Long-term Association Research Articles

Longitudinal associations between accelerometry-assessed sleep clusters and obesity in adolescence and young adulthood: the German GINIplus and LISA birth cohorts study

Abstract Background Some studies have identified diverse sleep patterns in adolescents and adults by considering multidimensional objective sleep parameters. However, whether sleep patterns are consistent from adolescence to young adulthood and their long-term associations with obesity remain unknown. Purpose This study aimed to investigate the longitudinal associations of objectively measured and clustering-identified sleep patterns with body mass index (BMI) and overweight/obesity in adolescence and young adulthood, and to test whether these associations change over time or are modified by genetic risk. Methods A total of 1973 participants wearing 7-day accelerometers in either 15-year (n=1347, aged 14.3-16.4 years) and/or 20-year (n=1262, aged 19.5-22.4 years) follow-ups of German GINIplus and LISA birth cohorts were included. Sleep clusters were identified by K-means cluster analysis on 12 accelerometry-assessed sleep characteristics at each follow-up. BMI and overweight/obesity were measured by physical exams or self-/parent-reported questionnaires. Multivariable linear and logistic regression models with generalized estimating equations were tested. The interaction effects with time of follow-ups and polygenic risk scores (PRS, n=1087) for BMI were further examined. Results Although sleep characteristics changed from adolescence to young adulthood, such as shorter total sleep time (mean 7.2 to 6.6 hours), the consistent five sleep clusters were classified in both periods: good sleep, delayed sleep phase, sleep irregularity and variability, fragmented sleep, and prolonged sleep latency. Compared to the "good sleep" cluster, the "prolonged sleep latency" cluster showed significant associations with higher BMI (β=0.56, 95% confidence interval (CI) = [0.06, 1.05]) and increased odds of overweight/obesity (odds ratio (OR)=1.55, 95%CI= [1.02, 2.34]). PRS was associated with higher BMI (β=0.65, 95%CI= [0.39, 0.91]) and overweight/obesity (OR=1.52, 95%CI= [1.15, 2.00]), with no significant gene-sleep cluster interaction effect. Only among males, the interaction effects with time of follow-ups on overweight/obesity were observed in the "delayed sleep phase", "sleep irregularity and variability", and "fragmented sleep" clusters (p-interaction <0.05), showing more harmful effects with increasing age. Conclusions Five sleep patterns were identified consistently across adolescence and young adulthood, and the "prolonged sleep latency" pattern was associated with higher BMI and overweight/obesity, independent of genetic risk. For young adult males, "delayed sleep phase", "sleep irregularity and variability" and "fragmented sleep" patterns seemed to have more unfavorable impacts on overweight/obesity.

Long-term effects of unintended pregnancies carried to term on mothers and children

Abstract Background Research on psychological effects of unintended pregnancies that are carried to term presents mixed results, and evidence on long-term associations is scarce. The aim of the current study was to examine effects of unintended pregnancies carried to term on both mothers and children, up to 16 years postpartum. Methods This study is based on the Dutch population-based birth cohort study ‘Amsterdam Born Children and their Development’ (ABCD-study), which included pregnant people in 2003 (n = 7784) and is still following these mothers and their children. Structural Equation Models were analyzed per time-point, examining associations between unintended pregnancy and maternal psychosocial distress, and children’s internalizing- and externalizing problems, while controlling for co-occurring risks. Further, mediating effects via maternal mental health and bonding on children were assessed. Results Around 5 years postpartum, pregnancy mistiming was positively associated to maternal psychological distress. Antenatal psychological distress was a much stronger predictor of maternal psychological distress than unintended pregnancy. Pregnancy mistiming was a significant predictor of internalizing and externalizing problems and unwanted pregnancy of internalizing problems in the children from these pregnancies, around 5 years postpartum. These associations were mostly mediated by maternal mental health and poorer maternal bonding. All associations were no longer present at 12 and 16 years postpartum. Conclusions Unintended pregnancies often coincide with maternal mental health problems, and results showed that associations between unintended pregnancy and both mother’s and children’s psychosocial problems are strongly influenced by maternal mental health. Therefore it is important to improve maternal mental health for the benefit of both mother and child, rather than on the isolated effect of unintended pregnancy. Key messages • Carrying an unintended pregnancy to term impacts psychological health in both mothers and their children up to 5 years but no longer at 12 or 16 years postpartum. • The effects of unintended pregnancy on psychological health in mothers and children are mostly explained by maternal mental health and bonding, so the focus should be on improving these.

