Epigenetic Contributions to Clinical Risk Prediction of Cardiovascular Disease.

BACKGROUND: Cardiovascular disease (CVD) is among the leading causes of death worldwide. The discovery of new omics biomarkers could help to improve risk stratification algorithms and expand our understanding of molecular pathways contributing to the disease. Here, ASSIGN-a cardiovascular risk prediction tool recommended for use in Scotland-was examined in tandem with epigenetic and proteomic features in risk prediction models in ≥12 657 participants from the Generation Scotland cohort. METHODS: Previously generated DNA methylation-derived epigenetic scores (EpiScores) for 109 protein levels were considered, in addition to both measured levels and an EpiScore for cTnI (cardiac troponin I). The associations between individual protein EpiScores and the CVD risk were examined using Cox regression (ncases≥1274; ncontrols≥11 383) and visualized in a tailored R application. Splitting the cohort into independent training (n=6880) and test (n=3659) subsets, a composite CVD EpiScore was then developed. RESULTS: Sixty-five protein EpiScores were associated with incident CVD independently of ASSIGN and the measured concentration of cTnI (P<0.05), over a follow-up of up to 16 years of electronic health record linkage. The most significant EpiScores were for proteins involved in metabolic, immune response, and tissue development/regeneration pathways. A composite CVD EpiScore (based on 45 protein EpiScores) was a significant predictor of CVD risk independent of ASSIGN and the concentration of cTnI (hazard ratio, 1.32; P=3.7×10-3; 0.3% increase in C-statistic). CONCLUSIONS: EpiScores for circulating protein levels are associated with CVD risk independent of traditional risk factors and may increase our understanding of the etiology of the disease.

Blood-based genome-wide DNA methylation correlations across body-fat- and adiposity-related biochemical traits.

The recent increase in obesity levels across many countries is likely to be driven by nongenetic factors. The epigenetic modification DNA methylation (DNAm) may help to explore this, as it is sensitive to both genetic and environmental exposures. While the relationship between DNAm and body-fat traits has been extensively studied, there is limited literature on the shared associations of DNAm variation across such traits. Akin to genetic correlation estimates, here, we introduce an approach to evaluate the similarities in DNAm associations between traits: DNAm correlations. As DNAm can be both a cause and consequence of complex traits, DNAm correlations have the potential to provide insights into trait relationships above that currently obtained from genetic and phenotypic correlations. Utilizing 7,519 unrelated individuals from Generation Scotland with DNAm from the EPIC array, we calculated DNAm correlations between body-fat- and adiposity-related traits by using the bivariate OREML framework in the OSCA software. For each trait, we also estimated the shared contribution of DNAm between sexes. We identified strong, positive DNAm correlations between each of the body-fat traits (BMI, body-fat percentage, and waist-to-hip ratio, ranging from 0.96 to 1.00), finding larger associations than those identified by genetic and phenotypic correlations. We identified a significant deviation from 1 in the DNAm correlations for BMI between males and females, with sex-specific DNAm changes associated with BMI identified at eight DNAm probes. Employing genome-wide DNAm correlations to evaluate the similarities in the associations of DNAm with complex traits has provided insight into obesity-related traits beyond that provided by genetic correlations.

Blood-based epigenome-wide analyses of 19 common disease states: A longitudinal, population-based linked cohort study of 18,413 Scottish individuals.

