Roles of serum uric acid on the association between arsenic exposure and incident metabolic syndrome in an older Chinese population.

Growing evidences showed that heavy metals exposure may be associated with metabolic diseases. Nevertheless, the mechanism underlying arsenic (As) exposure and metabolic syndrome (MetS) risk has not been fully elucidated. So we aimed to prospectively investigate the role of serum uric acid (SUA) on the association between blood As exposure and incident MetS. A sample of 1045 older participants in a community in China was analyzed. We determined As at baseline and SUA concentration at follow-up in the Yiwu Elderly Cohort. MetS events were defined according to the criteria of the International Diabetes Federation (IDF). Generalized linear model with log-binominal regression model was applied to estimate the association of As with incident MetS. To investigate the role of SUA in the association between As and MetS, a mediation analysis was conducted. In the fully adjusted log-binominal model, per interquartile range increment of As, the risk of MetS increased 1.25-fold. Compared with the lowest quartile of As, the adjusted relative risk (RR) of MetS in the highest quartile was 1.42 (95% confidence interval, CI: 1.03, 2.00). Additionally, blood As was positively associated with SUA, while SUA had significant association with MetS risk. Further mediation analysis demonstrated that the association of As and MetS risk was mediated by SUA, with the proportion of 15.7%. Our study found higher As was remarkably associated with the elevated risk of MetS in the Chinese older adults population. Mediation analysis indicated that SUA might be a mediator in the association between As exposure and MetS.

A summary of pain and pain-related variables in the Avon Longitudinal Study of Parents and Children.

Background: To study pain, data on pain characteristics, possible triggers and consequences - such as the impact of pain on people's lives - need to be available. When not collated, described and/or organised in a systematic manner, it can be difficult to assess how useful an existing dataset may be for one's project. This data note describes and categorises the complex and multi-modal indices of pain available in the Avon Longitudinal Study of Parents and Children (ALSPAC). Methods: Data from two generations of the ALSPAC cohort; index child participants (Generation 1, G1), their mothers and fathers/mothers' partners (Generation 0, G0) were used. Search terms such as 'pain', 'ache', 'hurt', 'sore', specific pain conditions, labour pain and methods of pain relief were used to identify pain and pain-related variables. These data were extracted from all waves of data collection. We developed pain categories and subsequently categorised variables in an iterative process. Repeated measurements of the same variables over waves of data collection were also identified. Results: We identified 21 categories of pain variables, which were subsequently grouped into themes: pain characteristics, extended pain characteristics and causes, treatment for pain, pain interference and pain-related to specific events. Pain and pain-related data have been collected from G1 participants, G0 mothers, and G0 partners, although there are fewer data for the partners. There were some repeated measurements, most commonly, of pain location. As is typical with longitudinal birth cohort studies, maternal proxy-reports were used during participants' younger years and self-reports were utilised from adolescence onwards. Conclusions: Researchers interested in studying pain can feasibly do so in two generations of a regional UK population who have been followed up over 30 years. ALSPAC can be used to study pain from the early years through to young adulthood and in mothers from the perinatal period onwards.

Researchers sometimes use existing datasets to study pain. Data may be available on different aspects of pain. For example, the intensity of pain, which part(s) of the body hurt, possible causes of pain and how pain may affect the individual's life. These existing datasets typically come from studies relating to health and wellbeing that were set up many years ago, often from birth, and may still be active. Researchers can apply to use data from these studies to answer health-related research questions. Although these data are available, researchers may not know how useful data from existing health-related studies may be for a new project that is being planned. Looking at a data note on a specific health topic is valuable to researchers as relevant data have been collated and organised to make it easier to see what data already exists. In this data note, the authors have collated and organised data on pain from an existing study called the Avon Longitudinal Study of Parents and Children (ALSPAC). ALSPAC was set up in the early 1990s to study health and development. ALSPAC was not specifically set up to study pain. The authors found that there was a wealth of information and questions asked about pain that could be organised into 21 pain categories. The data from these questions is described in this data note and comes from the original children recruited into the study, their mothers and their fathers/mothers' partners. The authors also found that some pain related data were collected in the same way at multiple time points (e.g. across a number of years or months) allowing researchers to look at patterns over time. Researchers interested in studying pain can use data from ALSPAC, which has data collected on two generations of a regional UK population for more than 30 years.

Effect of comorbidities on mortality in patients with nontuberculous mycobacterial infection in Korea: National Health Insurance Service-National Sample Cohort data.

