Exposure Factors Research Articles

Emergence of Streptococcus suis infection from Goa, India

Abstract Streptococcus suis is an emerging zoonotic bacterium that causes severe invasive disease in humans. In India, only two human case reports have been recorded till now. In the present report, we described the clinical case report along with an epidemiological investigation of the first S. suis case from Goa, India. The clinical presentation and detailed history regarding the potential exposure factors for the infection were recorded and to trace the source of the infection, the meat markets and the backyard piggeries in the vicinity of the patient’s residence were investigated. Case definitions were formulated and enhanced surveillance was initiated in the State to identify any additional cases. The case-patient was a co-morbid 63-year-old female, who was provisionally diagnosed with meningitis and septicaemia and S . suis infection was detected using automated microbial identification systems. The epidemiological investigation revealed that the patient was involved in handling raw pork one day prior to the symptom onset. Based on the active case finding, no additional case of S. suis was detected in the area. The present case was a sporadic case of S. suis in Goa, India and case-patient may have been exposed to the bacteria by handling raw pork while cooking. One Health impact statement Our investigation described the 3rd case of Streptococcous suis from India. This is significant because despite the abundance of the source of infection across the country i.e. high prevalence in the pig population, there are unusually low number of human cases, which can be attributed to very low clinical index of suspicion and lack of diagnostic tests in humans, as evidenced in the present case. A multi-disciplinary One Health approach has been applied for the present case investigation as the Human Health, Animal Health and Food Safety aspects were investigated in collaboration with the State Health & Animal Husbandry departments along with the academia. The findings of the present investigation will aid in enhancing the clinical index of suspicion among clinicians and awareness among high-risk groups like veterinarians for S. suis infection in humans and animals. The multi-disciplinary One Health approach aided us in tracing the source of the infection, which would help in generating evidence for designing preventive interventions.

EFFECTIVE DOSE ANALYSIS IN ABDOMEN AP EXAMINATION PATIENTS WITH CALDOSE_X VERSION 5.0

This study evaluates radiation dose exposure during diagnostic radiology procedures using X-rays and their potential risks, including cancer, to optimize radiation safety through the CALDose_X software that calculates the absorbed organ dose, effective dose, and cancer risk, according to the lowest possible achievable (ALARA) principle. This study used a quantitative experimental design to evaluate the impact of filter thickness variations on Entrance Surface Air Kerma (ESAK) and effective dose by analyzing data from 54 patients undergoing AP Abdominal X-ray examinations. The results showed that the effective dose to the abdominal organs varied with exposure factors and Focus to Detector Distance (FDD), where the colon wall had the highest sensitivity with doses ranging from 0.030 mSv to 0.126 mSv, followed by the stomach and pancreas. Increasing kV, mAs, and FDD increased the effective dose, emphasizing the importance of careful dose management. This study concluded that exposure factors and FDD affect the effective dose received by the abdominal organs, with recommendations to monitor patient doses, revise national diagnostic reference levels, and establish standard protocols with health authorities. Keywords: CALDose_X, X-ray Exposure Factor, patient dose, ESAK, Effective Dose, Abdomen AP.

The relationship between pulmonary ventilation function and bone marrow hematopoietic function: A mendelian randomization analysis

