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1.
Cell ; 167(7): 1867-1882.e21, 2016 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-27984733

RESUMEN

Functional genomics efforts face tradeoffs between number of perturbations examined and complexity of phenotypes measured. We bridge this gap with Perturb-seq, which combines droplet-based single-cell RNA-seq with a strategy for barcoding CRISPR-mediated perturbations, allowing many perturbations to be profiled in pooled format. We applied Perturb-seq to dissect the mammalian unfolded protein response (UPR) using single and combinatorial CRISPR perturbations. Two genome-scale CRISPR interference (CRISPRi) screens identified genes whose repression perturbs ER homeostasis. Subjecting ∼100 hits to Perturb-seq enabled high-precision functional clustering of genes. Single-cell analyses decoupled the three UPR branches, revealed bifurcated UPR branch activation among cells subject to the same perturbation, and uncovered differential activation of the branches across hits, including an isolated feedback loop between the translocon and IRE1α. These studies provide insight into how the three sensors of ER homeostasis monitor distinct types of stress and highlight the ability of Perturb-seq to dissect complex cellular responses.


Asunto(s)
Análisis de Secuencia de ARN/métodos , Análisis de la Célula Individual/métodos , Animales , Repeticiones Palindrómicas Cortas Agrupadas y Regularmente Espaciadas , Endorribonucleasas , Retroalimentación , Humanos , Modelos Moleculares , Proteínas Serina-Treonina Quinasas , ARN Guía de Kinetoplastida/metabolismo , Transcripción Genética , Respuesta de Proteína Desplegada
2.
Thorax ; 2024 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-38499347

RESUMEN

RATIONALE: Life course trajectories of lung function development and decline influence the risk for lung disease but are poorly documented. OBJECTIVE: To document lung function trajectories from childhood to mid-adult life. METHODS: We modelled forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC at ages 9, 11, 13, 15, 18, 21, 26, 32, 38 and 45 years from a population-based cohort using latent profile analysis to identify distinct subgroups of participants with similar lung function trajectories. Regression analyses were used to assess associations between the trajectories, early life factors and postbronchodilator airflow obstruction at age 45. RESULTS: Among 865 participants with ≥6 measures of lung function, we identified 10 distinct FEV1 trajectories. Most were approximately parallel except for a childhood airway hyper-responsiveness-related persistently low trajectory (3% of study population); two accelerated-decline trajectories, one of which (8%) was associated with smoking and higher adult body mass index (BMI) and a catch-up trajectory (8%). Findings for FEV1/FVC trajectories were similar. Nine trajectories were identified for FVC: most were also approximately parallel except for a higher BMI-related accelerated-decline trajectory. The three FEV1 trajectories leading to the lowest FEV1 values comprised 19% of the cohort but contributed 55% of airflow obstruction at age 45. CONCLUSIONS: Lung function trajectories to mid-adult life are largely established before adolescence, with a few exceptions: a childhood airway hyper-responsiveness-related persistently low trajectory, which starts low and gets worse with age, and accelerated adult decline trajectories associated with smoking and obesity. Adverse trajectories are associated with a high risk of airflow obstruction in mid-adult life.

3.
Anesth Analg ; 138(2): 475-479, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-38048631

RESUMEN

Fidel Pagés, a Spanish surgeon, tragically died in 1923 at the age of 37, just 2 years after his publication "Anestesia Metamérica," the first description of human thoracolumbar epidural anesthesia. In the intervening 100 years, epidural anesthesia has faced countless obstacles, starting with the dissemination of his initial report, which was not widely read nor appreciated at the time. However, the merits of the technique have fueled innovations to meet these challenges over the years. Even today, while epidural anesthesia is widely embraced, particularly in obstetric and chronic pain medicine, the pressures of the operating room for efficiency and a low tolerance for failure, pose modern-day challenges. Here, we revisit Pagés' original report and highlight the key innovations that have allowed for the evolution of this essential anesthesia technique.


