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1.
Biodemography Soc Biol ; : 1-8, 2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38828740

ABSTRACT

Polygenic scores (PGS) are broadly misconstrued as reflecting direct causal genetic effects on their respective phenotypes. While this assumption might be accurate for some anthropometric traits like height, more complex traits such as educational attainment show very large indirect effects that stem from many sources. One unexplored source of confounding is the possibility of evocative gene-environment correlation (rGE). Using data from the National Longitudinal Study of Adolescent to Adult Health, we examine the relationship between interviewer assessments of respondent appearance as a function of education PGS. We show a bivariate association between educational PGS and 1) perceived grooming, 2) physical attractiveness, and 3) personality. We then regress years of education on the educational PGS and show that very little of the association (~1-2%) is mediated by attractiveness or personality but 7.5% of the baseline association is confounded with how others may perceive grooming. These results highlight the importance of social-behavioral mechanisms that may link specific genotypes to successful transitions through high school and college and continue to bridge research from the social and biological sciences.

2.
Mult Scler J Exp Transl Clin ; 10(2): 20552173241251707, 2024.
Article in English | MEDLINE | ID: mdl-38715893

ABSTRACT

Background: Many patients report a wearing-off phenomenon with monoclonal antibody treatment for multiple sclerosis in which perceived benefits wear off before the next dose is due. Objectives: To determine prevalence of the wearing-off effect, symptoms experienced, impact on treatment satisfaction, and associated patient characteristics. Methods: Patients receiving natalizumab, ocrelizumab, ofatumumab, or rituximab at a tertiary multiple sclerosis center were invited to take an online survey interrogating their monoclonal antibody experience. Additional history and patient characteristic data were collected. Logistic regression was used to determine if patient characteristics predicted the wearing-off effect and linear regression to evaluate the impact of the wearing-off effect on treatment satisfaction. The models were adjusted for age, disease duration, race, sex, body mass index, education, and depression as measured by the Patient Health Questionnaire-9. Results: We received 258 qualifying responses and 141 (54.7%) patients reported the wearing-off phenomenon. The most common symptom was fatigue (47.7%). Higher Patient Health Questionnaire-9 scores were significantly associated with the wearing-off phenomenon (OR = 1.02, p = 0.005). The wearing-off effect (ß = -0.52, p = 0.04) and higher Patient Health Questionnaire-9 (ß = -0.09, p < 0.01) scores were associated with significantly reduced treatment satisfaction. Conclusion: The wearing-off phenomenon is common, associated with depression, and reduces treatment satisfaction. Research addressing mitigation strategies is needed.

3.
Demography ; 2024 May 29.
Article in English | MEDLINE | ID: mdl-38809598

ABSTRACT

Greater educational attainment is generally associated with healthier and longer lives. However, important heterogeneity in who benefits from educational attainment, how much, and why remains underexplored. In particular, in the United States, the physical health returns to educational attainment are not as large for minoritized racial and ethnic groups compared with individuals racialized as White. Yet, our current understanding of ethnoracial differences in educational health disparities is limited by an almost exclusive focus on the quantity of education attained without sufficient attention to heterogeneity within educational attainment categories, such as different institution types among college graduates. Using biomarker data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we test whether the physical health of college graduates in early adulthood (aged 24-32) varies by institution type and for White, Black, and Hispanic adults. In considering the role of the college context, we conceptualize postsecondary institutions as horizontally stratified and racialized institutional spaces with different implications for the health of their graduates. Finally, we quantify the role of differential attendance at and returns to postsecondary institution type in shaping ethnoracialized health disparities among college graduates in early adulthood.

4.
Neurosci Biobehav Rev ; : 105655, 2024 Apr 05.
Article in English | MEDLINE | ID: mdl-38583652

ABSTRACT

Social gradients in health and aging have been reported in studies across many human populations, and - as the papers included in this special collection highlight - also occur across species. This paper serves as a general introduction to the special collection of Neuroscience and Biobehavioral Reviews entitled "Social dimensions of health and aging: population studies, preclinical research, and comparative research using animal models". Authors of the fourteen reviews are primarily members of a National Institute of Aging-supported High Priority Research Network on "Animal Models for the Social Dimensions of Health and Aging". The collection is introduced by a foreword, commentaries, and opinion pieces by leading experts in related fields. The fourteen reviews are divided into four sections: Section 1: Biodemography and life course studies; Section 2: Social behavior and healthy aging in nonhuman primates; Section 3: Social factors, stress, and hallmarks of aging; Section 4: Neuroscience and social behavior.

