Epidemiolgia (Basel, Switzerland)最新文献

{"title":"Flavanone Intake and Cardiometabolic Outcomes: A Synthesis of Meta-Analytic Evidence from Cohort and Clinical Studies.","authors":"Saeid Doaei, Mercedes Gil-Lespinard, Zehra Elban, Maryam Gholamalizadeh, Enrique Almanza-Aguilera, Raul Zamora-Ros","doi":"10.3390/epidemiologia7040108","DOIUrl":"10.3390/epidemiologia7040108","url":null,"abstract":"<p><p>Flavanones, a subclass of flavonoids predominantly found in citrus fruits, have attracted growing interest for their potential role in cardiometabolic health. While evidence linking overall flavonoid intake to cardiometabolic benefits is relatively consistent, flavanones have received less attention, and available findings remain scattered across heterogeneous outcomes and study designs. This review synthesizes meta-analytic evidence from prospective cohort and intervention studies to provide a comprehensive assessment of the relationship between flavanone intake and cardiometabolic health. A comprehensive literature search was performed to identify published meta-analyses examining flavanone intake in relation to cardiometabolic outcomes and related biomarkers. Twenty-five eligible meta-analyses, including 12 meta-analyses of prospective cohort studies and 13 meta-analyses of randomized controlled trials, were included. Evidence from prospective cohort studies showed that higher flavanone intake was associated with a lower risk of cardiovascular disease (relative risk reductions ranging from 12% to 22%) and stroke (relative risk reductions ranging from 12% to 26%). Intervention studies demonstrated favorable effects on total cholesterol, LDL cholesterol, systolic blood pressure, fasting glucose, and C-reactive protein concentrations, although findings for anthropometric outcomes were inconsistent. Overall, the current evidence supports a potential protective role of flavanone intake in cardiometabolic health. However, these findings should be interpreted with caution given the heterogeneity of studies and outcome measures, as well as methodological limitations within the underlying meta-analyses.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal Inference in Non-Allergic Asthma Associated with Obesity: Application of the Bradford Hill Viewpoints to a Complex Epidemiological Association.","authors":"José J Leija-Martinez, Eduardo Ensaldo-Carrasco, Fausto Sánchez-Muñoz, Blanca E Del-Río-Navarro, Nayely Reyes-Noriega, Fengyang Huang","doi":"10.3390/epidemiologia7040107","DOIUrl":"10.3390/epidemiologia7040107","url":null,"abstract":"<p><p><b>Background/Objective:</b> Obesity has been linked to a distinct non-allergic, late-onset, neutrophilic asthma phenotype for more than two decades, yet whether obesity should be regarded as a cause of that phenotype rather than a coexisting comorbidity remains unresolved because randomised allocation to obesity is neither feasible nor ethical. This review asks whether the evidence accumulated between 1995 and 2026 supports a causal interpretation. <b>Methods:</b> A structured narrative synthesis was undertaken. PubMed/MEDLINE, Scopus and Web of Science were searched from January 1995 to June 2026 (the synthesis emphasises the 2020-2026 evidence while drawing on the full window for landmark studies) for cohort, cross-sectional, Mendelian randomisation (MR), interventional, mechanistic and pharmaco-epidemiological studies; landmark earlier work was retained where it remains the primary source for a given viewpoint. The retrieved evidence was mapped onto Sir Austin Bradford Hill's nine viewpoints (1965) and triangulated using E-values for unmeasured confounding, GRADE, directed acyclic graphs and MR. <b>Results:</b> All nine viewpoints were satisfied to varying degrees. Strength: effect estimates 1.4-6.8, E-values 4.8-13.1, MR summary risk ratio 1.05 per 1 kg/m². Consistency: replication across four continents, both sexes and multiple study designs. Temporality: prospective cohort and life-course MR evidence. Biological gradient: body mass index dose-response for TNFα, IL-17A and Th17 frequency. Plausibility: a twelve-layer architecture from adipose dysfunction to bronchial epithelium. Coherence, experimental evidence (bariatric surgery, lifestyle weight loss, GLP-1 receptor agonists, murine and in vitro models) and analogy were also supported; specificity was met at the phenotype level. <b>Conclusions:</b> The cumulative evidence strongly supports a causal contribution of obesity to the development of the late-onset, non-allergic asthma phenotype while falling short of definitive proof (GRADE: moderate certainty), with implications for primary prevention, endotype-targeted therapy and longitudinal research. Phenotype-stratified MR remains the principal missing element of the causal argument.