Background: In recent years, the comorbidity between respiratory and hematopoietic system diseases has emerged as a new challenge. However, the potential genetic link between the ventilatory function of the respiratory system and the hematopoietic function of the bone marrow remains unclear. In this study, we conducted a comprehensive investigation into the possible genetic connection between lung ventilatory function and bone marrow hematopoietic function. Methods: We selected two exposure factors, Forced Expiratory Volume in 1 second (FEV1) and Forced Vital Capacity (FVC), which represent pulmonary ventilation function, and two outcome indicators, Immature Fraction of Reticulocytes (IFR) and Reticulocyte Count (RC), which represent bone marrow hematopoiesis function, from published genome-wide association studies. Based on the three core assumptions of Mendelian randomization analysis, we extracted Single Nucleotide Polymorphism (SNPs) associated with FEV1 and FVC as instrumental variables for the exposure factors. We then conducted two-sample Mendelian randomization analyses using inverse variance weighted (IVW), weighted median, and MR-Egger regression methods. Lastly, we assessed the reliability of the testing results through MR-Egger, Cochran’s Q test, and the leave-one-out test. Through these steps, we aimed to explore the causal relationship between pulmonary ventilation function and the outcome of bone marrow hematopoiesis function and evaluated the reliability of the testing results using methods such as MR-Egger, Cochran’s Q test, and the leave-one-out test. Results: The IVW method revealed that a decrease in FEV1 is associated with an increase in IFR (β = −0.072, 95% CI: −0.131 to −0.014, p = 0.01), and the results from MR-Egger regression showed a similar association (β = −0.169, 95% CI: −0.342 to −0.004, p = 0.05). Furthermore, a decrease in FEV1 is associated with an increase in RC (β = −0.143, 95% CI: −0.198 to −0.087, p =4.00E-07), and MR-Egger regression yielded consistent results (β = −0.216, 95% CI: −0.381 to −0.541, p=1.07E-02). Similarly, a decrease in FVC is associated with an increase in IFR (β = −0.073, 95% CI: −0.116 to −0.031, p = 6.17E-04), and MR-Egger regression showed a similar trend (β = −0.046, 95% CI: −0.160 to −0.067, p=0.42). Additionally, a decrease in FVC is associated with an increase in RC (β = −0.173, 95% CI: −0.221 to −0.125, p = 2.33E-12), and MR-Egger regression yielded consistent results (β = −0.142, 95% CI: −0.272 to −0.012, p = 3.32E-02). The reliability tests indicated heterogeneity in the above MR analyses but no evidence of horizontal pleiotropy. Therefore, a fixed-effect model IVW was used to explore the causal relationships, which were found to be robust and reliable with no outliers or significant bias in this study. Conclusion: This study indicates that there is a negative causal relationship between pulmonary ventilation function and bone marrow hematopoietic function. A decrease in pulmonary ventilation function stimulates bone marrow hematopoiesis. However, further research is needed to elucidate this mechanism.

Risk Factors and Injury Prevention in the Throwing Athlete

Arm injuries are the most common throwing injury, with growing concern as the most severe injuries, such as UCL reconstruction continue to rise. Furthermore, throwing injuries are frequently recurrent suggesting once injured, players are at increased risk for another arm injury. The increase in injury rates and severity has been attributed to increases in pitching volume and year around participation, and specialized training. Thus, initial efforts to prevent arm injuries by USA Baseball and Little League have focused on the extrinsic factor of pitching exposure in the form of pitch counts, yet arm injury rates have stayed constant. Therefore, injury prevention strategies should include extrinsic factors, and address modifiable, intrinsic factors that are associated with arm injury. Collectively addressing factors such as shoulder range of motion and strength deficits, trunk and lower extremity function, and implantation of training programs yields a comprehensive approach to reduce arm injury rates. We will use a directed acyclic graph (DAG) to organize how the internal factors (i.e. fatigue, injury history, ROM and strength) interact with the external factors (i.e. training load and pitching exposure) and how together they are thought contribute to potential injury and inform arm injury reduction strategies. This will provide a roadmap to build adaptable arm injury reduction strategies to improve the modifiable physical factors in context of the external factors that change over time and between throwing athletes. Level of EvidenceLevel V, Expert Opinion

Changes in the prevalence of hepatitis B and C viral infections in Sindh province, Pakistan: Findings from two sero-surveys in 2007 and 2019.

Pakistan harbours a large burden of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. We utilised repeat sero-surveys to assess progress achieved towards hepatitis elimination in Pakistan. Multilevel logistic regression evaluated the change in HBV infection (HBV surface antigen (HBsAg)-positive) prevalence and HCV exposure (HCV antibody (HCV-Ab)-positive) prevalence between two sero-surveys from 2007 and 2019 for Sindh province and associated risk factors. Adjusted odds ratios (aORs) were estimated and population-attributable fractions (PAF) for modifiable risk factors for HCV exposure. The 2007 and 2019 surveys included 8855 and 6672 individuals. HBsAg prevalence decreased from 2.6% (95% confidence intervals (95% CI): 2.2-2.9) in 2007 to 1.1% (95% CI: 0.8-1.3) in 2019, while HCV-Ab prevalence increased from 5.1% (95% CI: 4.6%-5.5%) to 6.2% (95% CI: 5.6%-6.8%). The age and gender-adjusted HBsAg prevalence decreased by 80% (aOR = 0.2, 95% CI: 0.1-0.4) among children and 60% (aOR = 0.4, 95% CI: 0.3-0.6) among adults over 2007-2019, while HCV-Ab prevalence decreased by 60% (aOR = 0.4, 95%CI:0.2-0.7) in children and increased by 40% (aOR = 1.4, 95% CI: 1.2-1.7) in adults. HCV-Ab prevalence was lower in adults with secondary (aOR = 0.6, 95% CI: 0.5-0.8) and higher (aOR = 0.5, 95%CI:0.3-0.8) education compared to illiterates and higher among adults reporting blood transfusion (aOR = 1.7, 95% CI: 1.2-2.4), family history of hepatitis (aOR = 2.5, 95% CI: 1.9-3.3), past year medical injection (aOR = 2.1, 95% CI: 1.6-2.7), being tattooed (aOR = 1.4, 95% CI: 1.0-1.9) and shaved by traditional barber (aOR = 1.2, 95% CI: 1.0-1.5). Modifiable risk factors accounted for 45% of HCV exposure, with medical injection(s) accounting for 38% (95%CI,25.7-48.4%). Overall HCV has increased over 2007-2019 in Sindh province, while HBV prevalence has decreased. Medical injections should be an important focus of prevention activities.

