Lifestyle-related Factors Research Articles

Decadal changes in nocturia among American middle-aged and older men.

To estimate the prevalence of nocturia in middle-aged and elderly men and evaluate its associated factors and changes over time. Data of middle-aged and older men aged ≥40 years from the 2007-2008 and 2017-2020 cycles of the National Health and Nutrition Examination Survey were retrospectively analyzed. The prevalence of nocturia was estimated using participant questionnaires on nocturia, lifestyle-related factors, and health factors, and its decadal changes were examined using multivariate logistic regression analysis to determine related factors associated with the prevalence of nocturia. The prevalence of nocturia was 38.0% in 2007-2008 and 39.6% in 2017-2020, with no significant increase observed (P = 0.3989). Being a non-Hispanic black was positively correlated with nocturia (adjusted odds ratio [AOR] = 1.54, 1.22-1.93, P < 0.001), whereas the correlation with being a Mexican American disappeared (AOR = 1.25, 0.90-1.73, P = 0.187). Diabetes (AOR = 1.32, 1.07-1.64, P = 0.010) and sleep disorders (AOR = 1.31, 1.07-1.60, P = 0.008) showed a statistically significant positive correlation with nocturia, whereas a significant negative correlation was observed between employment (AOR = 0.66, 0.54-0.82, P < 0.001) and nocturia. Above-high-school education (AOR = 0.60, 0.47-0.76, P < 0.001) showed a constant trend toward a negative correlation with nocturia. The correlation between high school education or general educational development and nocturia disappeared (AOR = 0.81, 0.62-1.05, P = 0.112). Diabetes and sleep disorders contribute to the development of nocturia, while work and high educational attainment can actively combat nocturia. Geriatr Gerontol Int 2024; ••: ••-••.

Sources of variation in the serum metabolome of female participants of the HUNT2 study.

The aim of this study was to explore the intricate relationship between serum metabolomics and lifestyle factors, shedding light on their impact on health in the context of breast cancer risk. Detailed metabolic profiles of 2283 female participants in the Trøndelag Health Study (HUNT study) were obtained through nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry (MS).We show that lifestyle-related variables can explain up to 30% of the variance in individual metabolites. Age and obesity were the primary factors affecting the serum metabolic profile, both associated with increased levels of triglyceride-rich very low-density lipoproteins (VLDL) and intermediate-density lipoproteins (IDL), amino acids and glycolysis-related metabolites, and decreased levels of high-density lipoproteins (HDL). Moreover, factors like hormonal changes associated with menstruation and contraceptive use or education level influence the metabolite levels.Participants were clustered into three distinct clusters based on lifestyle-related factors, revealing metabolic similarities between obese and older individuals, despite diverse lifestyle factors, suggesting accelerated metabolic aging with obesity. Our results show that metabolic associations to cancer risk may partly be explained by modifiable lifestyle factors.

The MARVIN Hypothesis: Linking Unhealthy Lifestyles to Intracranial Aneurysm Rupture Risk and Clinical Prognosis

Background and Objectives: The rising incidence of modifiable lifestyle risk factors and cardiovascular diseases, driven by poor diet, inactivity, excessive alcohol use, and smoking, may influence the development and rupture of intracranial aneurysms (IA). This study aimed to examine the impact of lifestyle-related and cardiovascular risk factors on IA rupture and patient outcomes. Materials and Methods: We developed the “MARVIN” (Metabolic and Adverse Risk Factors and Vices Influencing Intracranial Aneurysms) model and conducted a retrospective analysis of 303 patients with 517 IAs, treated between 2007 and 2020. Of these, 225 patients were analyzed for rupture status and 221 for clinical outcomes. The analysis focused on hypertension, diabetes, hypercholesterolemia, vascular diseases, nicotine and alcohol abuse, obesity, aneurysm rupture status, and clinical outcomes. Logistic regression was used to evaluate the impact of these risk factors. Results: Among those with risk factors, 24.9% (56/225) and 25.3% (56/221) had one, 32.0% (72/225) and 30.8% (68/221) had two, 20.0% (45/225) and 20.4% (45/221) had three, 12.0% (27/225) and 12.2% (27/221) had four, 4.0% (9/225) and 4.1% (9/221) had five, 0.9% (2/225) had six in both groups, and 0.4% (1/225) and 0.5% (1/221) had seven risk factors, respectively. Strong relationships were found between lifestyle-related vascular risk factors, indicating multiple comorbidities in patients with unhealthy habits. Smokers with ruptured aneurysms had higher WFNS (World Federation of Neurosurgical Societies) scores, but nicotine abuse did not affect long-term outcomes. The most significant predictors for poor outcomes were WFNS score and age, while age and a history of vascular diseases were protective against rupture. Despite the high prevalence of modifiable risk factors, they did not significantly influence rupture risk. Conclusions: The findings suggest a need for multifactorial risk assessment strategies in managing IA patients. Future studies with larger cohorts are required to confirm these results and better understand IA progression.

