Significant Dose-response Relationship Research Articles

The Inhibitory Effect of Powdery Mildew-Induced Volatiles from Rose on Host Selection Behavior of Beet Armyworm Moths (Lepidoptera: Noctuidae)

Abstract Plant-mediated indirect interactions (PMIIs) between phytopathogenic fungi and herbivorous insects on shared host plants occur in nature. Knowledge of PMIIs is critical in plant molecular breeding and integrated pest management. We studied the response and chemical mechanism of beet armyworm, Spodoptera exigua (Hübner), adults to rose plants, Rosa chinensis Jacquin, infected with rose powdery mildew, Podosphaera pannosa (Wallr.: Fr.) de Bary. Using gas chromatography-electroantennographic detection (GC-EAD) coupled with electroantennogram (EAG), we found that beet armyworm antennae responded to 8, 11, and 3 volatile organic compounds (VOCs) from noninfected roses, mildew-infected roses, and mildew alone, respectively. The EAG analyses showed 11 chemicals (e.g., limonene [1], 2-ethyl-1-hexanol [2], linalool [3], nonanal [4], (E)-β-caryophyllene [5], 1-dodecanol [7], nhexadecane [9], 1-hexadecanol [11], methyl palmitate [12], 1-octadecanol [14], and n-butyl hexadecanoate [15]) elicited electrophysiological responses of beet armyworm antennae with significant dose-response relationships (P < 0.05). The EAG responses to the three chemicals (3, 11, and 15) were greater than that to the reference chemical [i.e., (E)-2-hexenal] at 0.5, 5.0, and 50.0 mg/ml. Olfactory and ovipositional behavior assays indicated that three chemicals (2, 3, and 5) significantly attracted beet armyworm females and four chemicals (7, 11, 14, and 15) strongly repelled females. Chemicals 2, 3, and 5 from healthy roses appear to be responsible for the attraction of beet armyworm moths to healthy roses, whereas chemicals 7, 11, 14, and 15 from mildew-infected roses play key roles in inhibiting attraction of moths. VOCs from mildew alone did not attract or repel beet armyworm moths.

New alternative for culicidian fauna control using Borago officinalis and Drimia maritima plant extracts

Abstract. Djeddar H, Boudjelida H, Arroussi DER. 2021. New alternative for culicidian fauna control using Borago officinalis and Drimia maritima plant extracts. Biodiversitas 22: 5688-5694. Focus on the development of insecticides based on botanical extracts may represent an alternative environmentally interesting tool to chemical control. The current study aimed to investigate the effects of both extracts of Drimia maritima (Asparagales: Asparagaceae) and Borago officinalis (Lamiales: Boraginaceae) on larvae sensibility, physiological and biochemical parameters of Culex pipiens (Diptera: Culicidae). The larvicidal bioassay exhibits a significant dose-response relationship against the fourth instar larvae of Cx. pipiens. Moreover, biochemical analyses revealed a decrease in proteins levels, carbohydrates and lipids in the whole larvae body treated with the lethal concentrations (LC50, LC90) of D. maritima extract as compared to the control series. Whereas, using B. officinalis herbal plants, the result showed a decrease in lipid and carbohydrate contents and an increase in protein. The ability of D. maritima and B. officinalis extracts to inhibit acetylcholinesterase (AChE) activity in a whole body of the treated larvae of Cx. pipiens is examined. The estimated specific activity of glutathione S-transferase (GST) at different times was significantly increased under the effects of both plants. The present study demonstrates that the aqueous extracts of D. maritima and B.officinalis present insecticidal properties with neurotoxic effects against larval stages of the domestic mosquito Cx. pipiens. In this context, the use of chemical insecticides for mosquito control is no longer recommended and the alternatives of eco-friendly products are encouraged.