5.
bioRxiv ; 2024 Mar 28.
Article in English | MEDLINE | ID: mdl-38585956

ABSTRACT

Importance: Epigenetic clocks represent molecular evidence of disease risk and aging processes and have been used to identify how social and lifestyle characteristics are associated with accelerated biological aging. However, most of this research is based on older adult samples who already have measurable chronic disease. Objective: To investigate whether and how sociodemographic and lifestyle characteristics are related to biological aging in a younger adult sample across a wide array of epigenetic clock measures. Design: Nationally representative prospective cohort study. Setting: United States (U.S.). Participants: Data come from the National Longitudinal Study of Adolescent to Adult Health, a national cohort of adolescents in grades 7-12 in U.S. in 1994 followed for 25 years over five interview waves. Our analytic sample includes participants followed-up through Wave V in 2016-18 who provided blood samples for DNA methylation (DNAm) testing (n=4237) at Wave V. Exposure: Sociodemographic (sex, race/ethnicity, immigrant status, socioeconomic status, geographic location) and lifestyle (obesity status, exercise, tobacco, and alcohol use) characteristics. Main Outcome: Biological aging assessed from blood DNAm using 16 epigenetic clocks when the cohort was aged 33-44 in Wave V. Results: While there is considerable variation in the mean and distribution of epigenetic clock estimates and in the correlations among the clocks, we found sociodemographic and lifestyle factors are more often associated with biological aging in clocks trained to predict current or dynamic phenotypes (e.g., PhenoAge, GrimAge and DunedinPACE) as opposed to clocks trained to predict chronological age alone (e.g., Horvath). Consistent and strong associations of faster biological aging were found for those with lower levels of education and income, and those with severe obesity, no weekly exercise, and tobacco use. Conclusions and Relevance: Our study found important social and lifestyle factors associated with biological aging in a nationally representative cohort of younger-aged adults. These findings indicate that molecular processes underlying disease risk can be identified in adults entering midlife before disease is manifest and represent useful targets for interventions to reduce social inequalities in heathy aging and longevity. Key Points: Question: Are epigenetic clocks, measures of biological aging developed mainly on older-adult samples, meaningful for younger adults and associated with sociodemographic and lifestyle characteristics in expected patterns found in prior aging research?Findings: Sociodemographic and lifestyle factors were associated with biological aging in clocks trained to predict morbidity and mortality showing accelerated aging among those with lower levels of education and income, and those with severe obesity, no weekly exercise, and tobacco use.Meaning: Age-related molecular processes can be identified in younger-aged adults before disease manifests and represent potential interventions to reduce social inequalities in heathy aging and longevity.

6.
Biodemography Soc Biol ; : 1-18, 2024 Mar 29.
Article in English | MEDLINE | ID: mdl-38551453

ABSTRACT

Biomarkers in population health research serve as indicators of incremental physiological deterioration and contribute to our understanding of mechanisms through which social disparities in health unfold over time. Yet, few population-based studies incorporate biomarkers of aging in early midlife, when disease risks may emerge and progress across the life course. We describe the distributions of several biomarkers of inflammation and neurodegeneration and their variation by sociodemographic characteristics using blood samples collected during Wave V of the National Longitudinal Study of Adolescent to Adult Health (ages 33-44 years). Higher mean levels of inflammatory and neurodegenerative biomarkers were associated with greater socioeconomic disadvantage. For example, the neurodegenerative markers, Neurofilament Light Chain and total Tau proteins were higher among lower income groups, though the relationship was not statistically significant. Similarly, proinflammatory marker Tumor Necrosis Factor-α (TNF-α) levels were higher among those with lower education. Significant differences in the mean levels of other proinflammatory markers were observed by race/ethnicity, sex, census region, BMI, and smoking status. These descriptive findings indicate that disparities in biomarkers associated with aging are already evident among young adults in their 30s and attention should focus on age-related disease risk earlier in the life course.

