Air pollution associated with cardiopulmonary disease and mortality among participants with preserved ratio impaired spirometry.

BACKGROUND: Epidemiological evidence regarding the association between air pollutants and cardiopulmonary disease, mortality in individuals with preserved ratio impaired spirometry (PRISm), and their combined effects remains unclear. METHODS: We followed 36,149 participants with PRISm in the UK Biobank study. Annual concentrations of PM2.5, PM10, NO2, NOx, and SO2 at residential addresses were determined using a bilinear interpolation method, accounting for address changes. A multistate model assessed the dynamic associations between air pollutants and cardiopulmonary diseases and mortality in PRISm. Quantile g-computation was used to investigate the joint effects of air pollutants. RESULTS: Long-term exposure to PM2.5, PM10, NO2, NOx, and SO2 was significantly associated with the risk of cardiopulmonary disease in PRISm. The corresponding hazard ratios (HRs) [95 % confidence intervals (95 % CIs)] per interquartile range (IQR) were 1.49 (1.43, 1.54), 1.52 (1.46, 1.57), 1.34 (1.30, 1.39), 1.30 (1.26, 1.34), and 1.44 (1.41, 1.48), respectively. For mortality, the corresponding HRs (95 % CIs) per IQR were 1.36 (1.25, 1.47), 1.35 (1.24, 1.46), 1.27 (1.18, 1.36), 1.23 (1.15, 1.31), and 1.29 (1.20, 1.39), respectively. In PRISm, quantile g-computation analysis demonstrated that a quartile increase in exposure to a mixture of all air pollutants was positively associated with the risk of cardiopulmonary disease and mortality, with HRs (95 % CIs) of 1.84 (1.76, 3.84) and 1.45 (1.32, 1.57), respectively. CONCLUSION: Long-term individual and joint exposure to air pollutants (PM2.5, PM10, NO2, NOx, and SO2) might be an important risk factor for cardiopulmonary disease and mortality in high-risk populations with PRISm.

Social Protections and Climate Migration: Service Navigation among Puerto Ricans Displaced by Hurricane Maria.

As climate change continues to displace greater numbers of people, transnational ties are important sources of social protection for climate migrants. Migrants assemble unique configurations of formal and informal social protections depending on the resources available within their sending and receiving communities. However, the specific constellations of social protections that climate migrants use following disaster and displacement remain underexamined. Authors conducted semistructured interviews with Puerto Ricans who migrated in the aftermath of Hurricane Maria (N = 41) and used qualitative content analysis to trace the assemblages of formal and informal social protections used to navigate the resettlement process. Results suggest that informal support from migrants' transnational ties was instrumental in successfully making use of formal sources of support, including federal emergency relief programs, to leave the island and resettle on the U.S. mainland. This reliance on informal social protections often strained participants' informal networks and raised questions of equity for people internally displaced by climate change. These findings highlight the need for a more equitable and effective linkage of climate migrants with public resources.

Associations between urinary rare Earth elements with renal function: Findings from a cross-sectional study in Guangxi, China.

BACKGROUND: With increased applications of rare earth elements (REEs) across various industries, evaluating the relationship between REEs exposure and potential health effects has become a public concern. In vivo experiments have established that REEs impact renal function. However, relevant epidemiological evidence on this relationship remains scarce. The objective of this study is to examine the impact of exposure to REEs on renal function. METHODS: In this cross-sectional study, 1052 participants were recruited from Guangxi, China. We measured urinary concentrations of 12 REEs using an inductively coupled plasma-mass spectrometer (ICP-MS). Multiple linear regression models were developed to explore the relationship between a single REEs exposure and the estimated glomerular filtration rate (eGFR), a marker of renal function. Weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) were used to examine the combined effects of REE co-exposure on eGFR. RESULTS: In the multiple linear regression analysis, increasing the concentrations of lanthanum (La, ß: 8.22, 95% CI: 5.67-10.77), cerium (Ce, ß:6.61, 95% CI: 3.80-9.43), praseodymium (Pr, ß: 8.46, 95% CI: 5.85-11.07), neodymium (Nd, ß:8.75, 95% CI: 6.10-11.41), and dysprosium (Dy, ß:7.38, 95% CI: 4.85-9.91) significantly increased the eGFR. In the WQS regression model, the WQS index was significantly associated with eGFR (ß: 4.03, 95% CI: 2.46-5.60), with Pr having the strongest correlation with eGFR. Similar results were obtained in the BKMR model. Additionally, interactions between Pr and La, and Pr and Nd were observed. CONCLUSIONS: Co-exposure to REEs is positively associated with elevated eGFR. Pr is likely to have the most significant influence on increased eGFRs and this might be exacerbated when interacting with La and Nd. Mixed exposure to low doses of REEs had a protective effect on renal function, which can provide some evidence for the exposure threshold of REEs in the environment. TRIAL REGISTRATION: The study has been approved by the Guangxi Medical University Medical Ethics Committee (#20170206-1), and all participants provided written informed consent.