Meal timing and risk of metabolic syndrome in the prospective French NutriNet-Santé biobank

Abstract Background Circadian rhythm disruption has been associated with higher risks of cardiometabolic diseases and several cancers. Mistimed eating patterns can desynchronize circadian rhythms, and could therefore influence metabolic health. However, long-term associations between meal timing and the metabolic syndrome remain unclear. The aim of this study was to evaluate the prospective associations between meal timing and the risk of developing metabolic syndrome. Methods We used measured biological and clinical data from 16 353 adults (51 years ± 13.72) in the NutriNet-Santé biobank (2011-2014), and examined the associations between meal timing, assessed with repeated 24-hour dietary records during the first two years of follow-up (starting 2009), and the risk of metabolic syndrome, using modified Poisson regression models, adjusted for main confounders. Results At the end of follow-up (mean 2.1 years (SD = 1.2)), a later timing of the first meal of the day was associated with a moderately higher risk of metabolic syndrome (1,788 cases; RR per 1-hour delay = 1.05; 95% CI: 1.00-1.10). However, after adjusting for overall diet quality, this association was attenuated (RR: 1.04; 95% CI: 0.99-1.09). Overall, we found no evidence of an association between the occurrence of metabolic syndrome and the time of the last meal (RR: 0.99; 95% CI: 0.95-1.05), the number of eating occasions (RR: 1.00; 95% CI: 0.98 - 1.03), or night-time fasting duration (RR: 1.03; 95% CI: 0.99 1.07). Conclusions In this large prospective study, timing of the first meal showed modest associations with metabolic syndrome. Further investigations using a longer follow-up are needed to elucidate how meal timing influences metabolic health. Key messages • Beyond the nutritional quality of meals, meal timing, particularly time of first meal, may be an accessible prevention strategy for metabolic health. • More largescale prospective and intervention studies are needed to better understand the links between meal timing and metabolic health.

Childhood socioeconomic status and depression in adulthood: systematic review

Abstract Background Low socioeconomic status (SES) is generally associated with poorer mental health, particularly depression. We carried out a systematic review to address the question of whether childhood SES is associated with depression in adulthood and the potential pathways which may explain this association. Methods We followed a systematic search strategy in PubMed and Scopus with specific inclusion and exclusion criteria. After removing duplicates, studies were screened for eligibility and quality was assessed independently by two assessors using the Newcastle-Ottawa scale. Results After the selection process, 20 observational studies (7 cohort and 13 cross-sectional) that examine the association between SES during childhood and depression in adulthood were included in the systematic review. The most common measures of childhood SES were parental education, occupation or family income, estimated subjectively and/or objectively. In 17 of the studies an inverse relationship between childhood SES and depression was shown. In 17 studies, models were employed to demonstrate the possible pathways which explain the relationship between childhood SES and depressive symptoms. The most important mediators were adult SES, psychosocial factors, childhood trauma and physical health. Conclusions Our findings reveal the long-term association between childhood socioeconomic conditions and depression later in life. Suboptimal childhood SES seems to be an important risk factor for depression in adulthood. Improving childhood socioeconomic conditions can potentially have lasting effects well beyond childhood. Key messages • Protecting children against the effects of socioeconomic adversity could reduce depression in adult life. • Policy makers should direct resources towards alleviating childhood disadvantage for promoting health in adulthood.

