scholarly journals Age of Initiation of Dual Tobacco Use and Binge Drinking among Youth (12–17 Years Old): Findings from the Population Assessment of Tobacco and Health (PATH) Study

2021 ◽  
Vol 18 (24) ◽  
pp. 12985
Author(s):  
Adriana Pérez ◽  
Arnold E. Kuk ◽  
Meagan A. Bluestein ◽  
Hui Min Shirlyn Sia ◽  
Baojiang Chen
Keyword(s):  
Binge Drinking ◽  
Tobacco Use ◽  
Proportional Hazard ◽  
Tobacco Products ◽  
The Public ◽  
Use Patterns ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
Race Ethnicity ◽  
Hispanic White

Earlier exposure to binge drinking and tobacco use is associated with higher odds of substance use disorders. Using national youth data from the PATH study, we prospectively estimate the age of initiating past 30-day use of (1) cigarettes, e-cigarettes, and binge drinking, and (2) cigarettes, cigarillos, and binge drinking. Cox proportional hazard models were used to estimate differences in the age of initiation by sex, race/ethnicity, and previous use of other tobacco products. By age 21, 4.4% (95% CI: 3.7–5.2) and 2.0% (95% CI: 1.2–2.8) of youth reported initiation of past 30-day use outcomes (1) and (2), respectively. After controlling for sex and previous use of other tobacco products, statistically significant differences in the age of initiation by race/ethnicity were found for each outcome: Hispanic and non-Hispanic Black youth were less likely than non-Hispanic White youth to initiate past 30-day use of both outcomes (1) and (2) at earlier ages. Although the initiation of both outcomes remained relatively low by age 21, these incidences represent 1.56 million and 700,000 youth, respectively. This study provides the public with evidence to identify the particular ages at which education campaigns may be most effective to prevent youth from initiating these three substances. Further research is needed to estimate the age of initiation of other dual tobacco use patterns with binge drinking.

Abstract P153: Dose-Response Associations Between Physical Activity And All-Cause Mortality Among A Multi-Ethnic Sample With Diabetes: NHANES 1999-2006

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
William Boyer ◽  
Madison Brenton ◽  
Allison Milano
Keyword(s):  
Mortality Risk ◽  
Mexican American ◽  
Statistical Significance ◽  
Significant Risk ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Models ◽  
Physician Diagnosis ◽  
Hispanic White

Introduction: Emerging evidence has suggested that those identifying as non-Hispanic white (NHW) or non-Hispanic black (NHB) have consistent and similar all-cause mortality risk reductions across dose of aerobic PA. In the same analyses, those identifying as Mexican American (MA) receive no protection from all-cause mortality across dose of aerobic PA. However, a single study has suggested that MAs meeting both the aerobic and muscular strengthening activity (MSA) recommendations have similar all-cause mortality risk reductions compared to NHW and NHB, highlighting the importance of MSA among MA. It is unknown, however, if these results translate to those who have diabetes. Hypothesis: NHW or NHB participants will have similar all-cause mortality risk reductions associated with aerobic PA independent of MSA participation. MA meeting both recommendations will have significant all-cause mortality risk reductions. Methods: The study sample (n=1,999) included adult (≥20 years of age) participants with diabetes from the 1999-2006 NHANES. Diabetes was defined as having one of the following: reported physician diagnosis, reported taking anti-hyperglycemic medication, or HbA1c ≥6.5%. PA was categorized into 6 categories based around the 2018 PA guidelines: category 1 (no aerobic PA and insufficient MSA), category 2 (insufficient aerobic PA and insufficient MSA), category 3 (active and insufficient MSA), category 4 (no aerobic PA and sufficient MSA), category 5 (insufficient aerobic PA and sufficient MSA), and category 6 (meeting both recommendations). Cox-proportional hazard models were used for all analyses. Results: A significant interaction (p<0.001) was found between categories of PA and race. Statistically significant risk reductions were found for categories 2,3 and 6 among NHW, and categories 2 and 3 among NHB; with a non-statistically significant risk reduction of 67% in category 6 (p=0.13) for NHB. A 45% reduction in risk was found among MA for category 6, however the estimate did not attain statistical significance (p=0.17). Conclusions: Similar to previous studies in those without diabetes, aerobic PA of any volume significantly reduced risk for all-cause mortality only among NHW and NHB with diabetes. While the risk reductions were clinically meaningful for both NHB and MA in category 6 compared to category 1, there was a lack of statistical significance. It is probable this may be, in part, influenced by a relatively low sample size within these two race-ethnic groups.

