The MTHFR C677T mutation is not a risk factor recognized for HBV-related HCC in a population with a high prevalence of this genetic marker

BackgroundPolymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene can affect disease progression in HBV infection. However, the results from different reports are inconsistent. The aim of this study was to investigate the association between the MTHFR C677T polymorphism and the outcome of HBV infection in a Tianjin Han population.MethodsTaqMan SNP genotyping was employed to determine the alleles and genotypes of MTHFR C677T in 2511 subjects from various stages of HBV infection and 549 healthy controls.ResultsOf the 3060 subjects, the genotypic frequencies were CT 48.9%, TT 29.3% and CC 21.8%; the allelic frequencies were T 53.8% and C 46.2%. There was no significant difference in genotypic or allelic distribution among the different disease groups. When either healthy subjects or self-limited subjects were used as controls, the TT genotype and the T allele conferred protective effects against hepatocellular carcinoma (HCC) (HCC vs healthy subjects: OR = 0.588, 95% CI = 0.413–0.836, P = 0.003; OR = 0.768, 95% CI = 0.645–0.915, P = 0.003, respectively. HCC vs self-limited subjects: OR = 0.598, 95% CI = 0.404–0.886, P = 0.010; OR = 0.772, 95% CI = 0.635–0.940, P = 0.010, respectively). After sub-stratification by gender, the prevalence of the TT genotype or T allele was the lowest in the male HCC group (TT 23.5%, T 49.8%). The protective effects of the TT genotype and the T allele were observed in male HCC and cirrhotic subjects (HCC vs self-limited subjects: OR = 0.470, 95% CI = 0.288–0.766, P = 0.002; OR = 0.681, 95% CI = 0.535–0.866, P = 0.002, respectively. Liver cirrhosis vs self-limited subjects: OR = 0.624, 95% CI = 0.392–0.992, P = 0.046; OR = 0.791, 95% CI = 0.627–0.998, P = 0.048, respectively), but not in female. When the subjects were stratified according to the clinical features, no statistically significant difference in the genotypic distribution was observed (P > 0.05).ConclusionsThe TT genotype and T allele of MTHFR C677T may confer a protective effect on disease progression to HCC in HBV-infected individuals, especially among male patients, in a population with a high prevalence of this genetic marker.     

Decreased accuracy in interpretation of community-based screening mammography for women with multiple clinical risk factors

ObjectiveTo assess the impact of women's breast cancer risk factors (use of hormone therapy, family history of breast cancer, previous breast biopsy) on radiologists' mammographic interpretive performance and whether the influence of risk factors varies according to radiologist characteristics.Study Design and SettingScreening mammograms (n = 638,947) performed from 1996 to 2005 by 134 radiologists from three Breast Cancer Surveillance Consortium registries was linked to cancer outcomes, radiologist surveys, and patient questionnaires. Interpretive performance measures were modeled using marginal and conditional logistic regression.ResultsHaving one or more clinical risk factors was associated with higher recall rates (1 vs. 0 risk factors: odds ratio [OR] = 1.17, 95% confidence interval [CI] = 1.15–1.19; ≥2 vs. 0: OR = 1.43, 95% CI = 1.40–1.47) and lower specificity (1 vs. 0: OR = 0.86 [95% CI = 0.84–0.88]; ≥2 vs. 0: OR = 0.70 [95% CI = 0.68–0.72]) without a corresponding improvement in sensitivity and only a small increase in positive predictive value (1 vs. 0: OR = 1.08 [95% CI = 0.99–1.19]; ≥2 vs. 0: OR = 1.12 [95% CI = 0.99–1.26]). There was no indication that influence of risk factors varied by radiologist characteristics.ConclusionWomen with clinical risk factors who undergo screening mammography are more likely recalled for false-positive evaluation without an associated increase in cancer detection. Radiologists and patients with risk factors should be aware of this increased risk of adverse screening events.     