Multicenter study of factors associated with nonsurvival in hospitalized periparturient goats.

Periparturient reproductive complications appear to be common in hospitalized goats. More information is needed about periparturient reproductive complications and survival in goats with these conditions. Identify exposure factors associated with nonsurvival in periparturient does hospitalized ≤1 day or ≥2 days. A total of 198 periparturient does presented to 9 university veterinary hospitals from October 2021 to June 2022. Multicenter, matched case-control study. Conditional logistic regression was used to identify exposure factors associated with nonsurvival in periparturient does hospitalized ≤1 day or ≥2 days. Overall doe survival was 79% (156/198). Survival in the 1st day of hospitalization was 71% (52/73) and survival in does hospitalized ≥2 days was 83% (104/125). Among goats hospitalized ≤1 day, labor duration before admission (odds ratio [OR] = 4.8; P = .04), uterine tears (OR = 48.2; P < .001), and vaginal/perineal trauma diagnosed during hospitalization (OR = 6.2; P = .03) were associated with nonsurvival. Among goats hospitalized ≥2 days, factors associated with nonsurvival included labor duration before admission (OR = 6.2; P = .004), pregnancy toxemia (OR = 6.07; P = .04), and Cesarean section (OR = 11.35; P = .02). Longer labor duration before admission is an important predictor of nonsurvival in hospitalized does. Clients should be educated that early detection and veterinary care are critical for improving outcome in periparturient does.

Assessment of variations in upper and lower gonial angle in children with mouth breathing habit

Background: Mouth breathing is one of the most common deleterious oral habits in children. The habitual position of muscles inside and outside the mouth will affect dental development. Mouth breathing influences skeletal growth and thereby affects the cephalometric parameters. The present study aimed to assess if there is any variation in upper and lower gonial angles in children with mouth breathing habit. Methods: The 33 patients in the age group of 8 to 12 years reporting to the Department of Pediatric and Preventive Dentistry with chief complaint of mouth breathing was selected for the study based on inclusion and exclusion criteria. Lateral cephalograms of these children were taken with a digital panoramic system under standard exposure factors, as recommended by the manufacturer. Upper and lower gonial angles were determined on the lateral cephalograms. The values obtained were tabulated and subjected to statistical evaluation. Results: The mean upper and lower gonial angles were seen to increase from the normal in children with mouth breathing habit. However, independent sample t test showed no statistically significant difference in upper and lower gonial angles with a p value of 0.598 in upper gonial angle and 0.714 in lower gonial angle. Contusions: Early detection of the changes in the upper and lower gonial angles can help a pediatric dentist in effectively framing a treatment plan in children with mouth breathing habit, to prevent further deterioration in the dental and skeletal structures and be able to correct the already occurred unfavourable changes in them.

Long-term effects of arsenic on glucose-insulin homeostasis: A gene-environment interaction study

