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Key Points: Question: Can the traditional Chinese version of the hearing handicap inventory for elderly screening (HHIE-S) checklist screen for age-related hearing loss (ARHL) in elderly individuals? Findings: In this cross-sectional study of 1696 Taiwanese patients who underwent annual government-funded geriatric health checkups, the Chinese version of the HHIE-S had a sensitivity of 76.9% and a specificity of 79.8% with a cutoff score greater than 6 for identifying patients with disabled hearing loss (defined as a PTA > 40 dB). Meaning: The traditional Chinese version of the HHIE-S is an effective test to detect ARHL and can improve the feasibility of large-scale hearing screening among elderly individuals. Purpose: The traditional Chinese version of the hearing handicap inventory for elderly screening (TC-HHIE-S) was translated from English and is intended for use with people whose native language is traditional Chinese, but its effectiveness and diagnostic performance are still unclear. The purpose of this study was to evaluate the validity and reliability of the traditional Chinese version of the HHIE-S for screening for age-related hearing loss (ARHL). Methods: A total of 1696 elderly people underwent the government’s annual geriatric medical examination at community hospitals. In this cross-sectional study, we recorded average conducted pure-tone averages (PTA) (0.5 kHz, 1 kHz, 2 kHz, 4 kHz), age, sex, and HHIE-S data. Receiver operating characteristic (ROC) curve analysis was used to identify the best critical point for detecting hearing impairment, and the validity of the structure was verified by the agreement between the TC-HHIE-S and PTA results. Results: The HHIE-S scores were correlated with the better-ear pure-tone threshold averages (PTAs) at 0.5–4 kHz (correlation coefficient r = 0.45). The internal consistency of the total HHIE-S score was excellent (Cronbach’s alpha = 0.901), and the test-retest reliability was also excellent (Spearman’s correlation coefficient = 0.60, intraclass correlation coefficient = 0.75). In detecting disabled hearing loss (i.e., PTA at 0.5–4 kHz > 40 dB), the HHIE-S cutoff score of > 6 had a sensitivity of 76.9% and a specificity of 79.8%. Conclusions: The traditional Chinese version of the HHIE-S is a valid, reliable, and efficient tool for large-scale screening for ARHL.

Essential hypertension is one of the most common conditions managed in pediatric cardiology and can result in lasting deleterious effects on the cardiovascular system. Pediatric hypertension is so prevalent in the United States that it is often referred to as a public health challenge. Social determinants of health (SDH) are the cultural, economic, educational, healthcare accessibility, and political influences in the environment in which an individual is born or lives, all of which can affect that individual's overall health. This study investigated the impact of social determinants such as rurality, food insecurity, transportation challenges, minority status, income, and race on cardiovascular outcomes in adolescent patients with essential hypertension. This study utilizes multiple validated tools including those from the United States Census and the United States Department of Agriculture (USDA). Using these tools, the patients were scored on their social vulnerability based on home address. These scores were then compared with their echocardiographic data, focusing on measures of end‐organ damage known to occur in the setting of hypertension, including but not limited to indexed left ventricular (LV) mass. LV mass is an independent risk factor for future adverse cardiovascular events. In this study, more social vulnerability and low income were associated with a greater indexed LV mass (r = 0.18, p = 0.008). African American race was associated with a higher left atrial (LA) volume (p = 0.03). These findings substantiate that adolescents with essential hypertension are not only impacted by biological factors but also a combination of intersecting social constructs. The results of this study provide both a deeper understanding of the challenges these patients face and the opportunity to develop real‐life interventions that can optimize clinical outcomes.

Sixteen percent of patients referred for cardiology evaluation are found to have no cause for palpitations. Studies show that hypertension intricately influences “heart rate” and “contractility,?” the key components of “palpitation.” While the prevalence of hypertension is 22.4% in 18–39‐year‐olds, the relationship between palpitations and hypertension remains unknown in this age group. In our study, we assessed the incidence and prevalence of hypertension over 5 years in 18–40‐year‐olds referred for palpitations who had no known arrhythmic cause for palpitations between January 1, 206 and December 31, 2017. We found that over a period of 2.2 (0.7–4.1) years, an additional 56% patients were diagnosed with stage 1 (65/130) and stage 2 (28/130) hypertension, increasing the prevalence from 16% at the start of the study period to 72% at the end of the study period (p < .0001). Hypertensive patients were obese (BMI: 29 [24–36] kg/m2 vs. 25 [22–31] kg/m2; p = .03), used nonsteroidal anti‐inflammatory drugs (NSAIDs) (62 vs. 35%; p = .04), had a stronger family history of hypertension (55 vs. 4%; p < .0001) and exhibited higher systolic (124[120–130] mmHg vs. 112[108–115] mmHg; p < .0001) and diastolic (80[76–83] mmHg vs. 72[69–75] mmHg; p < .0001) blood pressures. Hypertension is commonly diagnosed in 18–40‐year‐old predominantly white female patients referred for palpitations without a known arrhythmic cause. The possibility of untreated hypertension causing palpitations in this cohort needs further evaluation.

