Tag: pubmed

Menopause. 2022 Aug 16. doi: 10.1097/GME.0000000000002025. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to measure the impact of different risk factors in middle-aged women on longevity evaluated after three decades of an initial health screening.

METHODS: Women who received an annual check-up between 1990 and 1993 were recruited. Anamnesis and physical examination were recorded. Blood samples for the measurement of glycemia and lipids were taken. Data are reported as of December 2021.

RESULTS: A total of 1,158 women aged 40 to 60 were studied. At 30.9 years of follow-up, the Kaplan-Meier overall survival was 75.6% (95% confidence interval, 72.6-78.3). The main causes of the 260 deaths observed were the following: cancer (n = 88; 33.8%), cardiovascular disease (n = 55; 21.2%), and infectious disease (n = 41; 15.8%). The following hazard ratios were found with the flexible parametric survival model: personal history of fracture (hazard ratio, 2.55; 95% confidence interval, 1.29-5.02; P = 0.007), type 2 diabetes mellitus (2.14; 1.18-3.88; P = 0.012), personal history of heart disease (1.85; 1.09-3.13; P = 0.022), chronic arterial hypertension (1.65; 1.25-2.17; P < 0.001), postmenopausal status (1.60; 1.13-2.26; P = 0.008), unskilled jobs (1.56; 1.17-2.07; P = 0.002), cigarette smoking (1.51; 1.17-1.94; P = 0.002), age (1.06; 1.03-1.09; P < 0.001), body mass index (1.04; 1.01-1.07; P = 0.004), multiparous (0.72; 0.56-0.93; P = 0.012), and active sexual intercourse (0.68; 0.52-0.87; P = 0.003). Lipid disorders did not reach statistical significance as a risk factor.

CONCLUSIONS: In this cohort, it was observed that most of the classic risk factors for mortality were present. However, a history of fracture appears in middle-aged women as a strong predictor of mortality, surpassing diabetes and arterial hypertension. Multiparity, on the other hand, was a protective factor.

PMID:35969889 | DOI:10.1097/GME.0000000000002025

Blood. 2022 Aug 19:blood.2022015790. doi: 10.1182/blood.2022015790. Online ahead of print.

ABSTRACT

The frequency of pathogenic/likely pathogenic (P/LP) germline variants in myelodysplastic syndrome (MDS) patients diagnosed at or younger than 40 years old is 15 to 20%. However, there are no comprehensive studies assessing the frequency of such variants across the age spectrum. We performed augmented whole exome sequencing from peripheral blood of 404 MDS patients and their related donors prior to allogeneic hematopoietic stem cell transplantation. Single nucleotide and copy number variants in 233 genes were analyzed and interpreted. Germline status was established by the presence of a variant in the patient and related donor or for those seen previously only as germline alleles. We identified P/LP germline variants in 28 out of 404 MDS patients (7%) within all age deciles. Patients with P/LP variants were more likely to develop higher-grade MDS than those without (43% vs. 25%, p=0.04). There was no statistical difference in outcome parameters between patients with and without a germline variant, but the analysis was underpowered. P/LP variants in bone marrow failure syndrome genes were found in five patients under age 40, whereas variants in DDX41 (n=4), telomere biology disorder genes (n=2), and tumor predisposition genes (n=17) were found in patients over 40. If presumed germline variants were included, the yield of P/LP variants would increase to 11% and by adding suspicious variants of unknown significance, it would rise further to 12%. The high frequency of P/LP germline variants in our study supports comprehensive germline genetic testing for all MDS patients regardless of their age at diagnosis.

PMID:35969835 | DOI:10.1182/blood.2022015790

J ECT. 2022 Aug 9. doi: 10.1097/YCT.0000000000000879. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate intraocular pressure (IOP) changes during and after electroconvulsive therapy.

METHODS: In 20 patients, IOP was measured using a handheld iCare tonometer before, during, and up to 15 minutes after the seizure. Electrode placement was either right unilateral (RUL) or bilateral (BL). Statistical analyses were done at baseline, during, and 15 minutes after the seizure.