Association of human leukocyte antigen DP/DQ gene polymorphisms with chronic hepatitis B in Chinese Han and Uygur populations

Several genome-wide association studies (GWAS) have shown that human leukocyte antigen (HLA) DP/DQ gene polymorphisms are associated with susceptibility to chronic hepatitis B virus (HBV) infection. We clarified the roles of the HLA-DP/DQ gene in HBV infection in different nationalities. Three single nucleotide polymorphisms (SNPs) in HLA-DP (rs9277471, rs9277535 and rs9277542) and the SNP rs9272346 in HLA-DQ were studied. In total, 779 patients were recruited to this study, including 400 Chinese Han and 399 Uygurs. The rs9277535 variant genotypes were directly associated with HBV persistence compared to healthy controls in an additive model of the Chinese Han population (odds ratio [OR] = 1.88, 95% confidence interval [CI] = 1.03–3.41, P = 0.040), and in a recessive model of the Chinese female population (OR = 2.02, 95% CI = 1.26–3.24, P = 0.003). In addition, rs9277471 and rs9277542 variant genotypes significantly decreased the risk of HBV infection compared to healthy controls in an additive model of the Chinese Han population (OR = 0.53, 95% CI = 0.29–0.98, P = 0.042; OR = 0.53, 95% CI = 0.29–0.97, P = 0.039) and in a dominant model of the Chinese female population (OR = 0.50, 95% CI = 0.31–0.80, P = 0.004; OR = 0.49, 95% CI = 0.31–0.79, P = 0.003). The GG genotype of rs9277346 was associated with HBV infection in the Chinese Han population (additive model: OR = 0.38, 95%CI = 017–0.82, P = 0.014; recessive model: OR = 0.41, 95% CI = 0.19–0.86, P = 0.019) and in males (additive model: OR = 0.31, 95% CI = 0.14–0.65, P = 0.002; dominant model: OR = 0.65, 95% CI = 0.43–0.97, P = 0.034; recessive model: OR = 0.36, 95% CI = 0.18–0.73, P = 0.005). In addition, allele G of rs9277346 was marginally related to a reduction in risk for HBV infection in the Uygur population. Our study suggests that HLA-DP/DQ polymorphisms can affect susceptibility and resistance to HBV infection in Chinese populations, and are possibly linked to race and sex.     

The 23-valent pneumococcal polysaccharide vaccine is effective in elderly adults over 75 years old—Taiwan's PPV vaccination program

BackgroundPneumococcal infection is a serious cause of mortality and morbidity in the elderly. A nationwide pneumococcal polysaccharide vaccine (PPV) program for elderly adults aged 75 years and older was conducted in Taiwan in 2008. The efficacy of the PPV in this very elderly population was evaluated.MethodsThe data were analyzed using the Taiwan National Health Insurance Research Database (NHIRD), the cause-of-death registration database and the invasive pneumococcal disease (IPD) notification database of Taiwan's Ministry of Health and Welfare. The efficacy of PPV administration in this very elderly population was evaluated using multivariate logistic regression after propensity score matching (PSM). The rates of IPD, death from IPD, pneumonia hospitalization, death from pneumonia, and all-cause mortality were compared for those who did and did not receive the PPV.ResultsAmong the 1078,955 eligible people, 318,257 (29.5%) received the PPV, and 760,698 (70.5%) were not vaccinated. Using PSM to adjust for confounding factors, including age, gender, influenza vaccination status, associated chronic diseases and health care utilization, those who received the PPV had significantly lower odds ratios (ORs) for IPD (OR = 0.24, 95% CI = 0.123–0.461, p < 0.001), death from IPD (OR = 0.09, 95% CI = 0.011–0.704, p < 0.022, p < 0.001), pneumonia hospitalization (OR = 0.40, 95% CI = 0.395–0.415, p < 0.001), death from pneumonia (OR = 0.07, 95% CI = 0.059–0.082, p < 0.001), and all-cause mortality (OR = 0.07, 95% CI = 0.069–0.072, p < 0.001) compared with those who were not vaccinated.ConclusionsPPV vaccination in the previous year was associated with a 60% reduction in pneumonia hospitalization, a 76% reduction in IPD, and a greater than 90% reduction in death from pneumonia, IPD and all causes among people over 75 years old in Taiwan. Data from subsequent years in Taiwan and similar populations elsewhere are needed to evaluate the contribution of underlying variations in the mortality rate and the confounding effects of prior disease severity to these findings.     

