Estimate Odds Ratios Research Articles

SUBCLINICAL SEIZURES ON EEG WITH SLEEP PHASES AND CLINICAL SIGNIFICANCE IN PATIENTS WITH FOCAL EPILEPSY

Purpose: It is observed in studies that subclinical seizures have significant impact on the diagnosis, prognosis, and treatment responses. Aim of our study is investigating presence of these seizures, their relationship with sleep, contribution to diagnosis, and impact on treatment selection and prognosis in patients diagnosed with focal epilepsy. Materials and methods: Total of 1,626 EEGs conducted in the EEG unit were examined. Among them, 626 were found to belong to patients diagnosed with focal epilepsy. 140 patients who underwent twenty-minute EEG monitoring and 28 patients who underwent twenty-four-hour EEG monitoring were included in the study. Results: A comparative analysis was conducted between two cohorts of patients: one subjected to a twenty-minute EEG and the other undergoing a 24-hour EEG. In the presence of resistant epilepsy, the risk of SCS is increased by 3.1 times. The presence of SCS in frontal lobe epilepsies demonstrated a 2.2-fold elevation compared to temporal lobe epilepsies (1.0-5.3). A statistically significant relationship between Levetiracetam usage and seizures was observed (p=0.044). The calculated Odds Ratio for risk indicated a 1.2-fold (1-1.6) higher frequency of seizures with Levetiracetam usage. Risk analysis revealed a 1.5-fold (1.2-1.9) higher incidence of seizures with the use of well-known drugs in favor of lacozamide-zonisamide. Conclusion: SCSs are gaining increasing clinical significance in terms of diagnosis, prognosis, and treatment. The relationship between these sleep and SCSs holds importance for future research with a larger number of patients and centers.

HNF1B polymorphisms and endometrial cancer risk: validation of identified loci and evaluation of novel variants

ABSTRACT Background This study aimed to validate HNF1B single nucleotide polymorphisms (SNPs) associated with endometrial cancer risk in a Chinese Han population and explore novel SNPs. Our findings enhance the understanding of genetic components and are crucial for detection strategies and personalized medicine. Methods We genotyped four HNF1B SNPs in 637 patients and 667 controls using Agena MassARRAY. Logistic regression calculated odds ratios (ORs) and 95% CI. Forest plots visualize stratified analyses. Multiple comparisons tested genetic loci-clinical indicator associations. Results The study confirmed that rs4430796 (A>G) reduced endometrial cancer risk (OR = 0.83, 95% CI: 0.70–0.99, p = 0.041). Additionally, novel HNF1B mutations were associated with endometrial cancer risk: rs7405776 in individuals under the age of 55 (OR = 047, 95% CI: 0.25–0.91, p = 0.025) and nonsmokers (OR = 0.42, 95% CI: 0.23–0.75, p = 0.004), and rs11651755 in drinkers (OR = 0.39, 95% CI: 0.17–0.90, p = 0.027) and nonsmokers (OR = 0.43, 95% CI: 0.23–0.81, p = 0.009). The SNP rs4430796 was also associated with the CA125 level (p < 0.05). Conclusion HNF1B polymorphisms influence endometrial cancer risk in the Chinese Han population. Further studies are needed to explore the functional roles and clinical practicality of these SNPs.

The value of age of onset and family history as predictors of molecular diagnosis in a Swedish cohort of inherited retinal disease.

This study aimed to characterize clinical and genetic findings in a Swedish cohort with inherited retinal disease (IRD), identify predictors for achieving a molecular diagnosis and evaluate the effects of increased genetic testing over time. Clinical and genetic data from 324 nonrelated IRD index individuals referred for genetic testing in the Stockholm region between 2016 and 2023 were collected retrospectively and analysed by clinical subtype, age of onset and testing period (2016-2020 vs. 2021-2023). Logistic regression was used to calculate odds ratios for age of onset and family history on the likelihood of achieving a molecular diagnosis. The diagnostic yield was 55% and involved 56 genes. In 10% of solved individuals, the molecular diagnosis refined the clinical diagnosis. For each 1-year increase in age of onset, the odds of achieving a molecular diagnosis decreased by 3% (odds ratio 0.97, 95% confidence interval 0.96-0.98). A positive family history doubled the odds (odds ratio 2.1, 95% confidence interval 1.3-3.4). The use of genetic testing increased 2.1-fold and the number of molecular diagnoses increased 1.6-fold relative to the population of the Stockholm region between the two testing periods. This study adds to the knowledge of the clinical and genetic landscape of IRDs in Sweden and establishes age of onset and family history as significant predictors for achieving a molecular diagnosis. Increased genetic testing on a population level substantially increased the number of individuals receiving a molecular diagnosis with a high diagnostic yield compared to other rare diseases.