Regular use of fish oil supplements and course of cardiovascular diseases: prospective cohort study.

Objective: To examine the effects of fish oil supplements on the clinical course of cardiovascular disease, from a healthy state to atrial fibrillation, major adverse cardiovascular events, and subsequently death. Design: Prospective cohort study. Setting: UK Biobank study, 1 January 2006 to 31 December 2010, with follow-up to 31 March 2021 (median follow-up 11.9 years). Participants: 415 737 participants, aged 40-69 years, enrolled in the UK Biobank study. Main outcome measures: Incident cases of atrial fibrillation, major adverse cardiovascular events, and death, identified by linkage to hospital inpatient records and death registries. Role of fish oil supplements in different progressive stages of cardiovascular diseases, from healthy status (primary stage), to atrial fibrillation (secondary stage), major adverse cardiovascular events (tertiary stage), and death (end stage). Results: Among 415 737 participants free of cardiovascular diseases, 18 367 patients with incident atrial fibrillation, 22 636 with major adverse cardiovascular events, and 22 140 deaths during follow-up were identified. Regular use of fish oil supplements had different roles in the transitions from healthy status to atrial fibrillation, to major adverse cardiovascular events, and then to death. For people without cardiovascular disease, hazard ratios were 1.13 (95% confidence interval 1.10 to 1.17) for the transition from healthy status to atrial fibrillation and 1.05 (1.00 to 1.11) from healthy status to stroke. For participants with a diagnosis of a known cardiovascular disease, regular use of fish oil supplements was beneficial for transitions from atrial fibrillation to major adverse cardiovascular events (hazard ratio 0.92, 0.87 to 0.98), atrial fibrillation to myocardial infarction (0.85, 0.76 to 0.96), and heart failure to death (0.91, 0.84 to 0.99). Conclusions: Regular use of fish oil supplements might be a risk factor for atrial fibrillation and stroke among the general population but could be beneficial for progression of cardiovascular disease from atrial fibrillation to major adverse cardiovascular events, and from atrial fibrillation to death. Further studies are needed to determine the precise mechanisms for the development and prognosis of cardiovascular disease events with regular use of fish oil supplements.

High Dietary Intake of Iron Might Be Harmful to Atrial Fibrillation and Modified by Genetic Diversity: A Prospective Cohort Study.

Some studies suggest an association between iron overload and cardiovascular diseases (CVDs). However, the relationship between dietary iron intake and atrial fibrillation (AF) remains uncertain, as does the role of genetic loci on this association. The study involved 179,565 participants from UK Biobank, tracking incident atrial fibrillation (AF) cases. Iron intake was categorized into low, moderate, and high groups based on dietary surveys conducted from 2009 to 2012. The Cox regression model was used to estimate the risk of AF in relation to iron intake, assessing the hazard ratio (HR) and 95% confidence interval (95% CI). It also examined the impact of 165 AF-related and 20 iron-related genetic variants on this association. Pathway enrichment analyses were performed using Metascape and FUMA. During a median follow-up period of 11.6 years, 6693 (3.97%) incident AF cases were recorded. A total of 35,874 (20.0%) participants had high iron intake. High iron intake was associated with increased risk of AF [HR: 1.13 (95% CI: 1.05, 1.22)] in a fully adjusted model. Importantly, there were 83 SNPs (11 iron-related SNPs) that could enhance the observed associations. These genes are mainly involved in cardiac development and cell signal transduction pathways. High dietary iron intake increases the risk of atrial fibrillation, especially when iron intake exceeds 16.95 mg. The association was particularly significant among the 83 SNPs associated with AF and iron, the individuals with these risk genes. Gene enrichment analysis revealed that these genes are significantly involved in cardiac development and cell signal transduction processes.