BACKGROUND: DNA methylation is a dynamic epigenetic mechanism that occurs at cytosine-phosphate-guanine dinucleotide (CpG) sites. Epigenome-wide association studies (EWAS) investigate the strength of association between methylation at individual CpG sites and health outcomes. Although blood methylation may act as a peripheral marker of common disease states, previous EWAS have typically focused only on individual conditions and have had limited power to discover disease-associated loci. This study examined the association of blood DNA methylation with the prevalence of 14 disease states and the incidence of 19 disease states in a single population of over 18,000 Scottish individuals. METHODS AND FINDINGS: DNA methylation was assayed at 752,722 CpG sites in whole-blood samples from 18,413 volunteers in the family-structured, population-based cohort study Generation Scotland (age range 18 to 99 years). EWAS tested for cross-sectional associations between baseline CpG methylation and 14 prevalent disease states, and for longitudinal associations between baseline CpG methylation and 19 incident disease states. Prevalent cases were self-reported on health questionnaires at the baseline. Incident cases were identified using linkage to Scottish primary (Read 2) and secondary (ICD-10) care records, and the censoring date was set to October 2020. The mean time-to-diagnosis ranged from 5.0 years (for chronic pain) to 11.7 years (for Coronavirus Disease 2019 (COVID-19) hospitalisation). The 19 disease states considered in this study were selected if they were present on the World Health Organisation's 10 leading causes of death and disease burden or included in baseline self-report questionnaires. EWAS models were adjusted for age at methylation typing, sex, estimated white blood cell composition, population structure, and 5 common lifestyle risk factors. A structured literature review was also conducted to identify existing EWAS for all 19 disease states tested. The MEDLINE, Embase, Web of Science, and preprint servers were searched to retrieve relevant articles indexed as of March 27, 2023. Fifty-four of approximately 2,000 indexed articles met our inclusion criteria: assayed blood-based DNA methylation, had >20 individuals in each comparison group, and examined one of the 19 conditions considered. First, we assessed whether the associations identified in our study were reported in previous studies. We identified 69 associations between CpGs and the prevalence of 4 conditions, of which 58 were newly described. The conditions were breast cancer, chronic kidney disease, ischemic heart disease, and type 2 diabetes mellitus. We also uncovered 64 CpGs that associated with the incidence of 2 disease states (COPD and type 2 diabetes), of which 56 were not reported in the surveyed literature. Second, we assessed replication across existing studies, which was defined as the reporting of at least 1 common site in >2 studies that examined the same condition. Only 6/19 disease states had evidence of such replication. The limitations of this study include the nonconsideration of medication data and a potential lack of generalizability to individuals that are not of Scottish and European ancestry. CONCLUSIONS: We discovered over 100 associations between blood methylation sites and common disease states, independently of major confounding risk factors, and a need for greater standardisation among EWAS on human disease.

Robots for Elderly Care: Review, Multi-Criteria Optimization Model and Qualitative Case Study.

This paper focuses on three areas: the first is a review of current knowledge about social and service robots for elderly care. The second is an optimization conceptual model aimed at maximizing the efficiency of assigning robots to serve the elderly. The proposed multi-criteria optimization model is the first one proposed in the area of optimization for robot assignment for the elderly with robot utilization level and caregiver stress level. The third is the findings of studies on the needs, requirements, and adoption of technology in elderly care. We consider the use of robots as a part of the ENRICHME project for long-term interaction and monitoring of older persons with mild cognitive impairment, to optimize their independence. Additionally, we performed focus group discussions (FGD) to collect opinions about robot-related requirements of the elderly and their caregivers. Four FDGs of six persons were organized: two comprising older adults, and two of the other formal and informal caregivers, based on a detailed script. The statements of older participants and their caregivers were consistent in several areas. The analysis revealed user characteristics, robot-related issues, functionality, and barriers to overcome before the deployment of the robot. An introduction of the robot must be thoroughly planned, include comprehensive pre-training, and take the ethical and practical issues into account. The involvement of future users in the customization of the robot is essential.

Refining epigenetic prediction of chronological and biological age.

