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Hart JE, Bertrand KA, DuPre N, James P, Vieira VM, VoPham T, Mittleman MR, Tamimi RM, Laden F. Exposure to hazardous air pollutants and risk of incident breast cancer in the nurses' health study II. Environ Health 2018. [PMID: 29587753 DOI: 10.1186/sl2940-018-0372-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Findings from a recent prospective cohort study in California suggested increased risk of breast cancer associated with higher exposure to certain carcinogenic and estrogen-disrupting hazardous air pollutants (HAPs). However, to date, no nationwide studies have evaluated these possible associations. Our objective was to examine the impacts of mammary carcinogen and estrogen disrupting HAPs on risk of invasive breast cancer in a nationwide cohort. METHODS We assigned HAPs from the US Environmental Protection Agency's 2002 National Air Toxics Assessment to 109,239 members of the nationwide, prospective Nurses' Health Study II (NHSII). Risk of overall invasive, estrogen receptor (ER)-positive (ER+), and ER-negative (ER-) breast cancer with increasing quartiles of exposure were assessed in time-varying multivariable proportional hazards models, adjusted for traditional breast cancer risk factors. RESULTS A total of 3321 invasive cases occurred (2160 ER+, 558 ER-) during follow-up 1989-2011. Overall, there was no consistent pattern of elevated risk of the HAPs with risk of breast cancer. Suggestive elevations were only seen with increasing 1,2-dibromo-3-chloropropane exposures (multivariable adjusted HR of overall breast cancer = 1.12, 95% CI: 0.98-1.29; ER+ breast cancer HR = 1.09; 95% CI: 0.92, 1.30; ER- breast cancer HR = 1.14; 95% CI: 0.81, 1.61; each in the top exposure quartile compared to the lowest). CONCLUSIONS Exposures to HAPs during adulthood were not consistently associated with an increased risk of overall or estrogen-receptor subtypes of invasive breast cancer in this nationwide cohort of women.
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Affiliation(s)
- Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 401 Park Dr, Landmark Center, 3rd Floor West (BWH/HSPH), Boston, MA, 02215, USA.
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | | | - Natalie DuPre
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | | | - Trang VoPham
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 401 Park Dr, Landmark Center, 3rd Floor West (BWH/HSPH), Boston, MA, 02215, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Maggie R Mittleman
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 401 Park Dr, Landmark Center, 3rd Floor West (BWH/HSPH), Boston, MA, 02215, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 401 Park Dr, Landmark Center, 3rd Floor West (BWH/HSPH), Boston, MA, 02215, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 401 Park Dr, Landmark Center, 3rd Floor West (BWH/HSPH), Boston, MA, 02215, USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Abstract
PURPOSE OF REVIEW Many studies suggest that exposure to natural vegetation, or greenness, may be beneficial for a variety of health outcomes. We summarize the recent research in this area. RECENT FINDINGS We observed consistent and strong evidence of associations for higher greenness with improvements in birth weights and physical activity, as well as lower mortality rates. Recent studies also suggested that exposure to greenness may lower levels of depression and depressive symptoms. The evidence on greenness and cardiovascular health remains mixed. Findings are also inconsistent for greenness measures and asthma and allergies. Our knowledge of the impacts of greenness on a wide variety of health outcomes continues to evolve. Future research should incorporate information on specific species and some qualities of natural greenness that might drive health outcomes, integrate exposure assessments that incorporate personal mobility into analyses, and include prospective designs to add to the growing evidence that nature exposure positively affects health.
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Affiliation(s)
- Kelvin C Fong
- Department of Environmental Health, Harvard TH Chan School of Public Health, 401 Park Dr, Boston, MA, 02215, USA.
| | - Jaime E Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, 401 Park Dr, Boston, MA, 02215, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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Abstract
PURPOSE OF REVIEW Many studies suggest that exposure to natural vegetation, or greenness, may be beneficial for a variety of health outcomes. We summarize the recent research in this area. RECENT FINDINGS We observed consistent and strong evidence of associations for higher greenness with improvements in birth weights and physical activity, as well as lower mortality rates. Recent studies also suggested that exposure to greenness may lower levels of depression and depressive symptoms. The evidence on greenness and cardiovascular health remains mixed. Findings are also inconsistent for greenness measures and asthma and allergies. Our knowledge of the impacts of greenness on a wide variety of health outcomes continues to evolve. Future research should incorporate information on specific species and some qualities of natural greenness that might drive health outcomes, integrate exposure assessments that incorporate personal mobility into analyses, and include prospective designs to add to the growing evidence that nature exposure positively affects health.
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Affiliation(s)
- Kelvin C Fong
- Department of Environmental Health, Harvard TH Chan School of Public Health, 401 Park Dr, Boston, MA, 02215, USA.
| | - Jaime E Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, 401 Park Dr, Boston, MA, 02215, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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Campbell IG, Li N, Rowley S, Goode D, Devereux L, McInerny S, Grewal N, Lee A, Trainer A, Wong-Brown M, Scott R, Gorringe K, James P. Abstract PD1-04: The contribution of rare variants, polygenic risk, and novel candidate genes to the hereditary risk of breast cancer in a large cohort of breast cancer families. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd1-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Identifying the missing hereditary factors underlying the familial risk of breast cancer could have a major and immediate impact on managing the breast cancer risk for these families.
Methods: We identified candidate breast cancer predisposition genes through whole exome sequencing of BRCAx families and subsequently sequenced up to 1325 genes, along with 76 common low penetrance variants associated with breast cancer, in index cases from 6,000 BRCAx families and 6,000 cancer free women (ethnically matched on principal component analysis).
Results: The role of recently described (PALB2) or suspected (MRE11A) moderately penetrant genes was confirmed. Conversely, the size of the cohort means that the absence of enrichment for loss of function (LoF mutations) provides strong evidence against other reported breast cancer genes (BRIP1, RINT1, RECQL). For further moderate risk variants (in CHEK2, ATM, BRCA2) we observed significant risk modification based on the polygenic risk score (PRS - calculated from the common variant data), with the risk restricted to the co-occurrence of the rare variant and high PRS. Novel candidate genes were identified based on LoF mutations, including NTHL1 (38 cases versus 15 controls, OR 2.5 p=0.002): a member of the base excision repair (BER) pathway. DNA sequencing of the breast carcinomas from 17 heterozygous NTHL1 mutation carriers revealed a strong bias towards a C:G>T:A (C>T) transitions, consistent with a BER defect, which confirmed the recent findings in colorectal carcinomas from bi-allelic NTHL1 mutation carriers. This data extends the cancer predisposition phenotype of NTHL1 to heterozygous carriers. In addition to NTHL1, there are a large number of candidate genes where the ratio of LoF mutations in cases versus controls indicates that they may convey an actionable level of risk; 46 genes (519 families) meet the basic criteria of multiple LoF variants and an OR >2 for cases versus controls – including previously proposed breast cancer genes MRE11A, BLM, MLH1, MYH, FANCD2 and functionally plausible candidates such as MLH3, PARP2 and ATR. Collectively the OR of breast cancer for LoF mutations in this group of genes is 3.3 (95% CI 2.7-3.9, P=3.5x10-41).
Conclusion: Our data shows that the effect of rare variation in established and novel breast cancer genes, along with consideration of the background polygenic risk, together explains a substantial component of the heritable risk of breast cancer in our cohort.
Citation Format: Campbell IG, Li N, Rowley S, Goode D, Devereux L, McInerny S, Grewal N, Lee A, Trainer A, Wong-Brown M, Scott R, Gorringe K, James P. The contribution of rare variants, polygenic risk, and novel candidate genes to the hereditary risk of breast cancer in a large cohort of breast cancer families [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD1-04.
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Affiliation(s)
- IG Campbell
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Lifepool, PterMacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr., Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - N Li
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Lifepool, PterMacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr., Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - S Rowley
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Lifepool, PterMacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr., Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - D Goode
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Lifepool, PterMacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr., Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - L Devereux
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Lifepool, PterMacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr., Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - S McInerny
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Lifepool, PterMacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr., Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - N Grewal
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Lifepool, PterMacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr., Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - A Lee
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Lifepool, PterMacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr., Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - A Trainer
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Lifepool, PterMacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr., Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - M Wong-Brown
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Lifepool, PterMacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr., Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - R Scott
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Lifepool, PterMacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr., Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - K Gorringe
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Lifepool, PterMacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr., Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
| | - P James
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Lifepool, PterMacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr., Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Hunter Area Pathology Service, Newcastle, New South Wales, Australia
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Campbell IG, Rowley S, Devereux L, McInerny S, Grewal N, Young MA, Lee A, Trainer A, James P. Abstract PD1-07: Population genetic testing for breast cancer susceptibility. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd1-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. Germline mutations in certain genes account for a large proportion of inherited risk for breast and ovarian cancer. The identification of asymptomatic mutation carriers could significantly reduce the incidence of these diseases as active risk management can dramatically reduce the risk of developing cancer.
In most countries, identifying high-risk individuals is based on their family history. In general, a family is first identified because one family member develops cancer and, because of high-risk indicators is referred to a familial cancer centre (FCC). However, current data suggests that many BRCA1 or BRCA2 mutation carriers do not have a remarkable history of cancer in a close relative. Population-based genetic testing would be a far more effective strategy for identification of at-risk individuals. To test the feasibility of such a strategy we are conducting a population genetic testing trial for actionable mutations in 11 breast/ovarian cancer predisposition genes (BRCA1, BRCA2, PALB2, ATM, CDH1, PTEN, STK11, TP53, BRIP1, RAD51C, RAD51D) among 15,000 healthy women from the Australian population.
Methods. All subjects are female participants in the LifePool cohort (www.lifepool.org) who had no personal history of breast or ovarian cancer at the time of DNA collection. Participants found to carry an actionable germline mutation were notified by letter with an invitation to contact the PeterMac telephone genetic counselling service for further information and/or also invited for counselling at an FCC. Only participants with an actionable mutation were notified of their genetic testing result.
Results. Of the 5,557 women tested to date, 40 (0.72%) were carriers of mutations that are currently actionable in the Australian context (BRCA1 n=7, BRCA2 n=15, PALB2 n=15, ATM n=3). All 40 women accepted the invitation to attend a familial cancer centre for formal predictive testing. Less than 20% of the women would have met the minimum threshold for clinical genetic testing under current guidelines. A further 16 participants (0.29%) carried mutations in BRIP1, RAD51C and RAD51D but were not notified of the result as these genes are not currently actionable in Australia. No mutations were identified in CDH1, PTEN, STK11 or TP53.
Conclusions. A relatively large proportion of cancer free-women from Australia carry high-risk mutations in BRCA genes and subsequent uptake of clinical genetic testing was very high. Population-based genetic testing is well accepted and can identify a much larger proportion of the at risk-population than contemporary family history based approaches.
Citation Format: Campbell IG, Rowley S, Devereux L, McInerny S, Grewal N, Young M-A, Lee A, Trainer A, James P. Population genetic testing for breast cancer susceptibility [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD1-07.
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Affiliation(s)
- IG Campbell
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Garvan Institute, Sydney, New South Wales, Australia
| | - S Rowley
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Garvan Institute, Sydney, New South Wales, Australia
| | - L Devereux
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Garvan Institute, Sydney, New South Wales, Australia
| | - S McInerny
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Garvan Institute, Sydney, New South Wales, Australia
| | - N Grewal
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Garvan Institute, Sydney, New South Wales, Australia
| | - M-A Young
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Garvan Institute, Sydney, New South Wales, Australia
| | - A Lee
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Garvan Institute, Sydney, New South Wales, Australia
| | - A Trainer
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Garvan Institute, Sydney, New South Wales, Australia
| | - P James
- Research Division, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Parkville Familial Cancer Ctr, Peter MacCallum Cancer Ctr., Melbourne, Victoria, Australia; Garvan Institute, Sydney, New South Wales, Australia
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McMurrough I, Byrne J, Collins E, Smyth MR, Cooney J, James P. Automated and Manual In-Line Solid-Phase Sample Preparation for High-Performance Liquid Chromatography Analysis of Bittering Substances in Worts and Beers. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-46-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- I. McMurrough
- Research Centre, Guinness Brewing Worldwide, Dublin, Ireland
| | - J. Byrne
- Research Centre, Guinness Brewing Worldwide, Dublin, Ireland
| | - E. Collins
- Research Centre, Guinness Brewing Worldwide, Dublin, Ireland
| | - M. R. Smyth
- School of Chemical Sciences, National Institute of Higher Education, Dublin, Ireland
| | - J. Cooney
- School of Chemical Sciences, National Institute of Higher Education, Dublin, Ireland
| | - P. James
- School of Chemical Sciences, National Institute of Higher Education, Dublin, Ireland
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Popa T, Hubsch C, James P, Richard A, Russo M, Pradeep S, Krishan S, Roze E, Meunier S, Kishore A. Abnormal cerebellar processing of the neck proprioceptive information drives dysfunctions in cervical dystonia. Sci Rep 2018; 8:2263. [PMID: 29396401 PMCID: PMC5797249 DOI: 10.1038/s41598-018-20510-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 12/20/2017] [Indexed: 01/11/2023] Open
Abstract
The cerebellum can influence the responsiveness of the primary motor cortex (M1) to undergo spike timing-dependent plastic changes through a complex mechanism involving multiple relays in the cerebello-thalamo-cortical pathway. Previous TMS studies showed that cerebellar cortex excitation can block the increase in M1 excitability induced by a paired-associative stimulation (PAS), while cerebellar cortex inhibition would enhance it. Since cerebellum is known to be affected in many types of dystonia, this bidirectional modulation was assessed in 22 patients with cervical dystonia and 23 healthy controls. Exactly opposite effects were found in patients: cerebellar inhibition suppressed the effects of PAS, while cerebellar excitation enhanced them. Another experiment comparing healthy subjects maintaining the head straight with subjects maintaining the head turned as the patients found that turning the head is enough to invert the cerebellar modulation of M1 plasticity. A third control experiment in healthy subjects showed that proprioceptive perturbation of the sterno-cleido-mastoid muscle had the same effects as turning the head. We discuss these finding in the light of the recent model of a mesencephalic head integrator. We also suggest that abnormal cerebellar processing of the neck proprioceptive information drives dysfunctions of the integrator in cervical dystonia.
