Residential History Research Articles

Prevalence and associated factors of preoperative abnormal electrocardiography among older surgical patients in southern Ethiopia: Multicenter cross-sectional study

BackgroundThe prevalence of abnormal electrocardiography (ECG) increases with aging, and these abnormalities may have an impact on anesthesia management. Although a normal ECG does not guarantee a healthy heart, an abnormal ECG can quickly identify a patient who is at high risk of cardiac complications.ObjectiveThe aim of this study was to determine the prevalence and associated factors of preoperative abnormal electrocardiography among older surgical patients at selected teaching hospitals in southern Ethiopia, from February 15 to June 15, 2022.MethodologyA multicenter cross-sectional study was conducted at three randomly selected teaching hospitals in southern Ethiopia on 246 elderly surgical patients recruited consecutively. Data were entered into Epidata version 4.6, then exported and analyzed in STATA version 16. A binary logistic regression model was used to examine factors associated with abnormal ECG, and variables with a P-value < 0.2 were entered into the multivariate analysis to identify independent factors. Both crude and adjusted odds ratios were reported, and a P-value < 0.05 was considered statistically significant. The data were presented using frequencies, tables, charts, and figures.ResultIn the current study, 120 (48.78%) of older surgical patients had abnormal preoperative ECGs. In terms of severity, 55.3% were classified as minor, while 44.16% were major ECG abnormalities. The most common ECG abnormalities were left axis deviation (LAD), left ventricular hypertrophy (LVH), and ST segment changes. The presence of comorbidity (AOR = 3.44, P = 0.001), age ≥ 70 years (AOR = 2.5, P = 0.011), history of angina (AOR = 5.9, P = 0.011), history of smoking (AOR = 5.07, P = 0.024) and urban residency (AOR = 1.89, P = 0.039) were the strongest risk factors for an abnormal ECG.Conclusion and recommendationOur study shows that older patients are more likely to have an abnormal ECG before surgery, regardless of symptoms or risk factors. Therefore, it is suggested that all older patients undergo preoperative ECG screening. Further prospective cohort studies are needed to investigate the impact and outcome of patients with preoperative abnormal ECG.

Prenatal exposure to ambient fine particulate matter and child lung function in the CANDLE cohort

Background Ambient fine particulate matter (PM2.5) exposure adversely impacts child airway health; however, research on prenatal PM2.5 exposure, and child lung function is limited. We investigated these associations in the ECHO-PATHWAYS Consortium, focusing on the role of exposure timing during different phases of fetal lung development. Methods We included 675 children in the CANDLE cohort born between 2007 and 2011 in Memphis, TN, USA. Prenatal exposure to ambient PM2.5 was estimated using a spatiotemporal model based on maternal residential history and averaged over established prenatal periods of lung development. Forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) were measured by spirometry at age 8–9 years. We used linear regression and Bayesian Distributed Lag Interaction Models (BDLIM) to estimate associations between exposure and lung function z-scores, adjusting for maternal/child characteristics, prenatal/postnatal tobacco exposure, and birth year/season, and evaluating effect modification by child sex and allergic sensitization. Results The average ambient concentration of PM2.5 during pregnancy was 11.1 µg/m3 (standard deviation:1.0 µg/m3). In the adjusted linear regression and BDLIM models, adverse, but not statistically significant, associations were observed between exposure during the pseudoglandular (5–16 weeks of gestation) and saccular (24–36 weeks) phases of lung development and FEV1 and FVC. The strongest association was between a 2 μg/m3 higher concentration of PM2.5 during the saccular phase and FEV1 z-score (−0.176, 95% Confidence Interval [CI]: −0.361, 0.010). The FEV1/FVC ratio was not associated with PM2.5 in any exposure window. No effect modification by child sex or allergic sensitization was observed. Conclusions We did not find strong evidence of associations between prenatal ambient PM2.5 exposure and child lung function in a large, well-characterized study sample. However, there was a suggested adverse association between FEV1 and exposure during late pregnancy. The saccular phase of lung development might be an important window for exposure to PM2.5.

Associations between sociodemographic and clinical characteristics and adherence to self-management behaviours among community-dwelling older adults with mild cognitive impairment.

