Healthcare utilization is increased in children living in urban areas, with ethnicity-related disparities: A big data analysis study

This study aimed to investigate differences in pediatric healthcare utilization in Israel over 10 years by examining differences across populations defined by living environment and ethnicity. Data was obtained from the Clalit Health Care data warehouse, covering over 250,000 children residing in Haifa and Western Galilee districts. The population groups were categorized based on ethnicity (Jewish vs Arab) and residential settings (urban vs rural). Healthcare utilization was consistently higher among Jewish than Arab children, irrespective of the specific dimension analyzed. Additionally, urban-dwelling children exhibited higher usage rates than those residing in rural areas in all investigated dimensions. However, Jewish children showed significantly about 18% lower hospitalization rates than Arab children across all years (P < 0.001). No significant differences in hospitalizations were observed between urban and rural children (RR 0.999, CI (0.987-1.011)). Notably, the study revealed reduced antibiotic consumption and hospitalizations over the years for all populations. Additionally, we found that Arab children and those living in rural areas had reduced access to healthcare, as evidenced by 10-40% fewer physician visits, laboratory tests, and imaging (P < 0.001).    Conclusion: This study highlights the substantial population-based disparities in healthcare utilization among children in Israel despite the equalizing effect of the national health insurance law. Rural and low socioeconomic populations seem to have reduced healthcare access, showing decreased healthcare utilization. Consequently, it is imperative to address these disparities and implement targeted interventions to enhance healthcare access for Arab children and rural communities. The decline in antibiotic usage and hospitalizations suggests positive trends in pediatric health care, necessitating ongoing efforts to ensure equitable access and quality of care for all populations. What is Known: • Healthcare systems worldwide vary in coverage and accessibility, including Israel, which stands out for its diverse population. • Existing research primarily focuses on healthcare utilization among adults, leaving a need for comprehensive data on children's healthcare patterns globally. What is New: • Investigating over 250,000 children, this study reveals higher healthcare utilization among Jewish and urban children across all dimensions. • Despite Israel's national health insurance law, the study underscores the significant population-based disparities in healthcare utilization.

Population differences in completeness and reliability of Dutch COVID-19 registry data: The influence of testing policy, test readiness, and registration policy from an epidemiological perspective

During the COVID-19 pandemic, the bidirectional relationship between policy and data reliability has been a challenge for researchers of the local municipal health services. Policy decisions on population specific test locations and selective registration of negative test results led to population differences in data quality. This hampered the calculation of reliable population specific infection rates needed to develop proper data driven public health policy.

RMplex reveals population differences in RM Y-STR mutation rates and provides improved father-son differentiation in Japanese

Rapidly mutating Y chromosomal short tandem repeat markers (RM Y-STRs) -characterized by at least one mutation per 100 generations- are suitable for differentiating both related and unrelated males. The recently introduced multiplex method RMplex allows for the efficient analysis of 30 Y-STRs with increased mutation rates, including all 26 currently known RM Y-STRs. While currently available RM Y-STR mutation rates were established mostly from European individuals, here we applied RMplex to DNA samples of 178 genetically confirmed father-son pairs from East Asia. For several Y-STRs, we found significantly higher mutation rates in Japanese compared to previous estimates. The consequent father-son differentiation rate based on RMplex was significantly higher (52%) in Japanese than previously reported for Europeans (42%), and much higher than with Yfiler Plus in both sample sets (14% and 13%, respectively). Further analysis suggests that the higher mutation and relative differentiation rates in Japanese can in part be explained by on average longer Y-STR alleles relative to Europeans. Moreover, we show that the most striking difference, which was found in DYS712, could be linked to a Y-SNP haplogroup (O1b2-P49) that is common in Japanese and rare in other populations. We encourage the forensic Y-STR community to generate more RMplex data from more population samples of sufficiently large sample size in combination with Y-SNP data to further investigate population effects on mutation and relative differentiation rates. Until more RMplex data from more populations become available, caution shall be placed when applying RM Y-STR mutation rate estimates established in one population, such as Europeans, to forensic casework involving male suspects of paternal origin from other populations, such as non-Europeans.

