health challenges in the future.","authors":"Ashis Kumar Biswas, Sharmistha Roy","doi":"10.1101/2024.07.30.24311217","DOIUrl":"https://doi.org/10.1101/2024.07.30.24311217","url":null,"abstract":"Abstract: Objective: To compare the burden of communicable and non-communicable diseases (NCDs) in the USA and globally, particularly among 15-45-year-olds. Methods: The imported data from the WHO Mortality Database portal was analyzed by SPSS.\u0000Results: The study shows the percentage of deaths from NCDs out of total deaths in the USA in 2010 and 2019 were 86.7% and 86.8% which are higher than global rates of 78.1% and 80.2%. Despite a similar death percentage out of total death, the death rate due to NCDs increased from 601.04/100,000 (2010) to 687.99/100,000 (2019) and 790.29/100,000 (2020) globally; and from 693.60/100,000 (2010) to 753.35/100000 (2019) and 795.78/100000 (2020) in the USA. On the other hand, the death rate from communicable diseases were 56.57/100000, 55.52/100000, and 129.47/100000 globally; and 44.63/100000, 43.20/100000, and 151.99/100000 in the USA in the respective years. Young adults of 15-45 years show a higher NCD death rate in the USA with an increasing trend. Conclusion: The USA has a higher NCDs dependent mortality rate relative to the global mortality rate, particularly among the 15-45 years age group. During the COVID-19 pandemic, the relative increase in the rate of communicable disease death indicates an interplay between communicable and NCDs.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141885366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02DOI: 10.1101/2024.07.31.24311326
Matthew Ahmadi, Angelo Sabag, Raaj Biswas, Borja del Pozo Cruz, Clara K Chow, Emmanuel Stamatakis
Background: Hypertension is a major risk factor for cardiovascular disease. Although it is well established that physical activity is cardioprotective, it is less clear how cardiovascular stress-related properties (i.e. intensity and bout length) determine future cardiovascular risk in adults with hypertension. Objectives: We examined the dose-response associations of moderate and vigorous physical activity bouts of variable length with major adverse cardiovascular events (MACE) and its sub-types (stroke, myocardial infarction, heart failure) in adults with hypertension. Methods: Participants of the UK Biobank wearables sub-study with a clinical diagnosis of hypertension. Short bouts of moderate activity were classified as lasting up to 3 minutes and for vigorous activity up to 1 minute. Long bouts of moderate activity were classified as lasting >5 minutes, and for vigorous activity >2 minutes. In sensitivity analyses we also tested alternative vigorous intensity bout length definitions for short (up to 2 minutes) and long (> 3, >4, and >5 minutes). Results: Among 36,957 participants (62.1 (SD= 7.7) years; 58.4% female) with an average follow up of 7.9 (1.1) years, 1,374 MACE, 394 stroke, 623 myocardial infarction, and 357 heart failure events occurred. Moderate intensity was associated with lower risk of MACE and its individual sub-types for both short (<3 mins) and long (>5 mins) bout lengths with a stronger dose-response magnitude for longer bouts. We observed a consistent inverse dose response association for vigorous intensity accrued through short bouts (<1 min) and overall MACE, stroke, myocardial infarction, and heart failure risk. The median duration of 3.5 minutes/day corresponded to a hazard ratio (HR) ranging between 0.57 [0.39, 0.83] for heart failure to 0.66 [0.46, 0.96] for stroke. In contrast, vigorous intensity activity accrued through longer bouts showed a steep linear dose-response association for higher stroke risk. The median (6.0 minutes/day) and maximum (9.0 minutes/day) of activity accrued through vigorous bouts lasting >2 mins were associated with stroke HRs of 2.06 [1.38, 3.07] and 2.80 [1.72, 4.56], respectively. Additional analyses in 1 extra minute bout length increments revealed that the higher the 'long bout' threshold the steeper the stroke risk, e.g the median of bouts lasting >5 mins (6.4 minutes/day) was associated with a HR of 2.69 [1.72, 4.21]. Conclusion: For adults with hypertension, moderate intensity and short bouts of vigorous intensity were beneficially associated with lower MACE, stroke, myocardial infarction, and heart failure risk. Vigorous intensity accumulated in long bouts showed a steep deleterious dose-response with stroke risk, and were not associated with lower overall MACE, myocardial infarction, or heart failure. Our results highlight the importance of bout length for vigorous intensity as a determining factor for cardiovascular health in adults with hypertension
