Dual-trajectory of TyG levels and lifestyle scores and their associations with ischemic stroke in a non-diabetic population: a cohort study.

BACKGROUND: The Triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, has been implicated in the risk of ischemic stroke. However, the interplay between TyG levels, lifestyle factors, and their collective impact on stroke risk in non-diabetic populations remains inadequately explored. This study aims to evaluate the association of ischemic stroke with the joint development of the TyG index and lifestyle in the non-diabetic population. METHODS: In this prospective cohort study, data was collected across three consecutive biennial surveys of the Kailuan Study from 2006 to 2011. The dual-trajectory model was used to determine the temporal development of TyG levels and lifestyle scores. Statistical analysis involved Cox regression models to evaluate the association between TyG-lifestyle trajectories and ischemic stroke risk, adjusting for potential confounders. RESULTS: A total of 44,403 participants were included, with five distinct TyG levels and lifestyle scores trajectory subtypes identified. In the multivariable-adjusted analyses, significant differences in ischemic stroke risk among the trajectory subtypes. Group 5, characterized by the highest TyG levels and moderate lifestyle scores, exhibited the greatest ischemic stroke risk (HR = 1.81, 95% CI: 1.51-2.18), while group 4, with moderate TyG levels and higher lifestyle scores, demonstrated the lowest risk (HR = 1.19, 95% CI: 1.04-1.37), compared with group 3. Participants with elevated TyG levels were at an increased risk of ischemic stroke in cases of pronounced insulin resistance, even with a healthy lifestyle. CONCLUSIONS: This study reveals the significant associations between the identified TyG and lifestyle trajectories and the stratification of ischemic stroke risk among non-diabetics. The TyG index is a valuable indicator for assessing insulin resistance. However, the potential benefits of lifestyle changes for those with significantly high TyG levels need to be clarified by more research to develop more effective stroke prevention strategies.

Dual trajectories of depression and social participation among Chinese older adults.

OBJECTIVES: This study aimed to investigate the dual trajectories of social participation (SP) and depression among older adults, and explore common factors that may influence both trajectories. METHODS: The study utilized data from four waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011 to 2018). The dual-trajectory model was employed to estimate the dual trajectories of SP and depression. RESULTS: This study identified two SP and three depression trajectories. The results revealed that the reciprocal relationship between SP and depression trajectories is confirmed in all sub-groups of the dual trajectories. Our study identified six distinct sub-groups of individuals based on their SP and depression trajectories and some commen risk factors of SP and depression trajectories. CONCLUSIONS: Related intervention policies should consider the dual trajectories of SP and depression and focus on subgroups with high vulnerability, such as high depression but low SP. Additionally, attention should be given to addressing the common risk factors that underlie these trajectories.

Dual trajectory of sleep and frail in elderly people. / è€å¹´äººç¡çœ ä¸Žè¡°å¼±åŒè½¨è¿¹.

The high incidence of dual sleep and frail disorders in the elderly people, often occurring together, seriously affects the physical and mental health of the older people, effective research on the dynamics of dual sleep and frail disorders is important for improving the quality of life for the older people and responding to global ageing trend. While trajectory studies provide a unique practical scientific perspective to grasp the dynamics of development, dual trajectories unite dual barriers provide an opportunity to study the dynamic dependence of both sleep and frailty simultaneously sleep trajectories and frailty trajectories in older people are interrelated and interacted through deeper mechanisms. Therefore, it is necessary for the study not only focus on the ongoing development of health problems, but also needs to consider multiple aspects and propose targeted intervention program.

Insight into the longitudinal relationship between chronic subclinical inflammation and obesity from adolescence to early adulthood: a dual trajectory analysis.