Predictors of cardiovascular disease risk: findings from the National Survey of Health and Development Cohort

Abstract Background Cardiovascular disease (CVD) remains a significant cause of mortality and morbidity within the UK. CVDs and all-cause mortality can be predicted with varying levels of certainty with different models. Purpose This study aimed to explore the incremental effect of risk factors and respective biomarkers on CVD events risk estimation models. Methods The National Survey for Health and Development (NSHD) birth cohort study, including 2547 women 2815 men, was used to model relationships between conventional and emerging risk factors and cardiometabolic and vascular outcomes, including myocardial infarction and stroke between 1999 and 2009. Logistic regression or XGBoost (eXtreme Gradient Boosting) models were used to predict the outcomes (myocardial infarction and strokes). Model fit was assessed by comparing predicted and known incident events in a two-by-two error matrix for binary outcomes. Results In a model including both sex and smoking alcohol intake (β = -0.029g; p < 0.05), body mass index (BMI) (β = 0.095 kg/m2; p < 0.05), glycated haemoglobin (HbA1c) (β = 0.033 mmol/mol; p < 0.01) and total cholesterol/high density lipoprotein (TC/HDL) ratio (β = 0.459 mg/dL; p < 0.0001) waist-to-hip ratio (β = 5.632cm; p = 0.05) and waist circumference (β = 0.031cm; p < 0.01) were significant predictors of myocardial infarction. A lower risk was observed among those with higher average alcohol intake, whereas higher risk being observed among those with higher BMI, HbA1c levels, total cholesterol/HDL ratio, waist-to-hip ratio and waist circumference. For stroke, exercising 5+ times (β = -1.47; p < 0.01), systolic blood pressure (SBP) (β = 0.040mmHg; p < 0.001), diastolic blood pressure (DBP) (β = 0.027mmHg; p < 0.001), pulse pressure (β = 0.033mmHg; p < 0.01), triglycerides (β = 0.388; p < 0.05) and total cholesterol/HDL ratio (β = 0.419; p < 0.01) were all significant predictors of stroke. We found that higher values of SBP, DBP, pulse pressure, triglycerides and total cholesterol/HDL ratio were associated with higher risk of stroke, whereas higher levels of physical activity were associated with a lower risk. Additionally, by combining BMI, HbA1c and total cholesterol/HDL ratio to the baseline model it provided the greatest F1 score of all models (0.123) and the greatest precision (6.7%), with a recall of 72.4%. With XGBoost we observed a reduced F1 score from 0.123 to 0.079, although adding information on alcohol intake and waist to hip ratio to this model, as previous analysis indicated great improvements in prediction, the F1 score obtained using the XGBoost increased from to 0.079 to 0.103. Conclusion This research shows that clinical and laboratory measurements play a potentially powerful role in predicting health outcomes when using evidence-based risk calculators. Using large cohorts allows for real-life long-term associations to be explored and quantified with a higher level of certainty for replicability across other populations.

Stability and change in associations between social responsibility goals, achievement, and psychosomatic problems

ABSTRACT Social responsibility goals have shown positive relationships with performance and well-being. However, being too diligent has also been raised as a possible contributing factor to students’ reports of feeling stress and pressure in school, as well as experiencing psychosomatic problems. This study investigates the long-term associations between students’ social responsibility goals, academic achievements, and psychosomatic problems from Grade 9 (n = 4,573) to Grade 12 (n = 3,552), and gender differences in these associations. Descriptive statistics showed that girls reported more psychosomatic problems, higher social responsibility goals, and higher GPAs. Structural equation models showed that psychosomatic problems and achievement were stable over time. Social responsibility goals were associated with less psychosomatic problems and higher achievement in Grade 9. For girls, higher achievement was also associated with psychosomatic problems. Social responsibility goals did not predict later achievement, yet they predicted future psychosomatic problems, although the prediction was significant only for boys.

Polypharmacy in elective lumbar spinal surgery for degenerative conditions with 24-month follow-up

We sought to identify long-term associations of medical complications and healthcare utilization related to polypharmacy following spinal surgery for degenerative lumbar pathology. The IBM MarketScan dataset was used to select patients who underwent spinal surgery for degenerative lumbar pathology with 2-year follow-up. Regression analysis compared two matched cohorts: those with and without polypharmacy. Of 118,434 surgical patients, 68.1% met criteria for polypharmacy. In the first 30 days after discharge, surgical site infection was observed in 6% of those with polypharmacy and 4% of those without polypharmacy (p < 0.0001) and at least one complication was observed in 24% for the polypharmacy group and 17% for the non-polypharmacy group (p < 0.0001). At 24 months, patients with polypharmacy were more likely to be diagnosed with pneumonia (48% vs. 37%), urinary tract infection (26% vs. 19%), and surgical site infection (12% vs. 7%), (p < 0.0001). The most prescribed medication was hydrocodone (60% of patients) and more than 95% received opioids. Two years postoperatively, the polypharmacy group had tripled overall healthcare utilization payments ($30,288 vs. $9514), (p < 0.0001). Patients taking 5 or more medications concurrently after spinal surgery for degenerative lumbar conditions were more likely to develop medical complications, higher costs, and return to the emergency department.