Association of Frequent Moisturizer Use in Early Infancy With the Development of Food Allergy

It has been hypothesized that food allergy may develop through transcutaneous sensitization, especially in the presence of skin barrier impairment and inflammation. With this study, researchers sought to determine if regular moisturizer use in infants could potentially promote food sensitization and the development of food allergy.This hypothesis was studied in the Inquiring About Tolerance study population. The Inquiring About Tolerance study was a population-based randomized clinical trial conducted from January 15, 2008, to August 31, 2015, including 1303 exclusively breastfed 3-month-old infants and their families from England and Wales.At enrollment at 3 months, families completed a questionnaire that included questions about the frequency and type of moisturizer applied, use of corticosteroid creams, and parental report of dry skin or eczema. Infants were examined for visible eczema at the enrollment visit.A statistically significant dose-response relationship was observed between parent-reported moisturization frequency at 3 months of age and the subsequent development of food allergy. Each additional moisturization per week was associated with an adjusted odds ratio of 1.20 (95% confidence interval [CI]: 1.13 to 1.27; P < .0005) for developing a food allergy. For infants with no visible eczema at the enrollment visit, the corresponding adjusted odds ratio was 1.18 (95% CI: 1.07 to 1.30; P = .001), and, for those with eczema at the enrollment visit, corresponding adjusted odds ratio was 1.20 (95% CI: 1.11 to 1.31; P < .0005). Moisturizer frequency revealed similar dose-response relationships, with the development of both food and aeroallergen sensitization at 36 months.These findings support the idea that regular application of moisturizers to the skin of young infants may promote the development of food allergy through transcutaneous sensitization.The notion of transcutaneous sensitization has become popular over the past decade, and there is now an increasing body of research to support it. In short, it is hypothesized that early oral exposure is likely to induce tolerance, whereas skin exposure is more likely to lead to sensitization. This appears to be especially common in infants with eczema, likely because of both an impaired skin barrier and a greater inherited predisposition to develop allergy. It is also interesting to note that other studies have suggested that early and aggressive eczema care might prevent food allergy. There may therefore be a precarious balance, with the likely tipping point being the presence of allergen on the hands of the person applying the moisturizer.

Association between teeth loss and nasogastric tube feeding dependency in older adults from Taiwan: a retrospective cohort study

BackgroundTo examine the association between teeth loss and nasogastric tube feeding dependency in older people.MethodsThe National Health Interview Survey (NHIS) 2005, 2009, and 2013 in Taiwan. Participants were selected by a multistage stratified sampling method and baseline characteristics, including socioeconomic status and health habits, were obtained by well-trained interviewers. The NHIS was linked with the National Health Insurance research database 2000–2016 and the National Deaths Dataset, which contains all the medical information of ambulatory and inpatient care. Cox regression was used to examine the association between the number of teeth lost and nasogastric tube feeding dependency.ResultsThere were 6165 adults older than 65 years old enrolled in the analysis, with 2959 male (48%) and the mean (SD) age was 73.95(6.46) years old. The mean follow-up duration was 6.5(3.3) years. Regarding the teeth loss categories, 1660 (26.93%), 2123 (34.44%), and 2382 (38.64%) of participants were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. During 39,962 person-years of follow-up, new-onset nasogastric feeding dependency was recognized in 220(13.25%), 256(12.06%), and 461(19.35%) participants who were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. Kaplan-Meier curves demonstrated significant findings (Log-rank P < 0.01). After potential confounders were adjusted, compared with those without teeth loss, older adults who had lost 10–28 teeth had significantly increased risks of occurrence nasogastric feeding dependency (AHR, 1.31; 95% CI, 1.05–1.62; p-value = 0.02). Furthermore, a significant dose-response relation between the number of teeth lost and increased risk of nasogastric feeding was found (p for trend< 0.01).ConclusionsOlder adults who had lost 10–28 teeth had a significantly increased risk of nasogastric tube feeding dependency. Early identification of the oral disease is crucial for the prevention of the occurrence of teeth loss and the following nutrition problems, which would reduce risk of nasogastric tube feeding dependency.

Quantifying the relationship between dapagliflozin and loss of weight in type 1 diabetes mellitus patients.