scholarly journals Occupation and COVID-19 mortality in England: a national linked data study of 14.3 million adults

2021 ◽  
Author(s):  
Vahe Nafilyan ◽  
Piotr Pawelek ◽  
Daniel Ayoubkhani ◽  
Sarah Rhodes ◽  
Lucy Pembrey ◽  
...  
Keyword(s):  
Substantial Contribution ◽  
Proportional Hazard ◽  
The Public ◽  
Work Related ◽  
Private Households ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Models ◽  
Workplace Factors ◽  
Socio Demographic Factors

Objective: To estimate occupational differences in COVID-19 mortality, and test whether these are confounded by factors, such as regional differences, ethnicity and education or due to non-workplace factors, such as deprivation or pre-pandemic health. Design: Retrospective cohort study Setting: People living in private households England Participants: 14,295,900 people aged 40-64 years (mean age 52 years, 51% female) who were alive on 24 January 2020, living in private households in England in 2019, were employed in 2011, and completed the 2011 census. Main outcome measures: COVID-19 related death, assessed between 24 January 2020 and 28 December 2020. We estimated age-standardised mortality rates per 100,000 person-years at risk (ASMR) stratified by sex and occupations. To estimate the effect of occupation due to work-related exposures, we used Cox proportional hazard models to adjust for confounding (region, ethnicity, education), as well as non-workplace factors that are related to occupation. Results: There is wide variation between occupations in COVID-19 mortality. Several occupations, particularly those involving contact with patients or the public, show three-fold or four-fold risks. These elevated risks were greatly attenuated after adjustment for confounding and mediating non-workplace factors. For example, the hazard ratio (HR) for men working as taxi and cab drivers or chauffeurs changed from 4.60 [95%CI 3.62-5.84] to 1.47 [1.14-1.89] after adjustment. More generally, the overall HR for men working in essential occupations compared with men in non-essential occupations changed from 1.45 [1.34 - 1.56] to 1.22 [1.13 - 1.32] after adjustment. For most occupations, confounding and other mediating factors explained about 70% to 80% of the age-adjusted hazard ratios. Conclusions Working conditions are likely to play a role in COVID-19 mortality, particularly in occupations involving contact with COVID-19 patients or the public. However, there is also a substantial contribution from non-workplace factors, including regional factors, socio-demographic factors, and pre-pandemic health.

scholarly journals Who are the young users of tobacco products? Prevalence and characteristics of Danish adolescents who have either smoked cigarettes, used alternative tobacco products, or used both

2021 ◽  
pp. 145507252110276
Author(s):  
Simone Gad Kjeld ◽  
Susan Andersen ◽  
Anette Andersen ◽  
Stine Glenstrup ◽  
Lisbeth Lund ◽  
...  
Keyword(s):  
Binge Drinking ◽  
Tobacco Use ◽  
Social Relations ◽  
Well Being ◽  
Tobacco Product ◽  
Tobacco Products ◽  
Use Patterns ◽  
Multi Level ◽  
Reported Data ◽  
Alternative Tobacco Products

Aims: We examined characteristics (smoking in social relations, binge drinking, and well-being measures) of Danish 13-year-olds in relation to their tobacco use patterns. Ever use of cigarettes exclusively, ever use of alternative tobacco products (ATPs; e-cigarettes, snus, or waterpipe) exclusively, and use of both cigarettes and ATPs were studied. Methods: We used self-reported data from students at 46 Danish schools in 2017 comprising 2,307 students (response rate = 86%). Multi-level logistic regression analyses were used to examine the associations between student characteristics and the odds for having ever used any tobacco products, smoked cigarettes exclusively, used ATPs exclusively, or used both cigarettes and ATPs compared with never use of any tobacco products. Unadjusted estimates and estimates adjusted for gender were reported. Results: A significant minority of youth (13.2%) had used one or more tobacco products. Of these, 2.0% had exclusively smoked cigarettes, 7.2% had exclusively used ATPs, and 4.0% had used both. Findings showed that all included characteristics (families’ and friends’ smoking, binge drinking, and well-being characteristics) were associated with using any tobacco product; however, students with friends who smoked, had been binge drinking, and had low well-being at home had notably higher odds for having both smoked cigarettes and used ATPs compared to the other tobacco use patterns. Conclusion: ATPs were popular among Danish adolescents compared with conventional cigarettes. Thus, prevention efforts among adolescents should not merely focus on the health risks of conventional cigarette smoking but also on ATPs. Students with diverse tobacco use patterns were similar on various characteristics. However, findings indicate that adolescents who had used both conventional cigarettes and ATPs constitute a more risk-averse group in special need of prevention efforts. Gender did not markedly influence the results. These findings may help future strategies aiming at the youngest adolescents at risk of using tobacco products.