Long-term associations between time-varying exposure to ambient PM2.5 and mortality: an analysis of the UK Biobank.

Evidence for long-term mortality risks of PM2.5 comes mostly from large administrative studies with incomplete individual information and limited exposure definitions. Here we assess PM2.5-mortality associations in the UK Biobank cohort using detailed information on confounders and exposure. We reconstructed detailed exposure histories for 498,090 subjects by linking residential data with high-resolution PM2.5 concentrations from spatio-temporal machine learning models. We split the time-to-event data and assigned yearly exposures over a lag window of 8 years. We fitted Cox proportional hazard models with time-varying exposure controlling for contextual and individual-level factors, as well as trends. In secondary analyses, we inspected the lag structure using distributed lag models and compared results with alternative exposure sources and definitions. In fully adjusted models, an increase of 10 μg/m³ in PM2.5 was associated with hazard ratios (HRs) of 1.27 (95%CI: 1.06-1.53) for all-cause, 1.24 (1.03-1.50) for non-accidental, 2.07 (1.04-4.10) for respiratory, and 1.66 (0.86-3.19) for lung cancer mortality. We found no evidence of association with cardiovascular deaths (HR=0.88, 95%CI: 0.59-1.31). We identified strong confounding by both contextual- and individual-level lifestyle factors. The distributed lag analysis suggested differences in relevant exposure windows across mortality causes. Using more informative exposure summaries and sources resulted in higher risk estimates. We found associations of long-term PM2.5 exposure with all-cause, non-accidental, respiratory, and lung cancer mortality, but not with cardiovascular mortality. This study benefits from finely reconstructed time-varying exposures and extensive control for confounding, further supporting a plausible causal link between long-term PM2.5 and mortality.

Revisiting the dynamics of major cryptocurrencies

Purpose – This study aims to reassess the dynamics of major cryptocurrencies sur-rounding recent economic and geopolitical events. By employing wavelet analysis and quantile regression methods, it seeks to understand the behavior of cryptocurrencies before, during, and after the COVID-19 pandemic. Research methodology – This research employs the Least Asymmetric Daubechies (LA8) wavelet function to decompose log-returns of major cryptocurrencies into various frequency scales. Additionally, it utilizes wavelet coherence and quantile-on-quantile regression techniques to analyze daily price data spanning from July 2017 to May 2024. Findings – The findings reveal a strong long-term association among cryptocurrencies, with a decline in medium-term correlations. Bitcoin exhibits synchronization with major cryptocurrencies, excluding Tether, while BTC-ETH and BTC-BNB display a rapid, interconnected behavior alongside their fundamental links. Moreover, empirical evidence indicates Bitcoin’s heterogeneous nexus with other alternatives, showcasing greater sensitivity to positive extremes over negative ones. Research limitations – The study’s scope is delimited by the selected time frame (July 2017 to May 2024) for data analysis, potentially limiting insights into longer-term trends. Additionally, the reliance on specific methodologies like wavelet analysis might introduce constraints in capturing the entirety of cryptocurrency dynamics, leaving room for alternative interpretations or unexplored aspects. Practical implications – Results suggest that understanding the varying correlations among major cryptocurrencies during different market phases could aid investors and policymakers in devising more nuanced strategies. Recognizing the sensitivity of Bitcoin’s connections with alternatives to market trends could inform risk management approaches, particularly in navigating extreme market conditions. Originality/Value – The originality of this study lies in its comprehensive examination of cryptocurrency dynamics across varying time scales, utilizing wavelet analysis and quantile regression techniques. The findings offer valuable insights into the complex interconnections among cryptocurrencies, especially in terms of their sensitivity to different market conditions, providing a nuanced perspective for investors, analysts, and policymakers navigating the crypto landscape.