Lack of association between Toll-like receptor 4 gene Asp299Gly and Thr399Ile polymorphisms and tuberculosis susceptibility: A meta-analysis

ObjectiveToll-like receptor 4 (TLR4) plays a vital role in immunity to tubercle bacillus and its gene polymorphisms are supposed to affect tuberculosis susceptibility in some rather than all studies. Then, we integrated published data and performed a comprehensive meta-analysis to get more reliable estimations for the strength of associations between TLR4 gene polymorphisms and the risk of tuberculosis.MethodsWe systematically searched the electronic PubMed database for research articles about TLR4 gene polymorphisms and tuberculosis up to February 2012. Revman 5.0 software was adopted to conduct the meta-analysis. Crude odds ratio (ORs) and 95% confidence intervals (95% CIs) were calculated by either fixed-effects model or random-effects model.ResultsFinally, six case-control studies were identified, involving 1587 controls and 2110 patients. Overall, no significant associations were found between TLR4 gene Asp299Gly polymorphism and tuberculosis in the codominant models (GG vs AA: OR = 1.56, 95% CI = 0.76–3.21, P = 0.23; GA vs AA: OR = 1.01, 95% CI = 0.84–1.23, P = 0.89), the dominant model (GG + GA vs AA: OR = 1.04, 95% CI = 0.80–1.35, P = 0.75), the recessive model (GG vs GA + AA: OR = 1.55, 95% CI = 0.75–3.19, P = 0.24) and the allele model (G vs A: OR = 1.06, 95% CI = 0.81–1.40, P = 0.66). Similarly, no significant associations between TLR4 gene Thr399Ile and tuberculosis were observed (all P > 0.05).ConclusionsThe present meta-analysis suggests that TLR4 gene Asp299Gly and Thr399Ile polymorphisms are not associated with the susceptibility of tuberculosis.     

NRAMP1 D543N and INT4 polymorphisms in susceptibility to pulmonary tuberculosis: A meta-analysis

The association of natural resistance associated macrophage protein 1 (NRAMP1) polymorphisms (D543N, INT4) with pulmonary tuberculosis (PTB) risk have been widely reported. However, the findings of previous studies were inconsistent. To clarify the role of these polymorphisms in PTB, we performed a meta-analysis of all available and relevant published studies. Based on comprehensive searches of the PubMed, Medline, Embase, Web of Science, Elsevier Science Direct and Cochrane Library database, we identified outcome data from all articles estimating the association between NRAMP1 polymorphisms and PTB risk. For D543NA/G polymorphism, no associations were found in all genetic models. For INT4C/G polymorphism, significant increased PTB risk was observed in recessive model (CC vs. GC + GG: P = 0.025, OR = 1.35, 95% CI = 1.04–1.75). In the subgroup analysis by ethnicity, significantly increased risk were observed for D543NA/G polymorphism in Americans (GA vs. GG: P = 0.03, OR = 1.31, 95% CI = 1.03–1.67; AA + AG vs. GG: P = 0.032, OR = 1.29, 95% CI = 1.02–1.63). Moreover, the INT4C/G polymorphism was also associated with increased risk of TB for Africans in allele model (A vs. G: P = 0.012, OR = 1.41, 95% CI = 1.08–1.85), heterozygous model (GA vs. GG: P = 0.004, OR = 1.53, 95% CI = 1.14–2.04) and dominant model (AA + AG vs. GG: P = 0.007, OR = 1.49, 95% CI = 1.12–1.98). This meta-analysis provides evidences that INT4C/G was associated with increased susceptibility to pulmonary tuberculosis in overall population in recessive model. D543NA/G polymorphism was associated with PTB increased risk in Americans, while INT4C/G polymorphism in Africans. Further well-designed, large scale studies are required to confirm this conclusion.     

