Variation in hysterectomy prevalence and trends among U.S. States and Territories-Behavioral Risk Factor Surveillance System, 2012-2020.

PURPOSE: We estimated up-to-date state- and territory-level hysterectomy prevalence and trends, which can help correct the population at risk denominator and calculate more accurate uterine and cervical cancer rates. METHODS: We analyzed self-reported data for a population-based sample of 1,267,013 U.S. women aged ≥ 18 years who participated in the Behavioral Risk Factor Surveillance System surveys from 2012 to 2020. Estimates were age-standardized and stratified by sociodemographic characteristics and geography. Trends were assessed by testing for any differences in hysterectomy prevalence across years. RESULTS: Hysterectomy prevalence was highest among women aged 70-79 years (46.7%) and ≥ 80 years (48.8%). Prevalence was also higher among women who were non-Hispanic (NH) Black (21.3%), NH American Indian and Alaska Native (21.1%), and from the South (21.1%). Hysterectomy prevalence declined by 1.9 percentage points from 18.9% in 2012 to 17.0% in 2020. CONCLUSIONS: Approximately one in five U.S. women overall and half of U.S. women aged ≥ 70 years reported undergoing a hysterectomy. Our findings reveal large variations in hysterectomy prevalence within and between each of the four census regions and by race and other sociodemographic characteristics, underscoring the importance of adjusting epidemiologic measures of uterine and cervical cancers for hysterectomy status.

ECM-CSD: An Efficient Classification Model for Cancer Stage Diagnosis in CT Lung Images Using FCM and SVM Techniques.

As is eminent, lung cancer is one of the death frightening syndromes among people in present cases. The earlier diagnosis and treatment of lung cancer can increase the endurance rate of the affected people. But, the structure of the cancer cell makes the diagnosis process more challenging, in which the most of the cells are superimposed. By adopting the efficient image processing techniques, the diagnosis process can be made effective, earlier and accurate, where the time aspect is extremely decisive. With those considerations, the main objective of this work is to propose a region based Fuzzy C-Means Clustering (FCM) technique for segmenting the lung cancer region and the Support Vector Machine (SVM) based classification for diagnosing the cancer stage, which helps in clinical practice in significant way to increase the morality rate. Moreover, the proposed ECM-CSD (Efficient Classification Model for Cancer Stage Diagnosis) uses Computed Tomography (CT) lung images for processing, since it poses higher imaging sensitivity, resolution with good isotopic acquisition in lung nodule identification. With those images, the pre-processing has been made with Gaussian Filter for smoothing and Gabor Filter for enhancement. Following, based on the extracted image features, the effective segmentation of lung nodules is performed using the FCM based clustering. And, the stages of cancer are identified based on the SVM classification technique. Further, the model is analyzed with MATLAB tool by incorporating the LIDC-IDRI lung CT images clinical dataset. The comparative experiments show the efficiency of the proposed model in terms of the performance evaluation factors like increased accuracy and reduced error rate.

Convalescing Cluster Configuration Using a Superlative Framework.

Competent data mining methods are vital to discover knowledge from databases which are built as a result of enormous growth of data. Various techniques of data mining are applied to obtain knowledge from these databases. Data clustering is one such descriptive data mining technique which guides in partitioning data objects into disjoint segments. K-means algorithm is a versatile algorithm among the various approaches used in data clustering. The algorithm and its diverse adaptation methods suffer certain problems in their performance. To overcome these issues a superlative algorithm has been proposed in this paper to perform data clustering. The specific feature of the proposed algorithm is discretizing the dataset, thereby improving the accuracy of clustering, and also adopting the binary search initialization method to generate cluster centroids. The generated centroids are fed as input to K-means approach which iteratively segments the data objects into respective clusters. The clustered results are measured for accuracy and validity. Experiments conducted by testing the approach on datasets from the UC Irvine Machine Learning Repository evidently show that the accuracy and validity measure is higher than the other two approaches, namely, simple K-means and Binary Search method. Thus, the proposed approach proves that discretization process will improve the efficacy of descriptive data mining tasks.

Field-based video pre-test counseling, oral testing, and telephonic post-test counseling: implementation of an HIV field testing package among high-risk Indian men.

In India, men who have sex with men (MSM) and truck drivers are high-risk groups that often do not access HIV testing due to stigma and high mobility. This study evaluated a field testing package (FTP) that identified HIV positive participants through video pre-test counseling, OraQuick oral fluid HIV testing, and telephonic post-test counseling and then connected them to government facilities. A total of 598 MSM and truck drivers participated in the FTP and completed surveys covering sociodemographics, HIV testing history, risk behaviors, and opinions on the FTP. MSM and truck drivers equally preferred video counseling, although MSM who had been previously tested preferred traditional methods. Nearly all participants preferred oral testing. Rates of counseling completion and linkage to government centers were low, with one-third of newly identified positives completing follow-up. With increased public-private coordination, this FTP could identify many hard-to-reach preliminary positive individuals and connect them to government testing and care.

