Annals of Epidemiology

PurposeThe COVID-19 pandemic coincided with worsening U.S. drug overdose mortality and widening racial and ethnic disparities. We estimated race/ethnicity-specific excess overdose deaths at the state level during 2020-2023 and examined how these burdens scale with population size. MethodsWe analyzed annual overdose deaths from 2014-2023 for five racial/ethnic groups in 47 states and the District of Columbia. Pre-pandemic trends (2014-2019) were fit using a generalized growth model, and deaths e...

BackgroundInjury is one of the leading causes of hospitalization among Canadians and represents a substantial public health burden. However, at the population level, the lifetime risk of injury-related hospitalization is unknown. Estimating the lifetime risk of hospitalization due to injury among Canadians provides an intuitive and policy-relevant metric to inform the development of injury prevention strategies and health system planning. MethodsThis study used the Cumulative Risk Method to est...

Accurate diagnosis of urinary tract infection (UTI) in individuals with neurogenic lower urinary tract dysfunction (NLUTD) due to spinal cord injury or disease (SCI/D) remains a major clinical challenge. Standard diagnostic tools--including urine dipstick, urinalysis, and culture--lack population-specific reference ranges, and existing criteria are often insufficient to distinguish infection from background variability. To address this gap, we conducted a longitudinal study to define the range o...

BackgroundYoung adult hypertension increases risk of future cardiovascular disease (CVD) but is often overlooked. We aimed to identify opportunities to reduce blood pressure (BP) among younger adults by determining the drivers of hypertension detection, treatment and control in young adults in Australia. MethodsCross-sectional analysis of adults aged 18-39 years using nationally representative 2017-18 Australian National Health Survey data. Descriptive analyses were performed to determine hyper...

BackgroundTraumatic brain injury (TBI) remains a major cause of morbidity, yet U.S. comparisons of injury mechanisms in diverse urban settings are limited. We examined differences across motorized road injuries, non-motorized road injuries, and falls. MethodsWe performed a retrospective study of consecutive TBI admissions to an ACS-verified trauma center from 2017 to 2022. Mechanisms were categorized as motorized, non-motorized, or falls. Outcomes included mortality, ICU and ventilator use, and...

We present a new method for lung pathology detection in blood plasma, including lung cancer staging. Raman spectroscopy uses inelastically scattered laser light to obtain molecular information in a reagent-free manner. Obtaining Raman spectral data from liquid samples has long proven challenging, but we have developed a novel tool for obtaining spectra from 60 l liquid samples within two minutes: Raman of Well-based Samples (ROWS). With a low-cost ROWS device, we analyzed 372 blood plasma sample...

IntroductionLow-dose computed tomography (LDCT) lung cancer screening has significantly enhanced early detection and patient survival rates in the population at risk. Current screening methods, that primarily rely on LDCT imaging, will very likely benefit from molecular biomarkers to achieve a more comprehensive, accurate, personalized and non-invasive risk assessment leveraging multimodal tools. We present a novel open access multimodal (imaging, proteomics and demographic) dataset designed to ...

ImportancePersistent racial and ethnic disparities in breast and prostate cancer mortality are well documented. Most prior studies emphasize between-group differences and rely on population averages or single composite measures of social disadvantage, which can obscure high-need communities within groups. How socio-behavioral determinants of health vary within groups across local gradients of cancer mortality remains incompletely characterized. A framework that combines race- and cancer-specific...

BackgroundCardiometabolic disease risk is disproportionately high in rural U.S. communities, where behavioral and metabolic determinants often intersect. However, relationships between sleep, psychological distress, and blood pressure variability remain understudied in rural communities. ObjectiveTo assess how sleep, depressive symptoms, and metabolic indicators influence blood pressure outcomes in rural adults. MethodsIn this exploratory descriptive cross-sectional study, survey and clinical ...

BackgroundEffective hypertension prevention requires diagnostic tools applicable to broad populations, yet current models often rely on specialized laboratory testing. We aimed to develop and validate the Hypertension Population Risk Tool (HTNPoRT) - a diagnostic model derived with only readily available data, suitable for individual screening and population health planning. MethodsWe analyzed data from the Canadian Health Measures Survey (cycles 1-6, 2007-2019). The study included community-dw...

