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Cameron B, Webber K, Li H, Bennett B, Boyle F, de Souza P, Wilcken N, Lynch J, Friedlander M, Goldstein D, Lloyd A. Genetic associations of fatigue and other symptoms following breast cancer treatment: A prospective study. Brain Behav Immun Health 2021; 10:100189. [PMID: 34589724 PMCID: PMC8474532 DOI: 10.1016/j.bbih.2020.100189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/04/2020] [Accepted: 12/06/2020] [Indexed: 12/30/2022] Open
Abstract
Background Cancer-related fatigue, mood disturbances, pain and cognitive disturbance are common after adjuvant cancer therapy, but vary considerably between individuals despite common disease features and treatment exposures. A genetic basis for this variability was explored in a prospective cohort. Methods Physical and psychological health of women were assessed prospectively following therapy for early stage breast cancer with self-report questionnaires. Participation in a genetic association sub-study was offered. Indices for the key symptom domains of fatigue, pain, depression, anxiety, and neurocognitive difficulties were empirically derived by principal components analysis from end-treatment questionnaires, and then applied longitudinally. Genetic associations were sought with functional single nucleotide polymorphisms (SNPs) in pro- and anti-inflammatory cytokine genes - tumour necrosis factor (TNF)-α (−308 GG), interferon (IFN)-ɣ (+874 TA), interleukin (IL)-10 (1082 GA and −592 CA), IL-6 (−174 GC), IL-1β (−511 GA). Results Questionnaire data was available for 210 participants, of whom 111 participated in the genetic sub-study. As expected, symptom domain scores generally improved over several months following treatment completion. Tumour and adjuvant treatment related factors were unassociated with either severity or duration of the individual symptom domains, but severity of symptoms at end-treatment was strongly associated with duration for each domain (all p < 0.05). In multivariable analyses, risk genotypes were independently associated with: fatigue with IL-6 -174 GG/GC and IL-10 -1082 GG; depression and anxiety with IL-10 -1082 AA; neurocognitive disturbance: TNF-α −308 GG; depression IL-1β (all p < 0.05). The identified SNPs also had cumulative effects in prolonging the time to recovery from the associated symptom domain. Conclusions Genetic factors contribute to the severity and duration of common symptom domains after cancer therapy. Common symptoms following breast cancer treatment can be grouped into symptom domains. Symptom domains are useful to describe patterns and trajectories of symptoms following breast cancer treatment. Cytokine gene polymorphisms are associated with the severity and duration of symptom domains following cancer treatment. The symptom severity at final treatment predicts the duration of symptoms.
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Coll C, Ewerling F, Lynch J, Raj A, Victora C, Barros A. 369Womeńs empowerment benefits early childhood numeracy-literacy in 26 African countries. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Every year more than 200 million children under-five years fail to achieve their full developmental potential in low- and middle-income countries. We explored whether mothers’ empowerment is associated with early childhood development in 26 African countries.
Methods
We used data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys ranging from 2010 to 2018. Four developmental domains were assessed among children aged 36-59 months using the Early Childhood Development Index: literacy-numeracy, physical, learning and socioemotional. Women’s empowerment in attitude to violence, social independence and decision-making was evaluated using the SWPER Global, a validated survey-based index. We used logistic regression to estimate the associations between mother’s empowerment level in each domain and the development of their children controlled by wealth.
Results
Across all countries, 15·1% of the children were on track in the literacy-numeracy domain, 92·3% in physical, 81·3% in learning and 67·8% in socio-emotional. The odds of a child being on track in literacy-numeracy increased by 11%, 34% and 18%, with a one standard deviation increase in the scores of attitudes to violence, social independence and decision-making domains of empowerment, respectively. No effect of empowerment was observed for the other domains of child development in most countries.
Conclusions
We found a consistent and positive effect of mothers’ empowerment on the literacy-numeracy domain of child development. The null effects in other developmental domains may be related to lower variability in these outcomes, or to specific effects on literacy-numeracy.
Key messages
Womeńs empowerment has a potential to improve child development and their future human capital
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Gialamas A, Haag D, Mittinty M, Lynch J. 511Effects of educational activities prior to school entry are more important for socioeconomically disadvantaged children. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
We examined whether time in educational activities at 2-3 years and language ability at school entry differed among children from diverse socioeconomic backgrounds.
Methods
Data were drawn from the Longitudinal Study of Australian Children (n = 4253). Educational activities were collected using time-use diaries. Household income was measured using parent self-report. Language ability was assessed using the Peabody Picture Vocabulary Test. Marginal structural models with inverse probability of treatment weights were used to assess modification of the effect of time spent in educational activities on language ability by income.