BACKGROUND: Epigenetic clocks can track both chronological age (cAge) and biological age (bAge). The latter is typically defined by physiological biomarkers and risk of adverse health outcomes, including all-cause mortality. As cohort sample sizes increase, estimates of cAge and bAge become more precise. Here, we aim to develop accurate epigenetic predictors of cAge and bAge, whilst improving our understanding of their epigenomic architecture. METHODS: First, we perform large-scale (N = 18,413) epigenome-wide association studies (EWAS) of chronological age and all-cause mortality. Next, to create a cAge predictor, we use methylation data from 24,674 participants from the Generation Scotland study, the Lothian Birth Cohorts (LBC) of 1921 and 1936, and 8 other cohorts with publicly available data. In addition, we train a predictor of time to all-cause mortality as a proxy for bAge using the Generation Scotland cohort (1214 observed deaths). For this purpose, we use epigenetic surrogates (EpiScores) for 109 plasma proteins and the 8 component parts of GrimAge, one of the current best epigenetic predictors of survival. We test this bAge predictor in four external cohorts (LBC1921, LBC1936, the Framingham Heart Study and the Women's Health Initiative study). RESULTS: Through the inclusion of linear and non-linear age-CpG associations from the EWAS, feature pre-selection in advance of elastic net regression, and a leave-one-cohort-out (LOCO) cross-validation framework, we obtain cAge prediction with a median absolute error equal to 2.3 years. Our bAge predictor was found to slightly outperform GrimAge in terms of the strength of its association to survival (HRGrimAge = 1.47 [1.40, 1.54] with p = 1.08 × 10-52, and HRbAge = 1.52 [1.44, 1.59] with p = 2.20 × 10-60). Finally, we introduce MethylBrowsR, an online tool to visualise epigenome-wide CpG-age associations. CONCLUSIONS: The integration of multiple large datasets, EpiScores, non-linear DNAm effects, and new approaches to feature selection has facilitated improvements to the blood-based epigenetic prediction of biological and chronological age.

Metabolomic Investigation of Major Depressive Disorder Identifies a Potentially Causal Association With Polyunsaturated Fatty Acids.

BACKGROUND: Metabolic differences have been reported between individuals with and without major depressive disorder (MDD), but their consistency and causal relevance have been unclear. METHODS: We conducted a metabolome-wide association study of MDD with 249 metabolomic measures available in the UK Biobank (n = 29,757). We then applied two-sample bidirectional Mendelian randomization and colocalization analysis to identify potentially causal relationships between each metabolite and MDD. RESULTS: A total of 191 metabolites tested were significantly associated with MDD (false discovery rate-corrected p < .05), which decreased to 129 after adjustment for likely confounders. Lower abundance of omega-3 fatty acid measures and a higher omega-6 to omega-3 ratio showed potentially causal effects on liability to MDD. There was no evidence of a causal effect of MDD on metabolite levels. Furthermore, genetic signals associated with docosahexaenoic acid colocalized with loci associated with MDD within the fatty acid desaturase gene cluster. Post hoc Mendelian randomization of gene-transcript abundance within the fatty acid desaturase cluster demonstrated a potentially causal association with MDD. In contrast, colocalization analysis did not suggest a single causal variant for both transcript abundance and MDD liability, but rather the likely existence of two variants in linkage disequilibrium with one another. CONCLUSIONS: Our findings suggest that decreased docosahexaenoic acid and increased omega-6 to omega-3 fatty acids ratio may be causally related to MDD. These findings provide further support for the causal involvement of fatty acids in MDD.

Sex differences in genetic architecture in the UK Biobank.

Males and females present differences in complex traits and in the risk of a wide array of diseases. Genotype by sex (GxS) interactions are thought to account for some of these differences. However, the extent and basis of GxS are poorly understood. In the present study, we provide insights into both the scope and the mechanism of GxS across the genome of about 450,000 individuals of European ancestry and 530 complex traits in the UK Biobank. We found small yet widespread differences in genetic architecture across traits. We also found that, in some cases, sex-agnostic analyses may be missing trait-associated loci and looked into possible improvements in the prediction of high-level phenotypes. Finally, we studied the potential functional role of the differences observed through sex-biased gene expression and gene-level analyses. Our results suggest the need to consider sex-aware analyses for future studies to shed light onto possible sex-specific molecular mechanisms.

Use of a Novel Polymer-Coated Steel as an Alternative to Traditional Can Manufacturing in the Food Industry.

Metal containers (both food and beverage cans) are made from huge steel or aluminum coils that are transformed into two- or three-piece products. During the manufacturing process, the metal is sprayed on both sides and the aerosol acts as insulation, but unfortunately produces volatile organic compounds (VOCs). The present work presents a different way to manufacture these containers using a novel prelaminated two-layer polymer steel. It was experimentally possible to verify that the material survives all the involved manufacturing processes. Thus tests were carried out in an ironing simulator to measure roughness, friction coefficient and surface quality. In addition, two theoretical ironing models were developed: upper bound model and artificial neural network. These models are useful for packaging designers and manufacturers.

Factor Structure and Psychometric Properties of Emotional Eater Questionnaire (EEQ) in Spanish Colleges.

