Associations and predictive power of dietary patterns on metabolic syndrome and its components.

BACKGROUND AND AIMS: Metabolic syndrome (MetS) defines important risk factors in the development of cardiovascular diseases and other serious health conditions. This study aims to investigate the influence of different dietary patterns on MetS and its components, examining both associations and predictive performance. METHODS AND RESULTS: The study sample included 10,750 participants from the seventh survey of the cross-sectional, population-based Tromsø Study in Norway. Diet intake scores were used as covariates in logistic regression models, controlling for age, educational level and other lifestyle variables, with MetS and its components as response variables. A diet high in meat and sweets was positively associated with increased odds of MetS and elevated waist circumference, while a plant-based diet was associated with decreased odds of hypertension in women and elevated levels of triglycerides in men. The predictive power of dietary patterns derived by different dimensionality reduction techniques was investigated by randomly partitioning the study sample into training and test sets. On average, the diet score variables demonstrated the highest predictive power in predicting MetS and elevated waist circumference. The predictive power was robust to the dimensionality reduction technique used and comparable to using a data-driven prediction method on individual food variables. CONCLUSIONS: The strongest associations and highest predictive power of dietary patterns were observed for MetS and its single component, elevated waist circumference.

The prevalence of tinnitus in the Australian working population.

OBJECTIVES: To estimate the prevalence of tinnitus in Australian working people; to identify occupational and demographic factors associated with tinnitus. DESIGN: Cross-sectional national telephone survey of self-reported frequency and duration of tinnitus. SETTING, PARTICIPANTS: Australian Workplace Exposure Survey (AWES) - Hearing; 4970 currently employed people aged 18-64 years, recruited by random digit dialling, representative by sex of the workforce population, 7 June 2016 - 20 March 2017. MAIN OUTCOME MEASURES: Prevalence of occasional, intermittent, and constant tinnitus, and of any tinnitus, by occupational group, sex, and other demographic characteristics; estimated numbers of working people with constant or any tinnitus, by occupational group and sex. RESULTS: Of 4970 respondents, 1317 reported experiencing tinnitus (26.5%): 713 people had occasional tinnitus (14.3%), 259 intermittent tinnitus (5.2%), and 345 constant tinnitus (6.9%). The sample prevalence of constant tinnitus was greater among men (7.5%; 95% CI, 6.2-8.7%) than women (3.3%; 95% CI, 2.3-4.3%), and was higher in older age groups. After rake weighting our survey responses, we estimated that 2.4 million workers (24.8%; 95% CI, 23.2-26.4%) experience tinnitus, including 529 343 with constant tinnitus (5.5%; 95% CI, 4.6-6.3%). The estimated prevalence of constant tinnitus was highest for automotive workers (16.7%; 95% CI, 9.5-23.8%), drivers (13.0%; 95% CI, 7.3-18.6%), farmers (12.1%; 95% CI, 5.9-18.4%), and workers in other trades (10.4%; 95% CI, 4.6-16.2%). CONCLUSIONS: The prevalence of tinnitus in the Australian workforce is high, particularly in certain occupations. Workplace practices and conditions that increase the risk of tinnitus should be examined, and targeted workplace prevention strategies developed.

Exposure to noise and ototoxic chemicals in the Australian workforce.

OBJECTIVE: To determine the current prevalence of exposure to workplace noise and ototoxic chemicals, including co-exposures. METHOD: A cross-sectional telephone survey of nearly 5000 Australian workers was conducted using the web-based application, OccIDEAS. Participants were asked about workplace tasks they performed and predefined algorithms automatically assessed worker's likelihood of exposure to 10 known ototoxic chemicals as well as estimated their full shift noise exposure level (LAeq,8h) of their most recent working day. Results were extrapolated to represent the Australian working population using a raked weighting technique. RESULTS: In the Australian workforce, 19.5% of men and 2.8% of women exceeded the recommended full shift noise limit of 85 dBA during their last working day. Men were more likely to be exposed to noise if they were younger, had trade qualifications and did not live in a major city. Men were more likely exposed to workplace ototoxic chemicals (57.3%) than women (25.3%). Over 80% of workers who exceeded the full shift noise limit were also exposed to at least one ototoxic chemical in their workplace. CONCLUSION: The results demonstrate that exposures to hazardous noise and ototoxic chemicals are widespread in Australian workplaces and co-exposure is common. Occupational exposure occurs predominantly for men and could explain some of the discrepancies in hearing loss prevalence between genders.