Association between fine particulate matter (PM2.5) and infant mortality in a North Carolina birth cohort (2003-2015).

While the association between fine particulate matter (PM2.5) and adult mortality is well established, few studies have examined the association between long-term PM2.5 exposure and infant mortality. We conducted an unmatched case-control study of 5992 infant mortality cases and 60,000 randomly selected controls from a North Carolina birth cohort (2003-2015). PM2.5 during critical exposure periods (trimesters, pregnancy, first month alive) was estimated using residential address and a national spatiotemporal model at census block centroid. We fit adjusted logistic regression models and calculated odds ratios (ORs) and 95% confidence intervals (CIs). Due to differences in PM2 .5 over time, we stratified analyses into two periods: 2003-2009 (mean = 12.1 µg/m3, interquartile range [IQR]: 10.8-13.5) and 2011-2015 (mean = 8.4 µg/m3, IQR: 7.7-9.0). We assessed effect measure modification by birthing parent race/ethnicity, full-term birth, and PM2.5 concentrations. For births 2003-2015, the odds of infant mortality increased by 12% (95% CI: 1.06, 1.17) per 4.0 µg/m3 increase in PM2.5 exposure averaged over the pregnancy. After stratifying, we observed an increase of 4% (95% CI: 0.95, 1.14) for births in 2003-2009 and a decrease of 15% (95% CI: 0.72, 1.01) for births in 2011-2015. Among infants with higher PM2.5 exposure (≥12 µg/m3) during pregnancy, the odds of infant mortality increased (OR: 2.69; 95% CI: 2.17, 3.34) whereas the lower exposure (<8 µg/m3) group reported decreased odds (OR: 0.50; 95% CI: 0.28, 0.89). We observed differing associations of PM2.5 exposure with infant mortality across higher versus lower PM2.5 concentrations. Research findings suggest the importance of accounting for long-term trends of decreasing PM2.5 concentrations in future research.

Impact of financial support on treatment outcomes of multidrug-resistant tuberculosis: A population-based, retrospective cohort study in Shanghai, China

BackgroundTo date, the prolonged treatment duration and expensive second-line anti-tuberculosis drugs (SLDs) for multidrug-resistant tuberculosis (MDR-TB) can impose a significant financial burden, which may negatively impact treatment outcomes. This study examines the effect of a subsidy policy on treatment outcomes of MDR-TB patient.. MethodsWe collected demographic and drug resistance data of all registered MDR-TB patients between April 2011 and December 2019 in Shanghai, China. Documentation of financial support received was routinely maintained until December 2021. We employed multivariate logistic regression to assess the association between financial support and treatment outcomes, estimating odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). ResultsOf the 865 patients, 70.6% (611/865) achieved treatment success. The median amount compensated under the subsidy policy was 2359 United States dollar (USD), with an interquartile range from 1116 to 5652 USD. A positive association was found between benefiting from the subsidy policy and higher rate of treatment success, with an adjusted OR of 2.95 (95% CI, 2.03–4.28). Among the 641 patients covered by the policy, the adjusted OR comparing those with higher versus lower reimbursement was 1.74 (95% CI, 1.16–2.61). ConclusionsFinancial support policies for MDR-TB patients demonstrate a positive influence on treatment outcomes.