scholarly journals Age of e-cigarette initiation in USA young adults: Findings from the Population Assessment of Tobacco and Health (PATH) study (2013–2017)

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261243
Author(s):  
Adriana Pérez ◽  
Meagan A. Bluestein ◽  
Arnold E. Kuk ◽  
Baojiang Chen
Keyword(s):  
Young Adults ◽  
Secondary Analysis ◽  
Interval Censoring ◽  
Cigarette Use ◽  
Tobacco Products ◽  
Public Health Burden ◽  
The Public ◽  
Cox Proportional Hazard ◽  
Increased Risk ◽  
Cox Proportional Hazard Models

Introduction There is a lack of research prospectively estimating the age of e-cigarette initiation in U.S. young adults. Methods Secondary analysis of PATH young adults across 2013–2017 (waves 1–4) were conducted. We prospectively estimated age of initiation of: ever, past 30-day, and fairly regular e-cigarette use using weighted interval-censoring survival analyses. Interval-censoring Cox proportional hazard models adjusting for sex, race/ethnicity, and previous use of six other tobacco products (cigarettes, traditional cigars, filtered cigars, cigarillos, hookah, and smokeless tobacco) were fitted for each of the three e-cigarette initiation outcomes. Results Among never e-cigarette users, by age 21, 16.8% reported ever use, 7.2% reported past 30-day use, and 2.3% reported fairly regular e-cigarette use. Males had increased risk of initiating ever, past 30-day, and fairly regular e-cigarette use at earlier ages compared to females. Hispanic young adults had increased risk of initiating ever and past 30-day e-cigarette use at earlier ages compared to Non-Hispanic White young adults. Previous use of other tobacco products before e-cigarette initiation increased the risk of an earlier age of e-cigarette initiation. Conclusion Prevention and education campaigns should focus on young adults in order to alleviate the public health burden of initiating e-cigarette use at earlier ages.

scholarly journals Occupation and COVID-19 mortality in England: a national linked data study of 14.3 million adults

2021 ◽  
pp. oemed-2021-107818
Author(s):  
Vahe Nafilyan ◽  
Piotr Pawelek ◽  
Daniel Ayoubkhani ◽  
Sarah Rhodes ◽  
Lucy Pembrey ◽  
...  
Keyword(s):  
Residual Effects ◽  
Substantial Contribution ◽  
Confounding Factors ◽  
Proportional Hazard ◽  
The Public ◽  
Cox Proportional Hazard ◽  
Occupational Differences ◽  
Care Workers ◽  
Cox Proportional Hazard Models ◽  
Workplace Factors

ObjectivesTo estimate occupational differences in COVID-19 mortality and test whether these are confounded by factors such as regional differences, ethnicity and education or due to non-workplace factors, such as deprivation or prepandemic health.MethodsUsing a cohort study of over 14 million people aged 40–64 years living in England, we analysed occupational differences in death involving COVID-19, assessed between 24 January 2020 and 28 December 2020.We estimated age-standardised mortality rates (ASMRs) per 100 000 person-years at risk stratified by sex and occupation. We estimated the effect of occupation on COVID-19 mortality using Cox proportional hazard models adjusted for confounding factors. We further adjusted for non-workplace factors and interpreted the residual effects of occupation as being due to workplace exposures to SARS-CoV-2.ResultsIn men, the ASMRs were highest among those working as taxi and cab drivers or chauffeurs at 119.7 deaths per 100 000 (95% CI 98.0 to 141.4), followed by other elementary occupations at 106.5 (84.5 to 132.4) and care workers and home carers at 99.2 (74.5 to 129.4). Adjusting for confounding factors strongly attenuated the HRs for many occupations, but many remained at elevated risk. Adjusting for living conditions reduced further the HRs, and many occupations were no longer at excess risk. For most occupations, confounding factors and mediators other than workplace exposure to SARS-CoV-2 explained 70%–80% of the excess age-adjusted occupational differences.ConclusionsWorking conditions play a role in COVID-19 mortality, particularly in occupations involving contact with patients or the public. However, there is also a substantial contribution from non-workplace factors.

