Case-control Design Research Articles

Risk factors and drug resistance of adult community-onset urinary tract infections caused by Escherichia coli-producing extended-spectrum β-lactamase in the Chongqing region, China: a retrospective case-control study.

To evaluate the prevalence, resistance and risk factors of community-onset urinary tract infections (COUTIs) caused by extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) for providing a basis for the selection of clinical therapeutic agents. A retrospective case-control study. The Affiliated Dazu Hospital of Chongqing Medical University (also known as The People's Hospital of Dazu Chongqing), a 1000-bed tertiary hospital in China. This study encompassed adult patients diagnosed with community-acquired urinary tract infections (UTIs) caused by E. coli between May 2017 and December 2022 with exclusion criteria including incomplete clinical data, disagreement to participate in the study, hospitalisation duration exceeding 48 hours prior to confirmation of diagnosis and prior history of urinary tract infection caused by E. coli. The risk factors for COUTIs caused by ESBL-EC were evaluated using a case-control design, defining patients who were diagnosed with UTIs and had an ESBL-positive urine culture as the case group and patients who were diagnosed with UTIs and had an ESBL-negative urine culture as the control group. Perform drug susceptibility testing and resistance analysis on isolated ESBL-EC. In total, 394 cases of COUTIs caused by E. coli were included; 192 cases were ESBL-positive with a detection rate of 48.7% (192/394). Parenchymal tumour, history of urolithiasis stone fragmentation, history of urological surgery, hospitalisation within 6 months, indwelling catheter outside the hospital and antibiotic use (mainly third-generation cephalosporins) were the factors significantly associated with COUTIs caused by ESBL-EC (p<0.05) through logistic regression for univariate analysis. Multivariate analysis revealed that a history of urolithiasis stone fragmentation (OR=2.450; 95% CI: 1.342 to 4.473; p=0.004), urological surgery (OR=3.102; 95% CI: 1.534 to 6.270; p=0.002), indwelling catheter outside hospital (OR=2.059; 95% CI: 1.025 to 4.133; p=0.042), hospitalisation within 6 months (OR=2.127; 95% CI: 1.207 to 3.748; p=0.009) and use of third-generation cephalosporins (OR=1.903; 95% CI: 1.069 to 3.389; p=0.029) were the independent risk factors for COUTIs caused by ESBL-EC. The results of the drug susceptibility testing revealed that ESBL-EC exhibited the highest resistance rates to ampicillin, ceftriaxone and cefixime, all at 100%. Mezlocillin followed with a resistance rate of 98.7%. On the other hand, ESBL-EC strains displayed the highest sensitivity to carbapenem antibiotics (imipenem, meropenem, ertapenem) and amikacin, all at 100%. Sensitivity rates were also high for cefotetan at 96.6%, piperacillin/tazobactam at 95.3% and nitrofurantoin at 87.9%. Our results revealed high ESBL-EC detection rates. COUTIs caused by ESBL-EC are more likely to occur in patients with parenchymal tumour, a history of urolithiasis stone fragmentation, a history of urological surgery, hospitalisation within 6 months, indwelling catheter outside the hospital and use of third-generation cephalosporins. These patients were highly resistant to penicillins, cephalosporins and quinolones.

Hospital-acquired pressure ulcers among adult ICU patients in tertiary hospitals in Oman: a one-year prevalence study.