Abstract Background Arsenic exposure and genetic factors are associated with an increased risk of type 2 diabetes, yet study of environment-gene interaction on glucose-insulin homeostasis remains scarce. We aimed to investigate the associations and interactions of urinary total arsenic (UTAs) and genetic susceptibility with glucose-insulin homeostasis through a longitudinal epidemiological study. Methods A total of 6136 observations (3063 participants) from the baseline, 3-year follow-up, and 6-year follow-up of the Wuhan-Zhuhai cohort were included in this study. In each study period, we repeatedly measured UTAs, fasting plasma glucose (FPG), fasting plasma insulin (FPI), and homeostasis model-assessed insulin resistance (HOMA-IR) and β-cell function (HOMA-β). Polygenic risk scores (PRSs) specific for all traits were constructed by corresponding genome-wide association summary statistics. Linear mixed models were used to assess associations and interactions of UTAs and PRSs with four indicators of glucose-insulin homeostasis. Results After adjustment for all covariates, the βs (95% CIs) for the annual growth rates of FPG, FPI, and HOMA-IR were 0.020 (0.008, 0.032), 0.007 (0.002, 0.013), and 0.011 (0.004, 0.017), respectively, associated with each ln-unit increase in UTAs. Compared to subjects with the first-quartile PRS and low UTAs, participants with the fourth-quartile PRS and high UTAs had a 0.029 (0.012, 0.047) or 0.032 (0.012, 0.051) ln-unit increase in the annual growth rate of FPI or HOMA-IR, respectively. UTAs and PRS had significant interactions on the longitudinal progressive increases of FPI and HOMA-IR (P interaction &amp;lt; 0.05). Conclusions Arsenic exposure and genetic variants are significantly synergistic risk factors for dysregulation and progressive deterioration of glucose-insulin homeostasis. Our findings emphasize the importance of reducing arsenic exposure to maintain normal glucose-insulin metabolism, especially for those at higher genetic risk. Key messages • Arsenic exposure was associated with annual increased rates of FPG, FPI, and HOMA-IR. • Arsenic exposure and trait-specific PRSs are synergistic risk factors for glucose-insulin homeostasis impairment.

Healthy air for healthy minds

Abstract Background The adverse health effects from exposure to air pollution is increasingly known. A recent report shows that at least 95% of the world’s population breathe air containing dangerous levels of pollutants. According to estimates from the World Health Organization (WHO), ambient air pollution is related to 4.2 million deaths every year. Less is known about the association between indoor air (especially particulate matter 2.5 and volatile organic compounds (VOC) pollution and mental health conditions. Many sources of indoor air pollution exist, such as pressed wood products, pesticides, secondhand smoke, stoves, heaters, overcrowding and fireplaces. Aims We aim to synthesize knowledge on the effects of particulate matter 2.5 in indoor air and mental health conditions. Methods We systematically reviewed the association of indoor air pollution with mental health conditions using the databases Pubmed and EMBASE. Results Exposure to indoor air pollutants is associated with increased anxiety and depression and less cognitive performance. These results are robust; however, the impact of PM2.5 is larger for less-educated and female respondents. Females cook with solid fuels and biomass more often. Physical exposure and gender factors overlap in the exposure to indoor air pollutants. Discussion Poor indoor air quality should be part of a comprehensive assessment of factors influencing mental health and cognition. Neuroinflammation might explain the effects of poor air on mental health and cognition. Further research is needed to combine research on the social determinants of mental health and the effects of indoor air. Studies in different settings such as home, work, and hospitals are needed to better understand the specific exposures of indoor air pollution and mental health conditions in different population groups.

Social Media Shaping Youth’s Perception of Moroccan Female Political Leaders

This paper addresses the role of social media consumption amongst youth and its implications in shaping their perceptions of Moroccan female political leaders. Based on examining previous scholarly works, this research investigates a large body of literature including how social media platforms impacts youth’s engagement in political and civic activities. The role of social media in shaping perceptions about female political leaders is also discussed from a theoretical standpoint. Aiming to identify, the influence of a number of identified form the literature, this paper adopted a quantitative strategy utilizing a survey that was addressed to (N=309) participant targeted on both social media platforms and within university campus. Based on the descriptives, the correlation analysis and regression analysis of the data gathered, this study identified that the level of education, social media exposure, online interactions, political awareness, and cultural factors significantly influence youth’s perceptions of female political leaders. These findings highlight the factors influencing young adults’ perceptions about the Moroccan political landscape and the importance of media education and literacy to enhance critical thinking skills amongst Moroccan youth.

Occupational class difference in COVID-19 symptoms in France: contribution of work-related exposures