Self-management is vital for individuals with mild cognitive impairment (MCI) to enhance cognitive health and mitigate the risk of dementia. However, maintaining consistent engagement in self-management strategies can be challenging for older adults with MCI. This study aimed to explore the associations between sociodemographic and clinical characteristics and adherence to self-management behaviours among community-dwelling older adults with MCI. A cross-sectional study involving 467 community-dwelling older adults with MCI was conducted from July to November 2022 across Nanjing, Xuzhou, and Lianyungang in Jiangsu Province, China. Data on sociodemographic and clinical characteristics, as well as self-management behaviours for MCI, were collected. Multiple linear and binary logistic regressions were employed to identify factors influencing self-management behaviours. Among the four recommended self-management behaviours for MCI, participants adopted an average of 1.37 ± 1.202 behaviours. Physical exercise (n = 239; 51.2%) was the most prevalent behaviour, followed by modifiable risk factors management (n = 156; 33.4%), cognitive training (n = 144; 30.8%), and cognitive function monitoring (n = 103; 22.1%). Higher education level (B = 0.286, P < 0.001), urban employee medical insurance (B = 0.621, P < 0.001), and non-smoking status (B = 0.389, P = 0.002) positively correlated with aggregate MCI self-management behaviours, while older age (B = -0.295, P < 0.001) had a negative association. Marital status, monthly income, employment status, gender, residence, and family history of cognitive disorders were also found to be associated with specific self-management behaviours for MCI. Enhancing adherence to self-management among community-dwelling older adults with MCI is critical. Sociodemographic and clinical factors should be considered to pinpoint at-risk populations and accordingly tailor support strategies.

Effect of pre- and post-migration neighborhood environment on migrants’ mental health: the case of Shenzhen, China

ABSTRACT Existing mental health studies usually disregard people’s neighborhood experiences in the past, which may have long-lasting mental health effects. This may particularly be true for migrants. To assess how the perceived pre- and post-migration neighborhood environment shapes migrants’ mental health later on in life, a quasi-longitudinal survey (N = 591) among migrants was conducted in Shenzhen, China. The risk of poor mental health was screened with the General Health Questionnaire (GHQ). Perceptions of the pre- and post-migration neighborhood environment were measured retrospectively and assessed with structural equation models. The results show that the direct pathways linking the perceived post-migration neighborhood physical (NPE) and social environment (NSE) to migrants’ mental health are significant. No direct association is found between the pre-migration neighborhood environments and mental health. The indirect path between the pre-migration NPE/NSE and mental health is significantly mediated by the post-migration NPE and NSE. Migrants’ SES development and their neighborhood attainment interplay overtime which have long-term impacts on their mental health. Our findings suggest that the pre-migration neighborhood plays a crucial role in migrants’ mental health. This confirms a path dependency of migrants’ neighborhood environment throughout their migrations. Future mental health studies are advised to incorporate neighborhood characteristics along migrants’ residential histories.

Outdoor artificial light at night and risk of conversion from mild cognitive impairment to dementia

Abstract Background A few studies have suggested that exposure to lighting during night hours, i.e. light at night (LAN), may increase the risk of dementia. In this study, we aimed to evaluate the association between exposure to outdoor artificial LAN and risk of conversion to dementia in an Italian cohort of subjects with mild cognitive impairment (MCI). Methods We recruited subjects with a diagnosis of MCI at the Cognitive Neurology Clinic of Modena Hospital in the period 2008-2014, and we followed these subjects up to 2021 for conversion to dementia. We collected their residential history and we assessed LAN exposure at subjects’ residences using satellite imagery data available from the Visible Infrared Imaging Radiometer Suite (VIIRS) for the period 2014-2022. Using a Cox-proportional hazards model adjusted for relevant confounders, we computed the hazard ratio (HR) of dementia with 95% confidence interval (CI) according to increasing LAN exposure through linear, categorical, and non-linear restricted-cubic spline models. Results Out of 53 recruited subjects, 34 converted to dementia of any type including 26 Alzheimer’s dementia. In linear regression analysis, LAN exposure was positively associated with dementia conversion (HR 1.03, 95% CI 1.00-1.06 for 1-unit increase). Using as reference the lowest tertile, subjects at both intermediate and highest tertiles of LAN exposure showed increased risk of dementia conversion (HRs 2.26, 95% CI 0.88-5.85, and 2.89, 95% CI 1.10-7.58). In spline regression analysis, the risk linearly increased up to a LAN exposure of 30 nW/cm2/sr, above which a plateau seemed to be reached. Results were almost confirmed when limited to conversion to Alzheimer’s dementia, except for an almost linear relation. Conclusions Our findings suggest that exposure to outdoor artificial LAN may increase conversion from MCI to any type of dementia, especially above 30 nW/cm2/sr, while such relation appears to be almost linear for Alzheimer’s dementia. Key messages • Light at night exposure above 30 nW/cm2/sr was associated with risk of conversion to dementia. • Light at night showed almost linear association with risk of conversion to Alzheimer’s dementia.

