Populus Research Articles

Maternal Malnutrition and Elevated Disease Risk in Offspring.

US populations have seen dramatic increases in the prevalence of chronic disease over the past three generations. Rapid increases in type 2 diabetes and obesity have occurred in all the states but have been particularly striking in the Deep South. These increases have contributed to decreases in life expectancy and to painful elevations in health care costs. The causes of worsening population health are complex and incompletely understood. However, there is strong evidence that vulnerability to chronic conditions is determined in early life. Most chronic diseases are developmentally driven. There are specific stressors experienced in early life that influence epigenetic and structural changes during development. These include malnutrition, severe levels of social stress, toxic chemicals, and low oxygen levels. Most US populations have experienced a decrease in the quality of the food they consume as industrial foods have replaced garden-grown foods. Thus, the consumption of too few nutrients before and during pregnancy and during lactation influences the growth of the placenta and fetal organs and their level of resilience when faced with stresses in postnatal life and particularly as adults. Animal studies have shown that the effects of poor nutrition can be passed on to future generations. The most powerful way that the current epidemics of obesity and insulin resistance can be reversed is by providing key nutrients to prospective mothers and those already pregnant.

American mental models of scientific versus theological prestige: a freelist analysis

ABSTRACT In much public discourse, “Christianity” and “Science” are conceptualized as incompatible belief systems that make competing ontological claims. From this perspective, scientists and theologians are rival knowledge specialists. Prestige is one of the ways we evaluate who we should trust, but we do not know whether the prestige of scientists and theologians is conceptualized similarly, and whether they really are seen as rival knowledge specialists by the bulk of the US population. To investigate this question, we use a free listing methodology to explore public attitudes toward prestigious academic theologians and physicists in a US sample. We find that for all participants, prestige in physics is overwhelmingly associated with forms of intelligence necessary to unravel complex questions about the nature of reality. By contrast, the prestige even of academic theologians is more strongly associated with piety, virtue, and charisma than it is with raw intelligence. They appear to be seen as social models rather than ontological experts. Furthermore, we find that while both religious and nonreligious individuals share a unified representation for prestigious physicists, this is not the case with prestigious theologians: virtue is more salient in Christian evaluations of theological prestige, while charisma is more salient for the nonreligious.

Right-wing ideology fuels bias against sex trafficking victims: the mediating role of sexism

ABSTRACT The authors examined the relationship between right-wing beliefs and problematic attitudes towards victims of sex trafficking (ST). Study one used a cross-sectional survey (N = 444) to study the relationship between political orientation, right-wing authoritarianism, and beliefs about sex trafficking within US and UK populations. Results demonstrated that participants who were right-wing and participants from the US were more likely to report problematic attitudes towards victims of sex trafficking. Study two (N = 126) used a vignette-design to examine whether the relationship between right-wing beliefs and negative attitudes towards a ST victim was mediated by conservative biases such as just world beliefs and sexism. Findings indicated that hostile sexism, but not benevolent sexism or just world beliefs, mediated the relationship between right-wing beliefs and negative ST victim attitudes. Implicationshighlight the need for public organisations to ensure that members of the criminal justice system are educated around common ST misconceptions.