Dapagliflozin was the first oral treatment approved in type 1 diabetes mellitus (T1DM) patients, simultaneously improving body weight. However, the time course and dose effect of dapagliflozin on loss of weight in T1DM patients was still unknown. The present study aimed to investigate quantitative relationship between dapagliflozin and loss of weight in T1DM patients based on Model-based Meta-analysis. Five dapagliflozin dosage groups, two of them were 5mg/day and three of them were 10mg/day, 1612T1DM patients were analysed with maximal effect (Emax ) model, and evaluation index was change rate of body weight from baseline value. In these T1DM patients, dosages were not incorporated into model, indicating no significant dose-response relationship between 5 and 10mg/day affecting loss of weight. Emax and the treatment duration to reach half of the maximal effects (ET50 ) of dapagliflozin influencing loss of weight in T1DM patients were -4.9% and 10.4weeks, and the duration to achieve 25%, 50%, 75%, and 80% (plateau) of Emax were 3.5, 10.4, 31.2, and 41.6weeks. It was the first time to explore quantitative relationship between dapagliflozin and loss of weight in T1DM patients. To achieve the plateau period in loss of weight, 5mg/day dapagliflozin was required for at least 41.6weeks.

Life satisfaction and coronary atherosclerosis: The SCAPIS study

BackgroundThere is an increasing interest in the potential health benefits of positive psychological states, especially with regard to cardiovascular health. Life satisfaction is thought to be a constituent component of psychological well-being; however, among the few previous studies that have investigated its associations with early stages of the cardiovascular disease process, only one small study has focused on coronary atherosclerosis. The present study aimed to explore associations between life satisfaction and coronary artery disease. MethodsThe study used cross-sectional data from SCAPIS Malmö (n = 6251 randomly selected men and women, aged 50–64 years), including assessment of life satisfaction and coronary artery calcification. Adjustments were made for sociodemographic factors, depression, and cardiovascular risk factors as assessed with the SCORE instrument. ResultsHigher levels of life satisfaction were associated with lower odds of increased coronary artery calcification. This association persisted after adjusting for sociodemographic factors and depression, but lost significance after adjusting for cardiovascular risk factors. Sub-analyses revealed a significant dose-response relationship between higher life satisfaction and lower grade of coronary calcification in all investigated coronary artery regions. ConclusionIn this population-based sample, life satisfaction was associated with better coronary artery health. However, this association was largely explained by cardiovascular risk factors, indicating that life satisfaction is linked to coronary atherosclerosis through a decreased load of cardiovascular risk factors.

Secondhand smoke is associated with poor sleep quality in self-reported never-smokers of Northwest China: a cross-sectional study.

To investigate the relationship between secondhand smoke (SHS) exposure and sleep quality in never-smokers of Northwest China. Never-smoking adults (≥ 15years) from Xinjiang, Northwest China, were included in this cross-sectional survey between April and October 2019. SHS exposure in never-smokers was estimated using a structured questionnaire. Sleep quality was evaluated by Pittsburgh Sleep Quality Index (PSQI), with PSQI score > 5 classified as poor sleep quality. Association of SHS exposure and frequency and duration of SHS exposure with poor sleep quality were analyzed by using a multivariate logistic regression after adjusting for potential confounding factors, including stratification by sex. The mean age of participants was 48.0years, and 77% were females. Of 21,198 never-smokers, 13% (n = 2703) reported SHS exposure and 35% (n = 7390) reported poor sleep quality. In multivariate logistic regression analysis, a significant association was observed between SHS exposure and poor sleep quality (adjusted odds ratio (OR), 1.36; 95% confidence interval (CI)1.24-1.48). Subgroup analysis showed a negative association of SHS exposure with sleep quality in both sexes. However, a significant dose-response relationship of frequency and duration of SHS exposure per week with poor sleep quality was observed only in females. Consistent results were also observed in the aged ≥ 18years. Exposure to SHS is associated with poor sleep quality in never-smoking adults of Northwest China. A dose-response relationship between SHS exposure and poor sleep quality is found in women. Avoiding SHS exposure may have beneficial effects on sleep quality, especially for females.