[Population differences in the completeness and reliability of COVID-19 registration data]

During the COVID-19 pandemic, the bidirectional relationship between policy and data reliability has been a challenge for researchers of the local municipal health services. Policy decisions on population specific test locations and selective registration of negative test results led to population differences in data quality. This hampered the calculation of reliable population specific infection rates needed to develop proper data driven public health policy.

Rest-activity profiles among U.S. adults in a nationally representative sample: a functional principal component analysis

Background

The 24-h rest and activity behaviors (i.e., physical activity, sedentary behaviors and sleep) are fundamental human behaviors essential to health and well-being. Functional principal component analysis (fPCA) is a flexible approach for characterizing rest-activity rhythms and does not rely on a priori assumptions about the activity shape. The objective of our study is to apply fPCA to a nationally representative sample of American adults to characterize variations in the 24-h rest-activity pattern, determine how the pattern differs according to demographic, socioeconomic and work characteristics, and examine its associations with general health status.

Methods

The current analysis used data from adults 25 or older in the National Health and Nutrition Examination Survey (NHANES, 2011–2014). Using 7-day 24-h actigraphy recordings, we applied fPCA to derive profiles for overall, weekday and weekend rest-activity patterns. We examined the association between each rest-activity profile in relation to age, gender, race/ethnicity, education, income and working status using multiple linear regression. We also used multiple logistic regression to determine the relationship between each rest-activity profile and the likelihood of reporting poor or fair health.

Results

We identified four distinct profiles (i.e., high amplitude, early rise, prolonged activity window, biphasic pattern) that together accounted for 86.8% of total variation in the study sample. We identified numerous associations between each rest-activity profile and multiple sociodemographic characteristics. We also found evidence suggesting the associations differed between weekdays and weekends. Finally, we reported that the rest-activity profiles were associated with self-rated health.

Conclusions

Our study provided evidence suggesting that rest-activity patterns in human populations are shaped by multiple demographic, socioeconomic and work factors, and are correlated with health status.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01274-4.

Interleukin-8 genetic diversity, haplotype structure and production differ in two ethnically distinct South African populations

A single nucleotide polymorphism (SNP), 251 bases upstream from the IL-8 transcription start (-251A>T, rs4073), has been extensively investigated in cancers and inflammatory and infectious diseases in predominantly European and Asian populations. We sequenced the IL-8 gene of 109 black and 32 white South African (SA) individuals and conducted detailed characterization of gene variation and haplotype structure. IL-8 production in phytohaemagglutinin (PHA)-stimulated peripheral blood mononuclear cells (PBMCs) of a subset (black: N = 22; white: N = 32) of these individuals was measured using ELISA. Select variants were genotyped for additional black individuals (N = 141), and data from the 1000 Genomes Project were used for haplotype analysis and comparative purposes. In white individuals, the -251A>T SNP formed part of a prevalent six-variant haplotype [haplotype frequency (HF): 61%], Hap-1C, involving the following variants: -251A>T; +394T>G (rs2227307); +780C>T (rs2227306); +1240->A (rs2227541); +1635C>T (rs2227543) and +2770A>T (rs2227543). Hap-1C (-251T+394T+780C+1240+A+1635C+2770A) was composed of two three-variant sub-haplotypes [Hap-1Ca: -251T+394T+1240+A; Hap-1Cb: +780C+1635C+2770A) sharing similarities with haplotypes identified in the black population. Hap-1C was found to be present in European, East and South Asian populations. Four haplotypes were identified in the black population with the two prevalent haplotypes each comprised of two variants: Hap-1B [-251A>T and +1240->A; -251T+1240+A; HF: 14%] and Hap-2B [-743T>C (rs2227532) and +2452A>C (rs2227545); -743C+2452C; HF: 13%]. Populations did not differ in unstimulated PBMC IL-8 production. Upon PHA stimulation, PBMCs from white individuals produced more IL-8 (P = 0.04), suggesting the -251T allele is responsible for higher production, however further analysis revealed that Hap-1C (and constituent sub-haplotypes), did not associate with IL-8 production. Populations did however differ in monocyte number with the white population having significantly more monocytes compared to the black population (P = 0.025), and furthermore monocyte number strongly correlated with IL-8 production in both population groups (black: p = 0.0002, r = 0.71; white: P = 0.0005, r = 0.59). Hap-1B, Hap-2B, and a SNP located one base pair upstream of the IL-8 ATG start codon, +100C>T SNP (rs2227538), all associated with higher IL-8 production in the black population - individuals harbouring at least one of these haplotypes/variant associated with higher IL-8 production (P = 0.003) compared to individuals without. The black population was enriched for individuals harbouring Hap-1B and/or Hap-2B compared to the 1000 Genomes project sub-Saharan African population (P = 0.006), suggesting that SA black individuals may be high IL-8 producers. Given the paucity of IL-8-related studies that have been conducted in populations from sub-Saharan Africa, this study has significantly increased our understanding of this important chemokine in the South African population.