Estimated Exposure to 6 Potentially Hepatotoxic Botanicals in US Adults

Use of herbal and dietary supplements (HDSs) accounts for an increasing proportion of drug hepatotoxicity cases. Turmeric or curcumin, green tea extract, Garcinia cambogia, black cohosh, red yeast rice, and ashwagandha are the most frequently reported hepatoxic botanicals, but their prevalence and reasons for use in the general population are unknown. To assess the prevalence and clinical characteristics of adult consumers of 6 potentially hepatoxic botanicals. This survey study analyzed nationally representative data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative, cross-sectional survey of the general US population. Prescription drug and HDS exposure data in the past 30 days were analyzed, and 2020 US Census data were used for population estimates. Data were analyzed July 1, 2023, to February 1, 2024. Adult NHANES participants enrolled between January 2017 and March 2020. Baseline weighted characteristics of HDS users and users of 6 potentially hepatotoxic botanical products were compared with non-HDS users. Multivariable analysis was undertaken to identify factors associated with HDS use or at-risk botanical use. Among 9685 adults enrolled in this NHANES cohort, the mean (SE) age was 47.5 (0.5) years, and 51.8% (95% CI, 50.2%-53.4%) were female. The overall prevalence of HDS product use was 57.6% (95% CI, 55.9%-59.4%), while the prevalence of using the 6 botanicals of interest was 4.7% (95% CI, 3.9%-5.7%). Turmeric-containing botanicals were most commonly used (n = 236), followed by products containing green tea (n = 92), ashwagandha (n = 28), Garcinia cambogia (n = 20), red yeast rice (n = 20), and black cohosh (n = 19). Consumers of these 6 botanicals were significantly older (adjusted odds ratio [AOR], 2.36 [95% CI, 1.06-5.25]; P = .04 for 40-59 years of age and AOR, 3.96 [95% CI, 1.93-8.11]; P = .001 for ≥60 years of age), had a higher educational level (AOR, 4.78 [95% CI, 2.62-8.75]; P < .001), and were more likely to have arthritis (AOR, 2.27 [95% CI, 1.62-3.29]; P < .001) compared with non-HDS users. An estimated 15 584 599 (95% CI, 13 047 571-18 648 801) US adults used at least 1 of the 6 botanical products within the past 30 days, which was similar to the estimated number of patients prescribed potentially hepatotoxic drugs, including simvastatin (14 036 024 [95% CI, 11 202 460-17 594 452]) and nonsteroidal anti-inflammatory drugs (14 793 837 [95% CI, 13 014 623-16 671 897]). The most common reason for consuming turmeric and green tea was to improve or maintain health. In this survey study, an estimated 15.6 million US adults consumed at least 1 botanical product with liver liability within the past 30 days, comparable with the number of people who consumed nonsteroidal anti-inflammatory drugs and a commonly prescribed hypolipidemic drug. Given a lack of regulatory oversight on the manufacturing and testing of botanical products, clinicians should be aware of possible adverse events from consumption of these largely unregulated products.

Trees in cooler regions are more vulnerable to thermal stress: Evidence from temperate poplar plantations in Northern China during the 2022 heatwaves

Climate change is resulting in more intense and frequent heatwaves, posing a potential threat to the structure and function of forest biome. However, due to the lack of in-situ data, the responses of forest plantations to heatwaves and the role of growth environments and management practices in mitigating these effects remain poorly understood. To address these knowledge gaps, we took advantage of the 2022 summer heatwave to assess their impacts on 8-year-old poplar plantations in Northern China characterized by differing thermal environments (cooler vs. warmer). Stem daily radial increment and sap flow density were continuously monitored in two regions. Additionally, physiological traits, such as leaf gas exchange and water potential, were measured in the warmer region with two different irrigation treatments. Our results revealed that poplar trees in the cooler region experienced more pronounced negative effects from heatwaves compared to those in the warmer region. Poplar trees exhibited strong physiological plasticity to cope with heatwave stress, with increased sap flow density observed in both regions during heatwaves, facilitating a transpiration-cooling effect for minimizing thermal damage. However, increased transpiration rate also led to stored stem water depletion and higher tree water deficit. The ability of trees to regulate internal water balance, likely dependent on their root water supply capacity, accounted for the different responses of poplar growth to heatwaves in various regions. Unexpectedly, while irrigation assisted the functioning of poplar trees in some aspects, it did not alter their overall growth and physiological performance under heatwave conditions, possibly due to their deep root systems. Overall, growth environment temperatures and physiological plasticity are crucial factors affecting the ability to withstand thermal stress, and these variations will allow trees to persist in fluctuating environments. Our findings offer valuable insights for sustainable forest management under extreme climate conditions.

Thermoneutrality Inhibits Thermogenic Markers and Exacerbates Nonalcoholic Fatty Liver Disease in Mice.

Nonalcoholic fatty liver disease (NAFLD) affects over a third of the US population and 25% globally, with current treatments proving ineffective. This study investigates whether manipulating brown adipose tissue (BAT) and beige fat activity by housing C57BL/6J mice at thermoneutral (27 °C) or standard temperatures (22 °C) impacts NAFLD development. Male mice were fed either a chow diet (CHD) or a "fast food" diet (FFD) for 10 weeks. Mice at 27 °C had reduced food intake but increased body weight and plasma leptin levels. FFD-fed mice at 27 °C had greater liver weight (2.6 vs. 1.8 g), triglyceride content (7.6 vs. 3.9 mg/g), and hepatic steatosis compared to those at 22 °C. Gene expression of fatty acid synthase, sterol regulatory element-binding protein 1, and fatty acid translocase CD36 was elevated in FFD-fed mice at 27 °C, but not in CHD-fed mice. Thermoneutral housing also reduced expression of thermogenic markers in BAT and inguinal white adipose tissue (WAT) and caused BAT whitening. In conclusion, thermoneutrality inhibits thermogenic markers and exacerbates NAFLD. Activating BAT or promoting WAT browning via cold exposure or other stimuli may offer a strategy for managing NAFLD.

