Preprint Feed – Epidemiology

medrxiv Subject Collection: Epidemiology This feed contains articles for medRxiv Subject Collection "Epidemiology"

• Characterizing cancer patterns in Okinawan vs. mainland Japanese Americans: The Multiethnic Cohort Study

  by Streicher, S. A., Guillermo, C., Park, S., Chiang, C., Shepherd, J., Sheng, X., Bogumil, D., Park, S. L., Cheng, I., Lim, U., Franke, A., Stram, D., Conti, D. V., Haiman, C., Wilkens, L., Le Marchand, L. on July 15, 2025 at 12:00 am

  Differences in cancer rates have been documented in Japan between Okinawa and mainland Japan. Limited data exist on whether these differences are also present for established populations of Okinawans and mainland Japanese in the United States. Dimensionality reduction techniques for genetic data combined with Okinawan surnames were used to identify Multiethnic Cohort Japanese American participants (N=24,484) of Okinawan or mainland descent. Cox proportional hazards models were used to compare […]

• Spatial Point Pattern Analysis of Valley Fever in the Phoenix Metropolitan Area

  by Ginos, J. G., Sterner, B., Jevtic, P. on July 15, 2025 at 12:00 am

  Using a novel Arizona Medicaid data set, we model Valley Fever (VF) cases for each semester during the period 2013-2023 in the Phoenix Metropolitan Area (study region) as a spatial point process. We estimate the intensity function of VF cases, observed at residential locations of patients, as a function of environmental covariates available at high spatial resolutions, including land cover type, change in land cover type, Normalized Difference Vegetation Index (NDVI), change in NDVI, and using […]

• An unbiased comparison of 14 epigenetic clocks in relation to 10-year onset of 174 disease outcomes in 18,859 individuals.

  by Mavrommatis, C., Belsky, D., Ying, K., Moqri, M., Campbell, A., Richmond, A., Gladyshev, V., Chandra, T., McCartney, D., Marioni, R. on July 15, 2025 at 12:00 am

  Epigenetic Clocks have been trained to predict chronological age, healthspan and lifespan. Such clocks are often analysed in relation to disease outcomes – typically using small datasets and a limited number of clocks. Here, we present the first large-scale (n=18,849), unbiased comparison of 14 widely used clocks as predictors of 174 incident disease outcomes and all-cause mortality. Second-generation clocks significantly outperformed first-generation clocks, which have limited applications in […]

• Medication Use in Severe Anorexia Nervosa: A Danish Register-based Study

  by Zhang, Z.-P., Chatwin, H., Larsen, J. T., Clausen, L., Agerbo, E., Munk-Olsen, T., Bang Madsen, K., Vilhjalmsson, B. J., Petersen, L. V., Yilmaz, Z. on July 15, 2025 at 12:00 am

  Background: Severe anorexia nervosa (AN) represents a subgroup of individuals with AN with prolonged illness duration and poor prognosis. Previous research has reported increased medication use in AN, but prescription patterns in severe AN remain unexplored. Methods: Utilizing Danish registers, this cohort study included 7,654 individuals diagnosed with AN. We assigned cases to severe AN or less-severe AN groups based on their AN Register-based Severity Index scores. First, we examined […]

• Introducing the Canadian Area-Level Social Determinants of Health Indicators (CASDOHI)

  by Marouzi, A., Plante, C. on July 14, 2025 at 12:00 am

  There is a growing demand for social data to support evidence-based health planning in Canada. Although Statistics Canada has made small-area Canadian census data available to researchers online for over a decade, it remains underutilized due to its cumbersome data structure and the challenges in processing and linking it with other data sources. This paper introduces the Canadian Area-Level Social Determinants of Health Indicators (CASDOHI), a user-friendly dataset that includes over 100 […]

• Evaluating the impact of the increase in funding entitlement to Early Learning and Childcare from 600 to 1140 hours per year on family wellbeing in Scotland: statistical analysis plan

  by Lewsey, J., Mackay, D., Aitken, G., Patterson, H. on July 14, 2025 at 12:00 am

  This report provides the statistical analysis plan (SAP) for a study evaluating the impact of the increase in funding entitlement to Early Learning and Childcare from 600 to 1140 hours per year on family wellbeing in Scotland. In order to measure the outcomes for children, parents and carers, and families as a whole, this study is part of a larger outcomes-based evaluation that also includes an evaluation of the accessibility, flexibility, affordability, quality and take up of funded ELC and an […]