[Regional and demographic differences on passive smoking among non-smokers aged 30-79 years in 10 regions of China]

Objective: To describe the regional and demographic differences on passive non-smokers from 10 regions involved in the China Kadoorie Biobank (CKB) study. Methods: Detailed information regarding passive smoking behaviors related to 317 486 non-smokers who were 30-79 years old from the 10 study regions were gathered and analyzed. Results: Following the standardization of the 2010 China national population, the prevalence rate of passive smoking was 56.7%, and the prevalence rate of living with smokers was 66.5% among the Chinese adults. Both of the aforementioned rates were higher in rural than in urban areas. Meanwhile, the regional distribution of weekly passive smoking frequency and cumulative duration of passive smoking per week and cumulative duration of passive smoking per day were significantly different. The cumulative passive smoking duration per week increased along with the weekly frequency in people living in urban areas. Among women, the weekly passive smoking frequency was the highest, and the cumulative durations per week and per day appeared the lowest in Hunan, opposite to the situation in Henan. The prevalence of passive smoking among participants living with smokers was 2.27 times (95%CI: 2.24-2.29) of those who were not and the association appeared stronger in women (OR=2.61, 95%CI: 2.58-2.64) but not in men (OR=1.01, 95%CI: 0.95-1.06). Almost all the indicators seemed higher in women than those in men, except for the cumulative duration per day. Furthermore, these indicators appeared higher among those who were at younger age or with less education. The prevalence rates of passive smoking and living with smokers were lower but the cumulative duration per day was higher among those with lower household income. And the two rates were higher in married women and lower in married men, as compared to their counterparts. Conclusion: Regional and demographic differences in passive smoking were noticed among study population of CKB in the 10 regions.

Vocal Repertoire and Intraspecific Variation within Two Loud Calls of the Small-Eared Greater Galago (Otolemur garnettii) in Tanzania and Kenya

Vocal repertoires and call structure can provide insights into the behaviour and evolution of species, as well as aid in taxonomic classification. Nocturnal primates have large vocal repertoires. This suggests that acoustic communication plays an important role in their life histories. Little is known about the behavioural context or the intraspecific variation of their vocalisations. We used autonomous recording units and manual recorders to investigate the vocal behaviour and structure of loud calls of the small-eared greater galago (Otolemur garnettii)in Kenya and Tanzania. We describe the vocal repertoire, temporal calling patterns and structure of 2 loud calls of 2 subspecies: O. g. panganiensis and O. g. kikuyuensis. We found considerable intraspecific structural differences in both loud calls. These are congruent with the current subspecies classification. Differences in vocalisations among populations are not consistent with the "acoustic adaptation hypothesis," rather they are likely a result of geographic variation due to isolation caused by vegetational barriers in southern Kenya.

Divergences in learning and memory among wild zebrafish: Do sex and body size play a role?

Given its diverse ecological distribution, zebrafish has great potential for investigations on the effect of habitat characteristics on cognition. Studies were conducted on four wild-caught zebrafish populations to understand the role of native habitat, sex, and body size in determining learning through a novel task associated with a food reward. The habitat variables, namely, the relative abundances of zebrafish and predatory fish and the substrate and vegetation diversity, were quantified during fish sampling. Fish were subjected to a novel task to find a food reward in a maze over successive training trials followed by a test for memory. Performances of subjects were based on time taken to find the food reward and number of mistakes made during trials, and tests for memory. The experiments revealed significant differences in learning rates and memory across populations. Males made significantly fewer mistakes than females only within two populations. No relationship between performance and body size was observed. The differences in learning and memory among wild zebrafish could be due to differences in predation, complexity, and stability of the native habitats. These findings suggest the possible role of multiple interacting factors in determining learning and memory among populations and point to a need for incorporating effects of several factors in future studies.