Pepsinogen and Helicobacter pylori: Serum biomarkers for gastric cancer risk in a diverse United States population

BackgroundSerum Pepsinogen (PG) and Helicobacter pylori (Hp) have potential as biomarkers to identify persons at high risk for gastric cancer (GC) in low incidence populations. We explored the use of these biomarkers in a diverse US population. MethodsSingle institution study using serum samples from 32 newly diagnosed GC (before treatment) and 60 non-cancer participants. ELISA-based PG-I, PG-II, Hp IgG, and Hp virulence seromarker (CagA, VacA) tests were conducted to examine differences between GC and non-GC participants. ResultsMedian age was 58 (IQR 48–68); 56 % were females; 30.1 % were white, 14.8 % black, 28.7 % Hispanic, 6.1 % Asian and 18.2 % other/unknown race/ethnicity. Median values of Hp (47.9 vs 12.6 U/mL, p = 0.003) and pepsinogen ratio (PGR=PGI/PGII) (4.0 vs 7.5, p = 0.003) differed between GC and non-GC. Performance of pepsinogen tests using “standard” cut-offs (PGI ≤ 70 ng/mL and PGR ≤ 3) were highly specific (91.7 %), but not sensitive (34.4 %), while Hp IgG test using “standard” cut-off (≥ 30 U/mL) was sensitive (78.8 %), but less specific (41.2 %). Optimized cut-off values identified in our population using Youden’s Index were PGR ≤ 5.2 and Hp ≥ 17.5 U/mL. Using a combination of these values resulted in a significant increase in test sensitivity (87.9 %) with lower specificity (50.8 %). ConclusionThe combination of pepsinogens and Hp show promise as biomarkers of GC risk in a racially and ethnically diverse US population. Optimal biomarker cut-off points for US populations may differ from those established in East Asia. By adjusting cut-offs there is potential to design GC risk stratification tools tailored specifically for the diverse population within the US.

Projections of Endovascular Therapy-Eligible Patients With Stroke for the US Population.

As stroke endovascular thrombectomy (EVT) treatment indications expand, understanding population-based EVT eligibility becomes critical for resource planning. We aimed to project current and future population-based EVT eligibility in the United States. We conducted a post hoc analysis of the physician-adjudicated GCNKSS (Greater Cincinnati Northern Kentucky Stroke Study; 2015 epoch), a population-based, cross sectional, observational study of stroke incidence, treatment, and outcomes across a 5-county region. All hospitalized patients ≥18 years of age with acute ischemic stroke were ascertained using the International Classification of Diseases, Ninth Revision codes 430-436 and Tenth Revision codes I60-I67 and G45-G46 and extrapolated to the US adult census 2020. We determined the rate of EVT eligibility within the GCNKSS population using time from last known well to presentation (0-5 versus 5-23 hours), presenting National Institutes of Health Stroke Scale, and prestroke modified Rankin Scale. Both conservative and liberal estimates of prevalence of large vessel occlusion and large core were then applied based on literature review (unavailable within the 2015 GCNKSS). This eligibility was then extrapolated to the 2020 US population. Of the 1 057 183 adults within GCNKSS in 2015, 2741 had an ischemic stroke and 2176 had data available for analysis. We calculated that 8659 to 17 219 patients (conservative to liberal) meet the current guideline-recommended EVT criteria (nonlarge core, no prestroke disability, and National Institutes of Health Stroke Scale score ≥6) in the United States. Estimates (conservative to liberal) for expanded EVT eligibility subpopulations include (1) 5316 to 10 635 by large core; (2) 10 635 to 21 270 by mild presenting deficits with low National Institutes of Health Stroke Scale score; (3) 13 572 to 27 089 by higher prestroke disability; and (4) 7039 to 14 180 by >1 criteria. These expanded eligibility subpopulations amount to 36 562 to 73 174 patients. An estimated 8659 to 17 219 adult patients in the United States met strict EVT eligibility criteria in 2020. A 4-fold increase in population-based EVT eligibility can be anticipated with incremental adoption of recent or future positive trials. US stroke systems need to be rapidly optimized to handle all EVT-eligible patients with stroke.