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Affiliation(s)
- T Popa
- Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.
| | - C Hubsch
- Department of Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - P James
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
| | - A Richard
- Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - M Russo
- Department of Neurosciences, University of Messina, Messina, Italy
| | - S Pradeep
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
| | - S Krishan
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
| | - E Roze
- Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,Department of Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - S Meunier
- Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - A Kishore
- Comprehensive Care Centre for Movement Disorders, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
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Whitfield GP, Carlson SA, Ussery EN, Watson KB, Adams MA, James P, Brownson RC, Berrigan D, Fulton JE. Environmental Supports for Physical Activity, National Health Interview Survey-2015. Am J Prev Med 2018; 54:294-298. [PMID: 29246673 PMCID: PMC5866529 DOI: 10.1016/j.amepre.2017.09.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/06/2017] [Accepted: 09/26/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The Guide to Community Preventive Services recommends combined built environment approaches to increase physical activity, including new or enhanced transportation infrastructure (e.g., sidewalks) and land use and environmental design interventions (e.g., close proximity of local destinations). The aim of this brief report is to provide nationally representative estimates of two types of built environment supports for physical activity: near-home walkable infrastructure and destinations, from the 2015 National Health Interview Survey. METHODS Adults (n=30,453) reported the near-home presence of walkable transportation infrastructure (roads, sidewalks, paths, or trails where you can walk; and whether most streets have sidewalks) and four walkable destination types (shops, stores, or markets; bus or transit stops; movies, libraries, or churches; and places that help you relax, clear your mind, and reduce stress). The prevalence of each, and the count of destination types, was calculated (in 2017) and stratified by demographic characteristics. RESULTS Overall, 85.1% reported roads, sidewalks, paths, or trails on which to walk, and 62.6% reported sidewalks on most streets. Among destinations, 71.8% reported walkable places to relax; followed by shops (58.0%); transit stops (53.2%); and movies, libraries, or churches (47.5%). For most design elements, prevalence was similar among adults aged 18-24 and 25-34 years, but decreased with age >35 years. Adults in the South reported a lower prevalence of all elements compared with those in other Census regions. CONCLUSIONS Many U.S. adults report walkable built environment elements near their home; future efforts might target areas with many older adult residents or those living in the South.
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Affiliation(s)
- Geoffrey P Whitfield
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Susan A Carlson
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emily N Ussery
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen B Watson
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marc A Adams
- School of Nutrition and Health Promotion, Arizona State University, Tempe, Arizona
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri; Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - David Berrigan
- Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, Bethesda, Maryland
| | - Janet E Fulton
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Bowman M, Rimmer E, Houston DS, Israels SJ, James P. Discordant von Willebrand factor (VWF) activity in patients with VWF
p.Gly1324Ser confirmed in vitro. Haemophilia 2018; 24:e57-e59. [DOI: 10.1111/hae.13401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M. Bowman
- Department of Medicine; Queen's University; Kingston ON Canada
| | - E. Rimmer
- Department of Internal Medicine; University of Manitoba; Winnipeg MB Canada
- Department of Haematology and Medical Oncology; CancerCare Manitoba Winnipeg MB Canada
| | - D. S. Houston
- Department of Internal Medicine; University of Manitoba; Winnipeg MB Canada
- Department of Haematology and Medical Oncology; CancerCare Manitoba Winnipeg MB Canada
| | - S. J. Israels
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
| | - P. James
- Department of Medicine; Queen's University; Kingston ON Canada
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Ramchand J, Wallis M, Farouque O, Trainer A, Macciocca I, Lynch E, Martyn M, Phelan D, Chong B, Zentner D, Vohra J, James P, Hare D. A Prospective Evaluation of Whole-Exome Sequencing in Idiopathic Dilated Cardiomyopathy and Related Phenotypes. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Troped PJ, Tamura K, McDonough MH, Starnes HA, James P, Ben-Joseph E, Cromley E, Puett R, Melly SJ, Laden F. Direct and Indirect Associations Between the Built Environment and Leisure and Utilitarian Walking in Older Women. Ann Behav Med 2017; 51:282-291. [PMID: 27807683 DOI: 10.1007/s12160-016-9852-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The built environment predicts walking in older adults, but the degree to which associations between the objective built environment and walking for different purposes are mediated by environmental perceptions is unknown. PURPOSE We examined associations between the neighborhood built environment and leisure and utilitarian walking and mediation by the perceived environment among older women. METHODS Women (N = 2732, M age = 72.8 ± 6.8 years) from Massachusetts, Pennsylvania, and California completed a neighborhood built environment and walking survey. Objective population and intersection density and density of stores and services variables were created within residential buffers. Perceived built environment variables included measures of land use mix, street connectivity, infrastructure for walking, esthetics, traffic safety, and personal safety. Regression and bootstrapping were used to test associations and indirect effects. RESULTS Objective population, stores/services, and intersection density indirectly predicted leisure and utilitarian walking via perceived land use mix (odds ratios (ORs) = 1.01-1.08, 95 % bias corrected and accelerated confidence intervals do not include 1). Objective density of stores/services directly predicted ≥150 min utilitarian walking (OR = 1.11; 95% CI = 1.02, 1.22). Perceived land use mix (ORs = 1.16-1.44) and esthetics (ORs = 1.24-1.61) significantly predicted leisure and utilitarian walking, CONCLUSIONS: Perceived built environment mediated associations between objective built environment variables and walking for leisure and utilitarian purposes. Interventions for older adults should take into account how objective built environment characteristics may influence environmental perceptions and walking.
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Affiliation(s)
- Philip J Troped
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA, USA.
| | - Kosuke Tamura
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | | | - Heather A Starnes
- Department of Kinesiology, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Peter James
- Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Eran Ben-Joseph
- Department of Urban Studies and Planning, School of Architecture and Planning, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Ellen Cromley
- Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Robin Puett
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Steven J Melly
- Drexel University, Dornsife School of Public Health, Philadelphia, PA, USA
| | - Francine Laden
- Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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212
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Liljedahl L, Norlin J, McGuire JN, James P. Effects of insulin and the glucagon-like peptide 1 receptor agonist liraglutide on the kidney proteome in db/db mice. Physiol Rep 2017; 5:5/6/e13187. [PMID: 28330952 PMCID: PMC5371560 DOI: 10.14814/phy2.13187] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 02/09/2017] [Indexed: 01/04/2023] Open
Abstract
Diabetes mellitus (DM) is a worldwide disease that affects 9% of the adult world population and type 2 DM accounts for 90% of those. A common consequence of DM is kidney complications, which could lead to kidney failure. We studied the potential effects of treatment with insulin and the glucagon-like peptide 1 receptor (GLP-1R) agonist liraglutide on the diabetic kidney proteome through the use of the db/db mouse model system and mass spectrometry (MS). Multivariate analyses revealed distinct effects of insulin and liraglutide on the db/db kidney proteome, which was seen on the protein levels of, for example, pterin-4 α-carbinolamine dehydratase/dimerization cofactor of hepatocyte nuclear factor-1α (PCBD1), neural precursor cell expressed developmentally down-regulated-8 (NEDD8), transcription elongation factor-B polypeptide-1 (ELOC) and hepcidin (HEPC). Furthermore, the separation of the insulin, liraglutide and vehicle db/db mouse groups in multivariate analyses was not mainly related to the albumin excretion rate (AER) or the level of glycated hemoglobin A1c (HbA1c%) in the mice. In summary, we show that insulin and liraglutide give rise to separate protein profiles in the db/db mouse kidney.
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Affiliation(s)
- Leena Liljedahl
- Department of Immunotechnology, Lund University, Lund, Sweden
| | | | | | - Peter James
- Department of Immunotechnology, Lund University, Lund, Sweden
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213
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Kerr J, Marinac CR, Ellis K, Godbole S, Hipp A, Glanz K, Mitchell J, Laden F, James P, Berrigan D. Comparison of Accelerometry Methods for Estimating Physical Activity. Med Sci Sports Exerc 2017; 49:617-624. [PMID: 27755355 DOI: 10.1249/mss.0000000000001124] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE This study aimed to compare physical activity estimates across different accelerometer wear locations, wear time protocols, and data processing techniques. METHODS A convenience sample of middle-age to older women wore a GT3X+ accelerometer at the wrist and hip for 7 d. Physical activity estimates were calculated using three data processing techniques: single-axis cut points, raw vector magnitude thresholds, and machine learning algorithms applied to the raw data from the three axes. Daily estimates were compared for the 321 women using generalized estimating equations. RESULTS A total of 1420 d were analyzed. Compliance rates for the hip versus wrist location only varied by 2.7%. All differences between techniques, wear locations, and wear time protocols were statistically different (P < 0.05). Mean minutes per day in physical activity varied from 22 to 67 depending on location and method. On the hip, the 1952-count cut point found at least 150 min·wk of physical activity in 22% of participants, raw vector magnitude found 32%, and the machine-learned algorithm found 74% of participants with 150 min of walking/running per week. The wrist algorithms found 59% and 60% of participants with 150 min of physical activity per week using the raw vector magnitude and machine-learned techniques, respectively. When the wrist device was worn overnight, up to 4% more participants met guidelines. CONCLUSION Estimates varied by 52% across techniques and by as much as 41% across wear locations. Findings suggest that researchers should be cautious when comparing physical activity estimates from different studies. Efforts to standardize accelerometry-based estimates of physical activity are needed. A first step might be to report on multiple procedures until a consensus is achieved.
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Affiliation(s)
- Jacqueline Kerr
- 1Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA; 2Graduate School of Public Health, San Diego State University, San Diego, CA; 3Department of Electrical and Computer Engineering, University of California, San Diego, La Jolla, CA; 4Department of Parks, Recreation, and Tourism Management, North Carolina State University Center for Geospatial Analytics, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC; 5Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, PA; 6Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA; 7Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; 8Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; 9Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and 10National Cancer Institute, National Institutes of Health, Bethesda, MD
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214
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Segal-Salto M, Hansson K, Sapir T, Kaplan A, Levy T, Schweizer M, Frotscher M, James P, Reiner O. Proteomics insights into infantile neuronal ceroid lipofuscinosis (CLN1) point to the involvement of cilia pathology in the disease. Hum Mol Genet 2017; 26:1678. [PMID: 28334871 DOI: 10.1093/hmg/ddx074] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 02/20/2017] [Indexed: 01/23/2023] Open
Abstract
Mutations in the depalmitoylation enzyme, palmitoyl protein thioesterase (PPT1), result in the early onset neurodegenerative disease known as Infantile Neuronal Ceroid Lipofuscinosis. Here, we provide proteomic evidence suggesting that PPT1 deficiency could be considered as a ciliopathy. Analysis of membrane proteins from brain enriched for acylated proteins from neonate Ppt1 knock out and control mice revealed a list of 88 proteins with differential expression levels. Amongst them, we identified Rab3IP, which regulates ciliogenesis in concert with Rab8 and Rab11. Immunostaining analysis revealed that PPT1 is localized in the cilia. Indeed, an unbiased proteomics analysis on isolated cilia revealed 660 proteins, which differed in their abundance levels between wild type and Ppt1 knock out. We demonstrate here that Rab3IP, Rab8 and Rab11 are palmitoylated, and that palmitoylation of Rab11 is required for correct intracellular localization. Cells and brain preparations from Ppt1-/- mice exhibited fewer cells with cilia and abnormally longer cilia, with both acetylated tubulin and Rab3IP wrongly distributed along the length of cilia. Most importantly, the analysis revealed a difference in the distribution and levels of the modified proteins in cilia in the retina of mutant mice versus the wildtype, which may be important in the early neurodegenerative phenotype. Overall, our results suggest a novel link between palmitoylated proteins, cilial organization and the pathophysiology of Neuronal Ceroid Lipofuscinosis.
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Affiliation(s)
- Michal Segal-Salto
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Karin Hansson
- Department of Immunotechnology, Lund University, Medicon Village, Lund, Sweden and BTK, Åbo Academy University, Turku, Finland
| | - Tamar Sapir
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Anna Kaplan
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Talia Levy
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Michaela Schweizer
- Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Frotscher
- Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter James
- Department of Immunotechnology, Lund University, Medicon Village, Lund, Sweden and BTK, Åbo Academy University, Turku, Finland
| | - Orly Reiner
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
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215
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VoPham T, DuPré N, Tamimi RM, James P, Bertrand KA, Vieira V, Laden F, Hart JE. Environmental radon exposure and breast cancer risk in the Nurses' Health Study II. Environ Health 2017; 16:97. [PMID: 28882148 PMCID: PMC5590193 DOI: 10.1186/s12940-017-0305-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 09/03/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Radon and its decay products, a source of ionizing radiation, are primarily inhaled and can deliver a radiation dose to breast tissue, where they may continue to decay and emit DNA damage-inducing particles. Few studies have examined the relationship between radon and breast cancer. METHODS The Nurses' Health Study II (NHSII) includes U.S. female registered nurses who completed biennial questionnaires since 1989. Self-reported breast cancer was confirmed from medical records. County-level radon exposures were linked with geocoded residential addresses updated throughout follow-up. Time-varying Cox regression models adjusted for established breast cancer risk factors were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS From 1989 to 2013, 3966 invasive breast cancer cases occurred among 112,639 participants. Increasing radon exposure was not associated with breast cancer risk overall (adjusted HR comparing highest to lowest quintile = 1.06, 95% CI: 0.94, 1.21, p for trend = 0.30). However, women in the highest quintile of exposure (≥74.9 Bq/m3) had a suggested elevated risk of ER-/PR- breast cancer compared to women in the lowest quintile (<27.0 Bq/m3) (adjusted HR = 1.38, 95% CI: 0.97, 1.96, p for trend = 0.05). No association was observed for ER+/PR+ breast cancer. CONCLUSIONS Although we did not find an association between radon exposure and risk of overall or ER+/PR+ breast cancer, we observed a suggestive association with risk of ER-/PR- breast cancer.
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Affiliation(s)
- Trang VoPham
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Landmark Center 3rd Floor West (HSPH/BWH), 401 Park Drive, Boston, MA 02215 USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
| | - Natalie DuPré
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Landmark Center 3rd Floor West (HSPH/BWH), 401 Park Drive, Boston, MA 02215 USA
| | - Rulla M. Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Landmark Center 3rd Floor West (HSPH/BWH), 401 Park Drive, Boston, MA 02215 USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
| | - Peter James
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Landmark Center 3rd Floor West (HSPH/BWH), 401 Park Drive, Boston, MA 02215 USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | | | - Veronica Vieira
- Program in Public Health, University of California, Irvine, CA USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Landmark Center 3rd Floor West (HSPH/BWH), 401 Park Drive, Boston, MA 02215 USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA USA
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216
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Murray K, Godbole S, Natarajan L, Full K, Hipp JA, Glanz K, Mitchell J, Laden F, James P, Quante M, Kerr J. The relations between sleep, time of physical activity, and time outdoors among adult women. PLoS One 2017; 12:e0182013. [PMID: 28877192 PMCID: PMC5587264 DOI: 10.1371/journal.pone.0182013] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 07/11/2017] [Indexed: 12/25/2022] Open
Abstract
Physical activity and time spent outdoors may be important non-pharmacological approaches to improve sleep quality and duration (or sleep patterns) but there is little empirical research evaluating the two simultaneously. The current study assesses the role of physical activity and time outdoors in predicting sleep health by using objective measurement of the three variables. A convenience sample of 360 adult women (mean age = 55.38 ±9.89 years; mean body mass index = 27.74 ±6.12) was recruited from different regions of the U.S. Participants wore a Global Positioning System device and ActiGraph GT3X+ accelerometers on the hip for 7 days and on the wrist for 7 days and 7 nights to assess total time and time of day spent outdoors, total minutes in moderate-to-vigorous physical activity per day, and 4 measures of sleep health, respectively. A generalized mixed-effects model was used to assess temporal associations between moderate-to-vigorous physical activity, outdoor time, and sleep at the daily level (days = 1931) within individuals. There was a significant interaction (p = 0.04) between moderate-to-vigorous physical activity and time spent outdoors in predicting total sleep time but not for predicting sleep efficiency. Increasing time outdoors in the afternoon (versus morning) predicted lower sleep efficiency, but had no effect on total sleep time. Time spent outdoors and the time of day spent outdoors may be important moderators in assessing the relation between physical activity and sleep. More research is needed in larger populations using experimental designs.
