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2021 ◽  
Xingqi Cao ◽  
Jingyun Zhang ◽  
Chao Ma ◽  
Xueqin Li ◽  
Chia-Ling Kuo ◽  

Background: While childhood and adulthood traumatic experiences have been linked to subsequent cardiovascular disease (CVD), the relationship between life course traumas and CVD and the underpinning pathways are poorly understood. This study aimed to: (1) examine the associations of childhood, adulthood, and lifetime traumas with CVD; (2) examine the associations between diverse life course traumatic profiles and CVD; and (3) examine the extent to which Phenotypic Age (PhenoAge), a well-developed phenotypic aging measure, mediates these associations. Methods: We included 104,939 participants from the UK Biobank who completed the 2016 online mental health questionnaire. CVD outcomes including ischemic heart disease, myocardial infarction, and stroke were ascertained. Childhood, adulthood, and lifetime traumas were categorized into three subgroups (mild, moderate, and severe), respectively. Four life course traumatic profiles were defined as non-severe traumas across life course, non-severe childhood and severe adulthood traumas, severe childhood and non-severe adulthood traumas, and severe traumas across life course based on both childhood and adulthood traumas. PhenoAge was measured using an equation previously developed. Multivariable logistic models and formal mediation analyses were performed. Results: Of 104,939 participants, 7,398 (7.0%) were diagnosed with CVD. Subgroups of childhood, adulthood, and lifetime traumas were associated with CVD, respectively. Furthermore, life course traumatic profiles were significantly associated with CVD. For instance, compared with subgroups experiencing non-severe traumas across life course, those who experienced non-severe childhood and severe adulthood traumas, severe childhood and non-severe adulthood traumas, and severe traumas across life course had higher odd of CVD, with odds ratios of 1.07 (95% confidence interval [CI]: 1.00, 1.15), 1.17 (95% CI: 1.09, 1.25), and 1.33 (95% CI: 1.24, 1.43), respectively. Formal mediation analyses suggested that PhenoAge partially mediated the above associations. For instance, PhenoAge mediated 5.8% of increased CVD events in subgroups who experienced severe childhood traumas, relative to those experiencing mild childhood traumas. Conclusions: Childhood, adulthood, and lifetime traumas, as well as diverse life course traumatic profiles, were associated with CVD. Furthermore, phenotypic aging partially mediated these associations. These findings suggest a potential pathway from life course traumas to CVD through phenotypic aging, and underscore the importance of policy programs targeting traumatic events over the life course in ameliorating inequalities in cardiovascular health.

Kathryn Badarin ◽  
Tomas Hemmingsson ◽  
Lena Hillert ◽  
Katarina Kjellberg

Abstract Objective We investigated the separate and combined effects of musculoskeletal pain (MSP) and strenuous work (heavy physical workload (PWL)/low-decision authority) on poor physical work ability (WA). Methods This study uses baseline data from the 2010 Stockholm Public Health Questionnaire (SPHQ) including 9419 workers with good physical WA. Exposure to PWL and decision authority were estimated using sex-specific job-exposure matrices linked to occupations. Exposures (high/low) were combined with the presence of MSP. Follow-up data on physical WA were taken from the 2014 SPHQ and dichotomised (the responses: “moderate”, “rather poor” and “very poor” indicated poor WA). Logistic regression models calculated sex-specific odds ratios adjusting for age, education and health and lifestyle factors. Interaction between MSP and strenuous work was examined using the synergy index (SI). Analyses were conducted using SPSS.27. Results MSP, heavy PWL and low-decision authority were separately associated with poor WA. MSP was associated with higher odds of poor WA than strenuous work for women, the opposite for men. Combinations of MSP and strenuous work often resulted in higher risks of poor WA than when adding the effects of the single exposures (e.g., MSP and heavy PWL men: AOR 4.04 95% CI 2.00–8.15, women: AOR: 3.25 95% CI 1.81–5.83). The SI was non-significant for both sexes. Conclusion Workers with MSP and strenuous work often had higher risks of poor WA than would be expected from adding the effects of the single exposures. To decrease poor WA in this group, strenuous work should be lowered, and MSP addressed in workplaces.