Hospital-acquired pressure ulcer (HAPU) is a significant problem in healthcare settings and is associated with negative impacts on patient health. Although monitoring of pressure ulcers (PUs) among hospitalised patients was started more than a decade ago in Oman, no previous studies have been completed to estimate the prevalence and risk factors of HAPUs among patients in the intensive care unit (ICU). The aim of this study was to estimate the prevalence and identify risk factors for HAPUs among adult ICU patients in selected tertiary hospitals in Oman. A retrospective, cross-sectional, nested, case-control design was used to identify the prevalence rate of HAPUs and risk factors for a cohort of adult ICU patients over one calendar year (1 January-31 December 2019) in two tertiary hospitals in Oman. The prevalence rate for HAPU among ICU patients in Oman was 36.4%. However, when excluding cases of stage 1 ulcer, the rate was 30.37%. The most prevalent location was the sacrum (64.1%), and the most common stage was stage 2 (73.1%). The risk factors for HAPU included male sex (odds ratio (OR): 0.37; p=0.023), organ failure (OR: 3.2; p=0.033), cancer (OR: 3.41; p=0.049), cerebrovascular accident (OR: 12.33; p=0.001), mechanical ventilator (OR: 9.64; p=0.025) and ICU length of stay (OR: 1.24; p<0.001). HAPUs among ICU patients constitute a significant problem associated with severe clinical consequences and result in substantial adverse healthcare outcomes worldwide, including in Oman. Identifying the risk factors and the impact on the healthcare system is the foundation for preventing and managing HAPUs.

Social Support for Thai Adults with Type 2 Diabetes: A Case-Control Study.

Non-communicable diseases, including type 2 diabetes (T2DM), are the number one cause of death in Thailand. With its well-known social networking and strong kinship, evidence of social support may be a potential of low-cost approach for T2DM self- management. Social support is quite important for T2DM prevention and control but such evidence in Thai setting is still limited. Therefore, we aimed to study social support and associated determinants for T2DM patients compared to non-diabetes people. An observational study with a case-control study design was conducted in Chiang Mai, Thailand, in 2019-2020. Using inclusion and exclusion criteria, a total of 300 participants: 150 cases, 150 controls were recruited. Participants were selected based on outcome status of having "T2DM". Cases were defined as newly diagnosed (diagnosis of T2DM within 6 months) adult Thai residents and community controls were non-diabetes participants from the same residential area of cases. Data were analyzed by STATA 17. Descriptive analysis compared the characteristics between case and control group. The relation between social support and T2DM was investigated using multivariable Robust regression analysis. About 96.7% of T2DM patients had good social support. T2DM had a significant association with social support in all models defined by potential confounders. Social support was significantly positively associated with having family mealtimes in model 2 and model 3 and increasing age in model 2. BMI and T2DM family history had significant negative association in model 2 and model 3. Social support of Thai T2DM patients is higher than control group. It can either be originated from a newly acquired peer groups network or from the positive social support by family. Future research should focus on behavioral intervention including family and peers to help them understand their role in life-style modification and management of such a prevalent chronic disease.

Goat seropositivity as an indicator of Rift Valley fever (RVF) infection in human populations: A case-control study of the 2018 Rift Valley fever outbreak in Wajir County, Kenya

Rift Valley fever (RVF) is a viral zoonosis, which is considered as a threat to food security in the Horn of Africa. In Kenya, RVF is the 5th ranked priority zoonotic disease due to its high morbidity and mortality, frequent outbreak events, and associated socioeconomic impacts during outbreak events. In 2018, an RVF outbreak was confirmed in Kenya's Siaya, Wajir, and Marsabit counties. During this outbreak, 30 people were confirmed infected with RVF through laboratory tests; 21 in Wajir, 8 in Marsabit, and 1 in Siaya Counties.Seventy-five (75) households (15 cases and 60 controls) were selected and interviewed using a case-control study design in 2021 (?). A case was a household with a member who was diagnosed with RVF in 2018. In addition, a total of 1029 animals were purposively selected within these households and serologically tested for RVF. The study aimed to estimate the contribution of various risk factors to RVF human occurrence in Kenya with a special focus on Wajir County. Wajir County was chosen due to high number of confirmed human cases reported in the 2018 outbreak. A univariable regression model revealed that owner-reported RVF virus exposure in livestock significantly increased the odds of an RVF human case in the household by 32.7 times (95 % CI 4.0–267.4). The respondent being linked to a goat flock that was IgG-positive increased the odds of an RVF human case by 3.8 times (95 % CI 1.17–12.3). In the final multivariable analysis, the respondent being linked to their own animals affected by RVF increased odds of having an RVF human case in the household by 56.9 times (95 % CI 4.6–700.4), while the respondent being linked to a neighbor household member affected decreased odds of having a RVF human case by 0.1 times (95 % CI 0.08–0.75).In summary, these results have revealed a potential link for the spread of RVF infection from animals to humans in pastoralist households, hence it is critical to carry out targeted, community education, One Health surveillance, prevention, and control measures against the disease. This will be critical to protecting humans against potential spillovers of infections during outbreak events in livestock.