Patients with nontuberculous mycobacteria (NTM) infection have multiple comorbidities, but the impact of comorbidities on mortality are not well known. We aimed to compare the mortality between people with and without NTM infection and associated comorbidities and their prognostic value on mortality using National Health Insurance Service-National Sample Cohort data from 2006 to 2019. In this matched cohort study, people with and without NTM infection aged 20-89 years were matched 1:4 by sex, age, region, and income. The hazard ratios (HRs) with 95% confidence intervals (CIs) of mortality in patients with NTM infection were estimated using a Cox proportional hazard regression model. In total, 2421 patients with NTM infection (mean age, 54.8 years) and 9684 controls were included. NTM-infected patients had a significantly increased risk of mortality than matched controls in the multivariable model adjusted for age, sex, region, income, and Charlson comorbidity index (aHR = 1.88, 95% CI 1.65-2.14). Among patients with NTM infection, respiratory comorbidities including chronic obstructive pulmonary disease, asthma, interstitial lung disease, and moderate to severe liver disease and malignancy were positively associated with mortality. NTM infection was independently associated with an increased risk of mortality, and mortality risk in patients with NTM infection may be increased by coexisting comorbidities.

The joint effect of cumulative metabolic parameters on the risk of type 2 diabetes: a population-based cohort study.

BACKGROUND AND AIMS: This study aimed to examine the cumulative effects of body mass index (BMI), body roundness index (BRI), pulse pressure (PP), triglycerides (TG), high-density lipoprotein cholesterol (HDL) and fasting plasma glucose (FPG) on Type 2 diabetes (T2D) morbidity. METHODS: A total of 78,456 participants aged older than 45 years were extracted from basic public health services in China. During the 2-year follow-up, 6,942 individuals had developed T2D. The binary logistic regression models and multinomial logistic regression models were conducted to investigate the effects of cumulative metabolic parameters on incident T2D, prediabetes regression and progression. RESULTS: We found statistically deleterious impacts of exposure to high cumulative BMI, BRI, PP, TG and low cumulative HDL on T2D morbidity and prediabetes progression. Compared to the group with low cumulative of all five parameters, the adjusted ORs for new-onset T2D for participants presenting with 1-2, 3, and 4-5 elevated metabolic parameters were 1.41(1.31,1.52), 1.93(1.74,2.13) and 2.21(1.94,2.51), respectively. There was additive interaction between FPG level and cumulative metabolic parameters with T2D. Compared with participants with the lowest quartile of FPG and low cumulative of all 5 parameters, those with the highest quartile of FPG and high cumulative of 4-5 parameters had a 14.63 [95% CI (12.27, 17.42)] higher risk of incident T2D. CONCLUSIONS: Participants with more numbers of high-cumulative metabolic parameters were associated with a higher risk of incident T2D and prediabetes progression. A high level of normal FPG could enhance these risks.

Psychosocial determinants of handwashing and physical distancing behaviour during the COVID-19 pandemic in the Netherlands: A longitudinal analysis.

OBJECTIVES: Physical distancing and handwashing can be important infection prevention measures during an infectious disease outbreak such as the COVID-19 pandemic. To stimulate these behaviours, knowledge of psychosocial determinants as well as contextual factors is vital. We present longitudinal, within-person analyses of the impact of contextual and psychosocial factors on handwashing and distancing behaviour. DESIGN: We used individual-level data (186,490 participants completing 971,899 surveys) from the Corona Behavioural Unit COVID-19 Cohort, a dynamic cohort study conducted during 26 months of the COVID-19 pandemic in the Netherlands. METHODS: Fixed-effects models were employed to estimate within-person associations between psychosocial factors and behaviour, combined with main and moderating effects of contextual factors. RESULTS: Pandemic severity was associated with more handwashing and distancing behaviour, while the duration of the pandemic had little effect. Within-person changes in response efficacy were most relevant for changes in both handwashing and distancing behaviour, while self-efficacy, descriptive norms and perceived severity of infecting others affected behaviour indirectly. These effects were stable over time. Associations were larger in cross-sectional models, indicating that such models tend to overestimate effects. CONCLUSIONS: Our study highlights the importance of longitudinal data and within-person models to detect possible causal associations. The results suggest that during an outbreak, government and public health professionals should clearly communicate the severity of the pandemic (e.g., hospitalization rates) and the effectiveness of recommended prevention measures in reducing that risk; and seek to improve people's capabilities and opportunities to adhere to guidelines, for example, by modifying the environment.

The risk of type 2-diabetes among persons with intellectual disability: a Danish population-based matched cohort study.