Results
Children exposed to both <30 minutes/day in educational activities and being in a low-income household were at greater risk of poorer outcomes than the simple sum of their independent effects. Compared with children who spent ≥30 minutes/day in educational activities and from higher-income households, children who experienced <30 minutes/day from low-income households had a 2.30 (95% CI: 1.88, 2.80) higher risk of having lower language ability. The Relative Excess Risk Due to Interaction of 0.15 (95% CI:-0.15, 0.67) was greater than zero indicating a super-additive effect measure modification by income.
Conclusions
Our results suggest that boosting time in educational activities to 30 minutes/day would benefit the lower-income group relatively more than the higher-income group.
Key messages
If there was an intervention of sufficient dose to increase the amount of time spent in educational activities to 30 minutes/day for children in the lower-income group, the risk of children having lower language ability at school entry could be reduced by 45%.
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Brushe M, Lynch J, Reilly S, Melhuish E, Brinkman S. 409The Word Gap: At What Age Does it Emerge? Results from a Prospective Cohort Study. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Language is a critical development accomplishment of early childhood, enabling later literacy, education and employment. Previous studies have highlighted socioeconomic inequalities in the amount parents speak to their child, with researchers estimating by age four parents from professional backgrounds spoke 30 million more words to their children, than parents who were on welfare.
Methods
This study utilises innovative speech recognition technology called Language Environment Analysis (LENA), which counts the number of words children hear and speak over a day. LENA data is collected once every six months from 6 – 48 months of age, across two cohorts of children who are stratified by two levels of maternal education to examine the effects across socioeconomic groups.
Results
Results from the first three waves of data collection demonstrate that differences between education groups in the number of adult words spoken to the child are not evident until the children are 18 months old. Average change in adult word counts per day by maternal education show there is a difference of 17 words at 6 months, 568 words at 12 months and 3,851 words at 18 months.
Conclusions
This is the first study to be able to identify the age when socioeconomic differences in the amount of talk emerge. This has significant implications for the timing of interventions aiming to reduce the word gap, suggesting targeting the implementation of programs prior to 18 months.
Key messages
Socioeconomic differences in the amount parents talk to their children do not emerge until children are 18 months old.
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Chittleborough C, Brown T, Schuch H, Kalamkarian A, Pilkington R, Montgomerie A, Mittinty M, Lynch J. 838Thriving in adversity: positive child development despite early disadvantage in a whole-of-population data linkage study. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Experiencing socioeconomic disadvantage, poor health, or child maltreatment in early life has negative effects on child development. However, we know little about children who have good developmental outcomes despite experiencing adversity.
Methods
This study used de-identified, linked government administrative data from the South Australian Early Childhood Data Project: specifically Australian Early Development Census (AEDC) data for all South Australian born children in their first year of school in 2009, 2012 and 2015 (n = 47,179) and their corresponding birth, perinatal, school enrolment, hospital admission, emergency department presentation, public housing and child protection data. Latent class analyses constructed multidimensional measures of socioeconomic, health, and maltreatment adversities experienced from birth to age 5.
Results
Overall, 49.8% (95% CI 49.2-50.4) of children were on track on all five AEDC domains, but this ranged from 53.7% among children who did not experience high levels of adversity to 13.5% among children with high levels of all three adversities.
Conclusions
Among children who experienced high levels of two or three early adversity types, approximately 1 in 5 were developmentally on track. Understanding characteristics of these children who thrive, against the odds, will help identify intervention opportunities to improve child development.
Key messages
Compared with children who did not experience high levels of adversity, each additional adversity reduced the likelihood of being developmentally on track by approximately 10% to 15%. Children experiencing socioeconomic or maltreatment adversity were less likely to be developmentally on track than children experiencing health adversity.
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Chittleborough C, Schuch H, Pilkington R, Montgomerie A, Grant J, Petersen J, Lynch J. 844Considering child maltreatment in social inequalities of educational achievement: a whole-of-population data linkage study. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Strategies aimed at reducing health inequalities include a focus on improving education, a key determinant of health and labour market outcomes. Studies have demonstrated that both early life socioeconomic disadvantage and child maltreatment result in poorer educational outcomes, but have not examined the effect of the combination of these adversities.
Methods
This study used de-identified, linked government administrative data from the South Australian Early Childhood Data Project on children born in South Australia who completed Year 5 National Assessment Program—Literacy and Numeracy (NAPLAN) during 2008-2015 (n = 61,445), and their corresponding birth, perinatal, school enrolment and child protection system data.