OBJECTIVES AND DESIGN: This study aimed to understand the longitudinal relationship between C-reactive protein (CRP) and body mass index (BMI) from adolescence to early adulthood. METHODS: CRP and BMI were collected from participants of the Raine Study Gen2 at 14-, 17-, 20- and 22-year follow-ups (n = 1312). A dual trajectory analysis was conducted to assess the association between CRP and BMI trajectories, providing conditional probabilities of membership of CRP trajectory membership given BMI trajectory membership. Best model fit was assessed by systematically fitting two to eight trajectory groups with linear and quadratic terms and comparing models according to the Bayesian Information Criterion statistic. RESULTS: The three CRP trajectories were; "stable-low" (71.0%), "low-to-high" (13.8%) and "stable-high" (15.2%). Participants in a "high-increasing" BMI trajectory had a higher probability of being in the "stable-high" CRP trajectory (60.4% of participants). In contrast, individuals in the "medium-increasing" BMI trajectory did not have a significantly increased probability of being in the "stable-high" CRP trajectory. CONCLUSIONS: These findings support that chronic sub-clinical inflammation is present through adolescence into early adulthood in some individuals. Targeting chronic sub-clinical inflammation though obesity prevention strategies may be important for improving future health outcomes.

Co-development of Problem Gambling and Depression Symptoms in Emerging Adults: A Parallel-Process Latent Class Growth Model.

This study examines whether there are multiple joint trajectories of depression and problem gambling co-development in a sample of emerging adults. Data were from the Manitoba Longitudinal Study of Young Adults (n = 679), which was collected in 4 waves across 5 years (age 18-20 at baseline). Parallel process latent class growth modeling was used to identified 5 joint trajectory classes: low decreasing gambling, low increasing depression (81%); low stable gambling, moderate decreasing depression (9%); low stable gambling, high decreasing depression (5%); low stable gambling, moderate stable depression (3%); moderate stable problem gambling, no depression (2%). There was no evidence of reciprocal growth in problem gambling and depression in any of the joint classes. Multinomial logistic regression analyses of baseline risk and protective factors found that only neuroticism, escape-avoidance coping, and perceived level of family social support were significant predictors of joint trajectory class membership. Consistent with the pathways model framework, we observed that individuals in the problem gambling only class were more likely using gambling as a stable way to cope with negative emotions. Similarly, high levels of neuroticism and low levels of family support were associated with increased odds of being in a class with moderate to high levels of depressive symptoms (but low gambling problems). The results suggest that interventions for problem gambling and/or depression need to focus on promoting more adaptive coping skills among more "at-risk" young adults, and such interventions should be tailored in relation to specific subtypes of comorbid mental illness.

The Natural History of Knee Osteoarthritis Pain Experience and Risk Profiles.

The study aimed to characterize the natural history of the pain experience, concurrently considering intermittent and constant pain over 4 years, and determine baseline factors associated with unfavorable trajectories in individuals with chronic knee pain. The Osteoarthritis Initiative (OAI) is a prospective, observational study of people with or at higher risk for knee osteoarthritis. The Intermittent and Constant Osteoarthritis Pain (ICOAP) was assessed annually at 48-to-96-month OAI visits. Twenty-eight baseline sociodemographic, knee-specific, and health-related characteristics were assessed. Group-based dual-trajectory modeling identified pain experience patterns indicated by ICOAP intermittent and constant pain scores over 4 years. Multivariable multinomial logistic regression models determined baseline factors associated with membership in each dual-trajectory group. Four longitudinal pain experience patterns were identified (n = 3,584, mean age = 64.8 [standard deviation 9.0] years, BMI = 28.6 [5.0] kg/m2; 57.9% women). Group 1 (37.7%) had minimal intermittent and no constant pain; Group 2 (35.1%) had mild intermittent and no constant pain; Group 3 (18.5%) had mild intermittent and low-grade constant pain; and Group 4 (8.7%) had moderate intermittent and constant pain. Baseline widespread pain, knee stiffness, back pain, hip pain, ankle pain, obesity, depressive symptoms, more advanced radiographic disease, and analgesic use were each associated with an increased risk of membership in less favorable Groups 2, 3, and 4. These distinct courses of pain experience may be driven by different underlying pain mechanisms. The benchmarked ICOAP scores could be used to stratify patients and tailor management. Addressing and preventing the development of modifiable risks (eg, widespread pain and knee joint stiffness) may reduce the chance of belonging to unfavorable dual-trajectory groups. PERSPECTIVE: Concurrently tracking intermittent versus constant pain experience, group-based dual-trajectory modeling identified 4 distinct pain experience patterns over 4 years. The benchmarked ICOAP scores in these dual trajectories could aid in stratifying patients for tailored management strategies and intensity of care.