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Affiliation(s)
- Kate Murray
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
- Department of Family Medicine & Public Health, University of California, San Diego, La Jolla, California, United States of America
| | - Suneeta Godbole
- Department of Family Medicine & Public Health, University of California, San Diego, La Jolla, California, United States of America
| | - Loki Natarajan
- Department of Family Medicine & Public Health, University of California, San Diego, La Jolla, California, United States of America
| | - Kelsie Full
- Department of Family Medicine & Public Health, University of California, San Diego, La Jolla, California, United States of America
| | - J. Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, North Carolina State University, Raleigh, North Carolina, United States of America
- Center for Geospatial Analytics, North Carolina State University, Raleigh, North Carolina, United States of America
- Center for Human Health and the Environment, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Karen Glanz
- Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Jonathan Mitchell
- Division of Gastroenterology, Hepatology and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Francine Laden
- Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Peter James
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
| | - Mirja Quante
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Neonatology, University of Tuebingen, Tuebingen, Germany
| | - Jacqueline Kerr
- Department of Family Medicine & Public Health, University of California, San Diego, La Jolla, California, United States of America
- * E-mail:
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217
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James P, Bertrand KA, Hart JE, Schernhammer ES, Tamimi RM, Laden F. Outdoor Light at Night and Breast Cancer Incidence in the Nurses' Health Study II. Environ Health Perspect 2017; 125:087010. [PMID: 28886600 PMCID: PMC5783660 DOI: 10.1289/ehp935] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 03/17/2017] [Accepted: 03/20/2017] [Indexed: 05/03/2023]
Abstract
BACKGROUND Animal and epidemiologic studies suggest that exposure to light at night (LAN) may disrupt circadian patterns and decrease nocturnal secretion of melatonin, which may disturb estrogen regulation, leading to increased breast cancer risk. OBJECTIVES We examined the association between residential outdoor LAN and breast cancer incidence using data from the nationwide U.S.-based Nurses' Health Study II cohort. METHODS We followed 109,672 women from 1989 through 2013. Cumulative LAN exposure was estimated using time-varying satellite data for a composite of persistent nighttime illumination at ∼1 km2 scale for each residence during follow-up. Incident invasive breast cancer cases were confirmed by medical record review. We used Cox proportional hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for anthropometric, reproductive, lifestyle, and socioeconomic risk factors. RESULTS Over 2,187,425 person-years, we identified 3,549 incident breast cancer cases. Based on a fully adjusted model, the estimated HR for incident breast cancer with an interquartile range (IQR) (31.6 nW/cm2/sr) increase in cumulative average outdoor LAN was 1.05 (95% CI: 1.00, 1.11). An association between LAN and breast cancer appeared to be limited to women who were premenopausal at the time of a case [HR=1.07 (95% CI: 1.01, 1.14) based on 1,973 cases vs. HR=1.00 (95% CI: 0.91, 1.09) based on 1,172 cases in postmenopausal women; p-interaction=0.08]. The LAN-breast cancer association was observed only in past and current smokers at the end of follow-up [HR=1.00 (95% CI: 0.94, 1.07) based on 2,215 cases in never smokers; HR=1.10 (95% CI: 1.01, 1.19) based on 1,034 cases in past smokers vs. HR=1.21 (95% CI: 1.07, 1.37) for 300 cases in current smokers; p-interaction=0.08]. CONCLUSIONS Although further work is required to confirm our results and to clarify potential mechanisms, our findings suggest that exposure to residential outdoor light at night may contribute to invasive breast cancer risk. https://doi.org/10.1289/EHP935.
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Affiliation(s)
- Peter James
- Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School , Boston, Massachusetts, USA
| | | | - Jaime E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School , Boston, Massachusetts, USA
| | - Eva S Schernhammer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School , Boston, Massachusetts, USA
- Department of Epidemiology, Medical University of Vienna , Vienna, Austria
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles , Los Angeles, California, USA
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School , Boston, Massachusetts, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School , Boston, Massachusetts, USA
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Cross D, Nyman A, James P, Durward A. Safety and efficacy of rescue flexible bronchoscopic intubation using the Bentson floppy-tip guidewire via a supraglottic airway in critically ill children. Anaesthesia 2017; 72:1365-1370. [PMID: 28771680 DOI: 10.1111/anae.14008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2017] [Indexed: 11/26/2022]
Abstract
Difficulty in tracheal intubation in paediatric intensive care patients is associated with increased morbidity and mortality. Delays to intubation and interruption to oxygenation and ventilation are poorly tolerated. We developed a safe and atraumatic tracheal intubation technique. A floppy-tipped guidewire and airway exchange catheter were placed to a pre-determined length under bronchoscopic guidance while oxygenation and ventilation was maintained via a supraglottic airway device (SAD). We performed a retrospective review of this technique on patients who were either known to have or who had an unexpected difficultly in intubation. We describe the safety and experience of this in a broad range of critically ill children. Thirteen patients, median (IQR [range]) (9.0 (5.0-10.0 [4.0-12.0]) kg and 15.4 (12.1-23.2 [3.3-49.7]) months) underwent emergency tracheal intubation using this technique, after unsuccessful attempts at intubation using standard laryngoscopy blades. All intubations were successful at the first attempt using this technique and no airway trauma or significant clinical deteriorations were recorded.
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Affiliation(s)
- D Cross
- Paediatric Intensive Care, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Nyman
- Paediatric Intensive Care, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - P James
- Paediatric Intensive Care, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Anaesthesia, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Durward
- Paediatric Intensive Care, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
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219
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Niksirat H, Andersson L, Golpour A, Chupani L, James P. Quantification of egg proteome changes during fertilization in sterlet Acipenser ruthenus. Biochem Biophys Res Commun 2017; 490:189-193. [DOI: 10.1016/j.bbrc.2017.06.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 06/02/2017] [Indexed: 11/25/2022]
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220
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Casey JA, Morello-Frosch R, Mennitt DJ, Fristrup K, Ogburn EL, James P. Race/Ethnicity, Socioeconomic Status, Residential Segregation, and Spatial Variation in Noise Exposure in the Contiguous United States. Environ Health Perspect 2017; 125:077017. [PMID: 28749369 PMCID: PMC5744659 DOI: 10.1289/ehp898] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 02/06/2017] [Accepted: 02/06/2017] [Indexed: 05/18/2023]
Abstract
BACKGROUND Prior research has reported disparities in environmental exposures in the United States, but, to our knowledge, no nationwide studies have assessed inequality in noise pollution. OBJECTIVES We aimed to a) assess racial/ethnic and socioeconomic inequalities in noise pollution in the contiguous United States; and b) consider the modifying role of metropolitan level racial residential segregation. METHODS We used a geospatial sound model to estimate census block group–level median (L50) nighttime and daytime noise exposure and 90th percentile (L10) daytime noise exposure. Block group variables from the 2006–2010 American Community Survey (ACS) included race/ethnicity, education, income, poverty, unemployment, homeownership, and linguistic isolation. We estimated associations using polynomial terms in spatial error models adjusted for total population and population density. We also evaluated the relationship between race/ethnicity and noise, stratified by levels of metropolitan area racial residential segregation, classified using a multigroup dissimilarity index. RESULTS Generally, estimated nighttime and daytime noise levels were higher for census block groups with higher proportions of nonwhite and lower-socioeconomic status (SES) residents. For example, estimated nighttime noise levels in urban block groups with 75% vs. 0% black residents were 46.3 A-weighted decibels (dBA) [interquartile range (IQR): 44.3–47.8 dBA] and 42.3 dBA (IQR: 40.4–45.5 dBA), respectively. In urban block groups with 50% vs. 0% of residents living below poverty, estimated nighttime noise levels were 46.9 dBA (IQR: 44.7–48.5 dBA) and 44.0 dBA (IQR: 42.2–45.5 dBA), respectively. Block groups with the highest metropolitan area segregation had the highest estimated noise exposures, regardless of racial composition. Results were generally consistent between urban and suburban/rural census block groups, and for daytime and nighttime noise and robust to different spatial weight and neighbor definitions. CONCLUSIONS We found evidence of racial/ethnic and socioeconomic differences in model-based estimates of noise exposure throughout the United States. Additional research is needed to determine if differences in noise exposure may contribute to health disparities in the United States. https://doi.org/10.1289/EHP898
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Affiliation(s)
- Joan A Casey
- Robert Wood Johnson Foundation Health & Society Scholars Program, University of California, San Francisco and University of California, Berkeley , California, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy, and Management, and the School of Public Health; University of California , Berkeley, California, USA
| | - Daniel J Mennitt
- Department of Electrical & Computer Engineering, Colorado State University , Fort Collins, Colorado, USA
| | - Kurt Fristrup
- Natural Sounds and Night Skies Division, Natural Resource Stewardship and Science Directorate, National Park Service , Fort Collins, Colorado, USA
| | - Elizabeth L Ogburn
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Healthcare Institute; Departments of Epidemiology and Environmental Health, Harvard TH Chan School of Public Health; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital & Harvard Medical School, Boston, Massachusetts, USA
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Barber RM, Fullman N, Sorensen RJD, Bollyky T, McKee M, Nolte E, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abdulle AM, Abdurahman AA, Abera SF, Abraham B, Abreha GF, Adane K, Adelekan AL, Adetifa IMO, Afshin A, Agarwal A, Agarwal SK, Agarwal S, Agrawal A, Kiadaliri AA, Ahmadi A, Ahmed KY, Ahmed MB, Akinyemi RO, Akinyemiju TF, Akseer N, Al-Aly Z, Alam K, Alam N, Alam SS, Alemu ZA, Alene KA, Alexander L, Ali R, Ali SD, Alizadeh-Navaei R, Alkerwi A, Alla F, Allebeck P, Allen C, Al-Raddadi R, Alsharif U, Altirkawi KA, Martin EA, Alvis-Guzman N, Amare AT, Amini E, Ammar W, Amo-Adjei J, Amoako YA, Anderson BO, Androudi S, Ansari H, Ansha MG, Antonio CAT, Ärnlöv J, Artaman A, Asayesh H, Assadi R, Astatkie A, Atey TM, Atique S, Atnafu NT, Atre SR, Avila-Burgos L, Avokpaho EFGA, Quintanilla BPA, Awasthi A, Ayele NN, Azzopardi P, Saleem HOB, Bärnighausen T, Bacha U, Badawi A, Banerjee A, Barac A, Barboza MA, Barker-Collo SL, Barrero LH, Basu S, Baune BT, Baye K, Bayou YT, Bazargan-Hejazi S, Bedi N, Beghi E, Béjot Y, Bello AK, Bennett DA, Bensenor IM, Berhane A, Bernabé E, Bernal OA, Beyene AS, Beyene TJ, Bhutta ZA, Biadgilign S, Bikbov B, Birlik SM, Birungi C, Biryukov S, Bisanzio D, Bizuayehu HM, Bose D, Brainin M, Brauer M, Brazinova A, Breitborde NJK, Brenner H, Butt ZA, Cárdenas R, Cahuana-Hurtado L, Campos-Nonato IR, Car J, Carrero JJ, Casey D, Caso V, Castañeda-Orjuela CA, Rivas JC, Catalá-López F, Cecilio P, Cercy K, Charlson FJ, Chen AZ, Chew A, Chibalabala M, Chibueze CE, Chisumpa VH, Chitheer AA, Chowdhury R, Christensen H, Christopher DJ, Ciobanu LG, Cirillo M, Coggeshall MS, Cooper LT, Cortinovis M, Crump JA, Dalal K, Danawi H, Dandona L, Dandona R, Dargan PI, das Neves J, Davey G, Davitoiu DV, Davletov K, De Leo D, Del Gobbo LC, del Pozo-Cruz B, Dellavalle RP, Deribe K, Deribew A, Des Jarlais DC, Dey S, Dharmaratne SD, Dicker D, Ding EL, Dokova K, Dorsey ER, Doyle KE, Dubey M, Ehrenkranz R, Ellingsen CL, Elyazar I, Enayati A, Ermakov SP, Eshrati B, Esteghamati A, Estep K, Fürst T, Faghmous IDA, Fanuel FBB, Faraon EJA, Farid TA, Farinha CSES, Faro A, Farvid MS, Farzadfar F, Feigin VL, Feigl AB, Fereshtehnejad SM, Fernandes JG, Fernandes JC, Feyissa TR, Fischer F, Fitzmaurice C, Fleming TD, Foigt N, Foreman KJ, Forouzanfar MH, Franklin RC, Frostad J, G/hiwot TT, Gakidou E, Gambashidze K, Gamkrelidze A, Gao W, Garcia-Basteiro AL, Gebre T, Gebremedhin AT, Gebremichael MW, Gebru AA, Gelaye AA, Geleijnse JM, Genova-Maleras R, Gibney KB, Giref AZ, Gishu MD, Giussani G, Godwin WW, Gold A, Goldberg EM, Gona PN, Goodridge A, Gopalani SV, Goto A, Graetz N, Greaves F, Griswold M, Guban PI, Gugnani HC, Gupta PC, Gupta R, Gupta R, Gupta T, Gupta V, Habtewold TD, Hafezi-Nejad N, Haile D, Hailu AD, Hailu GB, Hakuzimana A, Hamadeh RR, Hambisa MT, Hamidi S, Hammami M, Hankey GJ, Hao Y, Harb HL, Hareri HA, Haro JM, Hassanvand MS, Havmoeller R, Hay RJ, Hay SI, Hendrie D, Heredia-Pi IB, Hoek HW, Horino M, Horita N, Hosgood HD, Htet AS, Hu G, Huang H, Huang JJ, Huntley BM, Huynh C, Iburg KM, Ileanu BV, Innos K, Irenso AA, Jahanmehr N, Jakovljevic MB, James P, James SL, Javanbakht M, Jayaraman SP, Jayatilleke AU, Jeemon P, Jha V, John D, Johnson C, Johnson SC, Jonas JB, Juel K, Kabir Z, Kalkonde Y, Kamal R, Kan H, Karch A, Karema CK, Karimi SM, Kasaeian A, Kassebaum NJ, Kastor A, Katikireddi SV, Kazanjan K, Keiyoro PN, Kemmer L, Kemp AH, Kengne AP, Kerbo AA, Kereselidze M, Kesavachandran CN, Khader YS, Khalil I, Khan AR, Khan EA, Khan G, Khang YH, Khoja ATA, Khonelidze I, Khubchandani J, Kibret GD, Kim D, Kim P, Kim YJ, Kimokoti RW, Kinfu Y, Kissoon N, Kivipelto M, Kokubo Y, Kolk A, Kolte D, Kopec JA, Kosen S, Koul PA, Koyanagi A, Kravchenko M, Krishnaswami S, Krohn KJ, Defo BK, Bicer BK, Kuipers EJ, Kulkarni VS, Kumar GA, Kumsa FA, Kutz M, Kyu HH, Lager ACJ, Lal A, Lal DK, Lalloo R, Lallukka T, Lan Q, Langan SM, Lansingh