• Use of the International Classification of Functioning, Disability and Health (ICF) in Randomized Controlled Trials of Rheumatoid Arthritis Pharmacological Treatments: a Scoping Review

  by Martinez-De la Torre, A., Leshetkina, P., Ahanor, O., Maritz, R. on July 14, 2025 at 12:00 am

  Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease affecting approximately 0.5-1.0% of the adult population and is a significant contributor of disability worldwide. While Phase III randomized controlled trials (RCTs) remain the gold standard for evaluating pharmacological treatments, they often fail to capture outcomes that reflect patients’ lived experiences, also referred to as functioning. The International Classification of Functioning, Disability and Health (ICF) Brief […]

• Adapting the intensity gradient for use across commonly derived accelerometer activity metrics: A LABDA Network project

  by Eckmann, H. R., Razieh, C., Chastin, S., Sherar, L. B., Hansen, B. H., Rowlands, A. V. on July 14, 2025 at 12:00 am

  The intensity gradient (IG) quantifies the distribution of time spent across accelerometer-assessed physical activity intensity and is positively associated with health. It was developed using the Euclidean Norm Minus One (ENMO) intensity metric. This study aimed to enable generation of comparable IGs across other metrics (mean amplitude deviation (MAD), monitor independent movement summary units (MIMS), and counts), by addressing a key step in the IG algorithm of dividing physical activity […]

• Childhood features associated with mens Beliefs in God and/or a Divine Power in England.

  by Golding, J., Morgan, J., Gregory, S., Iles-Caven, Y., Emond, A., Northstone, K., Park, C. on July 14, 2025 at 12:00 am

  Research has linked childhood experiences with subsequent religiousness and/or spirituality, but this work generally focuses on general religiousness or worship service attendance. Very little is known about how childhood experiences influence individuals religious or spiritual beliefs (RSBs). We have investigated whether the childhoods of men who have such a belief (measured by the question Do you believe in God or in some Divine power?) differ from those of their peers without such a […]

• Type I diabetes and incident dementia: a prospective study in the All of Us cohort

  by Pederson, A. M., Buto, P., Zimmerman, S. C., Velez, M., Sims, K. D., Murchland, A. R., Wang, J., Brennan, A. T., Glymour, M. M., Weuve, J. on July 14, 2025 at 12:00 am

  Importance: Although diabetes mellitus (DM) is a well-established determinant of dementia risk, most studies have evaluated type 2 DM (T2DM) or any DM without considering type 1 DM (T1DM) separately. Questions remain about the influence of T1DM on risk of dementia. Objective: To evaluate associations of T1DM and T2DM with incident dementia using linked electronic health records (EHRs). Design, Setting, Participants: This cohort study used data from the All of Us (AoU) cohort, a convenience […]

• Genetic Ancestry and Risk of Atrial Fibrillation in Individuals of Black Ethnicity in the UK Biobank

  by Liu, C., Sun, Y. V., Li, L., Collin, L. J., Shah, A. J., Alonso, A. on July 14, 2025 at 12:00 am

  Background: Black individuals have a lower incidence of atrial fibrillation (AF) than White individuals, despite a higher burden of traditional risk factors. Prior studies have suggested that European genetic ancestry may contribute to this paradox, but findings have been inconsistent. Methods: We examined the association between European genetic ancestry and incident AF among 6,920 UK Biobank (UKB) participants who self-identified as Black and were free of AF at baseline. European ancestry […]

• Individual and population level uncertainty interact to determine the performance of outbreak surveillance systems

  by Arnold, C. R. K., Kong, A. C., Winter, A. K., Moss, W. J., Patenaude, B. N., Ferrari, M. J. J. on July 14, 2025 at 12:00 am

  Background Outbreak detection frequently rely on imperfect individual-level case diagnosis. Both outbreaks and cases are discrete events that can be misclassified and uncertainty at the case level may impact the performance of outbreak alert and detection systems. Here, we describe how the performance of outbreak detection depends on individual-level diagnostic test characteristics and population-level epidemiology and describe settings where imperfect individual-level tests can achieve […]

• Integrating genomic data into test-negative designs for estimating lineage-specific COVID-19 vaccine effectiveness

  by Ma, K., Surie, D., Dean, N. E., Paden, C. R., Thornburg, N., Dawood, F. S. on July 11, 2025 at 12:00 am

  BackgroundSARS-CoV-2 lineage-specific vaccine effectiveness (VE) studies can inform decision-making on whether COVID-19 vaccine composition updates are needed to maintain effectiveness against severe disease as SARS-CoV-2 continues to evolve. Lineage assignment methods in VE test-negative design (TND) studies include sequence-based (whole-genome sequencing), proxy-based (e.g., S-gene target failure during polymerase chain reaction), and period-based (variant predominance time periods) […]