Facteurs sociodémographiques et recours aux soins pour raisons psychologiques chez les jeunes adultes

BackgroundAlthough young adults exhibit a high rate of psychiatric disorders, their rate of access to mental health care is low compared with older age groups. Our study examined the relationship between socio-demographic factors and the use of health care services for psychological reasons.MethodsWe studied a community sample of 1103 French 22 to 35-year-old (TEMPO cohort study) who were surveyed by mailed questionnaire in 2009. Data were collected regarding participants’ health (internalizing and externalizing psychological symptoms in 1991 and 2009), health care use (access to health professionals and psychotropic medications in case of psychological difficulties), and socio-demographic factors (sex, age, employment status, marital situation, social support). Parental history of depression was ascertained based on TEMPO participants’ and their parents’ reports (in the GAZEL cohort study).ResultsIn the 12 months preceding the study, 16.7% of study participants saw a health professional and 12.8% took a psychotropic medication for psychological reasons. In multivariate regression, models adjusted for all socio-demographic and psychological characteristics, access to health professionals was associated with being unemployed/out of the labor force (OR = 1.93; 95% CI = 1.11–3.30), family situation (OR in participants living with a partner with no children: 2.16; 95% CI 1.26–3.72; OR in participants not living with a partner: 2.29; 95% CI = 1.34–3.90), and having low social support (OR = 1.75; 95% CI = 1.21–2.54). The use of psychotropic medications was associated with female gender (OR = 2.70; 95% CI = 1.60–4.55), being unemployed/out of the labor force (OR = 3.85; 95% CI = 2.14–6.95), not living with a partner (OR = 2.04; 95% CI = 1.09–3.80) and having low social support (OR = 1.65; 95% CI = 1.05–2.59). Additionally, use of health services was associated with participants’ and their parents’ psychological difficulties.     

Healthy excessive weight in Portuguese women 4 years after delivery of a liveborn

ObjectiveTo quantify the prevalence of healthy excessive weight and determinants of metabolic profile, considering women's reproductive life.MethodsWe evaluated 1847 mothers of a birth cohort assembled after delivery and reevaluated 4 years later. A healthy profile was defined as the absence of hypertension, diabetes, dyslipidemia, C-reactive protein < 3 mg/l and being below the second tertile of HOMA-IR. Adjusted odds ratios (OR) and confidence intervals (95% CI) were computed using multinomial logistic regression, taking women with normal BMI as the reference category of the outcome.ResultsFour years after delivery, 47% of women had normal BMI, 33% were overweight and 20% obese. In each BMI class, 61%, 33% and 12% presented a healthy metabolic profile, respectively. Family history of CVD/cardiometabolic risk factors was associated with a higher probability of obesity with a not healthy metabolic profile (OR = 1.39 95% CI: 0.98–1.98). Women who breastfed the enrolled child for > 26 weeks and practiced physical exercise were less likely to be obese and metabolically unhealthy (OR = 0.39 95% CI: 0.23–0.68; OR = 0.48 95% CI: 0.33–0.70, respectively), with no effect on healthy excessive weight.ConclusionsThese results support the existence of a healthy excessive weight phenotype in women after motherhood, influenced by anthropometrics, genetic and lifestyles characteristics.     

Mean arterial pressure is better at predicting future metabolic syndrome in the normotensive elderly: A prospective cohort study in Taiwan