Allergic disease and keratoconus: A two-sample univariable and multivariable Mendelian randomization study

BackgroundThere is accumulating evidence that allergy is a risk factor for keratoconus. Nonetheless the association between allergic disease and keratoconus remains controversial. We performed a two-sample Mendelian randomization (MR) study to determine the putative causal association of 4 allergic diseases (allergic conjunctivitis, allergic asthma, allergic rhinitis and atopic dermatitis) with keratoconus. MethodsSummary statistics were obtained from genome-wide association studies (GWAS) of allergic conjunctivitis (AC) (20,958 cases and 356,319 controls), allergic asthma (AA) (9631 cases and 210,122 controls), allergic rhinitis (AR) (11,009 cases and 359,149 controls), atopic dermatitis (AD) (13,473 cases and 336,589 controls), keratoconus (KC) (2116 cases and 24,626 controls) and 91 circulating inflammatory cytokines (n = 14,824). Two-sample univariable and multivariable MR analyses were performed. A two-step MR was then applied to determine whether systemic inflammatory cytokines mediated the effect of allergic disease on keratoconus. ResultsThe causal odds ratio (OR) estimate of genetically determined KC was 1.66 (95% CI: 1.32–2.08; P < 0.001) for AC, 1.29 (95% CI: 1.10–1.51, P = 0.0014) for AA, 1.39 (95% CI: 1.15–1.68; P < 0.001) for AR and 1.30 (95% CI: 1.17–1.45, P < 0.001) for AD. Multivariable MR indicated a suggestive association between AC and KC after conditioning on other allergic diseases (OR 1.61; 95% CI: 1.10–2.34; P adjusted = 0.054). Two-step MR revealed that the effect was not mediated by systemic inflammatory cytokines. ConclusionsOur findings provide evidence of a potential causal relationship between AC and KC. The effect of AC on KC may be mediated via other systemic inflammatory cytokines not included in the present study, or by alternative mechanisms. These findings may offer insight for prevention and intervention strategies to lower the risk of KC in patients with AC.

Relationship between Shoulder Pain, Trunk and Lower Limb Pain in Overhead Athletes: A Systematic Review with Meta-analysis.

Forty-nine percent of overhead athletes suffer from shoulder pain. Throwing movements require the participation of all components of the kinetic chain to reduce risk for shoulder overuse. Thus, limited lower limb range of motion or weakness has been identified as a risk factor for shoulder pain in overhead athletes. This systematic review aims to evaluate the association between shoulder, trunk, and lower limb pain in overhead athletes. Systematic Review and Meta-analysis. A systematic review was conducted in the PubMed/MEDLINE, Science Direct and CENTRAL/Cochrane databases for observational studies. Search terms included sports-related terms (e.g., 'overhead', 'baseball', 'volleyball', 'handball') and injury-related terms (e.g., 'injury history', 'shoulder pain', 'lower limb pain', 'hip pain', 'knee pain', 'ankle pain', 'foot pain', 'trunk pain'). Studies were considered for review if they met the following criteria: inclusion of overhead athletes, investigation of injury or pain in shoulder and lower limb or trunk, had data related to or could calculate the calculation of odds ratio (OR) or relative risk (RR), available in French or English. The ROBINS-E tool was used to assess the methodological quality of each article. The data were pooled in a random-effects meta-analysis, using odds ratios to estimate the strength of the association between shoulder pain and pain at other locations. Seven articles were included. Five of them were at moderate risk of bias and two were at high risk of bias. Shoulder pain was associated with low back pain (OR=5.51), hip pain (OR=4.32), knee pain (OR=3.03) and ankle/foot pain (OR=2.84). This systematic review highlighted, with very low to low certainty, a significant association between shoulder pain and trunk/lower limb pain or injuries. Level 3.

The Independent Association Between Changes in Physical Activity Participation Time and Dyslipidemia Risk

Background and AimThis study aimed to examine the independent association between changes in participation time across different types of physical activities and dyslipidemia. Methods and ResultsThe study utilized data from a large-scale cohort survey of Koreans, comprising a total of 2,543 participants recruited during 2011-2012 and 2013-2014. Physical activity participation times by type were assessed using validated questionnaires, and changes in these participation times over two years were categorized into four groups(Consistently Inactive, Formerly Active, Newly Active, and Consistently Active). Dyslipidemia was classified according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Multiple logistic regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI) to assess the association between changes in physical activity participation times and dyslipidemia. The analysis revealed that, when adjusting for sex and age, the Consistently Active group had a 40% lower odds ratio (OR=0.60, 95% CI=0.45, 0.81) of dyslipidemia compared to the Consistently Inactive group. Similar results were observed after adjusting for various confounding factors. Also, being newly active(OR=0.75, 95% CI=0.58, 0.97) or consistently active(OR=0.63, 95% CI=0.41, 0.97) in moderate-intensity physical activity, as well as being consistently active(OR=0.76, 95% CI=0.61, 0.95), in walking, independently reduced the risk of dyslipidemia after adjusting for various confounding variables. ConclusionsMaintaining a high level of physical activity was associated with a reduced risk of dyslipidemia. Therefore, national recommendations should focus on sustaining and increasing physical activity levels to manage dyslipidemia effectively.