Describing functional low back pain disability in the American population: a crowd-sourced evaluation of the Oswestry disability index

BACKGROUND CONTEXTThe Oswestry disability index (ODI) is widely utilized as a patient reported outcome (PRO) tool to assess patients presenting with low back pain (LBP) and following thoracolumbar spine surgery. No primary study has calculated the baseline range of ODI values in the diverse American population. Establishing age-adjusted normative values for ODI in the American population is crucial for assessing the utility of treatment strategies. PURPOSEThe purpose of this study is to describe the baseline range of functional low back disability as measured by the ODI in an American population. STUDY DESIGN/SETTINGCross-Sectional Observational Study. PATIENT SAMPLEA total of 1214 participants were recruited from the United States in January 2024 using a combination of the Connect and PrimePanel platforms by CloudResearch to complete a survey administered on a RedCap online database. The survey consisted of 10 demographic questions and the 10 ODI survey questions. The distribution of the survey was designed to obtain approximately 100 respondents in each of the following age groups: 18–29, 30 to 39, 40 to 49, 50 to 59, 60 to 69, 70 to 79, and 80 to 89. The distribution of the sample was similarly designed to match the United States Census racial data with 78.1% White, 13.9% Black, and 7.9% other. OUTCOME MEASURESOswestry disability index (ODI). METHODSA crowd-sourcing platform called Cloudresearch was used to collect a representative sample of the US population by answering questions of the Oswestry disability questionnaire (ODQ), a 10-question survey. RESULTSThe final sample size was 797 participants including 386 (48.4%) males and 411 (51.6%) females; 169 participants were excluded that did not complete the survey and an additional 248 were excluded for failing attention check questions. The overall mean ODI score for the combined age groups was 14.35 (95% CI [13.33, 15.37]). The mean ODI scores increased with age, with the highest mean ODI in ages 70 to 79 at 18.0 (95% CI [14.76, 21.24]). Female participants reported higher mean ODI scores than their male counterparts in the 18 to 29 age group (p=.01), 50 to 59 age group (p=.01), and 60 to 69 age group (p=.02). Additionally, a weak positive correlation was found between Body Mass Index (BMI) and ODI scores (r = 0.22, p<.001). CONCLUSIONOur findings demonstrate a clear trend of increased disability with age. This study describes the baseline range of functional low back pain disability in the United States population. By defining these parameters, healthcare professionals can better tailor age and sex-specific interventions to manage disability in the aging US population, ultimately improving patient care and both operative and nonoperative treatment plans for LBP-related thoracolumbar pathology.

Precision Antiplatelet Therapy after Percutaneous Coronary Intervention (Precision PCI) Registry - Informing optimal antiplatelet strategies.

Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor inhibitor (clopidogrel, prasugrel, or ticagrelor) is indicated after percutaneous coronary intervention (PCI) to reduce the risk of atherothrombotic events. Approximately 30% of the US population has a CYP2C19 no-function allele that reduces the effectiveness of clopidogrel, but not prasugrel or ticagrelor, after PCI. We have shown improved outcomes with the integration of CYP2C19 genotyping into clinical care to guide the selection of prasugrel or ticagrelor in CYP2C19 no-function allele carriers. However, the influence of patient-specific demographic, clinical, and other genetic factors on outcomes with genotype-guided DAPT has not been defined. In addition, the impact of genotype-guided de-escalation from prasugrel or ticagrelor to clopidogrel in patients without a CYP2C19 no-function allele has not been investigated in a diverse, real-world clinical setting. The Precision Antiplatelet Therapy after Percutaneous Coronary Intervention (Precision PCI) Registry is a multicenter US registry of patients who underwent PCI and clinical CYP2C19 testing. The registry is enrolling a diverse population, assessing atherothrombotic and bleeding events over 12 months, collecting DNA samples, and conducting platelet function testing in a subset of patients. The registry aims to define the influence of African ancestry and other patient-specific factors on clinical outcomes with CYP2C19-guided DAPT, evaluate the safety and effectiveness of CYP2C19-guided DAPT de-escalation following PCI in a real-world setting, and identify additional genetic influences of clopidogrel response after PCI, with the ultimate goal of establishing optimal strategies for individualized antiplatelet therapy that improves outcomes in a diverse, real-world population.