Residential Mobility in Childhood and Union Dissolution Later in Life

The limited existing literature studying the effects of childhood residential mobility suggests that it influences a range of life outcomes, at least in young adulthood. Little is known about how the frequency of moving in childhood is related to later-life demographic behaviour in Europe. Drawing on residential and partnership histories from the Survey of Health, Ageing and Retirement in Europe (SHARE), this paper examines whether moving in childhood relates to union dissolution in adulthood. It empirically addresses two theoretical explanations underlying the potential association: First, according to the confounding hypothesis, effects of childhood residential mobility differ by family background and resources. Second, the family stress model suggests that the accumulated stress and conflicts associated with frequent residential mobility disrupt the family and child’s social ties, resulting in worse relationship skills in later life (mediation hypothesis). Applying discrete-time event history analysis to individuals born between 1945 and 1965 in Sweden, Denmark, and Finland, we find a significant association between childhood moves (prior to age 17) and adult union dissolution. The effect’s strength varies based on the number of childhood moves, demonstrating a clear gradient. Notably, adults with three or more childhood moves exhibit a 55% higher likelihood of union dissolution compared to non-movers. These associations persist even after accounting for childhood background factors, while family stress mediates the link partially. Our findings shed light on the role of spatial mobility in shaping demographic outcomes and underscore its potential contribution to the accumulation and reproduction of life disadvantages.

Ambient air pollution exposure is associated with liver fat and stiffness in Latino youth with a more pronounced effect in those with PNPLA3 genotype and more advanced liver disease

BackgroundExposure to ambient air pollutants has emerged as a risk for metabolic-dysfunction associated steatotic liver disease (MASLD). ObjectivesWe sought to examine associations between short-term (prior month) and long-term (prior year) ambient air pollution exposure with hepatic fat fraction (HFF) and liver stiffness in Latino youth with obesity. A secondary aim was to investigate effect modification by patatin-like phospholipase domain-containing protein 3 (PNPLA3) genotype and liver disease severity. MethodsData was analyzed from 113 Latino youth (age 11–19) with obesity in Southern California. Individual exposure to particulate matter with aerodynamic diameter ≤ 2.5μm (PM2.5), ≤ 10μm (PM10), nitrogen dioxide (NO2), 8-hour maximum ozone (8hrMax-O3), 24-hr O3, and redox-weighted oxidative capacity (Oxwt) were estimated using residential address histories and United States Environmental Protection Agency air quality observations. HFF and liver stiffness were measured using magnetic resonance imaging. Linear models were used to determine associations between short-term and long-term exposure to air pollutants with HFF and liver stiffness. Modification by PNPLA3 and liver disease severity was then examined. ResultsShort-term exposure to 8hrMax-O3 was positively associated with HFF. Relationships between air pollution exposure and HFF were not impacted by PNPLA3 genotype or liver disease severity. Long-term exposure to 8hrMax-O3 and Oxwt were positively associated with liver stiffness. Associations between air pollution exposure and liver stiffness depended on PNPLA3 genotype, such that individuals with GG genotypes exhibited stronger, more positive relationships between short-term exposure to PM10, 8hrMax-O3, 24-hr O3, and Oxwt and liver stiffness than individuals with CC/CG genotypes. In addition, relationships between short-term exposure to NO2 and liver stiffness were stronger in those with severe liver disease. DiscussionAir pollution exposure may be a risk factor for liver disease among Latino youth with obesity, particularly in those with other preexisting risks for liver damage.