7.
Sci Rep ; 14(1): 1255, 2024 01 13.
Article in English | MEDLINE | ID: mdl-38218990

ABSTRACT

Disparities in socio-economic status (SES) predict many immune system-related diseases, and previous research documents relationships between SES and the immune cell transcriptome. Drawing on a bioinformatically-informed network approach, we situate these findings in a broader molecular framework by examining the upstream regulators of SES-associated transcriptional alterations. Data come from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative sample of 4543 adults in the United States. Results reveal a network-of differentially expressed genes, transcription factors, and protein neighbors of transcription factors-that shows widespread SES-related dysregulation of the immune system. Mediational models suggest that body mass index (BMI) plays a key role in accounting for many of these associations. Overall, the results reveal the central role of upstream regulators in socioeconomic differences in the molecular basis of immunity, which propagate to increase risk of chronic health conditions in later-life.


Subject(s)
Social Class , Transcriptome , Adult , Adolescent , Humans , United States , Longitudinal Studies , Gene Expression Profiling , Transcription Factors/genetics , Socioeconomic Factors
8.
Int J Epidemiol ; 53(1)2024 Feb 01.
Article in English | MEDLINE | ID: mdl-38205821

ABSTRACT

BACKGROUND: Life course epidemiology examines associations between repeated measures of risk and health outcomes across different phases of life. Empirical research, however, is often based on discrete-time models that assume that sporadic measurement occasions fully capture underlying long-term continuous processes of risk. METHODS: We propose (i) the functional relevant life course model (fRLM), which treats repeated, discrete measures of risk as unobserved continuous processes, and (ii) a testing procedure to assign probabilities that the data correspond to conceptual models of life course epidemiology (critical period, sensitive period and accumulation models). The performance of the fRLM is evaluated with simulations, and the approach is illustrated with empirical applications relating body mass index (BMI) to mRNA-seq signatures of chronic kidney disease, inflammation and breast cancer. RESULTS: Simulations reveal that fRLM identifies the correct life course model with three to five repeated assessments of risk and 400 subjects. The empirical examples reveal that chronic kidney disease reflects a critical period process and inflammation and breast cancer likely reflect sensitive period mechanisms. CONCLUSIONS: The proposed fRLM treats repeated measures of risk as continuous processes and, under realistic data scenarios, the method provides accurate probabilities that the data correspond to commonly studied models of life course epidemiology. fRLM is implemented with publicly-available software.


Subject(s)
Breast Neoplasms , Renal Insufficiency, Chronic , Humans , Female , Life Change Events , Bayes Theorem , Inflammation , Renal Insufficiency, Chronic/epidemiology , Breast Neoplasms/epidemiology
9.
Anesth Analg ; 138(2): 438-446, 2024 Feb 01.
Article in English | MEDLINE | ID: mdl-37010953