Emotional eating (EE) patterns have been shown to play a relevant role in the development of overweight problems. However, there is a gap in research aimed at validating questionnaires to assess EE in specific populations. The aim of the study was to analyze factor structure and psychometric properties of Emotional Eater Questionnaire (EEQ) in Spanish universities. EEQ, state-anxiety subscale of STAI and a questionnaire about health habits were filled out by 295 students. Exploratory Factor Analysis (EFA) by using Unweight Least Squares (ULS) method was carried out. To determine factor numbers we used eigenvalues, parallel analysis, and goodness of fit statistics. Cronbach's alpha and Spearman correlations were used to analyze reliability, convergent, and concurrent validity. The parallel analysis and goodness of fit statistics showed that unifactorial structure of seven items was the most appropriate what accounted for 57% of the variance. Internal consistency was good (α = 0.753), as well as convergent validity (r = 0.317; p < 0.001). Concurrent validity was significant for three of the five criteria (r = -0.224; p < 0.001 and r = -0.259; p < 0.001). The results suggest some differences in the structure of the psychometric assessment of EE in sub-clinical population in comparison with previous studies carried on with an overweight population, what could be relevant to obesity prevention.

An Efficient COVID-19 Prediction Model Validated with the Cases of China, Italy and Spain: Total or Partial Lockdowns?

The present work develops an accurate prediction model of the COVID-19 pandemic, capable not only of fitting data with a high regression coefficient but also to predict the overall infections and the infection peak day as well. The model is based on the Verhulst equation, which has been used to fit the data of the COVID-19 spread in China, Italy, and Spain. This model has been used to predict both the infection peak day, and the total infected people in Italy and Spain. With this prediction model, the overall infections, the infection peak, and date can accurately be predicted one week before they occur. According to the study, the infection peak took place on 23 March in Italy, and on 29 March in Spain. Moreover, the influence of the total and partial lockdowns has been studied, without finding any meaningful difference in the disease spread. However, the infected population, and the rate of new infections at the start of the lockdown, seem to play an important role in the infection spread. The developed model is not only an important tool to predict the disease spread, but also gives some significant clues about the main factors that affect to the COVID-19 spread, and quantifies the effects of partial and total lockdowns as well.

A Multiomics Study To Unravel the Effects of Developmental Exposure to Endosulfan in Rats: Molecular Explanation for Sex-Dependent Effects.

Exposure to low levels of environmental contaminants, including pesticides, induces neurodevelopmental toxicity. Environmental and food contaminants can reach the brain of the fetus, affecting brain development and leading to neurological dysfunction. The pesticide endosulfan is a persistent pollutant, and significant levels still remain detectable in the environment although its use is banned in some countries. In rats, endosulfan exposure during brain development alters motor activity, coordination, learning, and memory, even several months after uptake, and does so in a sex-dependent way. However, the molecular mechanisms driving these effects have not been studied in detail. In this work, we performed a multiomics study in cerebellum from rats exposed to endosulfan during embryonic development. Pregnant rats were orally exposed to a low dose (0.5 mg/kg) of endosulfan, daily, from gestational day 7 to postnatal day 21. The progeny was evaluated for cognitive and motor functions at adulthood. Expression of messenger RNA and microRNA genes, as well as protein and metabolite levels, were measured on cerebellar samples from males and females. An integrative analysis was conducted to identify altered processes under endosulfan effect. Effects between males and females were compared. Pathways significantly altered by endosulfan exposure included the phosphatidylinositol signaling system, calcium signaling, the cGMP-PKG pathway, the inflammatory and immune system, protein processing in the endoplasmic reticulum, and GABA and taurine metabolism. Sex-dependent effects of endosulfan in the omics results that matched sex differences in cognitive and motor tests were found. These results shed light on the molecular basis of impaired neurodevelopment and contribute to the identification of new biomarkers of neurotoxicity.