ObjectiveTo compare four different blood pressure (BP) measurements—systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP)—in predicting future metabolic syndrome (MetS) among the normotensive elderly population, and to estimate the optimal cutoff value of the best single measurement for clinical practice.MethodsA total of 2782 non-medicated participants aged ≥ 60 years were enrolled in a standard health examination program in Taiwan from January 2004 to December 2013. Two thirds of the participants were randomly designated as the training group (n = 1855) and the other one third as the validation group (n = 927). The mean follow-up time was 3.60 years for both the training and validation groups. MAP and PP were calculated from SBP and DBP.ResultsSBP, DBP, and MAP were associated with future MetS, whereas PP was not. MAP had the largest hazard ratio in Cox regression (men 1.342 [95% CI 1.158–1.555] and women 1.348 [95% CI 1.185–1.534] in the training group; men 1.640 [95% CI 1.317–2.041] and women 1.485 [95% CI 1.230–1.794] in the validation group) and the largest area under the receiver operating characteristic curve (men 0.598 ± 0.021 and women 0.602 ± 0.021 in the training group). Multivariable Cox regression further indicated that a higher MAP level was independently associated with the future occurrence of MetS. Participants with MAP above the cutoff value (84.0 mm Hg for men, 83.3 mm Hg for women) had a higher cumulative incidence of MetS than did their counterparts after four years' follow-up in both the training and validation groups. The results derived from the training data could be replicated in the validation data, indicating that the results were generalizable across distinct samples.ConclusionsMAP is more accurate than SBP, DBP, and PP in predicting future MetS among the normotensive geriatric population. Calculation of MAP is recommended when dealing with normotensive patients aged ≥ 60 years in clinical practice.     

Early-life indoor environmental exposures increase the risk of childhood asthma

We aim to explore the relationships between exposure to dampness, pets, and environmental tobacco smoke (ETS) early in life and asthma in Taiwanese children, and to discuss their links to early- and late-onset asthma. We conducted a 1:2 matched case-control study from the Taiwan Children Health Study, which was a nationwide study that recruited 12-to-14 year-old school children in 14 communities. The 579 mothers of the participants were interviewed by telephone about their children's environmental exposures before they were 5 years old, including the in-utero period. Childhood asthma was associated with exposure to early life environmental factors, such as cockroaches (OR = 2.16; 95% CI, 1.15–4.07), visible mould (OR = 1.75; 95% CI, 1.15–2.67), mildewy odors (OR = 5.04; 95% CI, 2.42–10.50), carpet (OR = 2.36; 95% CI, 1.38–4.05), pets (OR = 2.11; 95% CI, 1.20–3.72), and more than one hour of ETS per day (OR = 1.93; 95% CI, 1.16–3.23). The ORs for mildewy odors, feather pillows, and ETS during early childhood were greater among children with late-onset asthma. Cockroaches, carpet, pets, and in-utero exposures to ETS affected the timing of early-onset asthma. Exposure to these factors led to dose-responsiveness in the risk of asthma. And the earlier exposures may trigger the earlier onset. Interventions in avoiding these environmental exposures are necessary for early-prevention of childhood asthma.     

Caractéristiques des centres de santé et conseils prénatals de préparation à la naissance

AimCounseling relating to birth preparedness is an essential component of the WHO Focused Antenatal Care model. During the antenatal visits, women should receive the information and education they need to make choices to reduce maternal and neonatal risks. The objective of this study conducted among women attending antenatal visits in rural Burkina Faso was to search for a link between the characteristics of the center delivering the health care and the probability of being exposed to information and advice relating to birth preparedness.MethodsA multilevel study was performed using survey data from women (n = 464) attending health centres (n = 30) in two rural districts in Burkina Faso (Dori and Koupela). The women were interviewed using the modified questionnaire of the Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO).ResultsWomen reported receiving advice about institutional delivery (72%), signs of danger (55%), cost of institutional delivery (38%) and advice on transportation in the event of emergency (12%). One independent factor was found to be associated with reception of birth preparedness advice: number of antenatal visits attended. Compared with women from Dori, women from Koupela were more likely to have received information on signs of danger (OR = 3.72; 95%CI: 1.26–7.89), institutional delivery (OR = 4.37; 95%CI: 1.70–10.14), and cost of care (OR = 3.01; 95%CI: 1.21–7.46). The reduced volume of consultations per day and the availability of printed materials significantly remain associated with information on the danger signs and with the institutional delivery advices. Comparison by center activity level showed that women attending health centers delivering less than 10 antenatal visits per day were more likely to receive information on signs of danger (OR = 2.63; 95%CI: 1.12–6.24) and to be advised about institution delivery (OR = 6.30; 95%CI: 2.47–13.90) compared to health centers delivering more than 20 antenatal visits per day. Women attending health centres equipped with printed materials (posters, illustrated documents) were more likely to receive information on signs of danger (OR = 4.25; 95%CI: 1.81–12.54) and be advised about institutional delivery (OR = 6.85; 95%CI: 3.17–14.77).ConclusionEfforts should be made to reach women with birth preparedness messages. Rural health centres in Burkna Faso need help to upgrade their organizational services and provide patients with printed materials so they can improve antenatal care delivery.     