ABSTRACT

BACKGROUND: Autism spectrum disorder (ASD) is a neurocognitive disorder characterized by impairments in communication and socialization. There are little data comparing the differences in perioperative outcomes in children with and without ASD. We hypothesized that children with ASD would have higher postoperative pain scores than those without ASD. METHODS: Pediatric patients undergoing ambulatory tonsillectomy/adenoidectomy, ophthalmological surgery, general surgery, and urologic procedures between 2016 and 2021 were included in this retrospective cohort study. ASD patients, defined by International Classification of Diseases-9/10 codes, were compared to controls utilizing inverse probability of treatment weighting based on surgical category/duration, age, sex, race and ethnicity, anesthetizing location, American Society of Anesthesiology physical status, intraoperative opioid dose, and intraoperative dexmedetomidine dose. The primary outcome was the maximum postanesthesia care unit (PACU) pain score, and secondary outcomes included premedication administration, behavior at induction, PACU opioid administration, postoperative vomiting, emergence delirium, and PACU length of stay. RESULTS: Three hundred thirty-five children with ASD and 11,551 non-ASD controls were included. Maximum PACU pain scores in the ASD group were not significantly higher than controls (median, 5; interquartile range [IQR], 0-8; ASD versus median, 5; IQR, 0-8 controls; median difference [95% confidence interval {CI}] of 0 [-1.1 to 1.1]; P = .66). There was no significant difference in the use of premedication (96% ASD versus 95% controls; odds ratio [OR], 1.5; [95% CI, 0.9-2.7]; P = .12), but the ASD cohort had significantly higher odds of receiving an intranasal premedication (4.2% ASD versus 1.2% controls; OR, 3.5 [95% CI, 1.8-6.8]; P < .001) and received ketamine significantly more frequently (0.3% ASD versus <0.1% controls; P < .001). Children with ASD were more likely to have parental (4.9% ASD versus 1.0% controls; OR, 5 [95% CI, 2.1-12]; P < .001) and child life specialist (1.3% ASD versus 0.1% controls; OR, 9.9 [95% CI, 2.3-43]; P < .001) presence at induction, but were more likely to have a difficult induction (11% ASD versus 3.4% controls; OR, 3.42 [95% CI, 1.7-6.7]; P < .001). There were no significant differences in postoperative opioid administration, emergence delirium, vomiting, or PACU length of stay between cohorts. CONCLUSIONS: We found no difference in maximum PACU pain scores in children with ASD compared to a similarly weighted cohort without ASD. Children with ASD had higher odds of a difficult induction despite similar rates of premedication administration, and significantly higher parental and child life specialist presence at induction. These findings highlight the need for future research to develop evidence-based interventions to optimize the perioperative care of this population.


Subject(s)
Autism Spectrum Disorder , Emergence Delirium , Humans , Child , Analgesics, Opioid/adverse effects , Autism Spectrum Disorder/diagnosis , Autism Spectrum Disorder/chemically induced , Retrospective Studies , Emergence Delirium/chemically induced , Pain, Postoperative/diagnosis , Pain, Postoperative/etiology , Pain, Postoperative/prevention & control
10.
J Aging Health ; 36(3-4): 230-245, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37335551

ABSTRACT

Objectives: Cognitive aging is a lifelong process with implications for Alzheimer's disease and dementia. This study aims to fill major gaps in research on the natural history of and social disparities in aging-related cognitive decline over the life span. Methods: We conducted integrative data analysis of four large U.S. population-based longitudinal studies of individuals aged 12 to 105 followed over two decades and modeled age trajectories of cognitive function in multiple domains. Results: We found evidence for the onset of cognitive decline in the 4th decade of life, varying gender differences with age, and persistent disadvantage among non-Hispanic Blacks, Hispanics, and those without college education. We further found improvement in cognitive function across 20th century birth cohorts but widening social inequalities in more recent cohorts. Discussion: These findings advance an understanding of early life origins of dementia risk and invite future research on strategies for promoting cognitive health for all Americans.


Subject(s)
Cognitive Aging , Cognitive Dysfunction , Dementia , Health Status Disparities , Humans , Aging/psychology , Cognitive Dysfunction/epidemiology , Dementia/epidemiology , Life Change Events , United States/epidemiology , Child , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over
11.
Fam Relat ; 72(4): 1748-1772, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37994316