Association between social jetlag and leisure-time physical activity and muscle strengthening exercise in young adults: findings from a nationally representative sample in South Korea

ObjectivesSocial jetlag (SJL), which is characterised by a misalignment between biological and social time, is associated with cardiometabolic risk factors. This study investigated the relationship between SJL, leisure-time physical activity (LTPA) and muscle strengthening exercise (MSE) in young adults. Study designThis was a cross-sectional study. MethodsThis cross-sectional study included a nationally representative sample of young adults aged 19–29 years (n = 2113). SJL was calculated as the difference in the midpoint of sleep onset and offset time between weekdays and weekends. The dependent variables were engagement in ≥150 min/week of moderate-to-vigorous LTPA and engagement in MSE ≥2 days/week based on guidelines provided by the World Health Organisation. Logistic regression analysis was performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Non-linear relationships were estimated using restricted cubic spline regression. ResultsThe study population comprised 975 men and 1138 women. Among participants, 4.6% had <0 min, 41.9% had 0–59 min, 25.7% had 60–119 min and 27.7% had ≥120 min SJL. Those with ≥120 min SJL had a reduced likelihood of achieving the recommended level of LTPA (OR: 0.71, 95% CI: 0.52–0.95) and MSE (OR: 0.73, 95% CI: 0.55–0.97). In the non-linear model, an inverse U-shaped association was observed, wherein the highest probability of meeting the recommended level of LTPA and MSE was observed in those with 45 min SJL, decreasing after this threshold. ConclusionsIndividuals with ≥120 min SJL were less likely to engage in the recommended level of both aerobic and anaerobic exercise. Although future studies using a longitudinal design are required to elucidate the causal relationship between SJL and physical activity, the current findings suggest that physical inactivity during leisure time may play an important role in the increased risk of cardiometabolic abnormalities in young adults with SJL.

Exploring Interaction Between Genetically Predicted Body Mass Index and Serum 25-hydroxyvitamin D Levels on the Odds for Psoriasis in UK Biobank and the HUNT Study: A Factorial Mendelian Randomisation Study

Mendelian randomisation (MR) studies show that higher body mass index (BMI) and lower 25-hydroxyvitamin D (25[OH]D) increase psoriasis risk. The combined effect of these factors has not been explored using factorial MR. Using cross-sectional data from UK Biobank (UKB, n=398 404) and the Trøndelag Health Study (HUNT, n=86 648), we calculated polygenic risk scores for BMI and 25(OH)D to estimate odds ratios for psoriasis using 2x2 and continuous factorial MR. We quantified additive interaction by relative excess risk due to interaction (RERI)-estimates. We also performed traditional observational analyses in UKB. There were 12 207 (3.1%) participants with psoriasis in UKB and 7794 (9.0%) in HUNT. In 2x2 factorial MR, we found no evidence of relative excess risk for psoriasis due to interaction between genetically predicted higher BMI and lower 25(OH)D, neither in UKB (RERI -0.01, 95% confidence interval (CI) -0.08, 0.07) nor in HUNT (RERI -0.04, 95% CI -0.14, 0.06). The same was observed in the continuous factorial MR and observational analyses. In conclusion, this study did not find evidence of interaction between BMI and 25(OH)D on the risk of psoriasis. Given minor differences in measured BMI and 25(OH)D between the factorial groups, small effects may have been undetected.