Fresh fruit, dried fruit, raw vegetables, and cooked vegetables consumption associated with progression trajectory of type 2 diabetes: a multi-state analysis of a prospective cohort.

PURPOSE: To examine the effects of fresh fruit, dried fruit, raw vegetables, and cooked vegetables on type 2 diabetes (T2D) progression trajectory. METHODS: We included 429,886 participants in the UK Biobank who were free of diabetes and diabetes complications at baseline. Food groups were determined using a validated food frequency questionnaire. Outcomes were T2D incidence, complications, and mortality. Multi-state model was used to analyze the effects of food groups on T2D progression. RESULTS: During a follow-up of 12.6 years, 10,333 incident T2D cases were identified, of whom, 3961 (38.3%) developed T2D complications and 1169 (29.5%) died. We found that impacts of four food groups on T2D progression varied depending on disease stage. For example, compared to participants who ate less than one piece of dried fruit per day, the hazard ratios and 95% confidence intervals for those who ate ≥ 2 pieces of dried fruit per day were 0.82 (0.77, 0.87), 0.88 (0.85, 0.92), and 0.86 (0.78, 0.95) for transitions from diabetes-free state to incident T2D, from diabetes-free state to total death, and from incident T2D to T2D complications, respectively. Higher intake of fresh fruit was significantly associated with lower risk of disease progression from diabetes-free state to all-cause death. Higher intake of raw and cooked vegetables was significantly associated with lower risks of disease progression from diabetes-free state to incident T2D and to total death. CONCLUSIONS: These findings indicate that higher intake of fresh fruit, dried fruit, raw vegetables, and cooked vegetables could be beneficial for primary and secondary prevention of T2D.

Associations of glycosylated hemoglobin, pre-diabetes, and type 2 diabetes with incident lung cancer: A large prospective cohort study.

BACKGROUND: The association of pre-diabetes and type 2 diabetes (T2D) with incident lung cancer is uncertain, and the incident risk across the glycemic spectrum is unclear. We aimed to explore the associations of glycosylated hemoglobin (HbA1c), pre-diabetes, and T2D with incident lung cancer in a large prospective cohort. METHODS: Leveraging a total of 210,779 cancer-free adults recruited in the UK Biobank between 2006 and 2010. We performed multivariable Cox proportional hazards models and restricted cubic spline methods to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the associations of HbA1c, pre-diabetes, and T2D with incident lung cancer. RESULTS: During a median follow-up of 11.06 years, 1738 incident lung cancer cases were ascertained. The incidence of lung cancer was 20% higher among people with diabetes (HR: 1.20, 95% CI: 1.02 to 1.42) and 38% higher among people with pre-diabetes (HR: 1.38, 95% CI: 1.15 to 1.65). After dividing people with diabetes by whether taking antidiabetic medications, the incidence was 28% higher among people with diabetes without medications (HR: 1.28, 95% CI: 1.02 to 1.61) and 15% higher among people with diabetes with medications (HR: 1.15, 95% CI: 0.93 to 1.41). The increased risk of incident lung cancer for each standard deviation (6.45 mmol/mol) increase in HbA1c was more pronounced across HbA1c values of 32-42 mmol/mol (HR: 1.37, 95% CI: 1.18 to 1.59). The risk was more pronounced among participants <60 years. CONCLUSIONS: Pre-diabetes and T2D are associated with an increased incidence of lung cancer. The increased risk of incident lung cancer is more pronounced across HbA1c values of 32-42 mmol/mol, which are currently considered normal values.