ABSTRACT

Objective: We examined the acculturation processes involving intergenerational consonance and dissonance in parent-child relationships in U.S. immigrant families. Background: This study is important because we lack national studies that examine the association between acculturation processes and intergenerational relationships among diverse racial/ethnic groups in immigrant families. Method: Using national data from Add Health with diverse race/ethnicity, we measured acculturation levels by immigrant generation, age of arrival, and length of time. Intergenerational consonance (the degree to which children and parents share the same values and activities) was measured by family cohesion and sharing meals (specifically dinners) with parents. Intergenerational dissonance (the degree to which parents and children differ in expected norms and parents lose authority over their children) was measured by parent-child conflict and parental control. Ordinary least square, binary logistic, ordered logistic, and Poisson regressions were conducted depending on the nature of the four dependent variables. Results: We found robust evidence that adolescents of the second immigrant generation acculturate more rapidly than those of the first generation and their immigrant parents creating a "gap" in intergenerational relationships. Thus, second-generation adolescents experience lower levels of family cohesion, less frequency of sharing weekly dinners with parents, less parental control of adolescents' activities, and more serious arguments about their behaviors with their parents than their first-generation counterparts. Conclusion: This is the new evidence that is based on national data, across multiple measures of intergenerational relationships, and holds for diverse racial and ethnic groups. Implications: The findings underscore the importance of developing culturally informed interventions supporting healthy parent-child relationships in immigrant families.

12.
Demography ; 60(6): 1815-1841, 2023 Dec 01.
Article in English | MEDLINE | ID: mdl-37982570

ABSTRACT

Despite the prominence of the weathering hypothesis as a mechanism underlying racialized inequities in morbidity and mortality, the life course social and economic determinants of Black-White disparities in biological aging remain inadequately understood. This study uses data from the Health and Retirement Study (n = 6,782), multivariable regression, and Kitagawa-Blinder-Oaxaca decomposition to assess Black-White disparities across three measures of biological aging: PhenoAge, Klemera-Doubal biological age, and homeostatic dysregulation. It also examines the contributions of racial differences in life course socioeconomic and stress exposures and vulnerability to those exposures to Black-White disparities in biological aging. Across the outcomes, Black individuals exhibited accelerated biological aging relative to White individuals. Decomposition analyses showed that racial differences in life course socioeconomic exposures accounted for roughly 27% to 55% of the racial disparities across the biological aging measures, and racial disparities in psychosocial stress exposure explained 7% to 11%. We found less evidence that heterogeneity in the associations between social exposures and biological aging by race contributed substantially to Black-White disparities in biological aging. Our findings offer new evidence of the role of life course social exposures in generating disparities in biological aging, with implications for understanding age patterns of morbidity and mortality risks.


Subject(s)
Aging , Black or African American , Health Status Disparities , Life Change Events , White , Humans , Morbidity , Mortality
13.
Res Sq ; 2023 Sep 05.
Article in English | MEDLINE | ID: mdl-37720018

ABSTRACT

Disparities in socio-economic status (SES) predict many immune system-related diseases, and previous research documents relationships between SES and the immune cell transcriptome. Drawing on a bioinformatically-informed network approach, we situate these findings in a broader molecular framework by examining the upstream regulators of SES-associated transcriptional alterations. Data come from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative sample of 4,543 adults in the United States. Results reveal a network-of differentially-expressed genes, transcription factors, and protein neighbors of transcription factors- that shows widespread SES-related dysregulation of the immune system. Mediational models suggest that body mass index plays a key role in accounting for many of these associations. Overall, the results reveal the central role of upstream regulators in socioeconomic differences in the molecular basis of immunity, which propagate to increase risk of chronic health conditions in later-life.

14.
Am J Epidemiol ; 192(12): 1981-1990, 2023 11 10.
Article in English | MEDLINE | ID: mdl-37431780

ABSTRACT

Diverse manifestations of biological aging often reflect disparities in socioeconomic status (SES). In this paper, we examine associations between indicators of SES and an mRNA-based aging signature during young adulthood, before clinical indications of aging are common. We use data from wave V (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health, a nationally representative study of adults aged 33-43 years, with transcriptomic data from a subset of 2,491 participants. Biological aging is measured using 1) a composite transcriptomic aging signature previously identified by Peters et al.'s out-of-sample meta-analysis (Nat Commun. 2015;6:8570) and 2) 9 subsets that represent functional pathways of coexpressed genes. SES refers to income, education, occupation, subjective social status, and a composite measure combining these 4 dimensions. We examine hypothesized mechanisms through which SES could affect aging: body mass index, smoking, health insurance status, difficulty paying bills, and psychosocial stress. We find that SES-especially the composite measure and income-is associated with transcriptomic aging and immune, mitochondrial, ribosomal, lysosomal, and proteomal pathways. Counterfactual mediational models suggest that the mediators partially account for these associations. The results thus reveal that numerous biological pathways associated with aging are already linked to SES in young adulthood.