Imaging-based body fat depots and new-onset atrial fibrillation in general population

Abstract Background Obesity is a well-established risk factor for incident atrial fibrillation (AF). Whether different body fat depots differentially associate with AF development remains largely unknown. Purpose We aimed to investigate the associations between various body fat depots and the risk of new-onset AF among middle-aged and elderly individuals from general population. Methods In the prospective population-based cohort study, body composition was assessed using dual-energy X-ray absorptiometry (DXA) and total body mass, lean mass, fat mass, android and gynoid fat were analyzed (N=3468). Liver fat and epicardial fat were assessed using computed tomography (CT) (N=2145). A body fat score was defined by adding tertiles of each fat depot. All participants were followed for the occurrence of AF until 1st Jan. 2014. Principle component analysis was conducted to identify body fat distribution patterns. Time-to-event analyses were performed using Cox proportional hazards regression analysis. Hazard ratios (HR) and 95% confidence-intervals (95% CI), adjusted for cardiovascular risk factors, were calculated. Results Mean (standard deviation) of age for participants in DXA study and CT study was 74.42 (6.85) and 68.66 (6.41) years, respectively. AF incidence rate was 13.1 per 1000 person-years during a median follow-up time of 9.62 years. In the adjusted model, fat mass (HR; 95% CI: 1.33; 1.05–1.68), lean mass (1.40; 1.15–1.72), gynoid fat mass (1.36; 1.12–1.65), and total body mass (1.51; 1.21–1.89) were significantly associated with new-onset AF. Of note, android-to-gynoid fat ratio was inversely associated with incident AF (HR; 95% CI: 0.81; 0.70–0.94). Larger body fat score was associated with increased risk of incident AF (P for trend &amp;lt;0.01). Two fat distribution patterns were identified. Adherence to the fat- and gynoid fat- pattern (P for trend = 0.035), but not muscle- and visceral fat- pattern (P for trend = 0.35), was significantly associated with larger risk of new-onset AF. Conclusions Various body fat depots were associated with new-onset AF. Larger values of total body mass carried the highest risk for incident AF. The inverse association between android to gynoid fat ratio with AF presents a novel finding. A significant dose-response relationship between body fat accumulation and risk of new-onset AF was observed, implying a collective impact of fat depots on AF development. Findings also suggest that various fat depots, characterized by different fat distribution patterns, may exert differential combined effect on the risk of incident AF. Funding Acknowledgement Type of funding sources: None. Fat depots and atrial fibrillation

A retrospective cohort study of the effects of the adverse childhood experience on chronic diseases of middle-aged and elderly

Objective: To investigate the adverse childhood experience (ACE) effects on the risk of chronic diseases among middle-aged and elderly. Methods: A retrospective cohort study was conducted using the China Health and Retirement Longitudinal Study data. We used life history study data in 2014 as baseline data and data of chronic diseases of middle-aged and elderly in 2015 as outcomes. A zero-inflated negative-binominal model was used to estimate the incidence rate ratio (IRR) for the association between ACE and chronic diseases. Results: Compared with the less than 4 points of ACE exposure in childhood, individuals with ACE exposure 4-, 6- and ≥9 were associated an increased risk of chronic disease, adjusted IRR (95%CI), 1.10(1.04-1.16), 1.18 (1.13-1.25), 1.34 (1.27-1.42), respectively, with a significant dose-response relationship that chronic diseases risks increase parallel with the increase of ACE exposure. Conclusions: ACE might serve as one of the critical risk factors of chronic diseases in middle-aged elderly. It's of public health significance for early screening and intervention of ACE, reducing the incidence of chronic diseases, and improving middle-aged and older adults' quality of life and health.