Association between outdoor light at night and hypertension and high-normal blood pressure: A nationwide cross-sectional study among Chinese adults.

The authors aimed to investigate the association between outdoor light at night (LAN) intensity and blood pressure. The study included 13 507 participants aged 45 and above from the 2011-2012 China Health and Retirement Longitudinal Study baseline survey. Blood pressure measurements were obtained by averaging the last two readings recorded (three measurements with an interval of 45-60 s between each measurement) during the survey. Outdoor LAN intensity was assessed using Defense Meteorological Satellite Program data. The study categorized participants based on quartiles of outdoor LAN intensity and employed statistical methods like linear regression, restricted cubic splines, and logistic models to analyze the connections. After adjusting for potential confounding factors, higher levels of outdoor LAN intensity were associated with increase in systolic blood pressure (0.592 mmHg/interquartile range [IQR], 95% confidence interval [CI]: 0.027,1.157), diastolic blood pressure (0.853 mmHg/IQR, 95% CI: 0.525,1.180) and mean arterial pressure (0.766 mmHg/IQR, 95% CI: 0.385,1.147). Interestingly, the relationship between LAN intensity and odds of hypertension followed a non-linear pattern, resembling a reverse "L" shape on cubic splines. Participants with the highest quartile of outdoor LAN intensity had 1.31-fold increased odds of hypertension (95% CI: 1.08-1.58) compared to the lowest quartile. Additionally, there was an observable trend of rising odds for high-normal blood pressure with higher levels of LAN intensity in the crude model, but no statistically significant differences were observed after adjusting for confounding factors. In conclusion, this study underscores a significant connection between outdoor LAN intensity and the prevalence of hypertension.

A machine learning approach using migration-related cultural stress to classify depression and post-traumatic stress disorder among hurricane survivors.

BACKGROUND: Data science approaches have increasingly been used in behavioral health research and may be useful for addressing social factors contributing to disparities in health status. This study evaluated the importance of cultural stress-related factors in classifying depression and post-traumatic stress disorder (PTSD) among adult survivors (N = 319) of Hurricane Maria who migrated from Puerto Rico to the United States mainland. METHODS: We evaluated the performance of random forests (RF) and logistic regression (LR) for classifying PTSD and depression. Models included demographic, hurricane exposure, and migration-related cultural stress variables. We inspected area under the receiver operating characteristic curve (AUC), accuracy, balanced accuracy, F1 score, precision, recall, and specificity. RESULTS: Negative context of reception and language-related stressors were moderately important for accurately classifying depression and PTSD. For classifying depression, RF showed higher accuracy, balanced accuracy, specificity, precision, and F1. For classifying PTSD, RF showed higher accuracy, specificity, precision, and F1. LIMITATIONS: A more thorough classification model would also include biomarkers (e.g., of allostatic load), family, community, or neighborhood-level attributes. Findings may not generalize to other groups who have experienced crisis-related migration. CONCLUSIONS: Findings underscore the importance of culturally and linguistically appropriate and trauma-informed clinical services for recent migrants. Use of assessments to identify pre-migration and post-migration stressors could inform clinical practice with migrants presenting with behavioral health-related difficulties.

Associations between air pollution and the risk of first admission and multiple readmissions for cardiovascular diseases.