VC, Larson HJ, Larsson A, Laryea DO, Latif AA, Lawrynowicz AEB, Leasher JL, Leigh J, Leinsalu M, Leshargie CT, Leung J, Leung R, Levi M, Liang X, Lim SS, Lind M, Linn S, Lipshultz SE, Liu P, Liu Y, Lo LT, Logroscino G, Lopez AD, Lorch SA, Lotufo PA, Lozano R, Lunevicius R, Lyons RA, Macarayan ERK, Mackay MT, El Razek HMA, El Razek MMA, Mahdavi M, Majeed A, Malekzadeh R, Malta DC, Mantovani LG, Manyazewal T, Mapoma CC, Marcenes W, Marks GB, Marquez N, Martinez-Raga J, Marzan MB, Massano J, Mathur MR, Maulik PK, Mazidi M, McAlinden C, McGrath JJ, McNellan C, Meaney PA, Mehari A, Mehndiratta MM, Meier T, Mekonnen AB, Meles KG, Memish ZA, Mengesha MM, Mengiste DT, Mengistie MA, Menota BG, Mensah GA, Mereta ST, Meretoja A, Meretoja TJ, Mezgebe HB, Micha R, Millear A, Mills EJ, Minnig S, Mirarefin M, Mirrakhimov EM, Mock CN, Mohammad KA, Mohammed S, Mohanty SK, Mokdad AH, Mola GLD, Molokhia M, Monasta L, Montico M, Moradi-Lakeh M, Moraga P, Morawska L, Mori R, Moses M, Mueller UO, Murthy S, Musa KI, Nachega JB, Nagata C, Nagel G, Naghavi M, Naheed A, Naldi L, Nangia V, Nascimento BR, Negoi I, Neupane SP, Newton CR, Ng M, Ngalesoni FN, Ngunjiri JW, Nguyen G, Ningrum DNA, Nolte S, Nomura M, Norheim OF, Norrving B, Noubiap JJN, Obermeyer CM, Ogbo FA, Oh IH, Okoro A, Oladimeji O, Olagunju AT, Olivares PR, Olsen HE, Olusanya BO, Olusanya JO, Opio JN, Oren E, Ortiz A, Osborne RH, Osman M, Owolabi MO, PA M, Pain AW, Pakhale S, Castillo EP, Pana A, Papachristou C, Parsaeian M, Patel T, Patton GC, Paudel D, Paul VK, Pearce N, Pereira DM, Perez-Padilla R, Perez-Ruiz F, Perico N, Pesudovs K, Petzold M, Phillips MR, Pigott DM, Pillay JD, Pinho C, Polinder S, Pond CD, Prakash V, Purwar M, Qorbani M, Quistberg DA, Radfar A, Rafay A, Rahimi K, Rahimi-Movaghar V, Rahman M, Rahman MHU, Rai RK, Ram U, Rana SM, Rankin Z, Rao PV, Rao PC, Rawaf S, Rego MAS, Reitsma M, Remuzzi G, Renzaho AMNN, Resnikoff S, Rezaei S, Rezai MS, Ribeiro AL, Roba HS, Rokni MB, Ronfani L, Roshandel G, Roth GA, Rothenbacher D, Roy NK, Sachdev PS, Sackey BB, Saeedi MY, Safiri S, Sagar R, Sahraian MA, Saleh MM, Salomon JA, Samy AM, Sanabria JR, Sanchez-Niño MD, Sandar L, Santos IS, Santos JV, Milicevic MMS, Sarmiento-Suarez R, Sartorius B, Satpathy M, Savic M, Sawhney M, Saylan MI, Schöttker B, Schutte AE, Schwebel DC, Seedat S, Seid AM, Seifu CN, Sepanlou SG, Serdar B, Servan-Mori EE, Setegn T, Shackelford KA, Shaheen A, Shahraz S, Shaikh MA, Shakh-Nazarova M, Shamsipour M, Islam SMS, Sharma J, Sharma R, She J, Sheikhbahaei S, Shen J, Shi P, Shigematsu M, Shin MJ, Shiri R, Shoman H, Shrime MG, Sibamo ELS, Sigfusdottir ID, Silva DAS, Silveira DGA, Sindi S, Singh A, Singh JA, Singh OP, Singh PK, Singh V, Sinke AH, Sinshaw AE, Skirbekk V, Sliwa K, Smith A, Sobngwi E, Soneji S, Soriano JB, Sousa TCM, Sposato LA, Sreeramareddy CT, Stathopoulou V, Steel N, Steiner C, Steinke S, Stokes MA, Stranges S, Strong M, Stroumpoulis K, Sturua L, Sufiyan MB, Suliankatchi RA, Sun J, Sur P, Swaminathan S, Sykes BL, Tabarés-Seisdedos R, Tabb KM, Taffere GR, Talongwa RT, Tarajia M, Tavakkoli M, Taveira N, Teeple S, Tegegne TK, Tehrani-Banihashemi A, Tekelab T, Tekle DY, Shifa GT, Terkawi AS, Tesema AG, Thakur JS, Thomson AJ, Tillmann T, Tiruye TY, Tobe-Gai R, Tonelli M, Topor-Madry R, Tortajada M, Troeger C, Truelsen T, Tura AK, Uchendu US, Ukwaja KN, Undurraga EA, Uneke CJ, Uthman OA, van Boven JFM, Van Dingenen R, Varughese S, Vasankari T, Venketasubramanian N, Violante FS, Vladimirov SK, Vlassov VV, Vollset SE, Vos T, Wagner JA, Wakayo T, Waller SG, Walson JL, Wang H, Wang YP, Watkins DA, Weiderpass E, Weintraub RG, Wen CP, Werdecker A, Wesana J, Westerman R, Whiteford HA, Wilkinson JD, Wiysonge CS, Woldeyes BG, Wolfe CDA, Won S, Workicho A, Workie SB, Wubshet M, Xavier D, Xu G, Yadav AK, Yaghoubi M, Yakob B, Yan LL, Yano Y, Yaseri M, Yimam HH, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yu C, Zaidi Z, El Sayed Zaki M, Zambrana-Torrelio C, Zapata T, Zenebe ZM, Zodpey S, Zoeckler L, Zuhlke LJ, Murray CJL. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 2015. Lancet 2017; 390:231-266. [PMID: 28528753 PMCID: PMC5528124 DOI: 10.1016/s0140-6736(17)30818-8] [Citation(s) in RCA: 307] [Impact Index Per Article: 43.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 02/26/2017] [Accepted: 02/28/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. METHODS We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. FINDINGS Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0-42·8) in 1990 to 53·7 (52·2-55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. INTERPRETATION This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. FUNDING Bill & Melinda Gates Foundation.
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Kane JPM, Surendranathan A, Barker SH, Bentley A, Allan LM, Taylor J, James P, Burn D, McKeith IG, Thomas A, O'Brien JT. [P2–526]: GEOGRAPHICAL VARIATIONS IN DIAGNOSTIC RATES FOR DEMENTIA WITH LEWY BODIES IN CLINICAL SERVICES. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | - Sally H. Barker
- Institute of Neuroscience, Newcastle UniversityNewcastleUnited Kingdom
| | | | | | | | - Peter James
- Newcastle UniversityNewcastle upon TyneUnited Kingdom
| | - David Burn
- Newcastle UniversityNewcastle upon TyneUnited Kingdom
| | | | - Alan Thomas
- Newcastle UniversityNewcastle upon TyneUnited Kingdom
| | - John T. O'Brien
- Department of PsychiatryUniversity of CambridgeCambridgeUnited Kingdom
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DuPre N, Poole EM, Holmes MD, Hart JE, James P, Beck A, Kraft P, Laden F, Tamimi R. Abstract 3278: Particulate matter and traffic-related exposures in relation to breast cancer survival. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-3278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Outdoor air pollution is considered a human carcinogen by the International Agency for Research on Cancer, particularly for its influence on lung cancer incidence and prognosis. While air pollution has not been consistently associated with breast cancer incidence, only one study has examined the impacts of air pollution on survival from breast cancer and was unable to consider important predictors of breast cancer mortality. We assessed whether PM exposures (PM2.5, PM2.510, and PM10) were associated with breast cancer specific-death and all-cause mortality.
Methods: The Nurses’ Health Studies (NHS and NHSII) are ongoing nationwide cohorts with detailed longitudinal data on medical history, addresses, lifestyle factors, and causes of death. We included women with confirmed Stage I-III breast cancer and collected additional clinical information from medical records. PM was estimated using GIS-based spatio-temporal models linked to addresses between 1989-2007. We performed Cox proportional hazards models to assess associations of breast cancer specific-death and overall mortality with PM exposures starting at diagnosis and updated over follow-up through June 2014.
Results: There were 1,211 breast-cancer specific deaths among 8,936 women with Stage I-III breast cancer. Overall, increases in PM were not associated with breast cancer survival (PM2.5: HR=1.09 95% CI 0.87, 1.36; PM2.5-10: HR=1.03 95% CI 0.85, 1.24; PM10: HR=1.05, 95% CI 0.89, 1.24, each per 10 μg/m3). However, each 10 μg/m3 increase in PM2.5 was associated with breast cancer death among participants with Stage I disease after adjusting for clinical, demographics and pre-diagnostic lifestyle factors (HR=1.69 95%CI 1.16, 2.47) and after additionally adjusting for post-diagnostic lifestyle factors (HR=1.64 95% CI 1.11, 2.43). Furthermore, PM exposures were associated with a 9-12% increase in all-cause mortality.
Conclusion:
Overall, PM exposures were not associated with breast cancer survival; however, increases in PM2.5 did appear to adversely impact prognosis among Stage I breast cancer patients.
Acknowledgments:
This work was funded by the NIH T32 CA 09001 and by a grant from the Susan G. Komen for the Cure ® (IIR13264020). We thank the NHS and NHSII participants and coordinators.
Citation Format: Natalie DuPre, Elizabeth M. Poole, Michelle D. Holmes, Jaime E. Hart, Peter James, Andrew Beck, Peter Kraft, Francine Laden, Rulla Tamimi. Particulate matter and traffic-related exposures in relation to breast cancer survival [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3278. doi:10.1158/1538-7445.AM2017-3278
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Affiliation(s)
- Natalie DuPre
- 1Harvard T.H. Chan School of Public Health, Boston, MA
| | - Elizabeth M. Poole
- 2Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA
| | | | - Jaime E. Hart
- 1Harvard T.H. Chan School of Public Health, Boston, MA
| | - Peter James
- 1Harvard T.H. Chan School of Public Health, Boston, MA
| | - Andrew Beck
- 3Beth Israel Deaconess Medical Center, Boston, MA
| | - Peter Kraft
- 1Harvard T.H. Chan School of Public Health, Boston, MA
| | | | - Rulla Tamimi
- 1Harvard T.H. Chan School of Public Health, Boston, MA
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Laramore MA, James P, Martis PC, Dudley A, Gazda LS, Borrebaeck CA, Smith BH. Abstract 5552: Differential proteomic responses of luminal-A and basal-like breast cancer cell lines during growth inhibition induced by co-culture with agarose encapsulated murine renal adenocarcinoma (RENCA) cells. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-5552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The existence of a tumor growth regulatory network that is conserved across tumor types and species has been hypothesized. Our evidence for this regulatory network is derived from studies demonstrating tumor growth inhibition by agarose encapsulated cancer cells (cancer macrobeads). The ability of encapsulated, thus growth restricted cells, to inhibit freely growing cancer cells has been shown when the encapsulated cells are murine (RENCA) or human (e.g., J82). Clinical trials are underway (NCT01053013, NCT02046174).
We have shown that RENCA macrobeads release >10 known tumor inhibitory proteins targeting several signaling pathways including Akt/PI3. To better understand the mechanism(s) of growth inhibition, we used a systems biology approach to identify protein profiles and interactions from macrobead-treated human breast carcinoma cell lines that are either mildly aggressive (MCF7) or highly aggressive (MDA-MB231 [MDA]).
Target cells were co-cultured with RENCA macrobeads or left untreated for 5 days. Lysates of target cells were prepared in Laemmli buffer, frozen, and sent for MS/MS. Samples were run in duplicate, protein intensities normalized, and the treated/untreated ratio log10 transformed to get a normal distribution. Protein profiles were analyzed using Key Pathway Analysis (KPA) and Metacore software. Growth inhibition by RENCA macrobeads was confirmed (MCF7 25%; MDA 57%).
KPA of MCF7 proteins showed upregulation of ubiquitin pathways involved in degradation of misfolded proteins. Stress induced apoptosis and DNA damage (which correlates with the growth inhibition) were the top 2 pathways upregulated using Pathway and Process Enrichment analysis. This is in line with a strong epigenetic gene deregulation (Metacore). Transcription Factor and Network analyses show upregulation of CREB, A2MR and ATF3 networks. Also, Regulated Network analysis suggests a role for A2MR or RAGE in the inhibition of proliferation and increased apoptosis.
Macrobead-treated MDA cells showed no significant changes using KPA. Pathway, Network and Process enrichment (Metacore) showed 5 of the top 10 upregulated processes were associated with cytoskeleton remodeling. Cell cycle and protein folding processes were also upregulated. Transcription factors associated with this response were similar to that of MCF7. RAGE again appears in many of the pathways as indicated by Network and Regulated Network analysis.
The protein response to RENCA macrobeads differs for these 2 cell lines. Proteins related to apoptosis are upregulated in the MCF7 cells whereas MDA have a preference for cytoskeleton remodeling. These data support the hypothesis that distinctive tumors may respond differently to RENCA macrobead exposure at both an epigenetic and protein level, nonetheless resulting in growth inhibition.
Citation Format: Melissa A. Laramore, Peter James, Prithy C. Martis, Atira Dudley, Lawrence S. Gazda, Carl A. Borrebaeck, Barry H. Smith. Differential proteomic responses of luminal-A and basal-like breast cancer cell lines during growth inhibition induced by co-culture with agarose encapsulated murine renal adenocarcinoma (RENCA) cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 5552. doi:10.1158/1538-7445.AM2017-5552
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Affiliation(s)
| | | | | | - Atira Dudley
- 1The Rogosin Institute - Xenia Division, Xenia, OH
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Mitchell JA, Quante M, Godbole S, James P, Hipp JA, Marinac CR, Mariani S, Cespedes Feliciano EM, Glanz K, Laden F, Wang R, Weng J, Redline S, Kerr J. Variation in actigraphy-estimated rest-activity patterns by demographic factors. Chronobiol Int 2017. [PMID: 28650674 DOI: 10.1080/07420528.2017.1337032] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Rest-activity patterns provide an indication of circadian rhythmicity in the free-living setting. We aimed to describe the distributions of rest-activity patterns in a sample of adults and children across demographic variables. A sample of adults (N = 590) and children (N = 58) wore an actigraph on their nondominant wrist for 7 days and nights. We generated rest-activity patterns from cosinor analysis (MESOR, acrophase and magnitude) and nonparametric circadian rhythm analysis (IS: interdaily stability; IV: intradaily variability; L5: least active 5-hour period; M10: most active 10-hour period; and RA: relative amplitude). Demographic variables included age, sex, race, education, marital status, and income. Linear mixed-effects models were used to test for demographic differences in rest-activity patterns. Adolescents, compared to younger children, had (1) later M10 midpoints (β = 1.12 hours [95% CI: 0.43, 1.18] and lower M10 activity levels; (2) later L5 midpoints (β = 1.6 hours [95% CI: 0.9, 2.3]) and lower L5 activity levels; (3) less regular rest-activity patterns (lower IS and higher IV); and 4) lower magnitudes (β = -0.95 [95% CI: -1.28, -0.63]) and relative amplitudes (β = -0.1 [95% CI: -0.14, -0.06]). Mid-to-older adults, compared to younger adults (aged 18-29 years), had (1) earlier M10 midpoints (β = -1.0 hours [95% CI: -1.6, -0.4]; (2) earlier L5 midpoints (β = -0.7 hours [95% CI: -1.2, -0.2]); and (3) more regular rest-activity patterns (higher IS and lower IV). The magnitudes and relative amplitudes were similar across the adult age categories. Sex, race and education level rest-activity differences were also observed. Rest-activity patterns vary across the lifespan, and differ by race, sex and education. Understanding population variation in these patterns provides a foundation for further elucidating the health implications of rest-activity patterns across the lifespan.
