Differential mortality risks associated with PM2.5 components

Epidemiology ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Pierre Masselot ◽  
Francesco Sera ◽  
Rochelle Schneider ◽  
Haidong Kan ◽  
Éric Lavigne ◽  
...  
Author(s):  
E. V. Kovalevskiy ◽  
J. . Schuz ◽  
S. V. Kashanskiy

In 2019, with the aim of assessing mortality risks, the formation of the world’s largest cohort of chrysotile asbestos miners and millers was completed at the largest developed chrysotile mine in the world, including a large proportion of working women with extensive data to assess individual exposure and vital status.


BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuntao Chen ◽  
Adriaan A. Voors ◽  
Tiny Jaarsma ◽  
Chim C. Lang ◽  
Iziah E. Sama ◽  
...  

Abstract Background Prognostic models developed in general cohorts with a mixture of heart failure (HF) phenotypes, though more widely applicable, are also likely to yield larger prediction errors in settings where the HF phenotypes have substantially different baseline mortality rates or different predictor-outcome associations. This study sought to use individual participant data meta-analysis to develop an HF phenotype stratified model for predicting 1-year mortality in patients admitted with acute HF. Methods Four prospective European cohorts were used to develop an HF phenotype stratified model. Cox model with two rounds of backward elimination was used to derive the prognostic index. Weibull model was used to obtain the baseline hazard functions. The internal-external cross-validation (IECV) approach was used to evaluate the generalizability of the developed model in terms of discrimination and calibration. Results 3577 acute HF patients were included, of which 2368 were classified as having HF with reduced ejection fraction (EF) (HFrEF; EF < 40%), 588 as having HF with midrange EF (HFmrEF; EF 40–49%), and 621 as having HF with preserved EF (HFpEF; EF ≥ 50%). A total of 11 readily available variables built up the prognostic index. For four of these predictor variables, namely systolic blood pressure, serum creatinine, myocardial infarction, and diabetes, the effect differed across the three HF phenotypes. With a weighted IECV-adjusted AUC of 0.79 (0.74–0.83) for HFrEF, 0.74 (0.70–0.79) for HFmrEF, and 0.74 (0.71–0.77) for HFpEF, the model showed excellent discrimination. Moreover, there was a good agreement between the average observed and predicted 1-year mortality risks, especially after recalibration of the baseline mortality risks. Conclusions Our HF phenotype stratified model showed excellent generalizability across four European cohorts and may provide a useful tool in HF phenotype-specific clinical decision-making.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanghee Lee ◽  
Yoon Jung Chang ◽  
Hyunsoon Cho

Abstract Background Cancer patients’ prognoses are complicated by comorbidities. Prognostic prediction models with inappropriate comorbidity adjustments yield biased survival estimates. However, an appropriate claims-based comorbidity risk assessment method remains unclear. This study aimed to compare methods used to capture comorbidities from claims data and predict non-cancer mortality risks among cancer patients. Methods Data were obtained from the National Health Insurance Service-National Sample Cohort database in Korea; 2979 cancer patients diagnosed in 2006 were considered. Claims-based Charlson Comorbidity Index was evaluated according to the various assessment methods: different periods in washout window, lookback, and claim types. The prevalence of comorbidities and associated non-cancer mortality risks were compared. The Cox proportional hazards models considering left-truncation were used to estimate the non-cancer mortality risks. Results The prevalence of peptic ulcer, the most common comorbidity, ranged from 1.5 to 31.0%, and the proportion of patients with ≥1 comorbidity ranged from 4.5 to 58.4%, depending on the assessment methods. Outpatient claims captured 96.9% of patients with chronic obstructive pulmonary disease; however, they captured only 65.2% of patients with myocardial infarction. The different assessment methods affected non-cancer mortality risks; for example, the hazard ratios for patients with moderate comorbidity (CCI 3–4) varied from 1.0 (95% CI: 0.6–1.6) to 5.0 (95% CI: 2.7–9.3). Inpatient claims resulted in relatively higher estimates reflective of disease severity. Conclusions The prevalence of comorbidities and associated non-cancer mortality risks varied considerably by the assessment methods. Researchers should understand the complexity of comorbidity assessments in claims-based risk assessment and select an optimal approach.