OBJECTIVES: We aimed to investigate the associations between air pollutants and the risk of admission and multiple readmission events for cardiovascular disease (CVD). METHODS: A total of 285 009 participants free of CVD at baseline from the UK Biobank were included in this analysis. Four major cardiovascular admission events were identified during the follow-up: chronic ischaemic heart disease (CIHD), cerebrovascular disease, atrial fibrillation and heart failure. We used Prentice, Williams and Peterson-Total Time model to examine the association between ambient air pollution and first admission, as well as multiple readmissions for these CVDs. RESULTS: During a median follow-up of 12 years, 17 176 (6.03%) participants were hospitalised with CVDs, and 6203 (36.11%) patients with CVD had subsequent readmission events for CVDs. We observed significant associations between air pollution and both first admission and readmission for CVDs, with generally stronger associations on readmission for cardiovascular events. For example, the adjusted HRs for the first admission and subsequent readmission for cerebrovascular disease were 1.130 (95% CI 1.070 to 1.194) and 1.270 (95% CI 1.137 to 1.418) for each IQR increase of particulate matter with a diameter ≤2.5 µm. The corresponding HRs for CIHD were 1.060 (95% CI 1.008 to 1.114) and 1.120 (95% CI 1.070 to 1.171). Sex stratified analyses showed that the associations were generally more pronounced among females than males. CONCLUSION: This study provides evidence that ambient air pollutants might play an important role in both first admission and readmission for cardiovascular events. In addition, patients with pre-existing CVDs may be more vulnerable to air pollution compared with healthy population.

Opioid Misuse and Associated Health Risks among Adults on Probation and Parole: Prevalence and Correlates 2015-2020.

BACKGROUND: As state legislatures work to reduce prison populations and increase the use of community-based alternatives, limited knowledge exists about the service needs of those under criminal justice supervision in the community. Preliminary research indicates unusually high rates of disease, disability, and death. Health risks for this population include opioid misuse, a form of substance misuse that has reached epidemic proportions in the U.S. Evidence indicates this may be one of multiple epidemics this population experiences, complicating intervention. METHODS: Our study included 5154 individuals on probation or parole. Using 2015-2020 data from the National Survey of Drug Use and Health (NSDUH), we conducted a series of logistic regressions examining associations between opioid misuse and a range of health risks, controlling for sociodemographic variables and survey year. RESULTS: Approximately 17% of those on probation or parole indicated past-year opioid misuse, a rate 4 times higher than in the general population. Compared to those on probation and parole who did not misuse opioids, it was associated with higher odds of other health risk behaviors and mental health problems. For example, the odds of marijuana and cocaine use were 4-6 times higher and the odds of substance use disorder were 10 times higher. Similarly, the odds of experiencing major depressive episodes and serious psychological distress were 2-3 times higher. CONCLUSIONS: Our findings reveal a markedly high risk for opioid misuse within this population along with associated risks for behavioral and mental health problems. The complex treatment needs of this population require greater policy attention and further research.

Prenatal Exposure to PFAS, Associations with Preterm Birth and Modification by Maternal Estrogen Levels: The Maoming Birth Study.

BACKGROUND: Estrogens play a critical role in parturition, and poly- and perfluoroalkyl substances (PFAS), which have estrogenic effects, have been associated with preterm birth. However, the impact of estrogens on the association between PFAS and preterm birth is unknown. OBJECTIVE: The objective of this study is to investigate if estrogens modified the association between PFAS and preterm birth, using a nested case-control study design. METHODS: A total of 371 preterm births and 508 controls were selected from a birth cohort study in China between 2016 and 2018. Perfluorobutanoic acid (PFBA), perfluorohexanesulfonic acid (PFHxS) and its branched isomer, perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS) and its branched isomer, and perfluorononanoic acid (PFNA) were quantified in maternal serum (mean gestational age of 32 wk). Estradiol and estriol were quantified in cord serum. Preterm birth was defined as live delivery at <37 gestational weeks. Causal mediation analysis was used to estimate the mediation and interaction effects of estrogen on the association between PFAS and preterm birth. Latent profile analysis was used to identify important estrogen profiles. Multiple linear regression was used to estimate associations between PFAS and preterm birth and interactions between PFAS and estrogens on preterm birth. RESULTS: Overall, higher odds ratios (ORs) of preterm birth were associated with each 1 ln-unit PFAS increase: PFBA [1.20, 95% confidence interval (CI): 1.14, 1.26], PFNA (1.30, 95% CI: 1.21, 1.39), PFOA (1.98, 95% CI: 1.54, 2.55), and PFOS (1.91, 95% CI: 1.76, 2.07) and its branched isomer (1.91, 95% CI: 1.90, 1.92). We detected statistically significant interactions between cord estradiol and PFAS on preterm birth, while no mediation effects of cord estrogen were observed. The ORs of PFOS (4.29, 95% CI: 1.31, 8.25), its branched isomer (6.71, 95% CI: 1.06, 11.91), and preterm birth were greater for participants with high cord estrogen levels than for participants with low cord estrogen levels. DISCUSSION: Our findings suggest that estrogen modified the association between maternal PFAS exposure and preterm birth. Further studies on maternal PFAS exposure and preterm birth, taking interaction effects of cord estrogens into account, are warranted. https://doi.org/10.1289/EHP11377.