RESULTS: In the RUL group (n = 14), the IOP in the left eye increased from 14.8 mm Hg before the seizure to 27.8 mm Hg during the seizure (P = 0.0001) and decreased to 14.0 mm Hg after the seizure (P = 0.0002). The IOP in the right eye increased from 15.4 mm Hg before the seizure to 34.4 mm Hg during the seizure (P = 0.0001) and decreased to 16.0 mm Hg after the seizure (P = 0.0002).In the BL group (n = 6), the IOP in the left eye increased from 13.0 mm Hg before the seizure to 26.3 mm Hg during the seizure (P = 0.1250) and decreased to 14.5 mm Hg after the seizure (P = 0.250). In the right eye, the IOP increased from 13.3 mm Hg before the seizure to 28.4 mm Hg during the seizure (P = 0.1250) and decreased to 13.7 mm Hg after the seizure (P = 0.25).When the results were compared between the 2 electrode placements, the difference in IOP between the right and left eye was higher in the RUL group during (RUL 6.7 mm Hg vs BL 2.0 mm Hg, P = 0.0231) and after (RUL 2.1 mm Hg vs BL -0.8 mm Hg, P = 0.0492) the seizure.

CONCLUSIONS: RUL stimulation with electroconvulsive therapy causes a rise in IOP that is partially lateralized, ipsilateral to the side of stimulation.

PMID:35969842 | DOI:10.1097/YCT.0000000000000879

Cancer Prev Res (Phila). 2022 Aug 15:CAPR-22-0086. doi: 10.1158/1940-6207.CAPR-22-0086. Online ahead of print.

ABSTRACT

The human papillomavirus vaccine (HPV) was indicated for the prevention of vulvovaginal cancers in 2008, but its impact on the incidence of vulvar cancers within the US is unknown. To determine this, we conducted a secondary analysis of 88,942 vulvar cancer cases among women 20+ years old using the US Cancer Statistics 2001-2018 databases. Data were stratified by tumor behavior (in situ or invasive), age (20-44, 45-64, 65+ years old), race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic), and US census region (Northeast, South, Midwest, West), and incidence rates and average annual percentage changes (AAPC) were calculated by group. Reversing previous trends, the incidence of vulvar carcinoma in situ significantly decreased between 2001-2018 among women from all age groups, races/ethnicities, and regions (combined AAPC: -4.3, 95% CI: -4.7, -3.8). The incidence of invasive vulvar squamous cell carcinoma decreased significantly among 20-44-year-old women (AAPC: -0.8, 95% CI: -1.3, -0.3), but significantly increased among those 45-64 (AAPC: 2.3, 95% CI: 1.8, 2.8) and 65+ years old (AAPC: 1.2, 95% CI: 1.1, 1.4). Regardless of tumor behavior, incidence was highest among non-Hispanic Whites and the Midwest region. Overall, the significant declines in vulvar carcinoma in situ among all ages, as well as invasive vulvar cancer among younger women, are encouraging and complement other recent data suggesting HPV vaccinations are already reducing anal and cervical cancer incidence. Over time, further declines in vulvar carcinoma incidence are likely as uptake and completion rates of the HPV vaccine increase in the US.

PMID:35969832 | DOI:10.1158/1940-6207.CAPR-22-0086

Environ Sci Technol. 2022 Aug 15. doi: 10.1021/acs.est.2c03255. Online ahead of print.

ABSTRACT

This study reports on the occurrence and distribution of short- and medium-chain chlorinated paraffins (SCCPs and MCCPs, respectively) in edible insects purchased from Asia and Europe. A total of 36 edible insect samples (n = 24 from Asia, n = 12 from Europe) authorized and prepared for human consumption were purchased and analyzed for SCCPs and MCCPs via gas chromatography and mass spectrometry. SCCPs were detected in 83% of all edible insect samples with an overall median ∑SCCP concentration of 8.7 ng/g dry weight (dw) and a range of <2.0 to 410 ng/g dw, while MCCPs were present in 92% of samples with a median ∑MCCP concentration of 51 ng/g dw and a range of <6.0 to 380 ng/g dw. Median ∑SCCP and ∑MCCP levels in edible insects purchased in Asia were approximately two- and four-times higher, respectively, than those from Europe, while the difference was statistically significant for ∑MCCPs (p < 0.001). Differences in homologue patterns were also observed between Asian and European samples to suggest diverse sources of CP contamination to insects which may include environmental accumulation, industrial processing equipment and food additives. Estimated daily intake of SCCPs and MCCPs via consumption of edible insects suggested that adverse health outcomes were very unlikely, but that continued monitoring of insect farming and processing practices are warranted.

