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1.
Hum Mol Genet ; 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31600786

RESUMO

We previously identified five SNPs at four susceptibility loci for diffuse large B-cell lymphoma (DLBCL) in individuals of European ancestry through a large genome-wide association study (GWAS). To further elucidate genetic susceptibility to DLBCL, we sought to validate 2 loci at 3q13.33 and 3p24.1 that were suggestive in the original GWAS with additional genotyping. In the meta-analysis (5,662 cases and 9,237 controls) of the four original GWAS discovery scans and three replication studies, the 3q13.33 locus (rs9831894; minor allele frequency [MAF]=0.40) was associated with DLBCL risk (OR=0.83, P=3.62x10-13). rs9831894 is in linkage disequilibrium (LD) with additional variants that are part of a super-enhancer that physically interacts with promoters of CD86 and ILDR1. In the meta-analysis (5,510 cases and 12,817 controls) of the four GWAS discovery scans and four replication studies, the 3p24.1 locus (rs6773363; MAF=0.45) was also associated with DLBCL risk (OR=1.20, P=2.31x10-12). This SNP is 29,426 bp upstream of the nearest gene EOMES and in LD with additional SNPs that are part of a highly lineage-specific and tumor-acquired super-enhancer that shows long-range interaction with AZI2 promoter. These loci provide additional evidence for the role of immune function in the etiology of DLBCL, the most common lymphoma subtype.

3.
Am J Epidemiol ; 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31364705

RESUMO

In this study, we identified plasma metabolites associated with habitual physical activity among 5197 U.S. participants from the Nurses' Health Study (NHS), NHSII, and the Health Professional Follow-up Study (HPFS). Physical activity was assessed every 2-4 years by self-reported questionnaires. Blood was collected in the NHS between 1989-1990, NHSII during 1996-1999, and the HPFS during 1993-1995. Metabolic profiling was conducted by liquid chromatography-mass spectrometry (LC-MS). Our study included 337 known metabolites, with 256 of them classified as lipids. We corrected for multiple testing by controlling the tail probability of the proportion of false positives (TPPFP) and accounted for correlated tests using bootstrapping. We independently replicated the identified metabolites among 2305 women in the Women's Health Initiative (WHI) in 1993. After adjusting for multiple variables including body mass index, physical activity was significantly associated with 20 metabolites after correcting for multiple testing (TPPFP<0.05). Specifically, physical activity was positively associated with two amino acids (citrulline and glycine), four cholesteryl esters [CEs] (C18:2, C18:1, C16:0, and C18:3), eight phosphocholines [PCs] and lysophosphatidylcholines [LPCs] (C36:4 PC-A, C34:3 PC plasmalogen, C36:3 PC plasmalogen, C34:2 PC plasmalogen, C36:2 PC, C18:2 LPC, C20:5 LPC, and C18:1 LPC), and three phosphatidylethanolamines [PEs] and lysophosphatidylethanolamines [LPEs] (C18:2 LPE, C18:1 LPE, and C38:3 PE plasmalogen). Half of the identified metabolites were replicated in the WHI. Our study may help identify biomarkers of physical activity and provide insight into biological mechanisms underlying the beneficial effect of being physically active on cardiometabolic health.

4.
Blood ; 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31420334

RESUMO

Venous thromboembolism (VTE) is a significant contributor to morbidity and mortality. To advance our understanding of the biology contributing to VTE, we conducted a genome-wide association study (GWAS) of VTE and a transcriptome-wide association study (TWAS) based on imputed gene expression from whole blood and liver. We meta-analyzed GWAS data from 18 studies for 30,234 VTE cases and 172,122 controls and assessed the association between 12,923,718 genetic variants and VTE. We generated variant prediction scores of gene expression from whole blood and liver tissue and assessed them for association with VTE. Mendelian randomization analyses were conducted for traits genetically associated with novel VTE loci. We identified 34 independent genetic signals for VTE risk from GWAS meta-analysis of which 14 are newly reported associations. This included 11 newly associated genetic loci (C1orf198, PLEK, OSMR-AS1, NUGGC/SCARA5, GRK5, MPHOSPH9, ARID4A, PLCG2, SMG6, EIF5A, and STX10) of which 6 replicated, and 3 new, independent signals in 3 known genes. Further, TWAS identified 5 additional genetic loci with imputed gene expression levels differing between cases and controls in whole blood (SH2B3, SPSB1, RP11-747H7.3, RP4-737E23.2) and in liver (ERAP1). At some GWAS loci, we found suggestive evidence that the VTE association signal for both novel and previously known regions co-localized with eQTL signals. Mendelian randomization analyses suggested that blood traits may contribute to the underlying risk of VTE. To conclude, we identified 16 novel susceptibility loci for VTE; for some loci, the association signals are likely mediated through gene expression of nearby genes.