Asunto(s)
Anestesia Epidural , Anestesiología , Cirujanos , Femenino , Humanos , Embarazo , Anestesia Epidural/historia , Anestesiología/historia , Anestesiología/métodos , Quirófanos , Cirujanos/historia , Anestesia Obstétrica/métodos
4.
Respirology ; 2024 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-38720400

RESUMEN

BACKGROUND AND OBJECTIVE: Lung function reaches a peak/plateau in early adulthood before declining with age. Lower early adult lung function may increase the risk for chronic obstructive pulmonary disease (COPD) in mid-late adult life. Understanding the effects of multiple childhood/adolescent exposures and their potential interactions on plateau lung function would provide insights into the natural history of COPD. METHODS: Longitudinal spirometry data from 688 participants with complete data from a population-based birth cohort (original n = 1037) were used to investigate associations between a wide range of childhood/adolescent exposures and repeated measures of FEV1, FVC and FEV1/FVC during the early-adult plateau phase. Generalized estimating equations were used to accommodate the multiple timepoints per participant. RESULTS: FEV1 reached a peak/plateau between ages 18 and 26 and FVC from 21 to 32 years, whereas FEV1/FVC declined throughout early adulthood. Childhood asthma and airway hyperresponsiveness were associated with lower early adult FEV1 and FEV1/FVC. Smoking by age 18 was associated with lower FEV1/FVC. Higher BMI during early adulthood was associated with lower FEV1 and FVC and lower FEV1/FVC. Physical activity during adolescence was positively associated with FEV1 and FEV1/FVC but this was only statistically significant in men. There was no convincing evidence of interactions between exposures. CONCLUSION: Childhood asthma and airway hyperresponsiveness are associated with lower lung function in early adulthood. Interventions targeting these may reduce the risk of COPD in mid-late adult life. Promotion of physical activity during adolescence, prevention of cigarette smoking and maintenance of a healthy body weight in early adulthood are also priorities.

5.
Ecotoxicol Environ Saf ; 275: 116243, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38522288

RESUMEN

Analysis of microplastics in the environment requires polymer characterization as a confirmation step for suspected microplastic particles found in a sample. Material characterization is costly and can take a long time per particle. When microplastic particle counts are high, many researchers cannot characterize every particle in their sample due to time or monetary constraints. Moreover, characterizing every particle in samples with high plastic particle counts is unnecessary for describing the sample properties. We propose an a priori approach to determine the number of suspected microplastic particles in a sample that should be randomly subsampled for characterization to accurately assess the polymer distribution in the environmental sample. The proposed equation is well-founded in statistics literature and was validated using published microplastic data and simulations for typical microplastic subsampling routines. We report values from the whole equation but also derive a simple way to calculate the necessary particle count for samples or subsamples by taking the error to the power of negative two. Assuming an error of 0.05 (5 %) with a confidence interval of 95 %, an unknown expected proportion, and a sample with many particles (> 100k), the minimum number of particles in a subsample should be 386 particles to accurately characterize the polymer distribution of the sample, given the particles are randomly characterized from the full population of suspected particles. Extending this equation to simultaneously estimate polymer, color, size, and morphology distributions reveals more particles (620) would be needed in the subsample to achieve the same high absolute error threshold for all properties. The above proposal for minimum subsample size also applies to the minimum count that should be present in samples to accurately characterize particle type presence and diversity in a given environmental compartment.