Subject(s)
Aging , Social Class , Adult , Adolescent , Humans , Young Adult , Longitudinal Studies , Aging/genetics , Smoking , Income , Socioeconomic Factors
15.
JAMA Dermatol ; 159(9): 930-938, 2023 09 01.
Article in English | MEDLINE | ID: mdl-37494057

ABSTRACT

Importance: Hidradenitis suppurativa (HS) is a common and severely morbid chronic inflammatory skin disease that is reported to be highly heritable. However, the genetic understanding of HS is insufficient, and limited genome-wide association studies (GWASs) have been performed for HS, which have not identified significant risk loci. Objective: To identify genetic variants associated with HS and to shed light on the underlying genes and genetic mechanisms. Design, Setting, and Participants: This genetic association study recruited 753 patients with HS in the HS Program for Research and Care Excellence (HS ProCARE) at the University of North Carolina Department of Dermatology from August 2018 to July 2021. A GWAS was performed for 720 patients (after quality control) with controls from the Add Health study and then meta-analyzed with 2 large biobanks, UK Biobank (247 cases) and FinnGen (673 cases). Variants at 3 loci were tested for replication in the BioVU biobank (290 cases). Data analysis was performed from September 2021 to December 2022. Main Outcomes and Measures: Main outcome measures are loci identified, with association of P < 1 × 10-8 considered significant. Results: A total of 753 patients were recruited, with 720 included in the analysis. Mean (SD) age at symptom onset was 20.3 (10.57) years and at enrollment was 35.3 (13.52) years; 360 (50.0%) patients were Black, and 575 (79.7%) were female. In a meta-analysis of the 4 studies, 2 HS-associated loci were identified and replicated, with lead variants rs10512572 (P = 2.3 × 10-11) and rs17090189 (P = 2.1 × 10-8) near the SOX9 and KLF5 genes, respectively. Variants at these loci are located in enhancer regulatory elements detected in skin tissue. Conclusions and Relevance: In this genetic association study, common variants associated with HS located near the SOX9 and KLF5 genes were associated with risk of HS. These or other nearby genes may be associated with genetic risk of disease and the development of clinical features, such as cysts, comedones, and inflammatory tunnels, that are unique to HS. New insights into disease pathogenesis related to these genes may help predict disease progression and novel treatment approaches in the future.


Subject(s)
Acne Vulgaris , Hidradenitis Suppurativa , Humans , Female , Male , Hidradenitis Suppurativa/genetics , Hidradenitis Suppurativa/pathology , Genome-Wide Association Study , Skin/pathology , Risk Factors
16.
Environ Int ; 177: 107987, 2023 07.
Article in English | MEDLINE | ID: mdl-37267730

ABSTRACT

BACKGROUND: Air pollution exposure is associated with cardiovascular morbidity and mortality. Although exposure to air pollution early in life may represent a critical window for development of cardiovascular disease risk factors, few studies have examined associations of long-term air pollution exposure with markers of cardiovascular and metabolic health in young adults. OBJECTIVES: By combining health data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) with air pollution data from the Fused Air Quality Surface using Downscaling (FAQSD) archive, we: (1) calculated multi-year estimates of exposure to ozone (O3) and particulate matter with an aerodynamic diameter ≤ 2.5 µm (PM2.5) for Add Health participants; and (2) estimated associations between air pollution exposures and multiple markers of cardiometabolic health. METHODS: Add Health is a nationally representative longitudinal cohort study of over 20,000 adolescents aged 12-19 in the United States (US) in 1994-95 (Wave I). Participants have been followed through adolescence and into adulthood with five in-home interviews. Estimated daily concentrations of O3 and PM2.5 at census tracts were obtained from the FAQSD archive and used to generate tract-level annual averages of O3 and PM2.5 concentrations. We estimated associations between average O3 and PM2.5 exposures from 2002 to 2007 and markers of cardiometabolic health measured at Wave IV (2008-09), including hypertension, hyperlipidemia, body mass index (BMI), diabetes, C-reactive protein, and metabolic syndrome. RESULTS: The final sample size was 11,259 individual participants. The average age of participants at Wave IV was 28.4 years (range: 24-34 years). In models adjusting for age, race/ethnicity, and sex, long-term O3 exposure (2002-07) was associated with elevated odds of hypertension, with an odds ratio (OR) of 1.015 (95% confidence interval [CI]: 1.011, 1.029); obesity (1.022 [1.004, 1.040]); diabetes (1.032 [1.009,1.054]); and metabolic syndrome (1.028 [1.014, 1.041]); PM2.5 exposure (2002-07) was associated with elevated odds of hypertension (1.022 [1.001, 1.045]). CONCLUSION: Findings suggest that long-term ambient air pollution exposure, particularly O3 exposure, is associated with cardiometabolic health in early adulthood.