Evaluación de dos guías de valoración de riesgos laborales en el embarazo / Assessment of two guideliness for occupatinal risks in pregnacy

Objetivos: El reconocimiento en España de la prestación derivada de contingencia profesional por exposición a riesgoslaborales en el embarazo originó que diversas instituciones elaboraran guías para orientar la actuación de los profesionales.El objetivo de este trabajo es evaluar la calidad de los métodos utilizados en la elaboración de las guías de la Asociación deMutuas de Accidentes de Trabajo (AMAT) y de la Sociedad Española de Ginecología y Obstetricia (SEGO), así como elcontenido de sus recomendaciones.Métodos: Estrategia de consenso formal en dos fases: valoración individual y reunión presencial. Para evaluar la calidadse utilizó el instrumento AGREE II estructurado en seis áreas generales (alcance y objetivos, rigor, participación, claridad,aplicabilidad e independencia). Se calcularon las puntuaciones estandarizadas por áreas (% sobre la máxima puntuaciónposible en cada área) y las medianas de respuesta por ítem. También se analizó la concordancia en las respuestas de los cincoevaluadores. Se evaluaron las similitudes y diferencias en las recomendaciones de ambas guías y la adecuación de las recomendacionesatendiendo a la experiencia profesional de cada evaluador y a la documentación científica disponible.Resultados: Las dos guías obtuvieron una evaluación global similar de calidad (<50%). La aplicabilidad fue el área peorevaluada en ambas guías (7%). El porcentaje de acuerdo general entre evaluadores fue superior al 75%. Los evaluadores semostraron más heterogéneos en la valoración de la adecuación de las recomendaciones presentes en las guías.Conclusiones: Ambas guías deberían ser modificadas, especialmente para mejorar su calidad general y las recomendacionesincluidas(AU)

Objectives: As a consequence of new legislation in Spain establishing particular conditions for the control of occupationalexposures during pregnancy, different Spanish associations have developed guides for professional practice. This paper evaluates the methodological quality and content of the guidelines of the Asociación de Mutuas de Accidentes de Trabajo(AMAT), an association of occupational health insurance companies, and the Sociedad Española de Ginecología y Obstetricia(SEGO), the Spanish professional society of obstetrics and gynecology.Methods: Formal consensus strategy in two phases: individual assessment and face-to-face meeting. To assess the quality,the AGREE II instrument was used, divided into six general areas (goals and objectives, rigor, participation, clarity,applicability, and independence). Standardized scores were calculated by area (as a percent of maximum score in each area),together with the medians of response to each item. Concordance among the five reviewers was also analyzed. Similaritiesand differences were also assessed, as was the adequacy of the recommendations in both guides according to the reviewers’own experience and the available scientific literature.Results: Both guides obtained similar overall quality scores (<50%). Applicability showed the lowest scores in bothguides (7%). The percentage of agreement between raters was greater than 75%. The experts showed greater heterogeneityregarding the adequacy of the recommendations in the guidelines.Conclusions: Both guides should be modified, mostly to improve their overall quality and recommendations(AU)

[Health Surveillance Guide of workers using video display terminals: evaluation from a visual health perspective]. / Protocolo de vigilancia sanitaria de trabajadores con pantallas de visualización de datos: una valoración desde la perspectiva de la salud visual.

BACKGROUND: Visual health surveillance is essential in the protection of workers who use video display terminals (VDT). In Spain, the most used is the Specific Health Surveillance Guide published in 1999 by the Ministry of Health. The increase of the scientific production upon computer related occupational visual hazards and the experience in its applicability during the last decade justify the aim of this work: reviewing the quality of the guide from the point of view of visual health. METHODS: A consensus strategy was used among nine experts by means of a mixed groupal technique in two consecutive stages combining some aspects of the Delphi method and of the nominal group: individual evaluation of the guide using the consensus guide made by the authors based on the AGREE instrument and the subsequent meeting in order to reach an agreement and to fix the final recommendations for improving it. For the analysis the standardized score of the review domains was calculated: scope and purpose, stakeholder involvement, rigour of development, clarity and presentation and applicability. It was also calculated for the items.' Concordance in the answers of the experts was also analyzed. RESULTS: All domains obtained scores under 50%. The applicability, rigour and stakeholder involvement during the development of the guide, where the most deficient domains. Six out of the nine experts would not recommend the guide and think it should be remade. CONCLUSIONS: The guide does not reach the necessary quality for the surveillance of the visual health of the workers who use VDT. Efforts must be focussed to improve the guide.