Effect of randomised blood pressure lowering treatment and intensive glucose control on dementia and cognitive decline according to baseline cognitive function and other subpopulations of individuals with type 2 diabetes: results from the ADVANCE trial

Background and aims: Accumulating evidence indicates that reducing high blood pressure (BP) prevents dementia and mild cognitive impairment (MCI). Furthermore, although diabetes is a risk factor for dementia and MCI, there is uncertainty of the effect of intensive glucose control on these endpoints. This study aimed to determine the effects of BP-lowering (vs placebo) and intensive glucose-lowering (vs standard control) treatments according to baseline cognition and other characteristics on dementia and cognitive decline (CD) in people with type 2 diabetes mellitus (T2DM). Methods: The Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial involved 11,140 individuals with T2DM. The effects of BP-lowering and intensive glucose-lowering treatments were explored in subgroups of baseline Mini-Mental State Examination (MMSE), categorised as cognitively normal (scores ≥28) and cognitive impairment (scores <28). The primary outcome was a composite of dementia/CD that accounted for the competing risk of death. Multinomial regression models, adjusted for common cardiovascular risk factors, were used to estimate odds ratios (OR) with 95% confidence intervals (CI) of the effects of the treatments on dementia/CD. Homogeneity of effects by subgroups were evaluated using interaction terms in the models. A two-sided p value less than 0.05 was regarded as statistically significant. Results: BP-lowering treatment (vs. placebo) was associated with a lower odds of dementia/CD in participants with cognitive impairment (OR 0.76, 95% CI 0.59-0.99) but not in those cognitively normal (OR 1.05, 95% CI 0.92-1.21; p for interaction 0.03). Those with a history of cardio-renal-metabolic syndrome did not experience a benefit of active BP lowering treatment compared with placebo on dementia/CD. There were no further subgroup effects of BP-lowering treatment. The effect of intensive glucose lowering (vs standard control) on the odds of dementia/CD did not vary by baseline cognition subgroup. However, it did vary by level of blood glucose at baseline (<7.9 mmol/L OR 1.12, 95%CI 0.96-1.30 vs ≥ 7.9 mmol/L 0.87 (0.75-1.00); p for interaction 0.02) and duration of T2DM (<10 years OR 0.92 (0.81-1.05) vs ≥10 years 1.16 (0.97-1.38); p for interaction 0.04). Conclusions: This study suggests greater effects of BP-lowering treatment in those with early loss of cognitive function than in those cognitively normal. There were also differential effects of intensive glucose-lowering on dementia and CD according to levels of blood glucose and duration of diabetes in people with T2DM. Clinical trial registration: ADVANCE is registered with ClinicalTrials.gov: number NCT00145925

The relationship of dietary omega-3 fatty acid and omega-6 to omega-3 ratio intake and likelihood of type 2 diabetes in a cross-sectional study

BackgroundThere is a belief that consuming a significant amount of omega-3 and omega-6 fatty acids can positively affect chronic diseases. However, the connection between these fatty acids and type 2 diabetes mellitus (T2DM) risk remains unclear. To explore this further, we conducted a study to investigate the relationship between dietary intake of omega-3 and omega-6 fatty acids (FA), as well as omega-6 to omega-3 ratio, and the odds of T2DM.MethodsOur research involved a cross-sectional analysis of data from the Ravansar Non-Communicable Disease (RaNCD) cohort. We evaluated their dietary habits using a comprehensive 118-item food frequency questionnaire (FFQ). To determine the aforementioned association, we employed logistic regression analysis to calculate odds ratios (OR) and 95% confidence intervals (CIs).ResultsThe prevalence of T2DM among 8744 qualified participants was 751 (8.6%). After considering all the possible factors that could affect the outcome, high dietary omega-3 intake was associated with a 58% lower likelihood of T2DM (OR: 0.42; 95% CI: 0.32, 0.56; P-trend: <0.001). In contrast, participants at the fourth quartile of the dietary omega 6 to omega 3 FA ratio had a higher odd of T2DM (OR: 1.42; 95%CI: 1.11, 1.84; P-trend: 0.01). Nevertheless, there was no significant connection between the highest and lowest quartile of dietary omega-6 intake (OR: 0.91; 95% CI: 0.71, 1.17; P-trend: 0.80).ConclusionAccording to the study, consuming omega-3 fatty acids through diet was linked with lower odds of type 2 diabetes. Conversely, an elevated omega-6 to omega-3 ratio was associated with a greater likelihood of T2DM.