Prevalence of Alexithymia and Associated Factors Among Dental Students in Saudi Arabia: A Cross-Sectional Study.

Background: Mental health challenges among university students are pervasive, with alexithymia posing a particularly significant yet understudied challenge. This condition significantly affects an individual's ability to cope with stress due to difficulties in recognizing, describing, and processing emotions. Objectives: This study aims to evaluate alexithymia prevalence and its associated factors among dental undergraduate students and interns enrolled at King Saud University in Riyadh, Saudi Arabia. Methods: Data were collected through a self-administered online survey that assessed alexithymia symptoms (using the Toronto Alexithymia Scale [TAS-20]), sociodemographic profiles, lifestyle-related factors, and health-related factors. The associations between participant factors and alexithymia were assessed using chi-square and multiple logistic regression analyses. Results: Of the 421 eligible participants, 369 completed the survey (87.6% response rate), revealing a significant prevalence of alexithymia (37.9%). Female gender (AOR = 1.7, p = 0.04), depression (AOR = 5.6, p < 0.0001), chronic diseases (AOR = 3.5, p = 0.003), and childhood abuse (AOR = 2.2, p = 0.047) were independent factors significantly associated with alexithymia. Conclusions: These findings highlight the pressing need for mental health support within dental education. Early interventions targeting alexithymia could mitigate its adverse consequences, promoting better student well-being and academic success.

Mendelian randomization studies of lifestyle-related risk factors for stroke: a systematic review and meta-analysis

ObjectiveStroke risk factors often exert long-term effects, and Mendelian randomization (MR) offers significant advantages over traditional observational studies in evaluating the causal impact of these factors on stroke. This study aims to consolidate and evaluate the relationships between potential causal factors and stroke risk, drawing upon existing MR research.MethodsA comprehensive search for MR studies related to stroke was conducted up to August 2023 using databases such as PubMed, Web of Science, Embase, and Scopus. This meta-analysis examines the relationships between potential causative factors and stroke risk. Both random-effects and fixed-effects models were utilized to compile the dominance ratios of various causative elements linked to stroke. The reliability of the included studies was assessed according to the Strengthening the Reporting of Observational Studies in Epidemiology incorporating Mendelian Randomization (STROBE-MR) guidelines.ResultsThe analysis identified several risk factors for stroke, including obesity, hypertension, low-density lipoprotein cholesterol (LDL-C), chronic kidney disease (CKD), and smoking. Protective factors included high-density lipoprotein cholesterol (HDL-C), estimated glomerular filtration rate (eGFR), and educational attainment. Subgroup analysis revealed that type 2 diabetes mellitus (T2DM), diastolic blood pressure (DBP) are risk factors for ischemic stroke (IS).ConclusionThis study confirms that variables such as obesity, hypertension, elevated LDL-C levels, CKD, and smoking are significantly linked to the development of stroke. Our findings provide new insights into genetic susceptibility and potential biological pathways involved in stroke development.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier CRD42024503049.