Long-Term Trajectories of Postoperative Recovery in Younger and Older Veterans

Major surgery sometimes involves long recovery or even permanent institutionalization. Little is known about long-term trajectories of postoperative recovery, as surgical registries are limited to 30-day outcomes and care can occur across various institutions. To characterize long-term postoperative recovery trajectories. This retrospective cohort study used Veterans Affairs (VA) Surgical Quality Improvement Program data (2016 through 2019) linked to the Residential History File, combining data from the VA, Medicare/Medicaid, and other sources to capture most health care utilization by days. Patients were divided into younger (younger than 65 years) or older (65 years or older) subgroups, as Medicare eligibility is age dependent. Latent-class, group-based trajectory models were developed for each group. These data were analyzed from February 2023 through August 2024. Surgical care in VA hospitals. Days elsewhere than home (DEH) were counted in 30-day periods for 275 days presurgery and 365 days postsurgery. A 5-trajectory solution was optimal and visually similar for both age groups (cases: 179 879 younger [mean age (SD) 51.2 (10.8) years; most were male [154 542 (83.0%)] and 198 803 older [mean (SD) age, 72.2 (6.0) years; 187 996 were male (97.6%)]). Most cases were in trajectories 1 and 2 (T1 and T2). T1 cases returned home within 30 days (younger, 74.0%; older, 54.2%), while T2 described delayed recovery within 30 to 60 days (younger, 21.6%; older, 35.5%). Trajectory 3 (T3) and trajectory 4 (T4) were similar for the first 30 days postsurgery, but subsequently separated with T3 representing protracted recovery of 6 months or longer (younger, 2.7%; older, 3.8%) and T4 indicating long-term loss of independence (younger, 1.3%; older, 5.2%). Few (trajectory 5) were chronically dependent, with 20 to 30 DEH per month before and after surgery (younger, 0.4%; older, 1.3%). In this study, trajectory models demonstrated clinically meaningful differences in postoperative recovery that should inform surgical decision-making. Registries should include longer-term outcomes to enable future research to distinguish patients prone to long-term loss of independence vs protracted, but meaningful recovery.

Childhood Air Pollution Exposure Associated with Self-reported Bronchitic Symptoms in Adulthood.

Rationale: Few studies have examined the effects of long-term childhood air pollution exposure on adult respiratory health, including whether childhood respiratory effects underlie this relation. Objectives: To evaluate associations between childhood air pollution exposure and self-reported adult bronchitic symptoms while considering child respiratory health in the Southern California Children's Health Study. Methods: Exposures to nitrogen dioxide (NO2), ozone, and particulate matter <2.5 μm and <10 μm in diameter (PM10) assessed using inverse-distance-squared spatial interpolation based on childhood (birth to age 17 yr) residential histories. Bronchitic symptoms (bronchitis, cough, or phlegm in the past 12 mo) were ascertained via a questionnaire in adulthood. Associations between mean air pollution exposure across childhood and self-reported adult bronchitic symptoms were estimated using logistic regression. We further adjusted for childhood bronchitic symptoms and asthma to understand whether associations operated beyond childhood respiratory health impacts. Effect modification was assessed for family history of asthma, childhood asthma, and adult allergies. Measurements and Main Results: A total of 1,308 participants were included (mostly non-Hispanic White [56%] or Hispanic [32%]). At adult assessment (mean age, 32.0 yr; standard deviation [SD], 4.7), 25% reported bronchitic symptoms. Adult bronchitic symptoms were associated with NO2 and PM10 childhood exposures. Odds ratios per 1-SD increase were 1.69 (95% confidence interval, 1.14-2.49) for NO2 (SD, 11.1 ppb) and 1.51 (95% confidence interval, 1.00-2.27) for PM10 (SD, 14.2 μg/m3). Adjusting for childhood bronchitic symptoms or asthma produced similar results. NO2 and PM10 associations were modified by childhood asthma, with greater associations among asthmatic individuals. Conclusions: Childhood NO2 and PM10 exposures were associated with adult bronchitic symptoms. Associations were not explained by childhood respiratory health impacts; however, participants with childhood asthma had stronger associations.

