Epidemiolgia (Basel, Switzerland)最新文献

{"title":"Socioeconomic Impact, Equity, and Sustainability in Head and Neck Cancer Surgery: A Structured Narrative Review.","authors":"Francesco Chiari, Salvatore Ferlito, Guglielmo Piccione, Rodolfo Modica, Mario Lentini, Giancarlo Carmelo Botto, Salvatore Maira, Skander Kedous, Carlos Chiesa-Estomba, Pierre Guarino, Jerome Rene Lechien, Antonino Maniaci","doi":"10.3390/epidemiologia7040088","DOIUrl":"10.3390/epidemiologia7040088","url":null,"abstract":"<p><strong>Background: </strong>Sustainable head and neck cancer (HNC) surgery is challenged by environmental impact, workforce shortages, inequitable access to advanced techniques, and policy constraints. Addressing these areas is critical for equitable, high-quality care.</p><p><strong>Methods: </strong>This structured narrative review synthesizes evidence on environmental sustainability, workforce development, technological innovation, health policy, and socioeconomic determinants in HNC surgery, without aiming to provide a systematic or exhaustive evidence synthesis. Sources included peer-reviewed literature, global workforce surveys, and international policy reports, with a focus on disparities between high-income countries (HICs) and low- and middle-income countries (LMICs).</p><p><strong>Results: </strong>Operating rooms produce up to 70% of hospital solid waste and consume 3-6 times more energy than other units; reusable instruments and improved waste segregation can reduce carbon footprints by over 50%. Workforce shortages are severe in LMICs, where subspecialty training is scarce; global partnerships, bidirectional education, and simulation-based learning can expand local capacity. Telemedicine, artificial intelligence, and three-dimensional printing enhance surgical planning, training, and access but may widen disparities without equitable deployment. Policy tools-including diagnosis-related groups, bundled payments, and universal coverage-affect access and innovation uptake. Pandemic preparedness underscores the value of resilient systems with flexible staffing and telehealth integration.</p><p><strong>Conclusions: </strong>HNC surgery requires coordinated action across environmental, workforce, technological, socioeconomic, and policy domains; however, future systematic reviews are needed to comprehensively map the evidence base and assess its methodological quality. Embedding sustainability in clinical practice, ensuring equitable innovation access, and aligning reimbursement with high-value care can strengthen system resilience, improve outcomes, and support long-term surgical service viability.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581397","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":"10-Year Change in the Laboratory-Based Prevalence of Chronic Kidney Disease in Patients from a Brazilian Cardiologic Center.","authors":"Farid Samaan, Rubens Carvalho Silveira, Kleber Gomes Franchini, Fausto Feres, Gianna Mastroianni-Kirsztajn, Ricardo Sesso","doi":"10.3390/epidemiologia7030087","DOIUrl":"10.3390/epidemiologia7030087","url":null,"abstract":"<p><p><b>Background:</b> We aim to estimate the variation in the prevalence of chronic kidney disease (CKD) in patients from a Brazilian cardiologic center. <b>Methods:</b> The outpatient serum creatinine level and urine albumin-creatinine ratio (UACR) in samples from patients ≥18 years old between 2014 and 2023 were evaluated. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m². Participants were categorized into low-, moderate-, high- or very high-risk groups according to the CKD heatmap, which combines eGFR with UACR results. <b>Results:</b> The mean number of adults with serum creatinine results per year was 36,477 ± 7239, and the mean number of those with UACR results was 16,870 ± 4310. The age- and sex-adjusted prevalence of participants with CKD increased significantly (from 20% to 31%; R² = 0.853; <i>p</i> < 0.001), as was the prevalence of individuals in the high or very high CKD risk groups (14% to 21%; R² = 0.945; <i>p</i> < 0.001). The cumulative incidence of CKD during the study period was 21.7% and was higher in females and in older age groups. <b>Conclusions:</b> The roughly 50% increase in the laboratory-based CKD prevalence over 10 years underscores the need for healthcare services to adapt to managing a population with growing complexity and a heightened risk of requiring kidney replacement therapy.