PMID:35969810 | DOI:10.1021/acs.est.2c03255

Clin J Sport Med. 2022 Aug 15. doi: 10.1097/JSM.0000000000001058. Online ahead of print.

ABSTRACT

OBJECTIVE: To identify risk factors for shoulder and elbow injuries in high-school baseball position players and pitchers in the preseason history and physical examination.

DESIGN: Retrospective cohort study.

SETTING: Community high-school baseball.

PARTICIPANTS: Three hundred seventy-one male baseball players’ mean age 15.0 ± 1.8 years.

OUTCOME MEASURES: A preseason history and physical examination was performed on all athletes. Injury information was collected by weekly self-report and athletic trainer injury logs throughout the season. Comparisons between injured and noninjured players were performed using t tests and χ2 analyses. Binary logistic regression models were developed to identify risk factors for injury.

RESULTS: Seventy-six injuries were recorded over the season. In univariate analysis, the injured group had greater months of baseball participation (P = 0.007) and shoulder visual analog scale for the past year (P = 0.003). The injured group also had more olecranon tenderness (P < 0.0001, odds ratio [OR] 2.9) and decreased elbow arc of motion. All other factors were not significantly different (P > 0.05). In multivariable logistic regression, months per year of baseball participation was the only factor significantly associated with injuries (P = 0.010, OR = 1.21).

CONCLUSIONS: Baseball players who developed arm injuries during a season were more likely to play more months of baseball and report shoulder pain in the previous year. The presence of preseason olecranon tenderness was associated with nearly triple the risk of injury during the season. Every additional month of baseball participation in the previous year was associated with a 1.2× increased odds of injury. The presence of glenohumeral internal rotation deficit was not a predictor of injury.

PMID:35969808 | DOI:10.1097/JSM.0000000000001058

Proc Natl Acad Sci U S A. 2022 Aug 23;119(34):e2117868119. doi: 10.1073/pnas.2117868119. Epub 2022 Aug 15.

ABSTRACT

Racial/ethnic disparities in academic performance may result from a confluence of adverse exposures that arise from structural racism and accrue to specific subpopulations. This study investigates childhood lead exposure, racial residential segregation, and early educational outcomes. Geocoded North Carolina birth data is linked to blood lead surveillance data and fourth-grade standardized test scores (n = 25,699). We constructed a census tract-level measure of racial isolation (RI) of the non-Hispanic Black (NHB) population. We fit generalized additive models of reading and mathematics test scores regressed on individual-level blood lead level (BLL) and neighborhood RI of NHB (RINHB). Models included an interaction term between BLL and RINHB. BLL and RINHB were associated with lower reading scores; among NHB children, an interaction was observed between BLL and RINHB. Reading scores for NHB children with BLLs of 1 to 3 µg/dL were similar across the range of RINHB values. For NHB children with BLLs of 4 µg/dL, reading scores were similar to those of NHB children with BLLs of 1 to 3 µg/dL at lower RINHB values (less racial isolation/segregation). At higher RINHB levels (greater racial isolation/segregation), children with BLLs of 4 µg/dL had lower reading scores than children with BLLs of 1 to 3 µg/dL. This pattern becomes more marked at higher BLLs. Higher BLL was associated with lower mathematics test scores among NHB and non-Hispanic White (NHW) children, but there was no evidence of an interaction. In conclusion, NHB children with high BLLs residing in high RINHB neighborhoods had worse reading scores.

PMID:35969764 | DOI:10.1073/pnas.2117868119

Proc Natl Acad Sci U S A. 2022 Aug 23;119(34):e2205518119. doi: 10.1073/pnas.2205518119. Epub 2022 Aug 15.