BACKGROUND: Previous research shows that obesity, unhealthy eating, physical inactivity and a high use of psychotropic medications are prevalent among persons with intellectual disability (ID), which might increase the risk of type 2-diabetes (T2DM). This study aims to investigate: (1) whether persons with ID have an increased risk of T2DM compared with an age- and sex-matched reference group and (2) differences in T2DM risk by sex, birth year, ID inclusion diagnosis and ID severity. METHODS: This study is a nationwide cohort study, including 65 293 persons with ID and 659 723 persons in an age- and sex-matched reference group without ID. Incidence rates for T2DM were calculated and Cox proportional regression models were used to estimate adjusted hazard ratios (aHRs) for the association between ID and T2DM. Follow-up began from the 1 January 1977 (when T2DM data were available), participants' 22nd birthday or from the date the participants immigrated to Denmark, whichever came last and continued until the onset of T2DM, emigration, death or end of follow-up (31 December 2021), whichever came first. RESULTS: Persons with ID had more than double risk of T2DM compared with the reference group [aHR = 2.15, 95% confidence interval (CI): 2.09-2.20]. The strongest associations were found among women, persons born between 1980 and 1999 and among persons with mild ID. CONCLUSIONS: Persons with ID have an increased risk of T2DM. This knowledge is important in relation to the development and prioritising of preventive initiatives among persons with ID in the healthcare sector. Future research should focus on the underlying mechanisms that can explain the possible association between ID and T2DM as it allows a more targeted prevention strategy.

Association of metabolic score for visceral fat with all-cause mortality, cardiovascular mortality, and cancer mortality: A prospective cohort study.

AIM: Our study aimed to evaluate the association between the metabolic score for visceral fat (METS-VF) and mortality. METHODS: We conducted a cohort study comprising 11,120 participants. We employed weighted multivariable Cox regression analysis to assess the relationship between METS-VF and mortality. Restricted cubic spline analyses were used to investigate potential non-linear associations. Receiver operating characteristic curves were used to evaluate the predictive value of METS-VF and other obesity-related indicators for mortality. Subgroup analysis and sensitivity analysis were performed to confirm the robustness of the results. Mendelian randomization analysis was utilized to assess potential causality. RESULTS: Over a median follow-up duration of 83 months, a total of 1014 all-cause deaths, 301 cardiovascular deaths, and 262 cancer deaths occurred. For every 0.2-unit increase in METS-VF, the hazard ratios(HRs) of all-cause mortality, cardiovascular mortality, and cancer mortality were 1.13 [95% confidence interval (CI): 1.06, 1.20], 1.18 (95% CI: 1.06, 1.31), and 1.13 (95% CI: 1.03, 1.25), respectively. In addition, restricted cubic spline analyses revealed no significant non-linear associations between METS-VF and all-cause mortality, cardiovascular mortality, and cancer mortality. In multivariate Cox regression models, hazard ratios of all-cause mortality, cardiovascular mortality and cancer mortality were higher in the highest METS-VF group compared to the reference group. Subgroup and sensitivity analyses confirmed that our results were robust. Receiver operating characteristic curves indicated that METS-VF predicted mortality better than other obesity-related indicators. Mendelian randomization analysis confirmed significant causal relationships. CONCLUSIONS: METS-VF was positively associated with all-cause mortality, cardiovascular mortality, and cancer mortality. These findings suggest that METS-VF could serve as a straightforward, reliable, and cost-effective marker for identifying individuals at high risk of mortality.

Accelerated biological aging, mediating amino acids, and risk of incident type 2 diabetes: a prospective cohort study.

PURPOSE: Aging plays an important role in type 2 diabetes mellitus (T2DM). But the association between accelerated biological age and T2DM, and the mechanisms underlying this association remains unclear. Thus, this study aimed to examine the associations of biological aging with T2DM, and explore the potential mediation effect of amino acids. METHODS: This prospective cohort study included 95,773 participants in the UK Biobank who were free of diabetes at baseline. Biological age was measured from clinical traits using PhenoAgeAccel. Cox proportional hazard models were used to estimate the hazard ritios (HRs) and 95% confidence intervals (CIs), and mediation analysis was used to explore the mediation effect of amino acids. RESULTS: During a median follow-up of 14.02 years, 6,347 incident T2DM cases were recorded. After multivariable adjustment for sociodemographic characteristics, lifestyle factors, and other risk factors of T2DM, participants with older biological age were at increased risk of incident T2DM (30% increase per standard deviation of PhenoAgeAccel, 95% CI: 28.0-33.0%). Additionally, higher branched chain amino acids (BCAAs) including isoleucine and leucine, aromatic amino acids (AAAs) including phenylalanine and tyrosine, were associated with increased PhenoAgeAccel and risk of incident T2DM; while glutamine and glycine were inversely associated. Alanine, glutamine, glycine, phenylalanine, tyrosine, isoleucine, leucine, and total concentration of branched-chain amnio acids could partially explain the associations between PhenoAgeAccel and T2DM. CONCLUSION: Accelerated biological aging was associated with increased risk of incident T2DM independent of chronological age and may be a risk factor of T2DM, partially mediated by several amino acids.