Role of ethnicity and residency in active tuberculosis in Karakalpakstan: study protocol of a matched case-control study

IntroductionUzbekistan is one of the 30 countries with the highest tuberculosis (TB) morbidity, accounting for 87% of all cases globally. The incidence of TB in the Republic of Karakalpakstan (RK)...

Effectiveness of influenza vaccines in children aged 6 to 59 months: a test-negative case-control study at primary care and hospital level, Spain 2023/24.

During 2023/24, all children aged 6 to 59 months were targeted for seasonal influenza vaccination in Spain nationally. Using a test-negative case-control design with sentinel surveillance data, we estimated adjusted influenza vaccine effectiveness (IVE) against any influenza type to be 70% (95% confidence interval (CI): 51 to 81%) for primary care patients with acute respiratory illness (ARI) and 77% (95% CI: 21 to 93%) for hospitalised patients with severe ARI. In primary care, where most subtyped viruses (61%; 145/237) were A(H1N1), adjusted IVE was 77% (95% CI: 56 to 88%) against A(H1N1)pdm09.

Peripheral Blood ABCG1 Gene DNA Methylation: Mediating the Relationship between Dietary Intake of Methyl Donor Nutrients and Stroke Risk

Dysregulation of methyl donor nutrients interferes with DNA methylation and is associated with neurological diseases. ABCG1 gene regulates cholesterol to HDL-C, maintains lipid homeostasis, and has been linked to both methyl nutrition and neurological risks. The aim was to investigate whether there is an effect of ABCG1 DNA methylation on the relationship between intake of methyl donor nutrients and the risk of stroke occurrence. We hypothesize that the intake of methyl donor nutrients may influence stroke occurrence by modulating the methylation status of ABCG1. This study utilized a case-control design and selected 52 stroke patients along with 52 healthy controls from Northwest China. Dietary information was collected using a FFQ, and methylation levels were measured at 29 CpG sites of the ABCG1 gene. A significant linear trend was found between dietary intake of the methyl donor nutrient choline and CpG_19.20 methylation of the ABCG1 gene (β = -0.037, P = 0.033). Additionally, a significant association was observed between CpG_19.20 methylation and the risk of stroke (OR 2.325, 95% CI 1.210 - 4.466). Mediation analysis revealed that choline intake indirectly influenced stroke occurrence through its effect on CpG_19.20 methylation levels in the ABCG1 gene (β = -0.015, SE = 0.013, 95% CI = [-0.053, -0.001]). We found that DNA methylation at specific CpG sites of the peripheral blood ABCG1 gene mediates the association between dietary methyl donor nutrient intake and stroke risk in an adult population from Northwest China. New insights are provided on the prevention and treatment of stroke.

Risk and determinants of sarcopenia in people with diabetes: a case–control study from Qatar Biobank cohort