Assessment of MIR3142HG genetic polymorphisms and the susceptibility of lumbar disc herniation in the Chinese population

Lumbar disc herniation (LDH) is a common degenerative disease of the lumbar spine, which is related to host genetic factors. Our study aimed to explore the association between MIR3142HG polymorphisms and LDH susceptibility. Six SNPs in MIR3142HG from 504 LDH patients and 500 healthy individuals were genotyped by the Agena MassARRAY platform. The relationship between SNPs and LDH susceptibility was evaluated with logistic regression analysis by calculating odds ratios (ORs) and 95% confidence intervals (CIs). The interactions between SNP and SNP were analyzed using the multifactor dimensionality reduction (MDR) method. Our study showed that rs7727115 was related to a decreased susceptibility to LDH. Rs2961920 and rs58747524 were significantly associated with an increased risk of LDH. Stratified analysis showed that rs7727115 reduced the risk of LDH in patients aged > 49 years. Rs17057846, rs2961920, and rs58747524 had a risk-increasing influence on patients aged > 49 years and women. Besides, rs7727115 decreased susceptibility in cases of disc prolapse, while rs2961920 and rs58747524 increased the risk. Rs2431689 increased susceptibility in patients with a single hernia, and rs58747524 correlated with an increased risk in cases of multiple hernias. Moreover, MDR analysis indicated that the combination of rs1582417, rs2431689, rs7727115, rs17057846, rs2961920, and rs58747524 was the best predictive model for LDH. Our study showed that MIR3142HG polymorphisms were significantly associated with LDH risk, which suggests that MIR3142HG polymorphisms play some potential roles in diagnosing LDH.

Association of Workplace Stressors Prior to infection and the development of long-COVID among workers during the COVID-19 pandemic: a cohort study in Japan.

Long COVID is a global health concern. While various risk factors are known, the link between workplace factors and Long COVID is underexplored. We conducted a cohort study to examine the impact of pre-infection workplace stressors on Long COVID among Japanese workers, with the aim of improving understanding of its disease process and inform workplace management. This prospective cohort study used online survey data collected in December 2020 and December 2022 from 1,539 participants with no initial infection history but later reported COVID-19. Workplace stressors were assessed at baseline using the Job Content Questionnaire, which measured job demands, job control, and social support. At the follow-up survey, COVID-19 infection was determined by self-reported positive SARS-CoV-2 test by PCR or antigen, and development of Long COVID was defined as symptoms persisting for over two months. Univariate and multivariate logistic regression analyses estimated odds ratios for the association between workplace stressors and the development of Long COVID. Of the participants, 248 reported Long COVID. Univariate analysis showed that both high job demands (OR: 1.55, 95% CI: 1.09-2.20) and poor job control (OR: 1.50, 95% CI: 1.04-2.18) increased the odds. Poor supervisor support (OR: 1.73, 95% CI: 1.16-2.58) and co-worker support (OR: 1.59, 95% CI: 1.13-2.23) were also significant. On multivariate analysis, job demands remained significantly associated with Long COVID. Our findings indicate that pre-infection workplace stressors may contribute to Long-COVID development in workers. Managing workplace stressors effectively could be a preventive measure.

Cerebral Amyloid Angiopathy, Dementia, and Alzheimer Neuropathologic Changes: Findings From the ACT Autopsy Cohort.

Cerebral amyloid angiopathy (CAA) is common in older adults and is associated with dementia. Less is known whether this association is mediated by Alzheimer disease (AD) neuropathologic changes, the examination of which was the objective of this study. This was a retrospective cross-sectional examination of the Kaiser Permanente Washington database of the Adult Changes in Thought (ACT) autopsy cohort with information on CAA, dementia, the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) (amyloid neuritic plaques), and Braak (tau neurofibrillary tangles). CAA was diagnosed by immunohistochemistry and dementia by ACT Consensus Diagnostic Conference. AD neuropathology was categorized by CERAD scores and Braak stages. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% CIs of the associations of CAA with dementia, adjusting for age at death and sex, and with additional adjustments separately for CERAD scores (moderate-severe vs mild-absent), Braak stages (V-VI vs 0-IV), APOE ε4, and stroke. Formal mediation analyses were conducted to estimate age-sex-adjusted OR (95% CI) for natural indirect effects (NIEs) of CERAD scores and Braak stages. The 848 participants had a mean age of 86.7 ± 4.6 years at death, and 57.6% were female. CAA was present in 322 participants (38.0%), of whom 152, 145, and 25 had mild, moderate, and severe CAA, respectively. Dementia was present in 384 participants (45.3%), of whom 317 had AD. Dementia was more common in those with CAA than without (53.7% vs 40.1%; age-sex-adjusted OR 1.57, 95% CI 1.18-2.10). This association remained significant after separate adjustment for other covariates but lost significance when adjusted for CERAD scores (OR 1.27, 95% CI 0.93-1.71) and Braak stages (OR 0.96, 95% CI 0.69-1.33). Findings from our formal mediation analyses show that ORs (95% CIs) for NIE of CERAD scores and Braak stages were 1.25 (1.13-1.37) and 1.63 (1.38-1.88), respectively, and CERAD scores and Braak stages mediated 53% and 111% of the total association, respectively. We observed a significant association between CAA and dementia that disappeared when adjusted for CERAD or Braak stages. Findings from our mediation analyses suggest that the CAA-dementia association may be potentially mediated by AD neuropathologic changes. This hypothesis needs to be tested in future mechanistic studies in AD accounting for unmeasured confounders.