5.
Cereb Cortex ; 2019 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-31329834

RESUMO

The functional heterogeneity of the ventromedial prefrontal cortex (vmPFC) suggests it may include distinct functional subregions. To date these have not been well elucidated. Regions with differentiable connectivity (and as a result likely dissociable functions) may be identified using emergent data-driven approaches. However, prior parcellations of the vmPFC have only considered hard splits between distinct regions, although both hard and graded connectivity changes may exist. Here we determine the full pattern of change in structural and functional connectivity across the vmPFC for the first time and extract core distinct regions. Both structural and functional connectivity varied along a dorsomedial to ventrolateral axis from relatively dorsal medial wall regions to relatively lateral basal orbitofrontal cortex. The pattern of connectivity shifted from default mode network to sensorimotor and multimodal semantic connections. This finding extends the classical distinction between primate medial and orbital regions by demonstrating a similar gradient in humans for the first time. Additionally, core distinct regions in the medial wall and orbitofrontal cortex were identified that may show greater correspondence to functional differences than prior hard parcellations. The possible functional roles of the orbitofrontal cortex and medial wall are discussed.

6.
BMC Bioinformatics ; 20(1): 407, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31357927

RESUMO

BACKGROUND: Ontologies are invaluable in the life sciences, but building and maintaining ontologies often requires a challenging number of distinct tasks such as running automated reasoners and quality control checks, extracting dependencies and application-specific subsets, generating standard reports, and generating release files in multiple formats. Similar to more general software development, automation is the key to executing and managing these tasks effectively and to releasing more robust products in standard forms. For ontologies using the Web Ontology Language (OWL), the OWL API Java library is the foundation for a range of software tools, including the Protégé ontology editor. In the Open Biological and Biomedical Ontologies (OBO) community, we recognized the need to package a wide range of low-level OWL API functionality into a library of common higher-level operations and to make those operations available as a command-line tool. RESULTS: ROBOT (a recursive acronym for "ROBOT is an OBO Tool") is an open source library and command-line tool for automating ontology development tasks. The library can be called from any programming language that runs on the Java Virtual Machine (JVM). Most usage is through the command-line tool, which runs on macOS, Linux, and Windows. ROBOT provides ontology processing commands for a variety of tasks, including commands for converting formats, running a reasoner, creating import modules, running reports, and various other tasks. These commands can be combined into larger workflows using a separate task execution system such as GNU Make, and workflows can be automatically executed within continuous integration systems. CONCLUSIONS: ROBOT supports automation of a wide range of ontology development tasks, focusing on OBO conventions. It packages common high-level ontology development functionality into a convenient library, and makes it easy to configure, combine, and execute individual tasks in comprehensive, automated workflows. This helps ontology developers to efficiently create, maintain, and release high-quality ontologies, so that they can spend more time focusing on development tasks. It also helps guarantee that released ontologies are free of certain types of logical errors and conform to standard quality control checks, increasing the overall robustness and efficiency of the ontology development lifecycle.