Intake, sources, and determinants of free sugars intake in Australian children aged 12-14 months.

The consumption of free sugars is directly associated with adiposity and dental caries in early childhood; however, intake data in the first 2 years of life are limited. This cross-sectional analysis aims to identify major food sources of free sugars for Australian children aged 12-14 months and investigate factors associated with meeting the World Health Organisation (WHO) Guideline for sugars intake. Three days of nonconsecutive dietary data were collected via a 24-hr recall and 2-day food record for 828 participants. Usual intake of energy, total sugars, and free sugars were estimated, along with food group contributions to free sugars. Multiple logistic regression analysis was used to investigate factors associated with exceeding the WHO conservative recommendation that <5% of energy should come from free sugars. Mean free sugars intake was 8.8 (SD 7.7, IQR 3.7-11.6) g/day, contributing 3.6% (SD 2.8, IQR 1.6-4.8) of energy. Only 2.4% of participants exceeded the WHO recommendation that <10% of energy should come from free sugars, with 22.8% of participants exceeding the <5% recommendation. Children from households with greater socio-economic disadvantage (IRSAD <5, OR = 1.94) and in the lowest income bracket (OR = 2.10) were more likely to have intakes ≥5% of energy. Major food sources of free sugars were commercial infant foods (26.6%), cereal-based products (19.7%), namely, sweet biscuits (8.3%) and cakes (7.6%), followed by yoghurt (9.6%), and fruit and vegetable beverages (7.4%). These findings highlight the substantial contribution of infant foods to free sugars intakes and provide further evidence that dietary intakes are influenced by social determinants.

Increased risk of death immediately after losing a spouse: Cause-specific mortality following widowhood in Norway.

OBJECTIVE: This paper examines the short-term risk of cause-specific death following widowhood. METHOD: We followed all individuals registered as married in Norway in 1975 for marital status and mortality until 2006. Widowed individuals were followed for mortality for 7years following widowhood. Causes of death were categorized into five cause-groups. Life tables were used in survival analyses. RESULTS: Deaths among the widowed were most frequent in the week following widowhood. In this week and compared to married individuals, there were more deaths including those from malignant cancer in men (hazard ratio (HR) of 1.51; 95% CI: 1.12, 1.89), from external causes in men (HR=3.64; 95% CI: 2.01, 5.28), and from respiratory diseases (HR=2.18; 95% CI: 1.52, 2.84 in men and HR=3.18; 95% CI: 2.26, 4.09 in women). A majority of respiratory deaths were from pneumonia. Thereafter excess mortality among the widowed dropped gradually. Although these numbers stabilized, they were still elevated in year 7. Excess mortality was particularly high in the youngest age group considered (55-64years) and decreased with age, though more so in men than in women. Only a few more widowed individuals than expected died of a condition in the same cause-group as their spouses. CONCLUSION: A novel finding was that excess deaths in the week following widowhood also were from cancer and respiratory diseases. Men in the youngest age group seemed most vulnerable. Prevention should be considered directly after the death of a spouse, and measures should be aimed at virtually all causes of death.

Mortality after the death of a spouse in Norway.

BACKGROUND: Previous studies on mortality of widowed individuals have produced varying estimates of mortality after the death of a spouse. This variation is because of the various data types used and methodologies applied, as well as to the failure to account for sources of bias. METHODS: We followed all married individuals in Norway (1,801,456 individuals) for 32 years, and information on marital status and death was collected for use in a new application of survival analysis in this field of research. RESULTS: We compared mortality of widowed individuals with that of married individuals. Widowed men and women had hazard ratios of 1.34 (95% confidence interval 1.31, 1.36) and 1.29 (1.26, 1.31), respectively, for the first year after spousal death. For the same period, values were highest in ages 60-64 years with 1.78 (1.57, 1.98) in men and 1.50 (1.35, 1.65) in women. Values dropped gradually with age and more rapidly in men than women to a low for ages 85-89 years of 1.24 (1.19, 1.29) in men and 1.25 (1.20, 1.31) in women. The risk was much higher 1 to 7 days after spousal death (1.69 [1.49, 1.88] in men and 1.76 [1.56, 1.96] in women), then it dropped during the first year and from then on remained stable to year 10, which was the last year considered. CONCLUSION: A considerable excess mortality risk was observed in widowed men and women from immediately after the loss of a spouse and for the next 10 years.