{"title":"Physical activity bout length and risk of major adverse cardiovascular events in adults with hypertension","authors":"Matthew Ahmadi, Angelo Sabag, Raaj Biswas, Borja del Pozo Cruz, Clara K Chow, Emmanuel Stamatakis","doi":"10.1101/2024.07.31.24311326","DOIUrl":"https://doi.org/10.1101/2024.07.31.24311326","url":null,"abstract":"Background: Hypertension is a major risk factor for cardiovascular disease. Although it is well established that physical activity is cardioprotective, it is less clear how cardiovascular stress-related properties (i.e. intensity and bout length) determine future cardiovascular risk in adults with hypertension. Objectives: We examined the dose-response associations of moderate and vigorous physical activity bouts of variable length with major adverse cardiovascular events (MACE) and its sub-types (stroke, myocardial infarction, heart failure) in adults with hypertension.\u0000Methods: Participants of the UK Biobank wearables sub-study with a clinical diagnosis of hypertension. Short bouts of moderate activity were classified as lasting up to 3 minutes and for vigorous activity up to 1 minute. Long bouts of moderate activity were classified as lasting >5 minutes, and for vigorous activity >2 minutes. In sensitivity analyses we also tested alternative vigorous intensity bout length definitions for short (up to 2 minutes) and long (> 3, >4, and >5 minutes). Results: Among 36,957 participants (62.1 (SD= 7.7) years; 58.4% female) with an average follow up of 7.9 (1.1) years, 1,374 MACE, 394 stroke, 623 myocardial infarction, and 357 heart failure events occurred. Moderate intensity was associated with lower risk of MACE and its individual sub-types for both short (<3 mins) and long (>5 mins) bout lengths with a stronger dose-response magnitude for longer bouts. We observed a consistent inverse dose response association for vigorous intensity accrued through short bouts (<1 min) and overall MACE, stroke, myocardial infarction, and heart failure risk. The median duration of 3.5 minutes/day corresponded to a hazard ratio (HR) ranging between 0.57 [0.39, 0.83] for heart failure to 0.66 [0.46, 0.96] for stroke. In contrast, vigorous intensity activity accrued through longer bouts showed a steep linear dose-response association for higher stroke risk. The median (6.0 minutes/day) and maximum (9.0 minutes/day) of activity accrued through vigorous bouts lasting >2 mins were associated with stroke HRs of 2.06 [1.38, 3.07] and 2.80 [1.72, 4.56], respectively. Additional analyses in 1 extra minute bout length increments revealed that the higher the 'long bout' threshold the steeper the stroke risk, e.g the median of bouts lasting >5 mins (6.4 minutes/day) was associated with a HR of 2.69 [1.72, 4.21].\u0000Conclusion: For adults with hypertension, moderate intensity and short bouts of vigorous intensity were beneficially associated with lower MACE, stroke, myocardial infarction, and heart failure risk. Vigorous intensity accumulated in long bouts showed a steep deleterious dose-response with stroke risk, and were not associated with lower overall MACE, myocardial infarction, or heart failure. Our results highlight the importance of bout length for vigorous intensity as a determining factor for cardiovascular health in adults with hypertension","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141885269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Violence against women and children (VAWC) is a significant health and human rights issue closely tied to multiple Sustainable Development Goals. While VAWC is prevalent in all countries, the severity and incidence of VAWC increase during wars, natural disasters, economic crises, and pandemics, all of which have affected Yemen in recent years. This systematic review synthesizes evidence from qualitative and quantitative studies on the types, prevalence, perpetrators of, and risk factors for VAWC in Yemen. Before initiating the search, the protocol and search strategy were registered to PROSPERO (CRD42021237855). We systematically searched four biomedical databases and grey literature sources and used reverse snowball sampling to identify eligible studies. The 31 studies included in the analysis depicted a range of forms of VAWC, encompassing honor violence, female genital mutilation and cutting, early and very early marriage, tourist marriage, family and intimate partner violence, and gender inequities in access to food, education, and medical care. Included studies reported a high prevalence of many forms of violence, including corporal punishment in schools and intimate partner violence. We reviewed study quality and how studies addressed ethical concerns in VAWC-related research. We found that several studies did not report ethics review or interviewer training and no studies discussed safety planning or addressing the mental health needs of participants in VAWC research. This systematic review provides a much-needed synthesis of existing research on VAWC in Yemen. Since the start of the 2014 war, Yemen has become the world's largest humanitarian crisis, with the highest rate of maternal mortality and gender inequality in the world. We only identified one study initiated after the recent war in Yemen. This deficiency represents a missed opportunity to understand how the ongoing war has reversed prior gains in reducing the prevalence of child and very early child marriage and introduced new forms of gender-based violence, including tourist marriage.