Lynn's r/k selection theory of criminality revisited: Consideration of individual differences and developmental life history contributions to the patterning of population differences in antagonistic social strategies

We revisit an old theory proposed by Lynn, connecting race differences in criminality and psychopathy with r/k selection. The origin of this group-difference is attributed to cold-selection in the Pleistocene. We contend that newer models of Life History Theory provide a better rubric within which to evaluate Lynn's arguments as a) they better account for the adaptive logic of the coherence pattern among the traits characteristic of so-called 'psychopathic personality', b) provide a normatively free language with which group differences in behavior can be described, and c) make predictions at the level of both the individual and intra-individual (developmental) levels, which permit the role of environmental contributions to these dispositions to be better comprehended. Thus newer approaches to understanding life history are necessarily more empirically nuanced. We also consider the merits of future, more systematic studies along the lines of Lynn's contribution.

Self-Rated Health and Glycemic Control in Type 2 Diabetes: Race by Gender Differences

BACKGROUND

Although some studies have shown a link between self-rated health (SRH) and glycemic control in type 2 diabetes (DM), other studies have failed to support this association. The purpose of this study was to determine whether these equivocal findings can be explained by specific interactions between gender, race, and SRH, as suggested by the intersectionality literature.

METHODS

This cross-sectional study included 287 patients with DM (85 Black men, 78 Black women, 64 White men, and 60 White women). After adjusting for demographic and medical factors, we regressed HbA1c on SRH with and without interactions between gender, race, and SRH. We conducted additional subgroup analyses to further characterize gender by race group differences.

RESULTS

Although there was no main effect of SRH upon HbA1c (b = .16, 95% CI: .08-.39), we found a significant interaction between gender and SRH on HbA1c (b = -.50, 95% CI: -.97 to -.03). In race by gender-stratified models, SRH (b = .53, 95% CI: .00-1.07) was associated with HbA1c in Black men. SRH was not associated with HbA1c in White men, White women, or Black women.

CONCLUSION

Combined race and gender differences may exist in the link between SRH and glycemic control in DM. Specifically, Black men with DM may be more attuned to the relationship between their overall health and their glycemic control.

Phenotypic correlates of melanization in two Sceloporus occidentalis (Phrynosomatidae) populations: Behavior, androgens, stress reactivity, and ectoparasites

Mechanisms underlying production of animal coloration can affect key traits besides coloration. Melanin, and molecules regulating melanin, can directly and indirectly affect other phenotypic traits including aggression, stress-reactivity, and immune function. We studied correlation of melanization with these other traits, comparing within- and between-population differences of adult male western fence lizards, Sceloporus occidentalis. We compared one high- and one low-elevation population in California where individuals are increasingly darker at higher elevations, working during comparable periods of the breeding season at each site (first egg clutch). We measured agonistic behaviors of free-ranging males in response to staged territorial intrusions (STIs). In other sets of males we measured baseline testosterone and corticosterone levels, and hormonal-reactivity to a stress handling paradigm. We counted ectoparasite loads for all males. There were no significant associations between individual variation in melanization and individual variation in any of the variables measured. However, analysis of behavior from the STIs revealed that males in the darker high-elevation population responded with more aggressive behavior compared to males in the lighter low-elevation population. Males in the low-elevation population had significantly higher mean baseline testosterone, but the two populations did not differ in adrenal function (baseline corticosterone or corticosterone after 1-h confinement stress). Males in the darker high-elevation population had higher mean mite loads compared to males in the lighter population. This array of phenotypic differences between the two populations, and the absence of trait associations when assessing individual variation, do not parallel the patterns in other vertebrates. We describe potential differences in selective regimes that could produce these different patterns across vertebrates. These data suggest that hormonal pleiotropy does not constrain phenotypic variation.