Opium use as an independent risk factor for pancreatic cancer: A case-control study

BackgroundPancreatic cancer (PC) is ranked as the seventh leading cause of cancer deaths worldwide. The current study was conducted to explore the correlation between the use of opium and its derivatives (opium) and PC in Iran. MethodsIn this case-control study which was conducted in Kerman province, south east part of Iran; 176 patients with PC, and 352 healthy individuals as the control group were matched in terms of age, sex, and place of residence. A structured questionnaire including questions of opium usage, alcohol usage, cigarette smoking, and diet was used to collect the data. The relation between the use of opium and PC was adjusted for tobacco smoking, education, daily intake of fruit, vegetables, red meat, and hydrogenated fats and analyzed using the conditional logistic regression. ResultsThere was a positive relationship between the opium use and the increased risk of PC (Adjusted Odds Ratio (AOR) = 4.33, 95 % CI: 2.09–8.95), which was even stronger than its association with cigarette smoking (AOR = 1.67, 95 % CI: 0.86–3.24), although their difference was not statistically significant. A significant dose-response relation was detected between the use of opium; as the relation was stronger in heavy users (AOR low users = 4.93, 95 % CI: 1.79–13.54 and AOR heavy users = 5.10, 95 % CI: 2.10−12.35). Moreover, PC was higher among participants starting the use of opium at a younger age than those who started opium at an older age (AOR = 8.03, 95 % CI: 3.19–20.23). ConclusionThis study demonstrated that opium use is associated with a high and strong risk of PC as an independent risk factor. Further studies should be done to reduce the use of opium in Iran and other world countries.

Association between Kidney Function, Proteinuria and the Risk of Multiple Myeloma: A Population-Based Retrospective Cohort Study in South Korea.

PurposeWhile renal impairment is one of the first clinical manifestations of multiple myeloma (MM), declined renal function may conversely be a risk factor for cancers including MM. In this study, we investigated the relationship between chronic kidney disease and MM at a population level.Materials and MethodsA total of 9,809,376 adults who participated in a nationwide health screening program and had no MM, cancer or end-stage renal disease at baseline were investigated for incidence of MM. The impact of estimated glomerular filtration rate (eGFR) and random urine dipstick proteinuria, and interactive associations of the two factors on the MM incidence were evaluated.ResultsThe general incidence of MM was 4.8 per 100,000 person-years (mean follow-up of 8.3 years). Participants with eGFR < 60 mL/min/1.73 m2 (5.8% of participants) had higher MM incidence than those with eGFR ≥ 60 mL/min/1.73 m2 (adjusted hazard ratio, 1.29; 95% confidence interval, 1.17 to 1.43). When eGFR was graded into five levels, there was a significant inverse dose-response relationship between eGFR level and MM incidence at the lower eGFR levels (reference: eGFR 60–89 mL/min/1.73 m2). A dose-response relationship was also found with degree of dipstick proteinuria and incidence of MM.ConclusionAdults with decreased renal function indicated either by decreased eGFR or presence of proteinuria are at a higher risk of developing MM compared to those without, and there is a dose-response relationship between the severity of renal impairment and MM incidence.

Hyperuricemia and Its Association With Ischemic Stroke.

Elevated serum uric acid (SUA) levels have been associated with an increased risk of cardiovascular (CV) disease and acute ischemic stroke (AIS) as well as many other medical conditions. AIS is a CV complication that is the second most common cause of mortality worldwide. It results from reduced blood flow to the brain by means of thrombosis, embolism, or systemic hypoperfusion. Studies have demonstrated an association between SUA levels and CV events, with a significant dose-response relationship between elevated SUA levels and stroke risk. Since the relationship between SUA levels and AIS risk has been established, studies are also being conducted in order to evaluate whether antihyperuricemic drugs can lower this risk. Allopurinol use in hyperuricemic patients has been shown to decrease the risk of major CV events, which include AIS. This narrative review aims to investigate the role of SUA as an independent risk factor for AIS along with the proposed biological mechanisms by thoroughly appraising research findings from relevant full-text articles and abstracts indexed in PubMed and the Cochrane Library. In this literature, we will be discussing hyperuricemia, AIS, the association between the two, and the use of antihyperuricemic medications on stroke prognosis. This review will also shed new light on studies that have begun to provide insight into the predictive role of hyperuricemia in AIS.