{"title":"Violence against women and children in Yemen: A mixed-methods systematic review","authors":"Samana Shreedhar, Sayali Arvind Chavan, Marwah Al-Zumair, Mirna Naccache, Priya Shreedhar, Lauren Maxwell","doi":"10.1101/2024.08.01.24310001","DOIUrl":"https://doi.org/10.1101/2024.08.01.24310001","url":null,"abstract":"Violence against women and children (VAWC) is a significant health and human rights issue closely tied to multiple Sustainable Development Goals. While VAWC is prevalent in all countries, the severity and incidence of VAWC increase during wars, natural disasters, economic crises, and pandemics, all of which have affected Yemen in recent years. This systematic review synthesizes evidence from qualitative and quantitative studies on the types, prevalence, perpetrators of, and risk factors for VAWC in Yemen. Before initiating the search, the protocol and search strategy were registered to PROSPERO (CRD42021237855). We systematically searched four biomedical databases and grey literature sources and used reverse snowball sampling to identify eligible studies. The 31 studies included in the analysis depicted a range of forms of VAWC, encompassing honor violence, female genital mutilation and cutting, early and very early marriage, tourist marriage, family and intimate partner violence, and gender inequities in access to food, education, and medical care. Included studies reported a high prevalence of many forms of violence, including corporal punishment in schools and intimate partner violence. We reviewed study quality and how studies addressed ethical concerns in VAWC-related research. We found that several studies did not report ethics review or interviewer training and no studies discussed safety planning or addressing the mental health needs of participants in VAWC research. This systematic review provides a much-needed synthesis of existing research on VAWC in Yemen. Since the start of the 2014 war, Yemen has become the world's largest humanitarian crisis, with the highest rate of maternal mortality and gender inequality in the world. We only identified one study initiated after the recent war in Yemen. This deficiency represents a missed opportunity to understand how the ongoing war has reversed prior gains in reducing the prevalence of child and very early child marriage and introduced new forms of gender-based violence, including tourist marriage.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"186 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141885275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02DOI: 10.1101/2024.07.31.24311277
Swapnoleena Sen, Braunack-Mayer Lydia, Kelly L. Sherrie, Thiery Masserey, Josephine Malinga, Joerg J. Moehrle, Melissa A. Penny
In 2022, the World Health Organization extended their guidelines for perennial malaria chemoprevention (PMC) from infants to children up to 24 months old. However, evidence for PMC's public health impact is primarily limited to children under 15 months. Further research is needed to assess the public health impact and cost-effectiveness of PMC, and the added benefit of further age-expansion. We integrated an individual-based model of malaria with pharmacological models of drug action to address these questions for PMC and a proposed age-expanded schedule (PMC+, for children 03-36 months). Across prevalence settings of 5-70% and different drug sensitivity assumptions, we predicted PMC and PMC+'s median efficacy of 18.6%(12.2-25.0%) and 21.9%(14.3-29.5%) against clinical disease and 9.0%(2.0-16.0%) and 10.8%(3.2-18.4%) against severe malaria, respectively, in children under three years. PMC's total impact outweighed risk of delayed malaria in children up to age five and remained cost-effective when delivered through the Expanded Program on Immunization.