Secular trend in the maturation of permanent teeth in a sample of Turkish children over the past 30 years

This study was performed to evaluate the influence of secular trends on dental maturation among Turkish children over the past 30 years. Orthopantomograms of 757 (385 boys, 372 girls) Turkish children born in the 1980s, 1990s, and 2000s were evaluated. Three groups were formed based on decade with five subgroups by age from 9 to 13 years old for each gender. The number of samples in each age group and gender were matched. The mandibular left seven permanent teeth were evaluated based on formation stage to determine the overall dental maturity score. The groups were compared based on decade and gender. The Bonferroni-corrected Mann-Whitney U test and Kruskal-Wallis tests were used for statistical evaluation. Among 11-, 12-, and 13-year-olds born in the 2000s, girls exhibited significantly more mature dentition than did boys (p<0.01, p<0.05, and p<0.05, respectively). Twelve-year-old girls born in the 1990s and 2000s exhibited significantly more mature dentition than did girls born in the 1980s (p<0.01). Girls generally exhibited more mature dentition than boys. No significant positive secular trends in dental maturity were observed from the 1980s through the 2000s. Dental maturation among Turkish children was not affected by a secular trend.

Genome-wide association study of nicotine dependence in American populations: identification of novel risk loci in both African-Americans and European-Americans

BACKGROUND

We report a genome-wide association study (GWAS) of nicotine dependence defined on the basis of scores on the Fagerström Test for Nicotine Dependence in European-American (EA) and African-American (AA) populations.

METHODS

Our sample, from the one used in our previous GWAS, included only subjects who had smoked >100 cigarettes lifetime (2114 EA and 2602 AA subjects) and an additional 927 AA and 2003 EA subjects from the Study of Addiction: Genetics and Environment project [via the database of Genotypes and Phenotypes (dbGAP)]. GWAS analysis considered Fagerström Test for Nicotine Dependence score as an ordinal trait, separately in each population and sample and by combining the results in meta-analysis. We also conducted analyses that were adjusted for other substance use disorder criteria in a single nucleotide polymorphism (SNP) subset.

RESULTS

In EAs, one chromosome 7 intergenic region was genome-wide significant (GWS): rs13225753, p = 3.48 × 10(-8) (adjusted). In AAs, GWS associations were observed at numerous SNPs mapped to a region on chromosome 14 of >305,000 base pairs (minimal p = 4.74 × 10(-10)). Two chromosome 8 regions were associated: p = 4.45 × 10(-8) at DLC1 SNP rs289519 (unadjusted) and p = 1.10 × 10(-9) at rs6996964 (adjusted for other substances), located between CSGALNACT1 and INTS10. No GWS associations were observed at the chromosome 15 nicotinic receptor gene cluster (CHRNA5-CHRNA3-CHRNB4) previously associated with nicotine dependence and smoking quantity traits. TSNAX-DISC1 SNP rs821722 (p = 1.46 × 10(-7)) was the most significant result with substantial contributions from both populations; we previously identified DISC1 associations with opioid dependence. Pathway analysis identified association with nitric oxide synthase and adenosine monophosphate-activated protein kinase pathways in EAs.

CONCLUSIONS

The key risk loci identified, which require replication, offer novel insights into nicotine dependence biology.

Behavioral responses to host foodplants of two populations of the insect parasitoid Cotesia congregata (Say)

To test the hypothesis that natural enemy populations differ in their behavioral responses to plants or to plant allelochemicals, we compared two populations of the gregarious larval endoparasitoid, Cotesia congregata (Say) (Hymenoptera: Braconidae) that differed in their historical and present exposure to tobacco. The major hosts for both populations were Manduca sexta L. and M. quinquemaculata (Haworth) (Lepidoptera: Sphingidae), but these hosts were typically encountered on tobacco by parasitoids in one population (Upper Marlboro) and on tomato by parasitoids in another population (Wye). Early in the season, Wye parasitoids preferred to oviposit in M. sexta on tomato rather than on tobacco and Upper Marlboro parasitoids showed no preference; neither population showed any preference later in the season. Neither of the strains originating from the two populations showed a landing preference for tobacco or tomato in flight chamber trials, but Upper Marlboro parasitoids searched longer on tobacco than on tomato, and Wye parasitoids searched longer on tomato. When nicotine solutions were applied to tobacco leaf, searching responses of Upper Marlboro parasitoids were enhanced by 0.001-1.0% nicotine, and searching responses of Wye parasitoids were decreased by 0.01-1.0% nicotine. We speculate that population differences in searching responses to tobacco and nicotine may explain the differential parasitism responses found early in the season.