• The effect of pre-booked appointments on COVID-19 vaccine uptake during the 2023 autumn campaign in the Netherlands: a regression discontinuity analysis

  by Haverkate, M., van de Kassteele, J., van den Hof, S., Sanders, J., Lambooij, M., de Bruin, M., de Melker, H., Hahne, S. on July 11, 2025 at 12:00 am

  IntroductionThere is evidence that pre-booked appointments (PBA) for vaccination can enhance uptake, but might also result in reactance. We assessed the effect of PBA (versus self-scheduling) on uptake of COVID-19 vaccination during the 2023 autumn campaign in the Netherlands. MethodsPersons aged [≥]60 years were personally invited by mail. Those born between 01-01-1934 and 01-05-1952 (i.e., age 71.7-90.0 on 31-12-2023) received a letter with a PBA, while the others received a letter […]

• Longitudinal Prediction of BMI using Explainable AI: Integrating Polygenic Scores, Maternal, Early-Life and Familial Factors

  by Chen, F., Melton, P., Vinsen, K., Mori, T. A., Beilin, L., Huang, R.-C. on July 11, 2025 at 12:00 am

  Background/ObjectivesThis study aimed to predict body mass index (BMI) trajectories from childhood to early adulthood using explainable artificial intelligence, integrating polygenic scores (PGS), maternal, early-life, and familial factors to identify key predictors of obesity risk and inform prevention strategies. Subjects/MethodsWe analysed longitudinal data from the Raine Study Gen2 cohort, recruiting 2 868 participants. This observational study, without randomization or case-control […]

• Social disparities in triple-negative breast cancer incidence and severity at diagnosis in Greater Paris, France: confronting race and ethnic blindness.

  by Chauvin, P., Huet, T., Gligorov, J., Sargent, C. on July 11, 2025 at 12:00 am

  Triple-negative breast cancer (TNBC), an aggressive subtype with poor prognosis, is of higher frequency in African-American women and women of Sub-Saharan African origin. In France, legal constraints on obtaining health data on race, ethnicity, or nationality in cancer registries and medical records make it difficult to estimate the prevalence of TNBC according to womens origins. These constraints result from a historical "universalist" approach to French citizenship which prohibits […]

• Bimodal Contact Reductions and Social Homophily during COVID-19

  by Paltra, S., Stellbrink, L., Friedel, J., Kretzschmar, M. E., Mortaga, M., Nagel, K., Nunner, H., Calero Valdez, A., Priesemann, V. on July 11, 2025 at 12:00 am

  BackgroundThe COVID-19 pandemic disrupted social life and forced people to reconsider how, where, and with whom to spend time. These decisions are deeply personal and their intricacies are still poorly understood. MethodsTo understand how people make such decisions, we conducted an online survey in summer 2023, collecting self-reported absolute contact numbers for four time points: 2019, 03/2020, summer 2021, and 01/2023. We analyzed the resulting contact data, focusing on the quantification […]

• Time trends in new diagnoses of 19 long-term conditions: a population-level cohort study in England using OpenSAFELY

  by Russell, M. D., Schaffer, A. L., Bechman, K., Gibson, M., Massey, J., Higgins, R., MacKenna, B., Bacon, S., Inglesby, P., Mehrkar, A., Goldacre, B., Alveyn, E., Allen, V., Yang, Z., Patel, S., Adas, M. A., Sandhu, G., Price, E., Gama, R. M., Bramham, K., Hotopf, M., Norton, S., Cope, A. P., Galloway, J. B. on July 11, 2025 at 12:00 am

  ObjectivesTo evaluate temporal changes in the incidence and prevalence of 19 long-term conditions in England, quantifying the impact of the COVID-19 pandemic on diagnosis rates by disease, age group, sex, socioeconomic status, and ethnicity. DesignObservational cohort study. SettingPrimary care and hospital admission data, with the approval of NHS England. Participants27,132,190 individuals registered with general practices in England contributing data to the OpenSAFELY-TPP platform. Main […]

• Spatiotemporal Transmission of Influenza in the US during the 2022/23 Season

  by Couture, A., Biggerstaff, M., Sheppard, M., Budd, A., Kite-Powell, A., Morris, S. on July 11, 2025 at 12:00 am

  Understanding the spatiotemporal dynamics of seasonal influenza spread across the United States (US) is crucial for informed public health planning. We explored patterns of influenza transmission during the 2022/23 season in the US and used a mathematical model to infer potential drivers and underlying mechanisms. Leveraging emergency department visit data, we first estimated the timing of influenza onset for the 2022/23 season at the Health Service Area (HSA) level. We then combined the […]