BackgroundRecurrent urinary tract infection (rUTI) is a major diagnostic and management challenge. Dysregulated innate immune responses, including antimicrobial peptides and cytokines, may underlie UTI susceptibility. This study investigates whether urinary concentrations of antimicrobial peptides and cytokines differ in children and adolescents with a history of rUTI and whether they can accurately classify rUTI status. MethodsUrine samples were collected from 42 girls and adolescent females w...

BackgroundHypertension guidelines recommend the use of automated BP devices over manual devices to reduce observer bias, such as terminal digit preference. We aimed to evaluate systematic differences in BP readings and the association with incident stroke according to type of measurement. MethodsUsing de-identified electronic health record data from Optum Labs Data Warehouse from primary care visits in 2024, we classified providers BP measurement method using proportion of odd terminal digit pr...

AimsTo characterize decreases in overdose mortality in the United States between 2023 and 2024 by substance involvement, geography, race/ethnicity, demographic, and other key dimensions. DesignPopulation-based study of national death records. SettingUnited States. Participants/casesAll individuals who died from drug overdose between January 1999 and December 2024. MeasurementsAnnual or monthly (annualized) overdose deaths per 100,000 population. Year and month of occurrence of overdose death...

PurposeMost spatio-temporal models identify COVID-19 sociodemographic and socioeconomic risk factors using methods that assume a single spatial dependency pattern across the city, which may not reflect reality. The purpose of this study is to apply a spatially and temporally localized Bayesian model to identify COVID-19 risk factors that account for localized context. MethodsFor this study, a spatio-temporal localized Bayesian Hierarchical Model (ST-LCAR) was used to assess the relationships be...

BackgroundThe introduction of mandatory calorie labelling among large food businesses (chains) in England in 2022 has been found to have little impact on consumer behaviour, but overall calories on restaurant menus have decreased slightly. This study examined menu changes post policy implementation, and the population groups likely to have been affected most. MethodsMenu data from 169 chains in Great Britain were extracted from two online food delivery platforms in June 2022 and June 2023. We s...

BackgroundIn 2016, Chile mandated that products high in sugar carry warning labels. Following this policy, use and consumption of non-nutritive sweeteners (NNS) increased, raising concerns about intake among children. Chile is now considering adding a new warning to its labeling system stating: "CONTAINS NON-NUTRITIVE SWEETENERS, AVOID CONSUMPTION AMONG CHILDREN." However, this and other NNS labeling approaches - e.g., Colombias "CONTAINS NON-NUTRITIVE SWEETENERS" stop signs - have never been em...

Front-of-pack nutrition labels (FOPLs) have been adopted as a key government strategy to address the significant burden of diet-related noncommunicable diseases. However, research on public knowledge and perceptions of FOPLs and their relationships with sugar-sweetened beverage (SSB) and artificially sweetened beverage (ASB) consumption remains limited. A cross-sectional study with 2870 individuals was conducted to explore their knowledge and perceptions of Nutri-Grade, a national front-of-pack ...

IntroductionMusculoskeletal injuries (MSKIs) are ubiquitous in the U.S. military, especially among high-performing service members such as Marines. Given that female service members only started to be assigned to ground combat roles since December 2015, evaluation of sex on MSKI risk in ground combat occupations has not been possible until there was an ample population to study. The purpose of this population-level epidemiological study was to assess (1) if female sex was a salient risk factor f...

BackgroundPacked lunches are a common feature of early childhood food provision, yet evidence describing their nutritional composition in early years settings remains limited. Understanding the foods provided during this developmental period is important, given the potential influence of early dietary exposures on later health. AimTo characterise the composition, nutritional quality, cost, and dietary patterns of packed lunches brought from home in Early Childhood Education and Care settings, a...

As plant-based (PB) diets become more common among UK children, understanding their nutritional adequacy and environmental impact is vital. This study assessed nutrient intake and dietary greenhouse gas emissions among children following omnivorous, vegetarian, and vegan diets. A cross-sectional analysis was conducted using three-day weighed food diaries from 39 UK children aged 2-12 years (omnivore n=15; and PB: vegetarian n=11; vegan n=13). Nutrients were analysed with and without supplementa...