Association of Ambient Air Pollution Exposure With Incident Glaucoma: 12-Year Evidence From the UK Biobank Cohort.

Glaucoma is the leading cause of irreversible blindness worldwide. Despite growing concerns about air quality and its impact on ocular health, there remains a knowledge gap regarding the long-term association between air pollution and glaucoma risk. This study investigates the relationship between exposure to ambient air pollution and incidence of glaucoma. In this prospective study, we used land use regression models to estimate levels of various air pollutants, including fine particulate matter (PM2.5), PM2.5 absorbance, PM2.5-10, PM10, nitrogen dioxide (NO2), and nitrogen oxides (NOx). Incidents of glaucoma were ascertained through routinely collected hospital admission records. Multivariate Cox proportional hazards models were used to examine the associations between air pollution exposure and glaucoma incidence, adjusting for potential confounding sociodemographic, physical, and lifestyle factors. Data from 481,113 participants were included. Over a median follow-up of 12.8 years, 9224 incident cases of glaucoma were identified. In the maximally adjusted model, per interquartile range increase in PM2.5 was associated with a 3% greater risk of developing glaucoma (hazard ratio [HR] = 1.03, 95% confidence interval [CI] = 1.00 to 1.06, P = 0.048). Participants in the highest quartile had a 10% increased risk of developing glaucoma compared to those in the lowest quartile (HR = 1.10, 95% CI = 1.03 to 1.17, P = 0.005). Higher levels of exposure to ambient air pollutants, particularly PM2.5, are associated with an increased risk of developing glaucoma. These results highlight the potential public health impact of ambient air pollution on glaucoma risk and underscore the urgent need for further research into targeted environmental interventions in this domain.

Predicting cognitive function changes from oral health status: a longitudinal cohort study

Recent studies indicate a potential link between oral health and cognitive function; however, long-term associations remain unclear. This study aimed to identify oral health factors that predict changes in cognitive function among older adults over time. The study included 583 independent older adults (201 male, 382 female) with a mean age of 72.7 years. Cognitive function was assessed using Mini-Mental State Examination (MMSE) at baseline and follow-up over two years, with relative change in MMSE (rMMSE) calculated. Baseline oral health variables included number of remaining teeth, masticatory performance, occlusal force, oral diadochokinesis and tongue pressure. Physical performance and confounding factors were also considered. The relationship between rMMSE and the variables was analyzed using Pearson’s correlation, Mann-Whitney U test, and multiple linear regression analysis. Cognitive function declined in 196 subjects, with rMMSE significantly correlated with oral diadochokinesis. Regression analysis revealed significant associations between cognitive changes and oral diadochokinesis (p = 0.020) and knee extension strength as a physical performance (p = 0.047). Our findings suggest that cognitive decline may be indicated by declines in both physical and oral motor performance. Incorporating oral diadochokinesis testing into health screenings could aid early detection of cognitive decline, improving outcomes and reducing healthcare burdens.

South! Phylogeography of the Antarctic fairy shrimp Branchinecta gaini and its closest Patagonian congener Branchinecta granulosa reveals a long-term association of freshwater fauna with the southern continent

AbstractBranchinecta gaini Daday, 1910 is the southernmost extant Anostracan species occurring in various localities across Maritime Antarctica. Since this region was almost completely glaciated during the Last Glacial Maximum, the identification of potential glacial refugia and the colonization sequence of freshwater habitats within Maritime Antarctica remains primary biogeographic objective for understanding the evolution of the Antarctic environment. To evaluate the history of B. gaini in Maritime Antarctica, we performed phylogeographic analyses of B. gaini and its closest Patagonian congener Branchinecta granulosa Daday, 1902. We sampled 47 populations from all three Antarctic bioregions where B. gaini occurs – South Orkney Islands, North-west and North-east Antarctic Peninsula. B. granulosa was represented by 8 populations from Patagonia. Molecular analyses of two mitochondrial (16S, COI) and one nuclear (ITS2) marker showed low overall mitochondrial variability and the ambiguous nature of ITS2 variability. The species assessment revealed insufficient genetic differentiation between B. gaini and B. granulosa to consider them two separate species. Therefore, the widely accepted idea that there is a species of Branchinecta endemic to Antarctica and sub-Antarctic islands should be omitted, and B. gaini should be synonymized with B. granulosa. Molecular clock analysis of COI for two substitution rates dated the separation of B. gaini from B. granulosa to the Pleistocene (170 – 502 ka BP and 17 – 50 ka BP, respectively). Therefore, Antarctic populations of B. gaini separated from Patagonian B. granulosa before or during the Last Glacial Maximum, indicating an older association with the southern continent than previously anticipated. The geographic distribution of haplotypes further suggests that B. gaini most likely survived at least the last glacial period in an as-yet unknown refugium in Antarctica.

