JAMA network open
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Current public health guidelines for obesity prevention and control focus on promoting a normal body mass index (BMI), rarely addressing central obesity, which is reflected by high waist circumference (WC) and common in the general population. Studies of the association of normal-weight central obesity with long-term health outcomes are sparse. ⋯ Normal-weight central obesity in women was associated with excess risk of mortality, similar to that of women with BMI-defined obesity with central obesity. These findings underscore the need for future public health guidelines to include the prevention and control of central obesity, even in individuals with normal BMI.
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Congenital Zika virus (ZIKV) infection may present with a spectrum of clinical and neuroradiographic findings. ⋯ Neuroimaging abnormalities of computed tomography and/or magnetic resonance imaging scans were common in ZIKV-exposed infants. While neuroimaging abnormalities were seen in 10% of infants without clinically severe ZIKV, most occurred almost exclusively among those with clinically severe ZIKV, especially among those with a history of ZIKV exposure in the first trimester.
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Although nearly 1 in 5 persons in the United States has a physical or mental disability, little is known about the association of the Patient Protection and Affordable Care Act (ACA) with health insurance coverage among persons with a disability. ⋯ Medicaid expansion appeared to be associated with lower uninsurance rates and higher Medicaid and private insurance coverage for persons with a disability. This study's findings suggest that the reduction in the uninsured rate and gains in Medicaid coverage were greater for persons without a disability than for persons with a disability.
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Inpatient violence remains a significant problem despite existing risk assessment methods. The lack of robustness and the high degree of effort needed to use current methods might be mitigated by using routinely registered clinical notes. ⋯ Internally validated predictions resulted in AUC values with good predictive validity, suggesting that automatic violence risk assessment using routinely registered clinical notes is possible. The validation of trained models using data from other sites corroborates previous findings that violence risk assessment generalizes modestly to different populations.
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Recent studies indicate that living near more green space may support mental and general health and may also prevent depression. However, most studies are cross-sectional, and few have considered whether some types of green space matter more for mental health. ⋯ Protection and restoration of urban tree canopy specifically, rather than any urban greening, may be a good option for promotion of community mental health.