Social, health and lifestyle-related determinants of older adults’ preferences for place of death in South Tyrol, Italy – a cross-sectional survey study

BackgroundAs the global aging population expands, understanding older adults’ preferences for place of death becomes pivotal in ensuring person-centered end-of-life care.ObjectiveThis study aimed to investigate the influence of sociodemographic, health, and lifestyle-related factors on end-of-life care preferences of older adults in South Tyrol, Italy.MethodsEmploying a cross-sectional design, a population-based survey was conducted with a stratified probabilistic sample of adults aged ≥ 75 years in South Tyrol (Autonomous Province of Bolzano/Bozen, Italy). From a randomly selected sample of 3,600 older adults, participants were invited to respond to a questionnaire that included items on older adults’ preferences for place of death and socio-demographic and health- and lifestyle-related factors, including frailty (e.g., PRISMA-7). Descriptive and multinomial logistic regression analyses were performed.ResultsThe majority (55.3%) of the 1,695 older adults (participation rate: 47%) expressed a preference for dying at home and 12.7% indicated a desire for specialized end-of-life care in a healthcare facility. However, 27.9% refrained from disclosing their end-of-life care preferences. The factors influencing these preferences concerning the place of death included age, native language, educational level, living situation, and community. Compared to the preference of dying at own home or home of family or friends, older adults aged ≥ 85 years (OR = 0.57, P = 0.002) and living in an urban area (OR = 0.40, P < 0.001) were less likely to prefer dying at a hospital, palliative care unit, or hospice. Older adults living alone (OR = 1.90, P < 0.001), Italian-speaking (OR = 1.46, P = 0.03), and those with an educational level above high school (OR = 1.69, P = 0.002) were more likely to prefer dying at a hospital, palliative care unit, or hospice.ConclusionsEnd-of-life care preferences among older adults in South Tyrol were associated with socio-demographic, yet not health- and lifestyle-related factors. Recognizing and integrating these preferences is essential for developing, implementing, and evaluating interventions to promote advance care planning and provide effective, patient-centered end-of-life care.

Lifestyle related health risk factors regarding non-communicable diseases among adults in Morang District

Introduction: Non-communicable diseases are the leading causes of disease burden worldwide. According to World Health Organization estimates, NCDs are responsible for 74% of all deaths globally, with around 77% of premature deaths from NCDs occurring in low- and middle-income countries. This study aims to assess the lifestyle related health risk factors of non-communicable diseases among adults in Nepal, in which two- third of annual deaths are attributable to non-communicable diseases. Methods: A cross sectional study was conducted among adults in Morang district, Nepal. Data collection involved the assessment of the risk factors of obesity, smoking, alcohol consumption, inadequate fruits and vegetable consumption, inadequate physical activity, are raising blood pressure. Ethnical approval was obtained. Results: Two hundred forty participants participated in the study, of which the most prevalent risk factor was obesity (58.3%). Out of total participants, 41.6% had consumed tobacco, 31.2% had consumed alcohol, 41.6% had consumed inadequate fruits and vegetables, 30.4% had inadequate physical activity, and 29.1% had raised blood pressure. Similarly, education is statistically associated with lifestyle risk factors. Male participants of age above 40 years were found to be statistically associated with current tobacco and alcohol consumption. Conclusion: Health related risk factors are causes of non-communicable disease. Most of the participants had two or more risk factors for non-communicable disease. Education is significantly associated with all the risk factors among the participants.

Prevention of dementia using mobile phone applications (PRODEMOS): a multinational randomised controlled effectiveness-implementation trial

Abstract Background The expected increase of dementia prevalence in the coming decades will mainly be within low-and middle-income countries and those with low socioeconomic status (SES) in high income countries. Forty percent of dementia is associated with modifiable, lifestyle-related cardiovascular risk factors. Mobile health interventions with remote coaching can help reach underserved high-risk populations globally. Methods This open label, blinded endpoint, hybrid effectiveness-implementation randomised controlled trial (RCT) investigated whether a coach-supported mHealth intervention can reduce dementia risk in persons aged 55-75 years of low SES in UK or from the general population in China with at least two dementia risk factors. The primary effectiveness outcome was change in CAIDE dementia risk score (including age, education, sex, systolic blood pressure, total cholesterol, BMI, physical exercise) after 12-18 months of intervention. Main implementation outcomes were coverage, acceptability, appropriateness, adoption, feasibility, sustainability, fidelity, and costs using a mixed methods approach. Findings Between 15th January 2021 and 18th April 2023, 1,488 persons were included and randomised (734 intervention, 754 control), with 1,229 (82·6%) available for analysis of the primary effectiveness outcome. After a mean follow-up of 16 months, the mean CAIDE score improved by 0·16 points in the intervention group vs. 0·01 in the control group (Mean Difference (MD) 0·16, 95% Confidence Interval (CI) 0·03-0·29). The effect was larger in those who adhered to the intervention (MD 0·27, 95%CI 0·12-0·44) and those planning to change lifestyle (MD 0·33, 95%CI 0·10-0·57). Ten percent of those invited participated; of these, 81% adopted the intervention and 50% continued active participation throughout the study. For the individual components of the CAIDE score, there were no statistically significant differences for systolic blood pressure, total cholesterol and BMI, but in the intervention group physical inactivity was reduced more than in the control group (MD 6·7%, 95%CI 2·1 to 11·2) and more participants quit smoking (MD -3·1%, 95%CI -4·8 to -1·5). Interpretation A coach-supported mHealth intervention to improve lifestyle is modestly effective in reducing dementia risk factors in those with low SES in the UK and any SES in China. Implementation is challenging in these populations, but those reached actively participated. Whether this will result in less cognitive decline and dementia requires a larger RCT with long follow-up.