Assuntos
Ontologias Biológicas , Software , Fluxo de Trabalho , Doença , Humanos , Linguagens de Programação
7.
Am J Hum Genet ; 105(1): 15-28, 2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31178129

RESUMO

Circulating levels of adiponectin, an adipocyte-secreted protein associated with cardiovascular and metabolic risk, are highly heritable. To gain insights into the biology that regulates adiponectin levels, we performed an exome array meta-analysis of 265,780 genetic variants in 67,739 individuals of European, Hispanic, African American, and East Asian ancestry. We identified 20 loci associated with adiponectin, including 11 that had been reported previously (p < 2 × 10-7). Comparison of exome array variants to regional linkage disequilibrium (LD) patterns and prior genome-wide association study (GWAS) results detected candidate variants (r2 > .60) spanning as much as 900 kb. To identify potential genes and mechanisms through which the previously unreported association signals act to affect adiponectin levels, we assessed cross-trait associations, expression quantitative trait loci in subcutaneous adipose, and biological pathways of nearby genes. Eight of the nine loci were also associated (p < 1 × 10-4) with at least one obesity or lipid trait. Candidate genes include PRKAR2A, PTH1R, and HDAC9, which have been suggested to play roles in adipocyte differentiation or bone marrow adipose tissue. Taken together, these findings provide further insights into the processes that influence circulating adiponectin levels.

8.
Ann Rheum Dis ; 78(10): 1412-1419, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31243017

RESUMO

OBJECTIVES: Disability prevention strategies are more achievable before osteoarthritis disease drives impairment. It is critical to identify high-risk groups, for strategy implementation and trial eligibility. An established measure, gait speed is associated with disability and mortality. We sought to develop and validate risk stratification trees for incident slow gait in persons at high risk for knee osteoarthritis, feasible in community and clinical settings. METHODS: Osteoarthritis Initiative (derivation cohort) and Multicenter Osteoarthritis Study (validation cohort) participants at high risk for knee osteoarthritis were included. Outcome was incident slow gait over up to 10-year follow-up. Derivation cohort classification and regression tree analysis identified predictors from easily assessed variables and developed risk stratification models, then applied to the validation cohort. Logistic regression compared risk group predictive values; area under the receiver operating characteristic curves (AUCs) summarised discrimination ability. RESULTS: 1870 (derivation) and 1279 (validation) persons were included. The most parsimonious tree identified three risk groups, from stratification based on age and WOMAC Function. A 7-risk-group tree also included education, strenuous sport/recreational activity, obesity and depressive symptoms; outcome occurred in 11%, varying 0%-29 % (derivation) and 2%-23 % (validation) depending on risk group. AUCs were comparable in the two cohorts (7-risk-group tree, 0.75, 95% CI 0.72 to 0.78 (derivation); 0.72, 95% CI 0.68 to 0.76 (validation)). CONCLUSIONS: In persons at high risk for knee osteoarthritis, easily acquired data can be used to identify those at high risk of incident functional impairment. Outcome risk varied greatly depending on tree-based risk group membership. These trees can inform individual awareness of risk for impaired function and define eligibility for prevention trials.

9.
J Acoust Soc Am ; 145(2): 1117, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30823810

RESUMO

Hospital soundscapes can be difficult environments to assess acoustically due to alarms, medical equipment, and the continuous activity within units. Routinely, patients perceive these soundscapes to be poor when rating their hospital experience on HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) surveys administered after discharge. In this study, five hospital units of widely varying HCAHPS "quietness" performance were analyzed. Sound pressure levels were measured in 15 patient rooms and 5 nursing stations over 24-h periods. HCAHPS "quietness of the hospital environment" patient survey data were correlated with measured acoustical data at a room-level, revealing acoustical metrics linked to patient perceptions of hospital soundscape conditions. Metrics found to be statistically correlated (p < 0.05) included the absolute LAMIN levels in patient rooms, which found significantly higher HCAHPS quietness scores in units with average LAMIN levels below 35 dBA, in addition to specific low frequency octave bands and occurrence rates. Many other standard acoustical metrics (such as LAEQ, LAMAX, LCPEAK, and LA90) were not found to be statistically correlated between measured acoustical data and HCAHPS quietness patient responses. Taken as a whole, this study provides insights into the potential relationships between hospital noise and patient satisfaction.