Candidate change agent identification among men at risk for HIV infection.

Despite limited HIV prevention potency, peer-based programs have become one of the most often used HIV prevention approaches internationally. These programs demonstrate a need for greater specificity in peer change agent (PCA) recruitment and social network evaluation. In the present three-phase study based in India (2009-2010), we first explored the nature of friendship among truck-drivers, a group of men at high risk for HIV infection, in order to develop a thorough understanding of the social forces that contribute to and maintain their personal networks. This was accomplished in the first two study phases through a combination of focus group discussions (n = 5 groups), in-depth qualitative interviews (n = 20), and personal network analyses (n = 25) of truck-drivers to define friendship and deepen our understanding of friendship across geographic spaces. Measures collected in phases I and II included friend typologies, discussion topics, social network influences, advice-giving, and risk reduction. Outcomes were assessed through an iterative process of qualitative textual analysis and social network analysis. The networks of truck-drivers were found to comprise three typologies: close friends, parking lot friends, and other friends. From these data, we developed an algorithmic approach to the identification of a candidate PCA within a high-risk man's personal network. In phase III we piloted field-use of this approach to identify and recruit PCAs, and further evaluated their potential for intervention through preliminary analysis of the PCA's own personal networks. An instrument was developed to translate what social network theory and analysis has taught us about egocentric network dynamics into a real-world methodology for identifying intervention-appropriate peers within an individual's personal network. Our approach can be tailored to the specifications of any high-risk population, and may serve to enhance current peer-based HIV interventions.

A protective effect of circumcision among receptive male sex partners of Indian men who have sex with men.

The role of circumcision in the transmission of human immunodeficiency virus (HIV) among men who have sex with men (MSM) in resource restricted regions is poorly understood. This study explored the association of circumcision with HIV seroprevalence, in conjunction with other risk factors such as marriage and sex position, for a population of MSM in India. Participants (n = 387) were recruited from six drop-in centers in a large city in southern India. The overall HIV prevalence in this sample was high, at 18.6%. Bivariate and multivariable analyses revealed a concentration of risk among receptive only, married, and uncircumcised MSM, with HIV prevalence in this group reaching nearly 50%. The adjusted odds of HIV infection amongst circumcised men was less than one fifth that of uncircumcised men [adjusted odds ratio (AOR) 0.17; 95% CI 0.07-0.46; P < 0.001]. Within the group of receptive only MSM, infection was found to be lower among circumcised individuals (AOR, 0.30, 95% CI 0.12-0.76; P < 0.05) in the context of circumcised MSM engaging in more UAI, having a more recent same sex encounter and less lubricant use when compared to uncircumcised receptive men. To further explain these results, future studies should focus on epidemiologic analyses of risk, augmented by social and sexual network analyses of MSM mixing.

Sex position, marital status, and HIV risk among Indian men who have sex with men: clues to optimizing prevention approaches.

A divide exists between categories of men who have sex with men (MSM) in India based on their sex position, which has consequences for the design of novel HIV prevention interventions. We examine the interaction between sex position and other attributes on existing HIV risk including previous HIV testing, unprotected anal intercourse (UAI), and HIV serostatus among MSM recruited from drop-in centers and public cruising areas in the twin cities of Hyderabad and Secunderabad, India. A survey was administered by trained research assistants and minimally invasive HIV testing was performed by finger-stick or oral testing. HIV seropositive MSM underwent CD4+ lymphocyte count measurement. In our sample (n = 676), 32.6% of men were married to women, 22.2% of receptive only participants were married, and 21.9% of men were HIV seropositive. In bivariate analysis, sex position was associated with previous HIV testing, UAI, HIV serostatus, and CD4+ lymphocyte count at diagnosis. In multivariate analysis with interaction terms, dual unmarried men were more likely to have undergone an HIV test than insertive unmarried men (odds ratio [OR] 2.8; 95% confidence interval [CI] 1.2-6.5), a relationship that did not hold among married men. Conversely, dual married men were less likely than insertive married men to engage in UAI (OR 0.3; 95% CI 0.1-0.6), a relationship that did not hold among unmarried men. Further implementation research is warranted in order to best direct novel biologic and behavioral prevention interventions towards specific risk behaviors in this and other similar contexts.

Genetics of otosclerosis.

Otosclerosis is an early-middle adult life genetic disease affecting bone remodelling in the ear. Current knowledge of otosclerosis as an inherited disease dates to the mid-19th century, and we report here an attempt to understand the genetics of otosclerosis and detect its heterogeneity. The analysis was conducted on 151 otosclerotic families. The results of our study indicate that while heredity plays an important role in the manifestation of the disease a substantial portion of otosclerotic cases could arise due to non-genetic causes.