Asunto(s)
Microplásticos , Contaminantes Químicos del Agua , Microplásticos/toxicidad , Plásticos/análisis , Contaminantes Químicos del Agua/análisis , Monitoreo del Ambiente
6.
Am J Respir Crit Care Med ; 205(10): 1179-1185, 2022 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-35073503

RESUMEN

Rationale: Evidence suggests that the effects of smoking cannabis on lung function are different from tobacco. However, long-term follow-up data are scarce and mostly based on young adults. Objectives: To assess the effects of cannabis and tobacco on lung function in mid-adult life. Methods: Cannabis and tobacco use were reported at ages 18, 21, 26, 32, 38, and 45 years in a population-based cohort study of 1,037 participants. Spirometry, plethysmography, and carbon monoxide transfer factor were measured at age 45. Associations between lung function and cannabis use were adjusted for tobacco use. Measurements and Main Results: Data were available from 881 (88%) of 997 surviving participants. Cumulative cannabis use was associated with lower FEV1/FVC ratios, owing to a tendency toward higher FVCs. Cannabis use was also associated with higher TLC, FRC, residual volume, and Va along with lower midexpiratory flows, airway conductance, and transfer factor. Quitting regular cannabis use between assessments was not associated with changes in spirometry. Conclusions: Cannabis use is associated with higher lung volumes, suggesting hyperinflation. There is evidence of increased large-airway resistance and lower midexpiratory airflow, but impairment of FEV1/FVC ratio is because of higher FVC. This pattern of effects is different to those of tobacco. We provide the first evidence that lifetime cannabis use may be associated with impairment of gas transfer.


Asunto(s)
Cannabis , Pulmón , Fumar Marihuana , Fumar , Uso de Tabaco , Adulto , Factores de Edad , Estudios de Cohortes , Volumen Espiratorio Forzado , Humanos , Pulmón/efectos de los fármacos , Pulmón/fisiología , Persona de Mediana Edad , Espirometría , Factor de Transferencia , Capacidad Vital , Adulto Joven
7.
Crim Justice Behav ; 50(7): 931-952, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37323998

RESUMEN

Using a retrospective study design, predictive validity of the Structured Assessment of Violence Risk in Youth, Short-Term Assessment of Risk and Treatability: Adolescent Version (START: AV), and the Violence Risk Scale-Youth Version (VRS-YV) was examined among 87 adolescents referred to a residential treatment program. With few exceptions, moderate to high accuracy was achieved for the three measures in predicting violence and suicidal/nonsuicidal self-injury occurring during the adolescents' time in treatment. Accuracy of the measures peaked within 90 days for violence and gradually increased over the 180-day follow-up for suicidal/nonsuicidal self-injury. Dynamic factors were more predictive of repeated events involving violence relative to static/historical factors, whereas only factors from the START: AV were predictive of repeated events involving suicidal/nonsuicidal self-injury. These results emphasize the need for further examining the risk of adverse outcomes beyond violence among adolescents.

8.
Glob Chang Biol ; 28(7): 2442-2460, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35023229

RESUMEN

Robust ecological forecasting of tree growth under future climate conditions is critical to anticipate future forest carbon storage and flux. Here, we apply three ingredients of ecological forecasting that are key to improving forecast skill: data fusion, confronting model predictions with new data, and partitioning forecast uncertainty. Specifically, we present the first fusion of tree-ring and forest inventory data within a Bayesian state-space model at a multi-site, regional scale, focusing on Pinus ponderosa var. brachyptera in the southwestern US. Leveraging the complementarity of these two data sources, we parsed the ecological complexity of tree growth into the effects of climate, tree size, stand density, site quality, and their interactions, and quantified uncertainties associated with these effects. New measurements of trees, an ongoing process in forest inventories, were used to confront forecasts of tree diameter with observations, and evaluate alternative tree growth models. We forecasted tree diameter and increment in response to an ensemble of climate change projections, and separated forecast uncertainty into four different causes: initial conditions, parameters, climate drivers, and process error. We found a strong negative effect of fall-spring maximum temperature, and a positive effect of water-year precipitation on tree growth. Furthermore, tree vulnerability to climate stress increases with greater competition, with tree size, and at poor sites. Under future climate scenarios, we forecast increment declines of 22%-117%, while the combined effect of climate and size-related trends results in a 56%-91% decline. Partitioning of forecast uncertainty showed that diameter forecast uncertainty is primarily caused by parameter and initial conditions uncertainty, but increment forecast uncertainty is mostly caused by process error and climate driver uncertainty. This fusion of tree-ring and forest inventory data lays the foundation for robust ecological forecasting of aboveground biomass and carbon accounting at tree, plot, and regional scales, including iterative improvement of model skill.