Influence of High-Altitude Residential History on Optimal HbA1c Cutoff for Detecting Abnormal Glucose Metabolism.

Aims: To explore the influence of recent high-altitude residential history on the optimal cutoff of glycosylated hemoglobin (HbA1c) for detecting abnormal glucose metabolism. Methods: The study included 505 self-reported healthy Han participants of age 18-65 years, recruited in Chengdu and categorized based on recent (within 3 months) high-altitude (>2,500 m) residential history. The 1999 WHO criteria was used as the gold standard for defining prediabetes and diabetes. HbA1c test performance was assessed using receiver operating characteristic curve, with the optimal cutoff determined by Maximum Youden index. Propensity score matching with 0.02 calipers and nearest neighbor method was used to balance confounding factors between groups. Results: Of the participants, 238 (47.13%) were populations with recent high-altitude residential history (HA group), and 267 (52.87%) were low-altitude dwellers (LA group). The HA group had slightly higher HbA1c levels (p > 0.05) and higher erythrocyte and hemoglobin levels (p < 0.05), compared to the LA group. Weak correlations between prediabetes and HbA1c levels were observed in the HA group (rs = 0.21, p < 0.05) and the LA group (rs = 0.07, p = 0.25). The optimal cutoff for the detection of diabetes was 6.5% (area under the curve [AUC] 0.94) in the HA group and 5.9% (AUC 0.97) in the LA group, which remained unchanged after adjustment for confounders. Conclusions: The optimal cutoff of HbA1c for the detection of diabetes in populations with recent history of living at high altitude was higher than that in general populations living at low altitude, and the diagnostic value of HbA1c for prediabetes was also inadequate.

A mixed method evaluation of knowledge, attitude and practice on dengue fever among Lalitpur Metropolitan City residents: a cross-sectional investigation.

Dengue poses a significant global public health challenge, including in Nepal. Understanding community's knowledge, attitudes, and behaviors concerning dengue fever is imperative to developing effective prevention and control strategies. This study aimed to assess the knowledge, attitude, and practices related to dengue fever among residents of Lalitpur Metropolitan City. A descriptive cross-sectional household study was conducted using a mixed-method approach, which included quantitatively studying 636 individuals and conducting 20 qualitative interviews. The data was collected between April 2023 and June 2023. The multistage cluster sampling method was applied for household selection during the quantitative study and a purposive judgmental sampling method was used to identify participants for the qualitative interviews. Face-to-face interviews were conducted using a structured questionnaire for the quantitative study and an interview guide for the qualitative study. Quantitative data were analysed using logistic regression in STATA version 13, and thematic analysis was applied to the qualitative data. The findings were validated through triangulation of results from both the qualitative and quantitative study. Regarding knowledge, 64.94% (n = 413/636) reported being informed about dengue fever. In terms of attitude, a substantial majority, 91.51% (n = 582/636), expressed a positive attitudes toward dengue fever, indicating a favorable perception and knowledge of its significance. Concerning practice, 49.84% (n = 317/636) of respondents reported actively engaging in dengue fever prevention measures. The variables gender, previous history of dengue fever and residency were the determinants of dengue fever knowledge. Additionally, gender, residency, and attitude were predictors of preventive practices concerning dengue fever. Our study revealed that while the community demonstrated good knowledge of dengue fever and positive attitudes toward prevention, their preventive practices were inconsistent, indicating a gap between knowledge and action. A positive attitude was linked to better adherence to preventive measures. To address this gap, it is crucial to promote a positive attitude toward dengue prevention through initiatives like education efforts and social mobilization programs. Implementing Social and Behavior Change Communication (SBCC) programs focused on dengue prevention and control measures can help bridge this knowledge-action gap.