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13297813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320891","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":"Interpretation of Epidemiological Studies on the Relationship Between Mobile Phone Use and Cancer.","authors":"Michael Kundi, Hans-Peter Hutter","doi":"10.3390/epidemiologia7030086","DOIUrl":"10.3390/epidemiologia7030086","url":null,"abstract":"<p><strong>Background: </strong>In May 2011 the IARC (International Agency for Research on Cancer) classified radiofrequency electromagnetic fields as a possible human carcinogen mainly based on epidemiological studies about the association between mobile phone (MP) use and brain tumors. Considering that brain tumors have long latencies of around 30 years, it is unlikely that this association is due to an 'initiating' activity of MPs since virtually all studied brain tumor cases must have had already a covertly growing tumor when they started MP use. But there could be other adverse effects exerted by a MP when acting on later stages of malignant development. We propose that MP use acts adversely by increasing tumor growth rate and model it by an impact on the latency distribution shifting the age-incidence function to younger age.</p><p><strong>Methods: </strong>We calculate (1) relative risks (RRs) for MP use in comparison to the meta-analytic RR estimate for glioma in adults; (2) RRs for neuroepithelial childhood brain tumors in comparison to the findings of the MOBIkids study; and (3) hazard ratios in comparison to the results of the Million Women Study (MWS).</p><p><strong>Results: </strong>The meta-analytical odds ratio for glioma and long-term MP use in adults of 1.22 (95% confidence-interval: 1.02-1.46) could be explained by a shift in the age-incidence function by 32% of MP usage duration. Applying a 20% shift for childhood neuroepithelial brain tumors reproduced the ORs that were predominantly less than 1 in the MOBIkids study. For glioma risk in perimenopausal women in relation to long-term MP use in the MWS we found hazard-ratios close to 1 applying a 32% shift in the age-incidence function.</p><p><strong>Conclusions: </strong>The standard interpretation of relative risk estimates must be revised if exposure to the agent commenced after the malignant development has already started. All reported RR estimates of MP use can be reproduced by positing MP use increased tumor growth rate. However, since these results are obtained applying a modeling approach, further tests using epidemiological methods, which will be difficult or hardly feasible, or utilizing more promising laboratory methods are needed.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320919","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":"Geospatial Visualisation of Distance to General Practitioner Facilities with Population Density Patterns in the United Kingdom.","authors":"Mathieu Di Miceli","doi":"10.3390/epidemiologia7030085","DOIUrl":"10.3390/epidemiologia7030085","url":null,"abstract":"<p><p><b>Background/Objectives</b>: To quantify geographical distances to nearest general practitioner (GP) services for all household postcodes in the United Kingdom. <b>Methods</b>: We mapped household postcodes in the United Kingdom and computed distances to nearest GP practice, using centroid geographical coordinates (latitude and longitude). We also analysed the total number of GP practices throughout local area districts (LADs) in relation to population density. <b>Results</b>: As of December 2023, there were 7965 active GP practices across the UK, serving a total registered population of over 73 million patients. Analysis of 1.78 million household postcodes revealed that 98.8% were within 10 km of a GP practice (measured as a straight-line). The most distant postcode was in the Shetland. Throughout the UK, population density was weakly or strongly correlated with number of GP practices in the different LADs, with wide variations, and the strongest correlation observed in Northern Ireland. <b>Conclusions</b>: In the UK, geographical proximity to nearest GP practice was found to be within 10 km for the vast majority of residents. Weak to strong correlations between population density and number of GP practices were observed. Future work should quantify the impact of both staffing capacity and public transport availability on distance to GP surgeries across the UK, to better characterise structural determinants of primary care accessibility.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320942","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 Weight and Dyslipidemia in Seri (Comcáac) Indigenous Children: A Cross-Sectional Study of Prevalences and Associated Factors.","authors":"Yazmín Hugues Ayala, María A Leal-Serna, Yamili Rojo-Medina, José M Moreno-Abril, Ana C Gallegos-Aguilar, Heliodoro Alemán-Mateo, Silvia Y Moya-Camarena, Araceli Serna-Gutiérrez, Karely Pérez-Gil, Julián Esparza-Romero","doi":"10.3390/epidemiologia7030084","DOIUrl":"10.3390/epidemiologia7030084","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Excess weight and dyslipidemia are health conditions growing worldwide in children, including indigenous populations. The concern is their related comorbidities, which could appear at an early