Impact of digital transformation on financial stability in emerging markets: evidence from Ethiopia

This insightful study delves into the intricate relationship between key digital finance adoption indicators and the stability of the banking sector in Ethiopia, an emerging economy undergoing rapid digitalization. Covering annual data from 1991 to 2022 and utilizing an autoregressive distributed lag (ARDL) approach alongside Fully Modified Ordinary Least Squares (FMOLS) and Dynamic Ordinary Least Squares (DOLS) techniques, the researchers uncover thought-provoking findings that challenge conventional wisdom. Contrary to expectations of a positive long-term association, the analysis reveals a statistically significant negative relationship between both internet usage and mobile phone subscriptions and Ethiopia's banking system's financial stability. This robust result, validated through rigorous robustness checks, suggests that the breakneck pace of digital transformation may outpace the development of robust regulatory frameworks and risk management practices, ultimately undermining the overall stability of the financial sector. Interestingly, the short-term analysis presents a more nuanced picture, with mobile phone subscriptions exhibiting a stabilizing effect in the immediate aftermath. This intriguing dichotomy highlights the complex and evolving dynamics at play, where the challenges of integrating digital finance with the traditional banking infrastructure and the persistence of informal financial activities potentially offset the benefits of enhanced financial inclusion and transaction efficiency. These thought-provoking findings carry crucial implications for policymakers and industry stakeholders navigating the digital revolution. Policy implications emphasize the need for robust regulatory frameworks, enhanced cyber security measures, and improved financial literacy. The findings underscore the importance of a nuanced approach to digital finance in emerging economies, advocating for continuous adaptation of policies to address the evolving landscape of financial technology. Continued inquiry can better guide policies that foster digital transformation while safeguarding stability, especially in rapidly developing regions like sub-Saharan Africa.Graphical

Exploring Saudi Arabia’s 2060 net zero-emission paths via fractional frequency Fourier procedures. The imperatives of resource efficiency, energy efficiency, and digitalization

ABSTRACT By applying the novel fractional frequency Fourier ARDL technique, we unraveled the intricacies underpinning resource efficiency, energy efficiency, digitalization, and environmental sustainability in Saudi Arabia. Compelled by the conflicting narratives of prior investigations and the need for updated insights, the analyzed time series spanning 1990–2022 periods divulged interesting insights amenable to policy optimization. First, the fractional frequency Fourier ADL cointegration procedure reveals a long-term association among all the enlisted series. Second, resource and energy efficiencies, as well as digitalization, improved environmental quality by limiting carbon intensities and ecological footprint with some heterogeneous attributes across the timeframes. Notably, while resource efficiency is more effective toward ecological footprint mitigations, energy efficiency proves more efficient for carbon intensity reductions. Lastly, the fractional frequency Fourier Toda-Yamamoto causality test affirms the predictive attributes of the enlisted series on environmental performance. Hence, these factors are critical to KSA’s environmental sustainability paths. Based on these empirical discoveries, policymakers in KSA must pay adequate attention to the efficient utilization of resources and energy to complement other steps toward realizing Saudi Arabia’s 2060 net zero-emission. Likewise, policymakers must ensure the efficient allocation of income to environmentally sensitive ventures to curtail its negative repercussions on the environment. Other relevant steps to curtail carbon intensities and ecological footprint for optimal environmental performance in KSA have been highlighted.