Lifestyle, dietary pattern and colorectal cancer: a case-control study

BackgroundIn Iran, not only the incidence of colorectal cancer (CRC) is increasing but also the age of patients at diagnosis is alarmingly dropping. We need urgent actions to better understand the epidemiology of CRC and the contributing factors for such pattern in Iranian population. The aim of our study was to determine the potential contribution of lifestyle, including dietary pattern, to CRC in a large Iranian province.MethodsA hospital based case-control study was performed on 572 participants (275 cases and 297 controls). Patients in the case group were newly diagnosed with CRC in a referral hospital and patients in the control group were selected from those patients with non-malignancy diseases who were admitted to the same hospital. Control group was frequency matched to the case group for gender and age.ResultsBased on the results of multivariable logistic regression analysis, direct associations were observed between usual pattern of defecation (OR> 3rd /every day =4.74, 95% CI: 1.78–12.59), chicken consumption (ORsometimes or always/occasionally = 6.33, 95% CI:3.23–12.43), family history of CRC (ORyes/no =5.79, 95% CI: 2.72–12.31), and alcohol consumption (ORyes/no =6.03, 95% CI: 2.14–16.98) with the odds of CRC among the study population. On the other hand, taking multivitamins (ORyes/no=0.09, 95% CI:0.04–0.20), consumption of coffee (ORalways/occasionally =0.29, 95% CI: 0.12–0.69), taking vitamins D supplement (ORyes/no =0.38,95% CI:0.22–0.66), and consumption of garlic (ORsometimes/occasionally =0.53,95% CI: 0.30–0.95) significantly reduced the odds of CRC.ConclusionsWe revealed potentially significant effects of several lifestyle related factors with CRC risk in Iranian population. More studies are required to understand the mechanism of action of the associated factors in developing CRC.

Sedentary Lifestyle Is a Modifiable Risk Factor for Cognitive Impairment in Patients on Dialysis and after Kidney Transplantation

Background: Chronic kidney disease (CKD) is a risk factor for cognitive impairment (CI), and this risk is the highest in patients with end-stage kidney disease (ESKD). As a multifactorial disease, CI may be influenced by several potentially modifiable lifestyle and behavioral factors that may reduce or increase the risk of dementia. The aim of this study was to evaluate the associations between the known modifiable risk factors for dementia and the risk of CI in patients with ESKD treated with renal replacement therapy. The Charlson Comorbidity Index and the risk of CI in patients with ESKD were also assessed. Methods: In this cross-sectional study, 225 consecutive patients with ESKD treated with different modalities of renal replacement therapy were assessed for cognitive decline using the Addenbrooke’s Cognitive Examination (ACE III) test. Information was also collected on modifiable risk factors for dementia, medical history and demographics. Results: This study included 117 patients after kidney transplantation (KT) and 108 patients with ESKD undergoing peritoneal dialysis and hemodialysis. The prevalence of modifiable risk factors for dementia differed between the groups; KT patients were more likely to be physically active, residing in cities with populations of less than 500,000 inhabitants, and were less likely to suffer from depression. Furthermore, the KT group had a lower Charlson Comorbidity Index score, indicating less severe comorbidities, and a lower risk of CI (3.6 ± 1.67 vs. 5.43 ± 2.37; p = 0.001). In both the KT and dialysis groups, patients with CI were more likely to have a sedentary lifestyle (45% vs. 9%, p = 0.001 and 88% vs. 48%, p = 0.001, respectively), whereas lower educational attainment and depression had a significant negative impact on ACE III test results, but only in KT patients. Finally, cognitive function in dialysis patients was negatively affected by social isolation and living in urban areas. Conclusions: Modifiable risk factors for dementia, particularly a sedentary lifestyle, are associated with a higher risk of CI in patients treated with different renal replacement therapy modalities. As CI is an irreversible condition, it is important to identify lifestyle-related factors that may lead to dementia in order to improve or maintain cognitive function in patients with ESKD.