Relationship between serum prealbumin level and prognosis of community-acquired bacterial meningitis in adults: a retrospective cohort study.

Background: Low serum prealbumin levels have been identified as a predictor of infectious complication in critically ill patients. However, the association in patients with Community-acquired bacterial meningitis (CABM) remains unclear. The aim of this study is to investigate the relationship of prealbumin and the poor outcome of CABM through a retrospective cohort study. Methods: A total of 77 patients of CABM were enrolled. They were divided into good outcome group (GOS: 5) and a bad outcome group (GOS: 1-4). Serum prealbumin and other clinical records were measured within 24 h after admission. Results: Among the included patients, 38(65.52%) had a bad outcome (the GOS score between 1 and 4). The mean age of the overall cohort was 45.3 ± 15.9 years, and 58.6% of patients were male. The mean prealbumin level in the bad outcome group was 115.4 ± 49.4 mmol/L, while the mean level in the good outcome group was 199.1 ± 49.3 mmol/L (p < 0.001). Individuals with plasma prealbumin level ≤180 mmol/L had a 3.32-fold higher risk of CABM than those with normal plasma prealbumin level [OR = 4.32 (1.02 ~ 18.24), p < 0.05]. Conclusion: Reduced plasma prealbumin level is independently associated with the poor outcome of CABM. Plasma prealbumin level might help to identify patients at high risk of bad outcome.

The impact of air temperature and humidity on Children's blood pressure mediated by Lipids: A prospective cohort study.

OBJECTIVES: Few studies illustrate the mechanism between air temperature and blood pressure (BP) in childhood. This study aims to investigate the associations between air temperature, humidity exposure, and BP trajectories in children and adolescents, and explore the potential mediating roles of lipid profiles in these relationships. METHODS: This prospective cohort study included 5,971 children with 10,800 person-times measurements at baseline from the Chongqing Health Cohort, with evaluations conducted in 2014-2015 (baseline) and follow-ups in 2016 (urban areas) and 2019 (urban and rural areas). Multilevel mixed-effects models were used to analyse the impacts of air temperature and humidity on BP levels and the incidence of elevated BP, while accounting for potential confounders. Mediation analyses were performed to evaluate the mediating effects of lipid profiles, including low-density lipoprotein (LDL), total cholesterol (TC), and specific lipid species. RESULTS: After adjusting for covariates, higher air temperature quartiles were associated with both decreased BP levels and elevated BP risk (RR: 0.83; 95 % CIs: 0.78, 0.89; P = 0.028). Conversely, higher humidity quartiles exhibited a U-shaped relationship with BP levels. Greater variability in air temperature was linked to increase BP levels. The cumulative effects of air temperature exposure on BP were significant from pregnancy to age 10, with females exhibiting larger effects (ß:-3.291, 95 % CIs: -4.242,-2.340, P < 0.001). LDL and TC partially mediated the associations between air temperature and BP levels, particularly in males. Specific lipid species, including SM (d21:1), LPC (17:0), and PC (O-36:3), also exhibited significant mediating effects. CONCLUSIONS: This study provides novel insights into the intricate interplay between air temperature, humidity, lipid metabolism, and blood pressure regulation in children. Lower average temperatures and extreme humidity levels were associated with increased risks of elevated BP, potentially mediated by lipid profiles. Early interventions targeting air temperature exposure and lipid metabolism could mitigate hypertension risk, promoting improved cardiovascular outcomes in children.

Predicted vitamin D levels and risk of depression in the SUN Project: A prospective cohort study.