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Integration, Social Support and Incident Type 2 Diabetes: Results from the Prospective Heinz Nixdorf Recall Cohort Study.","authors":"Bernd Kowall, Nico Dragano, Börge Schmidt, Andreas Stang","doi":"10.3390/epidemiologia7040106","DOIUrl":"10.3390/epidemiologia7040106","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Aspects of social relationships, like isolation and low social support, have been linked to type 2 diabetes onset, though evidence is inconsistent. We investigated whether social relationships mediate the association between socioeconomic status (SES) and diabetes or interact with SES in relation to diabetes. <i>Materials and Methods:</i> The study included 3642 participants (mean age 58.9 ± 7.6 years, 47.9% male) from the Heinz Nixdorf Recall Study, a population-based cohort in Germany. Baseline examinations took place in 2000-2003 with two 5-year follow-ups. Adjusted relative risks (RRs) were estimated for social relationships (isolation, partnership, instrumental, financial, emotional support) and incident diabetes using Poisson regression with robust variance. We performed causal mediation analyses and estimated relative excess risks due to interaction (RERI). <i>Results</i>: Associations between measures of social integration and diabetes incidence were weak (e.g., RR = 1.09 (95% CI: 0.86, 1.39) for lack of partnership). Limited financial support was associated with higher diabetes risk (RR = 1.33 (1.09, 1.62)), whereas instrumental or emotional support was not. Some evidence of mediation was found for limited financial support (14% (95% CI: -7%, 35%) for the income-diabetes association). There was hardly any excess risk of diabetes in persons with poor education, and poor income, respectively, and low social support (RERI = -0.33 to 0.27). <i>Conclusions</i>: In this prospective study, limited financial support emerged as a social risk factor for type 2 diabetes and explained a small proportion of socioeconomic inequalities in diabetes incidence. Other dimensions of social relationships showed little evidence of independent, mediating, or interaction effects. The findings regarding financial support require confirmation in further studies.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excess Mortality During the COVID-19 Pandemic in Sonora, Mexico, 2015-2022: A Time-Series Analysis of Cause-Specific Mortality.","authors":"Diego I Álvarez-López, Elizabeth Ferreira-Guerrero, Lina S Palacio-Mejía, Amado D Quezada-Sánchez, Jorge Laureano-Eugenio, Sergio Trujillo-López, Mariann Duarte-Badillo, Gerardo Álvarez-Hernández","doi":"10.3390/epidemiologia7040105","DOIUrl":"10.3390/epidemiologia7040105","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Excess mortality (EM) is a key indicator for assessing the population-level impact of large-scale health crises, particularly when cause-of-death ascertainment is incomplete or delayed. However, EM estimates are sensitive to methodological decisions, highlighting the need for operationally feasible approaches suitable for routine public health surveillance. <b>Methods</b>: We conducted time series analyses of routinely collected mortality data from a subnational setting in northern Mexico. Deaths recorded between 2015 and 2022 were grouped into 28 cause-of-death categories. Expected deaths during the COVID-19 pandemic period (March 2020-July 2022) were estimated using negative binomial regression models fitted to pre-pandemic data (2015-2019), incorporating a linear trend and monthly indicators to account for long-term trends and seasonality. Newey-West standard errors were used to address serial correlation and heteroskedasticity. EM was defined as the difference between observed and expected deaths. <b>Results</b>: An estimated 14,482 excess deaths were observed during the pandemic period, corresponding to a 30.9% increase relative to expected mortality. Time-series models identified four distinct peaks of excess mortality coinciding with major pandemic waves. Although COVID-19 accounted for most excess deaths, among non-COVID causes, only ischemic heart disease and diabetes showed statistically significant excess mortality among major non-communicable diseases after baseline adjustment. However, additional categories-including non-transport-related accidents, ill-defined causes, and other endocrine, metabolic, hematological, and immunological diseases-also exhibited statistically significant excess mortality. For several causes, increases in crude mortality did not translate into statistically significant excess mortality. <b>Conclusions</b>: Negative binomial time series regression provides an implementable framework for estimating EM, underscoring the importance of expected mortality estimation for understanding population-level mortality dynamics during health emergencies.