Coping with COVID-19: a prospective cohort study on young Australians' anxiety and depression symptoms from 2020–2021

BackgroundStudies have shown that the coronavirus (COVID-19) pandemic negatively impacted the mental health of young Australians. However, there is limited longitudinal research exploring how individual factors and COVID-19 related public-health restrictions influenced mental health in young people over the acute phase of the COVID-19 pandemic. This study aimed to identify risk and protective factors associated with changes in individual symptoms of anxiety and depression among young Australians during the COVID-19 pandemic.MethodsThis prospective cohort study collected data on anxiety and depression symptoms of young Australians aged 15–29 years old using the Depression, Anxiety and Stress Scale short form (DASS-21). We delivered four online questionnaires from April 2020 to August 2021 at intervals of 3, 6, and 12 months after the initial survey. We implemented linear mixed-effects regression models to determine the association among demographic, socioeconomic, lifestyle and COVID–19 public health restrictions related factors and the severity of anxiety and depression symptoms over time.ResultsAnalyses included 1936 young Australians eligible at baseline. There was a slight increase in DASS-21 anxiety mean scores from timepoint 3 to timepoint 4. DASS-21 depression scores showed slight fluctuations across timepoints with the highest mean score observed in timepoint 2. Factors associated with increases in anxiety and depression severity symptoms included LGBTQIA + identity, financial insecurity both before and during the pandemic, higher levels of loneliness, withdrawal or deferral of studies, spending more time on social media, and difficulties to sleep. Risk factors for only depression symptoms include unemployment during COVID-19 pandemic and being in lockdown. Living with someone was a protective factor for both anxiety and depression symptoms, pre-COVID-19 unemployment for depression symptoms, and older age and unemployment during the pandemic for anxiety symptoms.ConclusionThese findings indicate that during the first year of the pandemic in Australia, there were significant changes in young people’s mental health which were associated with multiple demographic, socioeconomic, lifestyle, and lockdown factors. Hence, in future public health crises, we suggest more inclusive guidelines that involve young people in their development and implementation ensuring that their unique perspectives and needs are adequately considered.

Postdischarge Mortality in a Cohort Hospitalized With Anorexia Nervosa.

To characterize mortality after hospital discharge in cohorts with and without anorexia nervosa (AN). We obtained data for all hospitalizations for psychiatric reasons in Canada (except Quebec) between April 1, 2006, and March 31, 2021 (n = 1.3 million admissions). Cases of AN were identified using ICD-10 (F50.0 and F50.1) codes. First admissions during this interval for AN and other psychiatric conditions were linked to vital statistics data. Mortality was characterized through cross-tabulation, Cox proportional hazards models, and competing cause regression. After adjustment for age and sex, there was no significant difference in mortality between AN and those with other psychiatric conditions (HR = 1.04; p = 0.644). Among AN admissions, 25% (95% CI 18.6-31.4) of deaths were attributed to psychiatric conditions (ICD-F codes), with 88% of these (comprising 22% of all deaths in the AN group) having AN itself identified as the underlying cause of death. In contrast, only 8% of deaths among non-AN admissions were attributed to a mental disorder. Prevention of premature mortality in the general psychiatric population emphasizes modification of metabolic (e.g., hyperlipidemia) and lifestyle-related (e.g., sedentary behavior) risk factors. However, as AN itself makes a major contribution to mortality, specialized preventive strategies may be required.