Trends in cannabis and tobacco co-use in the United States, 2002–2021

BackgroundCo-use of cannabis and tobacco poses greater risks than use of either substance individually and may be becoming more prevalent with increasing cannabis medicalization and legalization. We aimed to assess trends in the prevalence of cannabis and tobacco co-use between 2002–2019 and identify the updated prevalence and correlates of co-use in 2021 among US adults. MethodsThis study used data from the 2002–2021 National Survey on Drug Use and Health, a nationally-representative, cross-sectional survey in the US. We assessed prevalence trends in past 30-day cannabis and tobacco co-use, exclusive cannabis use, and exclusive tobacco use overall and by sociodemographic group using joinpoint regression. Additionally, multinomial models identified correlates of co-use in 2021. ResultsIn 2021, the weighted prevalence of cannabis and tobacco co-use was 6.38 %, the weighted prevalence of exclusive cannabis use was 7.28 %, and the weighted prevalence of exclusive tobacco use was 15.01 %. From 2002 to 2019, the prevalence of past 30-day co-use of cannabis and tobacco increased significantly (annual percentage change [APC]: 1.9 [1.4–2.4], P<0.05) among the overall US population. All subgroups of sex, race/ethnicity, and age also saw significant increases in co-use, other than young adults ages 18–25, for whom co-use was stagnant between 2002–2014 and then decreased significantly between 2014–2019. ConclusionThis study identified increasing cannabis and tobacco co-use overall and among most sociodemographic strata in the US. As cannabis policy changes rapidly, co-use requires closer surveillance, clinical screening, and dedicated research.

E-Cigarette Characteristics and Cigarette Cessation Among Adults Who Use E-Cigarettes

Population-level health outcomes associated with e-cigarettes depend in part on the association between e-cigarettes and combustible cigarette cessation. The US Food and Drug Administration has authority to regulate e-cigarette characteristics, including flavor and device type. To investigate whether e-cigarette characteristics are associated with cigarette cessation behaviors among adults in the US population who use e-cigarettes. This cohort study was conducted using longitudinal data collected in 2014 to 2021 by the Population Assessment of Tobacco and Health Study, a population-based, US nationally representative study. Participants were sampled from the civilian noninstitutionalized population using a 4-staged, stratified sampling design. Data were weighted and analyzed from 1985 adults ages 21 or older who smoked cigarettes daily and had used e-cigarettes in the past 30 days. Data were analyzed in May 2021 to May 2024. The following e-cigarette characteristics were assessed: use frequency (daily and nondaily), flavor type (tobacco, menthol or mint, sweet, and combination), device type (disposable, cartridge, and tank), and year of data collection as a proxy for the evolving e-cigarette marketplace. The following cigarette cessation behaviors were assessed: making a cigarette quit attempt, cigarette cessation among individuals who made a quit attempt, and overall cigarette discontinuation regardless of quit attempts. Associations were evaluated between e-cigarette characteristics (assessed at baseline in 1 approach and assessed at follow-up in another approach) and cigarette cessation outcomes, controlling for demographic, cigarette smoking, and other e-cigarette use characteristics. The study sample consisted of 1985 participants representing adults in the population (mean age, 40.0 years [95% CI, 39.2-40.9 years]; 49.4% [95% CI, 46.3%-52.6%] male; 11.4% [95% CI, 9.6%-13.4%] Black, 80.7% [95% CI, 77.8%-83.3%] White, and 8.0% [95% CI, 6.3%-10.0%] other race; 9.2% [95% CI, 7.5%-11.2%] Hispanic). Daily vs nondaily e-cigarette use was associated with greater overall cigarette discontinuation rates (12.8% [95% CI, 9.1%-17.7%] vs 6.1% [95% CI, 4.8%-7.7%]; adjusted odds ratio [aOR], 2.26 [95% CI, 1.34-3.81]), and use of e-cigarettes in 2019 to 2021 vs 2014-2015 to 2015-2016 was also associated with greater overall cigarette discontinuation rates (12.0% [95% CI, 8.8%-16.0%] vs 5.3% [95% CI, 2.9%-9.3%]; aOR, 2.75 [95% CI, 1.13-6.67]). Use of menthol or mint vs tobacco flavor e-cigarettes was associated with greater overall cigarette discontinuation rates (9.2% [95% CI, 6.6%-12.8%] vs 4.7% [95% CI, 3.0%-7.1%]; aOR, 2.63 [95% CI, 1.32-5.27]) only when assessing e-cigarette use at baseline. E-cigarette device type was not associated with cigarette discontinuation rates in adjusted analyses. In this study, daily e-cigarette use and use of e-cigarettes in 2019 to 2021 were consistently associated with greater cigarette discontinuation rates. These findings suggest that research focused on e-cigarettes marketed in recent years is needed to inform product regulation and public health policy decisions.