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproducible Gut Microbiome Alterations in Major Depressive Disorder: A Systematic Review of Taxonomic and Functional Findings.","authors":"Gulshat Dalibayeva, Maya Goremykina, Samat Kozhakhmetov, Almagul Kushugulova, Alibek Kossumov, Sundetgali Kalmakhanov, Ainur Doszhan","doi":"10.3390/epidemiologia7040104","DOIUrl":"10.3390/epidemiologia7040104","url":null,"abstract":"<p><strong>Background/objectives: </strong>Major depressive disorder (MDD) has been increasingly associated with alterations of the gut microbiome through the microbiota-gut-brain axis. However, published findings remain highly heterogeneous, limiting identification of reproducible microbial signatures associated with depression. This systematic review aimed to evaluate reproducible taxonomic and functional gut microbiome alterations in patients with MDD compared with healthy controls.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science Core Collection, and the Cochrane Library for studies published between January 2016 and December 2025. Observational human studies evaluating gut microbiome composition in adults with clinically diagnosed MDD and healthy control groups were included. Methodological quality was assessed using the Newcastle-Ottawa Scale. Due to substantial methodological heterogeneity, findings were synthesized using structured qualitative narrative analysis.</p><p><strong>Results: </strong>Sixteen observational studies were included in the qualitative synthesis. Findings related to alpha diversity were inconsistent across studies, whereas beta diversity alterations demonstrated greater reproducibility across independent cohorts. The most recurrent microbiome pattern involved depletion of short-chain fatty acid (SCFA)-producing bacteria, particularly Faecalibacterium and Roseburia, together with recurrent alterations affecting members of the Ruminococcaceae, Lachnospiraceae, and Clostridia groups. Functional microbiome alterations demonstrated greater consistency than higher-level taxonomic findings and included reduced butyrate synthesis pathways, dysregulated amino acid and tryptophan metabolism, increased lipopolysaccharide biosynthesis, and enrichment of pro-inflammatory microbial signatures. Antidepressant-naïve cohorts generally demonstrated more homogeneous dysbiosis patterns than mixed-treated populations.</p><p><strong>Conclusions: </strong>Current evidence suggests that functional gut microbiome dysregulation may represent a more reproducible biological feature of MDD than isolated taxonomic alterations alone. However, substantial heterogeneity in study design, participant characteristics, sequencing methodologies, and analytical approaches continues to limit clinical translation. Large-scale longitudinal multi-omics studies using standardized methodologies are required to clarify the role of the gut microbiome in depressive disorders and to evaluate the potential utility of microbiome-based biomarkers and interventions in mental health and public health practice.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional Profile of Children, Adolescents, and Women Living in Areas Potentially Affected by Heavy Metal Pollutants from the Revuè River in the Manica Province, Mozambique.","authors":"Tatiana J Marrufo, Osvaldo F Inlamea, Márcia I Xavier, Celso M Cumbula, Filipe Murgorgo, Cristovão Pereira, Ivalda Macicame, Bettencourt P S Capece, Maria-Raquel G Silva","doi":"10.3390/epidemiologia7040103","DOIUrl":"10.3390/epidemiologia7040103","url":null,"abstract":"<p><strong>Background: </strong>The global nutrition crisis continues to disproportionately affect vulnerable populations' health in regions where artisanal mining is high.</p><p><strong>Objective: </strong>This study assessed the nutritional status of children, adolescents, and women living in the Revuè sub-basin, who are potentially exposed to heavy metal contaminants.</p><p><strong>Methods: </strong>An observational and cross-sectional design was used to combine anthropometric and sociodemographic data with laboratory analysis for the assessment of heavy metal contaminants in drinking water sources.</p><p><strong>Results: </strong>Results indicated a high prevalence of stunting among children under five (28.4% of boys and 19.9% of girls) while female adolescents were underweight (25.7%), particularly during the rainy season. In contrast, 19% of women were overweight and 3.1% were obese. A modified Poisson regression analysis revealed a significant negative association between mercury exposure (RR = 0.77, <i>p</i> = 0.02) and stunting in children, whereas higher educational attainment among husbands was protective for women (RR = 0.76, <i>p</i> = 0.03). The assessment of mercury exposure through water consumption showed statistically significant variations across regions and seasons (<i>p</i> < 0.001). Water analyses identified high concentrations of arsenic (0.03 mg/L, 95% CI: 0.02-0.10) and mercury (0.09 mg/L (95% CI: 0.003-0.009), exceeding safety standards.</p><p><strong>Conclusion: </strong>Overall, these findings highlight the nutritional and health risks potentially linked to artisanal mining.