Knowledge, Attitude, and Practices for Occurrence of Weight Gain Among the Night Shift Working Professionals in Maharashtra, India: A Cross-Sectional Survey

Introduction: The biological clock or circadian rhythm of an organism is a set of regular oscillations. Working at night or on night shifts disrupts the circadian rhythm. When the circadian rhythm is disrupted, concentrations of adiponectin and leptin (satiety hormones) rise at night, leading to overeating and fat gain, while lack of sleep elevates ghrelin levels of the hunger hormone. Thus, the current study sought to explore the knowledge, attitudes, and practices about the dietary and lifestyle factors amongst night-shift working professionals and to assess the influence of knowledge and attitudes on their practices. Methods: A cross-sectional survey was conducted among individuals working night shifts in Maharashtra. A pre-tested questionnaire consisting of questions related to their knowledge, diet, and lifestyle was recorded and scored. Results: Among the 206 participants, a maximum of them were male (57.1%). Approximately 72.8% of respondents were quite young (25-30 years) and had been working the night shift for a period of 9-12 months. The majority (76.6%) of respondents had no medical conditions. Many (42.7%) of the night-shift working professionals were found to be obese. Significance was observed between knowledge and attitude among the overweight BMI category. Conclusion: The participants had good knowledge in terms of dietary habits and lifestyle-related factors. However, this was not reflected in their attitudes and practices. Therefore, interventional research targeting attitudes and behaviors is required to improve behavioral patterns among overweight/ obese people.

Epidemiological Profile of Oral Cancer Patients Attending at B.P. Koirala Memorial Cancer Hospital, Chitwan, Nepal

Background: Oral cancer is one of the most prevalent and leading causes of mortality in certain regions, like South-Central Asia. The incidence of oral cancer in Nepal is also increasing. Oral cancer is preventable and treatable if diagnosed in an early stage. The study conducted at B.P. Koirala Memorial Cancer Hospital (BPKMCH) in Bharatpur, Nepal, was aimed at assessing the epidemiological profile of oral cancer patients attending BPKMCH. Methods: A descriptive cross-sectional study design was used to assess the epidemiological profile of oral cancer, and 50 patients were included in this study during January to July 2023. A semi-structured interview schedule was developed, which has 3 parts, viz., i. socio-demographic variables, ii. Lifestyle-related factors and iii. Clinical profile of oral cancer, to obtain the information from the respondents. Results: The study findings revealed that out of 50 majorities of respondents (88%) were male. According to the religion, most of them (84%) were Hindu, and likewise, according to ethnicity, about half of them (40%) belong to Madeshi, followed by 30% Brahmin/Chhetri. Similarly, most of the respondents (90%) were married. Regarding the exposure to risk factors, half of the respondents (50%) had habits of smoking consumption, More than half (68%) had the habit of tobacco consumption, near to half (40%) had the habit of Gudka consumption, and 68% had the habit of alcohol consumption. None of the respondents had the habits of oral sex or a family history of oral cancer. Similarly, about one-third (30%) of respondents had stage IV, followed by 28% stage II, 26% stage I, and only a few (14%) stages in III disease; all the oral cancer was OSCC. Concerning the treatment modalities, 36% of respondents had surgery, near to one quarter (20%) received chemotherapy, 10% received radiation therapy, and 30% of respondents had surgery with adjuvant therapy. Conclusion: The study found that the majority of oral cancer patients attending BPKMCH were between the ages of 30 and 45 and were predominantly male. Smoking, tobacco, and Gudka consumption are the main risk factors for oral cancer. The risk assessment approach and screening program should be focused on preventing oral cancer.

Effort-reward imbalance at work assessed at midlife and prediabetes prevalence assessed 18 years later in a prospective cohort of white-collar workers.

Evidence suggests that workers exposed to psychosocial stressors at work from the effort-reward imbalance (ERI) model are at increased risk for type 2 diabetes mellitus (T2DM). However, evidence about the effect of ERI on prediabetes is scarce. This study aimed to examine the association between effort-reward imbalance at work, glycated hemoglobin level and the prevalence of prediabetes in women and men from a prospective cohort study. This study was conducted among 1354 white-collar workers followed for an average of 18 years. Effort-reward imbalance at work was measured in 1999 to 2001 using a validated instrument. Glycated hemoglobin was assessed at follow-up (2015 to 2018). Differences in mean glycated hemoglobin levels were estimated with linear models. Prediabetes prevalence ratios (PRs) were computed using robust Poisson regression models. In women, those exposed to effort-reward imbalance at work at baseline had a higher prevalence of prediabetes (PR = 1.60, 95% confidence interval: 1.02-2.49) at follow-up following adjustment for sociodemographic, lifestyle-related, clinical, and other occupational risk factors. There was no difference in mean glycated hemoglobin levels. Among women, effort-reward imbalance at work at midlife was associated with the prevalence of prediabetes, at older age. Preventive workplace interventions aiming to reduce the prevalence of effort-reward imbalance at work may be effective to reduce the prevalence of prediabetes among women.