{"title":"Public health impact of current and proposed age-expanded perennial malaria chemoprevention: a modelling study","authors":"Swapnoleena Sen, Braunack-Mayer Lydia, Kelly L. Sherrie, Thiery Masserey, Josephine Malinga, Joerg J. Moehrle, Melissa A. Penny","doi":"10.1101/2024.07.31.24311277","DOIUrl":"https://doi.org/10.1101/2024.07.31.24311277","url":null,"abstract":"In 2022, the World Health Organization extended their guidelines for perennial malaria chemoprevention (PMC) from infants to children up to 24 months old. However, evidence for PMC's public health impact is primarily limited to children under 15 months. Further research is needed to assess the public health impact and cost-effectiveness of PMC, and the added benefit of further age-expansion. We integrated an individual-based model of malaria with pharmacological models of drug action to address these questions for PMC and a proposed age-expanded schedule (PMC+, for children 03-36 months). Across prevalence settings of 5-70% and different drug sensitivity assumptions, we predicted PMC and PMC+'s median efficacy of 18.6%(12.2-25.0%) and 21.9%(14.3-29.5%) against clinical disease and 9.0%(2.0-16.0%) and 10.8%(3.2-18.4%) against severe malaria, respectively, in children under three years. PMC's total impact outweighed risk of delayed malaria in children up to age five and remained cost-effective when delivered through the Expanded Program on Immunization.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141885365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02DOI: 10.1101/2024.07.31.24311162
Charles A Narh, Edwin Tetteh, NSPA-NMIMR
Background: The National Service Personnel Association of the Noguchi Memorial Institute for Medical Research (NSPA-NMIMR) carries out an annual community outreach project comprising health education and medical screening for some of the diseases that the institute works on. Therefore, the NSPA 2009/2010 group (40 personnel) conducted Buruli ulcer community health education and medical screening (BU-CHEMS) in the Ga South District of Ghana in July 2010. Method: BU is caused by mycobacterium ulcerans, and starts as a painless nodule, which can progress to ulcer, particularly on the upper and lower extremities. BU is often associated with witchcraft in some Ghanaian communities, and as a result, some patients reluctantly seek medical treatment. Therefore, prior to the screening program, the NSPA and medical staff from the Obom Health Centre showed video documentaries on BU as a way of educating and dispelling myths about the disease. This was followed by screening for nodules and ulcers among 2,500 people, mostly children in primary schools, residing in four endemic communities in the Ga South District. Other medical screening activities included blood group/pressure tests, Body Mass Index (BMI) and body temperature checks. Results and conclusion: Suspected cases of BU (N=33) ranging from nodules, plagues, oedema and ulcers of the disease on various parts of the body including the lower and upper extremities were identified, and samples were sent to NMIMR for PCR confirmation. All the PCR-positive cases (78%), including children (<15 years, 88%) were referred to the Obom Health Center for clinical treatment. The BU-CHEMS organized by NSPA 2009/2010 group (with sponsorship from corporate organizations) contributed to NMIMR mandate: improving the health and wellbeing of Ghanaians and mankind through focused and relevant quality biomedical research, human resource development and support of national public health activities.