10.
Am J Prev Med ; 56(5): 664-672, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30902564

RESUMO

INTRODUCTION: Physical activity guidelines recommend minimum thresholds. This study sought to identify evidence-based thresholds to maintain disability-free status over 4years among adults with lower extremity joint symptoms. METHODS: Prospective multisite Osteoarthritis Initiative accelerometer monitoring cohort data from September 2008 through December 2014 were analyzed. Adults (n=1,564) aged ≥49years at elevated disability risk because of lower extremity joint symptoms were analyzed for biennial assessments of disability-free status from gait speed ≥1meter/second (mobility disability-free) and self-report of no limitations in activities of daily living (activities of daily living disability-free). Classification tree analyses conducted in 2017-2018 identified optimal thresholds across candidate activity intensities (sedentary, light, moderate-vigorous, total light and moderate-vigorous activity, and moderate-vigorous accrued in bouts lasting ≥10 minutes). RESULTS: Minimal thresholds of 56 and 55 moderate-vigorous minutes/week best predicted disability-free status over 4years from mobility and activities of daily living disabilities, respectively, across the candidate measures. Thresholds were consistent across sex, BMI, age, and knee osteoarthritis presence. Mobility disability onset was one eighth as frequent (3% vs 24%, RR=0.14, 95% CI=0.09, 0.20) and activities of daily living disability onset was almost half (12% vs 23%, RR=0.55, 95% CI=0.44, 0.70) among people above versus below the minimum threshold. CONCLUSIONS: Attaining an evidence-based threshold of approximately 1-hour moderate-vigorous activity/week significantly increased the likelihood of maintaining disability-free status over 4years. This minimum threshold tied to maintaining independent living abilities has value as an intermediate goal to motivate adults to take action towards the many health benefits of a physically active lifestyle.

11.
Circ Cardiovasc Qual Outcomes ; 12(4): e005284, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30909729

RESUMO

BACKGROUND: Empirical data on the link between stress and cardiovascular disease (CVD) risk among black women is limited. We examined associations of stressful life events and social strain with incident CVD among black women and tested for effect modification by resilience. METHODS AND RESULTS: Our analysis included 10 785 black women enrolled in the Women's Health Initiative Observational Study and Clinical Trials cohort. Participants were followed for CVD for up to 23 years (mean, 12.5). Multivariable Cox regression was used to estimate hazard ratios and 95% CIs for associations between stress-related exposures and incident CVD. We included interactions between follow-up time (age) and stressful life events because of evidence of nonproportional hazards. Effect modification by resilience was examined in the sub-cohort of 2765 women with resilience and stressful life events measures. Higher stressful life events were associated with incident CVD at ages 55 (hazard ratio for highest versus lowest quartile=1.80; 95% CI, 1.27-2.54) and 65 (hazard ratio for highest versus lowest quartile=1.40; 95% CI, 1.16-1.68), but not at older ages. Adjustment for CVD risk factors attenuated these associations. Similar associations were observed for social strain. In the sub-cohort of women with updated stressful life events and resilience measures, higher stressful life events were associated with incident CVD in multivariable-adjusted models (hazard ratio=1.61; 95% CI, 1.04-2.51). Resilience did not modify this association nor was resilience independently associated with incident CVD. CONCLUSIONS: In this cohort of older black women, recent reports of stressful life events were related to incident CVD. Resilience was unrelated to incident CVD. CLINICAL TRIALS REGISTRATION: URL: https://www.clinicaltrials.gov . Unique identifier: NCT00000611.

12.
Cortex ; 113: 279-297, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30716610

RESUMO

Resting-state networks (RSNs; groups of regions consistently co-activated without an explicit task) are hugely influential in modern brain research. Despite this popularity, the link between specific RSNs and their functions remains elusive, limiting the impact on cognitive neuroscience (where the goal is to link cognition to neural systems). Here we present a series of logical steps to formally test the relationship between a coherent RSN with a cognitive domain. This approach is applied to a challenging and significant test-case; extracting a recently-proposed semantic RSN, determining its relation with a well-known RSN, the default mode network (DMN), and assessing their roles in semantic cognition. Results showed the DMN and semantic network are two distinct coherent RSNs. Assessing the cognitive signature of these spatiotemporally coherent networks directly (and therefore accounting for overlapping networks) showed involvement of the proposed semantic network, but not the DMN, in task-based semantic cognition. Following the steps presented here, researchers could formally test specific hypotheses regarding the function of RSNs, including other possible functions of the DMN.