Asunto(s)
Bosques , Pinus , Teorema de Bayes , Carbono , Cambio Climático , Incertidumbre
9.
J Clin Gastroenterol ; 56(1): e1-e10, 2022 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-34049375

RESUMEN

GOAL: We aimed to extract the percent of signs and symptoms at the time of diagnosis from published studies and to pool these using meta-analytic techniques. BACKGROUND: Delayed or misdiagnosis of chronic pancreatitis may occur because the signs and symptoms are nonspecific and varied. STUDY: We performed a systematic review of studies reporting the signs and symptoms of chronic pancreatitis at diagnosis. The percentage of patients with each sign and symptom was extracted and random-effects meta-analyses used to calculate pooled percentages. RESULTS: In total, 22 observational studies were included. Across 14 studies, 55% of chronic pancreatitis patients were classified as having alcoholic etiology. Abdominal pain was the most common symptom (76%), and weight loss was reported in 22% of patients. Jaundice occurred in 11% of patients and steatorrhoea in 3%. Half of the patients had a history of acute pancreatitis, and 28% had diabetes mellitus at diagnosis. Heterogeneity between the studies was high for all signs and symptoms. CONCLUSIONS: This research has identified some common features of patients with chronic pancreatitis, but the high heterogeneity makes it difficult to draw solid conclusions. Carefully designed studies to examine the signs and symptoms leading up to a diagnosis of chronic pancreatitis, and common combinations, are required. These would enable the development of a tool to aid in the early identification of chronic pancreatitis in the primary care setting, with potential for improved short-term and long-term outcomes for patients.


Asunto(s)
Pancreatitis Crónica , Síntomas Prodrómicos , Enfermedad Aguda , Humanos , Pancreatitis Crónica/diagnóstico , Atención Primaria de Salud
10.
Eur J Oral Sci ; 130(1): e12829, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34874583

RESUMEN

The oral microbiome is ecologically diverse, complex, dynamic, and little understood. We describe the microbiota of four oral habitats in a birth cohort at age 32 and examine differences by sex, oral hygiene, and current smoking status, dental caries, and periodontal health. Oral biofilm samples collected from anterior labial supragingival, posterior lingual supragingival, subgingival, and tongue sites of 841 Dunedin Multidisciplinary Health and Development Study members were analysed using checkerboard DNA-DNA hybridization; focusing on 30 ecologically important bacterial species. The four habitats exhibited distinct microbial profiles that differed by sex. Streptococcus gordonii was more dominant in supragingival and tongue biofilms of males; Porphyromonas gingivalis exhibited higher relative abundance in subgingival biofilm of females. Males had higher scores than females for periodontal pathogens at supragingival sites. The relative abundance of several putative caries and periodontal pathogens differed in smokers and non-smokers. With poor oral hygiene significantly higher proportions of Gram-negative facultative anaerobes were present in subgingival biofilm and there were higher scores for the principal components characterised by putative cariogenic and periodontal pathogens at each site. Distinctive microenvironments shape oral biofilms and systematic differences exist by sex, oral hygiene, and smoking status.


Asunto(s)
Caries Dental , Placa Dental , Microbiota , Adulto , Biopelículas , Placa Dental/microbiología , Femenino , Humanos , Masculino , Higiene Bucal , Porphyromonas gingivalis , Fumar
11.
Int J Technol Assess Health Care ; 38(1): e44, 2022 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-35513309

