Corrigendum: Associations between serum biomarkers and non-alcoholic liver disease: results of a clinical study of Mediterranean patients with obesity

[This corrects the article DOI: 10.3389/fnut.2022.1002669.].

Association between Multiple Myeloma and Ulcerative Colitis: A Cross-Sectional Analysis

BACKGROUND AND AIMS

Multiple myeloma (MM) is a plasma cell dyscrasia that is common among patients with autoimmune diseases. However, the association between ulcerative colitis (UC) and multiple myeloma (MM) is yet to be established. We aimed to evaluate the prevalence of MM among patients with UC in the United States.

METHODS

This cross-sectional cohort analysis used the National Inpatient Sample from 2015-2018 to assess the overall MM prevalence among patients with and without UC, and within specific demographic subgroups. Prevalences were compared using a logistic regression model controlling for sex and age.

RESULTS

The crude prevalence of MM among patients with UC (n = 1750) compared with patients without UC (n = 366,265) was 0.44% vs. 0.37%, respectively. Patients with UC had increased overall odds of having MM (odds ratio (OR), 1.26). Males with UC had higher prevalence of MM (53.7% vs. 46.3%, respectively) than females. Patients with UC and MM were more likely to be African American than White (15.6% vs. 9.2%, respectively). Patients with UC age >64 had a higher prevalence of MM than those aged below 65 (70.9% vs. 29.1%, respectively). Patients with UC who were obese (BMI > 30) had a higher prevalence of MM than those who were non-obese (12.6% vs. 8.3%).

CONCLUSIONS

Overall, UC appears to be associated with MM. This association can be particularly observed in specific demographic groups, such as obese, African American males, or patients >64 years of age. Thus, a high degree of clinical suspicion for MM is warranted, even with minimal symptomatology, in patients with UC, in particular among elder, obese, and African American males.

Physical activity pattern in Iran: Findings from STEPS 2021

Background

Insufficient physical activity (IPA) is a significant risk factor for various non-communicable diseases. The Iran action plan is a 20% reduction in IPA. Therefore, we aimed to describe the age and sex pattern of physical activity domains, IPA, the intensity of physical activity, sedentary behavior, and their associates at Iran's national and provincial levels in 2021.

Methods

This study used the data of the STEPwise Approach to NCD Risk Factor Surveillance (STEPS) 2021 in Iran. The STEPS study used the Global Physical Activity Questionnaire (GPAQ) version two developed by WHO for the assessment of physical activity, which included work, transport, and recreational activities domains. We showed and compared demographic and clinical characteristics of participants between males and females, using t-test and Chi-square test. A logistic regression model adjusted for residential areas, years of schooling, wealth index, age, marital status, and occupation has also been implemented. The results were presented as percentages and 95% confidence intervals (CI).

Results

We included 27,874 participants with a mean (SD) age of 45.69 (15.91), among whom 12,479 (44.77%) were male. The mean prevalence of IPA for the whole population for all ages was 51.3% (50.62-51.98%). By sex, 41.93% (40.88-42.98%) and 57.87% (56.99-58.75%) of men and women had IPA, respectively. According to the physical activity domains, the age-standardized prevalence of no recreational activity was 79.40% (78.80-79.99%), no activity at work was 66.66% (65.99-67.32%), and no activity at transport was 49.40% (48.68-50.11%) for both sexes combined. Also, the overall age-standardized prevalence of sedentary behaviors was 50.82% (50.11-51.53%). Yazd province represented the highest prevalence of IPA (63.45%), while West Azerbaijan province represented the lowest prevalence (39.53%). Among both sexes, living in the urban area vs. rural area [adjusted OR: 1.44; (1.31-1.58)], married vs. single status [adjusted OR: 1.33; (1.16-1.53)], and wealth index of class 3 vs. class 1 [adjusted OR: 1.15; (1.01-1.30)] were significantly associated with a higher rate of IPA.

Conclusion

The prevalence of IPA was considerably high in Iran. To achieve the predefined goal of reducing IPA, the health system should prioritize increasing physical activity, especially in urban areas and among females.