Application of dual-trajectory screws in revision surgery for lumbar adjacent segment disease: a finite element study.

BACKGROUND: Advancements in medicine and the popularity of lumbar fusion surgery have made lumbar adjacent segment disease (ASDz) increasingly common, but there is no mature plan for guiding its surgical treatment. Therefore, in this study, four different finite element (FE) ASDz models were designed and their biomechanical characteristics were analysed to provide a theoretical basis for clinical workers to choose the most appropriate revision scheme for ASDz. METHODS: According to whether internal fixation was retained, different FE models were created to simulate ASDz revision surgery, and flexion, extension, axial rotation and lateral bending were simulated by loading. The biomechanical characteristics of the adjacent segments of the intervertebral disc and the internal fixation system and the range of motion (ROM) of the lumbar vertebrae were analysed. RESULTS: The difference in the ROM of the fixed segment between FE models that did or did not retain the original internal fixation was less than 0.1°, and the difference was not significant. However, the stress of the screw-rod system when the original internal fixation was retained and prolonged fixation was performed with dual-trajectory screws was less than that when the original internal fixation was removed and prolonged fixation was performed with a long bar. Especially in axial rotation, the difference between models A and B is the largest, and the difference in peak stress reached 30 MPa. However, for the ASDz revision surgery segment, the endplate stress between the two models was the lowest, and the intradiscal pressure (IDP) of the adjacent segment was not significantly different between different models. CONCLUSION: Although ASDz revision surgery by retaining the original internal fixation and prolonging fixation with dual-trajectory screws led to an increase in stress in the fusion segment endplate, it provides stability similar to ASDz revision surgery by removing the original internal fixation and prolonging fixation with a long bar and does not lead to a significant change in the IDP of the adjacent segment while avoiding a greater risk of rod fracture.

Functional disability and utilisation of long-term care in the older population in England: a dual trajectory analysis.

This study investigates the developmental trajectories of long-term care needs and utilisation in older people aged 65 years and over in England. The data came from the English Longitudinal Survey of Ageing (ELSA, waves 6-9, 2012-2018, N = 13,425). We conducted dual trajectory analyses to cluster people's trajectories of care needs (measured by functional disability) and utilisation into distinct groups. We conducted logistic regression analyses to identify the factors associated with trajectory memberships. We identified three trajectories of long-term needs (low, medium, and high) and three trajectories of care utilisation (low, medium, and high). Both care needs and care hours increased with age, but the speed of increase varied by trajectory. Females, minority ethnic groups, people with low wealth, and those experiencing housing problems were more likely to follow the joint trajectories characterised by higher care needs and higher care intensity. People with low or medium care needs stayed in the same trajectories of care utilisation. In contrast, people in the high-needs trajectory followed divergent trajectories of care utilisation: 63% of them followed the trajectory of high care intensity and the rest (37%) followed the trajectory of medium care intensity. Lack of spouse care was the leading predictor of trajectory divergence (OR = 3.57, p < 0.001). Trajectories of care needs and utilisation are highly heterogeneous in later life, which indicates persistent inequalities over time. Single people with multiple functional limitations face an acute and enduring risk of inadequate care and unmet needs. The amount of support is as important as the availability of support. Supplementary Information: The online version contains supplementary material available at 10.1007/s10433-022-00723-0.

What Influences the Victimization of High-Level Offenders? A Dual Trajectory Analysis of the Victim-Offender Overlap From the Perspective of Routine Activities With Peer Groups.