2021 ◽  
Ryan H Boe ◽  
Vinay Ayyappan ◽  
Lea Schuh ◽  
Arjun Raj

Accurately functioning genetic networks should be responsive to signals but prevent transmission of stochastic bursts of expression. Existing data in mammalian cells suggests that such transcriptional "noise" is transmitted by some genes and not others, suggesting that noise transmission is tunable, perhaps at the expense of other signal processing capabilities. However, systematic claims about noise transmission in genetic networks have been limited by the inability to directly measure noise transmission. Here we build a mathematical framework capable of modeling allelic correlation and noise transmission. We find that allelic correlation and noise transmission correspond across a broad range of model parameters and network architectures. We further find that limiting noise transmission comes with the trade-off of being unresponsive to signals, and that within the parameter regimes that are responsive to signals, there is a further trade-off between response time and basal noise transmission. Using a published allele specific single cell RNA-sequencing dataset, we found that genes with high allelic odds ratios are enriched for cell-type specific functions, and that within multiple signaling pathways, factors which are upstream in the pathway have higher allelic odds ratios than downstream factors. Overall, our findings suggest that some degree of noise transmission is required to be responsive to signals, but that minimization of noise transmission can be accomplished by trading-off for a slower response time.

2021 ◽  
Vol 31 (1) ◽  
Antonius Schneider ◽  
Katharina Rauscher ◽  
Christina Kellerer ◽  
Klaus Linde ◽  
Frederike Kneissl ◽  

AbstractThe study aimed to evaluate the diagnostic accuracy of contact history and clinical symptoms and to develop decision rules for ruling-in and ruling-out SARS-CoV-2 infection in family practice. We performed a prospective diagnostic study. Consecutive inclusion of patients coming for COVID-PCR testing to 19 general practices. Contact history and self-reported symptoms served as index test. PCR testing of nasopharyngeal swabs served as reference standard. Complete data were available from 1141 patients, 605 (53.0%) female, average age 42.2 years, 182 (16.0%) COVID-PCR positive. Multivariable logistic regression showed highest odds ratios (ORs) for “contact with infected person” (OR 9.22, 95% CI 5.61–15.41), anosmia/ageusia (8.79, 4.89–15.95), fever (4.25, 2.56–7.09), and “sudden disease onset” (2.52, 1.55–4.14). Patients with “contact with infected person” or “anosmia/ageusia” with or without self-reported “fever” had a high probability of COVID infection up to 84.8%. Negative response to the four items “contact with infected person, anosmia/ageusia, fever, sudden disease onset” showed a negative predictive value (NPV) of 0.98 (95% CI 0.96–0.99). This was present in 446 (39.1%) patients. NPV of “completely asymptomatic,” “no contact,” “no risk area” was 1.0 (0.96–1.0). This was present in 84 (7.4%) patients. To conclude, the combination of four key items allowed exclusion of SARS-CoV-2 infection with high certainty. With the goal of 100% exclusion of SARS-CoV-2 infection to prevent the spread of SARS-CoV-2 to the population level, COVID-PCR testing could be saved only for patients with negative response in all items. The decision rule might also help for ruling-in SARS-CoV-2 infection in terms of rapid assessment of infection risk.

2021 ◽  
Vol 11 (1) ◽  
Bettina M. Rosner ◽  
Martyna Gassowski ◽  
Stefan Albrecht ◽  
Klaus Stark

AbstractSurveillance of notified Campylobacter enteritis in Germany revealed a recurrent annual increase of cases with disease onset several days after the Christmas and New Year holidays (“winter peak”). We suspected that handling and consumption of chicken meat during fondue and raclette grill meals on the holidays were associated with winter peak Campylobacter infections. The hypothesis was investigated in a case–control study with a case-case design where notified Campylobacter enteritis cases served as case-patients as well as control-patients, depending on their date of disease onset (case-patients: 25/12/2018 to 08/01/2019; control-patients: any other date between 30/11/2018 and 28/02/2019). The study was conducted as an online survey from 21/01/2019 to 18/03/2019. Adjusted odds ratios (aOR) were determined in single-variable logistic regression analyses adjusted for age group and sex. We analysed 182 data sets from case-patients and 260 from control-patients and found associations of Campylobacter infections after the holidays with meat fondue (aOR 2.2; 95% confidence interval (CI) 1.2–3.8) and raclette grill meals with meat (aOR 1.5; 95% CI 1.0–2.4) consumed on the holidays. The associations were stronger when chicken meat was served at these meals (fondue with chicken meat: aOR 2.7; 95% CI 1.4–5.5; raclette grill meal with chicken meat: aOR 2.3; 95% CI 1.3–4.1). The results confirmed our initial hypothesis. To prevent Campylobacter winter peak cases in the future, consumers should be made more aware of the risks of a Campylobacter infection when handling raw meat, in particular chicken, during fondue or raclette grill meals on the holidays.