Abstract Background The association between socio-occupational class and SARS-CoV-2 infection remains inconclusive and may depend on the setting and the pandemic stage. Our study aims to quantify self-reported COVID-19 symptoms by occupational class (OC) in spring 2020 in France and explain observed differences using work-related risk factors. Methods We analyzed data from the EpiCoV population-based cohort, comprising 46,849 active workers aged 18-64 in metropolitan France. COVID-19 symptoms were sudden loss of taste/smell, fever with cough, fever with shortness of breath, or fever with chest oppression. Separating regions highly affected by COVID-19 from other regions, we related OC with reporting of COVID-19 symptoms and assessed the mediation effect of work-related SARS-CoV-2 exposures (contact with the public, using public transportation, self-perceived exposure) using the Karlson-Holm-Breen mediation analysis method. Results During the study period, 7.1% of the workers reported COVID-19 symptoms. In both regions, work-related SARS-CoV-2 exposures were related to higher reporting of symptoms, and those exposures were more prevalent in the lowest than in the highest OCs. However, the association of OC with reporting symptoms was not the same in the two regions. In less affected regions, the lowest OC reported COVID-19 symptoms less often than the highest OC, whereas in highly affected regions, symptoms were more frequent in middle OCs, and this was partly explained by work-related SARS-CoV-2 exposures. Conclusions Different socio-occupational patterns of symptoms were observed in the two groups of regions. The situation in the less affected regions, with more reporting in the highest relative to the lowest classes, may be attributable to exposure factors playing a role opposite to that of work-related exposures. Further studies on OC disparities in COVID-19 severity are needed based on hospitalization and mortality. Key messages • During the early pandemic, in regions less affected by COVID-19, the upper occupational class reported more COVID-19 symptoms, whereas the middle class did so in highly affected regions. • Work-related exposure to SARS-CoV-2 mediates the association between occupational class and reporting COVID-19 symptoms to some extent, even when the occupational gradient is reversed.

Mendelian Randomization Analysis of Non-small Cell Lung Cancer and Five Exposure Factors Based on Pathway Enrichment Analysis

Mendelian Randomization Analysis of Non-small Cell Lung Cancer and Five Exposure Factors Based on Pathway Enrichment Analysis

Causal associations of MICB, CTSA, and MMP9 proteins with oral cancer: Mendelian randomization study

Oral cancer (ORCA) is the most prevalent histological subtype of oral malignancies in which immune modulation is relevant. The goal of this work was to employ Mendelian randomization (MR) to investigate the causal connection between the immune-related proteins MICB, CTSA, MMP9, and ORCA. The Open GWAS database of the Integrative Epidemiology Unit (IEU) was accessed to collect GWAS data for ORCA (ieu-b-4961), MICB (prot-a-1898), CTSA (prot-a-717) and MMP9 (prot-a-1921). From 372,373 samples, the ORCA dataset comprises 7,723,107 single nucleotide polymorphisms (SNPs). MICB, CTSA, and MMP9 all have 10,534,735 SNPs and 3,301 sample sizes. Then, the primary SVMR implementation approaches were weighted mode, simple mode, inverse variance weighted (IVW), weighted median, and MR-Egger. IVW was the most effective technique. A sensitivity study was also carried out to assess the correctness of SVMR data, with special focus devoted to heterogeneity, horizontal pleiotropy, and Leave-One-Out (LOO). MVMR was eventually implemented as well. A Mendelian randomization analysis of the three exposure factors in the dataset (ieu-b-94, ebi-a-GCST012237) was also performed to validate the study results. According to the SVMR results, there was a noteworthy causal interaction between ORCA and MICB (P = 0.0014), MMP9 (P = 0.0343), and CTSA (P = 0.0003). Furthermore, odds ratios (ORs) values revealed that MMP9 (OR = 1.0005) was an ORCA risk factor, whereas MICB (OR = 0.9994) and CTSA (OR = 0.9993) were security factors. The robustness of the SVMR findings was confirmed by the p-values of the heterogeneity and horizontal pleiotropy, both of which were greater than 0.05. The MVMR result did not affect any of the safety or hazard features of these three exposure factors. However, the P value for MMP9 was greater than 0.05, implying that MICB and CTSA may have a greater influence on ORCA than MMP9. The validation outcomes in both datasets harmonized with the findings from previous research, thereby solidifying the reliability of results. Our investigation provided a crucial resource for further research on the subject by demonstrating a causal relationship between ORCA and MICB, CTSA, and MMP9.

The causality between gut microbiota and functional dyspepsia: A two-sample Mendelian randomization analysis.