age. Given limited information on Seri children, this study aimed to evaluate the prevalence of excess weight and dyslipidemia, and to identify factors associated with BMI-for-age Z-score and dyslipidemia. <b>Methods</b>: This cross-sectional study was conducted among Seri children aged 3-11 years. For prevalence analysis, the BMI-for-age Z-score was calculated as an indicator of excess weight. Dyslipidemia was assessed only in school-age children. Information was collected on potential associated variables, including maternal nutritional status, children's sleep behaviors, physical activity, diet, and cardiovascular health, as well as household characteristics such as the modernity index and food insecurity. <b>Results</b>: A total of 154 Seri children were evaluated. Among preschoolers, 18.8% were classified at risk of overweight. In school-age children, the combined prevalence of overweight and obesity was 32.8%. Maternal BMI and weight, the modernity index, and being a boy were positively associated with the BMI-for-age Z-score, whereas having food insecurity, cardiovascular health score, and sleep time were negatively associated. Dyslipidemia prevalence was 46.1% among school-age Seri children. Having dyslipidemia was positively associated with maternal BMI, percentage of energy intake from ultra-processed products, paternal occupation as a merchant, and child age, and negatively associated with the number of remunerative maternal economic activities. <b>Conclusions</b>: These findings provide evidence on the prevalence of excess weight and dyslipidemia and their associated factors among Seri children and may inform future research and health strategies in Seri and other vulnerable populations.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320921","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":"Quantifying Epidemiological Risk Transitions of COVID-19 in the Brazilian State of Ceará (2020-2023): A Generalized Linear Modeling Approach.","authors":"Matheus Paiva Emidio Cavalcanti, Carlos Mendes Tavares, Yasmin Esther Barreto, Alexandre Castelo Branco Araujo, Rosalina Semedo de Andrade, Luiz Carlos de Abreu","doi":"10.3390/epidemiologia7030083","DOIUrl":"10.3390/epidemiologia7030083","url":null,"abstract":"<p><strong>Background/objectives: </strong>While the descriptive trajectory of COVID-19 is well-documented, there is a methodological gap in quantifying the precise magnitude of risk reduction across multi-year pandemic phases in Brazilian subnational units. This study aimed to fill this gap by applying Generalized Linear Models (GLMs) to quantify the temporal transition of epidemiological risks (Incidence, Mortality, and Case Fatality) in Ceará (2020-2023), using the first year of the pandemic as a statistical baseline.</p><p><strong>Methods: </strong>Ecological time-series study was conducted using official surveillance data. We employed GLMs with Poisson distribution to calculate Rate Ratios (RRs) and 95% Confidence Intervals, allowing for a robust comparative risk modeling between 2020 (reference) and subsequent years (2021-2023).</p><p><strong>Results: </strong>Modeling revealed a significant epidemiological dissociation between transmission and severity. While the risk of incidence remained high through 2022 (RR = 1.42), the mortality risk showed an earlier and more drastic decline, with a 68% reduction as early as 2022 (RR = 0.32) and 99% in 2023 (RR = 0.01). The Case Fatality Rate (CFR) risk decreased consistently from 2021 onwards, reaching its lowest point in 2023 (RR = 0.09; 91% reduction).</p><p><strong>Conclusions: </strong>Between 2020 and 2023, Ceará transitioned to reduced COVID-19 severity. Despite ecological design and data limitations, these findings underscore the importance of resilient health systems and equitable immunization.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320885","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":"Prevalence and Determinants of Uncontrolled Hypertension Among Treated Adults in a Rural Primary Health Care Facility in South Africa: A Cross-Sectional Study.","authors":"Guillermo Alfredo Pulido Estrada, Mercedes Nico-Garcia, Olufunmilayo Olukemi Akapo, Mirabel Kah-Keh Nanjoh","doi":"10.3390/epidemiologia7030082","DOIUrl":"10.3390/epidemiologia7030082","url":null,"abstract":"<p><strong>Background: </strong>Hypertension remains one of the leading modifiable risk factors for cardiovascular diseases globally, yet blood pressure control remains suboptimal in many low- and middle-income countries. Understanding the prevalence of uncontrolled hypertension and its associated factors is important for improving treatment outcomes, particularly in rural primary health care settings.