Subject(s)
Air Pollutants , Air Pollution , Hypertension , Metabolic Syndrome , Ozone , Young Adult , Humans , Adolescent , United States/epidemiology , Adult , Air Pollutants/adverse effects , Air Pollutants/analysis , Longitudinal Studies , Metabolic Syndrome/epidemiology , Metabolic Syndrome/chemically induced , Environmental Exposure/adverse effects , Environmental Exposure/analysis , Air Pollution/adverse effects , Air Pollution/analysis , Particulate Matter/adverse effects , Particulate Matter/analysis , Ozone/analysis , Hypertension/chemically induced
17.
Adv Healthc Mater ; 12(26): e2300906, 2023 10.
Article in English | MEDLINE | ID: mdl-37163283

ABSTRACT

Herein a practical strategy for augmenting immune activation in transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) is presented. Pluronic F127 (PF127) is incorporated with Lipiodol (LPD) to achieve safe and effective delivery of therapeutic agents during transcatheter intra-arterial (IA) local delivery. Enhanced emulsion stability, IA infusion, embolic effect, safety, pharmacokinetics, and tumor response of Doxorubicin loaded PF127-LPD (Dox-PF127-LPD) for TACE in both in vitro and in vivo preclinical VX2 liver cancer rabbit model and N1S1 HCC rat model are demonstrated. Then, transcatheter arterial chemo-immuno-embolization (TACIE) combining TACE and local delivery of immune adjuvant (TLR9 agonist CpG oligodeoxynucleotide) is successfully performed using CpG-loaded Dox-PF127-LPD. Concurrent and safe local delivery of CpG and TACE during TACIE demonstrate leveraged TACE-induced immunogenic tumor microenvironment and augment systemic anti-tumor immunity in syngeneic N1S1 HCC rat model. Finally, the broad utility and enhanced therapeutic efficacy of TACIE are validated in the diethylnitrosamine-induced rat HCC model. TACIE using clinically established protocols and materials shall be a convenient and powerful therapeutic approach that can be translated to patients with HCC. The robust anti-cancer immunity and tumor regression of TACIE, along with its favorable safety profile, indicate its potential as a novel localized combination immunotherapy for HCC treatment.


Subject(s)
Carcinoma, Hepatocellular , Chemoembolization, Therapeutic , Liver Neoplasms , Humans , Rats , Animals , Rabbits , Carcinoma, Hepatocellular/drug therapy , Carcinoma, Hepatocellular/pathology , Liver Neoplasms/drug therapy , Liver Neoplasms/pathology , Emulsions , Temperature , Chemoembolization, Therapeutic/methods , Ethiodized Oil/therapeutic use , Doxorubicin/therapeutic use , Treatment Outcome , Tumor Microenvironment
18.
Prev Med ; 169: 107455, 2023 04.
Article in English | MEDLINE | ID: mdl-36804566