Effects of Rare Earth Elements on Blood Pressure and Their Exposure Biomarkers: Evidence from Animal Experiments.

Solid fuel combustion is an important source of the release of rare earth elements (REEs) into the ambient environment, resulting in potential adverse effects on human cardiovascular health. Our study aimed to identify reliable exposure biomarkers of REE intake and their potential role in blood pressure change. A total of 24 rats were administered with 14 REE chlorides at four doses (six rats per group). Fur samples were collected both before and after administration. Blood samples were collected after 12 weeks of REE intake. The REE concentrations in rat fur and blood samples were measured by inductively coupled plasma mass spectrometry. For each week, blood pressure, as well as heart rate and pulse pressure, were measured. The linear mixed-effect model was used to analyze the relationship between REE administration dose and blood pressure change. We found that the REE concentration in fur, but not blood, samples exhibited significant dose–response relationships with administration dose. It suggested that hair samples are a more efficient matrix for indicating the exposure level of a population to REEs than blood samples. However, there was no dose–response relationships between the administration dose and blood pressure change of rats, or with heart rate and pulse pressure for the 14 REEs. We also did not find a dose–response relationship between REE administration levels and plasma concentration of 8-hydroxy-2’-deoxyguanosine, as an important DNA oxidative stress damage biomarker. In conclusion, hair samples are more suitable as a sample type to reliably assess exposure to REEs than blood samples, and REEs did not have a direct adverse effect on blood pressure in our rat model.

484Reduced glomerular filtration rate and risk of stroke

Abstract Background Although chronic kidney disease is recognized as an independent risk factor for cerebrovascular disease, its association with hemorrhagic and ischemic stroke remains controversial. Methods A retrospective cohort study conducted using the National Health Insurance Service-National Sample Cohort, which is representative of the entire Korean population. Overall, 196,005 Korean who were not diagnosed with ischemic and hemorrhagic stroke before 2009 were included from 2009 to 2013. The eGFR was divided into six categories (≥90, 75–89, 60–74, 45–59, 30–44, &amp;lt;30 mL/min/1.73 m2). The Kaplan-Meier plot was illustrated to compare the cumulative incidence of ischemic stroke and hemorrhagic stroke. Cox proportional hazard model was used to estimate the hazard ratio (HR) of eGFR for risk of ischemic and hemorrhagic stroke. Results During an average of 4.36 years follow-up period, 2,236 and 668 people were diagnosed with newly ischemic stroke and hemorrhagic stroke, respectively. Among people with eGFR&amp;gt;90 mL/min/1.73 m2, age and sex adjusted incidence rate for ischemic stroke was 452.3 per 100,000 person-years, whereas the adjusted incidence rate for ischemic stroke among people eGFR with 30-44 and 45 mL/min/1.73m2 was 833.5 and 617.7 per 100,000 person-years, respectively. After adjusting for multiple covariates, the adjusted HR for ischemic stroke increased with decreasing eGFR (p for trend=0.005). However, there was no significant dose-response relationship between eGFR and risk of hemorrhagic stroke. Conclusions Reduced glomerular filtration rate less than 45 mL/min/1.73 m2 was associated with an increased risk of ischemic stroke but not hemorrhagic stroke. Key messages Reduction in kidney function had inverse dose-response relationship with the risk of ischemic stroke, but not with the hemorrhagic stroke. Especially, the risk of ischemic stroke was markedly increased from estimated glomerular filtration rate &amp;lt; 45 mL/min/1.73 m2.