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology, Risk Factors, and Mortality in Unprovoked and Provoked Pulmonary Embolism-A Single-Center Retrospective Study in the Israeli Population: Gender and Ethnic Differences.","authors":"Raymond Farah, Nicola Luigi Bragazzi, Halil İbrahim Ceylan, Łukasz Szarpak, Agnese Maria Fioretti, Wisam Mahajna, Noor Ashqar, Rola Khamisy-Farah","doi":"10.3390/epidemiologia7040101","DOIUrl":"10.3390/epidemiologia7040101","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary embolism (PE) is a leading cause of morbidity and mortality worldwide, ranking third among cardiovascular-related deaths after myocardial infarction and stroke. Despite extensive research, data on PE incidence and characteristics within the Israeli population remain limited. This study aimed to investigate the demographic, clinical, and prognostic factors associated with provoked (PPE) and unprovoked PE (UPE) cases in Israel.</p><p><strong>Methods: </strong>We conducted a retrospective observational study analyzing medical records of patients diagnosed with PE at Ziv Medical Center, Safed, Israel, from 2017 to 2022. Patients were classified into PPE or UPE groups based on identifiable risk factors. Demographic data, clinical characteristics, and mortality outcomes were compared using descriptive and inferential statistical methods, including the Mann-Whitney U test, chi-square test, logistic regression, Kaplan-Meier survival analysis, and Cox proportional hazards modeling.</p><p><strong>Results: </strong>A total of 348 patients (mean age: 68.6 ± 17.6 years; 54.3% female) were included, with 189 (54.3%) classified as PPE and 159 (45.7%) as UPE. Female patients were significantly older than males (<i>p</i> < 0.001), and Jewish patients were slightly older than Arab patients (<i>p</i> = 0.060). The average hospital stay was 10.7 ± 16.2 days. Although no group differences emerged in unadjusted analyses, male sex was associated with longer hospitalization and UPE with shorter hospitalization than PPE in the adjusted model. Ethnicity emerged as a significant predictor of PE type, with Jewish patients less likely to have UPE (OR = 0.457, 95% CI 0.256-0.817, <i>p</i> = 0.008). Among PPE cases, 67.2% were of Jewish origin and 32.8% were Arab, compared to 56.0% and 44.0%, respectively, in the UPE group. In-hospital mortality was 16.1% (<i>n</i> = 56). Age was a significant predictor of mortality (HR = 1.03, 95% CI 1.00-1.06, <i>p</i> = 0.020), while ethnicity, gender, and PE type showed no significant associations in multivariable models.</p><p><strong>Conclusions: </strong>Our findings highlight key demographic and clinical factors influencing PE outcomes in Israel. The significant association between ethnicity and PE type warrants further investigation to refine diagnostic and therapeutic strategies for high-risk populations.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infodemiology of West Nile Virus in Greece, 2024-2025, with Descriptive One Health Preparedness Evidence from Crete.","authors":"Antonios Papadakis, Eleftherios Koufakis, Sandra Gewehr, Spiros Mourelatos, Elias Ath Chaidoutis, George Pitsoulis, Apostolos Kamekis, Areti Lagiou","doi":"10.3390/epidemiologia7040102","DOIUrl":"10.3390/epidemiologia7040102","url":null,"abstract":"<p><strong>Background/objectives: </strong>West Nile virus (WNV) is a persistent mosquito-borne threat in Greece. This study examined whether online information-seeking patterns reflected official WNV surveillance during 2024-2025, with Crete providing descriptive field-level One Health preparedness context.</p><p><strong>Methods: </strong>Official national surveillance data were compared with country-level Google Trends relative search volume and Greek-language Wikipedia pageviews, focusing on weekly locally acquired West Nile neuroinvasive disease/central nervous system (WNND/CNS) cases. The Crete component separately summarized regional One Health preparedness.</p><p><strong>Results: </strong>Greece reported 220 locally acquired WNV cases (157 WNND/CNS) in 2024 and 96 (76 WNND/CNS) in 2025. Wikipedia pageviews showed the strongest full-year associations with WNND/CNS activity when pageviews followed cases by one week (2024: Spearman rho = 0.802; 2025: rho = 0.763; both <i>p</i> < 0.001). Google Trends showed weaker associations at the same lag (2024: rho = 0.402, <i>p</i> = 0.003; 2025: rho = 0.452, <i>p</i> < 0.001). Transmission-period sensitivity analyses attenuated several associations: the 2025 Wikipedia associations and the Google Trends associations in both years were not statistically significant. The first-difference lag analysis identified no leading digital signal.</p><p><strong>Conclusions: </strong>Wikipedia showed more stable language-specific temporal concordance with national surveillance than Google Trends. However, the digital indicators reflected concurrent or lagging public attention and did not demonstrate predictive capacity. The Crete component separately illustrates how regional One Health preparedness complements national surveillance and risk communication.