• Community-wide annual tuberculosis screening over four years: Findings from the HPTN 071 (PopART) trial.

  by Gachie, T., Schaap, A., Yang, B., Sakala, E., Phiri, M., Shanaube, K., Dunbar, R., Thomas, R., Fidler, S., Bock, P., Dodd, P. J., Hayes, R., Telisinghe, L., Floyd, S., Ayles, H. on July 11, 2025 at 12:00 am

  BackgroundThe World Health Organization suggest that systematic tuberculosis (TB) screening may be conducted in high prevalence settings (>0.5%), though supporting evidence is limited. MethodsBetween January-2014 to December-2017, the HPTN 071 (PopART) cluster-randomized trial implemented universal HIV and TB testing across 21 communities in Zambia and South Africa (SA), with TB prevalence of 0.5% and 1.6%, respectively. Trained community health workers visited households annually to offer […]

• Mpox clinical and epidemiological patterns in the Central African Republic: a systematic review and meta-analysis

  by Cheuyem, F. Z. L., Takpando-le-grand, D. R., Achangwa, C., Boukeng, L. B. K., Dabou, S., Mutarambirwa, H. D., Otsali, R. K. N., Nouko, A., Edzamba, M. F., Tsafack, M. G. M., Mbarga, A. E., Nguefack-Tsague, G. on July 10, 2025 at 12:00 am

  BackgroundMpox remains a critical public health challenge in Central Africa, where endemic circulation of the virulent Clade I virus persists through zoonotic and human-to-human transmission. This systematic review and meta-analysis synthesize 40 years of evidence (1984-2024) to characterize Mpox epidemiology, vaccination gaps and clinical pattern in the Central African Republic (CAR), informing targeted control strategies for this re-emerging threat. MethodsFollowing PRISMA guidelines, we […]

• Stochastic Chaos in Influenza Data – An Application of Topological Methods

  by Goncalves, C. P. d. S., Rouco, C. on July 10, 2025 at 12:00 am

  Empirical methods of chaos theory have been applied to epidemiological data, uncovering evidence of chaos. In the current work, we apply, to the weekly share of positive tests for influenza in the Northern Hemisphere, an empirical methodology for studying stochastic chaos using topological data analysis methods combining chaos theory, topological machine learning, and nonlinear time series analysis for attractor reconstruction and decomposition to decompose a stochastic chaotic dynamics down to […]

• Considering causality in normal tissue complication probability model development: a literature review

  by Mulder, A. M., Choi, J., Meijerink, L. M., van Amsterdam, W., Leeuwenberg, A. M., Schuit, E. on July 10, 2025 at 12:00 am

  Backgroundnormal-tissue probability models that estimate the probability of complications often associated with radiotherapy could potentially be used to help clinicians make decisions regarding the radiation dose or the type of radiation treatment. In order to be able to use NTCP models in this way, they should accurately capture the causal relation between dose and complication risk. The question then remains: do current normal-tissue complication probability models for radiation treatment […]

• Genomic Epidemiology of Enterococcus faecium Bloodstream Infections During a VanB-type VRE Peak Reveals an Oligoclonal Scenario: An Observational Study at a German University Hospital (2017-2022)

  by Knegendorf, L., Sommer, A., Baier, C., Weber, R. E., Fischer, M. A., Werner, G., Ziesing, S., Schlüter, D. on July 10, 2025 at 12:00 am

  BackgroundA substantial and rapid increase, followed by a sharp decline in vanB-type vancomycin-resistant E. faecium (VRE), occurred in Germany in the late 2010s. This unusual epidemiological trend prompted detailed genomic investigations to explore the underlying dynamics at a German university hospital. MethodsWe retrospectively analyzed E. faecium bloodstream infection (BSI) isolates collected between 2017 and 2022. Isolates were classified as vanA-positive, vanB-positive, or van-negative. […]

• Reduced risk of household secondary invasive Group A Streptococcal infections after a prophylaxis policy change, the Netherlands, 2022-2024

  by de Gier, B., Vlaminckx, B. J. M., van Roon, A., Knol, M. J., te Wierik, M. J. M., Notermans, D. W., de Melker, H. E., van Sorge, N. M. on July 10, 2025 at 12:00 am