Metabolic syndrome is a cluster of risk factors for cardiovascular diseases, indicating great clinical attention. However, much less attention has been given to metabolic syndrome in the study area. The objective of this study is to determine the prevalence of metabolic syndrome and its associated factors in the adult population of West Gojjam zone, Ethiopia. A community-based cross-sectional study was conducted in West Gojjam from September 15 to October 20, 2018. A total of 627 participants were randomly selected. The data were collected using the WHO STEP-wise approach for non-communicable diseases by contextualizing the instrument based on the study questions. The collected data were entered into and analyzed in SPSS version 20. Binary logistic regression was used to identify predictors of the dependent variable. The odds ratio was used to measure the strength of association between variables. For all statistical significance tests, the cut-off value set was < 0.05 with CI of 95%. In the studied region, high prevalence of metabolic syndrome at 17.3% is documented. In the final model, age (adjusted odds ratio [AOR] = 1.02, CI: 1.01-1. 05), occupation (AOR = 2.97, CI: 1.25-7.04), a moderate or high level of physical activity (AOR = 0.28, CI: 0.14-0.56 and AOR = 0.42, CI: 0.18-0.97) and type of oil used for cooking (AOR = 2.62, CI: 1.87-7.86) are significantly associated with metabolic syndrome. The prevalence of metabolic syndrome in this study is high, and it is determined by age, occupation, physical activity and type of oil used for cooking. Designing an intervention which focuses on promoting a healthy lifestyle like physical activity and using oils which are liquid at room temperature to prevent the risk of major non-communicable diseases is needed.

Measuring heterogeneity of dengue illness is necessary to define suitable endpoints in dengue vaccine and therapeutic trials and will help clarify behavioral responses to illness. To quantify heterogeneity in dengue illness, including milder cases, we developed the Dengue Illness Perceptions Response (IPR) survey, which captured detailed symptom data, including intensity, duration, and character, and change in routine activities caused by illness. During 2016-2019, we collected IPR data daily during the acute phase of illness for 79 persons with a positive reverse transcription PCR result for dengue virus RNA. Most participants had mild ambulatory disease. However, we measured substantial heterogeneity in illness experience, symptom duration, and maximum reported intensity of individual symptoms. Symptom intensity was a more valuable predicter of major activity change during dengue illness than symptom presence or absence alone. These data suggest that the IPR measures clinically useful heterogeneity in dengue illness experience and its relation to altered human behavior.

Introduction: COVID-19 pandemic, declared on March 11, 2020, constitute an extraordinary health, social and economic global challenge. The impact on people's mental health is expected to be high. This paper sought to systematically review community-based studies on depression conducted during the COVID-19 and estimate the pooled prevalence of depression. Method: We searched for cross-sectional, community-based studies listed on PubMed or Web of Science from January 1, 2020 to May 8, 2020 that reported prevalence of depression. A random effect model was used to estimate the pooled proportion of depression. Results: A total of 12 studies were included in the meta-analysis, with prevalence rates of depression ranging from 7.45% to 48.30%. The pooled prevalence of depression was 25% (95% CI: 18%−33%), with significant heterogeneity between studies (I2=99.60%, p<.001). Conclusions: Compared with a global estimated prevalence of depression of 3.44% in 2017, our pooled prevalence of 25% appears to be 7 times higher, thus suggesting an important impact of the COVID-19 outbreak on people's mental health. Addressing mental health during and after this global health crisis should be placed into the international and national public health agenda to improve citizens’ wellbeing. Introducción: La pandemia de COVID-19, declarada el 11 de marzo de 2020, representa un reto global extraordinario a nivel sanitario, social y económico. Se espera un impacto alto en la salud mental de las personas. Este artículo tiene como objetivo realizar una revisión sistemática de estudios transversales basados en muestras comunitarias que proporcionaban la prevalencia de depresión durante la crisis del COVID-19. Método: Se realizó una búsqueda de estudios comunitarios publicados en Pubmed y Web of Science desde el 1 de enero del 2020 al 8 de mayo del 2020 y que informaron sobre la prevalencia de depresión. Se usó un modelo de efectos aleatorios para estimar la proporción agrupada de depresión. Resultados: Un total de 12 estudios fueron incluidos en el meta-análisis, con prevalencias de depresión que oscilaban entre 7,45% y 48,30%. La prevalencia agrupada de depresión fue de 25% (95% CI: 18%-33%), con heterogeneidad significativa entre estudios (I2=99,60%, p<0,001). Conclusiones: En comparación con una estimación global de depresión en 2017 del 3,44%, nuestra prevalencia agrupada del 25% es 7 veces mayor, sugiriendo un impacto importante del brote de COVID-19 en la salud mental de las personas. El abordaje de la salud mental durante y después de esta crisis global sanitaria debe ser parte de las agendas de salud pública nacionales e internacionales para mejorar el bienestar de los ciudadanos.