BackgroundDiabetes is associated with impairments in muscle mass and quality increasing the risk of sarcopenia. Thus, this study aimed to investigate the odds of sarcopenia and its associated risk factors among Qatari adults (> 18 years), while exploring the modulating effects of health and lifestyle factors.MethodsUsing a case–control design, data from 767 participants (481 cases with diabetes and 286 controls without diabetes) was collected from Qatar Biobank (QBB). Sociodemographic, lifestyle factors including dietary intake, anthropometric and biochemical measures were analyzed. Handgrip strength, Dual X-ray absorptiometry (DXA), and Bio-impedance were used to assess muscle strength, muscle mass and muscle quality, respectively. The risk of sarcopenia was estimated using the European consensus on definition and diagnosis of sarcopenia.ResultsCases with diabetes were older (55 vs. 36 years; P < 0.001), had higher BMI (31.6 vs. 28.3 kg/m2; P < 0.001), lower cardiorespiratory fitness (50.0% “Moderate” fitness for cases, 62.9% “High” fitness for controls), and consumed less total (59.0 vs. 64.0; P = 0.004) and animal protein (39.0 vs. 42.0; P = 0.001), compared to controls based on a computed score. Participants with diabetes also had lower appendicular lean mass/BMI, handgrip strength, and higher probability of sarcopenia/probable sarcopenia (P < 0.005). Adjusted multiple logistic regression revealed that elevated cardiorespiratory fitness (β = 0.299, 95%CI:0.12–0.74) and blood triglycerides (β = 1.475, 95% CI: 1.024–2.124), as well as being a female (β = 0.086, 95%CI: 0.026–0.288) and having higher BMI (β = 0.908, 95%CI: 0.852–0.967) and ALM/BMI (β = 0.000, 95% CI: 0.000–0.007) are independent predictors (p < 0.05) of sarcopenia risk.ConclusionsThis study highlights the intricate relationship between diabetes and sarcopenia, revealing modifiable risk factors. Individuals with diabetes were found to have a higher likelihood of sarcopenia, which was associated with lower fitness levels and higher blood triglycerides. Protective factors against sarcopenia included being female and having higher BMI and ALM/BMI ratios.

Powerful Rare-Variant Association Analysis of Secondary Phenotypes.

Most genome-wide association studies are based on case-control designs, which provide abundant resources for secondary phenotype analyses. However, such studies suffer from biased sampling of primary phenotypes, and the traditional statistical methods can lead to seriously distorted analysis results when they are applied to secondary phenotypes without accounting for the biased sampling mechanism. To our knowledge, there are no statistical methods specifically tailored for rare variant association analysis with secondary phenotypes. In this article, we proposed two novel joint test statistics for identifying secondary-phenotype-associated rare variants based on prospective likelihood and retrospective likelihood, respectively. We also exploit the assumption of gene-environment independence in retrospective likelihood to improve the statistical power and adopt a two-step strategy to balance statistical power and robustness. Simulations and a real-data application are conducted to demonstrate the superior performance of our proposed methods.

HALP and PNI Score as Predictors of Nutritional Status in the Incidence of Incisional Hernia after Laparotomy in Colorectal Cancer Patients: A Case-Control Study

Background: Colorectal cancer ranks as the third most common cancer in the world. If patients can still be resected, surgical therapy is carried out. An incisional hernia is one of the complications after laparotomy surgery. Nutritional status can influence the incidence of incisional hernias after laparotomy. Colorectal cancer patients must have their nutritional status assessed using a simple scoring. This research aims to evaluate Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) and Prognostic Nutritional Index (PNI) scores as a predictor of incisional hernia after laparotomy surgery in colorectal cancer patients at Dr. Sardjito General Hospital, Yogyakarta. Methods: This study uses a case-control study design which consisted of two groups, a case group of colorectal cancer patients with incisional hernias after laparotomy surgery and a control group of colorectal cancer patients without incisional hernias. The independent variable was nutritional status which was assessed by HALP and PNI score, and the dependent variable was incisional hernia. This research by taking data from laboratory patients at Dr. Sardjito General Hospital, Yogyakarta. For multivariate analysis, a logistic regression test was used with a significance value of p 0.05. Results: There is a relationship between the stage of cancer and the comorbid diabetes mellitus with the incidence of incisional hernias after laparotomy, this can be seen in the results of the chi-square test. Advanced stage has an OR of 13 (P=.001; OR=13; 95% CI 3.551-47.597), while comorbid diabetes mellitus has an OR of 6.571 (P=.002; OR=6.571; 95% CI 2.109-20.479). However, there is no correlation between the HALP and PNI score with the incidence of incisional hernia after laparotomy. The multivariate analysis results in HALP score have a significant correlation between the nutritional status and the incidence of incisional hernia with OR=17.981 (p= 0.037 OR=17; 95% CI 1.198-269.803). Conclusions: The HALP score can be used as a screening predictor in the incidence of incisional hernia after laparotomy for colorectal cancer patients.