A comparative study between current and past Helicobacter pylori infection in terms of microalbuminuria in patients with type 2 diabetes

BackgroundThe prevalence of Helicobacter pylori (H. pylori) infection and its potential relationship to various diseases is currently a focus of attention. The aim of this study is to investigate the association between current and past H. pylori infections and elevated levels of microalbuminuria in type 2 diabetic patients.MethodsTwo hundred patients with type 2 diabetes mellitus were tested for the presence of H. pylori infection. They were divided into three groups: 52 had a current H. pylori infection, 38 had a past H. pylori infection, and 110 had no H. pylori infection. All study participants underwent assessments of plasma glucose levels, glycated hemoglobin (HbA1c), albuminuria levels, inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), as well as other relevant investigations.ResultsThe prevalence of H. pylori infection (current and past) was detected in 90 out of 200 diabetic patients (45%). There was no statistically significant difference between the three groups in terms of age, diabetes duration, family history of DM, family history of hypertension, residence, or dyspeptic symptoms, indicating that current or past infection with H. pylori has no association with these variables. The current H. pylori infection group showed the highest levels of inflammatory markers, ESR and CRP, which were significantly different from those in the non-infected group (p = 0.013 and p < 0.001, respectively). The median (IQR) of albuminuria levels in the current H. pylori infection group, the past H. pylori infection group, and the non-infected group were 125 (4.8–290), 7.6 (2.4–271), and 5.1 (1.2–173), respectively. The current H. pylori infection group showed the highest albuminuria level, which was significantly different from that of the non-infected group (p = 0.001).ConclusionThere might be an association between microalbuminuria levels, general inflammatory markers (ESR and CRP), and current H. pylori infection in type 2 diabetic patients.

Factors Influencing Delay in Seeking Post-abortion Care among Women in Keffi, Nasarawa State

Background: Unsafe abortion complications are a significant public health concern, particularly in underdeveloped countries, resulting in maternal mortality. Delays in seeking Post-abortion Care (PAC) at the clinical area leave health workers minimal options for resolving the situation. Objective: To identify the factors that contribute to the delay in obtaining PAC among women with post-abortion complications in Keffi, Nasarawa State. Methods: A mixed-method, prospective, cross-sectional survey was carried out at the Federal Medical Centre Keffi. A total of 60 patients were polled, and 15 of the polled patients participated in in-depth interviews. Quantitative and qualitative data were gathered by questionnaires and structured interview guides, respectively. Results: The predictors of delayed presentation were age 15-24 years (OR = 16, CI = 1.42 – 180.90, p = 0.047), a secondary level of education (OR = 38, CI = 4.15 – 347.89, p &lt; 0.001), earning less than ₦30,000/Month (OR = 25.00, CI = 3.45 – 180.98, p = 0.001), living in rural areas (OR = 5.20, CI = 1.72 – 47.30, p &lt; 0.001), having an abortion performed at a chemist's shop (OR = 7.564, CI = 6.70 – 10.00, p = 0.011), and use of herbs to induce abortion (OR = 1.23, CI = 1.04 – 1.45, p = 0.047). Conclusion: The study identified younger age, low level of education, occupation, place of residence, low income, and previous history of induced abortion as factors contributing to delayed presentation for PAC. Effective counselling for the use of contraceptives among women who are not ready for pregnancy is recommended.

Comparison and Analysis of Clinical Characteristics of Common COVID-19 and NSIP Patients