RESUMEN

South Africa has embarked on major health policy reform to deliver universal health coverage through the establishment of National Health Insurance (NHI). The aim is to improve access, remove financial barriers to care, and enhance care quality. Health technology assessment (HTA) is explicitly identified in the proposed NHI legislation and will have a prominent role in informing decisions about adoption and access to health interventions and technologies. The specific arrangements and approach to HTA in support of this legislation are yet to be determined. Although there is currently no formal national HTA institution in South Africa, there are several processes in both the public and private healthcare sectors that use elements of HTA to varying extents to inform access and resource allocation decisions. Institutions performing HTAs or related activities in South Africa include the National and Provincial Departments of Health, National Treasury, National Health Laboratory Service, Council for Medical Schemes, medical scheme administrators, managed care organizations, academic or research institutions, clinical societies and associations, pharmaceutical and devices companies, private consultancies, and private sector hospital groups. Existing fragmented HTA processes should coordinate and conform to a standardized, fit-for-purpose process and structure that can usefully inform priority setting under NHI and for other decision makers. This transformation will require comprehensive and inclusive planning with dedicated funding and regulation, and provision of strong oversight mechanisms and leadership.


Asunto(s)
Programas Nacionales de Salud , Evaluación de la Tecnología Biomédica , Seguro de Salud , Sector Privado , Sudáfrica , Cobertura Universal del Seguro de Salud
12.
J Ethn Subst Abuse ; : 1-30, 2022 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-35973048

RESUMEN

Recent upticks of stimulant presence in overdose deaths suggest the opioid epidemic is morphing, which raises questions about what drugs are involved and who is impacted. We investigate annual and growth rate trends in combined opioid-stimulant overdose toxicology between 2013 and 2019 for White, Black, and Hispanic male and female decedents in Delaware. During these years, toxicology shifted to illegal drugs for all with fentanyl leading the increase and opioid-cocaine combinations rising substantially. While combined opioid-cocaine toxicology grew among Black and Hispanic Delawareans, White males continue to report the highest rates overall. These findings depart from historical patterns and may challenge existing opioid epidemic policies.

13.
Anal Chem ; 93(21): 7543-7548, 2021 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-34009953

RESUMEN

Microplastic pollution research has suffered from inadequate data and tools for spectral (Raman and infrared) classification. Spectral matching tools often are not accurate for microplastics identification and are cost-prohibitive. Lack of accuracy stems from the diversity of microplastic pollutants, which are not represented in spectral libraries. Here, we propose a viable software solution: Open Specy. Open Specy is on the web (www.openspecy.org) and in an R package. Open Specy is free and allows users to view, process, identify, and share their spectra to a community library. Users can upload and process their spectra using smoothing (Savitzky-Golay filter) and polynomial baseline correction techniques (IModPolyFit). The processed spectrum can be downloaded to be used in other applications or identified using an onboard reference library and correlation-based matching criteria. Open Specy's data sharing and session log features ensure reproducible results. Open Specy houses a growing library of reference spectra, which increasingly represents the diversity of microplastics as a contaminant suite. We compared the functionality and accuracy of Open Specy for microplastic identification to commonly used spectral analysis software. We found that Open Specy was the only open source software and the only software with a community library, and Open Specy had comparable accuracy to popular software (OMNIC Picta and KnowItAll). Future developments will enhance spectral identification accuracy as the reference library and functionality grows through community-contributed spectra and community-developed code. Open Specy can also be used for applications beyond microplastic analysis. Open Specy's source code is open source (CC-BY-4.0, attribution only) (https://github.com/wincowgerDEV/OpenSpecy).


Asunto(s)
Microplásticos , Plásticos , Algoritmos , Programas Informáticos
14.
Sex Transm Dis ; 48(7): 493-498, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-33264263