2021 ◽  
Thanh Huong Phung ◽  
Khanh Ngoc Cong Duong ◽  
Mac Ardy Junio Gloria ◽  
Thien Khac Nguyen

Aim: Phenytoin (PHT) is a common anticonvulsant agent known for inducing severe cutaneous adverse reactions (SCARs). HLA-B*15:02 as a risk factor of PHT-induced SCARs was reported in numerous studies with inconsistent results. This meta-analysis aimed to establish pooling evidence of this association. Materials & methods: Pooled odds ratios (ORs) with 95% CIs were estimated using a random-effects model. Results: A total of 11 studies on 1389 patients, were included for the analyses. There was a significant association between HLA-B*15:02 and PHT-induced SCAR (pooled OR = 2.29, 95% CI: 1.25–4.19, p = 0.008). Furthermore, there was a significant association regarding Stevens–Johnson syndrome/toxic epidermal necrolysis (OR = 3.63, 95% CI: 2.15–6.13, p < 0.001) but no association regarding drug reaction with eosinophilia and systemic symptom. Conclusion: The results supported the recommendations of HLA-B*15:02 screening before treatment with PHT.

2021 ◽  
Vol 17 (1) ◽  
Christian S. Alvarez ◽  
M. Larissa Avilés-Santa ◽  
Neal D. Freedman ◽  
Krista M. Perreira ◽  
Olga Garcia-Bedoya ◽  

Abstract Background The hygiene hypothesis posits that microbial exposure reduces risk of asthma and other respiratory-related diseases. Helicobacter pylori and hepatitis A virus (HAV) are common fecal–oral infections. Our study aimed to examine associations of seropositivity to these agents with asthma in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods A total of 12,471 HCHS/SOL participants with baseline data on self-reported physician-diagnosed asthma, and antibodies anti-H. pylori and anti-HAV were included in this cross-sectional analysis. Multivariable logistic regression models were used to estimate the odds ratios and 95% confidence intervals for the overall associations of seropositivity to each agent with asthma. Analyses were also stratified by Hispanic/Latino background. Effect modification by smoking status and nativity were tested. An analysis restricted to individuals with spirometry-defined chronic obstructive pulmonary disease (COPD) was also considered. Results The weighted overall prevalence of asthma was 16.6%. The weighted seroprevalence of H. pylori was 56.6% and of HAV was 76.6%, and they significantly differed by Hispanic/Latino background. After accounting for age, sex, education and other key confounders, we found no associations between H. pylori or HAV seropositivity with asthma (with and without COPD), either for all individuals combined or for any of the six specific backgrounds. There were no significant interactions by smoking and nativity. Conclusion Our findings did not provide support for the role of H. pylori or HAV, as evidence of the hygiene hypothesis in asthma among the large and diverse Hispanic/Latino populations of the HCHS/SOL. Trial registration NCT02060344

2021 ◽  
Vol 21 (1) ◽  
Francis Appiah ◽  
Edward Kwabena Ameyaw ◽  
Joseph Kojo Oduro ◽  
Linus Baatiema ◽  
Francis Sambah ◽  

Abstract Background Hypertension is one of the leading causes of cardiovascular morbidities in Ghana and represents a major public health concern. There is dearth of information on the rural-urban disparity in hypertension among women in Ghana. Therefore, this study aimed at examining the rural-urban variation in hypertension among women in Ghana. Methods We extracted data from the women’s file of the 2014 Ghana Demographic and Health Survey. The sample included 9333 women aged 15–49 with complete data on hypertension. The analysis was done using Pearson Chi-square and binary logistic regression at 95% confidence interval. The results of the binary logistic regression were presented as Odds Ratios (ORs) and Adjusted Odds Ratios (AORs). Statistical significance was set at p < 0.05. Results Hypertension prevalence among urban and rural residents were 9.5% and 5.1% respectively. Rural women had lower odds of hypertension [OR = 0.59; 95% CI = 0.52, 0.67] compared to urban women, however, this was insignificant in the adjusted model [aOR = 0.84; 95% CI = 0.70, 1.00]. The propensity to be hypertensive was lower for women aged 15–19 [aOR = 0.07; 95% CI = 0.05, 0.11]. The poorest were less likely to be hypertensive [aOR = 0.63; 95% CI = 0.45, 0.89]. Single women were also less probable to have hypertension [aOR = 0.66; 95% CI = 0.46, 0.97]. Conclusions Women from urban and rural areas shed similar chance to be hypertensive in Ghana. Therefore, the health sector needs to target women from both areas of residence (rural/urban) when designing their programmes that are intended to modify women’s lifestyle in order to reduce their risks of hypertension. Other categories of women that need to be prioritised to avert hypertension are those who are heading towards the end of their reproductive age, richest women and the divorced.