Results
Overall, 23.7% (95% CI 23.4-24.1) had a poor NAPLAN outcome (at or below national minimum standard on three or more of the five domains - reading, writing, spelling, grammar and punctuation, numeracy). This proportion was approximately double for children who experienced substantiated maltreatment compared to children who did not experience contact with the child protection system, irrespective of the social circumstances (parental education, employment, housing and area-level disadvantage) in which the child lived.
Conclusions
Social advantage is not sufficient to protect children from poor educational outcomes if they experience substantiated maltreatment. Interventions and services will need to focus on child maltreatment, in addition to socioeconomic factors, to improve educational outcomes in the population.
Key messages
Within each social group, from advantaged to disadvantaged children, the risk of poor NAPLAN outcomes was greater for children who had contact with the child protection system.
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Lynch J, Lorenz L, Brueggemeyer JL, Lanzarotta A, Falconer TM, Wilson RA. Simultaneous Temperature Measurements and Aerosol Collection During Vaping for the Analysis of Δ 9-Tetrahydrocannabinol and Vitamin E Acetate Mixtures in Ceramic Coil Style Cartridges. Front Chem 2021; 9:734793. [PMID: 34434923 PMCID: PMC8381023 DOI: 10.3389/fchem.2021.734793] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/27/2021] [Indexed: 01/09/2023] Open
Abstract
Incidence of e-cigarette, or vaping, product use-associated lung injury (EVALI) has been linked to the vaping of tetrahydrocannabinol (THC) products to which vitamin E acetate (VEA) has been added. In this work we vaped THC/VEA mixtures at elevated power levels using a variety of ceramic coil vaping cartridges and a commercially available vaping device, while simultaneously measuring temperature and collecting the vaporized condensate. The collected vapor condensate was analyzed for evidence of VEA decomposition by GC/MS, GC/FT-IR/MS, and LC-APCI-HRMS/MS. Mean temperature maxima for all examined cartridges at the selected power exceeded 430°C, with a range of 375–569°C, well beyond that required for thermal decomposition of VEA. The percent recovery of VEA and Δ9-THC from the vaporized mixture in six cartridges ranged from 71.5 to 101% and from 56.4 to 88.0%, respectively. Analysis of the condensed vaporized material identified VEA decomposition products duroquinone (DQ), 1-pristene, and durohydroquinone monoacetate (DHQMA); a compound consistent with 4-acetoxy-2,3,5-trimethyl-6-methylene-2,4-cyclohexadienone (ATMMC) was also detected. The concentration of DQ produced from vaporization of the THC/VEA mixture in one cartridge was found to be 4.16 ± 0.07 μg per mg of vapor condensate.
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Allen M, Tanaka K, Macey A, Cain M, Jenkins S, Lynch J, Smith M. Ensuring that offsets and other internationally transferred mitigation outcomes contribute effectively to limiting global warming. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2021; 16:074009. [PMID: 34178096 PMCID: PMC8222969 DOI: 10.1088/1748-9326/abfcf9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/24/2021] [Accepted: 04/29/2021] [Indexed: 05/10/2023]
Abstract
Ensuring the environmental integrity of internationally transferred mitigation outcomes, whether through offset arrangements, a market mechanism or non-market approaches, is a priority for the implementation of Article 6 of the Paris Agreement. Any conventional transferred mitigation outcome, such as an offset agreement, that involves exchanging greenhouse gases with different lifetimes can increase global warming on some timescales. We show that a simple 'do no harm' principle regarding the choice of metrics to use in such transactions can be used to guard against this, noting that it may also be applicable in other contexts such as voluntary and compliance carbon markets. We also show that both approximate and exact 'warming equivalent' exchanges are possible, but present challenges of implementation in any conventional market. Warming-equivalent emissions may, however, be useful in formulating warming budgets in a two-basket approach to mitigation and in reporting contributions to warming in the context of the global stocktake.
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Brown A, Schwarcz L, Counts CR, Barnard LM, Yang BY, Emert JM, Latimer A, Drucker C, Lynch J, Kudenchuk PJ, Sayre MR, Rea T. Risk for Acquiring Coronavirus Disease Illness among Emergency Medical Service Personnel Exposed to Aerosol-Generating Procedures. Emerg Infect Dis 2021; 27:2340-2348. [PMID: 34197282 PMCID: PMC8386780 DOI: 10.3201/eid2709.210363] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
We investigated the risk of coronavirus disease (COVID-19)- patients transmitting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to emergency medical service (EMS) providers, stratified by aerosol-generating procedures (AGP), in King County, Washington, USA, during February 16-July 31, 2020. We conducted a retrospective cohort investigation using a statewide COVID-19 registry and identified 1,115 encounters, 182 with ≥1 AGP. Overall, COVID-19 incidence among EMS personnel was 0.57 infections/10,000 person-days. Incidence per 10,000 person-days did not differ whether or not infection was attributed to a COVID-19 patient encounter (0.28 vs. 0.59; p>0.05). The 1 case attributed to a COVID-19 patient encounter occurred within an at-risk period and involved an AGP. We observed a very low risk for COVID-19 infection attributable to patient encounters among EMS first responders, supporting clinical strategies that maintain established practices for treating patients in emergency conditions.