RESUMEN

BACKGROUND: Diagnosis rates of Chlamydia trachomatis are high in New Zealand; 1.3% of men and 3.7% of women aged 15 to 29 years were diagnosed in 2016. Because testing rates are also higher in women, we sought to understand chlamydia testing by demographic and behavioral characteristics. METHODS: Chlamydia testing in the past year, sexual behavior, and demographic characteristics were reported in the population-based 2014/2015 New Zealand Health Survey. Those aged 16 to 44 years who had a sexual partner in the past year were included. Testing prevalence was calculated, and associations were modeled. RESULTS: A total of 1677 men and 2323 women participated (89% response rate). Of these, 5.6% (95% confidence interval, 4.3%-7.2%) of men and 16.6% (14.7%-18.7%) of women were tested in the past year. Likelihood of testing in men was associated with having multiple partners and any condomless sex (adjusted relative risk, 11.93; 95% confidence interval, 5.70-24.98) and multiple partners with consistent condom use (3.77, 1.40-10.15) compared with one sexual partner and consistent condom use, and with Maori ethnicity (1.87, 1.05-3.31) compared with European/other. Among women, testing was associated with multiple partners with and without condomless sex (3.61 [2.69-4.85] and 2.81 [1.95-4.05], respectively), pregnancy (1.61, 1.18-2.18), and Asian ethnicity (0.52, 0.30-0.89). CONCLUSIONS: The study confirms that New Zealand men are much less likely to be tested than women, a potential reason for ongoing high chlamydia incidence among both sexes. The high testing rate in women includes many at low risk, and this divergence from recommendations is another issue to address.


Asunto(s)
Infecciones por Chlamydia , Parejas Sexuales , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Nueva Zelanda/epidemiología , Conducta Sexual
15.
BMC Cancer ; 21(1): 821, 2021 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-34271862

RESUMEN

BACKGROUND: Myeloma survival has greatly increased over past decades. We investigated trends in survival over time in New Zealand by age, ethnicity, and geography and thus examined potential inequalities among these population subgroups. METHODS: From data supplied by the New Zealand Ministry of Health, all new diagnoses of multiple myeloma (ICD-10 code C90) between 1990 and 2016 were extracted, as well as their matched mortality data. Cox's proportional hazards regression and competing risks regression were used to estimate multivariable survival functions. RESULTS: Between 1 January 1990 and 1 December 2015, 6642 myeloma cases were registered by the New Zealand Cancer Registry. Although survival from myeloma increased substantially from 1990-1994 to 2010-2015, 5-year survival was still only about 60% in 2010-2015. The greatest improvement in survival was for people aged 60-69 years at diagnosis. Using Cox's proportional hazards regression, Maori showed an increased risk of myeloma death but this was predominantly due to differences in competing risks among ethnic groups. Competing risks analysis found the greatest improvement in myeloma survival in Pacific Islanders, and in 2010-2015 Maori had better survival than other ethnicities. Myeloma survival improved significantly over time in all regional health authorities but in all time periods the Central and Southern regions had significantly poorer survival than the Midland region. CONCLUSIONS: Improvements in myeloma survival have been unequal across subgroups and regions in New Zealand. Detailed information about utilization of chemotherapeutic agents and transplantation in New Zealand is not available. This information, as well as more detailed hematological data, is essential to further explore the relationships and reasons for differing myeloma survival in population subgroups of New Zealand.


Asunto(s)
Mieloma Múltiple/mortalidad , Anciano , Anciano de 80 o más Años , Femenino , Historia del Siglo XXI , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Análisis de Supervivencia
16.
Environ Sci Technol ; 55(9): 6032-6041, 2021 05 04.
Artículo en Inglés | MEDLINE | ID: mdl-33896174

RESUMEN

River flow is a major conveyance of microplastic (1-5000 µm) pollution from land to marine systems. However, the current approaches to monitoring and modeling fluvial transport of microplastic pollution have primarily relied on sampling the surface of flow and assumptions about microplastic concentration depth profiles to estimate the depth-averaged concentration. The Rouse profile was adapted to show that fluvial transport of microplastic pollution includes all traditional domains of transport (bed load, settling suspended load, and wash load), as well as additional domains specific to low-density materials with rising velocities in water (rising suspended load and surface load). The modified Rouse profile was applied to describe the positively buoyant particle concentration depth profiles and compared to field observations to showcase the utility of this approach. A procedure was developed for assessing the uncertainty and bias from using a surface sample to estimate the depth-averaged concentration while assuming either surface load or wash load concentration depth profiles. Both assumptions may introduce a large amount of uncertainty due to the range of suspended microplastic concentration depth profiles. Monitoring microplastic pollution and estimating the depth-averaged concentration of microplastics in fluvial systems would further benefit from broader adoption of depth-integrated sampling, characterization of particle concentration depth profiles, and estimation of uncertainties in depth-averaged concentration based on the sampling approach.