Nitin Y. Dhupdale ◽  
Vedang Sawant ◽  
Bolivia Crocete Aloysia Fernandes ◽  
Jagadish Cacodcar ◽  
Steffi Barretto

Background: The ongoing COVID-19 pandemic led to surge in mortality. In the absence of definitive treatment, convalescent plasma therapy was accepted as a modality to treat COVID-19 patients. There exists hesitancy with regards to COVID-19 convalescent plasma donation. To find the deterrents to CCP donation.Methods: An online survey was conducted by snowball technique. The study participants were COVID-19 survivors. They were asked to express their willingness to donate CCP. The reasons for not donating CCP were recorded. The data was analyzed using R-program. The adjusted and unadjusted Odds ratios were calculated to find the predictors of willingness to donate CCP.Results: 110 study participants responded to the survey. 49.1% of the responders were willing to donate plasma. The top three deterrents of CCP donation were ill health (27.6%; 95% CI, 18.28%-39.27%), ineligibility (10.5%; 95% CI, 4.98%-20.21%), not recovered completely (6.58%; 95% CI, 2.45%-15.34%). The female gender, older age, being symptomatic, unaware of government incentives, tested by RAT, and unaware of CPT were associated with lower odds of donating CCP.Conclusions: Ill health, ineligibility, and perceived incomplete recovery were the major deterrents of CCP donation. Being female, older age, being symptomatic, unaware of government incentives, tested by RAT, and unaware of CPT were associated with lower willingness to donate CCP. There is a need to develop interventions to target these factors to improve CCP donation whenever it is indicated.

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12453
Locksley L. McV. Messam ◽  
Hsin-Yi Weng ◽  
Nicole W. Y. Rosenberger ◽  
Zhi Hao Tan ◽  
Stephanie D. M. Payet ◽  

Background Despite much discussion in the epidemiologic literature surrounding the use of null hypothesis significance testing (NHST) for inferences, the reporting practices of veterinary researchers have not been examined. We conducted a survey of articles published in Preventive Veterinary Medicine, a leading veterinary epidemiology journal, aimed at (a) estimating the frequency of reporting p values, confidence intervals and statistical significance between 1997 and 2017, (b) determining whether this varies by article section and (c) determining whether this varies over time. Methods We used systematic cluster sampling to select 985 original research articles from issues published in March, June, September and December of each year of the study period. Using the survey data analysis menu in Stata, we estimated overall and yearly proportions of article sections (abstracts, results-texts, results-tables and discussions) reporting p values, confidence intervals and statistical significance. Additionally, we estimated the proportion of p values less than 0.05 reported in each section, the proportion of article sections in which p values were reported as inequalities, and the proportion of article sections in which confidence intervals were interpreted as if they were significance tests. Finally, we used Generalised Estimating Equations to estimate prevalence odds ratios and 95% confidence intervals, comparing the occurrence of each of the above-mentioned reporting elements in one article section relative to another. Results Over the 20-year period, for every 100 published manuscripts, 31 abstracts (95% CI [28–35]), 65 results-texts (95% CI [61–68]), 23 sets of results-tables (95% CI [20–27]) and 59 discussion sections (95% CI [56–63]) reported statistical significance at least once. Only in the case of results-tables, were the numbers reporting p values (48; 95% CI [44–51]), and confidence intervals (44; 95% CI [41–48]) higher than those reporting statistical significance. We also found that a substantial proportion of p values were reported as inequalities and most were less than 0.05. The odds of a p value being less than 0.05 (OR = 4.5; 95% CI [2.3–9.0]) or being reported as an inequality (OR = 3.2; 95% CI [1.3–7.6]) was higher in the abstracts than in the results-texts. Additionally, when confidence intervals were interpreted, on most occasions they were used as surrogates for significance tests. Overall, no time trends in reporting were observed for any of the three reporting elements over the study period. Conclusions Despite the availability of superior approaches to statistical inference and abundant criticism of its use in the epidemiologic literature, NHST is substantially the most common means of inference in articles published in Preventive Veterinary Medicine. This pattern has not changed substantially between 1997 and 2017.

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