Food environments in schools and in the immediate vicinity are associated with unhealthy food consumption among Brazilian adolescents

BackgroundEvidence of the influence of the school food environment on adolescent diet is still little explored in low- and middle-income countries. We aimed to evaluate the association between food environment in schools and the immediate vicinity and the regular consumption of unhealthy food among adolescents.MethodsWe used cross-sectional data collected by the Brazilian National Survey of School Health (PeNSE) from a representative sample of adolescents attending 9th grade public and private schools in Brazil, in 2012. We estimated students' regular consumption (> 5 days/week) of unhealthy food (soft drinks, bagged salty snacks, deep fried salty snacks and sweets) and school availability, in the cafeteria or an alternative outlet, of the same food plus some healthy options (fruit and natural fruit juice). We performed multilevel logistic regression models.ResultsHaving a cafeteria inside school selling soft drinks (private schools OR = 1.23; 95% CI = 1.14–1.33; public schools OR = 1.13; 95% CI = 1.06–1.20) and deep fried salty snacks (private schools OR = 1.41 95% CI = 1.26–1.57; public schools OR = 1.16 95% CI = 1.08–1.24) was associated with a higher consumption of these unhealthy foods of among students. In private schools, cafeteria selling fruit and natural fruit juice was associated with lower student consumption of bagged salty snacks (OR = 0.86; 95% CI 0.77–0.96) and soft drinks (OR = 0.85; 95% CI = 0.76–0.94). In addition, eating meals from the Brazilian School Food Program in public schools was associated with a lower consumption of unhealthy foods.ConclusionsFoods available in the school food environment are associated with the consumption of unhealthy food among adolescents in Brazil.     

Energy and fat intake are not associated with abdominal adiposity

Background and objectiveCentral or abdominal obesity (AA) is a highly prevalent determinant of the metabolic syndrome and its control requires intervention strategies. This study investigated the risk factors associated with the presence of AA in hospitalized individuals.Patients and methodsA total of 1626 patients were studied. The investigated risk factors possibly associated with AA were gender, age, body mass index (BMI), habitual energy intake (HEI) and fat intake (FI). AA was determined by waist circumference (WC) and waist-to-hip ratio (WHR). The chi², Mann-Whitney and Kruskal-Wallis tests were used to compare the data and univariate and multiple logistic regressions were used to identify the predictive factors of AA.ResultsWomen were at higher risk of developing AA than men (P < 0.0001). The HEI and FI of individuals with and without AA and of women and men were not significantly different. According to multivariate analysis, HEI was not a predictive factor of AA, contrary to gender and age. The risk factors for AA, determined by WC, were gender (OR = 6.8; CI = 5.3–8.7) and age (OR = 1.0; CI = 1.0–1.0). Women were six times more likely to develop AA than men.ConclusionsEvidence of an association between AA and HEI or FI was not found, but gender and age were associated with AA.     