Asunto(s)
Microplásticos , Contaminantes Químicos del Agua , Monitoreo del Ambiente , Plásticos , Ríos , Contaminantes Químicos del Agua/análisis
17.
Aust N Z J Obstet Gynaecol ; 61(3): 439-447, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33644852

RESUMEN

BACKGROUND: Studies in southern New Zealand indicate that up to a quarter of women experienced infertility, likely due to delay in childbearing. However, these findings may not be generalisable to the whole population. AIMS: To assess the lifetime prevalence of infertility and evidence for disparities for New Zealand men and women in a nationally representative sample. MATERIALS AND METHODS: In 2014/15 a general health survey with a module on sexual and reproductive health was conducted among New Zealand residents aged 16-74 years; 3792 men and 5222 women provided information on infertility. RESULT(S): There were 8.2% (95% CI 7.1-9.4%) of men and 12.5% (11.3-13.8%) of women who had experienced infertility; among fertility-tested women this was 15.4% (14.0-16.9%). Prevalence peaked in the 35-44 year age group (14.3% for men, 19.1% for women and 20.8% for fertility-tested women). Estimates for European, Maori and Asian ethnicities were similar. Pacific men and women had higher relative risks: 2.37 (95% CI 1.51-3.71) and 1.76 (1.27-2.44), respectively, compared with Europeans. Medical help was sought by 69.3% (95% CI 62.4-75.5%) of infertile men and 68.2% (63.1-72.9%) of women; this was significantly lower for Maori and Pacific. CONCLUSIONS: Infertility levels for those of European ethnicity were similar to studies in southern New Zealand, and in other high-income countries. However, infertility levels were just as high for Maori, and higher for Pacific people, despite experiencing fertility at younger ages. Focusing on reducing causes of infertility other than delayed childbearing would likely contribute to addressing this health disparity.


Asunto(s)
Infertilidad , Etnicidad , Femenino , Humanos , Masculino , Nueva Zelanda , Prevalencia , Encuestas y Cuestionarios
18.
Eur J Nutr ; 59(3): 909-919, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30929067

RESUMEN

PURPOSE: We aimed to evaluate the effectiveness of consuming iodine-fortified toddler milk for improving dietary iodine intakes and biochemical iodine status in toddlers. METHODS: In a 20-week parallel randomised controlled trial, healthy 12-20-month-old children were assigned to: Fortified Milk [n = 45; iodine-fortified (21.1 µg iodine/100 g prepared drink) cow's milk], or Non-Fortified Milk (n = 90; non-fortified cow's milk). Food and nutrient intakes were assessed with 3-day weighed food records at baseline, and weeks 4 and 20. Urinary iodine concentration (UIC) was measured at baseline and 20 weeks. RESULTS: At baseline, toddlers' median milk intake was 429 g/day. There was no evidence that milk intakes changed within or between the groups during the intervention. Toddlers' baseline geometric mean iodine intake was 46.9 µg/day, and the median UIC of 43 µg/L in the Fortified Milk group and 55 µg/L in the Non-Fortified Milk group indicated moderate and mild iodine deficiency, respectively, with this difference due to chance. During the intervention, iodine intakes increased by 136% (p < 0.001) and UIC increased by 85 µg/L (p < 0.001) in the Fortified Milk group compared to the Non-Fortified Milk group. The 20-week median UIC was 91 µg/L in the Fortified Milk group and 49 µg/L in the Non-Fortified Milk group. CONCLUSIONS: Consumption of ≈ 1.7 cups of iodine-fortified toddler milk per day for 20 weeks can increase dietary iodine intakes and UIC in healthy iodine-deficient toddlers. This strategy alone is unlikely to provide sufficient intake to ensure adequate iodine status in toddlers at risk of mild-to-moderate iodine deficiency.