History of the Surveillance, Epidemiology, and End Results (SEER) Program.

The Surveillance, Epidemiology, and End Results (SEER) Program established in 1973 was the first laboratory for experimenting with new methods for cancer data collection and translating the data into population-based cancer statistics. The SEER Program staff have been instrumental in the development of the International Classification of Disease-Oncology and successfully implemented the routine collection of anatomic and prognostic cancer stage at diagnosis. Currently the program consists of 21 central registries that generate cancer statistics covering more than 48% of the US population and an additional 10 research support registries contributing to certain research projects, such as the National Childhood Cancer Registry. In parallel with the geographical expansion, the program built an architecture of methods and tools for population-based cancer statistics, with SEER*Explorer as the most recent online tool for descriptive statistics. In addition, SEER releases annual updates for a comprehensive data product line, which includes SEER*Stat databases with an annual caseload of more than 800 000 incident cases. Furthermore, the program developed a full suite of analytical applications for population-based cancer statistics that include Joinpoint (regression-based trend analysis), DevCan (risk of diagnosis and death), CanSurv (survival models), and ComPrev and PrejPrev (cancer prevalence), among others. The future of the SEER Program is closely aligned to the overall goals of the "war on cancer." The program aims to release longitudinal treatment data coupled with a comprehensive genomic characterization of cancers with a declared goal of decreasing the cancer burden and disparities across a wide spectrum of diseases and communities.

Association of Definitive Radiotherapy for Esophageal Cancer and the Incidence of Secondary Head and Neck Cancers: A SEER Population-Based Study.

Impact of radiotherapy (RT) for esophageal cancer (EC) patients on the development of secondary head and neck cancer (SHNC) remains equivocal. The objective of this study was to investigate the link between definitive RT used for EC treatment and subsequent SHNC. This study was conducted using the Surveillance, Epidemiology, and End Results (SEER) database to collect the data of primary EC patients. Fine-Gray competing risk regression and standardized incidence ratio (SIR) and propensity score matching (PSM) method were used to match SHNC patients with only primary head and neck cancer (HNC) patients. Overall survival (OS) rates were applied by Kaplan-Meier analysis. In total, 14,158 EC patients from the SEER database were included, of which 9,239 patients (65.3%) received RT and 4,919 patients (34.7%) received no radiation therapy (NRT). After a 12-month latency period, 110 patients (1.2%) in the RT group and 36 patients (0.7%) in the NRT group experienced the development of SHNC. In individuals with primary EC, there was an increased incidence of SHNC compared to the general US population (SIR = 5.95, 95% confidence interval (CI): 5.15 - 6.84). Specifically, the SIR for SHNC was 8.04 (95% CI: 6.78 - 9.47) in the RT group and 3.51 (95% CI: 2.64 - 4.58) in the NRT group. Patients who developed SHNC after RT exhibited significantly lower OS compared to those after NRT. Following PSM, the OS of patients who developed SHNC after RT remained significantly lower than that of matched patients with only primary HNC. An association was discovered between RT for EC and increased long-term risk of SHNC. This work enables radiation oncologists to implement mitigation strategies to reduce the long-term risk of SHNC in patients who have received RT following primary EC.

Association of triglyceride-glucose index with helicobacter pylori infection and mortality among the US population

BackgroundLimited research has explored the potential association between the Triglyceride-Glucose (TyG) and mortality, especially in individuals with Helicobacter pylori (H. pylori) infection. This study seeks to investigate the correlation between the TyG index and H. pylori infection and investigate whether the associations between the TyG index exposure and all-cause mortality are mediated by H. pylori infection.MethodsThe study utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999–2018, incorporating a final sample size of 2,187 participants. Both univariable and multivariable-adjusted logistic regression analyses were employed to examine the relationship between H. pylori infection and relevant covariates. To assess the association between TyG index, and all-cause mortality in individuals with or without H. pylori infection, Cox regression analysis, and restricted regression cubic spline analysis were implemented.ResultsA significant positive correlation was observed between the TyG index and an elevated risk of H. pylori infection [OR 1.157, 95% CI (1.383 ~ 1.664)]. This correlation persisted even after adjusting for confounding factors [OR 1.189, 95% CI (1.003, 1.411), P < 0.05]. Furthermore, in patients with positive H. pylori infection, a noteworthy nonlinear correlation between the TyG index and all-cause mortality was identified (P = 0.0361). With an increase in the TyG index, all-cause mortality exhibited a corresponding rise, particularly following adjustment for all potential confounding factors. Conversely, in patients with negative H. pylori infection, no significant association was observed between the TyG index and all-cause mortality after adjusting for potential confounding factors.ConclusionA higher TyG index was linked to increased H. pylori infection risks. Participants in the higher quantile group of the TyG index are positively associated with higher all-cause mortality compared to the higher quantile group of the TyG index in H. pylori-positive participants instead of H. pylori-negative participants.