13.
BMC Public Health ; 19(1): 170, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30760243

RESUMO

BACKGROUND: In an attempt to improve children's physical activity levels governments have introduced policies specifying the minimum time schools are to schedule physical activity each week. Despite this, the majority of schools in many jurisdictions fail to implement these policies. This study will assess the effectiveness of a multi-component implementation strategy on increasing the minutes of planned physical activity scheduled by primary school teachers each week. METHODS: A cluster randomised controlled trial will be conducted in 62 primary schools in the Hunter New England region of New South Wales, Australia. Schools will be randomly allocated to receive either a multi-component implementation strategy that includes; obtaining executive support, training in-school champions, provision of tools and resources, implementation prompts, reminders and feedback; or usual practice. The study will employ an effectiveness-implementation hybrid design, assessing both policy implementation and individual (student) behavioural outcomes. The primary trial outcome of mean minutes of physical activity scheduled by classroom teachers across the school week will be measured via teacher log-book at baseline and approximately 12 and 18 months post baseline. A nested evaluation of the impact of policy implementation on child physical activity will be undertaken of students in Grades 2 and 3. Analyses will be performed using an intention to treat framework. Linear mixed effects regression models will be used to assess intervention effects on the primary outcome at both follow-up periods. DISCUSSION: This study will be the one of the first well powered randomised trials internationally to examine the impact of an implementation strategy for a physical activity policy in primary schools and will address a fundamental research translation gap. Given the dearth of research, the findings will be important in informing future implementation efforts in this setting. TRIAL REGISTRATION: ANZCTR ACTRN12617001265369 version 1 registered 1st September 2017.


Assuntos
Exercício , Promoção da Saúde/organização & administração , Políticas , Serviços de Saúde Escolar/organização & administração , Professores Escolares/organização & administração , Criança , Feminino , Humanos , Capacitação em Serviço , Masculino , New South Wales , Educação Física e Treinamento , Projetos de Pesquisa , Capacitação de Professores , Fatores de Tempo
14.
Genet Epidemiol ; 43(4): 449-457, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30659681

RESUMO

Although recent Genome-Wide Association Studies have identified novel associations for common variants, there has been no comprehensive exome-wide search for low-frequency variants that affect the risk of venous thromboembolism (VTE). We conducted a meta-analysis of 11 studies comprising 8,332 cases and 16,087 controls of European ancestry and 382 cases and 1,476 controls of African American ancestry genotyped with the Illumina HumanExome BeadChip. We used the seqMeta package in R to conduct single variant and gene-based rare variant tests. In the single variant analysis, we limited our analysis to the 64,794 variants with at least 40 minor alleles across studies (minor allele frequency [MAF] ~0.08%). We confirmed associations with previously identified VTE loci, including ABO, F5, F11, and FGA. After adjusting for multiple testing, we observed no novel significant findings in single variant or gene-based analysis. Given our sample size, we had greater than 80% power to detect minimum odds ratios greater than 1.5 and 1.8 for a single variant with MAF of 0.01 and 0.005, respectively. Larger studies and sequence data may be needed to identify novel low-frequency and rare variants associated with VTE risk.


Assuntos
Exoma/genética , Estudo de Associação Genômica Ampla/métodos , Sequenciamento de Nucleotídeos em Larga Escala , Análise em Microsséries/métodos , Tromboembolia Venosa/genética , Afro-Americanos/genética , Alelos , Estudos de Casos e Controles , Feminino , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Sequenciamento de Nucleotídeos em Larga Escala/estatística & dados numéricos , Humanos , Masculino , Análise em Microsséries/estatística & dados numéricos , Razão de Chances , Polimorfismo de Nucleotídeo Único , Tamanho da Amostra , Tromboembolia Venosa/etnologia
15.
Gerontol Geriatr Educ ; : 1-12, 2018 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-30526441

RESUMO

This study presents a training that was developed for staff members at Medicare/Medicaid agencies to improve their knowledge and comfort levels in working on advance care planning (ACP) with their clients in a culturally competent manner. The training was developed to address the need to clarify the different types and purposes of ACP and to help develop the skills needed to work with clients of diverse cultural backgrounds. The evaluation of findings from the training showed the positive impacts that it had on participants; in particular, they exhibited demonstrated improvement in their knowledge of and comfort levels with ACP. The participants also expressed interest in receiving continued training surrounding ACP to increase their cultural competency skills and to receive updated information on ACP policies and practices.