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McEwen AE, Cohen S, Bryson-Cahn C, Liu C, Pergam SA, Lynch J, Schippers A, Strand K, Whimbey E, Mani NS, Zelikoff AJ, Makarewicz VA, Brown ER, Bakhash SAM, Baker NR, Castor J, Livingston RJ, Huang ML, Jerome KR, Greninger AL, Roychoudhury P. Variants of concern are overrepresented among post-vaccination breakthrough infections of SARS-CoV-2 in Washington State. Clin Infect Dis 2021; 74:1089-1092. [PMID: 34166484 PMCID: PMC8394820 DOI: 10.1093/cid/ciab581] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Indexed: 12/22/2022] Open
Abstract
Across 20 vaccine breakthrough cases detected at our institution, all 20 (100%) infections were due to variants of concern (VOCs) and had a median Ct of 20.2 (IQR, 17.1–23.3). When compared with 5174 contemporaneous samples sequenced in our laboratory, VOCs were significantly enriched among breakthrough infections (P < .05).
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Blakely T, Lynch J, Simons K, Bentley R, Rose S. Reflection on modern methods: when worlds collide-prediction, machine learning and causal inference. Int J Epidemiol 2021; 49:2058-2064. [PMID: 31298274 DOI: 10.1093/ije/dyz132] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2019] [Indexed: 02/06/2023] Open
Abstract
Causal inference requires theory and prior knowledge to structure analyses, and is not usually thought of as an arena for the application of prediction modelling. However, contemporary causal inference methods, premised on counterfactual or potential outcomes approaches, often include processing steps before the final estimation step. The purposes of this paper are: (i) to overview the recent emergence of prediction underpinning steps in contemporary causal inference methods as a useful perspective on contemporary causal inference methods, and (ii) explore the role of machine learning (as one approach to 'best prediction') in causal inference. Causal inference methods covered include propensity scores, inverse probability of treatment weights (IPTWs), G computation and targeted maximum likelihood estimation (TMLE). Machine learning has been used more for propensity scores and TMLE, and there is potential for increased use in G computation and estimation of IPTWs.
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Kluczkovski A, Lait R, Martins CA, Reynolds C, Smith P, Woffenden Z, Lynch J, Frankowska A, Harris F, Johnson D, Halford JCG, Cook J, Tereza da Silva J, Schmidt Rivera X, Huppert JL, Lord M, Mclaughlin J, Bridle S. Learning in lockdown: Using the COVID-19 crisis to teach children about food and climate change. NUTR BULL 2021; 46:206-215. [PMID: 33821147 PMCID: PMC8014588 DOI: 10.1111/nbu.12489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/03/2021] [Accepted: 02/08/2021] [Indexed: 11/29/2022]
Abstract
Food systems are significant sources of global greenhouse gas emissions (GHGE). Since emission intensity varies greatly between different foods, changing food choices towards those with lower GHGE could make an important contribution to mitigating climate change. Public engagement events offer an opportunity to communicate these multifaceted issues and raise awareness about the climate change impact of food choices. An interdisciplinary team of researchers was preparing food and climate change educational activities for summer 2020. However, the COVID-19 pandemic and lockdown disrupted these plans. In this paper, we report on shifting these events online over the month of June 2020. We discuss what we did and the reception to our online programme. We then reflect on and highlight issues that arose. These relate to: (1) the power dynamics of children, diet and climate change; (2) mental health, diet and COVID-19; (3) engaging the wider science, agriculture and food communities; (4) the benefits of being unfunded and the homemade nature of this programme; (5) the food system, STEAM (science, technology, engineering, arts and mathematics) and diversity; and (6) how our work fits into our ongoing journey of food and climate change education.