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 103 hypertensive patients receiving follow-up care at a rural community health centre in the Eastern Cape Province of South Africa between August and October 2024. Sociodemographic, lifestyle, and clinical information were collected using a semi-structured questionnaire and medical record review. Medication adherence was assessed using the Hill-Bone Compliance to High Blood Pressure Therapy Scale. Uncontrolled hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Associations between explanatory variables and uncontrolled hypertension were analysed using chi-square tests and multivariable logistic regression.</p><p><strong>Results: </strong>The mean age of participants was 63 ± 13 years, and 65% were female. The prevalence of uncontrolled hypertension was 63.1% (65/103), while 36.9% (38/103) achieved blood pressure control. The median systolic blood pressure was 149 mmHg (IQR: 135-163) and the median diastolic blood pressure was 84 mmHg (IQR: 76-89). Low medication adherence was significantly associated with uncontrolled hypertension (OR = 4.20, 95% CI: 1.75-10.09, <i>p</i> = 0.001). Forgetfulness and non-use of reminders were common barriers to adherence.</p><p><strong>Conclusions: </strong>Uncontrolled hypertension remains highly prevalent among treated patients in this rural setting. Low medication adherence was significantly associated with uncontrolled hypertension, suggesting that adherence support strategies warrant further investigation in similar resource-limited primary health care settings.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320904","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":"Racial Disparities and the Use of Artificial Intelligence for Predicting Maternal Mortality: A Literature Review.","authors":"Gustavo Gonçalves Dos Santos, Anuli Njoku, Ana Carolina Pereira Mass, Ellen Eduarda Santos Ribeiro, Letícia Eduarda de Oliveira, Maria Julia Cunha Silva Lima, Taís de Abreu Ferro, Lilian Reinaldi Ribeiro Pirozi, Antônio Augusto de Freitas Peregrino, Célia Maria Pinheiro Dos Santos, Lucia Helena Ferreira Viana, Marilda Gonçalves de Sousa, Carla Helena Cappello, Cely de Oliveira, Luis Henrique de Andrade, Cindy Ferreira Lima, Isabelle Cristinne Pinto Costa","doi":"10.3390/epidemiologia7030081","DOIUrl":"10.3390/epidemiologia7030081","url":null,"abstract":"<p><strong>Background: </strong>Maternal mortality remains a major global health challenge, disproportionately affecting black and Indigenous women. Hypertensive disorders of pregnancy and postpartum hemorrhage are the leading direct causes of maternal death. Artificial intelligence (AI) tools have emerged as potential strategies for predicting these complications, yet concerns persist about their equity and validation across racial groups.</p><p><strong>Methods: </strong>A rapid review was conducted in five databases, PubMed, EMBASE, Web of Science, Scopus and LILACS, to synthesize recent evidence on the use of AI for preventing maternal mortality due to hypertension and postpartum hemorrhage. Studies published in the last five years that included racial or ethnic data were selected and analyzed narratively.</p><p><strong>Results: </strong>Ten studies met the inclusion criteria, showing high predictive accuracy of AI models (AUROC often >0.95) for severe maternal outcomes. However, few models incorporated racial variables or underwent external validation in racially diverse or low-resource populations. Evidence suggests that unrepresentative datasets may perpetuate or exacerbate existing health inequities.</p><p><strong>Conclusions: </strong>AI demonstrates strong technical performance in predicting maternal complications but limited equity in application. Broader racial representation, external validation, and ethical governance are essential for ensuring that AI-based tools reduce rather than reinforce racial disparities in maternal mortality.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13297638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320909","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":"Cerebrovascular Diagnoses During First Recorded Pregnancies in a 17-Year Period-A Nationwide Analysis of Healthcare Administrative Records Between 2004 and 2020 in a Central-Eastern European Population.","authors":"Dániel Bereczki, Péter Vinnai, Mónika Bálint, Ferenc Oberfrank, Balázs Dobi, Dániel Bereczki, Ildikó Vastagh","doi":"10.3390/epidemiologia7030080","DOIUrl":"10.3390/epidemiologia7030080","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Cerebrovascular disorders are major contributors to maternal morbidity and mortality during pregnancy. In this nationwide study in Hungary, we evaluated the frequency of cerebrovascular diagnoses during first recorded pregnancies in a 17-year period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;In the framework of the NEUROHUN project utilising nationwide administrative healthcare data, we included women with at least one delivery and with at least