To investigate the potential link between gut microbiota and functional dyspepsia (FD). Genome-wide association studies (GWAS) of gut microbiota and FD were used in Mendelian randomization (MR) research. Using the GWAS of 18,340 people, instrumental variables related to gut microbiota as an exposure factor were identified. In a GWAS investigation, 189,695 control individuals and 4376 FD patients were included as outcome variables. The primary analysis technique was inverse variance weighted analysis. The reliability of MR analysis results is tested using sensitivity analysis. Two-sample Mendelian randomization analysis revealed the presence of 7 gut microbiota associated to FD. In the inverse variance weighted analysis method, Order Erysipelotrichales (odds ratio (OR): 1.301; 95% confidence interval (CI): 1.016, 1.665; P = .037), Family Erysipelotrichales (OR: 1.301; 95% CI: 1.016, 1.665; P = .037), Genus Haemophilus (OR: 1.236; 95% CI 1.059, 1.442; P = .007), Genus Ruminiclostridium 9 (OR: 1.422; 95% CI: 1.078, 1.877; P = .013), Genus Lachnospiraceae NK4A 136 group (OR: 1.297; 95% CI: 1.059, 1.589; P = .012) was positively associated with FD. Class Gammaproteobacteria (OR: 0.705; 95% CI: 0.522, 0.952; P = .022) and Genus Erysipelatoclostridium (OR: 0.747; 95% CI: 0.628, 0.888; P = .001) were found to be inversely related to FD. There was no evidence of pleiotropy or heterogeneity in the sensitivity analysis. Our research provides evidence for a possible link between FD and a number of gut microbiota. The role that gut microbiota plays in the development of FD requires more investigation.

Bidirectional causal relationship between glucose-lipid metabolism, obesity indicators, and myocardial infarction: a bidirectional Mendelian randomization analysis study

Objective: To explore the causal association of glucose-lipid metabolism and obesity indicators with myocardial infarction by a two-sample Mendelian randomization analysis. Methods: Single nucleotide polymorphisms (SNPs) related to phenotypes were obtained from genome-wide association study databases. The body mass index (BMI) and glycated hemoglobin dataset includes 99 998 samples and 8 126 035 SNPs; the waist-to-hip ratio dataset includes 224 459 samples and 2 562 516 SNPs; the waist circumference and hip circumference dataset includes 462 166 samples and 9 851 867 SNPs; the fasting glucose dataset includes approximately 12 million SNPs; the low-density lipoprotein cholesterol (LDL-C) dataset includes 201 678 samples and 12 321 875 SNPs; the high-density lipoprotein cholesterol (HDL-C), and triglycerides dataset includes 156 109 samples and 15 784 414 SNPs; and the body fat percentage, whole-body fat mass, trunk fat percentage, and trunk fat mass dataset includes 454 588 samples and 9 851 867 SNPs. This study primarily used inverse-variance weighted method to analyze the associations between various exposure factors and outcomes. Heterogeneity among SNPs was assessed using Cochran's Q test, and horizontal pleiotropy of SNPs was examined using the MR-Egger method. Additionally, a multivariable MR approach was used to adjust for BMI, further validating associations between exposure factors and the risk of myocardial infarction. Results: Higher BMI (OR=1.070, 95%CI: 1.041-1.100), waist-to-hip ratio (OR=1.366, 95%CI: 1.113-1.677), LDL-C (OR=1.638, 95%CI: 1.488-1.803), triglycerides (OR=1.445, 95%CI: 1.300-1.606), waist circumference (OR=1.841, 95%CI: 1.650-2.055), hip circumference (OR=1.247, 95%CI: 1.132-1.372), body fat percentage (OR=1.795, 95%CI: 1.568-2.055), whole-body fat mass (OR=1.519, 95%CI: 1.381-1.670), trunk fat percentage (OR=1.538, 95%CI: 1.374-1.723), and trunk fat mass (OR=1.421, 95%CI: 1.294-1.561), as well as lower HDL-C (OR=0.799, 95%CI: 0.729-0.875), have causal effects on myocardial infarction (all P<0.05). After adjusting for BMI, hip circumference, trunk fat percentage, and trunk fat mass were no longer associated with myocardial infarction. However, waist-to-hip ratio (OR=1.457, 95%CI: 1.132-1.877), fasting glucose (OR=1.191, 95%CI: 1.024-1.383), glycated hemoglobin (OR=1.129, 95%CI: 1.034-1.233), LDL-C (OR=1.592, 95%CI: 1.314-1.929), triglycerides (OR=1.410, 95%CI: 1.279-1.553), waist circumference (OR=1.922, 95%CI: 1.448-2.551), body fat percentage (OR=1.421, 95%CI: 1.072-1.884), and whole-body fat mass (OR=1.295, 95%CI: 1.031-1.626) remained positively associated with myocardial infarction, while HDL-C (OR=0.809, 95%CI: 0.729-0.897) remained negatively associated. Conclusions: Abdominal obesity and dysregulation of glucose-lipid metabolism are risk factors for myocardial infarction. Screening for glucose-lipid metabolism (fasting glucose, HDL-C, LDL-C, triglycerides) and obesity-related indicators (waist circumference, waist-to-hip ratio, body fat percentage, and whole-body fat mass) is of great importance for the primary prevention of myocardial infarction.