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Affiliation(s)
- Jonathan A Mitchell
- a Division of Gastroenterology, Hepatology and Nutrition , Children's Hospital of Philadelphia , Philadelphia , PA , USA.,b Department of Pediatrics, Perelman School of Medicine , University of Pennsylvania , Philadelphia , PA , USA
| | - Mirja Quante
- c Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology , Brigham & Women's Hospital & Harvard Medical School , Boston , MA , USA.,d Department of Neonatology , University of Tuebingen , Tuebingen , Germany
| | - Suneeta Godbole
- e Department of Family Medicine & Public Health , University of California, San Diego , San Diego , CA , USA
| | - Peter James
- f Channing Division of Network Medicine , Brigham and Women's Hospital & Harvard Medical School , Boston , MA , USA.,g Departments of Environmental Health and Epidemiology , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - J Aaron Hipp
- h Department of Parks, Recreation, and Tourism Management, Center for Geospatial Analytics, and Center for Human Health and the Environment , NC State University , Raleigh , NC , USA
| | | | - Sara Mariani
- c Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology , Brigham & Women's Hospital & Harvard Medical School , Boston , MA , USA
| | | | - Karen Glanz
- k Perelman School of Medicine and School of Nursing, University of Pennsylvania , Philadelphia , PA , USA
| | - Francine Laden
- f Channing Division of Network Medicine , Brigham and Women's Hospital & Harvard Medical School , Boston , MA , USA.,g Departments of Environmental Health and Epidemiology , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Rui Wang
- c Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology , Brigham & Women's Hospital & Harvard Medical School , Boston , MA , USA
| | - Jia Weng
- c Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology , Brigham & Women's Hospital & Harvard Medical School , Boston , MA , USA
| | - Susan Redline
- c Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology , Brigham & Women's Hospital & Harvard Medical School , Boston , MA , USA.,l Beth Israel Deaconess Medical Center , Boston , MA , USA
| | - Jacqueline Kerr
- e Department of Family Medicine & Public Health , University of California, San Diego , San Diego , CA , USA
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226
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James P, Seward MW, James O'Malley A, Subramanian SV, Block JP. Changes in the food environment over time: examining 40 years of data in the Framingham Heart Study. Int J Behav Nutr Phys Act 2017. [PMID: 28646894 PMCID: PMC5483254 DOI: 10.1186/s12966-017-0537-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Research has explored associations between diet, body weight, and the food environment; however, few studies have examined historical trends in food environments. Methods In the Framingham Heart Study Offspring (N = 3321) and Omni (N = 447) cohorts, we created food environment metrics in four Massachusetts towns utilizing geocoded residential, workplace, and food establishment addresses from 1971 to 2008. We created multilevel models adjusted for age, sex, education, and census tract poverty to examine trends in home, workplace, and commuting food environments. Results Proximity to and density of supermarkets, fast-food, full service restaurants, convenience stores, and bakeries increased over time for residential, workplace, and commuting environments; exposure to grocery stores decreased. The greatest increase in access was for supermarkets, with residential distance to the closest supermarket 1406 m closer (95% CI 1303 m, 1508 m) by 2005–2008 than in 1971–1975. Although poorer census tracts had higher access to fast-food restaurants consistently across follow-up, this disparity dissipated over time, due to larger increases in proximity to fast-food in wealthier neighborhoods. Conclusions Access to most food establishment types increased over time, with similar trends across home, workplace, and commuter environments. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0537-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Peter James
- Division of Chronic Disease Research Across the Life Course (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr Suite 401, Boston, MA, 02215, USA.
| | - Michael W Seward
- Division of Chronic Disease Research Across the Life Course (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr Suite 401, Boston, MA, 02215, USA
| | - A James O'Malley
- Department of Biomedical Data Science, The Dartmouth Institute, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA.,Harvard Center for Population and Development Studies, Harvard University, Boston, MA, USA
| | - Jason P Block
- Division of Chronic Disease Research Across the Life Course (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr Suite 401, Boston, MA, 02215, USA.,Harvard Center for Population and Development Studies, Harvard University, Boston, MA, USA
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227
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Felton I, James P, Benson S, Schelenz S, Moffatt M, Loebinger M, Simmonds N, Cookson W. WS03.4 The distinct airways mycobiome in adult cystic fibrosis and bronchiectasis. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30171-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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228
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Reynen E, Grabell J, Ellis AK, James P. Let's Talk Period! Preliminary results of an online bleeding awareness knowledge translation project and bleeding assessment tool promoted on social media. Haemophilia 2017; 23:e282-e286. [DOI: 10.1111/hae.13271] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2017] [Indexed: 11/29/2022]
Affiliation(s)
- E. Reynen
- Department of Medicine; Queen's University; Kingston Ontario Canada
| | - J. Grabell
- Department of Medicine; Queen's University; Kingston Ontario Canada
| | - A. K. Ellis
- Department of Medicine; Queen's University; Kingston Ontario Canada
| | - P. James
- Department of Medicine; Queen's University; Kingston Ontario Canada
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229
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Quante M, Mitchell JA, Godbole S, James P, Hipp A, Marinac CR, Mariani S, Cespedes Feliciano EM, Glanz K, Laden F, Wang R, Weng J, Redline S, Kerr J. 0693 VARIATION IN ACTIGRAPHY-ESTIMATED REST-ACTIVITY PATTERNS BY DEMOGRAPHIC FACTORS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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230
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Banay RF, Bezold CP, James P, Hart JE, Laden F. Residential greenness: current perspectives on its impact on maternal health and pregnancy outcomes. Int J Womens Health 2017; 9:133-144. [PMID: 28280395 PMCID: PMC5338951 DOI: 10.2147/ijwh.s125358] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Recent research in environmental epidemiology has attempted to estimate the effects of exposure to nature, often operationalized as vegetation, on health. Although many analyses have focused on vegetation or greenness with regard to physical activity and weight status, an incipient area of interest concerns maternal health and birth outcomes. This paper reviews 14 studies that examined the association between greenness and maternal or infant health. Most studies were cross-sectional and conducted in birth cohorts. Several studies found evidence for positive associations between greenness and birth weight and maternal peripartum depression. Few studies found evidence for an association between greenness and gestational age or other birth outcomes, or between greenness and preeclampsia or gestational diabetes. Several assessed effect modification by individual or area-level socioeconomic status and found that effects were stronger among those of lower socioeconomic status. Few studies conducted mediation analyses of any kind. Future research should include more diverse birth outcomes and focus on maternal health (especially mental health) and capitalize on richer exposure information during pregnancy rather than cross-sectional assessment at birth.
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Affiliation(s)
| | - Carla P Bezold
- Department of Epidemiology, Harvard T.H. Chan School of Public Health
| | - Peter James
- Department of Environmental Health; Department of Epidemiology, Harvard T.H. Chan School of Public Health; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jaime E Hart
- Department of Environmental Health; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health; Department of Epidemiology, Harvard T.H. Chan School of Public Health; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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231
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James P, Hart JE, Hipp JA, Mitchell JA, Kerr J, Hurvitz PM, Glanz K, Laden F. GPS-Based Exposure to Greenness and Walkability and Accelerometry-Based Physical Activity. Cancer Epidemiol Biomarkers Prev 2017; 26:525-532. [PMID: 28196848 DOI: 10.1158/1055-9965.epi-16-0925] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/30/2017] [Accepted: 02/06/2017] [Indexed: 12/16/2022] Open
Abstract
Background: Physical inactivity is a risk factor for cancer that may be influenced by environmental factors. Indeed, dense and well-connected built environments and environments with natural vegetation may create opportunities for higher routine physical activity. However, studies have focused primarily on residential environments to define exposure and self-reported methods to estimate physical activity. This study explores the momentary association between minute-level global positioning systems (GPS)-based greenness exposure and time-matched objectively measured physical activity.Methods: Adult women were recruited from sites across the United States. Participants wore a GPS device and accelerometer on the hip for 7 days to assess location and physical activity at minute-level epochs. GPS records were linked to 250 m resolution satellite-based vegetation data and Census Block Group-level U.S. Environmental Protection Agency (EPA) Smart Location Database walkability data. Minute-level generalized additive mixed models were conducted to test for associations between GPS measures and accelerometer count data, accounting for repeated measures within participant and allowing for deviations from linearity using splines.Results: Among 360 adult women (mean age of 55.3 ± 10.2 years), we observed positive nonlinear relationships between physical activity and both greenness and walkability. In exploratory analyses, the relationships between environmental factors and physical activity were strongest among those who were white, had higher incomes, and who were middle-aged.Conclusions: Our results indicate that higher levels of physical activity occurred in areas with higher greenness and higher walkability.Impact: Findings suggest that planning and design policies should focus on these environments to optimize opportunities for physical activity. Cancer Epidemiol Biomarkers Prev; 26(4); 525-32. ©2017 AACRSee all the articles in this CEBP Focus section, "Geospatial Approaches to Cancer Control and Population Sciences."
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Affiliation(s)
- Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. .,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jaime E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - J Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, North Carolina State University, Raleigh, North Carolina.,Center for Geospatial Analytics, North Carolina State University, Raleigh, North Carolina
| | - Jonathan A Mitchell
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jacqueline Kerr
- Department of Family Medicine & Public Health, University of California, San Diego, San Diego, California
| | | | - Karen Glanz
- Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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232
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Abstract
It really is good to talk.
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Affiliation(s)
| | | | | | - Peter James
- City Hospital Campus. Nottingham University Hospitals NHS Trust
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233
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Zentner D, Thompson T, Taylor J, Bogwitz M, Trainer A, Vohra J, Winship I, James P. Predicting Yield From Cardiac Genetic Testing–A Clinically Achievable Way to Achieve Equity and Triage Appropriately. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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234
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James P, Hart JE, Banay RF, Laden F, Signorello LB. Built Environment and Depression in Low-Income African Americans and Whites. Am J Prev Med 2017; 52:74-84. [PMID: 27720338 PMCID: PMC5167658 DOI: 10.1016/j.amepre.2016.08.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 06/21/2016] [Accepted: 08/05/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Urban environments are associated with a higher risk of adverse mental health outcomes; however, it is unclear which specific components of the urban environment drive these associations. METHODS Using data collected in 2002-2009 from 73,225 low-income, racially diverse individuals across the Southeastern U.S., analyses evaluated the cross-sectional relationship between a walkability index and depression. Walkability was calculated from population density, street connectivity, and destination count in the 1,200-meter area around participants' homes, and depression was measured using the Center for Epidemiologic Studies Depression Scale for depression symptomatology and questionnaire responses regarding doctor-diagnosed depression and antidepressant use. Data were analyzed in 2015. RESULTS Participants living in neighborhoods with the highest walkability index had 6% higher odds of moderate or greater depression symptoms (score ≥15, 95% CI=0.99, 1.14), 28% higher odds of doctor-diagnosed depression (95% CI=1.20, 1.36), and 16% higher odds of current antidepressant use (95% CI=1.08, 1.25), compared with those in the lowest walkability index. Higher walkability was associated with higher odds of depression symptoms in the most deprived neighborhoods only, whereas walkability was associated with lower odds of depression symptoms in the least deprived neighborhoods. CONCLUSIONS Living in a more walkable neighborhood was associated with modestly higher levels of doctor-diagnosed depression and antidepressant use, and walkability was associated with greater depression symptoms in neighborhoods with higher deprivation. Although dense urban environments may provide opportunities for physical activity, they may also increase exposure to noise, air pollution, and social stressors that could increase levels of depression.
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Affiliation(s)
- Peter James
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts;.
| | - Jaime E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Rachel F Banay
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Lisa B Signorello
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Cancer Prevention Fellowship Program, National Cancer Institute, Rockville, Maryland
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235
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Wong EHC, Dhariwal J, Cuthbertson L, James P, Cox M, Moffatt M, Cookson W, Johnston S. P242 The airway microbiota in human rhinovirus induced asthma exacerbation. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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236
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Mukaetova-Ladinska EB, Steel M, Coppock M, Cosker G, James P, Scully A, McNally RJ. Dysphoria is a risk factor for depression in medically ill older people. Int J Geriatr Psychiatry 2016; 31:1233-1240. [PMID: 26834033 DOI: 10.1002/gps.4432] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 09/08/2015] [Accepted: 12/14/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Depression in older people is commonly under diagnosed and is associated with increased morbidity and mortality. Because older people currently occupy 65% of acute hospital beds, it is crucial for them to be properly assessed for depression to optimise their medical care. The aim of this study was to identify potential risk factors for depression in the medically ill in order to improve their inpatient care. METHODS This was a 2-year observational study of consequent referrals to the Newcastle Liaison Team for Older Adults. Out of a total number of 1586 referred patients, 1197 were included in the final analysis of data. Information about their age, main medical history, cognitive impairment and use of antidepressants was collected. All subjects were screened for dementia, depression and delirium. Proportions were compared using the chi-squared test. Clinical depression as a binary variable was modelled using logistic regression. RESULTS Higher risk for depression was associated with pain (odds ratio (OR) = 1.76; p = 0.033) and a previous history of depression (OR = 2.22; p < 0.001). Cognitive impairment (OR = 0.44, p < 0.001) and delirium (OR = 0.49; p < 0.001) decreased the likelihood for having depression. Subjective feelings of emptiness, being unhappy and depressed alone (R2 = 37.4%) and cognitive impairment (R2 = 39.5%) were the best multivariable model to explain depression in medically ill people. CONCLUSION Dysphoric mood results in depression in older people with medical health problems. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- E B Mukaetova-Ladinska
- Institute of Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK. .,Newcastle Liaison Team for Older Adults, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.
| | - M Steel
- Institute of Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - M Coppock
- Newcastle Liaison Team for Older Adults, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - G Cosker
- Newcastle Liaison Team for Older Adults, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - P James
- Institute of Health and Society, Sir James Spence Institute, Newcastle University, Newcastle upon Tyne, UK
| | - A Scully
- Newcastle Liaison Team for Older Adults, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - R J McNally
- Institute of Health and Society, Sir James Spence Institute, Newcastle University, Newcastle upon Tyne, UK
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237
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James P, Jankowska M, Marx C, Hart JE, Berrigan D, Kerr J, Hurvitz PM, Hipp JA, Laden F. "Spatial Energetics": Integrating Data From GPS, Accelerometry, and GIS to Address Obesity and Inactivity. Am J Prev Med 2016; 51:792-800. [PMID: 27528538 PMCID: PMC5067207 DOI: 10.1016/j.amepre.2016.06.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 05/05/2016] [Accepted: 06/04/2016] [Indexed: 01/23/2023]
Abstract
To address the current obesity and inactivity epidemics, public health researchers have attempted to identify spatial factors that influence physical inactivity and obesity. Technologic and methodologic developments have led to a revolutionary ability to examine dynamic, high-resolution measures of temporally matched location and behavior data through GPS, accelerometry, and GIS. These advances allow the investigation of spatial energetics, high-spatiotemporal resolution data on location and time-matched energetics, to examine how environmental characteristics, space, and time are linked to activity-related health behaviors with far more robust and detailed data than in previous work. Although the transdisciplinary field of spatial energetics demonstrates promise to provide novel insights on how individuals and populations interact with their environment, there remain significant conceptual, technical, analytical, and ethical challenges stemming from the complex data streams that spatial energetics research generates. First, it is essential to better understand what spatial energetics data represent, the relevant spatial context of analysis for these data, and if spatial energetics can establish causality for development of spatially relevant interventions. Second, there are significant technical problems for analysis of voluminous and complex data that may require development of spatially aware scalable computational infrastructures. Third, the field must come to agreement on appropriate statistical methodologies to account for multiple observations per person. Finally, these challenges must be considered within the context of maintaining participant privacy and security. This article describes gaps in current practice and understanding and suggests solutions to move this promising area of research forward.