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Zhao Y, Zhu Z, Chang J, Wang G, Zheng S, Kwoh CK, Lynch J, Hunter DJ, Ding C. Predictive value of the morphology of proximal tibiofibular joint for total knee replacement in patients with knee osteoarthritis. J Orthop Res 2021; 39:1289-1296. [PMID: 32940927 DOI: 10.1002/jor.24862] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/06/2020] [Accepted: 09/14/2020] [Indexed: 02/04/2023]
Abstract
The association between proximal tibiofibular joint (PTFJ) and knee osteoarthritis (OA) has been understudied. The objective of this study was to determine whether the morphology of PTFJ has predictive value for the risk of total knee replacement (TKR). Case knees from Osteoarthritis Initiative participants with TKR at 24-60 months follow up (cases) were 1:1 matched with control knees (no TKR throughout 60 months) by baseline age, sex, and Kellgren-Lawrence grade. PTFJ morphological parameters, including coronal inclination angle (angle α), sagittal inclination angle (angle β), fibular contacting area (S), load-bearing area (Sτ), lateral stress-bolstering area (Sφ), and posterior stress-bolstering area (Sυ) were assessed using coronal and sagittal magnetic resonance imaging (MRI), respectively. Associations of the morphological measures at baseline and the time point before TKR (T0 ) and their changes with TKR risks were examined using conditional logistic regression analyses. Two hundred and twenty-three knees of 193 participants received TKR between 12 and 60 months and therefore were matched with 223 control knees. Of these, 173 paired knees had MRI readings available both at baseline and T0 time point. While baseline angle α was positively associated with TKR risk, other measures at baseline and all measures at T0 were not significantly associated with TKR risk. Changes in S, Sτ, and Sυ were significantly and negatively associated with the risk of TKR (ΔS, odds ratio [OR] = 0.38, 95% confidence interval [CI]: 0.19-0.76; ΔSτ, OR = 0.37, 95% CI: 0.16-0.87; ΔSυ, OR = 0.22, 95% CI: 0.08-0.62, respectively). This data shows that morphological changes of PTFJ predict the risk of TKR, suggesting PTFJ may play a role in knee OA.
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Cuschieri J, Robinson B, Lynch J, Mitchell S, Arbabi S, Bryson C, Sayre M, Maier RV, Bulger E. The Covid-19 Pandemic: Lessons Learned for Sustained Trauma Preparedness and Responses. Ann Surg 2021; 273:1051-1059. [PMID: 33378302 DOI: 10.1097/sla.0000000000004695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The emergence of coronavirus disease 2019 (COVID-19) that is caused by the SARS-CoV-2 virus has led to an overwhelming strain on healthcare delivery. This pandemic has created a sustained stress on the modern healthcare system, with unforeseen and potential drastic effects. Although the initial focus during this pandemic has been preparedness and response directed to the pandemic itself, traumatic injury has continued to remain a common problem that requires immediate evaluation and care to provide optimal outcomes. The State of Washington had the first reported case and death related to COVID-19 in the United States. Harborview Medical Center, which serves as the sole Level-1 adult and pediatric trauma center for the state, was rapidly affected by COVID-19, but still needed to maintain preparedness and responses to injured patients for the region. Although initially the focus was on the emerging pandemic on institutional factors, it became obvious that sustained efforts for regional trauma care required a more global focus. Because of these factors, Harborview Medical Center was quickly entrusted to serve as the coordinating center for the regions COVID-19 response, while also continuing to provide optimal care for injured patients during the pandemic. This response allowed the care of injured patients to be maintained within designated trauma centers during this pandemic. This present report summarizes the evolution of trauma care delivery during the first phase of this pandemic and provides informative recommendations for sustained responses to the care of injured patients during the pandemic based on lessons learned during the initial response.
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Brushe ME, Lynch J, Reilly S, Melhuish E, Mittinty MN, Brinkman SA. The education word gap emerges by 18 months: findings from an Australian prospective study. BMC Pediatr 2021; 21:247. [PMID: 34020609 PMCID: PMC8139043 DOI: 10.1186/s12887-021-02712-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The idea of the '30 million word gap' suggests families from more socioeconomically advantaged backgrounds engage in more verbal interactions with their child than disadvantaged families. Initial findings from the Language in Little Ones (LiLO) study up to 12 months showed no word gap between maternal education groups. METHODS Families with either high or low maternal education were purposively recruited into a five-year prospective study. We report results from the first three waves of LiLO when children were 6, 12 and 18 months old. Day-long audio recordings, obtained using the Language Environment Analysis software, provided counts of adult words spoken to the child, child vocalizations and conversational turns. RESULTS By the time children were 18 months old all three measures of talk were 0.5 to 0.7 SD higher among families with more education, but with large variation within education groups. Changes in talk from 6 to 18 months highlighted that families from low educated backgrounds were decreasing the amount they spoke to their children (- 4219.54, 95% CI -6054.13, - 2384.95), compared to families from high educated backgrounds who remained relatively stable across this age period (- 369.13, 95% CI - 2344.57, 1606.30). CONCLUSIONS The socioeconomic word gap emerges between 12 and 18 months of age. Interventions to enhance maternal communication, child vocalisations and vocabulary development should begin prior to 18 months.