Co-developing frameworks towards environmentally directed pharmaceutical prescribing in Scotland – A mixed methods study

The presence of human pharmaceuticals in the aquatic environment is recognised internationally as an important public health and environmental issue. In Scotland, healthcare sustainability targets call for improvements to medicine prescribing and use to reduce healthcare's impact on the environment. This proof-of-concept study aimed to develop a framework on the environmental impact of pharmaceuticals to use as a knowledge support tool for healthcare professionals, focussing on pharmaceutical pollution. Nominal Group Technique was applied to achieve consensus on pharmaceuticals and modelling factors for the framework, working with a panel of cross-sector stakeholders. Bayesian Belief Network modelling was applied to predict the environmental impact (calculated from hazard and exposure factors) of selected pharmaceuticals, with Scotland-wide mapping for visualisation in freshwater catchments. The model calculated the pollution risk score of the individual pharmaceuticals, using the ratio of prescribed mass vs. mass that would not exceed the predicted no-effect concentration in the freshwater environment. The pharmaceuticals exhibited different risk patterns, and spatial variation of risk was evident (generally related to population density), with the most catchments predicted to exceed the pollution risk score for clarithromycin (probability >80 % in 35 of 40 modelled catchments). Simulated risk scores were compared against observed risk calculated as the ratio of measured environmental concentrations from national regulatory and research monitoring and predicted no-effect concentrations. The model generally overpredicted risk, likely due to missing factors (e.g. solid-phase sorption, temporal variation), low spatial resolution, and low temporal resolution of the monitoring data. This work demonstrates a novel, trans-disciplinary approach to develop tools aiding collation and integration of environmental information into healthcare decision-making, through application of public health, environmental science, and health services research methods. Future work will refine the framework with additional clinical and environmental factors to improve model performance, and develop electronic interfaces to communicate environmental information to healthcare professionals.

The association between dietary consumption habits and psoriasis: a two-sample Mendelian randomization study.

Psoriasis is a chronic inflammatory skin disease characterized primarily by erythema and scales, having a wide-ranging impact globally. Previous studies have suggested that dietary consumption habits may influence psoriasis. The objective of this study was to determine the causal relationship between dietary consumption habits and psoriasis using the Mendelian Randomization (MR) approach. SNP data for 29 dietary consumption habits and psoriasis were obtained from the GWAS catalog database and the FinnGen database, respectively. The Mendelian Randomization analysis was performed using R software, with the 29 dietary consumption habits as the exposure factors and psoriasis as the outcome. Three MR analysis methods-Inverse Variance Weighted (IVW), Weighted Median Estimator (WME), and MR-Egger regression-were employed to study the causal relationship between dietary consumption habits and psoriasis. The IVW analysis indicated an OR (95%CI) of 0.065 (0.008-0.555), p = 0.012, demonstrating a negative correlation between the consumption of dried fruit and psoriasis. Among the 29 dietary consumption habits analyzed, the intake of dried fruits is a protective factor against psoriasis. Therefore, it is clinically advisable to appropriately increase the intake of dried fruits among patients with psoriasis, serving as a nutritional therapy method in conjunction with pharmacological treatment.

Association between dried fruit intake and kidney function: research from univariate and multivariate Mendelian randomized studies.