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Affiliation(s)
- Peter James
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | | | - Christine Marx
- Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Jaime E Hart
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - David Berrigan
- Health Behaviors Research Branch, Behavioral Research Program, National Cancer Institute, Bethesda, Maryland
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California; Psychology Department, Graduate School of Public Health, San Diego State University, San Diego, California
| | | | - J Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, North Carolina State University, Raleigh, North Carolina
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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238
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Liljedahl L, Pedersen MH, Norlin J, McGuire JN, James P. N-glycosylation proteome enrichment analysis in kidney reveals differences between diabetic mouse models. Clin Proteomics 2016; 13:22. [PMID: 27757071 PMCID: PMC5065702 DOI: 10.1186/s12014-016-9123-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 08/23/2016] [Indexed: 11/26/2022] Open
Abstract
Background Diabetic nephropathy (DN) is a late complication in both type 1 diabetes mellitus (T1DM) and T2DM. Already at an early stage of DN morphological changes occur at the cell surface and in the extracellular matrix where the majority of the proteins carry N-linked glycosylations. These glycosylated proteins are highly important in cell adhesion and cell–matrix processes but not much is known about how they change in DN or whether the distinct etiology of T1DM and T2DM could have an effect on their abundances. Method We enriched for the N-glycosylated kidney proteome in db/db mice dosed with insulin or vehicle, in streptozotocin-induced (STZ) diabetic mice and healthy control mice dosed with vehicle. Glycopeptides were analyzed with label-free shotgun mass spectrometry and differential protein abundances identified in both mouse models were compared using multivariate analyses. Results The majority of the N-glycosylated proteins were similarly regulated in both mouse models. However, distinct differences between the two mouse models were for example seen for integrin-β1, a protein expressed mainly in the glomeruli which abundance was increased in the STZ diabetic mice while decreased in the db/db mice and for the sodium/glucose cotransporter-1, mainly expressed in the proximal tubules which abundance was increased in the db/db mice but decreased in the STZ diabetic mice. Insulin had an effect on the level of both glomerular and tubular proteins in the db/db mice. It decreased the abundance of G-protein coupled receptor-116 and of tyrosine-protein phosphatase non-receptor type substrate-1 away from the level in the healthy control mice. Conclusions Our finding of differences in the N-glycosylation protein profiles in the db/db and STZ mouse models suggest that the etiology of DN could give rise to variations in the cell adhesion and cell–matrix composition in T1DM and T2DM. Thus, N-glycosylated protein differences could be a clue to dissimilarities in T1DM and T2DM at later stages of DN. Furthermore, we observed insulin specific regulation of N-glycosylated proteins both in the direction of and away from the abundances in healthy control mice. Electronic supplementary material The online version of this article (doi:10.1186/s12014-016-9123-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Leena Liljedahl
- Department of Immunotechnology, Lund University, House 406, Medicon Village, 221 83 Lund, Sweden
| | | | - Jenny Norlin
- Novo Nordisk A/S, Novo Nordisk Park, 2760 Måløv, Denmark
| | | | - Peter James
- Department of Immunotechnology, Lund University, House 406, Medicon Village, 221 83 Lund, Sweden
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239
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Lim SS, Allen K, Bhutta ZA, Dandona L, Forouzanfar MH, Fullman N, Gething PW, Goldberg EM, Hay SI, Holmberg M, Kinfu Y, Kutz MJ, Larson HJ, Liang X, Lopez AD, Lozano R, McNellan CR, Mokdad AH, Mooney MD, Naghavi M, Olsen HE, Pigott DM, Salomon JA, Vos T, Wang H, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abdulle AM, Abraham B, Abubakar I, Abu-Raddad LJ, Abu-Rmeileh NME, Abyu GY, Achoki T, Adebiyi AO, Adedeji IA, Afanvi KA, Afshin A, Agarwal A, Agrawal A, Kiadaliri AA, Ahmadieh H, Ahmed KY, Akanda AS, Akinyemi RO, Akinyemiju TF, Akseer N, Al-Aly Z, Alam K, Alam U, Alasfoor D, AlBuhairan FS, Aldhahri SF, Aldridge RW, Alemu ZA, Ali R, Alkerwi A, Alkhateeb MAB, Alla F, Allebeck P, Allen C, Al-Raddadi R, Alsharif U, Altirkawi KA, Martin EA, Alvis-Guzman N, Amare AT, Amberbir A, Amegah AK, Amini H, Ammar W, Amrock SM, Andersen HH, Anderson BO, Anderson GM, Antonio CAT, Anwari P, Ärnlöv J, Artaman A, Asayesh H, Asghar RJ, Atique S, Avokpaho EFGA, Awasthi A, Quintanilla BPA, Azzopardi P, Bacha U, Badawi A, Balakrishnan K, Banerjee A, Barac A, Barber R, Barker-Collo SL, Bärnighausen T, Barrero LH, Barrientos-Gutierrez T, Basu S, Bayou TA, Bazargan-Hejazi S, Beardsley J, Bedi N, Beghi E, Béjot Y, Bell ML, Bello AK, Bennett DA, Bensenor IM, Benzian H, Berhane A, Bernabé E, Bernal OA, Betsu BD, Beyene AS, Bhala N, Bhatt S, Biadgilign S, Bienhoff KA, Bikbov B, Binagwaho A, Bisanzio D, Bjertness E, Blore J, Bourne RRA, Brainin M, Brauer M, Brazinova A, Breitborde NJK, Broday DM, Brugha TS, Buchbinder R, Butt ZA, Cahill LE, Campos-Nonato IR, Campuzano JC, Carabin H, Cárdenas R, Carrero JJ, Carter A, Casey D, Caso V, Castañeda-Orjuela CA, Rivas JC, Catalá-López F, Cavalleri F, Cecílio P, Chang HY, Chang JC, Charlson FJ, Che X, Chen AZ, Chiang PPC, Chibalabala M, Chisumpa VH, Choi JYJ, Chowdhury R, Christensen H, Ciobanu LG, Cirillo M, Coates MM, Coggeshall M, Cohen AJ, Cooke GS, Cooper C, Cooper LT, Cowie BC, Crump JA, Damtew SA, Dandona R, Dargan PI, Neves JD, Davis AC, Davletov K, de Castro EF, De Leo D, Degenhardt L, Del Gobbo LC, Deribe K, Derrett S, Des Jarlais DC, Deshpande A, deVeber GA, Dey S, Dharmaratne SD, Dhillon PK, Ding EL, Dorsey ER, Doyle KE, Driscoll TR, Duan L, Dubey M, Duncan BB, Ebrahimi H, Endries AY, Ermakov SP, Erskine HE, Eshrati B, Esteghamati A, Fahimi S, Farid TA, Farinha CSES, Faro A, Farvid MS, Farzadfar F, Feigin VL, Felicio MM, Fereshtehnejad SM, Fernandes JG, Fernandes JC, Ferrari AJ, Fischer F, Fitchett JRA, Fitzmaurice C, Foigt N, Foreman K, Fowkes FGR, Franca EB, Franklin RC, Fraser M, Friedman J, Frostad J, Fürst T, Gabbe B, Garcia-Basteiro AL, Gebre T, Gebrehiwot TT, Gebremedhin AT, Gebru AA, Gessner BD, Gillum RF, Ginawi IAM, Giref AZ, Giroud M, Gishu MD, Giussani G, Godwin W, Gona P, Goodridge A, Gopalani SV, Gotay CC, Goto A, Gouda HN, Graetz N, Greenwell KF, Griswold M, Gugnani H, Guo Y, Gupta R, Gupta R, Gupta V, Gutiérrez RA, Gyawali B, Haagsma JA, Haakenstad A, Hafezi-Nejad N, Haile D, Hailu GB, Halasa YA, Hamadeh RR, Hamidi S, Hammami M, Hankey GJ, Harb HL, Haro JM, Hassanvand MS, Havmoeller R, Heredia-Pi IB, Hoek HW, Horino M, Horita N, Hosgood HD, Hoy DG, Htet AS, Hu G, Huang H, Iburg KM, Idrisov BT, Inoue M, Islami F, Jacobs TA, Jacobsen KH, Jahanmehr N, Jakovljevic MB, James P, Jansen HAFM, Javanbakht M, Jayaraman SP, Jayatilleke AU, Jee SH, Jeemon P, Jha V, Jiang Y, Jibat T, Jin Y, Jonas JB, Kabir Z, Kalkonde Y, Kamal R, Kan H, Kandel A, Karch A, Karema CK, Karimkhani C, Karunapema P, Kasaeian A, Kassebaum NJ, Kaul A, Kawakami N, Kayibanda JF, Keiyoro PN, Kemmer L, Kemp AH, Kengne AP, Keren A, Kesavachandran CN, Khader YS, Khan AR, Khan EA, Khan G, Khang YH, Khoja TAM, Khosravi A, Khubchandani J, Kieling C, Kim CI, Kim D, Kim S, Kim YJ, Kimokoti RW, Kissoon N, Kivipelto M, Knibbs LD, Kokubo Y, Kolte D, Kosen S, Kotsakis GA, Koul PA, Koyanagi A, Kravchenko M, Krueger H, Defo BK, Kuchenbecker RS, Kuipers EJ, Kulikoff XR, Kulkarni VS, Kumar GA, Kwan GF, Kyu HH, Lal A, Lal DK, Lalloo R, Lam H, Lan Q, Langan SM, Larsson A, Laryea DO, Latif AA, Leasher JL, Leigh J, Leinsalu M, Leung J, Leung R, Levi M, Li Y, Li Y, Lind M, Linn S, Lipshultz SE, Liu PY, Liu S, Liu Y, Lloyd BK, Lo LT, Logroscino G, Lotufo PA, Lucas RM, Lunevicius R, El Razek MMA, Magis-Rodriguez C, Mahdavi M, Majdan M, Majeed A, Malekzadeh R, Malta DC, Mapoma CC, Margolis DJ, Martin RV, Martinez-Raga J, Masiye F, Mason-Jones AJ, Massano J, Matzopoulos R, Mayosi BM, McGrath JJ, McKee M, Meaney PA, Mehari A, Mekonnen AB, Melaku YA, Memiah P, Memish ZA, Mendoza W, Mensink GBM, Meretoja A, Meretoja TJ, Mesfin YM, Mhimbira FA, Micha R, Miller TR, Mills EJ, Mirarefin M, Misganaw A, Mitchell PB, Mock CN, Mohammadi A, Mohammed S, Monasta L, de la Cruz Monis J, Hernandez JCM, Montico M, Moradi-Lakeh M, Morawska L, Mori R, Mueller UO, Murdoch ME, Murimira B, Murray J, Murthy GVS, Murthy S, Musa KI, Nachega JB, Nagel G, Naidoo KS, Naldi L, Nangia V, Neal B, Nejjari C, Newton CR, Newton JN, Ngalesoni FN, Nguhiu P, Nguyen G, Le Nguyen Q, Nisar MI, Pete PMN, Nolte S, Nomura M, Norheim OF, Norrving B, Obermeyer CM, Ogbo FA, Oh IH, Oladimeji O, Olivares PR, Olusanya BO, Olusanya JO, Opio JN, Oren E, Ortiz A, Osborne RH, Ota E, Owolabi MO, PA M, Park EK, Park HY, Parry CD, Parsaeian M, Patel T, Patel V, Caicedo AJP, Patil ST, Patten SB, Patton GC, Paudel D, Pedro JM, Pereira DM, Perico N, Pesudovs K, Petzold M, Phillips MR, Piel FB, Pillay JD, Pinho C, Pishgar F, Polinder S, Poulton RG, Pourmalek F, Qorbani M, Rabiee RHS, Radfar A, Rahimi-Movaghar V, Rahman M, Rahman MHU, Rahman SU, Rai RK, Rajsic S, Raju M, Ram U, Rana SM, Ranabhat CL, Ranganathan K, Rao PC, Refaat AH, Reitsma MB, Remuzzi G, Resnikoff S, Ribeiro AL, Blancas MJR, Roba HS, Roberts B, Rodriguez A, Rojas-Rueda D, Ronfani L, Roshandel G, Roth GA, Rothenbacher D, Roy A, Roy N, Sackey BB, Sagar R, Saleh MM, Sanabria JR, Santos JV, Santomauro DF, Santos IS, Sarmiento-Suarez R, Sartorius B, Satpathy M, Savic M, Sawhney M, Sawyer SM, Schmidhuber J, Schmidt MI, Schneider IJC, Schutte AE, Schwebel DC, Seedat S, Sepanlou SG, Servan-Mori EE, Shackelford K, Shaheen A, Shaikh MA, Levy TS, Sharma R, She J, Sheikhbahaei S, Shen J, Sheth KN, Shey M, Shi P, Shibuya K, Shigematsu M, Shin MJ, Shiri R, Shishani K, Shiue I, Sigfusdottir ID, Silpakit N, Silva DAS, Silverberg JI, Simard EP, Sindi S, Singh A, Singh GM, Singh JA, Singh OP, Singh PK, Skirbekk V, Sligar A, Soneji S, Søreide K, Sorensen RJD, Soriano JB, Soshnikov S, Sposato LA, Sreeramareddy CT, Stahl HC, Stanaway JD, Stathopoulou V, Steckling N, Steel N, Stein DJ, Steiner C, Stöckl H, Stranges S, Strong M, Sun J, Sunguya BF, Sur P, Swaminathan S, Sykes BL, Szoeke CEI, Tabarés-Seisdedos R, Tabb KM, Talongwa RT, Tarawneh MR, Tavakkoli M, Taye B, Taylor HR, Tedla BA, Tefera W, Tegegne TK, Tekle DY, Shifa GT, Terkawi AS, Tessema GA, Thakur JS, Thomson AJ, Thorne-Lyman AL, Thrift AG, Thurston GD, Tillmann T, Tobe-Gai R, Tonelli M, Topor-Madry R, Topouzis F, Tran BX, Truelsen T, Dimbuene ZT, Tura AK, Tuzcu EM, Tyrovolas S, Ukwaja KN, Undurraga EA, Uneke CJ, Uthman OA, van Donkelaar A, Varakin YY, Vasankari T, Vasconcelos AMN, Veerman JL, Venketasubramanian N, Verma RK, Violante FS, Vlassov VV, Volkow P, Vollset SE, Wagner GR, Wallin MT, Wang L, Wanga V, Watkins DA, Weichenthal S, Weiderpass E, Weintraub RG, Weiss DJ, Werdecker A, Westerman R, Whiteford HA, Wilkinson JD, Wiysonge CS, Wolfe CDA, Wolfe I, Won S, Woolf AD, Workie SB, Wubshet M, Xu G, Yadav AK, Yakob B, Yalew AZ, Yan LL, Yano Y, Yaseri M, Ye P, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yu C, Zaidi Z, El Sayed Zaki M, Zambrana-Torrelio C, Zapata T, Zegeye EA, Zhao Y, Zhou M, Zodpey S, Zonies D, Murray CJL. Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015. Lancet 2016; 388:1813-1850. [PMID: 27665228 PMCID: PMC5055583 DOI: 10.1016/s0140-6736(16)31467-2] [Citation(s) in RCA: 250] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 08/13/2016] [Accepted: 08/16/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). METHODS We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices. FINDINGS In 2015, the median health-related SDG index was 59·3 (95% uncertainty interval 56·8-61·8) and varied widely by country, ranging from 85·5 (84·2-86·5) in Iceland to 20·4 (15·4-24·9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r2=0·88) and the MDG index (r2=0·92), whereas the non-MDG index had a weaker relation with SDI (r2=0·79). Between 2000 and 2015, the health-related SDG index improved by a median of 7·9 (IQR 5·0-10·4), and gains on the MDG index (a median change of 10·0 [6·7-13·1]) exceeded that of the non-MDG index (a median change of 5·5 [2·1-8·9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened. INTERPRETATION GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs. FUNDING Bill & Melinda Gates Foundation.