Associations between gestational exposure to neighbourhood socioeconomic deprivation and early childhood weight status.

This study aimed to examine associations between prenatal neighbourhood socioeconomic deprivation (NSD) with early offspring weight status and to assess potential modification by race and ethnicity. We used data from the Newborn Epigenetics STudy (NEST) cohort. Gestational NSD was assessed as neighbourhood deprivation index (NDI) tertiles. Offspring height and weight were assessed at 6 months (N = 1023), 1 year (N = 1268), 2 years (N = 1033) and 3 years (N = 1038). Multilevel logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for the relationship of NDI with overweight or obesity and rapid infant weight gain, adjusting for gestational parent age, race/ethnicity, marital status and educational attainment. Models were estimated in the total sample and also stratified by race and ethnicity. Children exposed to NDI in the highest (compared to the lowest) tertile had increased odds of having overweight/obesity at 1 year (OR = 1.53, 95%CI = 1.09-2.15). In stratified models, children of NH Black gestational parents residing in the highest tertile of NDI (compared to the lowest) had increased odds of having overweight/obesity at 1 year (OR = 1.67, 95%CI = 1.00-2.77). This findings suggest that higher gestational exposure to NSD may play a role in early childhood weight status, which has important implications for later development and health.

Identifying diagnosed major chronic diseases associated with recent housing instability among aging adults: data from the 'All of Us' research program.

Housing instability is a known barrier to healthcare utilization potentially affecting the prevention, diagnosis and treatment of chronic diseases among diverse groups of adults. We examined the intersection of recent housing instability with prevalent cardiovascular disease, diabetes, cancer and psychiatric diagnoses among aging adults. Cross-sectional data on 147465 participants of the 'All of Us' Research Program (6 May 2018-1 July 2022), ≥50years of age at enrollment, were analyzed. Self-reported housing instability over the past 6 months was examined in relation to diagnosed conditions at age≥50years based on electronic health records. Multivariable logistic regression models sequentially adjusting for demographic and socioeconomic characteristics were constructed to estimate odds ratios (OR) with their 95% confidence intervals (CI). After adjusting for confounders, past 6 months housing instability was associated with lower odds of diagnosed cardiovascular disease (OR=0.89, 95% CI: 0.87, 0.93) and cancer (OR=0.82, 95% CI: 0.78, 0.86), higher odds of diagnosed psychiatric (OR=1.35, 95% CI: 1.30, 1.40) conditions, but was unrelated to diagnosed diabetes (OR=0.98, 95% CI: 0.94, 1.01). Recent housing instability among aging adults is positively associated with psychiatric diagnoses, but negatively associated with cardiovascular and cancer diagnoses, with implications for chronic disease prevention.

Risk Factors and Characteristics Associated with Visual Impairment and Eye Diseases in Moyamoya Disease: Insights from a National Database.