Although the consistent association between offending and victimization is a long-noted phenomenon, current criminological research is still engaged to gather profound knowledge on the etiology of this victim-offender overlap. Beyond that, the examination of its development over the life course requires further attention to create a better understanding of why offending and victimization are strongly connected. Applying a joint trajectory technique, the present study examines the overlap between distinct trajectories of offending and violent victimization throughout the phase of youth and adolescence using seven consecutive waves from the German longitudinal study "Crime in the Modern City." In particular, the victimization of high-level offenders is investigated taking a routine activity perspective with a focus on activities with peers. The results indicate that there is a sizable overlap between trajectories of violent victimization and constant offending with four out of five high-level offenders being repeatedly victimized. Furthermore, the examination shows that meeting more frequently with friends, going out and drinking alcohol, doing forbidden things for fun, and casually hanging out with friends increases the risk of high-level offending significantly. Moreover, the analysis indicates that meeting frequently with friends enhances the risk of violent victimization for offenders, whereas casually hanging out reduces the risk. However, these impacts can only be observed for the present sample and cannot be generalized with sufficient certainty. In addition, the analysis provides evidence that gender differences in the victim-offender overlap are mediated through diverging activities. Implications and limitations are discussed.

Co-occurring Hearing Loss and Cognitive Decline in Older Adults: A Dual Group-Based Trajectory Modeling Approach.

Hearing loss and cognitive impairments are both highly prevalent neurological complications for older adults. While there is growing evidence to suggest that these two conditions are interrelated, little research has been conducted that directly examines the progression and developmental trajectories of these complications contemporaneously. The aim of the study is to identify the distinct trajectory profiles for hearing loss and cognitive function in an older population over a 10-year period. Through dual trajectory modeling, the interrelationship, co-occurring movements, and overlaps between these two complications were examined. We also investigated the influence of hearing aid ownership on cognitive function trajectories. We utilized longitudinal data from 1,445 participants in the Blue Mountains Hearing Study (aged 55+ years) involving repeated measures from a population-based survey with audiometric hearing assessments. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). The group-based trajectory modeling (GBTM) identified three trajectory profiles for both hearing loss and cognitive function in two older age groups (55-69 years and 70+ years). The outputs from the dual trajectories models showed the conditional probability for "no hearing loss" trajectories to be around 90% more likely to have "high-normal" cognitive function, demonstrating co-occurring overlap. In contrast, for "moderate to severe hearing loss" trajectories, the conditional probability drops to 65% and 79% for the 55-69 age group and 70+ age group respectively. There was also an increasing probability for "cognitive decline" conditional on the severity of hearing loss with 6.7%, 7.5%, and 8.7% for no hearing loss, mild hearing loss, and moderate to severe hearing loss trajectory groups. While we did not find any statistically significant difference in the influence of hearing aid use in the cognitive function trajectories, there was a consistent greater representation of non-hearing aid users in the trajectories with poorer cognitive function. This study found GBTM to identify trajectories that were in agreement with our current understanding of hearing loss and cognitive impairment in older adults. This study also adds to the existing evidence-base as dual trajectories demonstrated co-occurrence in developmental changes in these two common neurological complications for the older population.

Classifying and predicting risky driving among novice drivers: A group-based trajectory approach.