The current study aimed to investigate the association between predicted vitamin D status and depression in a prospective Spanish cohort of university graduates. The SUN Project is a dynamic cohort study designed to investigate multiple aspects of health and lifestyle. Participants were asked to complete a comprehensive questionnaire consisting of 556 items, that included a validated food-frequency questionnaire. Participants initially free of depression were classified as incident cases if they reported a medical diagnosis of depression during follow-up. Serum vitamin D levels were predicted by a previously validated equation. Vitamin D deficiency was defined as vitamin D levels below 20 ng/mL. Cox models were used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (95% CI). We included 15,175 Spanish university graduates [mean (SD) age: 36.9 year (11.5)] followed-up for a median of 12.7 years. Among 192,976 person-years of follow-up, we identified 753 incident cases of depression. Participants with vitamin D deficiency had a 27% higher risk of depression as compared to those with vitamin D sufficiency (HR: 1.27, 95% CI: 1.09-1.48; p = 0.002) after adjusting for potential confounders. Furthermore, a significant effect modification by female sex was observed with higher depression risks associated with vitamin D deficiency in women than in men (p for interaction = 0.034). In educated middle-aged Spanish adults, we observed a direct association between vitamin D deficiency and the risk of depression, that was stronger among women.

New-onset atrial fibrillation after coronary surgery and stroke risk: a nationwide cohort study.

BACKGROUND: New-onset postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) increases ischaemic stroke risk, yet factors influencing this risk remain unclear. We sought to identify factors associated with 1-year ischaemic stroke risk, compare the CHA2DS2-VASc (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes, previous Stroke/transient ischaemic attack (TIA), Vascular disease, Age 65-74 years, Sex category) and ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) scores' predictive abilities for ischaemic stroke, and assess oral anticoagulation (OAC) dispensing at discharge in patients with POAF. METHODS: This nationwide cohort study used prospectively collected data from four mandatory Swedish national registries. All first-time isolated CABG patients who developed POAF during 2007-2020 were included. Multivariable logistic models were used to identify ischaemic stroke predictors and C-statistics to assess the predictive abilities of the CHA2DS2-VASc and ATRIA scores in patients without OAC. OAC dispensing patterns were described based on stroke-associated factors. RESULTS: In total, 10 435 patients with POAF were identified. Out of those not receiving OAC (n=6903), 3.1% experienced an ischaemic stroke within 1 year. Advancing age (adjusted OR (aOR) 1.86 per 10-year increase, 95% CI 1.45 to 2.38), prior ischaemic stroke (aOR 18.56, 95% CI 10.05 to 34.28 at 60 years, aOR 5.95, 95% CI 3.78 to 9.37 at 80 years, interaction p<0.001), myocardial infarction (aOR 1.55, 95% CI 1.14 to 2.10) and heart failure (aOR 1.53, 95% CI 1.06 to 2.21) were independently associated with ischaemic stroke. The area under the receiver-operating characteristic curve was 0.72 (0.69-0.76) and 0.74 (0.70-0.78) for CHA2DS2-VASc and ATRIA, respectively (p=0.021). Altogether, 71.0% of patients with a stroke risk >2%/year, according to the CHA2DS2-VASc score, were not discharged on OAC. CONCLUSIONS: Prior ischaemic stroke, advancing age, history of heart failure and myocardial infarction were associated with 1-year ischaemic stroke risk in patients with POAF after CABG. CHA2DS2-VASc and ATRIA scores predicted stroke risk with similar accuracy as in non-surgical atrial fibrillation cohorts. OAC dispense at discharge does not seem to reflect individual stroke risk.

Characterisation of older patients that require, but do not undergo, emergency laparotomy: a multicentre cohort study.

BACKGROUND: Older adults (≥65 yr) account for the majority of emergency laparotomies in the UK and are well characterised with reported outcomes. In contrast, there is limited knowledge on those patients that require emergency laparotomy but do not undergo surgery (NoLaps). METHODS: A multicentre cohort study (n=64 UK surgical centres) recruited 750 consecutive NoLap patients (February 15th - November 15th 2021, inclusive of a 90-day follow up period). Each patient was admitted to hospital with a surgical condition treatable by an emergency laparotomy (defined by The National Emergency Laparotomy Audit (NELA) criteria), but a decision was made not to undergo surgery (NoLap). RESULTS: NoLap patients were predominately female (452 patients, 60%), of advanced age (median age 83.0 yr, interquartile range 77.0-88.8), frail (523 patients, 70%), and had severe comorbidity (750 patients, 100%); 99% underwent CT scanning. The commonest diagnoses were perforation (26%), small bowel obstruction (17%), and ischaemic bowel (13%). The 90-day mortality was 79% and influencing factors were >80 yr, underweight BMI, elevated serum lactate or creatinine concentration. The majority of patients died in hospital (77%), with those with ischaemic bowel dying early. For the 21% of NoLap patients that survived to 90 days, 77% returned home with increased care requirements. CONCLUSIONS: This study reports that the NoLap patient population present significant medical challenges because of their extreme levels of comorbidity, frailty, and physiology. Despite these complexities a fifth remained alive at 90 days. Further work is underway to explore this high-risk decision-making process. CLINICAL TRIAL REGISTRATION: ISRCTN14556210.