EGFR mutations in patients with lung adenocarcinoma and malignant pleural effusion: a propensity score-matched analysis of a single-center database.

Malignant pleural effusion (MPE) is associated with poor prognosis in patients with advanced lung adenocarcinoma (LUAD), and abnormal activation of epidermal growth factor receptor (EGFR) plays a crucial role in the development of LUAD. This study aimed to investigate the correlation between EGFR mutations and the occurrence of MPE in patients with LUAD and evaluate the effect of EGFR mutations on the prognosis of patients with LUAD with MPE. A case-control study design was adopted that included patients pathologically diagnosed with LUAD. Clinical data were collected, and patients were divided into the MPE group and the non-MPE (N-MPE) group based on the presence of MPE. Propensity score matching (PSM) was used to control for confounding factors. The correlation between EGFR mutations and the occurrence of MPE in LUAD was initially examined. Additionally, various factors affecting the overall survival (OS) of patients with LUAD and MPE were evaluated. A total of 849 patients were included in the study. After 1:2 PSM, there were 180 patients in the MPE group and 360 in the N-MPE group. The EGFR mutation rate was significantly higher in the MPE group compared to the N-MPE group [62.7% vs. 50.2%; odds ratio (OR) =1.668; P=0.006]. This difference was primarily attributed to the T790M mutation (8.3% vs. 1.3%; OR =8.015; P<0.001), but no significant differences observed in other mutation sites between the groups. Further evaluation of factors affecting OS in patients with LUAD and MPE revealed that EGFR mutation was an independent protective factor for OS [hazard ratio (HR) 0.662, 95% CI: 0.456-0.962; P=0.03]. For patients with LUAD, MPE, and EGFR mutations, treatment with third-generation EGFR-tyrosine kinase inhibitors (TKIs) alone (HR 0.466, 95% CI: 0.233-0.930; P=0.03) or sequential first- and third-generation EGFR-TKIs (HR 0.385, 95% CI: 0.219-0.676; P=0.001) was associated with better median OS compared to first-generation EGFR-TKIs alone (first-generation EGFR-TKIs: 35 months, 95% CI: 28.4-41.6; third-generation EGFR-TKIs: 50 months, 95% CI: 37.3-62.7; sequential first- and third-generation EGFR-TKIs: 51 months, 95% CI: 45.6-56.4; P<0.001). This study found there to be a positive correlation between EGFR mutations, particularly the T790M mutation, and MPE in patients with LUAD. EGFR mutation was associated with improved OS in patients with LUAD and MPE. For patients with LUAD, MPE, and EGFR mutations, sequential treatment with first- and third-generation EGFR-TKIs or third-generation EGFR-TKIs alone is recommended, as these regimens provide significant benefit to OS.

Mitochondrial tRNAAsn, tRNACys and tRNATyr encoding genes mutations landscape in colorectal cancer patient

The colorectal cancer (CRC) is one of the significant diseases implicated in high mortality rates in the world. Multi factors contributed in the cancer development and progression like tRNA encoding genes which have been linked with colorectal cancer. The present study aimed to report Mitochondrial tRNAAsn, tRNACys and tRNATyr encoding genes mutations landscape in colorectal cancer patients. A case control design depended on using PCR-sequencing of mtDNA region consisting of three tRNA genes. Data analysis was implemented using multiple alignment seq, tRNA secondary structure construction and phylogenic tree construction. The results showed that one case (female) was 25 years old and cancer stage T3N1MX has shown 6 mutations in tRNAAsn and 3 mutations in both tRNACys and tRNATyr while other samples did not show variations in the patients and control groups. The secondary structure of varied tRNAAsn, tRNACys and tRNATyr in this case might have been affected. The phylogenetic tree showed the conservative sequence of all CRC patients except the case that has a single cluster. The present finding concluded that there was non-association between tRNAAsn, tRNACys and tRNATyr encoding genes in mtDNA with colorectal cancer. One patient has mutations in tRNAs that may be affected in tRNA secondary structure and may be contributed for cancer progression.