TCT-711 Long-term Temporal Association Between Clinical Outcomes and Fractional Flow Reserve After Coronary Stenting: Insights From the International Post-PCI FFR Extended Registry

TCT-711 Long-term Temporal Association Between Clinical Outcomes and Fractional Flow Reserve After Coronary Stenting: Insights From the International Post-PCI FFR Extended Registry

Does living close to allergenic street trees affect lung function in German adults?

IntroductionStudies on greenspace and lung function in adults produced divergent results. Some of the adverse findings could be due to long-term exposure to allergenic tree pollen. We investigated whether having more birch trees or more allergenic trees around home is related to worse lung function and whether these exposures confound the association between greenspace and lung function. MethodsThe analytic sample consisted of 874 adults aged 20–44 years at baseline from the German study centers, Erfurt and Hamburg, of the ECRHS cohort study. Spirometric lung function was measured in 1991/92, 2000/01, and 2011/12. We counted trees based on tree registries and classified them into allergenic and non-allergenic. We assessed exposure to greenspace with the normalized difference vegetation index (NDVI), tree cover density, and total number of trees in a 300 m buffer around home. Linear mixed models were used. ResultsThe forced expiratory volume in 1 s (FEV1) and the forced vital capacity (FVC) were decreased in the presence of more birch trees after adjusting for confounders and co-exposures. For every 10 additional birch trees in a 300 m buffer around home, the average change in FEV1 was −27.6 mL (95% confidence interval (CI): [-58.7, 3.5]). For FVC the average change was −28.2 mL (95% CI: [-62.0, 5.6]). No consistent associations were found for allergenic trees, total trees, tree cover density, or NDVI. Unlike other associations, those of birch trees with FEV1 and FVC were not moderated by allergic sensitization to birch pollen, history of asthma symptoms or nasal allergies including hay fever, ozone, NO2, or age. DiscussionLiving close to birch trees had an adverse long-term association with lung function. That tree registries were limited to street trees prevented us from answering the question of a potential confounding of greenspace effects by allergenic neighborhood trees.

Exposure to Sexually Explicit Internet Material in Adolescence and Unwanted Sexual Behavior in Emerging Adulthood

Abstract: This longitudinal study examines long-term associations between the use of sexually explicit internet material (SEIM) during adolescence and engagement in unwanted sexual behaviors in emerging adulthood. Drawing on a four-wave panel study among 377 participants (aged 18–24, 44.3% male), using logistic regression analysis, we found that SEIM use during adolescence predicted a higher odds of having sexually touched a stranger and of having insisted on sex with someone who had refused by emerging adulthood, 5 years later. That said, the proportion of participants committing these unwanted sexual behaviors is relatively small. Respectively 10.3%, 8.5%, and 1.1% of emerging adults had sexually touched a stranger, insisted on sex with a partner who had refused, or had used force to try to have sex.

Is Childhood Adversity Before Age 5 Associated with Adolescent and Young Adult Substance Use? Findings from a U.S. Prospective Cohort Study

Objective Growing research suggests that adversity experienced early in life can affect young children’s development, with implications for health-related outcomes years later. This study explored long-term associations between early life adversity before age 5 (ELA) and later substance use outcomes, and racial and ethnic differences in associations. Method Data are from children born 1984–2000 to female participants in the U.S. National Longitudinal Study of Youth-1979 cohort (N = 4582 children nested within 2683 mothers, with 1.4–1.8 outcome observations on average for each child in each age period). ELA at ages 0–4 was measured through home observations and maternal surveys, and included high parental conflict and maternal hazardous drinking/drug use (threat-related exposures), and low cognitive stimulation, low emotional support, and household poverty (deprivation-related exposures). Alcohol and cannabis use frequency were measured in biennial adolescent and young adult surveys through 2016. Analyses involved multilevel regression and interactions accounting for demographics, birth cohort, and family history of alcoholism. Results ELA-threat exposure was associated with greater alcohol and cannabis use frequency in mid-adolescence and at ages 22–25 and 26–32 [exp( β ^ )’s = 1.05 to 1.13, p’s < 0.05]. Associations of ELA-deprivation with substance use were either null or negative. There were pronounced racial and ethnic inequities in ELA exposure but no evidence of racial and ethnic differences in associations between ELA and later substance use. Conclusions Broadening substance use research to focus on early childhood conditions appears warranted. Studies that identify intervening pathways to outcomes could inform early, targeted substance use prevention. Efforts are needed to eliminate racial and ethnic inequities in early life conditions.