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Barnsley JE, Chandrakumar C, Gonzalez-Fischer C, Eme PE, Bourke BEP, Smith NW, Dave LA, McNabb WC, Clark H, Frame DJ, Lynch J, Roche JR. Lifetime climate impacts of diet transitions: a novel climate change accounting perspective. SUSTAINABILITY 2021; 13:5568. [PMID: 34164161 PMCID: PMC7611040 DOI: 10.3390/su13105568] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Dietary transitions, such as eliminating meat consumption, have been proposed as one way to reduce the climate impact of the global and regional food systems. However, it should be ensured that replacement diets are indeed nutritious and that climate benefits are accurately accounted for. This study uses New Zealand food consumption as a case study for exploring the cumulative climate impact of adopting the national dietary guidelines and the substitution of meat from hypothetical diets. The new GWP* metric is used as it was designed to better reflect the climate impacts of the release of methane than the de facto standard 100-year Global Warming Potential metric (GWP100). A transition at age 25 to the hypothetical dietary guideline diet reduces cumulative warming associated with diet by 7 to 9% at the 100th year compared with consuming the average New Zealand diet. The reduction in diet-related cumulative warming from the transition to a hypothetical meat-substituted diet varied between 12 and 15%. This is equivalent to reducing an average individual's lifetime warming contribution by 2 to 4%. General improvements are achieved for nutrient intakes by adopting the dietary guidelines compared with the average New Zealand diet; however, the substitution of meat items results in characteristic nutrient differences, and these differences must be considered alongside changes in emission profiles.
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Joseph GB, Ramezanpour S, McCulloch CE, Nevitt MC, Lynch J, Lane NE, Pedoia V, Majumdar S, Link TM. Weight Cycling and Knee Joint Degeneration in Individuals with Overweight or Obesity: Four-Year Magnetic Resonance Imaging Data from the Osteoarthritis Initiative. Obesity (Silver Spring) 2021; 29:909-918. [PMID: 33797183 PMCID: PMC9404626 DOI: 10.1002/oby.23129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/29/2020] [Accepted: 01/19/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the associations between weight cycling and knee joint degeneration in individuals with overweight or obesity with different patterns of weight change over 4 years. METHODS A total of 2,271 individuals from the Osteoarthritis Initiative database were assessed (case-control study). Linear regression models using annual BMI measurements over 4 years were used to classify participants as weight cyclers or noncyclers. 3-T magnetic resonance imaging was used to quantify knee cartilage transverse relaxation time (T2) and cartilage thickness annually over 4 years in all subjects. Whole-Organ Magnetic Resonance Imaging Scores (WORMS) were obtained for cartilage, meniscus, and bone-marrow abnormalities in 958 subjects at baseline and at the 4-year follow-up. The longitudinal differences in cartilage T2 and thickness between weight cyclers and noncyclers were assessed using general estimating equations, whereas the differences in WORMS outcomes were compared using general linear models. RESULTS No significant differences in the rate of change of cartilage thickness or T2 were found between weight cyclers and noncyclers. However, increases in maximum cartilage WORMS (P = 0.0025) and bone-marrow abnormalities (P = 0.04) were significantly greater in weight cyclers than in noncyclers. CONCLUSIONS Although participants' intent for weight cycling in this study was unknown, weight cyclers had significantly greater increases in cartilage and bone-marrow abnormalities over 4 years than noncyclers, independent of weight gain and loss.