Objective: To investigate the relationship between coronavirus disease 2019 (COVID-19) and non-specific interstitial pneumonia (NSIP), with a focus on the clinical features of COVID-19 and NSIP, and the key points of differential diagnosis. Methods: The clinical data of 20 patients with common-type COVID-19 and NSIP admitted to Linyi People’s Hospital from January 21, 2020, to June 21, 2022, were retrospectively analyzed. Gender, age, history of residence in Hubei province, underlying diseases, clinical manifestations, laboratory test results (including blood routine indexes, inflammatory markers, liver function indexes, and coagulation indexes), and computed tomography (CT) scan images were compared between the two groups. Results: COVID-19 patients were younger than NSIP patients (P &lt; 0.05). Nine COVID-19 patients had a travel history to Hubei province, while none of the NSIP patients did (P &lt; 0.05). Eight COVID-19 patients had underlying chronic conditions, fewer than the NSIP group (12 patients; P &lt; 0.05). Both groups experienced symptoms such as shortness of breath, expectoration, fatigue, and runny nose, but fever and cough were more severe and more frequent in the COVID-19 group. Compared to normal reference ranges, both groups exhibited normal white blood cell counts (WBC) and liver function indexes, but elevated lymphocyte counts (LYMP), inflammatory markers, and coagulation indexes, with reduced neutrophil counts (NE). WBC and LYMP were higher in the COVID-19 group compared to the NSIP group. Male patients in the COVID-19 group had higher erythrocyte sedimentation rates and C-reactive protein values than those in the NSIP group, while procalcitonin levels were lower in the COVID-19 group, although the differences were not statistically significant (all P &gt; 0.05). The NE count in the COVID-19 group was significantly lower than in the NSIP group (P &lt; 0.05). Alanine aminotransferase, total bilirubin, and indirect bilirubin were significantly higher in the COVID-19 group compared to the NSIP group (P &lt; 0.05). Chest CT scans of both groups showed bilateral patchy ground-glass opacities, but the lesions in COVID-19 patients were scattered. NSIP patients’ chest CTs showed diffuse lesions centered around the hilum or multiple lesions in both lungs, with pleural involvement being rare. Conclusion: While there are certain specific clinical, laboratory, and imaging findings in both COVID-19 and NSIP, the specificity of these features is not high. Differentiating the two requires careful consideration of epidemiological history, nucleic acid testing, and antigen-antibody levels.

Abstract C078: Optimizing exposure science to understand disparities: the Bayview Hunters Point residential history study

Abstract Background: Understanding environmental impacts on local cancer burden requires accurate documentation of residential histories. Collection of residential history data is challenging because individuals may have difficulty recalling addresses over decades, or the detailed dates living at each location. In addition, some communities may have different concepts of where they live versus their home address. Recently, Surveillance Epidemiology and End Results (SEER) data was linked to LexisNexis longitudinal residential history database, which could address some of these challenges. As part of a larger effort to understand the impact of environmental exposures in Bayview Hunters Point (BVHP), we compared the oral residential histories against commercially available data found in LN. We hypothesized that for communities with limited financial mobility, who live in multi-generational households or have diverse definitions of “home,” commercially available data sets may fail to capture accurate residential histories and has implications for studying environmental exposures and cancer. Methods: After institutional IRB approval, community advocates helped identify long term (&amp;gt;20 years) BVHP residents. Group interviews, including a friend/family member to support detailed recall of residential history, were conducted. Interviews elicited residential histories (RH) with addresses and concepts of ‘home.’ Participant-reported RH were compared against records in LexisNexis (LN). We used three levels of identifiers to locate participant records: 1. Name and Date of Birth (DOB); 2. Name, DOB, and middle initial and aliases; 3. Name, DOB, augmented name, and alternate family members’ addresses. Participants were categorized by the amount of data required to find the LN record; and those who could not be located at all. Qualitative data was analyzed using Dedoose Version 7.0.23 (2016), Los Angeles, California. Results: The study included 20 participants who lived on average 40 years in BVHP. Of those, 90% were African American. The majority (65%) were female with an average age of 61. LN records for 4 participants (20%) were identified using minimal identifiers; five (25%) required inclusion of aliases. Nearly half (n=8 (40%)) required search terms that included aliases and an alternative address, highlighting the difference between where people “live” versus where they “stay;” and suggesting the importance of differences in definitions of ‘home.’ Three (15%) participants’ records could not be found in LN. Conclusion: In a historically redlined community situated at one of the country’s most contaminated superfund sites, LN data was limited in capturing complete RH. The NCI’s recent linkage of SEER with LN residential history data relies on assumptions about financial mobility and multigenerational households. The dataset may fail to capture exposures when locations where people “stay” differ from their permanent address. Our results suggest that SEER-LN data to evaluate environmental exposures should be used with caution. Citation Format: Chinomnso Okorie, Dalila Adofo, Michael Bennett, Debora Oh, Galen Joseph, Scarlett Gomez, Kim F. Rhoads. Optimizing exposure science to understand disparities: the Bayview Hunters Point residential history 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 C078.