Subsequent risk of cancer among adults with peripheral artery disease in the community: The atherosclerosis risk in communities (ARIC) study

Background and aimsSeveral studies reported an increased cancer risk related to lower-extremity peripheral artery disease (PAD) but had important caveats: not accounting for key confounders like smoking, follow-up <10 years, or no race-specific results. To assess the long-term independent association of PAD with cancer incidence in a bi-racial community-based cohort. MethodsWe categorized 13,106 ARIC participants without cancer at baseline (mean age 54.0 [SD 5.7] years, 45.7 % male, and 26.1 % Black) into symptomatic PAD (clinical history or intermittent claudication), asymptomatic PAD (ankle-brachial index [ABI] ≤0.9), and five ABI categories (0.1-interval between 0.9 and 1.3 and > 1.3). We used cancer registries and medical records to ascertain cancer cases and ran multivariable Cox models. ResultsDuring the median follow-up of 25.3 years, there were 4143 incident cancer cases. 25-year cumulative incidence was 37.2 % in symptomatic PAD, 32.3 % in asymptomatic PAD, and 28.0–31.0 % in the other categories. Symptomatic and asymptomatic PAD remained significantly associated with cancer incidence after adjusting for potential confounders, including smoking and diabetes (hazard ratio [HR] 1.42 [1.05–1.92] and 1.24 [1.05–1.46], respectively). When stratified by smoking status, we observed a robust association of PAD (symptomatic and asymptomatic combined) vs. no PAD with cancer risk in ever smokers (HR 1.42 [1.21–1.67]) but not in never smokers. The results were most evident for lung cancer (HR 2.16 (95 %CI 1.65–2.83) for PAD vs. no PAD within ever smokers). ConclusionsSymptomatic and asymptomatic PAD conferred cancer risk, particularly among ever smokers and for lung cancer. Patients with PAD should receive evidence-based cancer prevention and screening.

Association between long-term exposure to low ambient PM2.5 and cardiovascular hospital admissions: A UK Biobank study

IntroductionA causal link between air pollution exposure and cardiovascular events has been suggested. However fewer studies have investigated the shape of the associations at low levels of air pollution and identified the most important temporal window of exposure. Here we assessed long-term associations between particulate matter < 2.5 µm (PM2.5) at low concentrations and multiple cardiovascular endpoints using the UK Biobank cohort. MethodsUsing data on adults (aged > 40) from the UK Biobank cohort, we investigated the associations between 1-year, 3-year and 5-year time-varying averages of PM2.5 and incidence of major adverse cardiovascular events (MACE), myocardial infarction (MI), heart failure, atrial fibrillation and flutter and cardiac arrest. We also investigated outcome subtypes for MI and stroke. Events were defined as hospital inpatient admissions. We fitted Cox proportional hazard regression models applying extensive control for confounding at both individual and area level. Finally, we assessed the shape of the exposure–response functions to assess effects at low levels of exposure. ResultsWe analysed data from 377,736 study participants after exclusion of prevalent subjects. The average follow-up (2006–2021) was 12.9 years. We detected 19,353 cases of MACE, 6,562 of acute MI, 6,278 of heart failure, 1,258 for atrial fibrillation and flutter, and 16,327 for cardiac arrest. Using a 5-year exposure window, we detected positive associations (for 5 μg/m3 increase in PM2.5) for 5-point MACE of [1.12 (95 %CI: 1.00–1.26)], heart failure [1.22 (1.00–1.50)] and cardiac arrest [1.16 (1.03–1.31)]. We did not find any association with acute MI, while non-ST-elevation MI was associated with the 1-year exposure window [1.52 (1.12–2.07)]. The assessment of the shape of the exposure–response relationships suggested that risk is approximately linear for most of the outcomes. ConclusionsWe found positive associations between long-term exposure to PM2.5 and multiple cardiovascular outcomes for different exposure windows. The cardiovascular risk tends to rise even at exposure concentrations below 12–15 μg/m3, indicating high risk below UK national and international thresholds.