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Korda RJ, Biddle N, Lynch J, Eynstone-Hinkins J, Soga K, Banks E, Priest N, Moon L, Blakely T. Education inequalities in adult all-cause mortality: first national data for Australia using linked census and mortality data. Int J Epidemiol 2021; 49:511-518. [PMID: 31581296 PMCID: PMC7266531 DOI: 10.1093/ije/dyz191] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2019] [Indexed: 12/16/2022] Open
Abstract
Background National linked mortality and census data have not previously been available for Australia. We estimated education-based mortality inequalities from linked census and mortality data that are suitable for international comparisons. Methods We used the Australian Bureau of Statistics Death Registrations to Census file, with data on deaths (2011–2012) linked probabilistically to census data (linkage rate 81%). To assess validity, we compared mortality rates by age group (25–44, 45–64, 65–84 years), sex and area-inequality measures to those based on complete death registration data. We used negative binomial regression to quantify inequalities in all-cause mortality in relation to five levels of education [‘Bachelor degree or higher’ (highest) to ‘no Year 12 and no post-secondary qualification’ (lowest)], separately by sex and age group, adjusting for single year of age and correcting for linkage bias and missing education data. Results Mortality rates and area-based inequality estimates were comparable to published national estimates. Men aged 25–84 years with the lowest education had age-adjusted mortality rates 2.20 [95% confidence interval (CI): 2.08‒2.33] times those of men with the highest education. Among women, the rate ratio was 1.64 (1.55‒1.74). Rate ratios were 3.87 (3.38‒4.44) in men and 2.57 (2.15‒3.07) in women aged 25–44 years, decreasing to 1.68 (1.60‒1.76) in men and 1.44 (1.36‒1.53) in women aged 65–84 years. Absolute education inequalities increased with age. One in three to four deaths (31%) was associated with less than Bachelor level education. Conclusions These linked national data enabled valid estimates of education inequality in mortality suitable for international comparisons. The magnitude of relative inequality is substantial and similar to that reported for other high-income countries.
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Lynch J, Cain M, Frame D, Pierrehumbert R. Agriculture's Contribution to Climate Change and Role in Mitigation Is Distinct From Predominantly Fossil CO 2-Emitting Sectors. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2021; 4:518039. [PMID: 33644695 PMCID: PMC7116829 DOI: 10.3389/fsufs.2020.518039] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Agriculture is a significant contributor to anthropogenic global warming, and reducing agricultural emissions—largely methane and nitrous oxide—could play a significant role in climate change mitigation. However, there are important differences between carbon dioxide (CO2), which is a stock pollutant, and methane (CH4), which is predominantly a flow pollutant. These dynamics mean that conventional reporting of aggregated CO2-equivalent emission rates is highly ambiguous and does not straightforwardly reflect historical or anticipated contributions to global temperature change. As a result, the roles and responsibilities of different sectors emitting different gases are similarly obscured by the common means of communicating emission reduction scenarios using CO2-equivalence. We argue for a shift in how we report agricultural greenhouse gas emissions and think about their mitigation to better reflect the distinct roles of different greenhouse gases. Policy-makers, stakeholders, and society at large should also be reminded that the role of agriculture in climate mitigation is a much broader topic than climate science alone can inform, including considerations of economic and technical feasibility, preferences for food supply and land-use, and notions of fairness and justice. A more nuanced perspective on the impacts of different emissions could aid these conversations.
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Blakely T, Pearce N, Lynch J, Dharmage S, Russell M, Lawlor D, Bentley R. Causal ordering among risk factors in the PURE study. Lancet 2021; 397:278. [PMID: 33485448 DOI: 10.1016/s0140-6736(20)32404-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 09/14/2020] [Indexed: 11/20/2022]
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Clark MA, Domingo NGG, Colgan K, Thakrar SK, Tilman D, Lynch J, Azevedo IL, Hill JD. Global food system emissions could preclude achieving the 1.5° and 2°C climate change targets. Science 2020; 370:705-708. [PMID: 33154139 DOI: 10.1126/science.aba7357] [Citation(s) in RCA: 214] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 09/01/2020] [Indexed: 12/13/2022]
Abstract
The Paris Agreement's goal of limiting the increase in global temperature to 1.5° or 2°C above preindustrial levels requires rapid reductions in greenhouse gas emissions. Although reducing emissions from fossil fuels is essential for meeting this goal, other sources of emissions may also preclude its attainment. We show that even if fossil fuel emissions were immediately halted, current trends in global food systems would prevent the achievement of the 1.5°C target and, by the end of the century, threaten the achievement of the 2°C target. Meeting the 1.5°C target requires rapid and ambitious changes to food systems as well as to all nonfood sectors. The 2°C target could be achieved with less-ambitious changes to food systems, but only if fossil fuel and other nonfood emissions are eliminated soon.