Identifying dietary patterns across age, educational level and physical activity level in a cross-sectional study: the Tromsø Study 2015 - 2016.

BACKGROUND: A healthy diet can decrease the risk of several lifestyle diseases. From studying the health effects of single foods, research now focuses on examining complete diets and dietary patterns reflecting the combined intake of different foods. The main goals of the current study were to identify dietary patterns and then investigate how these differ in terms of sex, age, educational level and physical activity level (PAL) in a general Nordic population. METHODS: We used data from the seventh survey of the population-based Tromsø Study in Norway, conducted in 2015-2016. The study included 21,083 participants aged [Formula: see text] years, of which [Formula: see text] completed a comprehensive food frequency questionnaire (FFQ). After exclusion, the study sample included 10,899 participants with valid FFQ data. First, to cluster food variables, the participants were partitioned in homogeneous cohorts according to sex, age, educational level and PAL. Non-overlapping diet groups were then identified using repeated hierarchical cluster analysis on the food variables. Second, average standardized diet intake scores were calculated for all individuals for each diet group. The individual diet (intake) scores were then modelled in terms of age, education and PAL using regression models. Differences in diet scores according to education and PAL were investigated by pairwise hypothesis tests, controlling the nominal significance level using Tukey's method. RESULTS: The cluster analysis revealed three dietary patterns, here named the Meat and Sweets diet, the Traditional diet, and the Plant-based- and Tea diet. Women had a lower intake of the Traditional diet and a higher preference for the Plant-based- and Tea diet compared to men. Preference for the Meat and Sweets diet and Traditional diet showed significant negative and positive trends as function of age, respectively. Adjusting for age, the group having high education and high PAL compared favourably with the group having low education and low PAL, having a significant lower intake of the Meat and Sweets and the Traditional diets and a significant higher intake of the Plant-based- and Tea diet. CONCLUSIONS: Three dietary patterns (Meat and Sweets, Traditional, and Plant-based- and Tea) were found by repeated clustering of randomly sampled homogeneous cohorts of individuals. Diet preferences depended significantly on sex, age, education and PAL, showing a more unhealthy dietary pattern with lower age, low education and low PAL.

Estimation of Excess Mortality and Years of Life Lost to COVID-19 in Norway and Sweden between March and November 2020.

We estimate the weekly excess all-cause mortality in Norway and Sweden, the years of life lost (YLL) attributed to COVID-19 in Sweden, and the significance of mortality displacement. We computed the expected mortality by taking into account the declining trend and the seasonality in mortality in the two countries over the past 20 years. From the excess mortality in Sweden in 2019/20, we estimated the YLL attributed to COVID-19 using the life expectancy in different age groups. We adjusted this estimate for possible displacement using an auto-regressive model for the year-to-year variations in excess mortality. We found that excess all-cause mortality over the epidemic year, July 2019 to July 2020, was 517 (95%CI = (12, 1074)) in Norway and 4329 [3331, 5325] in Sweden. There were 255 COVID-19 related deaths reported in Norway, and 5741 in Sweden, that year. During the epidemic period of 11 March-11 November, there were 6247 reported COVID-19 deaths and 5517 (4701, 6330) excess deaths in Sweden. We estimated that the number of YLL attributed to COVID-19 in Sweden was 45,850 [13,915, 80,276] without adjusting for mortality displacement and 43,073 (12,160, 85,451) after adjusting for the displacement accounted for by the auto-regressive model. In conclusion, we find good agreement between officially recorded COVID-19 related deaths and all-cause excess deaths in both countries during the first epidemic wave and no significant mortality displacement that can explain those deaths.

Modelling suggests limited change in the reproduction number from reopening Norwegian kindergartens and schools during the COVID-19 pandemic.