Asunto(s)
Alimentos Fortificados/estadística & datos numéricos , Yodo/administración & dosificación , Yodo/orina , Leche/química , Estado Nutricional/efectos de los fármacos , Animales , Femenino , Humanos , Lactante , Masculino , Nueva Zelanda
19.
Environ Res ; 191: 110192, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32956654

RESUMEN

Microplastic is exposed to numerous weathering processes in the environment, which change particle properties and thus influence transport behaviors, including settling and rising velocities in aquatic environments. However, the extent to which particles in the environment differ from virgin particles in their transport behaviors has not yet been investigated. The settling and rising velocities of weathered fluvial microplastic and macroplastic particles collected from environmental samples are determined in this study and the transferability of theoretical approaches to predicting their transport behaviors is examined. The settling velocities of the environmental particles were between 0.16 and 3.52 cm/s and the rising velocities between 0.18 and 19.85 cm/s. Formulas were applied that were developed using experiments with virgin microplastic, but do not account for the effects of environmental impacts such as degradation, fragmentation and biofouling on the velocities. Accordingly, the transferability of the formulas to environmental particles must be verified. The formulas proved to be suitable for describing the settling and rising velocities of environmental microplastic particles in the shapes of pellets, fragments and foams, and were less suitable for describing the velocities of films and macroplastic particles. Further experiments will be necessary in the future to integrate effects from biofilm and particle deformation on the transport behaviors to adequately model the behavior of the highly diverse micro- and macroplastic particles in the aquatic environment.


Asunto(s)
Incrustaciones Biológicas , Plásticos , Monitoreo del Ambiente , Tiempo (Meteorología)
20.
Int Psychogeriatr ; 32(2): 241-254, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31514759

RESUMEN

AIMS: The USA and UK governmental and academic agencies suggest that up to 35% of dementia cases are preventable. We canvassed dementia risk and protective factor awareness among New Zealand older adults to inform the design of a larger survey. METHOD: The modified Lifestyle for Brain Health scale quantifying dementia risk was introduced to a sample of 304 eligible self-selected participants. RESULTS: Two hundred and sixteen older adults (≥50 years), with mean ± standard deviation age 65.5 ± 11.4 years (50-93 years), completed the survey (71% response rate). Respondents were mostly women (n = 172, 80%), European (n = 207, 96%), and well educated (n = 100, 46%, with a tertiary qualification; including n = 17, 8%, with a postgraduate qualification). Around half of the participants felt that they were at a future risk of living with dementia (n = 101, 47%), and the majority felt that this would change their lives significantly (n = 205, 95%), that lifestyle changes would reduce their risk (n = 197, 91%), and that they could make the necessary changes (n = 189, 88%) and wished to start changes soon (n = 160, 74%). Only 4 of 14 modifiable risk or protective factors for dementia were adequately identified by the participants: physical exercise (81%), depression (76%), brain exercises (75%), and social isolation (83%). Social isolation was the commonly cited risk factor for dementia, while physical exercise was the commonly cited protective factor. Three clusters of brain health literacy were identified: psychosocial, medical, and modifiable. CONCLUSION: The older adults in our study are not adequately knowledgeable about dementia risk and protective factors. However, they report optimism about modifying risks through lifestyle interventions.


Asunto(s)
Encéfalo , Demencia/etiología , Demencia/prevención & control , Alfabetización en Salud , Estilo de Vida , Anciano , Anciano de 80 o más Años , Ejercicio Físico , Femenino , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud , Humanos , Masculino , Persona de Mediana Edad , Nueva Zelanda , Proyectos Piloto , Factores Protectores , Factores de Riesgo , Conducta de Reducción del Riesgo , Encuestas y Cuestionarios
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