Firearm injury among people experiencing homelessness: Cross-sectional evidence from a national survey of United States emergency departments.

Objectives: Persons experiencing homelessness (PEH) are at high risk for violent victimization. This study leverages unique data from a national study in the United States of America to provide estimates of non-fatal firearm injury among PEH and to describe the contexts related to injury, such as substance use, intent of the injury, and precipitating interpersonal factors. Study design: Cross-sectional. Methods: Data from the 1993-2020 National Electronic Injury Surveillance System-Firearm Injury Surveillance Study (NEISS-FISS) were used to describe the context and characteristics of non-fatal firearm injury among PEH aged 16 years or older. Homeless status and substance use data were extracted from a de-identified narrative field. Estimates were weighted to account for the NEISS-FISS complex sampling design. Results: Probable homelessness was identified in 0.10% of cases (n = 3,225). Substance use was documented in 22.73% of cases. Assault comprised 82.64% of injuries. Patients were mostly male (81.38%). Missing data were common on contextual variables: verbal argument (64.62%), physical fight (54.48%) or other criminal activity (62.33%). Conclusions: Assault is a leading cause of non-fatal firearm injury for PEH and is greater than rates of assault in non-fatal firearm injuries in the general population. Substance use was documented in nearly one quarter of patients, although this is less than expected given prior evidence. Reliance on narrative fields for key variables likely underestimates rates of PEH and substance use.

Ranking age-specific modifiable risk factors for cardiovascular disease and mortality: evidence from a population-based longitudinal study.

Background: Cardiovascular disease (CVD) remains a paramount contemporary health challenge. This study examined age-specific effects of 14 risk factors on CVD and mortality in different age groups. Methods: We analyzed data from 226,759 CVD-free participants aged 40 years and older in the UK Biobank during the period from baseline time (2006-2010) to September 30, 2021. The primary CVD outcome was a composite of incident coronary artery disease, heart failure, and stroke. We calculated age-specific hazard ratios (HRs) and population-attributable fractions (PAF) for CVD and mortality associated with 14 potentially modifiable risk factors. Findings: During 12.17-year follow-up, 23,838 incident CVD cases and 11,949 deaths occurred. Age-specific disparities were observed in the risk factors contributing to CVD, and the overall PAF declined with age (PAF of 56.53% in middle-age; 49.78% in quinquagenarian; 42.45% in the elderly). Metabolic factors had the highest PAF in each age group, with hypertension (14.04% of the PAF) and abdominal obesity (9.58% of the PAF) being prominent. Behavioral factors had the highest PAF in the middle-aged group (10.68% of the PAF), and smoking was the leading behavioral factor in all age groups. In socioeconomic and psychosocial risk clusters, low income contributed most among middle-aged (3.74% of the PAF) and elderly groups (3.66% of the PAF), while less education accounted more PAF for quinquagenarian group (4.46% of the PAF). Similar age-specific patterns were observed for cardiovascular subtypes and mortality. Interpretation: A large fraction of CVD cases and deaths were associated with modifiable risk factors in all age groups. Targeted efforts should focus on the most impactful risk factors, as well as age-specific modifiable risk factors. These findings may inform the development of more precise medical strategies to prevent and manage CVD and related mortality. Funding: The work was supported by the Bill & Melinda Gates Foundation (grant number: INV-016826 to Hualiang Lin) and the National Natural Science Foundation of China (grant number: 82373534 to Hualiang Lin).