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Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, Casey DC, Charlson FJ, Chen AZ, Coates MM, Coggeshall M, Dandona L, Dicker DJ, Erskine HE, Ferrari AJ, Fitzmaurice C, Foreman K, Forouzanfar MH, Fraser MS, Fullman N, Gething PW, Goldberg EM, Graetz N, Haagsma JA, Hay SI, Huynh C, Johnson CO, Kassebaum NJ, Kinfu Y, Kulikoff XR, Kutz M, Kyu HH, Larson HJ, Leung J, Liang X, Lim SS, Lind M, Lozano R, Marquez N, Mensah GA, Mikesell J, Mokdad AH, Mooney MD, Nguyen G, Nsoesie E, Pigott DM, Pinho C, Roth GA, Salomon JA, Sandar L, Silpakit N, Sligar A, Sorensen RJD, Stanaway J, Steiner C, Teeple S, Thomas BA, Troeger C, VanderZanden A, Vollset SE, Wanga V, Whiteford HA, Wolock T, Zoeckler L, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abera SF, Abreu DMX, Abu-Raddad LJ, Abyu GY, Achoki T, Adelekan AL, Ademi Z, Adou AK, Adsuar JC, Afanvi KA, Afshin A, Agardh EE, Agarwal A, Agrawal A, Kiadaliri AA, Ajala ON, Akanda AS, Akinyemi RO, Akinyemiju TF, Akseer N, Lami FHA, Alabed S, Al-Aly Z, Alam K, Alam NKM, Alasfoor D, Aldhahri SF, Aldridge RW, Alegretti MA, Aleman AV, Alemu ZA, Alexander LT, Alhabib S, Ali R, Alkerwi A, Alla F, Allebeck P, Al-Raddadi R, Alsharif U, Altirkawi KA, Martin EA, Alvis-Guzman N, Amare AT, Amegah AK, Ameh EA, Amini H, Ammar W, Amrock SM, Andersen HH, Anderson BO, Anderson GM, Antonio CAT, Aregay AF, Ärnlöv J, Arsenijevic VSA, Artaman A, Asayesh H, Asghar RJ, Atique S, Avokpaho EFGA, Awasthi A, Azzopardi P, Bacha U, Badawi A, Bahit MC, Balakrishnan K, Banerjee A, Barac A, Barker-Collo SL, Bärnighausen T, Barregard L, Barrero LH, Basu A, Basu S, Bayou YT, Bazargan-Hejazi S, Beardsley J, Bedi N, Beghi E, Belay HA, Bell B, Bell ML, Bello AK, Bennett DA, Bensenor IM, Berhane A, Bernabé E, Betsu BD, Beyene AS, Bhala N, Bhalla A, Biadgilign S, Bikbov B, Abdulhak AAB, Biroscak BJ, Biryukov S, Bjertness E, Blore JD, Blosser CD, Bohensky MA, Borschmann R, Bose D, Bourne RRA, Brainin M, Brayne CEG, Brazinova A, Breitborde NJK, Brenner H, Brewer JD, Brown A, Brown J, Brugha TS, Buckle GC, Butt ZA, Calabria B, Campos-Nonato IR, Campuzano JC, Carapetis JR, Cárdenas R, Carpenter DO, Carrero JJ, Castañeda-Orjuela CA, Rivas JC, Catalá-López F, Cavalleri F, Cercy K, Cerda J, Chen W, Chew A, Chiang PPC, Chibalabala M, Chibueze CE, Chimed-Ochir O, Chisumpa VH, Choi JYJ, Chowdhury R, Christensen H, Christopher DJ, Ciobanu LG, Cirillo M, Cohen AJ, Colistro V, Colomar M, Colquhoun SM, Cooper C, Cooper LT, Cortinovis M, Cowie BC, Crump JA, Damsere-Derry J, Danawi H, Dandona R, Daoud F, Darby SC, Dargan PI, das Neves J, Davey G, Davis AC, Davitoiu DV, de Castro EF, de Jager P, Leo DD, Degenhardt L, Dellavalle RP, Deribe K, Deribew A, Dharmaratne SD, Dhillon PK, Diaz-Torné C, Ding EL, dos Santos KPB, Dossou E, Driscoll TR, Duan L, Dubey M, Duncan BB, Ellenbogen RG, Ellingsen CL, Elyazar I, Endries AY, Ermakov SP, Eshrati B, Esteghamati A, Estep K, Faghmous IDA, Fahimi S, Faraon EJA, Farid TA, Farinha CSES, Faro A, Farvid MS, Farzadfar F, Feigin VL, Fereshtehnejad SM, Fernandes JG, Fernandes JC, Fischer F, Fitchett JRA, Flaxman A, Foigt N, Fowkes FGR, Franca EB, Franklin RC, Friedman J, Frostad J, Fürst T, Futran ND, Gall SL, Gambashidze K, Gamkrelidze A, Ganguly P, Gankpé FG, Gebre T, Gebrehiwot TT, Gebremedhin AT, Gebru AA, Geleijnse JM, Gessner BD, Ghoshal AG, Gibney KB, Gillum RF, Gilmour S, Giref AZ, Giroud M, Gishu MD, Giussani G, Glaser E, Godwin WW, Gomez-Dantes H, Gona P, Goodridge A, Gopalani SV, Gosselin RA, Gotay CC, Goto A, Gouda HN, Greaves F, Gugnani HC, Gupta R, Gupta R, Gupta V, Gutiérrez RA, Hafezi-Nejad N, Haile D, Hailu AD, Hailu GB, Halasa YA, Hamadeh RR, Hamidi S, Hancock J, Handal AJ, Hankey GJ, Hao Y, Harb HL, Harikrishnan S, Haro JM, Havmoeller R, Heckbert SR, Heredia-Pi IB, Heydarpour P, Hilderink HBM, Hoek HW, Hogg RS, Horino M, Horita N, Hosgood HD, Hotez PJ, Hoy DG, Hsairi M, Htet AS, Htike MMT, Hu G, Huang C, Huang H, Huiart L, Husseini A, Huybrechts I, Huynh G, Iburg KM, Innos K, Inoue M, Iyer VJ, Jacobs TA, Jacobsen KH, Jahanmehr N, Jakovljevic MB, James P, Javanbakht M, Jayaraman SP, Jayatilleke AU, Jeemon P, Jensen PN, Jha V, Jiang G, Jiang Y, Jibat T, Jimenez-Corona A, Jonas JB, Joshi TK, Kabir Z, Kamal R, Kan H, Kant S, Karch A, Karema CK, Karimkhani C, Karletsos D, Karthikeyan G, Kasaeian A, Katibeh M, Kaul A, Kawakami N, Kayibanda JF, Keiyoro PN, Kemmer L, Kemp AH, Kengne AP, Keren A, Kereselidze M, Kesavachandran CN, Khader YS, Khalil IA, Khan AR, Khan EA, Khang YH, Khera S, Khoja TAM, Kieling C, Kim D, Kim YJ, Kissela BM, Kissoon N, Knibbs LD, Knudsen AK, Kokubo Y, Kolte D, Kopec JA, Kosen S, Koul PA, Koyanagi A, Krog NH, Defo BK, Bicer BK, Kudom AA, Kuipers EJ, Kulkarni VS, Kumar GA, Kwan GF, Lal A, Lal DK, Lalloo R, Lallukka T, Lam H, Lam JO, Langan SM, Lansingh VC, Larsson A, Laryea DO, Latif AA, Lawrynowicz AEB, Leigh J, Levi M, Li Y, Lindsay MP, Lipshultz SE, Liu PY, Liu S, Liu Y, Lo LT, Logroscino G, Lotufo PA, Lucas RM, Lunevicius R, Lyons RA, Ma S, Machado VMP, Mackay MT, MacLachlan JH, Razek HMAE, Magdy M, Razek AE, Majdan M, Majeed A, Malekzadeh R, Manamo WAA, Mandisarisa J, Mangalam S, Mapoma CC, Marcenes W, Margolis DJ, Martin GR, Martinez-Raga J, Marzan MB, Masiye F, Mason-Jones AJ, Massano J, Matzopoulos R, Mayosi BM, McGarvey ST, McGrath JJ, McKee M, McMahon BJ, Meaney PA, Mehari A, Mehndiratta MM, Mejia-Rodriguez F, Mekonnen AB, Melaku YA, Memiah P, Memish ZA, Mendoza W, Meretoja A, Meretoja TJ, Mhimbira FA, Micha R, Millear A, Miller TR, Mirarefin M, Misganaw A, Mock CN, Mohammad KA, Mohammadi A, Mohammed S, Mohan V, Mola GLD, Monasta L, Hernandez JCM, Montero P, Montico M, Montine TJ, Moradi-Lakeh M, Morawska L, Morgan K, Mori R, Mozaffarian D, Mueller UO, Murthy GVS, Murthy S, Musa KI, Nachega JB, Nagel G, Naidoo KS, Naik N, Naldi L, Nangia V, Nash D, Nejjari C, Neupane S, Newton CR, Newton JN, Ng M, Ngalesoni FN, de Dieu Ngirabega J, Nguyen QL, Nisar MI, Pete PMN, Nomura M, Norheim OF, Norman PE, Norrving B, Nyakarahuka L, Ogbo FA, Ohkubo T, Ojelabi FA, Olivares PR, Olusanya BO, Olusanya JO, Opio JN, Oren E, Ortiz A, Osman M, Ota E, Ozdemir R, PA M, Pain A, Pandian JD, Pant PR, Papachristou C, Park EK, Park JH, Parry CD, Parsaeian M, Caicedo AJP, Patten SB, Patton GC, Paul VK, Pearce N, Pedro JM, Stokic LP, Pereira DM, Perico N, Pesudovs K, Petzold M, Phillips MR, Piel FB, Pillay JD, Plass D, Platts-Mills JA, Polinder S, Pope CA, Popova S, Poulton RG, Pourmalek F, Prabhakaran D, Qorbani M, Quame-Amaglo J, Quistberg DA, Rafay A, Rahimi K, Rahimi-Movaghar V, Rahman M, Rahman MHU, Rahman SU, Rai RK, Rajavi Z, Rajsic S, Raju M, Rakovac I, Rana SM, Ranabhat CL, Rangaswamy T, Rao P, Rao SR, Refaat AH, Rehm J, Reitsma MB, Remuzzi G, Resnikoff S, Ribeiro AL, Ricci S, Blancas MJR, Roberts B, Roca A, Rojas-Rueda D, Ronfani L, Roshandel G, Rothenbacher D, Roy A, Roy NK, Ruhago GM, Sagar R, Saha S, Sahathevan R, Saleh MM, Sanabria JR, Sanchez-Niño MD, Sanchez-Riera L, Santos IS, Sarmiento-Suarez R, Sartorius B, Satpathy M, Savic M, Sawhney M, Schaub MP, Schmidt MI, Schneider IJC, Schöttker B, Schutte AE, Schwebel DC, Seedat S, Sepanlou SG, Servan-Mori EE, Shackelford KA, Shaddick G, Shaheen A, Shahraz S, Shaikh MA, Shakh-Nazarova M, Sharma R, She J, Sheikhbahaei S, Shen J, Shen Z, Shepard DS, Sheth KN, Shetty BP, Shi P, Shibuya K, Shin MJ, Shiri R, Shiue I, Shrime MG, Sigfusdottir ID, Silberberg DH, Silva DAS, Silveira DGA, Silverberg JI, Simard EP, Singh A, Singh GM, Singh JA, Singh OP, Singh PK, Singh V, Soneji S, Søreide K, Soriano JB, Sposato LA, Sreeramareddy CT, Stathopoulou V, Stein DJ, Stein MB, Stranges S, Stroumpoulis K, Sunguya BF, Sur P, Swaminathan S, Sykes BL, Szoeke CEI, Tabarés-Seisdedos R, Tabb KM, Takahashi K, Takala JS, Talongwa RT, Tandon N, Tavakkoli M, Taye B, Taylor HR, Ao BJT, Tedla BA, Tefera WM, Have MT, Terkawi AS, Tesfay FH, Tessema GA, Thomson AJ, Thorne-Lyman AL, Thrift AG, Thurston GD, Tillmann T, Tirschwell DL, Tonelli M, Topor-Madry R, Topouzis F, Towbin JA, Traebert J, Tran BX, Truelsen T, Trujillo U, Tura AK, Tuzcu EM, Uchendu US, Ukwaja KN, Undurraga EA, Uthman OA, Dingenen RV, van Donkelaar A, Vasankari T, Vasconcelos AMN, Venketasubramanian N, Vidavalur R, Vijayakumar L, Villalpando S, Violante FS, Vlassov VV, Wagner JA, Wagner GR, Wallin MT, Wang L, Watkins DA, Weichenthal S, Weiderpass E, Weintraub RG, Werdecker A, Westerman R, White RA, Wijeratne T, Wilkinson JD, Williams HC, Wiysonge CS, Woldeyohannes SM, Wolfe CDA, Won S, Wong JQ, Woolf AD, Xavier D, Xiao Q, Xu G, Yakob B, Yalew AZ, Yan LL, Yano Y, Yaseri M, Ye P, Yebyo HG, Yip P, Yirsaw BD, Yonemoto N, Yonga G, Younis MZ, Yu S, Zaidi Z, Zaki MES, Zannad F, Zavala DE, Zeeb H, Zeleke BM, Zhang H, Zodpey S, Zonies D, Zuhlke LJ, Vos T, Lopez AD, Murray CJL. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388:1459-1544. [PMID: 27733281 PMCID: PMC5388903 DOI: 10.1016/s0140-6736(16)31012-1] [Citation(s) in RCA: 4031] [Impact Index Per Article: 503.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. METHODS We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). FINDINGS Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4-61·9) in 1980 to 71·8 years (71·5-72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7-17·4), to 62·6 years (56·5-70·2). Total deaths increased by 4·1% (2·6-5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8-18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6-16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9-14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1-44·6), malaria (43·1%, 34·7-51·8), neonatal preterm birth complications (29·8%, 24·8-34·9), and maternal disorders (29·1%, 19·3-37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. INTERPRETATION At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. FUNDING Bill & Melinda Gates Foundation.