This study aims to investigate the incidence and risk factors of visual impairment and eye diseases in patients with moyamoya disease (MMD), a rare cerebrovascular disorder. Understanding these associations is crucial for improving patient management and outcomes. This study utilized International Classification of Diseases (ICD) codes from both the 9th edition (ICD-9-CM) and 10th edition (ICD-10-CM) to define diagnoses, complications, and procedures within the National Inpatient Sample (NIS) Database. Data elements were extracted from discharge summaries. Statistical analysis was performed using IBM SPSS Statistics software version 25. Chi-square tests were employed for univariate analysis to assess the relationships between visual impairment, eye diseases, and MMD. Subsequently, multivariate logistic regression was utilized to calculate odds ratios (OR) and their corresponding 95% confidence intervals (CI) over a 10-year period to further investigate these relationships. The incidence of visual impairment and eye diseases in MMD was 3.7%. Visual impairment and eye diseases in MMD were associated with Asian or Pacific Islander race (OR = 1.538, 95% CI 1.058-2.237), self-pay insurance (OR = 1.796, 95% CI 1.503-3.061), and hospitalization in the Midwest or North Central region (OR = 1.466, 95% CI 1.035-2.076). Visual impairment and eye diseases in moyamoya disease were associated with ischemic stroke (OR = 2.001, 95% CI 1.564-2.560), hypertension (OR = 1.508, 95% CI 1.089-2.088), headache (OR = 2.834, 95% CI 1.968-4.081), migraine (OR = 2.156, 95% CI 1.544-3.011), memory loss (OR = 3.866, 95% CI 1.493-10.012), and dizziness (OR = 1.322, 95% CI 0.549-3.182). Our analysis of a large, population-based sample in the US reveals a notable association between MMD and the presence of visual impairment and eye diseases.

Airway, breathing, cellphone: a new vital sign?

IntroductionIn emergency medicine, triage encompasses more than the initial prioritization of treatment; it also includes decisions about the most suitable level of care and disposition for each patient. However, the increasing use of mobile technology by patients in the emergency department (ED) introduces a new factor. This study aims to explore the relationship between patients’ cellphone use at the time of initial assessment and final disposition in the ED.MethodsA prospective, cross-sectional study was conducted on 292 patients who presented to the ED between 9/1/2021 and 8/9/2022. Patients were stratified into two cohorts based on their behavior during the initial assessment: actively using a cell phone (n = 32) or not using a cell phone (n = 259). Final disposition was dichotomously recorded as admission or discharge. Hospital admission, hospital observation, and admission to the ED observation unit were consolidated into the combined category of admission.ResultsPatients not actively using their cell phone on initial assessment exhibited a discharge rate of 64%, while those engaged with their cellphones displayed notably higher dismissal rates at 94%. The calculated odds ratio (OR) of 8.4 (95% confidence interval: 1.96-36.0, p = 0.004) underscores a significantly heightened likelihood of dismissal among individuals actively using their cellphones, suggesting a potential association between cellphone use and a reduced probability of hospital admission.ConclusionThe study suggests an association between cellphone use during initial ED assessment and higher discharge rates. While this introduces a novel concept, the study’s potential contribution to more informed and efficient triage decisions warrants careful consideration in future research and clinical applications.

Association between chronic long-term exposure to airborne dioxins and breast cancer

Breast cancer is the most common type of cancer among women. Environmental pollutants, specifically those with endocrine disrupting properties like dioxins, may impact breast cancer development. Current epidemiological studies on the association between exposure to dioxins and the risk of breast cancer show inconsistent results. To address these uncertainties, our objective was to investigate the impact of airborne dioxin exposure on breast cancer risk within the E3N cohort, encompassing 5222 cases identified during the 1990–2011 follow-up and 5222 matched controls. Airborne dioxin exposure was assessed using a Geographic Information System-based metric considering residential proximity to dioxin emitting sources, their technical characteristics, exposure duration and wind direction. Additional analyses were performed using dioxin concentrations estimated by a chemistry transport model, CHIMERE. The results suggest a slightly increased risk between cumulative dioxin exposure at the residential address and overall breast cancer risk (adjusted odds ratio (OR) = 1.03, 95% confidence interval (CI): 0.99–1.07, for a one standard deviation (SD) increment among controls (14.47 log-μg-TEQ/m2). The associations remained consistent for sources within 3, 5, and 10 km, and when restricting exposure to dioxin emissions from household waste incinerators. Similar OR estimates (OR = 1.02, 95% CI: 0.97–1.07, for a one SD increment) were obtained using the CHIMERE model. The findings of this study suggest the possibility of an increased risk of breast cancer associated with long-term residential exposure to dioxins and emphasize the importance of efforts to mitigate air pollution exposure.