Associations of Sleep Patterns With Dynamic Trajectory of Cardiovascular Multimorbidity and Mortality: A Multistate Analysis of a Large Cohort.

Background The purpose of this study was to explore the association of sleep patterns with the development of first cardiovascular diseases (FCVD), progression to cardiovascular multimorbidity (CVM), and subsequently to mortality. Methods and Results This prospective study included 381 179 participants without coronary heart disease, stroke, atrial fibrillation, or heart failure at baseline, and they were followed up until March 31, 2021. We generated sleep patterns by summing the scores for 5 sleep behaviors, whereby <7 or >8 hours/d of sleep, evening chronotype, frequent insomnia, snoring, and daytime dozing were defined as high-risk groups. We used a multistate model to estimate the impacts of sleep patterns on the dynamic progression of cardiovascular diseases. Over a median follow-up of 12.1 years, 41 910 participants developed FCVD, 7302 further developed CVM, and 20 707 died. We found that adverse sleep patterns were significantly associated with the transition from health to FCVD, from FCVD to CVM, and from health to death, with hazard ratio associated with 1-factor increase in sleep scores being 1.08 (95% CI, 1.07-1.09), 1.04 (95% CI, 1.02-1.06), and 1.04 (95% CI, 1.02-1.05), respectively. When further dividing FCVD into coronary heart disease, stroke, atrial fibrillation, and heart failure, adverse sleep patterns showed a significant and persistent effect on the transition from health to each cardiovascular disease, and from heart failure or atrial fibrillation to CVM. Conclusions Our study provides evidence that adverse sleep patterns might increase the risk for the progression from health to cardiovascular diseases and further to CVM. Our findings suggest that improving sleep behaviors might be helpful for the primary and secondary prevention of cardiovascular diseases.

Prevalence and correlates of knife-related victimization: Insights from the 2019 Nationwide Emergency Department Sample.

Few studies have explored the incidence and general trends in knife-related victimizations in the United States (US), especially in settings where preventive interventions can potentially be initiated such as emergency departments (EDs). The goal of the present investigation was to provide an empirical portrait of the psychosocial and behavioral health characteristics of patients assaulted by sharp objects, particularly knives, as revealed in EDs in the US, as less research has focused on knife victimization in the US than internationally. This study uses data from the 2019 Nationwide Emergency Department Sample (NEDS), which is part of the Healthcare Cost and Utilization Project distributed by the Agency for Healthcare Research and Quality. Findings revealed that demographically males (especially those aged 18-25), those in poverty, and members of racially minoritized groups were more likely to be present with knife-related assault. Key factors increasing the odds of knife-related victimization treated in EDs were homelessness, legal involvement, and substance use, particularly alcohol and stimulant use disorder. Somewhat surprisingly, mental health diagnosis was not associated with increased knife-related victimization. Although EDs are critical to treating knife-related victimization, they are also potentially key points to launch prevention for high-risk individuals to reduce subsequent violence stemming from escalation of interpersonal disputes.

Driving under the influence of cannabis and alcohol: Evidence from a national sample of young drivers.

OBJECTIVE: Driving under the influence (DUI) of psychoactive substances is an important public health and criminal justice issue, impacting the lives of millions of Americans. Although recent research provides up-to-date information regarding DUI among adults, there is a pressing need for research that focuses specifically on younger/underage drivers. We draw from a large, nationally-representative sample to provide up-to-date evidence as to the prevalence and key criminal justice, substance use, and behavioral health correlates of DUI of cannabis and alcohol among drivers ages 16 to 20 in the United States. METHODS: We used data from the 2020 and 2021 National Survey on Drug Use and Health (young drivers ages 16-20; N=12,863). All analyses-survey adjusted prevalence estimates, logistic regression-were conducted using Stata SE 17.0 and weighted to account for the study's stratified cluster sampling design. RESULTS: The prevalence of DUI-cannabis for the full sample-including those not endorsing past-year use-was 6.3%. Among youth endorsing past-year cannabis use, 24.5% reported DUI of cannabis. In the full sample and among cannabis users, DUI-cannabis risk was elevated among older and male youth. The prevalence of DUI-alcohol was 2.6% among all youth and 6.1% among youth reporting past-year alcohol consumption. CONCLUSIONS: Estimates indicate that more than one million young drivers each year are placing their lives and those of others at risk by operating motor vehicles after consuming cannabis and/or alcohol. Findings underscore the importance of prevention efforts targeting underaged cannabis and alcohol-impaired driving.