INTRODUCTION: Classifying risky driving among new teenage drivers is important for efficiently targeting driving interventions. We thoroughly investigated whether novice drivers can be clustered by their driving outcome profiles over time. METHODS: A sample of 51 newly licensed teen drivers was recruited and followed over a period of 20 weeks. An in-vehicle video recording system was used to gather data on dangerous driving events referred to as DDEs (elevated g-force, near-crash, and crash events), risky driving behaviors referred to as RDBs (e.g., running stop signs, cell phone use while driving), and miles traveled. The DDE and RDB weekly rates rate were determined by dividing the number of DDEs and RDBs in a week by the number of miles traveled in that week, respectively. Group-based trajectory modeling was used to map the clustering of DDE rate and RDB rate patterns over time and their associated covariates. RESULTS: Two distinct DDE rate patterns were found. The first group (69.1% of the study population) had a lower DDE rate which was consistent over time. The second had a higher DDE rate pattern (30.9%) and characterized by a rising trend in DDE rate followed by a steady decrease (inverted U-shaped pattern). Two RDB rate patterns were also identified: a lower RDB rate pattern (83.4% of the study population) and a higher RDB rate pattern (16.6%). RDB and DDE rate patterns were positively related, and therefore, co-occurred. The results also showed that males were more likely than females to be in the higher DDE and RDB rate patterns. CONCLUSION: The groups identified by trajectory models may be useful for targeting driving interventions to teens that would mostly benefit as the different trajectories may represent different crash risk levels. Practical applications: Parents using feedback devices to monitor the driving performance of their teens can use the initial weeks of independent driving to classify their teens as low or high-risk drivers. Teens making a very few DDEs during their early weeks of independent driving are likely to remain in the lower risk group over time and can be spared from monitoring and interventions. However, teens making many DDEs during their initial weeks of unsupervised driving are likely to continue to make even more DDEs and would require careful monitoring and targeted interventions.

Dual trajectory of sleep and frail in elderly people / 中南大学学报(医学版)

The high incidence of dual sleep and frail disorders in the elderly people, often occurring together, seriously affects the physical and mental health of the older people, effective research on the dynamics of dual sleep and frail disorders is important for improving the quality of life for the older people and responding to global ageing trend. While trajectory studies provide a unique practical scientific perspective to grasp the dynamics of development, dual trajectories unite dual barriers provide an opportunity to study the dynamic dependence of both sleep and frailty simultaneously sleep trajectories and frailty trajectories in older people are interrelated and interacted through deeper mechanisms. Therefore, it is necessary for the study not only focus on the ongoing development of health problems, but also needs to consider multiple aspects and propose targeted intervention program.

Within-couple specialisation in paid work: A long-term pattern? A dual trajectory approach to linking lives.

Research on the division of labour has mainly focussed on transitions between individuals' labour market states during the first years of parenthood. A common conclusion has been that couples specialize--women in unpaid and men in paid work--either due to gender ideologies or a comparative advantage in the labour market. But what happens later in life? The German Socio-Economic Panel now provides researchers with a continuous measure of working hours across decades of couples' lives, enabling a dual trajectory analysis to explore couples' long-term specialisation patterns. I focus on the career trajectories of West German couples, and specifically, due to the relatively low institutional and normative support for female employment during its members' early years, on the 1956-65 female birth cohort. Even in this setting and with a conservative estimate, a surprisingly small number of couples--only a fifth--adopt full specialisation in later life. A sizable proportion--a third--moves into dual full-time employment. This trend is even more common among highly educated couples: half of those couples move into dual full-time employment. I find that highly educated women are not only less likely to permanently specialise but also more likely to try working full-time, possibly because their partners' comparative advantages are lower. But despite high opportunity costs, 45% of highly educated parents never try to pursue a dual career either because of a satiation of material wants or because of low societal support for maternal employment. The latter phenomenon is further underscored by the finding that many couples' increase in working hours occurs only when a youngest child is a teenager.

Parallel Development of Risk Behaviors in Adolescence: Potential Pathways to Co-occurrence.

This study used data from 5,382 adolescents from the 1997 U.S. National Longitudinal Survey of Youth (NLSY97) to investigate developmental pathways of alcohol use, marijuana use, sexual risk behaviors, and delinquency across ages 14 to 20, examine interrelationships among these risk behaviors across adolescence, and evaluate association between risk behavior trajectories and depressive symptoms in adolescence. Group-based dual trajectory modeling, examining trajectories of two outcomes over time, revealed strong interrelationships among developmental trajectories of the four risk behaviors, and indicated potential pathways to co-occurring risk behaviors. Adolescents with higher levels of alcohol use or marijuana use were more likely to engage in higher levels of early sexual risk-taking and delinquency. Moreover, adolescents involved in higher levels of delinquency were at higher risk for engaging in early sexual risk-taking. Also belonging to the highest risk trajectory of any of the four risk behaviors was positively associated with depressive symptoms in adolescence.