scholarly journals LAMB1 Is Related to the T Stage and Indicates Poor Prognosis in Gastric Cancer

2021 ◽  
Vol 20 ◽  
pp. 153303382110049
Author(s):  
Tao Ran ◽  
ZhiJi Chen ◽  
LiWen Zhao ◽  
Wei Ran ◽  
JinYu Fan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Poor Prognosis ◽  
Hazard Models ◽  
Proportional Hazard ◽  
Kegg Analysis ◽  
Proportional Hazard Models ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Models ◽  
Gastric Cancer Patients

Background and Objective: Gastric cancer (GC) is a common tumor malignancy with high incidence and poor prognosis. Laminin is an indispensable component of basement membrane and extracellular matrix, which is responsible for bridging the internal and external environment of cells and transmitting signals. This study mainly explored the association of the LAMB1 expression with clinicopathological characteristics and prognosis in gastric cancer. Methods: The expression data and clinical information of gastric cancer patients were downloaded from The Cancer Genome Atlas (TCGA) and Asian Cancer Research Group (ACRG). And we analyzed the relationship between LAMB1 expression and clinical characteristics through R. CIBERSORTx was used to calculate the absolute score of immune cells in gastric tumor tissues. Then COX proportional hazard models and Kaplan-Meier curves were performed to evaluate the role of LAMB1 and its influence on prognosis in gastric cancer patients. Finally, GO and KEGG analysis were applied for LAMB1-related genes in gastric cancer, and PPI network was constructed in Cytoscape software. Results: In the TCGA cohort, patients with gastric cancer frequently generated LAMB1 gene copy number variation, but had little effect on mRNA expression. Both in the TCGA and ACRG cohorts, the mRNA expression of LAMB1 in gastric cancer tissues was higher than it in normal tissues. All patients were divided into high expression group and low expression group according to the median expression level of LAMB1. The elevated expression group obviously had more advanced cases and higher infiltration levels of M2 macrophages. COX proportional hazard models and Kaplan-Meier curves revealed that patients with enhanced expression of LAMB1 have a worse prognosis. GO/KEGG analysis showed that LAMB1-related genes were enriched in PI3K-Akt signaling pathway, focal adhesion, ECM-receptor interaction, etc. Conclusions: The high expression of LAMB1 in gastric cancer is related to the poor prognosis of patients, and it may be related to microenvironmental changes in tumors.

scholarly journals Inflammatory and Hypercoagulable Biomarkers and Clinical Outcomes in COVID-19 Patients

2021 ◽  
Vol 10 (14) ◽  
pp. 3086
Author(s):  
Hiroki Kitakata ◽  
Shun Kohsaka ◽  
Shunsuke Kuroda ◽  
Akihiro Nomura ◽  
Takeshi Kitai ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Risk Estimation ◽  
Interquartile Range ◽  
Proportional Hazard ◽  
Multicenter Observational Study ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
Time Of Admission ◽  
Mortality Hazard Ratio ◽  
D Dimer