An Examination of Economic Strain, Negative Emotions, and Low Self-Control: A Test With Institutionalized Juveniles.

Strain and low self-control theory are two prominent theories of crime. However, there has been little research comparing the two perspectives to examine their relationship to self-reported delinquency among institutionalized juveniles. We begin to address this gap in the literature by assessing the impacts of economic strain, negative emotions, and low self-control on the commission of property and violent crime using a near census of institutionalized delinquents from Missouri. Results indicated self-control was more essential to understanding both property and violent crime among institutionalized youth as compared to economic strain and negative emotions. Any associations between negative emotions and delinquency were mediated by the effect of low self-control. The theoretical and practical implications of these results are discussed.

Correlates of Homelessness Among Adults with Personality Disorder.

Although personality disorders (PDs) are more common among persons experiencing homelessness than the general population, few studies have investigated the risk of experiencing homelessness among persons with PDs. This study seeks to identify the demographic, socioeconomic, and behavioral health correlates of past-year homelessness among persons with antisocial, borderline, and schizotypal PDs. Nationally representative data of the civilian, noninstitutionalized population of the United States was used to identify correlates of homelessness. Descriptive statistics and bivariate associations between variables and homeless status were summarized prior to conducting several multivariate logistic regression models to identify correlates of homelessness. Main findings revealed positive associations between poverty, relationship dysfunction, and lifetime suicide attempt with homelessness. In the antisocial PD (ASPD) and borderline PD (BPD) models, comorbid BPD and ASPD, respectively, were associated with higher odds of past-year homelessness. Findings underscore the importance of poverty, interpersonal difficulties, and behavioral health comorbidities on homelessness among persons with ASPD, BPD, and schizotypal PD. Strategies to promote economic security, stable relationships, and interpersonal functioning may buffer against the effects of economic volatility and other systemic factors that could contribute to homelessness and persons with PD.

Sexual minorities and substance use treatment utilization: New evidence from a national sample.

INTRODUCTION: Minority stress theory suggests that sexual minorities would be, on average, less likely than heterosexual individuals to seek out substance use treatment (due to concerns of stigma and rejection). However, prior research on the subject is mixed, and largely dated. In light of historic increases in societal acceptance and legal protections for sexual minorities, the field needs an up-to-date assessment of treatment utilization among this population. METHODS: This study used data from the 2015-2019 National Survey on Drug Use and Health to examine the association between key independent variables (sexual identity, gender) and substance use treatment utilization using binary logistic regression. We conducted analyses using a sample of adults with a past-year substance use disorder (N = 21,926). RESULTS: Controlling for demographic factors, with heterosexual individuals as the comparison group, gay/lesbian individuals (AOR = 2.12, CI = 1.19-3.77) were significantly more likely and bisexual individuals (AOR = 0.49, CI = 0.24-1.00) significantly less likely to report treatment utilization. Bisexual individuals were also less likely than gay/lesbian individuals to report treatment utilization (AOR = 0.10, CI = 0.05-0.23). Interaction tests examining sexual orientation and gender showed no difference in treatment utilization between gay men and lesbian women, and revealed that bisexual identity was associated with decreased likelihood of treatment utilization for men (p = .004) but not for women. CONCLUSION: Sexual orientation, particularly in the context of social identity, plays a significant role in substance use treatment utilization. Bisexual men face unique barriers to treatment, which is concerning given the high rates of substance use among this and other sexual minority populations.