ABSTRACT

Testing the significance of predictors in a regression model is one of the most important topics in statistics. This problem is especially difficult without any parametric assumptions on the data. This paper aims to test the null hypothesis that given confounding variables Z, X does not significantly contribute to the prediction of Y under the model-free setting, where X and Z are possibly high dimensional. We propose a general framework that first fits nonparametric machine learning regression algorithms on [Formula: see text] and [Formula: see text], then compares the prediction power of the two models. The proposed method allows us to leverage the strength of the most powerful regression algorithms developed in the modern machine learning community. The P value for the test can be easily obtained by permutation. In simulations, we find that the proposed method is more powerful compared to existing methods. The proposed method allows us to draw biologically meaningful conclusions from two gene expression data analyses without strong distributional assumptions: 1) testing the prediction power of sequencing RNA for the proteins in cellular indexing of transcriptomes and epitopes by sequencing data and 2) identification of spatially variable genes in spatially resolved transcriptomics data.

PMID:35969737 | DOI:10.1073/pnas.2205518119

Can J Urol. 2022 Aug;29(4):11204-11208.

ABSTRACT

INTRODUCTION: Women, underrepresented minorities, and international medical graduates are underrepresented in urology. We sought to compare demographics of leaders in academic urology to urology faculty and academic medical faculty.

MATERIALS AND METHODS: The Association of American Medical Colleges provided academic medical faculty demographics. Women, underrepresented minorities, and international medical graduates in leadership roles (department/division chair or full professor) were identified. Fisher’s exact tests were performed to compare proportions of those groups in urology leadership to academic urology, academic medicine leadership, and academic medicine.

RESULTS: In 2019, there were 179,105 faculty in academic medicine with 41,766 in leadership and 1,614 faculty in urology with 567 in leadership. Significantly fewer women were in urology leadership compared to academic urology (7.4% vs. 22.0%, p < 0.0001), academic medical leadership (7.4% vs. 25.0%, p < 0.0001), and academic medicine (7.4% vs. 42.0%, p < 0.0001). Significantly fewer underrepresented minorities were in urology leadership compared to academic medicine (6.9% vs. 9.4%, p = 0.04) with no significant difference when compared to urology faculty (6.9% vs. 8.1%, p = 0.4) or medical faculty leadership (6.9% vs. 6.4%, p = 0.6). Significantly more international medical graduates were in urology leadership compared to across academic urology, (32% vs. 24%, p = 0.0006), but significantly fewer than those in leadership across all medical specialties (32% vs. 40%, p = 0.0001).

CONCLUSIONS: Women and underrepresented minorities are significantly underrepresented in academic urologic leadership while international medical graduates are statistically overrepresented. Considering calls for diversity, equity, and inclusion, these data highlight a need for increased representation in leadership positions in academic urology.

PMID:35969723

J Homosex. 2022 Aug 15:1-24. doi: 10.1080/00918369.2022.2105674. Online ahead of print.

ABSTRACT

Affirming and accessible health care may improve health outcomes for trans individuals in the U.S. We explored strategies to improve affirming care for trans individuals from the perspectives of providers and transgender and non-binary community members. Forty members of a collective group of gender-affirming providers (GAP) in the southern U.S. were recruited to participate in a brief online survey. A graphical LASSO undirected network analysis approach visualized associations across outcomes and explanatory variables. Multinomial ordered (or logistic, for binary outcomes) models explored associations between a common set of explanatory variables and outcomes. Strong partial correlations (network) and statistically significant explanatory variables (ordinal and logistic models) were identified. Additionally, we conducted three focus groups (FGs) audio-recorded over Zoom with 11 community members. Four study team members analyzed the transcripts using content analyses. Survey results indicated that higher frequency of attendance at monthly provider meetings, additional training, and provision of training and consultation were associated with greater perceived competence among GAP members. To improve services, FG participants suggested treating patients as experts, increasing diversity and representation among providers, and expanding the GAP group. These results highlight the critical need to design and implement community-identified interventions to improve gender-affirming services and enhance provider training.

PMID:35969714 | DOI:10.1080/00918369.2022.2105674