ABSTRACT

Violence victimization has been associated with low-grade inflammation. Lesbian, Gay, and Bisexual (LGB) individuals are at greater risk for victimization in childhood and young adulthood compared to heterosexuals. Moreover, the intersection of LGB identity with gender, race/ethnicity, and educational attainment may be differentially associated with victimization rates. However, no previous study has examined the role of cumulative life-course victimization during childhood and young adulthood in the association between 1) LGB identity and low-grade inflammation during the transition to midlife, and 2) intersection of LGB identity with gender, race/ethnicity, and educational attainment and low-grade inflammation during the transition to midlife. We utilized multi-wave data from a national sample of adults entering midlife in the United States- the National Longitudinal Study of Adolescent to Adult Health (Add Health; n = 4573) - and tested four bootstrapped mediation models. Results indicate LGB identity, LGB and White, and LGB and Black identities were indirectly associated with low-grade inflammation during the transition to midlife via higher levels of cumulative life-course victimization. Moreover, among LGB adults, the association between 1) less than college education and 2) some college education, and low-grade inflammation was mediated by cumulative life-course victimization. For LGB females, there was a direct association between identity and low-grade inflammation and this association was mediated by cumulative life-course victimization . Reducing accumulation of victimization could be critical for preventing biological dysregulation and disease onset among LGB individuals, particularly for those with multiple marginalized identities.


Subject(s)
Crime Victims , Sexual and Gender Minorities , Adult , Adolescent , Humans , Female , Male , United States/epidemiology , Young Adult , Ethnicity , Longitudinal Studies , Sexual Behavior , Educational Status , Inflammation
19.
Soc Sci Med ; 320: 115764, 2023 03.
Article in English | MEDLINE | ID: mdl-36764088

ABSTRACT

Despite considerable scientific interest in documenting growing despair among U.S. adults, far less attention has been paid to defining despair and identifying appropriate measures. Emerging perspectives from social science and psychiatry outline a comprehensive, multidimensional view of despair, inclusive of individuals' cognitive, emotional, biological and somatic, and behavioral circumstances. The current study assesses the structure and plausibility of this framework based on longitudinal data spanning early to middle adulthood. We identified 40 measures of different dimensions of despair in Wave IV (2008-2009) of the National Longitudinal Study of Adult to Adolescent Health (n = 9149). We used structural equation modeling to evaluate hypothesized relationships among observed and latent variables; we then regressed Wave V (2016-2018) suicidality, heavy drinking, marijuana use, prescription drug misuse, and illicit drug use on latent despair. Our analyses find that models for separate dimensions of despair and overall despair demonstrated excellent fit. Overall despair was a significant predictor of Wave V outcomes, especially suicidality, accounting for 20% of its variation, as compared to 1%-7% of the variation in substance use. Suicidality was consistently associated with all domains of despair; behavioral despair explained the most variation in substance use. Given these results we contend that, lacking direct measures, latent despair can be modeled using available survey items; however, some items are likely better indicators of latent dimensions of despair than others. Moreover, the association between despair and key health behaviors varies considerably, challenging its status as a mechanism simultaneously underlying increased substance use and suicide mortality in the United States. Critically, further validation of measures in other surveys can improve the operationalization of despair and its associated conceptual and theoretical frameworks, thus advancing our understanding of this concept.


Subject(s)
Substance-Related Disorders , Suicide , Adult , Adolescent , Humans , United States , Longitudinal Studies , Substance-Related Disorders/psychology , Suicidal Ideation , Emotions
20.
J Perianesth Nurs ; 38(1): 6-11, 2023 02.
Article in English | MEDLINE | ID: mdl-35970662

ABSTRACT

Children with autism spectrum disorder have unique needs during medical procedures involving anesthesia. However, with early patient identification, provider champions can adapt their practice to better serve this population, thereby improving patient satisfaction and outcomes. This article describes a novel protocol developed by an anesthesia resource center to modify care for children with autism spectrum disorder and their families. This information serves as a template for perianesthesia nurses and advanced care providers to implement practice accommodations. Two case examples, based on parent interviews and chart review, are presented to exemplify this protocol.


Subject(s)
Anesthesia , Anesthesiology , Autism Spectrum Disorder , Humans , Child , Autism Spectrum Disorder/therapy , Anesthesia/methods , Parents , Patient Satisfaction
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