131Spatio-temporal analysis to assess health effects of landscape fire smoke: an empirical model

Abstract Background Understanding the health effects of smoke from landscape fires (LFs), including wildfires and prescribed burns, is limited due to lack of adequate smoke exposure measures. Methods We used the reported LFs to determine smoke plume shapes from satellite images. Daily remotely sensed fire radiative power, aerosol optical depth, smoke plumes, fire danger rating, venting index and previous day PM 2.5 were then used to estimate smoke-related particulate matter 2.5 (PM2.5). A population based time series design was used to assess associations between smoke-related PM2.5 and selected adverse health outcomes such as hospital admissions, emergency department visits and ambulance callouts. Results We found a significant dose-response relationship between increased smoke-related PM2.5 concentration and 1% to 5% increase for total emergency department attendances and total hospital admissions on the same day and the lag effects of 3 days where the PM2.5 was at medium level (95-98th percentile) and high level ( &amp;gt; =99th percentile) compared to the low level (&amp;lt;95th percentile). There was also 1% to 25% increased risk for individuals who were exposed to high level LF smoke with selected respiratory and cardiovascular diseases in selected health care utilisations. Conclusions Exposure to LF smoke at a high level was spatio-temporally associated with a wide range of adverse respiratory and cardiovascular diseases in selected health care utilisations. Key messages

Out-of-hospital cardiac arrest and ambient air pollution: A dose-effect relationship and an association with OHCA incidence.

Pollution has been suggested as a precipitating factor for cardiovascular diseases. However, data about the link between air pollution and the risk of out-of-hospital cardiac arrest (OHCA) are limited and controversial. By collecting data both in the OHCA registry and in the database of the regional agency for environmental protection (ARPA) of the Lombardy region, all medical OHCAs and the mean daily concentration of pollutants including fine particulate matter (PM10, PM2.5), benzene (C6H6), carbon monoxide (CO), nitrogen dioxide (NO2), sulphur dioxide (SO2), and ozone (O3) were considered from January 1st to December 31st, 2019 in the southern part of the Lombardy region (provinces of Pavia, Lodi, Cremona and Mantua; 7863 km2; about 1550000 inhabitants). Days were divided into high or low incidence of OHCA according to the median value. A Probit dose-response analysis and both uni- and multivariable logistic regression models were provided for each pollutant. The concentrations of all the pollutants were significantly higher in days with high incidence of OHCA except for O3, which showed a significant countertrend. After correcting for temperature, a significant dose-response relationship was demonstrated for all the pollutants examined. All the pollutants were also strongly associated with high incidence of OHCA in multivariable analysis with correction for temperature, humidity, and day-to-day concentration changes. Our results clarify the link between pollutants and the acute risk of cardiac arrest suggesting the need of both improving the air quality and integrating pollution data in future models for the organization of emergency medical services.

Positive Association between Endothelium-Platelet Microparticles and Urinary Concentration of Lead and Cadmium in Adolescents and Young Adults.

(1) Background: In previous research, higher levels of urine heavy metals, especially lead and cadmium, have been associated with increased cardiovascular risk. However, there is no information linking exposure to heavy metal to endothelial and platelet microparticles (EMPs and PMPs), particularly in the younger population, which are novel biomarkers of endothelial dysfunction. (2) Methods: From a nationwide database, which was incepted in 1992–2000, screening for renal health among Taiwanese school children, a total of 789 subjects were recruited. Cross-sectional analysis was performed to evaluate the association between serum EMPs/PMPs and urine iron, nickel, copper, cadmium, lead, chromium, manganese, and zinc levels in the adolescent and young adult population. (3) Results: After we adjusted the conventional cardiovascular risk factors, CD31+/CD42a− and CD31+/CD42a+ counts, in subjects’ serum, respective markers of EMP and PMP displayed a significant positive dose-response relationship with urinary lead and cadmium levels. Higher quartiles of urine lead and cadmium levels were associated with an increased risk of higher EMPs/PMPs (≥75th percentile) in a multivariate logistic regression model. (4) Conclusion: Higher urinary lead and cadmium concentrations are strongly associated with endothelium–platelet microparticles in this adolescent and young adult population, which could help explain, in part, the mechanism through which heavy metal exposure results in cardiotoxicity.