Association between chronic hepatitis C infection and metabolic syndrome: A meta-analysis

BackgroundHepatitis C virus (HCV) infected patients have been found to be more susceptible to metabolic syndrome (MetS), but the results remain unclear and lack of a meta-analysis.MethodsDatabases including PubMed, Web of Science, EMBASE and the Cochrane Library were searched to identify all studies concerning HCV and MetS. Funnel plots combined with Begg's tests and Egger's tests were used to analysis the possible publication bias. The odds ratios (ORs) with 95% confidence intervals (CIs) were used to access the effect of HCV infection on the risk of MetS.ResultsEight articles, involving a total of 57387 HCV patients were included. HCV infection was significantly associated with an increased incidence of MetS (OR = 1.73; 95% CI, 1.19–2.52). After adjustment according to the sensitivity analysis, one included article was removed to decrease the publication bias and high heterogeneity, of which the results showed that HCV infection was still associated with an increased incidence of MetS (OR = 1.93; 95% CI, 1.39–2.68).ConclusionsHCV patients tend to have a significant increased risk for MetS, but more large-scale studies are needed to confirm this and explore the exact mechanism.     

Travel to,and use of,twenty-one Michigan trails

Objective and methodsThis study examined trail use among 857 trail users on 21 trails in Michigan from 2008 to 2011 using a valid and reliable intercept survey.ResultsMost of the 857 participants traveled to the trail from their home (92.6%), lived within 15 min of the trails (74.8%), and used active transport to travel to the trails 69.7%. The odds of active transport to the trails were greater among those who had not graduated high school (OR = 3.49; 95% CI = 1.02, 11.99) and high school graduates (OR = 7.432; 95% CI = 2.02, 27.30) compared to college graduates. Whites and adults also had greater odds of active transport than non-Whites (OR = 3.160, 95% CI: 1.65, 6.05), and older adults (OR = 1.75; 95% CI: 1.20, 2.54). The majority of respondents (89.7%) reported using trails for recreational purposes. A significantly greater proportion of females (73.3%) compared to males (64.7%) reported using the trail with others.ConclusionsThe findings from this study might enable health and parks and recreation professionals to better promote physical activity on trails.     

Immigration Measures and Reproductive Health Among Hispanic Youth: Findings from the National Longitudinal Survey of Youth, 1997–2003

PurposeTo explore relationships between immigration measures and risk of reproductive and sexual events among U.S. Hispanic adolescents.MethodsWe examined generation status, language in the home and country of origin in relation to sexual activity, contraception, and childbearing among 1614 Hispanic adolescents, using nationally representative 1997–2003 longitudinal data. Multivariable analyses controlled for potentially confounding variables. Tests for effect modification by gender and Mexican origin were conducted.ResultsFewer first generation adolescents transitioned to sexual intercourse before age 18 (odds ratio [OR] = .80, 95% confidence interval [CI] = .66–.98) and fewer first and second generation sexually active teens used contraceptives consistently at age 17 (OR = .32, 95% CI = .17–.60 and OR = .50, 95% CI = .31–.80, respectively) than third-generation teens. Language was similarly associated with the transition to sexual intercourse and contraceptive practices. Versus teens of Mexican origin, teens of Puerto Rican origin and origins other than Cuba and Central/South America had greater odds of becoming sexually active; youth of all origins except Central/South America had fewer multiple live births (OR = .14–.31). Gender modified the effects of generation on consistent use of contraceptives and condoms at age 17. Gender also modified the effect of country of origin on transitioning to sexual intercourse before age 18 years.ConclusionsResults expand on previous observations that generation, language, and country of origin are predictors of reproductive and sexual risks for Hispanic adolescents. These immigration measures may therefore be useful in targeting community and clinical preventive services.     

Levels of physical activity and relationship with markers of diabetes and cardiovascular disease risk in 5474 white European and South Asian adults screened for type 2 diabetes

ObjectiveInvestigate levels of physical activity and their association with health in a white European (WE) and South Asian (SA) population.MethodsThis study reports data from a diabetes screening programme, 2004–2007, Leicester, UK. Physical activity was measured using the International Physical Activity Questionnaire; additional outcomes included fasting and 2-h post-challenge glucose, lipid profile, body mass index (BMI) and waist circumference.Results1164 SA (female = 48%) and 4310 WE (female = 53%) were included. SAs were more likely fall below the minimum physical activity recommendations for health compared to WEs (age-adjusted OR for SA men = 2.35; 95% CI = 1.89–2.93, age adjusted OR for SA women = 2.25; 95% CI = 1.81–2.80). There were significant associations between levels of physical activity and BMI (men and women), waist circumference (men and women), 2-h glucose (women), HDL-cholesterol (men) and triglycerides (men) in WEs and waist circumference (women) and HDL-cholesterol (men) in SAs. Significant interactions between ethnicity and physical activity existed in the relationship with BMI and waist circumference in men.ConclusionsSAs are substantially less physically active than WEs. There may also be differences between SAs and WEs in the health benefits associated with higher physical activity that warrant further investigation.     