ANALISIS GEOGRAPHIC INFORMATION SYSTEM FAKTOR RISIKO BAYI BERAT BADAN LAHIR RENDAH (BBLR) PADA IBU HAMIL DENGAN MALARIA: STUDI KASUS

Papua has the highest rate of malaria cases among all provinces in Indonesia. Malaria is a scourge, especially among vulnerable groups, including pregnant women. Pregnant women with malaria increase the risk of giving birth to Low Birth Weight (LBW). This study aimed to analyze geographic information system risk factors for LBW in pregnant women with malaria. This research method was observational analytics using a matched case-control design. The study encompassed pregnant women residing in the Sentani health center working area, who were both afflicted with and unaffected by malaria, and sought outpatient care at the health center. With a population of 104 pregnant woman, and the sample used was the Total sampling technique. This study found that the distribution of LBW cases tends to increase if there are many malaria incidents in the area. The distribution pattern of malaria cases shows a tendency to gather in areas with high rainfall, areas with low air humidity and areas with high air temperatures, namely Nolokla and Asei Villages. To maintain the health of mothers and babies and avoid possible risks, it is necessary to increase supervision and vigilance in the months where the intensity of rain increases, namely from November to March, where rainfall is also related to humidity and temperature so that it affects the sustainability of mosquito larvae habitat

Insomnia Catastrophizing and Affective Temperaments in Major Depressive Disorder

Background and Objective We aim to assess the role of affective temperaments, insomnia severity, sleep quality, and depressive anxiety symptoms in predicting catastrophizing insomnia in patients with major depressive disorder (MDD).Methods Our study employed a case-control design, involving 90 drug-free MDD patients and 90 healthy controls (HCs) with identical sociodemographic characteristics. Participants completed a comprehensive set of assessments, including the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Insomnia Catastrophizing Scale (ICS), and Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire (TEMPS-A).Results Among the 90 MDD patients, 80% were female (n = 72), with a mean age of 32.2 ± 13.6 years. The MDD group exhibited significantly higher scores on the BDI, BAI, ISI, PSQI, ICS night, ICS daytime, and ICS total scores, along with depressive, cyclothymic, irritable, and anxious temperament scores, compared to the HCs (p &lt; 0.001). Notably, the hyperthymic temperament showed no correlation with insomnia catastrophizing in either group. Our findings revealed that the ISI score was a predictive factor for the ICS night; age and ISI were predictive factors for the ICS daytime; and age, anxious temperament, and ISI were predictive factors for the ICS total in the MDD group.Conclusions The severity of insomnia, young age, and an anxious temperament were identified as positive predictors of insomnia catastrophizing.

A CASE-CONTROL STUDY OF HEMATOLOGICAL ANALYSIS ON DIABETES AND COVID-19 SEVERITY

This study investigates the relationship between diabetes comorbidity and COVID-19 severity in Muhammadiyah Palembang Hospital, focusing on hematological parameters as potential predictors of disease progression. Utilizing a case-control design with 61 respondents, demographic data, COVID-19 severity classifications, and hematological profiles were analyzed. Results reveal a prevalence rate of diabetes mellitus among COVID-19 patients at 32.8%, with diabetic individuals experiencing higher rates of moderate clinical complications. Hematological analysis demonstrates variations in parameters such as hemoglobin levels, platelet counts, and neutrophil-to-lymphocyte ratio between diabetic and non-diabetic COVID-19 patients. These findings underscore the importance of tailored interventions for diabetic individuals infected with COVID-19 and highlight the potential of hematological parameters in predicting disease severity. The study suggests the need for larger-scale, multicenter research to validate findings and inform evidence-based clinical practice in managing COVID-19 patients with comorbid diabetes mellitus.