Association of hearing loss with total and cause-specific mortality in US adults.

We expected to explore the associations of hearing loss and hearing thresholds at different frequencies with total and cause-specific mortality. In this study, 11,732 individuals derived from the National Health and Nutrition Examination Survey (NHANES) 1999-2012 were included. Data of death was extracted from the NHANES Public-Use Linked Mortality File through December 31, 2015. Cox proportional hazards models were used to explore the associations between hearing loss, hearing thresholds at different frequencies, and total or cause-specific mortality. A total of 1,253 deaths occurred with a median follow-up of 12.15 years. A significant positive dose-response relationship between hearing loss in speech frequency and total mortality was observed, and the HRs and 95% CIs were 1.16 (0.91, 1.47), 1.54 (1.19, 2.00), and 1.85 (1.36, 2.50), respectively, for mild, moderate, and severe speech-frequency hearing loss (SFHL) with a P trend of 0.0003. In addition, moderate (HR: 1.90, 95% CI: 1.20-3.00) and greater (3.50, 1.38-8.86) SFHL significantly elevated risk of heart disease mortality. Moreover, hearing thresholds of >25 dB at 500, 1000, or 2000 Hz were significantly associated with elevated mortality from all causes (1.40, 1.17-1.68; 1.44, 1.20-1.73; and 1.33, 1.10-1.62, respectively) and heart disease (1.89, 1.08-3.34; 1.95, 1.21-3.16; and 1.89, 1.16-3.09, respectively). Hearing loss is associated with increased risks of total mortality and heart disease mortality, especially for hearing loss at speech frequency. Preventing or inhibiting the pathogenic factors of hearing loss is important for reducing the risk of death.

The long arm of childhood: The prolonged influence of adverse childhood experiences on depression during middle and old age in China.

Utilizing data from the nationally representative China Health and Retirement Longitudinal Study, this study analyzed the effect of intensity and duration of adverse childhood experiences on depression in middle aged and older aged adults in China. The mediating effect of cumulative health risk and personal factors were validated through the Karlson-Holm-Breen method. The results showed a significant dose-response relationship between adverse childhood experiences and adult depression. The elevated health risks of chronic diseases, disabilities, and physical pain, as well as the disadvantages in education, employment, and economic status caused by the adverse childhood experiences indirectly worsen adult depression.

Effectiveness of spironolactone dispensation in reducing weekly alcohol use: a retrospective high-dimensional propensity score-matched cohort study.

There is a need to increase the armamentarium of pharmacotherapies for alcohol use disorder (AUD). Recent research suggests that mineralocorticoid receptor (MR) antagonism via spironolactone may represent a novel pharmacological treatment for AUD. We conducted a pharmacoepidemiologic retrospective cohort study (June 1, 2014 to May 31, 2018) to examine whether spironolactone dispensation (≥90 continuous days), for any indication, is associated with changes in weekly alcohol use about 6 months later. We compared 523 spironolactone-treated adults and 2305 untreated adults, matched on high-dimensional propensity scores created from a set of predefined (sociodemographic and health characteristics, diagnoses, and service utilization) and empirical electronic health record-derived covariates. The sample was 57% female and 27% non-White with a mean age of 59.2 years (SD = 19.3). Treated patients reduced their weekly alcohol use by 3.50 drinks (95% CI = -4.22, -2.79), while untreated patients reduced by 2.74 drinks (95% CI = -3.22, -2.26), yielding a significant difference of 0.76 fewer drinks (95% CI = -1.43, -0.11). Among those who drank >7 drinks/week at baseline, treated patients, compared to untreated patients, reported a greater reduction in weekly alcohol use by 4.18 drinks (95% CI = -5.38, -2.97), while there was no significant difference among those who drank less. There was a significant dose-response relationship between spironolactone dosage and change in drinks/week. Pending additional evidence on its safety and efficacy in individuals with AUD, spironolactone (and MR blockade, at large) may hold promise as a pharmacotherapy for AUD.