16.
Clin Rheumatol ; 2018 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-30417223

RESUMO

OBJECTIVE: Validation of a symptom measure for early knee OA may help identify new treatments and modifiable risk factors. Symptom measures that consider pain in the context of activity level may provide better discrimination than pain alone. Therefore, we aimed to compare sensitivity to change for radiographic progression between Ambulation Adjusted Score for Knee pain (AASK), which accounts for self-reported ambulation, and Western Ontario McMaster Osteoarthritis (WOMAC) knee pain score. DESIGN: Participants were assessed annually up to 48 months using WOMAC, Physical Activity Scale for the Elderly (PASE) ambulation, and knee radiographs. AASK was defined as ((WOMAC pain) + 1)/((average daily hours of walking) + 1). Radiographs were scored for Kellgren-Lawrence (KL) grade. Linear regression, stratified by OA status, evaluated relationships between changes in AASK and WOMAC pain and KL grade over time. RESULTS: For 4191 people (8030 knees), the mean age was 61.2 (+ 9.2) years old and BMI was 28.6 (+ 4.8) kg/m2; 58% female. Over 40% of knees had WOMAC pain scores of 0; by design, no knees had AASK scores of 0. Annual changes in AASK were more sensitive to changes in KL than changes in WOMAC in those without baseline OA (0.20 and 0.16 change per unit KL change, p = 0.005 and 0.070 respectively), but performed similarly in knees with OA. CONCLUSION: AASK is simple to assess using existing validated questionnaires. AASK performs well in individuals with and without OA and should be considered in clinical trials and observational studies of early knee OA.

17.
J Bone Miner Res ; 2018 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-30461066

RESUMO

Sleep disturbances are common and may influence falls and fracture directly by influencing bone turnover and muscle strength or indirectly through high comorbidity or poor physical function. To investigate the association between self-reported sleep and falls and fractures, we prospectively studied 157,306 women in the Women's Health Initiative (WHI) using information on sleep quality, sleep duration, and insomnia from questionnaires. Annual self-report of falling two or more times (ie, "recurrent falling") during each year of follow-up was modeled with repeated measures logistic regression models fit by generalized estimating equations. Cox proportional hazards models were used to investigate sleep disturbance and time to first fracture. We examined the risks of recurrent falls and fracture by sleep duration with 7 hours as referent. We examined the risks across categories of sleep disturbance, insomnia status, and sleep quality. The average follow-up time was 7.6 years for falls and 12.0 years for fractures. In multivariable adjusted models, including adjustment for comorbidity, medications, and physical function, women who were short (≤5 hours) and long (≥10 hours) sleepers had increased odds of recurrent falls (odds ratio [OR] 1.28; 95% confidence interval [CI], 1.23 to 1.34 and OR 1.25; 95% CI, 1.09 to 1.43, respectively). Poor sleep quality, insomnia, and more sleep disturbances were also associated with an increased odds of recurrent falls. Short sleep was associated with an increased risk of all fractures, and upper limb, lower limb, and central body fractures, but not hip fractures, with hazard ratios ranging from 1.10 to 1.13 (p < 0.05). There was little association between other sleep characteristics and fracture. In conclusion, short and long sleep duration and poor sleep quality were independently associated with increased odds of recurrent falls. Short sleep was associated with modest increase in fractures. Future long-term trials of sleep interventions should include falls and fractures as endpoints. © 2018 American Society for Bone and Mineral Research.