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Finn KS, Lynch J, Aufox S, Bland S, Chung W, Halverson C, Hebbring S, Hoell C, Holm I, Jarvik G, Kullo I, Leppig K, Myers M, Prows C, Rasouly HM, Singh R, Weisner G, Williams J, Wynn J, Smith M, Sharp R. Returning negative results from
large‐scale
genomic screening: Experiences from the
eMERGE III
network. Am J Med Genet A 2020; 185:508-516. [DOI: 10.1002/ajmg.a.62002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Smith KH, Budhraja A, Lynch J, Roberts K, Panetta JC, Connelly JP, Turnis ME, Pruett-Miller SM, Schuetz JD, Mullighan CG, Opferman JT. The Heme-Regulated Inhibitor Pathway Modulates Susceptibility of Poor Prognosis B-Lineage Acute Leukemia to BH3-Mimetics. Mol Cancer Res 2020; 19:636-650. [PMID: 33288732 DOI: 10.1158/1541-7786.mcr-20-0586] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/28/2020] [Accepted: 12/02/2020] [Indexed: 11/16/2022]
Abstract
Antiapoptotic MCL1 is one of the most frequently amplified genes in human cancers and elevated expression confers resistance to many therapeutics including the BH3-mimetic agents ABT-199 and ABT-263. The antimalarial, dihydroartemisinin (DHA) translationally represses MCL-1 and synergizes with BH3-mimetics. To explore how DHA represses MCL-1, a genome-wide CRISPR screen identified that loss of genes in the heme synthesis pathway renders mouse BCR-ABL+ B-ALL cells resistant to DHA-induced death. Mechanistically, DHA disrupts the interaction between heme and the eIF2α kinase heme-regulated inhibitor (HRI) triggering the integrated stress response. Genetic ablation of Eif2ak1, which encodes HRI, blocks MCL-1 repression in response to DHA treatment and represses the synergistic killing of DHA and BH3-mimetics compared with wild-type leukemia. Furthermore, BTdCPU, a small-molecule activator of HRI, similarly triggers MCL-1 repression and synergizes with BH3-mimetics in mouse and human leukemia including both Ph+ and Ph-like B-ALL. Finally, combinatorial treatment of leukemia bearing mice with both BTdCPU and a BH3-mimetic extended survival and repressed MCL-1 in vivo. These findings reveal for the first time that the HRI-dependent cellular heme-sensing pathway can modulate apoptosis in leukemic cells by repressing MCL-1 and increasing their responsiveness to BH3-mimetics. This signaling pathway could represent a generalizable mechanism for repressing MCL-1 expression in malignant cells and sensitizing them to available therapeutics. IMPLICATIONS: The HRI-dependent cellular heme-sensing pathway can modulate apoptotic sensitivity in leukemic cells by repressing antiapoptotic MCL-1 and increasing their responsiveness to BH3-mimetics.
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Begum M, Chittleborough C, Pilkington R, Mittinty M, Lynch J, Penno M, Smithers L. Incidence of type 1 diabetes by socio-demographic characteristics among South Australian children: Whole-of-population study. J Paediatr Child Health 2020; 56:1952-1958. [PMID: 32932553 DOI: 10.1111/jpc.15104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 06/17/2020] [Accepted: 07/06/2020] [Indexed: 11/30/2022]
Abstract
AIM To describe and compare the incidence of type 1 diabetes (T1D) in South Australia by individual and area-level socio-economic characteristics among children aged ≤11 years. METHODS This is a whole-of-population, data linkage study (n = 231 685) conducted in South Australia, and included children born from 2002 to 2013, hospitalisation followed from 2002 to 2014. The study used de-identified, linked administrative hospitalisation, birth and perinatal data from the South Australian Early Childhood Data Project. Incidence was calculated by identifying T1D cases from T1D-related hospitalisations using International Classification of Disease, 10th Revision, Australian Modification diagnosis codes (E10, E101-E109). RESULTS Overall, 333 children aged ≤11 years (173 boys) were identified as having T1D. The T1D incidence rate was 23.0 per 100 000 person-years (95% confidence interval (CI): 20.7-25.7), with no sex difference. T1D incidence was higher among children whose mothers were Caucasian, private patients and whose parents were employed. For example, T1D incidence was 26.0 per 100 000 (95% CI: 22.8-29.5) among children with both parents employed, compared to 20.0 per 100 000 (95% CI: 12.3-30.6) among children with both parents unemployed. There was no clear gradient in the association between area-level socio-economic position and T1D, with highest incidence for the fourth quintile (26.5 per 100 000 (95% CI: 20.9-33.1)). The most advantaged area (19.4 per 100 000 (95% CI: 13.8-26.5)) had lower incidence than the most disadvantaged area (23.5 per 100 000 (95% CI: 18.9-28.9)). CONCLUSION T1D incidence rates differed depending on the measures of socio-economic characteristics. Individual-level indicators showed higher incidence among more advantaged children; however, there was no clear area-level socio-economic patterning of T1D.
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Houlihan LM, Halloran PJO, Lynch J, Widdess-Walsh P, Brennan P, Javadpour M. Reversible cerebral vasoconstrictive syndrome preceded by minor head trauma. Br J Neurosurg 2020; 34:647-649. [DOI: 10.1080/02688697.2019.1672858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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