History of symptoms consistent with REM sleep behavior disorder in a population with Parkinson's Disease

REM Sleep Behavioral Disorder (RBD) is a parasomnia marked by the maintenance of muscle tone during REM sleep. Evidence has placed RBD as one of the possible prodromal stages of Parkinson's Disease (PD), but data on the proportion of people with PD who have had symptoms of RBD are limited. This study aimed to investigate the history of symptoms compatible with RBD in a population with PD. The sample was composed by 73 patients with clinically diagnosed PD being followed up at a reference outpatient setting, compared to 73 age- and sex-matched individuals with no PD. The evaluation of symptoms compatible with RBD was performed using the Brazilian version of the RBD Screening Questionnaire (RBDSQ). The prevalence of symptoms compatible with RBD was 65 % for PD and 10.09 % for controls. The RBDSQ score was significantly higher in the PD group (6.03 ± 0.35) in comparison to the control group (2.38 ± 0.23). The odds ratio for presenting previous RBD-compatible symptoms was 12.09 in favor of positive PD cases. PD diagnosis has the following diagnostic properties in relation to presenting RBD symptoms: sensitivity of 0.65, specificity of 0.86, positive predictive value of 0.82 and negative predictive value of 0.71. In conclusion, the proportion of PD patients showing RBD symptoms is high, corroborating the expected neuroprogression of the disease on a case-control design comprising outpatient PD cases. Clinical practitioners should include evaluations of RBD-compatible symptoms during the PD assessment and, if positive, forward to a sleep specialist.

Memory T-Cells Contribute to Calcium Release from Bones during Lactation in Mice

Objective: Milk production during lactation places a high demand for calcium that is fulfilled both from maternal bone resorption and diet. While it is known that mammary gland-derived PTHrP drives bone resorption during lactation, the impact of postpartum estrogen loss on bone has been unclear. Methods: We used a case-control study design to test the effect of estrogen loss in lactating mice. Results: In the present study, we show for the first time that estrogen loss during lactation activates memory T-cells (TM) to produce TNFα and IL-17A to aid in bone resorption and calcium release. Our studies reveal a new mechanism for the release of calcium from bone postpartum. The findings provide several new insights. First, the immune system plays a critical role in milk production postpartum. Second, evolutionarily, the pathway serves the physiological purpose of increasing bone resorption to release calcium for breastmilk production postpartum but becomes maladaptive postmenopause, leading to osteoporosis. Finally, these results highlight the crosstalk between the brain–bone–breast–endocrine axis and the immune system during lactation.

Co-Occurring Mental and Physical Health Conditions Among Older Adults With and Without Post-traumatic Stress Disorder: A Case Control Study.

Rates of post-traumatic stress disorder (PTSD) among older adults range from 0.4%-4.5%. Research examining PTSD in adults has demonstrated numerous associations between physical and mental health conditions; however, these are less well characterized in older adults. The current study aimed to identify base rates of such conditions among older adults with and without a history of PTSD. In a case control design using the National Alzheimer's Coordinating Center Uniform Data Set, adults 65 years or older from the United States who endorsed either the presence or absence of PTSD were matched by age to assess between-group differences (N = 472; 236 pairs). We examined differences across self-reported sociodemographics and physical health, mental health, and substance use histories. More participants with a history of PTSD identified as Hispanic, non-white, non-married, and functionally independent. Compared to individuals without a history of PTSD, significantly more individuals with a history of PTSD had histories of depression, anxiety, substance abuse, Parkinson's disease, seizures, insomnia, and TBI. Among participants without PTSD history, only 14.7% reported a history of TBI, compared to 41.1% of individuals with PTSD history. Findings showed expected trends toward worse physical and mental health among older adults with self-reported PTSD. There was a striking difference in the frequency of TBI history between participants with and without PTSD. These findings underscore a need to assess for PTSD among older adults, particularly those reporting a history of TBI.