{"title":"Buruli Ulcer Community Health Education and Medical Screening (BU-CHEMS) in Ga South District, Ghana","authors":"Charles A Narh, Edwin Tetteh, NSPA-NMIMR","doi":"10.1101/2024.07.31.24311162","DOIUrl":"https://doi.org/10.1101/2024.07.31.24311162","url":null,"abstract":"Background: The National Service Personnel Association of the Noguchi Memorial Institute for Medical Research (NSPA-NMIMR) carries out an annual community outreach project comprising health education and medical screening for some of the diseases that the institute works on. Therefore, the NSPA 2009/2010 group (40 personnel) conducted Buruli ulcer community health education and medical screening (BU-CHEMS) in the Ga South District of Ghana in July 2010. Method: BU is caused by mycobacterium ulcerans, and starts as a painless nodule, which can progress to ulcer, particularly on the upper and lower extremities. BU is often associated with witchcraft in some Ghanaian communities, and as a result, some patients reluctantly seek medical treatment. Therefore, prior to the screening program, the NSPA and medical staff from the Obom Health Centre showed video documentaries on BU as a way of educating and dispelling myths about the disease. This was followed by screening for nodules and ulcers among 2,500 people, mostly children in primary schools, residing in four endemic communities in the Ga South District. Other medical screening activities included blood group/pressure tests, Body Mass Index (BMI) and body temperature checks. Results and conclusion: Suspected cases of BU (N=33) ranging from nodules, plagues, oedema and ulcers of the disease on various parts of the body including the lower and upper extremities were identified, and samples were sent to NMIMR for PCR confirmation. All the PCR-positive cases (78%), including children (<15 years, 88%) were referred to the Obom Health Center for clinical treatment. The BU-CHEMS organized by NSPA 2009/2010 group (with sponsorship from corporate organizations) contributed to NMIMR mandate: improving the health and wellbeing of Ghanaians and mankind through focused and relevant quality biomedical research, human resource development and support of national public health activities.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141885271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1101/2024.07.30.24311229
James Eugene Dennison
Objectives: Methamphetamine (meth) use in the United States has been a significant problem for many years. Beyond impacts to the users, two additional consequences of the meth problem are on-going exposure to non-users in contaminated homes and the significant cost of remediation. This study reports the first U.S. national and state-level estimates of the number of contaminated properties, the number of exposed non-users, and the costs associated with remediation. Methods: The ability to estimate these endpoints relies on having random surveys of the frequency or incidence of residential contamination, but such surveys are difficult to perform and therefore scarce. The results of the only identified random survey were used in this study and appropriate geographical and temporal adjustments were made. The overall rate of contamination of Housing Units (HUs) was determined from estimates of the rates of HU contamination by meth smoking, rates of contamination from meth manufacturing, and rates of HU decontamination. Rates equations were integrated to estimate the number of contaminated HUs, the number of people living in contaminated HUs, and potential remediation costs. Results: The random survey found 3.5% of HUs to be contaminated in 2018. Currently, over 5,000,000 (4%) of U.S. HUs are estimated to be contaminated above average health standards. Based on this, the current estimated cost for remediation of all contaminated HUs would be $15 billion per year and $250 billion for the backlog of all currently contaminated HUs. The estimated number of persons currently exposed to meth above average health standards is 13,000,000 people. Conclusions: While the accuracy of these estimates is limited, they indicate that meth-contaminated housing is a significant environmental health and economic issue in the U.S. that has been previously under-recognized. Additional studies of health effects, fate and transport mechanisms, and remediation methods are needed.
{"title":"Methamphetamine-Contaminated Residences in the United States: Assessment of the Environmental Health Significance of Third-Hand Exposure","authors":"James Eugene Dennison","doi":"10.1101/2024.07.30.24311229","DOIUrl":"https://doi.org/10.1101/2024.07.30.24311229","url":null,"abstract":"Objectives: Methamphetamine (meth) use in the United States has been a significant problem for many years. Beyond impacts to the users, two additional consequences of the meth problem are on-going exposure to non-users in contaminated homes and the significant cost of remediation. This study reports the first U.S. national and state-level estimates of the number of contaminated properties, the number of exposed non-users, and the costs associated with remediation. Methods: The ability to estimate these endpoints relies on having random surveys of the frequency or incidence of residential contamination, but such surveys are difficult to perform and therefore scarce. The results of the only identified random survey were used in this study and appropriate geographical and temporal adjustments were made. The overall rate of contamination of Housing Units (HUs) was determined from estimates of the rates of HU contamination by meth smoking, rates of contamination from meth manufacturing, and rates of HU decontamination. Rates equations were integrated to estimate the number of contaminated HUs, the number of people living in contaminated HUs, and potential remediation costs.\u0000Results: The random survey found 3.5% of HUs to be contaminated in 2018. Currently, over 5,000,000 (4%) of U.S. HUs are estimated to be contaminated above average health standards. Based on this, the current estimated cost for remediation of all contaminated HUs would be $15 billion per year and $250 billion for the backlog of all currently contaminated HUs. The estimated number of persons currently exposed to meth above average health standards is 13,000,000 people. Conclusions: While the accuracy of these estimates is limited, they indicate that meth-contaminated housing is a significant environmental health and economic issue in the U.S. that has been previously under-recognized. Additional studies of health effects, fate and transport mechanisms, and remediation methods are needed.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141867825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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