COVID-19 vaccine uptake among physicians during the second wave of COVID-19 pandemic: Attitude, intentions, and determinants: A cross-sectional study

Background

Developed within a short period of time, the COVID-19 vaccine is not yet widely accepted among the public despite its availability, including by physicians, who are considered a vulnerable group.

Methodology

A descriptive cross-sectional study selected 436 governmental physicians from different specializations, representing four random administrative regions in Egypt. The data were collected through a self-administrated online questionnaire and analyzed using suitable tests.

Results

Out of the studied 436 physicians, 229 (52.2%) [aged 20-30, 284 (65.1%)] were women, 270 (61.9%) were residents, 219 (50.2%) were married, 398 (91.3%) were non-smokers, and 263 (60.3%) were non-frontline caregivers. The majority of the physicians, 227 (52.1%) of them, hesitated to take the vaccine, 236 (54.1%) had not decided on the preferred type of vaccine, and 101 (23.2%) were neutrally confident in the Egyptian healthcare system; 302 (96.3%) had no history of drug or food hypersensitivity. There was no statistically significant (p < 0.05) relationship between the physicians' attitude toward COVID-19 vaccine uptake and the studied demographic variables. There was a statistically significant connection between all of the doctors' intentions to get the COVID-19 vaccine and all of the four attitude domains that were looked at.

Conclusion

The study concluded that a low level of willingness among Egyptian physicians to take the COVID-19 vaccine is a prevalent problem. COVID-19 vaccination hesitancy and non-acceptance were linked to negative attitudes about natural immunity, mistrust of vaccine benefits, and concerns about commercial profiteering.

Characteristics of US Adults Delaying Dental Care Due to the COVID-19 Pandemic

Background:

Coronavirus disease 2019 (COVID-19) has disrupted the delivery of health care services, including dental care. The objective of this study was to quantify and describe US adults who delayed dental care due to the COVID-19 pandemic.

Methods:

We analyzed cross-sectional responses collected from a nationally representative and long-running panel survey of US adults conducted in late May and early June 2020 (response rate = 70%). The survey included questions about dental care delayed due to the COVID-19 pandemic, purpose of the delayed dental visits, timing of future dental visits, and demographic information. Pearson’s chi-square tests were used to determine if rates of delayed dental care varied by subgroup. A multivariable regression model, adjusted for age, race, Hispanic ethnicity, census division, and rurality, was estimated to predict the odds of reporting delayed dental care.

Results:

Nearly half of respondents (46.7%) reported delaying going to the dentist or receiving dental care due to the COVID-19 pandemic. Among adults who reported delaying dental care due to the pandemic, 74.7% reported delaying a checkup, 12.4% reported delaying care to address something that was bothering them, and 10.5% reported delaying care to get planned treatment. About 44.4% of adults reported that they planned to visit the dentist within the next 3 mo. In the multivariable regression model, only living in an urban (vs. rural) area was associated with significantly higher odds of delayed dental care due to the pandemic (odds ratio: 1.5; 95% confidence interval: 1.1, 2.1).

Conclusions:

Nearly half of US adults reported delaying dental care due to the COVID-19 pandemic during the spring of 2020. Our results offer insight into the experiences of patients seeking dental care this spring and the economic challenges faced by dental providers due to the pandemic.

Knowledge Transfer Statement:

This article describes US adults who delayed dental care due to the COVID-19 pandemic. Results can be used by clinicians and policymakers to understand delayed care during the pandemic.

Prevalence and determinants of unconscious stereotyping among primary care physicians. An analytical cross-section study

OBJECTIVES

To explore implicit stereotyping among primary healthcare (PHC) physicians and to identify determinants of physicians' stereotyping of patients based on the patients' characteristics and appearance.

METHODS

This study followed an analytical cross-sectional design conducted between October 2019 and December 2019, and included 250 primary healthcare (PHC) physicians in Aseer Region, Kingdom of Saudi Arabia. Data was collected using a self-administered questionnaire, which included items concerning physicians' sociodemographic characteristics, and their attitudes toward patient characteristics and patient appearance.