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Hawke L, Grabell J, Sim W, Thibeault L, Muir E, Hopman W, Smith G, James P. Obstetric bleeding among women with inherited bleeding disorders: a retrospective study. Haemophilia 2016; 22:906-911. [PMID: 27704714 DOI: 10.1111/hae.13067] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2016] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Women with inherited bleeding disorders are at increased risk for bleeding complications during pregnancy and the postpartum period, particularly postpartum haemorrhage (PPH). AIM This retrospective study evaluates pregnancy management through the Inherited Bleeding Disorders Clinic of Southeastern Ontario, the clinical factors associated with pregnancy-related abnormal bleeding and assesses tranexamic acid use in the postpartum treatment of bleeding disorder patients. METHODS A chart review of 62 pregnancies, from 33 women, evaluated patient characteristics (age, haemostatic factor levels) and delivery conditions (mode of delivery, postpartum treatment) in relation to abnormal postpartum bleeding. RESULTS This cohort revealed increased risk of immediate PPH with increased age at delivery (mean age: 30.1 years with PPH, 26.5 years without PPH, P < 0.013), and birth by vaginal delivery (P < 0.042). Low von Willebrand factor (VWF) antigen or factor VIII (FVIII) in the third trimester was not associated with an increased risk of PPH; however, low VWF:RCo was associated with increased immediate PPH despite treatment with continuous factor infusion (P < 0.042). Women treated with tranexamic acid postpartum had less severe bleeding in the 6-week postpartum (P < 0.049) with no thrombotic complications. CONCLUSIONS This study contributes to the growing body of work aimed at optimizing management of bleeding disorder patients through pregnancy and the postpartum period, showing patients are at a higher risk of PPH as they age. Risk factors such as low third trimester VWF:RCo have been identified. Treatment with tranexamic acid in the postpartum period is associated with a reduced incidence of abnormal postpartum bleeding.
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Affiliation(s)
- L Hawke
- Queen's University, Kingston, ON, Canada
| | - J Grabell
- Queen's University, Kingston, ON, Canada
| | - W Sim
- Queen's University, Kingston, ON, Canada
| | - L Thibeault
- Kingston General Hospital, Kingston, ON, Canada
| | - E Muir
- Queen's University, Kingston, ON, Canada
| | - W Hopman
- Queen's University, Kingston, ON, Canada
| | - G Smith
- Queen's University, Kingston, ON, Canada
| | - P James
- Queen's University, Kingston, ON, Canada.,Kingston General Hospital, Kingston, ON, Canada
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Mitchell JA, Godbole S, Moran K, Murray K, James P, Laden F, Hipp JA, Kerr J, Glanz K. No Evidence of Reciprocal Associations between Daily Sleep and Physical Activity. Med Sci Sports Exerc 2016; 48:1950-6. [PMID: 27285490 PMCID: PMC5026562 DOI: 10.1249/mss.0000000000001000] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE This study aimed to determine whether physical activity patterns are associated with sleep later at night and if nighttime sleep is associated with physical activity patterns the next day among adult women. METHODS Women (N = 353) living throughout the United States wore a wrist and a hip accelerometer for 7 d. Total sleep time (TST, hours per night) and sleep efficiency (SE, %) were estimated from the wrist accelerometer, and moderate to vigorous physical activity (MVPA, >1040 counts per minute, h·d) and sedentary behavior (SB, <100 counts per minute, h·d) were estimated from the hip accelerometer. Mixed-effects models adjusted for age, race, body mass index, education, employment, marital status, health status, and hip accelerometer wear time were used to analyze the data. Follow-up analyses using quantile regression were used to investigate associations among women with below average TST and MVPA and above average SB. RESULTS The average age of our sample was 55.5 yr (SD = 10.2 yr). The majority of participants were White (79%) and married (72%), and half were employed full time (49%). The participants spent on average 8.9 and 1.1 h·d in SB and MVPA, respectively, and 6.8 h per night asleep. No associations were observed between MVPA and SB with nighttime TST or SE. There were no associations between nighttime TST and SE with MVPA or SB the next day. The findings were the same in the quantile regression analyses. CONCLUSION In free-living adult women, accelerometry-estimated nighttime sleep and physical activity patterns were not associated with one another. On the basis of our observational study involving a sample of adult women, higher physical activity will not necessarily improve sleep at night on a day-to-day basis (and vice versa).
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Affiliation(s)
- Jonathan A Mitchell
- 1Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA; 2Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; 3Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA; 4Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; 5School of Psychology and Counseling, Queensland University of Technology, Brisbane, AUSTRALIA; 6Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; 7Department of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; 8Department of Parks, Recreation, and Tourism Management and Center for Geospatial Analytics, NC State University, Raleigh, NC; 9Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, PA
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Kirkpatrick E, Pearse J, James P, Basu A. Effect of parent-delivered action observation therapy on upper limb function in unilateral cerebral palsy: a randomized controlled trial. Dev Med Child Neurol 2016; 58:1049-56. [PMID: 27038153 DOI: 10.1111/dmcn.13109] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2016] [Indexed: 11/28/2022]
Abstract
AIM To determine whether home-based, parent-delivered therapy comprising action observation (AO) and repeated practice (RP) improves upper limb function more than RP alone in children with unilateral cerebral palsy (UCP). DESIGN single-blinded parallel-group randomized controlled trial with 1:1 allocation comparing AO+RP (intervention) with RP alone (control). RANDOMIZATION computer-generated, with allocation concealment by opaque sequentially-numbered envelopes. SETTING northern England, August 2011 to September 2013. PARTICIPANTS 70 children with UCP; mean age 5.6 years (SD 2.1), 31 female. INTERVENTION home-based activities were provided, tailored to interests and abilities. DURATION 15 minutes/day, 5 days/week for 3 months. ASSESSMENTS Assisting Hand Assessment (AHA; primary outcome measure), Melbourne Assessment 2 (MA2), and ABILHAND-Kids at baseline, 3 months, and 6 months. RESULTS Outcome data was available at 3 months for 28 children in the AO+RP group and 31 controls, and at 6 months for 26 and 28 children respectively. There were no between-group differences in AHA, MA2, or ABILHAND-Kids at 3 or 6 months versus baseline (all p>0.05). Combined-group improvements (p<0.001), observed in AHA and MA2 at 3 months, were maintained at 6 months. ABILHAND-Kids also showed improvement at 3 months (p=0.003), maintained at 6 months. INTERPRETATION Parent-delivered RP (with or without AO) improves upper limb function and could supplement therapist input.
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Affiliation(s)
- Emma Kirkpatrick
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Janice Pearse
- Paediatric Occupational Therapy Services, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Peter James
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Anna Basu
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
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Stella R, Barrucci F, Angeletti R, James P, Montesissa C, Biancotto G. Targeted proteomics for the indirect detection of dexamethasone treatment in bovines. Anal Bioanal Chem 2016; 408:8343-8353. [DOI: 10.1007/s00216-016-9951-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 08/01/2016] [Accepted: 09/15/2016] [Indexed: 01/08/2023]
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Xu Y, Deforest M, Grabell J, Hopman W, James P. Relative contributions of bleeding scores and iron status on health-related quality of life in von Willebrand disease: a cross-sectional study. Haemophilia 2016; 23:115-121. [DOI: 10.1111/hae.13062] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Y. Xu
- School of Medicine; Queen's University; Kingston Canada
| | - M. Deforest
- NCIC Clinical Trials Group; Queen's University; Kingston Canada
| | - J. Grabell
- Department of Pathology and Molecular Medicine; Queen's University; Kingston Canada
| | - W. Hopman
- Clinical Research Centre, Kingston General Hospital; Queen's University; Kingston Canada
- Department of Public Health Sciences; Queen's University; Kingston Canada
| | - P. James
- Department of Pathology and Molecular Medicine; Queen's University; Kingston Canada
- Department of Medicine; Queen's University; Kingston Canada
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James P, Hart JE, Banay RF, Laden F. Exposure to Greenness and Mortality in a Nationwide Prospective Cohort Study of Women. Environ Health Perspect 2016; 124:1344-52. [PMID: 27074702 PMCID: PMC5010419 DOI: 10.1289/ehp.1510363] [Citation(s) in RCA: 290] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 10/27/2015] [Accepted: 03/17/2016] [Indexed: 05/20/2023]
Abstract
BACKGROUND Green, natural environments may ameliorate adverse environmental exposures (e.g., air pollution, noise, and extreme heat), increase physical activity and social engagement, and lower stress. OBJECTIVES We aimed to examine the prospective association between residential greenness and mortality. METHODS Using data from the U.S.-based Nurses' Health Study prospective cohort, we defined cumulative average time-varying seasonal greenness surrounding each participant's address using satellite imagery [Normalized Difference Vegetation Index (NDVI)]. We followed 108,630 women and observed 8,604 deaths between 2000 and 2008. RESULTS In models adjusted for mortality risk factors (age, race/ethnicity, smoking, and individual- and area-level socioeconomic status), women living in the highest quintile of cumulative average greenness (accounting for changes in residence during follow-up) in the 250-m area around their home had a 12% lower rate of all-cause nonaccidental mortality [95% confidence interval (CI); 0.82, 0.94] than those in the lowest quintile. The results were consistent for the 1,250-m area, although the relationship was slightly attenuated. These associations were strongest for respiratory and cancer mortality. The findings from a mediation analysis suggested that the association between greenness and mortality may be at least partly mediated by physical activity, particulate matter < 2.5 μm, social engagement, and depression. CONCLUSIONS Higher levels of green vegetation were associated with decreased mortality. Policies to increase vegetation may provide opportunities for physical activity, reduce harmful exposures, increase social engagement, and improve mental health. Planting vegetation may mitigate the effects of climate change; in addition, evidence of an association between vegetation and lower mortality rates suggests it also might be used to improve health. CITATION James P, Hart JE, Banay RF, Laden F. 2016. Exposure to greenness and mortality in a nationwide prospective cohort study of women. Environ Health Perspect 124:1344-1352; http://dx.doi.org/10.1289/ehp.1510363.
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Affiliation(s)
- Peter James
- Department of Epidemiology, and
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Address correspondence to P. James, Department of Epidemiology and Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Dr., 3rd Floor West, Boston, MA 02215 USA. Telephone: (617) 525-2567. E-mail:
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Rachel F. Banay
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Department of Epidemiology, and
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Tucker-Seeley RD, Bezold CP, James P, Miller M, Wallington SF. Retail Pharmacy Policy to End the Sale of Tobacco Products: What Is the Impact on Disparity in Neighborhood Density of Tobacco Outlets? Cancer Epidemiol Biomarkers Prev 2016; 25:1305-10. [PMID: 27302724 PMCID: PMC5010482 DOI: 10.1158/1055-9965.epi-15-1234] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 01/22/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Population-level research on the implications of retail pharmacy policies to end the sale of tobacco products is scant, and the impact of such policies on racial/ethnic and socioeconomic disparities across neighborhoods in access to tobacco products remains unexplored. METHODS We investigated the association between neighborhood sociodemographic characteristics and tobacco retail density in Rhode Island (RI; N = 240 census tracts). We also investigated whether the CVS Health (N = 60) policy to end the sale of tobacco products reduces the disparity in the density of tobacco retail across neighborhoods, and we conducted a prospective policy analysis to determine whether a similar policy change in all pharmacies in RI (N = 135) would reduce the disparity in tobacco retail density. RESULTS The results revealed statistically significant associations between neighborhood sociodemographic characteristics and tobacco retail outlet density across RI neighborhoods. The results when excluding the CVS Health locations, as well as all pharmacies as tobacco retailers, revealed no change in the pattern for this association. CONCLUSIONS The results of this study suggest that while a commendable tobacco control policy, the CVS Health policy appears to have no impact on the neighborhood racial/ethnic and socioeconomic disparities in the density of tobacco retailers in RI. Prospective policy analyses showed no impact on this disparity even if all other pharmacies in the state adopted a similar policy. IMPACT Policy efforts aimed at reducing the disparity in access to tobacco products should focus on reducing the density of tobacco outlets in poor and racial/ethnic neighborhoods. Cancer Epidemiol Biomarkers Prev; 25(9); 1305-10. ©2016 AACR.
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Affiliation(s)
- Reginald D Tucker-Seeley
- Center for Community Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Carla P Bezold
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Peter James
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Melecia Miller
- Center for Community Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Sherrie F Wallington
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
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Blusztein D, Jayadeva P, Thompson T, Zentner D, Trainer A, James P, Winship I, Kalman J, Vohra J. Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): Genotype and Phenotype Analysis of a Cohort of Probands. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
PURPOSE To compare dynamic hip screw (DHS) fixation with multiple screw fixation for intracapsular hip fractures in terms of complications and conversion to hemiarthroplasty or total hip arthroplasty (THA). METHODS Records of 52 884 patients aged ≥50 years who underwent internal fixation using a dynamic hip screw (n=18 014, 34.1%) or multiple screws (n=34 870, 65.9%) for intracapsular femoral neck fracture from September 2007 to September 2013 were extracted from the hospital admission database that covers all admissions to the National Health Service hospitals in England using the ICD-10 and OPCS-4 codes. Gender, age, and Charlson comorbidity score of each patient were recorded, as were complications at specific time intervals and revision to hemiarthroplasty or THA at one and 4 years. RESULTS Compared with DHS fixation, multiple screw fixation resulted in shorter hospital stay (15 vs. 13 days, p<0.001) and lower rates of 30-day myocardial infarction (2% vs. 1.5%, p=0.022), 30-day lower respiratory tract infection (12.4% vs. 10.6%, p=0.001), 90-day mortality (10.4% vs. 8.6%, p=0.001), and avascular necrosis (0.1% vs. 0.06%, p=0.032), but a higher rate of conversion to hemiarthroplasty or THA at one or 4 years (all p<0.001). CONCLUSION Multiple screw fixation for intracapsular hip fracture was associated with a higher conversion rate to hemiarthroplasty or THA at one and 4 years, compared with DHS fixation.
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Affiliation(s)
- P Jettoo
- Northern Deanery Trauma & Orthopaedic Training Scheme, Newcastle Upon Tyne, United Kingdom
| | - P James
- CHKS Healthcare Intelligence Services, Warwickshire, United Kingdom
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Zentner D, Thompson T, Taylor J, Bogwitz M, Macciocca I, Trainer A, Winship I, Vohra J, James P. The Advent of Gene Panel Testing: Has It Changed the Outcome of Mutation Detection Gene Testing in a Cardiac Genetics Clinic? Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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