  ImportanceHousehold contacts of patients with invasive group A streptococcal (iGAS) disease have an increased risk of developing iGAS. In the Netherlands, the iGAS public health policy was changed in January 2023, offering antibiotic prophylaxis to household contacts of all iGAS patients rather than only those presenting with necrotising fasciitis or streptococcal toxic shock syndrome. ObjectiveTo estimate risk of iGAS in the general population and among household- and other contacts of […]

• Risk and protective factors against cognitive decline in older adults from a nationally representative sample in India: Results from the LASI-DAD

  by Gross, A. L., Nichols, E., Arce Renteria, M., Khobragade, P. Y., Meijer, E., Petrosyan, S., Varghese, M., Weerman, A., Hu, P., Banerjee, J., Chien, S., Angrisani, M., Dhankhar, A., Vishwakarrma, H., Ali, I., Zhou, Z., Aravindakshan, R., Chakrabarti, S. S., Das, M. P., De, K., Dhar, M., Dewangan, G. C., Gupta, M., Khan, U. H., Jain, V., John, J. P., Kirti, R., Kokane, A., Lehl, S. S., Mohanty, R. R., Pandit, V., Rajguru, C., Sahoo, D. P., Sankhe, L., Sukumar, M., Talukdar, A., Gunasekaran, V., Sekher, T. V., Bloom, D. E., Langa, K. M., Sivakumar, P. T., Ganguli, M., Crimmins, E. M., Dey, S., De on July 10, 2025 at 12:00 am

  INTRODUCTIONWe characterized modifiable risk and protective factors for cognitive decline in India. METHODSUsing the first nationally representative population-based longitudinal sample of N=6,168 older adults in India, we evaluated associations of risk factors (demographic characteristics, self-reported and objective health characteristics, health behaviors, and sensory function) for late-life cognitive decline with up to 6.4 years of follow-up (range: 2.8 to 6.4 years). RESULTSThe mean rate […]

• Impact of Preexisting Rare Diseases on COVID-19 Severity, Reinfection, and Long COVID, and the Modifying Effects of Vaccination and Antiviral Therapy: A Retrospective Study from the N3C Data Enclave

  by Yadaw, A. S., Sahner, D. K., Sid, E., Chew, E. Y., Pichard, D. C., Mathe, E. A. on July 10, 2025 at 12:00 am

  BackgroundOver 10,000 rare diseases (RDs) affect more than 300 million people globally, yet their influence on COVID-19 severity, reinfection risk, and long COVID remains poorly understood. This study evaluates the impact of RDs on these outcomes and examines the effectiveness of vaccination and antiviral treatments among individuals with and without RDs. MethodsWe conducted a retrospective cohort study using harmonized electronic health records (EHRs) from the National COVID Cohort […]

• Identifying county-level effect modifiers of the association between heat waves and preterm birth using a Bayesian spatial meta regression approach

  by Lin, S., Chang, H. H., Darrow, L. A., Strickland, M. J., Fitch, A., Newman, A., Zheng, X., Warren, J. L. on July 8, 2025 at 12:00 am

  High temperature is associated with adverse health outcomes, particularly for vulnerable subpopulations including pregnant individuals and their unborn babies. Several recent studies have investigated the association between temperature and preterm birth at different geographic scales and across different spatial locations. However, there has been less focus on characterizing spatial heterogeneity in risks and identifying modifiable factors that contribute to the observed variation. In this […]

• ViralSim – A Novel Method for Simulating Pandemics with Geographical Data

  by Cai, B. D. on July 8, 2025 at 12:00 am

  Accurately simulating viral evolution is critical for evaluating analytical tools, forecasting outbreaks, and improving our understanding of pathogen dynamics. ViralSim introduces a geographically structured agent-based model that emphasizes spatial transmission across clustered populations. Unlike prior approaches that primarily focus on genetic, purely statistical, or temporal parameters, ViralSim incorporates location-driven spread and explicit trait evolution. More over, the produced […]

• Wastewater Parvovirus B19 Signal Amid Rising Maternal Cases

  by Clark, J. R., Tisza, M. J., Hammerquist, A. L., Prakash, H., Munoz, J. L., Surathu, A., Javornik Cregeen, S. J., Parker, N. W., Sanz Cortes, M., Hanson, B., Deegan, J., Boerwinkle, E., Barrozo, E. R., Maresso, A. W. on July 8, 2025 at 12:00 am

  We report widespread detection of parvovirus B19 in Texas Wastewater using hybrid-capture virome sequencing across 43 sites. Wastewater signal correlated with clinical cases at institutional, county, and state levels and preceded case surges by one month. Full-genome coverage enabled real-time mutation tracking, highlighting wastewaters utility for epidemiologic surveillance.