RESULTS

Prevalence of stereotyping among PHC physicians was 63.6% with respect to patient characteristics and 57.6% with respect to patient appearance. Stereotyping based on patient characteristics was higher among younger participants, females, those with bachelor's degrees, those in general practitioner positions, and those with less experience in PHC.

CONCLUSION

Most PHC physicians in Aseer Region, Kingdom of Saudi Arabia, are liable to implicit stereotyping based on patient characteristics (namely, gender and educational level) and patient appearance (namely, clothing). Therefore, it is recommended to train PHC physicians in cultural competency to reduce unintentional acts of discrimination toward their patients.

Racial/Ethnic Disparities in Readmissions in US Hospitals: The Role of Insurance Coverage

We examine differences in rates of 30-day readmissions across patients by race/ethnicity and the extent to which these differences were moderated by insurance coverage. We use hospital discharge data of patients in the 18 years and above age group for 5 US states, California, Florida, Missouri, New York, and Tennessee for 2009, the latest year prior to the start of Centers for Medicare & Medicaid Services’ Hospital Compare program of public reporting of hospital performance on 30-day readmissions. We use logistic regression models by state to estimate the association between insurance status, race, and the likelihood of a readmission within 30 days of an index hospital admission for any cause. Overall in 5 states, non-Hispanic blacks had a slightly higher risk of 30-day readmissions relative to non-Hispanic whites, although this pattern varied by state and insurance coverage. We found higher readmission risk for non-Hispanic blacks, compared with non-Hispanic whites, among those covered by Medicare and private insurance, but lower risk among uninsured and similar risk among Medicaid. Hispanics had lower risk of readmissions relative to non-Hispanic whites, and this pattern was common across subgroups with private, Medicaid, and no insurance coverage. Uninsurance was associated with lower risk of readmissions among minorities but higher risk of readmissions among non-Hispanic whites relative to private insurance. The study found that risk of readmissions by racial ethnic groups varies by insurance status, with lower readmission rates among minorities who were uninsured compared with those with private insurance or Medicare, suggesting that lower readmission rates may not always be construed as a good outcome, because it could result from a lack of insurance coverage and poor access to care, particularly among the minorities.

Clinical and Environmental Correlates of Serum BDNF: A Descriptive Study with Plausible Implications for AD Research

BACKGROUND

Brain derived neurotrophic factor (BDNF) may play a central role in the pathogenesis of Alzheimer's disease (AD) through neurotrophic effects on basal cholinergic neurons. Reduced serum levels of BDND are observed among AD patients and may predict AD risk. Nevertheless, knowledge about factors associated with its levels in blood is lacking.

OBJECTIVE

To identify clinical and demographic correlates of serum BDNF levels.

METHODS

BDNF was measured from serum collected between 1992-1996 and 1998-2001 in participants from the Original and Offspring cohorts of the Framingham Study, respectively. A cross-sectional analysis was done to evaluate the relationship between clinical measures and BDNF levels using standard linear regression and stepwise models. Analyses were conducted in the total sample and separately in each cohort, and were adjusted for age and sex.

RESULTS

BDNF was measured in 3,689 participants (mean age 65 years, 56% women; 82% Offspring). Cigarette smoking and high total cholesterol were associated with elevated BDNF levels, and history of atrial fibrillation was associated with decreased levels. Elevated BDNF levels were related to greater physical activity and lower Tumor Necrosis Factor-α levels in Offspring. Stepwise models also revealed associations with statin use, alcohol consumption and Apolipoprotein Eε4 genotype.

CONCLUSION

Serum BDNF correlates with various metabolic, inflammatory and life-style measures which in turn have been linked with risk of AD. Future studies of serum BDNF should adjust for these correlates and are needed to further explore the underlying interplay between BDNF and other factors in the pathophysiology of cognitive impairment and AD.