Genetic variation in IL28RA is associated with the outcomes of HCV infection in a high-risk Chinese population

Hepatitis C virus (HCV) infection varies in the outcomes depending on both viral and host factors. This study aims to investigate the association of single-nucleotide polymorphisms (SNPs) of IFNAR2, IL10RB, and IL28RA genes with susceptibility to HCV infection and resolution. Genotyping of IFNAR2, IL10RB, and IL28RA gene polymorphisms were performed using TaqMan® method from 552 patients with sero-positive anti-HCV and 421 uninfected controls. The distribution of IFNAR2 and IL10RB genotypes among the control, persistent infection, and spontaneous clearance groups did not differ. However, IL28RA-rs10903035 A allele was over-represented in persistent infection group when compared with uninfected controls and spontaneous clearance group, respectively (OR = 1.54, 95%CI = 1.23–1.92, P = 0.004; OR = 1.42, 95%CI = 1.12–1.81, P = 0.016), and AA genotype had a significant increased risk of persistent infection in different strata except for the females subgroup (P < 0.05). IL28RA-rs11249006 GG genotype showed reduced susceptibility to persistent HCV infection (OR = 0.53, 95%CI = 0.31–0.91, P = 0.044), and the protective effect was significantly different among subgroups stratified by age and likely source of infection (P < 0.05). Besides, AG genotype had a significant negative effect on spontaneous clearance of HCV among young subjects (aged ?40) and patients infected with viral genotype-1 (P < 0.05). Stratified analysis also showed that IL10RB-rs2834167 AG genotype was associated with an increased risk of persistent HCV infection in females, and GG genotype was associated with an increased risk of persistent HCV infection in females and patients with viral genotype non-1 (P < 0.05). Haplotype analysis showed that IL28RA rs10903035-rs11249006 haplotype GG played a protective effect for HCV infection (OR = 0.21, 95%CI = 0.13–0.36, P < 0.001; OR = 0.20, 95%CI = 0.12–0.34, P < 0.001). This study indicates that two SNPs in IL28RA are correlated with susceptibility to HCV infection and spontaneous viral clearance, which implicates a primary role of IL28RA in the outcomes of HCV infection.     

Prevalence of physical activity in European adults — Compliance with the World Health Organization's physical activity guidelines

BackgroundAdults are recommended to engage in at least 150 min/week of moderate-to-vigorous physical activity (PA).PurposeThis study aimed to examine the level of compliance with PA recommendations among European adults.MethodsUsing data from European Social Survey round 6, PA self-report data was collected from 52,936 European adults from 29 countries in 2012. Meeting PA guidelines was assessed using World Health Organization criteria.Results61.47% (60.77% male, 62.05% female) of European adults reported to be engaged in moderate to vigorous PA at least 30 min on 5 or more days per week. The likelihood of achieving the PA recommended levels was higher among respondents older than 18–24. For those aged 45–64 years the likelihood increased 65% (OR = 1.65, 95% CI: 1.51–1.82, p < 0.001) and 112% (OR = 2.12, 95% CI: 1.94–2.32, p < 0.001) for males and females, respectively. Those who were high school graduates were more likely to report achieving the recommended PA levels than those with less than high school education (males: OR = 1.19, 95% CI: 1.12–1.27, p < 0.001; females: OR = 1.13, 95% CI: 1.06–1.20, p < 0.001).ConclusionAlthough about 60% of European adults reported achieving the recommended levels of PA, there is much room for improvement among European adults, particularly among relatively inactive subgroups.