Observational studies have identified an association between dried fruit intake and kidney function. However, these studies have limitations such as vulnerability to confounders and reverse causality bias. Therefore, this study aimed to explore the potential causal relationship between dried fruit intake and kidney function. A two-sample Mendelian randomization (MR) study was conducted using a large-scale genome-wide association study dataset to investigate the causal relationship between dried fruit intake and kidney function markers (blood urea nitrogen (BUN), creatinine (CR), uric acid (UA), cystatin C (CyC), hematuria, microalbuminuria). The main analytical method was inverse variance weighting. In addition, we applied the MR Egger and weighted median to assess the robustness of the results. Finally, Multivariate Mendelian randomization (MVMR) was used to estimate the direct effect of dried fruit intake on kidney function markers. The univariate MR analysis showed that increased dried fruit intake was associated with lower kidney function markers, including BUN (β: -0.171, 95% confidence interval (CI): -0.239 to -0.102, p = 1.063 × 10-6), CR (β: -0.205, 95% CI: -0.311 to -0.099, p = 1.455 × 10-4), UA (β = -0.317, 95% CI: -0.384 to -0.249, p = 4.439 × 10-20), and CysC (β = -0.323, 95% CI: -0.384 to -0.249, p = 1.074 × 10-11); however, it was unrelated to hematuria and microalbuminuria. Causality persisted after performing MVMR analysis; however, with the addition of alcohol consumption and smoking as exposure factors, the causality for UA (β = -0.296, 95% CI: -0.523 to -0.068, p = 1.094 × 10-2) and CysC (β = -0.238, 95% CI: -0.465 to -0.011, p = 4.024× 10-2) weakened, while the causality for BUN (β = -0.038, 95% CI: -0.215 to 0.138, p = 6.698 × 10-1) and CR (β = -0.038, 95% CI: -0.431 to 0.046, p = 1.347 × 10-1) disappeared. Increased dried fruit intake was associated with lower kidney function markers (BUN, CR, UA, and CysC) in the absence of smoking and alcohol consumption; however, the causal relationship between dried fruit intake and BUN and CR disappeared in the presence of smoking and alcohol consumption. These results provide a promising avenue for delaying the course of chronic kidney disease.

Genes Related to Motility in an Ionizing Radiation and Estrogen Breast Cancer Model

Breast cancer is a major global health concern as it is the primary cause of cancer death for women. Environmental radiation exposure and endogenous factors such as hormones increase breast cancer risk, and its development and spread depend on cell motility and migration. The expression of genes associated with cell motility, such as ADAM12, CYR61, FLRT2, SLIT2, VNN1, MYLK, MAP1B, and TUBA1A, was analyzed in an experimental breast cancer model induced by radiation and estrogen. The results showed that TUBA1A, SLIT2, MAP1B, MYLK, and ADAM12 gene expression increased in the irradiated Alpha3 cell line but not in the control or the malignant Tumor2 cell line. Bioinformatic analysis indicated that FLERT2, SLIT2, VNN1, MAP1B, MYLK, and TUBA1A gene expressions were found to be higher in normal tissue than in tumor tissue of breast cancer patients. However, ADAM12 and CYR61 expressions were found to be higher in tumors than in normal tissues, and they had a negative correlation with ESR1 gene expression. Concerning ESR2 gene expression, there was a negative correlation with CYR61, but there was a positive correlation with FLRT2, MYLK, MAP1B, and VNN1. Finally, a decreased survival rate was observed in patients exhibiting high expression levels of TUBA1A and MAP1B. These genes also showed a negative ER status, an important parameter for endocrine therapy. The genes related to motility were affected by ionizing radiation, confirming its role in the initiation process of breast carcinogenesis. In conclusion, the relationship between the patient’s expression of hormone receptors and genes associated with cell motility presents a novel prospect for exploring therapeutic strategies.

Association of abruptio placentae with hypertension in pregnancy: Analysis of risk factors in Nigerian women

AbstractObjectiveThe incidence of abruptio placentae complicating hypertensive diseases of pregnancy is high in Nigerian referral hospitals. We conducted a retrospective case‐control study to identify the socio‐demographic, behavioural, and clinical risk factors associated with abruptio placentae in women with hypertensive diseases of pregnancy.MethodsThe 41 cases of hypertensive diseases complicated by abruptio placentae identified in the records of the University of Benin Teaching Hospital over 2 years (January 2021–December 2022) were compared with 208 women (controls) who had hypertensive diseases without developing abruptio placentae. Multiple regression analysis was used to develop maximum likelihood estimates of the adjusted odds ratios and 95% confidence intervals to predict the likelihood of the association between the exposure factors and the risk of abruptio placentae.ResultsHigh blood pressure levels at presentation, when managed, can decrease the odds for abruptio placentae by 9% OR 0.91, CI:0.83–0.9, but smoking and alcohol intake were not significantly associated with abruptio placentae. A higher haemoglobin concentration decreased the likelihood of abruptio placentae by 60% OR 0.40, (CI 0.24– 0.68), while higher birth weight babies minimally decreased the odds for abruptio placentae, OR 1.01 (CI 0.08–12.49).ConclusionWe conclude that abruptio placentae is most likely to complicate hypertensive diseases of pregnancy in Nigerian women when there are concurrent pregnancy anaemia and low birth weight babies, while higher blood pressure levels at presentation, when promptly managed, can reduce the risk of abruptio placentae. Efforts to address the concurrent management of anaemia associated with hypertensive diseases in pregnancy will most likely reduce the incidence of abruptio placentae in this population.