Systemic inflammation and hypercoagulopathy are known pathophysiological processes of coronavirus disease 2019 (COVID-19), particularly in patients with known cardiovascular disease or its risk factors (CVD). However, whether a cumulative assessment of these biomarkers at admission could contribute to the prediction of in-hospital outcomes remains unknown. The CLAVIS-COVID registry was a Japanese nationwide retrospective multicenter observational study, supported by the Japanese Circulation Society. Consecutive hospitalized patients with pre-existing CVD and COVID-19 were enrolled. Patients were stratified by the tertiles of CRP and D-dimer values at the time of admission. Multivariable Cox proportional hazard models were constructed. In 461 patients (65.5% male; median age, 70.0), the median baseline CRP and D-dimer was 58.3 (interquartile range, 18.2–116.0) mg/L and 1.5 (interquartile range, 0.8–3.0) mg/L, respectively. Overall, the in-hospital mortality rate was 16.5%, and the rates steadily increased in concordance with both CRP (5.0%, 15.0%, and 28.2%, respectively p < 0.001) and D-dimer values (6.8%, 19.6%, and 22.5%, respectively p = 0.001). Patients with the lowest tertiles of both biomarkers (CRP, 29.0 mg/L; D-dimer, 1.00 mg/L) were at extremely low risk of in-hospital mortality (0% until day 50, and 1.4% overall). Conversely, the elevation of both CRP and D-dimer levels was a significant predictor of in-hospital mortality (Hazard ratio, 2.97; 95% confidence interval, 1.57–5.60). A similar trend was observed when the biomarker threshold was set at a clinically relevant threshold. In conclusion, the combination of these abnormalities may provide a framework for rapid risk estimation for in-hospital COVID-19 patients with CVD.

scholarly journals Prognostic implications of depression and inflammation in patients with metastatic lung cancer

2020 ◽  
Author(s):  
Daniel C McFarland ◽  
Rebecca M. Saracino ◽  
Andrew H. Miller ◽  
William Breitbart ◽  
Barry Rosenfeld ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Hazard Ratio ◽  
Proportional Hazard ◽  
Metastatic Lung Cancer ◽  
Proportional Hazard Models ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Metastatic Lung ◽  
Cox Proportional Hazard Models ◽  
Prognostic Implications

Background: Lung cancer-related inflammation is associated with depression. Both elevated inflammation and depression are associated with worse survival. However, outcomes of patients with concomitant depression and elevated inflammation are not known. Materials & methods: Patients with metastatic lung cancer (n = 123) were evaluated for depression and inflammation. Kaplan–Meier plots and Cox proportional hazard models provided survival estimations. Results: Estimated survival was 515 days for the cohort and 323 days for patients with depression (hazard ratio: 1.12; 95% CI: 1.05–1.179), 356 days for patients with elevated inflammation (hazard ratio: 2.85, 95% CI: 1.856–4.388), and 307 days with both (χ2 = 12.546; p < 0.001]). Conclusion: Depression and inflammation are independently associated with inferior survival. Survival worsened by inflammation is mediated by depression-a treatable risk factor.

scholarly journals Potato consumption and risk of pancreatic cancer in the HELGA cohort

2018 ◽  
Vol 119 (12) ◽  
pp. 1408-1415
Author(s):  
Lene A. Åsli ◽  
Tonje Braaten ◽  
Anja Olsen ◽  
Anne Tjønneland ◽  
Kim Overvad ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Registries ◽  
Glycaemic Index ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
The Mean ◽  
Potato Consumption ◽  
Adjusted Model

AbstractPotatoes have been a staple food in many countries throughout the years. Potatoes have a high glycaemic index (GI) score, and high GI has been associated with several chronic diseases and cancers. Still, the research on potatoes and health is scarce and contradictive, and we identified no prospective studies that had investigated the association between potatoes as a single food and the risk of pancreatic cancer. The aim of this study was to prospectively investigate the association between potato consumption and pancreatic cancer among 114 240 men and women in the prospective HELGA cohort, using Cox proportional hazard models. Information on diet (validated FFQ’s), lifestyle and health was collected by means of a questionnaire, and 221 pancreatic cancer cases were identified through cancer registries. The mean follow-up time was 11·4 (95 % CI 0·3, 16·9) years. High consumption of potatoes showed a non-significantly higher risk of pancreatic cancer in the adjusted model (hazard ratio (HR) 1·44; 95 % CI 0·93, 2·22,Pfor trend0·030) when comparing the highestv.the lowest quartile of potato consumption. In the sex-specific analyses, significant associations were found for females (HR 2·00; 95 % CI 1·07, 3·72,Pfor trend0·020), but not for males (HR 1·01; 95 % CI 0·56, 1·84,Pfor trend0·34). In addition, we explored the associations by spline regression, and the absence of dose–response effects was confirmed. In this study, high potato consumption was not consistently associated with a higher risk of pancreatic cancer. Further studies with larger populations are needed to explore the possible sex difference.

Sign in / Sign up

Export Citation Format

Share Document