The temporal dynamics of the gut mycobiome and its association with cardiometabolic health in a nationwide cohort of 12,641 Chinese adults.

The dynamics of the gut mycobiome and its association with cardiometabolic health remain largely unexplored. Here, we employ internal transcribed spacer (ITS) sequencing to capture the gut mycobiome composition and dynamics within a nationwide human cohort of 12,641 Chinese participants, including 1,946 participants with repeated measurements across three years. We find that the gut mycobiome is associated with cardiometabolic diseases and related biomarkers in both cross-sectional and dynamic analyses. Fungal alpha diversity indices and 19 mycobiome genera are the major contributors to the mycobiome-cardiometabolic disease link. Particularly, Saccharomyces emerges as an effect modifier of traditional risk factors in promoting type 2 diabetes risk. Further integration of multi-omics data reveals key metabolites such as γ-linolenic acid and L-valine linking the gut mycobiome to type 2 diabetes. This study advances our understanding of the potential roles of the gut mycobiome in cardiometabolic health.

A description of the THRIVE ("The study of host-bacterial relationships in different vaginal environments") bacterial vaginosis observational study.

Bacterial vaginosis contributes to poor reproductive health and is characterized by a displacement of Lactobacillus in the vaginal microbiome. However, treatment for bacterial vaginosis is limited to antibiotics and half of women treated experience recurrence within a year. OBJECTIVES: THRIVE is a prospective study in XXXXX, which is designed to capture daily variation of the microbiome and host mucosal immunity during treatment. The objective of this study is to identify host and bacterial factors that associate with vaginal microbiome stability to better inform therapeutic interventions. METHODS: Women treated for bacterial vaginosis, and controls, are followed for 6 months collecting daily vaginal swabs and monthly questionnaires. Comprehensive mucosal sampling, including swabs, cytobrushes, biopsies, and blood are collected at baseline, months 1 and 6 post-enrollment. RESULTS: We performed analysis on the first 52 participants, (19 BV+, 33 BV-). Molecular profiling by 16s RNA sequencing showed 20 women with non-Lactobacillus dominant microbiomes and 32 with Lactobacillus-dominant microbiomes, with increased microbial diversity in non-Lactobacillus dominant microbiomes (P = 3.1E-05). A pilot analysis in 2 participants demonstrates that multi-omics profiling of self-collected daily swabs provides high-quality data identifying 73 bacterial species, 1773 mucosal proteins and 117 metabolites. Initial flow cytometry analysis showed increased CD4+ T cells and neutrophil activation (CD11b+CD62Lneg/dim) in the positive participant at baseline, while after treatment these shifted and resembled the control participant. CONCLUSION: This study provides a framework to comprehensively investigate the kinetics of vaginal mucosal microbiome alterations, providing further insight into host and molecular features predicting bacterial vaginosis recurrence. RéSUMé: La vaginose bactérienne contribue à une mauvaise santé reproductive et se caractérise par un remplacement des lactobacilles dans le microbiome vaginal. Cependant, le traitement de la vaginose bactérienne se limite aux antibiotiques et la moitié des femmes traitées connaissent une récidive dans l'année qui suit. OBJECTIFS: THRIVE est une étude prospective menée à XXXXX et conçue pour mesurer les variations quotidiennes du microbiome et de l'immunité muqueuse de l'hôte pendant le traitement. L'objectif de cette étude est de déterminer les facteurs hôtes et bactériens qui sont associés à la stabilité du microbiome vaginal afin de mieux orienter les interventions thérapeutiques. MéTHODES: Les femmes traitées pour une vaginose bactérienne, ainsi que les témoins, sont suivies pendant 6 mois au moyen de prélèvements vaginaux quotidiens et de questionnaires mensuels. Une analyse détaillée des muqueuses a été effectuée au recrutement puis à 1 et 6 mois après le recrutement par divers prélèvements, à savoir par écouvillon, cytobrosse, biopsie et prise de sang. RéSULTATS: Nous avons effectué une analyse auprès des 52 premières participantes (19 VB+, 33 VB-). Le profilage moléculaire par séquençage de l'ARN 16S a montré que 20 femmes avaient un microbiome à dominance non-lactobacille et 32 avaient un microbiome à dominance lactobacille, la diversité microbienne étant accrue dans les microbiomes à dominance non-lactobacille (P = 3,1E-05). Une analyse pilote sur 2 participantes démontre que le profilage multiomique d'écouvillonnages quotidiens autoadministrés fournit des données de haute qualité permettant d'identifier 73 espèces bactériennes, 1773 protéines des muqueuses et 117 métabolites. L'analyse initiale par cytométrie en flux a montré une élévation des cellules T CD4+ et une activation des neutrophiles (CD11b+CD62Lnég/faible) chez la patiente positive au recrutement, alors qu'après le traitement, ces cellules ont changé pour finalement ressembler à celles de la participante témoin. CONCLUSION: Cette étude donne un cadre pour étudier de manière exhaustive la cinétique des altérations du microbiome de la muqueuse vaginale, ce qui permet de mieux comprendre les caractéristiques de l'hôte et les caractéristiques moléculaires prédisant la récidive de la vaginose bactérienne.