Auto-Immune Diseases, Head and Neck Trauma, and Smoking Are Strong Predictors of Multiple Sclerosis.

Several health, environmental, and lifestyle-related factors have been separately linked to multiple sclerosis (MS) by different studies. However, these studies did not adequately account for the temporal association of these factors with MS while considering the influence of other variables in the analysis. A comprehensive investigation of these factors remains scarce. A hospital-based case-control study was carried out between Jun 2020 to Mar 2021 on 525 cases and 1050 controls frequently matched by age and sex. Cases and controls were selected at the same time and from the same centers (Motahari and Imam Reza referral centers) in Shiraz (the capital of Fars Province). Health, socio-demographic, and lifestyle status during adolescence were studied in this case-control study. The likelihood of having a history of autoimmune disease(s) (ORyes/no=15.67, P<0.001) and family history of MS (ORyes/no=11.57, P<0.001) were higher in cases. In addition, the likelihoods of reporting a history of head/neck traumas (ORhaving a history/no history=9.16, P<0.001), smoking (ORregular/other =2.24, P=0.008), and stressful events (ORyes/no=1.47, P=0.007) were higher among the case group. On the other hand, the odds of sun exposure (ORmost the time/seldom =0.14, P<0.001), physical activity (ORactive/inactive=0.45, P<0.001), and good quality sleep (OR=0.93, P<0.001) were significantly lower in the case group. This study provided a broad picture of the factors associated with MS, most of which were modifiable. Positive alterations to these factors through social and health educational programs are likely to reduce the burden of MS in Iran.

Therapeutic Prospects of Abemaciclib for Patients with Endometrial Cancer.

Endometrial cancer (EC) is a common gynecologic malignancy with a rising incidence due to obesity, comorbid conditions, and related lifestyle factors. The standard of care for primary disease consists of surgical resection with/without chemotherapy ± radiotherapy for select patients. Recurrence is common in patients with advanced-stage disease and/or high-risk features, who primarily are treated with systemic therapy. The identification of novel targets in malignant EC has led to the development of wide-range inhibitors. Abemaciclib is an orally active unique cyclin-dependent kinase (CDK) inhibitor, selective for the CDK4 and CDK6 cell cycle pathways. This agent has potential anti-neoplastic activity and is indicated in combination with various therapies such as endocrine therapy, aromatase inhibitors, and hormone therapies, primarily in breast cancer (BC). Herein, we sought to summarize the biochemical/pharmacological properties of abemaciclib and its therapeutic potential in EC. While the therapeutic role(s) of abemaciclib was fairly established in a subset of patients with advanced/metastatic BC through the pivotal MONARCH trials, its attributes and clinical utility in EC are limited. Thus, based on some promising pre-clinical/translational insights and a recent phase II study, we highlight abemaciclib's properties and potential clinical usefulness in patients with EC, particularly in recurrent estrogen-receptor-positive cases.

Efficacy of Brodalumab in Patients with Psoriasis and Risk Factors for Treatment Failure: A Review of Post Hoc Analyses.