Background Understanding the relationship between relative skeletal muscle mass and newly proposed steatotic liver disease (SLD) is crucial, but research gaps still exist. Based on a cohort study, we investigated the impact of relative skeletal muscle mass on incident SLD and its subtypes and explored potential mediators involved in these relationships. Methods We followed 1964 subjects aged 55–70 years (median age: 61.4 [58.4–65.1] years; 45.5% male participants). Appendicular skeletal muscle mass (ASM) was measured using bioelectrical impedance analysis and adjusted for height squared (ASM/height2), weight (ASM/weight) and body mass index (ASM/BMI) to quantify relative skeletal muscle mass. SLD was diagnosed using ultrasonography and classified into metabolic dysfunction–associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol‐associated liver disease (MetALD) and alcohol‐associated liver disease (ALD). Results Over a mean 4.3‐year follow‐up period, 598 participants (30.4%) developed SLD: 539 MASLD (27.4%), 38 MetALD (1.9%) and 21 ALD (1.1%). Higher ASM/weight and ASM/BMI were associated with lower risks of SLD and MASLD (RR per SD [95% CI]: 0.71 [0.61–0.82], 0.59 [0.46–0.76]; 0.66 [0.58–0.76], 0.51 [0.40–0.64]; all p < 0.001). Associations of ASM/height2 with SLD and MASLD shifted from positive to negative after adjustment for BMI (from 1.67 [1.51–1.84] to 0.77 [0.67–0.89]; from 2.30 [1.92–2.76] to 0.61 [0.47–0.79], all p < 0.001). ASM/height2 and ASM/weight were negatively associated with MetALD (0.49 [0.26–0.94], p = 0.031; 0.50 [0.27–0.93], p = 0.029), whereas ASM/BMI was inversely associated with ALD (0.40 [0.18–0.88], p = 0.023). The effects of ASM/height2, ASM/weight and ASM/BMI on incident MASLD were partially mediated by adiponectin (percentage mediated [95% CI]: 6.3% [2.5%–11.1%]; 9.4% [5.0%–14.6%]; 9.5% [5.1%–15.5%]), uric acid (4.7% [1.6%–8.9%]; 5.3% [2.6%–8.5%]; 5.3% [2.4%–8.8%]), triglyceride (7.1% [3.9%–11.1%]; 7.5% [4.4%–10.9%]; 8.7% [5.3%–13.4%]) and homeostasis model assessment of insulin resistance (13.9% [9.5%–20.4%]; 15.0% [10.0%–20.2%]; 14.5% [9.9%–20.7%]). The effects of ASM/weight and ASM/BMI on incident MASLD were mediated by cholinesterase (8.2% [3.6%–13.1%]; 10.5% [6.1%–16.3%]), prealbumin (6.2% [2.9%–9.8%]; 6.0% [3.0%–10.1%]), retinol‐binding protein‐4 (5.4% [3.0%–8.5%]; 4.6% [1.9%–8.5%]) and osteocalcin (2.1% [0.1%–4.5%]; 2.9% [0.6%–5.7%]). Conclusions Relative skeletal muscle mass adjusted for weight or BMI, rather than height alone, better reflects protective effects against SLD. Mediation analysis reveals key metabolic factors linking muscle mass and liver health, offering insights into the pathogenic pathways involved in muscle–liver crosstalk.