one cerebrovascular diagnosis during their first pregnancies recorded between 2004 and 2020. To minimise the number of misclassified first pregnancies due to database limitations appearing towards the beginning of the database, trend analyses using linear regression models were restricted to the 2011-2020 period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During first recorded pregnancies in the 17-year study time frame (&lt;i&gt;n&lt;/i&gt; = 952,451), the frequency of ICD-10 cerebrovascular diagnoses was 0.17% (&lt;i&gt;n&lt;/i&gt; = 1614), with an estimated overall prevalence rate of 169.4 per 100,000 women (95% CI: 161.4-177.9). Transient ischaemic attack (TIA) was the most prevalent specific diagnosis, with a rate of 72.7 per 100,000 (95% CI: 67.4-78.3). In a multiple linear regression model on the mean age at first recorded birth within 2004-2020, women diagnosed with a cerebrovascular disorder were, on average, 1.935 years older at the time of their first birth compared to those without a diagnosis (mean difference: 1.935 years; 95% CI [1.188-2.682], &lt;i&gt;p&lt;/i&gt; &lt; 0.001). This analysis, adjusted for calendar year trends between 2011 and 2020, suggests that higher maternal age is an important factor associated with these events. In a sensitivity analysis of the linear regression using the diagnoses of G45, I60, I61, I63, and I67 we found that the relationship between the presence of diagnosis and mean age remained significant in the case of G45, I63 and I67, but not for I60 and I61. In the logistic regression model, compared to the reference group of women &lt; 25 years, the prevalence for all evaluable cerebrovascular diagnoses was significantly higher in the &gt;34 age group, and was also significantly higher for TIA (G45) and cerebral infarction (I63) diagnoses in the 25-34 age group. The rate of cerebral infarction among cerebrovascular disorders showed an increasing trend towards higher maternal age (&lt;25 years age group: 12%; 25-34 years age group: 16.5%; &gt;34 years age group: 20.0%). Also, when compared to the reference category of diagnosed women &lt; 25 years, the increase in the odds of cerebral infarction was significant at the 5% level among women &gt; 34 years. In contrast, there was no increment in the proportion of intracranial bleedings at older age.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion and conclusion: &lt;/strong&gt;The prevalence of most cerebrovascular diagnoses increases significantly with higher maternal age. Allowing for the limitations of our study, we found that in a Central-Eastern European population, the ","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13297908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320903","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":"From Ebola to H5N1: Strengthening the U.S. Special Pathogen Response System.","authors":"Anthony Joseph Lo Piccolo, Erin McGuire, Radu Postelnicu, Kathryn Jano, Ryan Leone, Eliana Jacobson, Angela Vasa, Michelle Schwedhelm, Vikramjit Mukherjee","doi":"10.3390/epidemiologia7030079","DOIUrl":"10.3390/epidemiologia7030079","url":null,"abstract":"<p><p>The National Special Pathogens System (NSPS) stratifies U.S. healthcare facilities by their readiness level to care for patients with high-consequence infectious diseases (HCIDs). While NSPS Level 1 and 2 facilities possess advanced biocontainment capabilities to care for patients for the duration of their illness, most U.S. hospitals fall under a NSPS Level 3 or 4 designation, with limited resources to manage patients with a suspected or confirmed HCID. However, emerging zoonotic threats like H5N1 underscore the need to bolster HCID preparedness across all NSPS Levels. Beginning in March 2024, the U.S. H5N1 outbreak has primarily impacted wild bird flocks, poultry, and cattle, along with some human infections. The continuation of this outbreak in wild and domesticated animals increases the likelihood of further human spillover and eventual viral evolution in human hosts. At the frontlines, rural farming communities are likely to be most affected, with potential outbreaks exacerbated by a lack of accessible NSPS Level 1, 2, or 3 facilities in these regions. Thus, strengthening the HCID preparedness of local NSPS Level 4 facilities is critical to preventing transmission, minimizing societal disruption, protecting communities and the healthcare workforce, along with ensuring an equitable, coordinated response to future emerging infectious disease threats. This manuscript explores the financial, societal and health system impacts of HCID outbreaks to delineate the necessity of strengthening the preparedness of NSPS Level 4 facilities.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13297867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320911","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}