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unrecognized Dengue Transmission in Socially Vulnerable Peri-Urban Neighborhoods of a Temperate Argentine City: Integrating Serology with Knowledge, Attitudes, and Practices.","authors":"Diego A Mendicino, Tamara Ricardo, Maximiliano A Cristaldi, Mariana Maglianese, Gastón Guzmán, Sebastián Claussen, Romina Chiaraviglio, Federico Costa, Christian A Avalos, M Andrea Previtali","doi":"10.3390/epidemiologia7040099","DOIUrl":"10.3390/epidemiologia7040099","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Dengue is an emerging arboviral disease in temperate South America, where urban expansion, climate variability, and social vulnerability favor transmission. In Argentina, the endemic circulation of dengue was established in the late 1990s and outbreaks are reported every three or four years. <b>Methods:</b> This cross-sectional study assessed dengue virus (DENV) seropositivity and associated sociodemographic, environmental, and knowledge-attitudes-practices (KAPs) factors in three socioeconomically vulnerable peripheral neighborhoods of Santa Fe, Argentina, between December 2019 and March 2020. <b>Results:</b> A total of 188 adults were surveyed and tested for anti-DENV IgG using ELISA. KAPs questionnaires and direct peridomiciliary observations were used to characterize exposure contexts. Apparent seropositivity was 16.5%, with an adjusted estimate of 10.7% after accounting for test performance, indicating substantial unrecognized DENV circulation. Most seropositive individuals had no previous dengue diagnosis, highlighting underdetection likely related to asymptomatic infections, limited healthcare access, or surveillance gaps. Although dengue awareness was high (98.4%), knowledge was often incomplete and was weakly correlated with preventive practices, suggesting that awareness alone does not translate into effective risk reduction under structural constraints. In multivariate analysis, living farther from vacant lots was associated with higher odds of seropositivity, consistent with transmission concentrated in denser urban settings. <b>Conclusions:</b> Integrating serology with KAPs surveys provides critical insights into hidden transmission and supports targeted surveillance and public health interventions in vulnerable urban settings.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combustible Cigarette Smoking, Electronic Cigarette Use, and Metabolic Syndrome in a Working Population.","authors":"Astrid Lorena Urbano Cano, Rosa Elvira Alvarez Rosero, Nelson Esteban Portuguez Jaramillo, Jose Luis Piñeros-Alvarez","doi":"10.3390/epidemiologia7040100","DOIUrl":"10.3390/epidemiologia7040100","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome is a major public health concern because of its association with cardiovascular disease and type 2 diabetes. Tobacco exposure, including combustible cigarette smoking and electronic cigarette use, has increasingly been linked to cardiometabolic dysfunction; however, evidence in occupational populations remains limited.</p><p><strong>Objectives: </strong>This study evaluated the association of combustible cigarette smoking, electronic cigarette use, and dual use with metabolic syndrome in a working population from southwestern Colombia.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 822 workers from formal companies. Tobacco exposure was self-reported and categorized as exclusive electronic cigarette use, exclusive combustible cigarette smoking, dual use, or non-use. Sociodemographic, anthropometric, and metabolic variables were collected using standardized procedures. Logistic regression models were fitted to estimate crude and adjusted odds ratios with 95% confidence intervals.</p><p><strong>Results: </strong>Metabolic syndrome was identified in 39.8% of participants. It was more frequent in men, who also exhibited a greater accumulation of metabolic abnormalities. Hypertriglyceridemia and low high-density lipoprotein cholesterol were the components most strongly associated with metabolic syndrome. Compared with non-use, the odds of metabolic syndrome were higher across all tobacco-exposed groups, with odds ratios of 3.02 for exclusive electronic cigarette use, 7.29 for exclusive combustible cigarette smoking, and 4.75 for dual use. The strongest association was observed for exclusive combustible cigarette smoking.</p><p><strong>Conclusions: </strong>Metabolic syndrome was prevalent in this occupational population, and tobacco-related exposures were associated with a less favorable cardiometabolic profile. These findings support integrated workplace prevention strategies that combine smoking control with early detection of metabolic risk.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}