Ultraprocessed food intake and body mass index change among youths: a prospective cohort study.

BACKGROUND: Suboptimal diets may promote undesired weight gain in youths, with high ultraprocessed food (UPF) intake becoming a significant concern in the United States. OBJECTIVES: We evaluated the association between UPF intake and body mass index [BMI (in kg/m2)] change in large United States youth cohorts. METHODS: Participants included children and adolescents (7-17 y) from the Growing Up Today Study (GUTS1 and GUTS2) who completed baseline and ≥1 follow-up diet and anthropometrics assessment (GUTS1 1996-2001: N = 15,797; GUTS2 2004-2011: N = 9720). Follow-up years were based on diet assessment availability. UPFs were categorized using the Nova system, with intakes evaluated as the cumulative mean percent energy from UPFs and subgroups. BMI was assessed using self-reported body weight/height. Changes in BMI annually and over 2, 4-5, and 7 y in association with UPF intake were examined using multivariable repeated-measure linear mixed models. RESULTS: At baseline, the mean percentage of energy from UPFs was 49.9% in GUTS1 and 49.5% in GUTS2 participants; mean BMI was 18.7 and 19.8, respectively. After multivariable adjustments for sociodemographic and lifestyle factors, each 10% increment in UPF intake was associated with a 0.01 (95% confidence interval: 0.003, 0.03) increase annually and a 0.07 (0.01, 0.13) increase over 5 y in GUTS1 participants. In GUTS2, increases were 0.02 (0.003, 0.04) annually and 0.09 (0.01, 0.18) over 4 y. Among GUTS1, statistically significant annual BMI increases of 0.02-0.07 were associated with elevated intake of ultraprocessed breakfast cereals, savory snacks, and ready-to-eat/heat foods, especially pizza, burgers, and sandwiches. No association was found between UPF intake and overweight/obesity risk. CONCLUSIONS: A higher UPF intake was associated with a modest yet significant increase in BMI in large prospective cohorts of United States youths, calling for public health efforts to promote healthful food intake among youths to prevent excessive weight gain.

Household fuel use and the regression from prehypertension to normotension among Chinese middle-aged and older adults: a cohort study.

To examine the association of household fuel use with prehypertension regression among middle-aged and older people based on the China Health and Retirement Longitudinal Study (CHARLS), we included a total of 3501 participants with prehypertension at baseline, and they were followed up from 2011-2012 to 2015-2016 with information on blood pressure and household solid fuel use (heating and cooking fuels). Cox proportional hazards regression models were used to explore the hazard ratio (HR) and 95% confidence interval (CI) between fuel use and prehypertension regression. Additionally, we investigated the impact of switching fuels (2011-2013) on the regression to normotension during the 4-year follow-up. Linear regression was used to examine the effect of household fuel use on changes in blood pressure. Compared to solid fuel users, those who used clean fuel for heating at baseline had a positive effect on the regression of prehypertension (HR: 1.28, 95% CI: 1.08-1.53). Participants who used clean fuels for both heating and cooking had increased odds for the regression of prehypertension (HR: 1.32, 95% CI: 1.09-1.60). Compared to consistent solid fuel users, those who consistently used clean fuel for heating had a higher likelihood of transitioning from prehypertension to normotension (HR: 1.36, 95% CI: 1.06-1.73) and exhibited 2.45 mmHg lower systolic blood pressure. In conclusion, household clean fuel use for heating was positively associated with the regression of prehypertension to normotension. Furthermore, switching from solid fuel to clean fuel for heating could reduce the risk of prehypertension in Chinese middle-aged and older adults.

Associations of childhood physical activity and screen time with cardiometabolic health in preteens who were born to mothers with previous macrosomic delivery: Findings from the ROLO longitudinal birth cohort study.