Equity in the Early Pain Management of Long Bone Fractures in Black vs White Patients: We Have Closed the Gap.

Patients with long bone fractures often present to the emergency department (ED) with severe pain and are typically treated with opioid and non-opioid analgesics. Historical data reveals racial disparities in analgesic administration, with White patients more likely to receive analgesics. With the diversifying US population, health equity is increasingly crucial. In this study we aimed to evaluate the early administration of opioid and non-opioid analgesia among Black and White patients with long bone and femur fractures in EDs over different time frames using a substantial database. We retrospectively extracted Information from 57 US healthcare organizations within the TriNetX database, encompassing 95 million patients. The ED records from 2003-2023 were subjected to propensity score matching for age and gender. We focused on four cohorts: two comprising Black and White patients diagnosed with long bone fractures, and another two with Black and White patients diagnosed solely with femur fractures. We examined analgesic administration rates over 20years (2003-2023) at five-year intervals (2003-2008; 2008-2013; 2013-2018; 2018-2023), and further analyzed the rates for the most recent two-year period (2021-2023). Disparities in analgesic administration significantly diminished over the study period. For patients with long bone fractures (1,095,052), the opioid administration gap narrowed from 6.3% to 1.1%, while non-opioid administration disparities reduced from 4.4% to 0.3%. Similar trends were noted for femur fractures (265,181). By 2021-2023, no significant differences in analgesic administration were observed between racial groups. Over the past 20years, the gap in early administration of opioid and non-opioid analgesics for Black and White patients presenting with long bone fractures or femur fractures has been disappearing.

Mortality due to falls by county, age group, race, and ethnicity in the USA, 2000–19: a systematic analysis of health disparities

Fall-related mortality has increased rapidly over the past two decades in the USA, but the extent to which mortality varies across racial and ethnic populations, counties, and age groups is not well understood. The aim of this study was to estimate age-standardised mortality rates due to falls by racial and ethnic population, county, and age group over a 20-year period. Redistribution methods for insufficient cause of death codes and validated small-area estimation methods were applied to death registration data from the US National Vital Statistics System and population data from the US National Center for Health Statistics to estimate annual fall-related mortality. Estimates from 2000 to 2019 were stratified by county (n=3110) and five mutually exclusive racial and ethnic populations: American Indian or Alaska Native (AIAN), Asian or Pacific Islander (Asian), Black, Latino or Hispanic (Latino), and White. Estimates were corrected for misreporting of race and ethnicity on death certificates using published misclassification ratios. We masked (ie, did not display) estimates for county and racial and ethnic population combinations with a mean annual population of less than 1000. Age-standardised mortality is presented for all ages combined and for age groups 20-64 years (younger adults) and 65 years and older (older adults). Nationally, in 2019, the overall age-standardised fall-related mortality rate for the total population was 13·4 deaths per 100 000 population (95% uncertainty interval 13·3-13·6), an increase of 65·3% (61·9-68·8) from 8·1 deaths per 100 000 (8·0-8·3) in 2000, with the largest increases observed in older adults. Fall-related mortality at the national level was highest across all years in the AIAN population (in 2019, 15·9 deaths per 100 000 population [95% uncertainty interval 14·0-18·2]) and White population (14·8 deaths per 100 000 [14·6-15·0]), and was about half as high among the Latino (8·7 deaths per 100 000 [8·3-9·0]), Black (8·1 deaths per 100 000 [7·9-8·4]), and Asian (7·5 deaths per 100 000 [7·1-7·9]) populations. The disparities between racial and ethnic populations varied widely by age group, with mortality among younger adults highest for the AIAN population and mortality among older adults highest for the White population. The national-level patterns were observed broadly at the county level, although there was considerable spatial variation across ages and racial and ethnic populations. For younger adults, among almost all counties with unmasked estimates, there was higher mortality in the AIAN population than in all other racial and ethnic populations, while there were pockets of high mortality in the Latino population, particularly in the Mountain West region. For older adults, mortality was particularly high in the White population within clusters of counties across states including Florida, Minnesota, and Wisconsin. Age-standardised mortality due to falls increased over the study period for each racial and ethnic population and almost every county. Wide variation in mortality across geography, age, and race and ethnicity highlights areas and populations that might benefit most from efficacious fall prevention interventions as well as additional prevention research. US National Institutes of Health (Intramural Research Program, National Institute on Minority Health and Health Disparities; National Heart, Lung, and Blood Institute; Intramural Research Program, National Cancer Institute; National Institute on Aging; National Institute of Arthritis and Musculoskeletal and Skin Diseases; Office of Disease Prevention; and Office of Behavioral and Social Sciences Research).