Abstract A001: Health expenditure trajectory and gastric cancer incidence in the National Health Insurance Senior Cohort: A nested case-control study

Abstract Background: Gastric cancer is the fourth most common cancer and highly prevalent in South Korea. Given its prolonged disease progression, understanding the impact of health expenditure patterns over time is crucial. This nested case-control study aimed to identify the association between health expenditure trajectory and incidence of gastric cancer. Methods: Data from the National Health Insurance Service Senior Cohort of South Korea were used. Individuals diagnosed with gastric cancer (N = 14,873) were matched to a non-diagnosed group (N = 44,619) in a 1:3 ratio using a nested case-control design. A latent class trajectory analysis was performed to identify the patterns of health expenditure among the matched participants. Furthermore, conditional logistic regression analysis was conducted to examine the relationship between healthcare expenditure trajectories and gastric cancer incidence. Results: Seven distinct health expenditure trajectories over a 5-year period were identified: consistently lowest (13.9%), rapidly increasing (6.4%), gradually increasing (14.1%), consistently second-highest (22.1%), middle-low (17.8%), gradually decreasing (12.8%), and consistently highest (12.9%). Compared to the Middle-low group, individuals in the rapidly increasing (OR = 2.07; 95% confidence interval [CI], 1.90–2.25), consistently lowest (OR = 1.43; 95% CI, 1.33–1.55), gradually increasing (OR = 1.23; 95% CI, 1.15–1.32), and consistently highest (OR = 1.08; 95% CI, 1.01–1.17) groups exhibited a higher risk of developing gastric cancer. Conclusion: Our findings emphasize the importance of monitoring health expenditures to prevent gastric cancer. The categorization of health expenditure by trajectories allowed the identification of specific risk groups that may be targeted by appropriate interventions. Citation Format: Minjee Lee, Ki-Bong Yoo, Woo-Ri Lee. Health expenditure trajectory and gastric cancer incidence in the National Health Insurance Senior Cohort: A nested case-control study [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A001.

Estimates of vaccine effectiveness of the updated monovalent XBB.1.5 COVID-19 vaccine against symptomatic SARS-CoV-2 infection, hospitalization, and receipt of oxygen therapy in South Korea - October 26 to December 31, 2023

ObjectivesWe evaluated the vaccine effectiveness of monovalent XBB.1.5 vaccine against symptomatic COVID-19 infection, hospitalization, and the need for oxygen therapy in South Korea. DesignThis study employed a test-negative case-control design. COVID-19 test results in symptomatic subjects from six university hospitals across South Korea were collected (October 26–December 31, 2023). The adjusted absolute and relative vaccine effectiveness were assessed. ResultsIn total, 5516 subjects were enrolled: 4,824 were unvaccinated with XBB.1.5, and 692 were vaccinated with XBB.1.5 COVID-19 mRNA vaccines. The absolute vaccine effectiveness when comparing the odds between XBB.1.5 vaccination and no vaccination against symptomatic COVID-19 infection, hospitalization, and oxygen therapy was 65.2% (95% CI, 36.1-81.0), 77.3% (95% CI, 51.1-89.5), and 85.3% (95% CI, 57.8-94.9), respectively. The relative vaccine effectiveness when comparing the odds between XBB.1.5 vaccination and no XBB.1.5 vaccination against symptomatic COVID-19 infection, hospitalization, and oxygen therapy was 57.7% (95% CI, 34.7-72.6), 64.3% (95% CI, 35.9-80.2), and 65.5% (95% CI, 27.0-83.7), respectively. ConclusionThe short-term effectiveness of the XBB.1.5 vaccine against symptomatic COVID-19 infection, hospitalization, and receipt of oxygen therapy in South Korea was significant. Long-term vaccine effectiveness warrants evaluation, and these assessments should be conducted regularly.