18.
Artigo em Inglês | MEDLINE | ID: mdl-30489433

RESUMO

OBJECTIVE: The aim of the study was to determine factors associated with the development of cervical malignancy among women participating in an organized cervical screening program. MATERIALS AND METHODS: A population-based retrospective cohort study was performed examining the screening histories 2 to 10 years before diagnosis of invasive cancer in Ontario women between 2011 and 2014. RESULTS: A total of 2,002 cases of cervical cancer were identified; 1,358 (68%) were squamous cell carcinomas and 644 (32%) were adenocarcinomas. The mean age at the time of diagnosis was 50.3 years. More than 60% of the cohort had at least 1 cytology test within 2 to 10 years of their diagnosis. Of the women having a cytology result 24 to 36 months before diagnosis, 69% had a normal cytology whereas only 7% had a high-grade cytology result. Stage of cancer was most advanced in women who did not have cytology in the 2 to 10 years before their diagnosis. On multivariate regression, those with cervical cancer who were less likely to have undergone screening include older age, advanced stage, lower income, not having a family physician, and those diagnosed with adenocarcinoma. CONCLUSIONS: Although nonparticipation in screening is the greatest factor associated with cervical cancer diagnosis, failure of cervical cytology to detect cytologic abnormalities in women 2 to 3 and 3 to 5 years before diagnosis is of concern. Efforts must be directed to recruitment of women for screening as well as improving the sensitivity of screening tests to detect existing abnormalities.

19.
MMWR Morb Mortal Wkly Rep ; 67(39): 1094-1097, 2018 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-30286058

RESUMO

Carpal tunnel syndrome (CTS) occurs when the median nerve becomes compressed as it passes through the wrist within the carpal tunnel, resulting in pain, tingling, weakness, or numbness in the hand or the wrist. Occupational risk factors for CTS include engaging in work activities that require forceful, repetitive tasks, prolonged use of the hands or wrists in an awkward posture, or vibration (1). To assess trends and identify high-risk industries and occupations for CTS, the California Department of Public Health (CDPH) analyzed California workers' compensation claims for CTS by industry (2007-2014) and occupation (2014) and calculated rates per full-time equivalent (FTE) worker. During 2007-2014, a total of 139,336 CTS cases were reported (incidence = 6.3 cases per 10,000 FTE) in California workers; the rate among women (8.2) was 3.3 times higher than that among men (2.5). Industries with the highest rates of CTS were textile, fabric finishing, and coating mills (44.9), apparel accessories and other apparel manufacturing (43.1), and animal slaughtering and processing (39.8). Industries with high rates of CTS should consider implementing intervention measures, including ergonomic evaluations and development of tools and instruments that require less repetition and force and that correct awkward postures.


Assuntos
Síndrome do Túnel Carpal/epidemiologia , Indústrias/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Ocupações/estatística & dados numéricos , Indenização aos Trabalhadores/estatística & dados numéricos , Adolescente , Adulto , Idoso , California/epidemiologia , Feminino , Humanos , Incidência , Sistemas de Informação , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
20.
Sci Rep ; 8(1): 14048, 2018 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-30232386

RESUMO

It is proposed that emissions of volatile sulfur compounds by coral reefs contribute to the formation of a biologically-derived feedback on sea surface temperature (SST) through the formation of marine biogenic aerosol (MBA). The direction and strength of this feedback remains uncertain and constitutes a fundamental constraint on predicting the ability of corals to cope with future ocean warming. We investigate the effects of elevated SST and irradiance on satellite-derived fine-mode aerosol optical depth (AOD) throughout the Great Barrier Reef, Australia (GBR) over an 18-year time period. AOD is positively correlated with SST and irradiance and increases two-fold during spring and summer with high frequency variability. As the influence of non-biogenic and distant aerosol sources are found to be negligible, the results support recent findings that the 2,300 km stretch of coral reefs can be a substantial source of biogenic aerosol and thus, influence local ocean albedo. Importantly however, a tipping point in the coral stress response is identified, whereby thermal stress reaches a point that exceeds the capacity of corals to influence local atmospheric properties. Beyond this point, corals may become more susceptible to permanent damage with increasing stress, with potential implications for mass coral bleaching events.

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