BACKGROUND: Macrosomia (birthweight ≥4 kg) may alter the associations of physical activity (PA) and screen time (ST) throughout childhood with later cardiometabolic risk. OBJECTIVE: To investigate associations of PA and ST over a 4-6-year follow-up period with cardiometabolic outcomes in preteens (9-11-year-olds) who were born to mothers with previous macrosomic delivery. METHODS: This is an analysis of 402 preteens from the ROLO study, who were born to mothers that previously delivered an infant with macrosomia. Parental-reported measures of PA and ST were obtained in early childhood at 5-years of age. Preteen self-reported PA, parental-reported ST, anthropometry, dual-energy x-ray absorptiometry, blood pressure, heart rate, cardiorespiratory endurance, and blood biomarkers were obtained at 9-11-years. Crude and adjusted linear regression models explored associations and the interaction of birthweight was investigated in all models. RESULTS: Early childhood PA and ST at the 5-year follow-up were not related to preteen cardiometabolic outcomes. In adjusted models, higher preteen PA was associated with lower sum of skinfolds (B = -3.00, 95% CI -5.98, -0.02, p = 0.048) and higher cardiorespiratory endurance (B = 0.50, 95% CI 0.20, 0.80, p = 0.001) at the same time point. No strong evidence for modification by birthweight was found. CONCLUSION: Higher preteen PA may have potential benefits for cardiometabolic health, irrespective of birthweight.

Impaired head circumference growth and behavioural problems in childhood: Longitudinal findings from the MINA-Brazil birth cohort.

BACKGROUND: Previous evidence on the relation between early head circumference (HC) growth and behavioural outcomes in preschoolers has been inconsistent. OBJECTIVE: We aimed to investigate whether HC growth from birth to 5 years of age was related to internalising or externalising behavioural problems at 5 years of age in a sex-specific manner. METHODS: Among 303 girls and 318 boys from the MINA-Brazil birth cohort, we examined the associations between changes in HC from birth to 5 years of age and internalising and externalising behaviour problem scores at 5 years according to the Strengths and Difficulties Questionnaire for parents. HC values were transformed into sex- and age-specific z-scores (HCZ) using World Health Organisation standards, and the differences between values at 5 years of age and birth were classified into quintiles. We estimated adjusted mean differences with 95% confidence intervals in behavioural problem scores between HCZ change quintiles using multivariable linear regression by sex. To examine nonlinear associations, we included cubic spline terms. RESULTS: Head circumference growth from birth to 5 years of age was inversely and nonlinearly associated with internalising problems in girls. Compared with girls at the lowest quintile of HC growth, those above had an adjusted 1.27 (95% confidence interval 0.28, 2.27) points lower mean internalising problems score. This association was mostly driven by HC growth during the first 2 years. We found no association between HC growth and externalising behaviour in either sex. CONCLUSIONS: Impaired HC growth was related to higher mean internalising problem scores at 5 years of age in girls but not in boys. HC growth was not associated with externalising problems.

Trajectories of work disability and unemployment before and after a common mental disorder diagnosis among young private sector employees in Sweden-a register-based longitudinal study.

PURPOSE: To identify trajectory groups of work disability (WD), including sick leave and disability pension, and unemployment three years before and six years (from Y-3 to Y + 6) after a common mental disorder (CMD) diagnosis and to investigate associations of socio-demographic, work-related and clinical factors with trajectory membership. METHODS: A longitudinal nationwide register-based study was conducted including individuals aged 22-29 years, gainfully employed in the private sector, with a CMD diagnosis in specialised healthcare or prescribed antidepressant (N = 12,121) in 2014 (Year 0/Y0), with follow-up from Y-3 to Y + 6. Group-based trajectory analyses identified groups of individuals who followed similar trajectories of months of WD and unemployment, respectively. Multinomial logistic regression determined associations between socio-demographic, work-related and clinical factors and trajectory membership. RESULTS: In the CMD group, we identified three trajectory groups, each for WD and unemployment. Only 7% individuals belonged to a 'Fluctuant high' trajectory group with four months of WD in Y0, which peaked at 7 months in Y + 3 and reduced to 5 months in Y + 6. For unemployment, 15% belonged to an 'Increasing medium' trajectory group that steadily increased from 1.3 months in Y0 to 2.6 months in Y + 6. Sex, educational level and musculoskeletal disorders for WD, and educational level, living area and occupational class for unemployment, influentially determined the variance across the CMD trajectory groups. CONCLUSIONS: Specific vulnerable groups regarding unfavourable WD (women, low education and musculoskeletal disorders) and unemployment (manual work, low education and rural residence) trajectories require special attention regarding their return-to-work process following a CMD diagnosis.