Abstract This study determined the prevalence of chronic traumatic encephalopathy (CTE) and cortical aging-related tau astrogliopathy (ARTAG) in a European community-based population (n = 310). The frontal, parietal, and temporal cortices, representing initial stages of CTE were assessed. No case fulfilling CTE consensus criteria was found. However, isolated astroglial or neuronal tau pathologies were recognized in the depths of cortical sulci (<2%). A single case (female, 85 years) without a history of traumatic brain injury (TBI) showed combined tau-immunoreactive features confined to frontal sulci without perivascular accumulation. Another 24 cases had single tau pathologies in cortical sulci. ARTAG was identified in 117 cases (38%), with a similar regional prevalence. Gray matter ARTAG was the most common followed by subpial, white matter, and perivascular. The presence of any type of ARTAG was strongly associated with having another type of ARTAG in the same region (p < 0.05). In summary, although isolated tau pathologies in the depths of cortical sulci were identified, no case fulfilled diagnostic criteria of CTE. Cortical ARTAG in this population is common and contrasts the high prevalence of CTE in individuals with repeated mild TBI. ARTAG in isolation might not be indicative of CTE although commonalities in pathogenesis should be considered.

Globally, alcohol-abuse is a major cause of mortality and morbidity. Consumption of alcohol has increased in India in the recent decades. It is imperative to know the patterns of alcohol consumption among different types of consumers to launch a well-planned nationwide programme for the prevention and control of this devastating social pathology. This community-based, cross-sectional study was undertaken to identify the patterns of alcohol intake among different types of alcohol consumers and to assess the clinical signs of chronic harmful alcohol-use. A predesigned, pretested, semi-structured alcohol-use disorders identification test (AUDIT) questionnaire was used for interviewing males, aged >18 years, selected by random sampling from an updated household list of a randomly-selected sector of the service area of the Urban Health Centre in Chetla, Kolkata, West Bengal, India. Written informed consents were obtained from all the respondents. Relevant clinical examination for chronic harmful alcohol-use was done according to the AUDIT clinical screening procedures. The results revealed that 65.8% (150/228) were current consumers of alcohol; 14% were alcohol-dependents; 8% were hazardous or harmful consumers, and 78% were nonhazardous non-harmful consumers. The mean age of the respondents at the initiation of drinking alcohol was 20.8+5.9 years. Eighty-six percent of dependents (n=21) took both Indian-made foreign liquor and locally-made alcoholic beverages. The proportions of alcohol consumers who drank alone among alcoholdependents, hazardous or harmful consumers, and non-hazardous non-harmful consumers were 71.4%, 50%, and 7.7% respectively, and the difference was significant (p<0.01). Forty-one percent of the consumers drank at public places and workplaces, which may be socially harmful. About 38% of the dependents purchased alcohol from unlicensed liquor shops. Only 16% expressed concerns for their drinking habit mainly to the past illness. The proportion of the concerned respondents was higher in the hazardous and harmful drinking patterns than in the non-hazardous non-harmful drinking pattern, and the difference was significant (p<0.05). About 62% of the dependents had clinical signs of chronic alcohol consumption. The presence of a considerable proportion of alcohol-dependents, the low mean age at initiation of drinking alcohol, and the habit of drinking in public places and workplaces are the main areas that need special emphasis by intervention programmes.

Abstract Rationale The impact of a broad range of occupational exposures on subclinical interstitial lung disease (ILD) has not been studied. Objectives To determine whether occupational exposures to vapors, gas, dust, and fumes (VGDF) are associated with high-attenuation areas (HAA) and interstitial lung abnormalities (ILA), which are quantitative and qualitative computed tomography (CT)-based measurements of subclinical ILD, respectively. Methods We performed analyses of participants enrolled in MESA (Multi-Ethnic Study of Atherosclerosis), a population-based cohort aged 45–84 years at recruitment. HAA was measured at baseline and on serial cardiac CT scans in 5,702 participants. ILA was ascertained in a subset of 2,312 participants who underwent full-lung CT scanning at 10-year follow-up. Occupational exposures were assessed by self-reported VGDF exposure and by job-exposure matrix (JEM). Linear mixed models and logistic regression were used to determine whether occupational exposures were associated with log-transformed HAA and ILA. Models were adjusted for age, sex, race/ethnicity, education, employment status, tobacco use, and scanner technology. Measurements and Main Results Each JEM score increment in VGDF exposure was associated with 2.64% greater HAA (95% confidence interval [CI], 1.23–4.19%). Self-reported vapors/gas exposure was associated with an increased odds of ILA among those currently employed (1.76-fold; 95% CI, 1.09–2.84) and those less than 65 years old (1.97-fold; 95% CI, 1.16–3.35). There was no consistent evidence that occupational exposures were associated with progression of HAA over the follow-up period. Conclusions JEM-assigned and self-reported exposures to VGDF were associated with measurements of subclinical ILD in community-dwelling adults.