PagMYB128 regulates secondary cell wall formation by direct activation of cell wall biosynthetic genes during wood formation in poplar.

The biosynthesis of cellulose, lignin, and hemicelluloses in plant secondary cell walls (SCWs) is regulated by a hierarchical transcriptional regulatory network. This network features orthologous transcription factors shared between poplar and Arabidopsis, highlighting a foundational similarity in their genetic regulation. However, knowledge on the discrepant behavior of the transcriptional-level molecular regulatory mechanisms between poplar and Arabidopsis remains limited. In this study, we investigated the function of PagMYB128 during wood formation and found it had broader impacts on SCW formation compared to its Arabidopsis ortholog, AtMYB103. Transgenic poplar trees overexpressing PagMYB128 exhibited significantly enhanced xylem development, with fiber cells and vessels displaying thicker walls, and an increase in the levels of cellulose, lignin, and hemicelluloses in the wood. In contrast, plants with dominant repression of PagMYB128 demonstrated the opposite phenotypes. RNA sequencing and reverse transcription - quantitative polymerase chain reaction showed that PagMYB128 could activate SCW biosynthetic gene expression, and chromatin immunoprecipitation along with yeast one-hybrid, and effector-reporter assays showed this regulation was direct. Further analysis revealed that PagSND1 (SECONDARY WALL-ASSOCIATED NAC-DOMAIN PROTEIN1) directly regulates PagMYB128 but not cell wall metabolic genes, highlighting the pivotal role of PagMYB128 in the SND1-driven regulatory network for wood development, thereby creating a feedforward loop in SCW biosynthesis.

Establishment and verification of novel TNM staging system for lung mucinous adenocarcinoma

BackgroundLung adenocarcinoma is a high-mortality rate cancer. Within this category, Lung mucinous adenocarcinoma (LMAC) is a rare and distinct subtype of lung adenocarcinoma necessitating further investigation. The study was launched to compare the difference of survival features between LMAC and lung non-mucinous adenocarcinoma (LNMAC) and to investigate the significance and demand for developing a new staging system tailored to LMAC.MethodsThis retrospective study assessed the suitableness of the current staging system for LMAC. It compared the overall survival (OS) between LMAC and LNMAC from 2004 to 2020 (LNMAC: 160,387; LMAC: 6,341) and instituted a novel classification framework for LMAC based on US population. Verification group consisting of patients from two Chinese medical centers from 2010 to 2018 (n = 392) was set to ascertain the applicability of this novel system. The primary endpoint was OS. To minimize the bias, propensity score match (PSM) was employed. Survival analysis and Log-rank test were executed to explore the survival features of LMAC.ResultsThe results indicated that the existed staging system was not suitable for LMAC. Patients diagnosed with LMAC exhibited a superior OS compared to those with LNMAC in stage IA2 (P < 0.0001), IA3 (P < 0.0001), IB (P = 0.0062), IIA (P = 0.0090), IIB (P = 0.0005). In contrast, a worse OS in stage IVA (P = 0.0103) was found in LMAC patients. The novel classification system proposed for LMAC proved to be highly applicable and demonstrated substantial efficacy, as confirmed by the verification group.ConclusionThe newly established classification system was more effective for LMAC, but it necessitates large-scale verification to confirm its applicability and reliability.

Flip the narrative

As the United States approaches the 2024 presidential election, its citizens are experiencing extreme political and religious schism. Separation of church and state is no longer the mantra of the US population. Instead, declarations of which political candidate is “anointed” by God fill the airwaves as well as social media networks. Individuals on both sides of the schism are convinced they know and hear the voice of God and are convinced their favored candidate is the one ordained by God to be the next president of the United States. The confusion created by this rhetoric is intensified by declarations from both sides that democracy is at risk. This article strives to answer the question, “What is really at stake?”