Xu et al. Respond to "Improving spatial exposure data for everyone: lifecourse social context and ascertaining residential history".

Xu et al. Respond to "Improving spatial exposure data for everyone: lifecourse social context and ascertaining residential history".

Knowledge-Driven Data Sharing Governance: Developing a data provenance model for constructing context-aware data sharing frameworks for linkage data within the All of Us Research Program.

Health data access and sharing in the U.S. have been hindered by complex privacy and security conditions, limiting research and improvement of health outcomes. This challenge is even greater in minority and sensitive populations - who would benefit most from integrative research. The All of Us Research Program is a National Institutes of Health funded initiative aiming to enhance health research through the analysis of lifestyle, environment, and genetics data from over one million participants, with a focus on communities historically underrepresented in biomedical research. The program is enhancing the utility of data by incorporating passive data streams, such as claims, electronic health records (EHRs), environmental, geocodes, mortality, and residential history. Further, through the use of national health information exchange standards, All of Us also aims to address technical challenges in linking EHRs from health information networks to deliver a more complete longitudinal participant record. However, such an initiative necessitates a thoughtful approach through data awareness, advancing data access in ways that preserve individual privacy while increasing scientific utility. Here, we describe our privacy-preserving record linkage (PPRL) and data privacy risk disclosure control strategy, emphasizing fit-for-purpose data provisioning. Our knowledge-driven data ecosystem architecture leverages a combination of PPRL, data provenance, and geocoding at multiple levels to support context-aware data sharing granular access control.

Structure Induced by a Multiple Membership Transformation on the Conditional Autoregressive Model

The objective of disease mapping is to model data aggregated at the areal level. In some contexts, however, (e.g. residential histories, general practitioner catchment areas) when data is arising from a variety of sources, not necessarily at the same spatial scale, it is possible to specify spatial random effects, or covariate effects, at the areal level, by using a multiple membership principle (MM) (Petrof et al., 2020; Gramatica et al., 2021). A weighted average of conditional autoregressive (CAR) spatial random effects embeds spatial information for a spatially-misaligned outcome and estimate relative risk for both frameworks (areas and memberships). In this paper we investigate the theoretical underpinnings of these application of the multiple membership principle to the CAR prior, in particular with regard to parameterisation, properness and identifiability. We carry out simulations involving different numbers of memberships as compared to number of areas and assess impact of this on estimating parameters of interest. Both analytical and simulation study results show under which conditions parameters of interest are identifiable, so that we can offer actionable recommendations to researchers. Finally, we present the results of an application of the multiple membership model to diabetes prevalence data in South London, together with strategic implications for public health considerations.

Cumulative arsenic exposure from residential histories and its association with individual arsenic levels in saliva

Cumulative arsenic exposure from residential histories and its association with individual arsenic levels in saliva

The Association between Long-term PM2.5 Exposure and Risk for Pancreatic Cancer: An Application of Social Informatics.

There is a profound need to identify modifiable risk factors to screen and prevent pancreatic cancer. Air pollution, including fine particulate matter (PM2.5), is increasingly recognized as a risk factor for cancer. We conducted a case-control study using data from the electronic health record (EHR) of Duke University Health System, 15-year residential history, NASA satellite fine particulate matter (PM2.5) and neighborhood socioeconomic data. Using deterministic and probabilistic linkage algorithms, we linked residential history and EHR data to quantify long term PM2.5 exposure. Logistic regression models quantified the association between a one interquartile range (IQR) increase in PM2.5 concentration and pancreatic cancer risk. The study included 203 cases and 5027 controls (median age of 59 years, 62% female, 26% Black). Individuals with pancreatic cancer had higher average annual exposure (9.4 μg/m3) as compared to IQR increase in average annual PM2.5 was associated with greater odds of pancreatic cancer (OR=1.20; 95% CI: 1.00-1.44). These findings highlight the link between elevated PM2.5 exposure and increased pancreatic cancer risk. They may inform screening strategies for high-risk populations and guide air pollution policies to mitigate exposure.