Factors such as obesity, alcohol consumption, and tobacco use are associated with both increased psoriasis severity and inadequate response to systemic and biologic therapies. Obesity is linked to chronic inflammation, which can contribute to psoriasis pathogenesis. Fixed-dose therapies may have reduced efficacy in patients with a higher body mass index, while weight-based dosing can increase the burden of drug-specific side effects. Alcohol and nicotine from tobacco have also been shown to stimulate keratinocyte and immune cell proliferation and production of proinflammatory cytokines. While these risk factors are prevalent among patients with moderate-to-severe psoriasis, their influence on treatment outcomes may be overlooked when evaluating therapeutic options. Brodalumab is a fully human interleukin-17 receptorA antagonist approved for the treatment of moderate-to-severe psoriasis. In this review, we describe the lifestyle-related risk factors associated with decreased response to treatment. We further summarize the post hoc analyses of brodalumab in participant subgroups with moderate-to-severe psoriasis and a history of prior biologic failure, obesity, and alcohol or tobacco use from two phase 3 clinical trials (AMAGINE-2 and AMAGINE-3; ClinicalTrials.gov identifiers: NCT01708603 and NCT01708629, respectively). Our review of clinical trial and real-world data suggests that brodalumab is an efficacious and safe treatment option for patients with lifestyle factors that increase the likelihood of treatment failure, allowing them to achieve skin clearance and improve quality of life.

Cancer risk among air transportation industry workers in Korea: a national health registry-based study

BackgroundFlight attendants face various risk factors in their working environments, particularly occupational exposure to cosmic radiation. This study aimed to assess cancer risk among air transportation industry workers, including flight attendants, in Korea by constructing a cohort using national health registry-based data and analyzing cancer incidence risk.MethodsWe used the Korea National Health Insurance Service database from 2002 to 2021 to construct a cohort of 37,011 workers in the air transportation industry. Cancer incidence was defined using the tenth version of the International Classification of Diseases. We calculated the age- and sex-specific standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) by applying the cancer incidence rate of the general population between 2002 and 2019.ResultsApproximately 5% of the cohort developed cancer. Overall, the cancer incidence in the cohort was similar to or lower than that of the general population, with the SIRs for all cancers being lower. However, significantly higher SIRs were observed for nasopharyngeal cancer (SIR, 3.21; 95% CI, 1.71–5.48) and non-Hodgkin lymphoma (SIR, 1.57; 95% CI, 1.02–2.32) in male workers and breast and genital cancer (SIR, 1.51; 95% CI, 1.34–1.70) and thyroid cancer (SIR, 1.25; 95% CI, 1.05–1.47) in female workers.ConclusionsThe lower overall cancer incidence among air transportation industry workers observed in this study could indicate the “healthy worker effect”; however, the incidences of certain cancers were higher than those in the general population. Given that these workers are exposed to multiple occupational and lifestyle-related risk factors, including cosmic radiation, further studies are necessary to determine radiation-induced cancer risk while considering potential confounding factors.

Epidemiology and Risk Factors of Dry Eye Disease: Considerations for Clinical Management.

Dry eye disease is a multifactorial condition characterised by tear film instability, hyperosmolarity and ocular surface inflammation. Understanding the epidemiology of dry eye disease and recognising both modifiable and non-modifiable risk factors can assist eye care practitioners in assessing, treating, and managing patients with the condition. This review considers current knowledge surrounding its incidence and prevalence, as well as associated demographic, systemic, ocular, and iatrogenic, and lifestyle-related modifiable risk factors. Population-based prevalence estimates vary according to the diagnostic criteria used to define dry eye disease, as well as severity and demographic characteristics of the population. Considering recent data and variable population demographics, conservative prevalence estimates suggest that 10-20% of the population over 40 years of age report moderate to severe symptoms and/or seek treatment for dry eye disease. Individuals with specific non-modifiable demographic risk factors may be at increased risk of developing dry eye disease. Advanced age, female sex and East Asian ethnicity have been identified as key non-modifiable demographic features predisposing individuals to dry eye disease. Systemic conditions that have been associated with an increased risk of dry eye disease include migraine, Sjögren syndrome, connective tissue disorders, mental health disorders, diabetes mellitus and androgen deficiency. Medications that may contribute to this risk include antidepressants, antihistamines, and hormone replacement therapy. Ocular and iatrogenic risk factors of dry eye disease include blepharitis, Demodex infestation, ocular surgery, blink completeness, contact lens wear, and topical ophthalmic medications. A range of modifiable lifestyle factors that can increase the risk of dry eye disease have also been identified, including low humidity environments, digital screen use, quality of sleep, diet, and eye cosmetic wear. Dry eye is a common disease affecting millions globally. Increasing knowledge regarding its associated risk factors can better prepare the eye care practitioner to successfully manage patients with this ocular surface disease.