BACKGROUND: To suppress the COVID-19 outbreak, the Norwegian government closed all schools on March 13, 2020. The kindergartens reopened on April 20, and the schools on April 27 and May 11 of 2020. The effect of these measures is largely unknown since the role of children in the spread of the SARS-CoV-2 virus is still unclear. There are only a few studies of school closures as a separate intervention to other social distancing measures, and little research exists on the effect of school opening during a pandemic. OBJECTIVE: This study aimed to model the effect of opening kindergartens and the schools in Norway in terms of a change in the reproduction number (R). A secondary objective was to assess if we can use the estimated R after school openings to infer the rates of transmission between children in schools. METHODS: We used an individual-based model (IBM) to assess the reopening of kindergartens and schools in two Norwegian cities, Oslo, the Norwegian capital, with a population of approximately 680 000, and Tromsø, which is the largest city in Northern Norway, with a population of approximately 75 000. The model uses demographic information and detailed data about the schools in both cities. We carried out an ensemble study to obtain robust results in spite of the considerable uncertainty that remains about the transmission of SARS-CoV-2. RESULTS: We found that reopening of Norwegian kindergartens and schools are associated with a change in R of 0.10 (95%CI 0.04-0.16) and 0.14 (95%CI 0.01-0.25) in the two cities under investigation if the in-school transmission rates for the SARS-CoV-2 virus are equal to what has previously been estimated for influenza pandemics. CONCLUSION: We found only a limited effect of reopening schools on the reproduction number, and we expect the same to hold true in other countries where nonpharmaceutical interventions have suppressed the pandemic. Consequently, current R-estimates are insufficiently accurate for determining the transmission rates in schools. For countries that have closed schools, planned interventions, such as the opening of selected schools, can be useful to infer general knowledge about children-to-children transmission of SARS-CoV-2.

Exposure to Hand-Arm Vibration in the Australian Workforce.

OBJECTIVE: To estimate the prevalence of hand-arm vibration (HAV) in Australian workplaces. METHODS: The Australian Workplace Exposure Survey (AWES)-Hearing was a cross-sectional telephone survey of Australian workers conducted in 2016-2017. Respondents were asked about the time spent using tools or performing tasks known to be associated with HAV during their most recent working day. We created a library of HAV magnitude levels for each tool/task and estimated each worker's daily HAV exposure level using standard formulae. We categorized each worker as to whether they exceeded the daily occupational limits of 2.5 and 5.0 m/s2. Results were extrapolated to the Australian working population using a raked weighting method. RESULTS: In our sample of 4991 workers, 5.4% of men and 0.7% of women exceeded the HAV action limit of 2.5 m/s2 on their most recent working day. We estimate that 3.8% of the Australian workforce exceeds the HAV limit of 2.5 m/s2 and 0.8% exceeds the 5 m/s2 limit. Men were more likely to exceed the HAV limits than women, as were those with trade qualifications, and those who worked in remote locations. Workers in the construction, farming, and automobile industries had the highest prevalence of HAV exposure. Tool groups that contributed to higher exposure levels included: compactors, rollers, and tampers; power hammers and jackhammers; and underground mining equipment. CONCLUSIONS: HAV is common in the Australian working population. Given the health risks associated with this exposure, reduction strategies and interventions should be developed, with engineering controls as the starting point for exposure reduction strategies.

Quality of life in substance use disorder patients with and without attention deficit hyperactivity disorder 12 months after treatment: a naturalistic follow-up study.

There is sparse research on quality of life (QoL) as an outcome measure in patients with substance use disorders (SUD), with or without attention deficit hyperactivity disorder (ADHD). We aimed to investigate whether SUD patients with and without ADHD (SUD + ADHD vs. SUD - ADHD) differed in QoL at baseline and at a 12-month follow-up after SUD treatment. The groups were additionally compared with data from a national population sample (NPS). From a sample of 16 SUD + ADHD and 87 SUD - ADHD patients originally recruited between 2010 and 2012, eight SUD + ADHD (50.0%) and 28 SUD - ADHD (32.2%) patients were reached at follow-up. QoL was measured with the short version of the World Health Organization QoL instrument (WHOQOL-BREF). Cross-sectional data on QoL from NPS was utilized. Compared to NPS, SUD patients reported significantly lower QoL at baseline and follow-up. Furthermore, QoL was similar at baseline in SUD + ADHD and SUD - ADHD patients. At a 12-month follow-up after SUD treatment, SUD + ADHD patients 'QoL had improved, however, not significantly differing from SUD - ADHD patients or the NPS. SUD - ADHD patients' QoL remained significantly lower. At follow-up, SUD + ADHD patients' QoL improved nominally compared to SUD - ADHD patients, but not the NPS. The clinical and functional relevance of these findings should be investigated further.