1974 ◽  
Vol 22 (2) ◽  
pp. 213 ◽  
Author(s):  
I Abdelrahman

A, melinus produced more female progeny and more than twice as many total progeny as A. chrysomphali; it also destroyed almost twice as many hosts through oviposition and mutiliation. A. chrysomphali had a longer post-oviposition period than A. melinus, especially at 30�C. The proportion of single progeny in a host was higher for A, chrysomphali than for A. melinus at all temperatures, and was related to temperature positively in A. chrysomphali and inversely in A. melinus. Large old female A. melinus produced only males at the end of their lives; they did not mate at that stage when offered males, not because they were aged but because they mate only once in their lives. As temperature decreased, female A. melznus ceased producing females earlier, probably because temperature affected either longevity of sperms or the mechanism controlling their release. Differential mortality, temperature, and age of mothers all influenced sex ratio. Pupal mortality was inversely related to temperature within the observed range 20-30�C; in female pupae of A. chrysomphali it was lower than that in either female or male pupae of A. melinus; it was higher in male than female pupae in A. melinus. A. melinus lived longer than A. chrysomphali at all temperatures. Duration of development was longer for A. chrysomphali than for A. melinus at 30�C, but shorter at 20 and 25�C. The threshold of development was 8.5C for A. chrysomphali and 11C for A. melinus. A. chrysomphali had a higher rm at 20 and 25�C than A. melinus, but much lower at 30�C. The highest rate of increase was at > 30�C for A. melinus, and at about 25�C for A. chrysomphali. The rm of the parasites was 3.1-5.0 times that of red scale, depending on parasite species and temperature. A. chrysomphali is smaller than A. melinus, and from the positive relationship between adaptation to cold and speed of development, and the negative relationship between speed of development and size, a negative relationship between size and adaptation to cold within Aphytis spp. may be postulated. A. chrysomphali is more adapted to cold and less to heat than A. melinus. This explains the seasonal and annual fluctuation in their relative abundance in southern Australia. The species would complement each other in controlling red scale; from the data presented here it is possible that Aphytis spp. in Australia may have evolved into more efficient control agents of red scale than elsewhere. Knowledge on the searching ability of Aphytis at different host densities is wanting.


Author(s):  
Hiromi Sugiyama ◽  
Munechika Misumi ◽  
Ritsu Sakata ◽  
Alina V. Brenner ◽  
Mai Utada ◽  
...  

AbstractWe examined the mortality risks among 2463 individuals who were exposed in utero to atomic bomb radiation in Hiroshima or Nagasaki in August 1945 and were followed from October 1950 through 2012. Individual estimates of mother’s weighted absorbed uterine dose (DS02R1) were used. Poisson regression method was used to estimate the radiation-associated excess relative risk per Gy (ERR/Gy) and 95% confidence intervals (CI) for cause-specific mortality. Head size, birth weight, and parents’ survival status were evaluated as potential mediators of radiation effect. There were 339 deaths (216 males and 123 females) including deaths from solid cancer (n = 137), lymphohematopoietic cancer (n = 8), noncancer disease (n = 134), external cause (n = 56), and unknown cause (n = 4). Among males, the unadjusted ERR/Gy (95% CI) was increased for noncancer disease mortality (1.22, 0.10–3.14), but not for solid cancer mortality (− 0.18, < − 0.77–0.95); the unadjusted ERR/Gy for external cause mortality was not statistically significant (0.28, < − 0.60–2.36). Among females, the unadjusted ERRs/Gy were increased for solid cancer (2.24, 0.44–5.58), noncancer (2.86, 0.56–7.64), and external cause mortality (2.57, 0.20–9.19). The ERRs/Gy adjusted for potential mediators did not change appreciably for solid cancer mortality, but decreased notably for noncancer mortality (0.39, < − 0.43–1.91 for males; 1.48, − 0.046–4.55 for females) and external cause mortality (0.10, < − 0.57–1.96 for males; 1.38, < − 0.46–5.95 for females). In conclusion, antenatal radiation exposure is a consistent risk factor for increased solid cancer mortality among females, but not among males. The effect of exposure to atomic bomb radiation on noncancer disease and external cause mortality among individuals exposed in utero was mediated through small head size, low birth weight, and parental loss.


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