COPD in primary lung cancer patients: prevalence and mortality.

BACKGROUND: Previous studies have relied on international spirometry criteria to diagnose COPD in patients with lung cancer without considering the effect lung cancer might have on spirometric results. The aim of this study was to examine the prevalence of COPD and emphysema at the time of primary lung cancer diagnosis and to examine factors associated with survival. MATERIALS AND METHODS: Medical records, pulmonary function tests, and computed tomography scans were used to determine the presence of COPD and emphysema in patients diagnosed with primary lung cancer at the University Hospital of North Norway in 2008-2010. RESULTS: Among the 174 lung cancer patients, 69% had COPD or emphysema (39% with COPD, 59% with emphysema; male:female ratio 101:73). Neither COPD nor emphysema were significantly associated with lung cancer mortality, whereas patients with non-small-cell lung cancer other than adenocarcinoma and squamous cell carcinoma had a risk of lung cancer mortality that was more than four times higher than that of patients with small-cell lung cancer (hazard ratio [HR] 4.19, 95% confidence interval [CI] 1.56-11.25). Females had a lower risk of lung cancer mortality than males (HR 0.63, 95% CI 0.42-0.94), and patients aged ≥75 years had a risk that was twice that of patients aged <75 years (HR 2.48, 95% CI 1.59-3.87). Low partial arterial oxygen pressure (4.0-8.4 kPa) increased the risk of lung cancer mortality (HR 2.26, 95% CI 1.29-3.96). So did low partial arterial carbon dioxide pressure (3.0-4.9 kPa) among stage IV lung cancer patients (HR 2.23, 95% CI 1.29-3.85). Several patients with respiratory failure had previously been diagnosed with COPD. CONCLUSION: The observed prevalence of COPD was lower than that in previous studies. Neither COPD nor emphysema were significantly associated with lung cancer mortality.

[Mortality in Norway by time of year, day of the week and date of birth]. / Dødelighet i Norge etter tid på året, ukedag og fødselsdato.

BACKGROUND: The number of deaths increases in winter, and there are also reports on variation by day of week. MATERIAL AND METHODS: Records of all deaths in Norway from 1991 to 1995, a total of 225 439, were provided by Statistics Norway. RESULTS: On average, the yearly number of excess deaths in winter was 2589, or 12 %. These excess deaths were mainly caused by cardiovascular and respiratory diseases; no increase was observed in death from cancer. The excess winter mortality was observed only among elderly women (starting at 71 years of age) and men (age 68) and was particularly strong in years with influenza epidemics. On Mondays, 3 % more deaths occurred than on Saturdays; this difference was mainly due to cardiovascular diseases. INTERPRETATION: Dying on a Monday is somewhat more likely than on the other weekdays, and elderly men and women are more likely to die during winter than in the rest of the year.

Environmental adaptation of proteins: regression models with simple physicochemical properties.

Bio-sequences from ortholog proteins are well suited for statistical inference when the sequences can be divided into ordinal groups based on known environmental features or traits of the host organisms. In this paper two new regression models are described for extracting proteomic trends of extreme environments. The approach is based on physicochemical properties of the amino acids, and may also utilise stratification of the data. We are especially looking for connections of temperature adaptation between the organism and its molecular level. To show the applicability of the methods, we present analyses of genomic data from proteobacteria orders, where we examine the cold adaptation of membrane proteins, intracellular proteins, and the enzyme endonuclease I. Our results confirm earlier findings that redistribution of charge and increase of surface hydrophobicity might be some of the most important signatures for cold adaptation.