99 results on '"Leander, K."'
Search Results
2. Role of Polyunsaturated Fat in Modifying Cardiovascular Risk Associated With Family History of Cardiovascular Disease : Pooled De Novo Results From 15 Observational Studies
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Laguzzi, F., Åkesson, A., Marklund, Matti, Qian, F., Gigante, B., Bartz, T. M., Bassett, J. K., Birukov, A., Campos, H., Hirakawa, Y., Imamura, F., Jäger, S., Lankinen, M., Murphy, R. A., Senn, M., Tanaka, T., Tintle, N., Virtanen, J. K., Yamagishi, K., Allison, M., Brouwer, I. A., De Faire, U., Eiriksdottir, G., Ferrucci, L., Forouhi, N. G., Geleijnse, J. M., Hodge, A. M., Kimura, H., Laakso, M., Risérus, Ulf, van Westing, A. C., Bandinelli, S., Baylin, A., Giles, G. G., Gudnason, V., Iso, H., Lemaitre, R. N., Ninomiya, T., Post, W. S., Psaty, B. M., Salonen, J. T., Schulze, M. B., Tsai, M. Y., Uusitupa, M., Wareham, N. J., Oh, S.-W., Wood, A. C., Harris, W. S., Siscovick, D., Mozaffarian, D., Leander, K., Laguzzi, F., Åkesson, A., Marklund, Matti, Qian, F., Gigante, B., Bartz, T. M., Bassett, J. K., Birukov, A., Campos, H., Hirakawa, Y., Imamura, F., Jäger, S., Lankinen, M., Murphy, R. A., Senn, M., Tanaka, T., Tintle, N., Virtanen, J. K., Yamagishi, K., Allison, M., Brouwer, I. A., De Faire, U., Eiriksdottir, G., Ferrucci, L., Forouhi, N. G., Geleijnse, J. M., Hodge, A. M., Kimura, H., Laakso, M., Risérus, Ulf, van Westing, A. C., Bandinelli, S., Baylin, A., Giles, G. G., Gudnason, V., Iso, H., Lemaitre, R. N., Ninomiya, T., Post, W. S., Psaty, B. M., Salonen, J. T., Schulze, M. B., Tsai, M. Y., Uusitupa, M., Wareham, N. J., Oh, S.-W., Wood, A. C., Harris, W. S., Siscovick, D., Mozaffarian, D., and Leander, K.
- Abstract
BACKGROUND: It is unknown whether dietary intake of polyunsaturated fatty acids (PUFA) modifies the cardiovascular disease (CVD) risk associated with a family history of CVD. We assessed interactions between biomarkers of low PUFA intake and a family history in relation to long-term CVD risk in a large consortium. METHODS: Blood and tissue PUFA data from 40 885 CVD-free adults were assessed. PUFA levels ≤25th percentile were considered to reflect low intake of linoleic, alpha-linolenic, and eicosapentaenoic/docosahexaenoic acids (EPA/DHA). Family history was defined as having ≥1 first-degree relative who experienced a CVD event. Relative risks with 95% CI of CVD were estimated using Cox regression and meta-analyzed. Interactions were assessed by analyzing product terms and calculating relative excess risk due to interaction. RESULTS: After multivariable adjustments, a significant interaction between low EPA/DHA and family history was observed (product term pooled RR, 1.09 [95% CI, 1.02-1.16]; P=0.01). The pooled relative risk of CVD associated with the combined exposure to low EPA/DHA, and family history was 1.41 (95% CI, 1.30-1.54), whereas it was 1.25 (95% CI, 1.16-1.33) for family history alone and 1.06 (95% CI, 0.98-1.14) for EPA/DHA alone, compared with those with neither exposure. The relative excess risk due to interaction results indicated no interactions. CONCLUSIONS: A significant interaction between biomarkers of low EPA/DHA intake, but not the other PUFA, and a family history was observed. This novel finding might suggest a need to emphasize the benefit of consuming oily fish for individuals with a family history of CVD.
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- 2024
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3. The Journey of Bereavement
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Mitchell, Leander K., primary
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- 2022
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4. Telehealth Cognitive Behavior Therapy to Reduce Anxiety in People Living with Cognitive Impairment: A Randomized Feasibility Pilot Study
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Pacas Fronza, Gabriela, primary, Mitchell, Leander K., additional, Pachana, Nancy A., additional, Byrne, Gerard J., additional, Liddle, Jacki, additional, Yang, Jihyun, additional, Brooks, Deborah, additional, Au, Tiffany, additional, Pourzinal, Dana, additional, Worthy, Peter, additional, Comans, Tracy, additional, Beattie, Elizabeth, additional, Bennett, Sally, additional, Russell, Trevor, additional, and Dissanayaka, Nadeeka N., additional
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- 2024
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5. Association Between History of Adverse Pregnancy Outcomes and Coronary Artery Disease Assessed by Coronary Computed Tomography Angiography
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Sederholm Lawesson, S., primary, Swahn, E., additional, Pihlsgård, M., additional, Andersson, T., additional, Angerås, O., additional, Bacsovics Brolin, E., additional, Bergdahl, E., additional, Blomberg, M., additional, Christersson, C., additional, Gonçalves, I., additional, Gunnarsson, O.S., additional, Jernberg, T., additional, Johnston, N., additional, Leander, K., additional, Lilliecreutz, C., additional, Pehrson, M., additional, Rosengren, A., additional, Sandström, A., additional, Sarno, G., additional, Själander, S., additional, Svanvik, T., additional, Thunström, E., additional, Wikström, A.K., additional, and Timpka, S., additional
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- 2023
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6. Menopausal vasomotor symptoms and subclinical atherosclerotic cardiovascular disease
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Nilsson, S, primary, Qvick, A, additional, Henriksson, M, additional, Sederholm Lawesson, S, additional, Spetz Holm, A C, additional, and Leander, K, additional
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- 2023
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7. A Systematic Review of Psychotherapy Approaches for Anxiety in Parkinson's Disease.
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Roper, Amy, Pacas Fronza, Gabriela, Dobkin, Roseanne D., Beaudreau, Sherry A., Mitchell, Leander K., Pachana, Nancy A., Thangavelu, Karthick, and Dissanayaka, Nadeeka N.
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ANXIETY treatment ,PSYCHOLOGY information storage & retrieval systems ,ONLINE information services ,CINAHL database ,SYSTEMATIC reviews ,PATIENT-centered care ,TREATMENT effectiveness ,PARKINSON'S disease ,DESCRIPTIVE statistics ,RESEARCH funding ,ANXIETY ,MEDLINE ,PSYCHOTHERAPY ,DISEASE complications ,EVALUATION - Abstract
Anxiety is common in Parkinson's disease (PD), negatively impacting daily functioning and quality of life in PD patients and their families. This systematic review evaluates the effectiveness of different psychotherapeutic approaches for reducing anxiety in PD and provides recommendations for clinical practise. Following PRISMA guidelines, 36 studies were included and risk of bias was evaluated. We identified cognitive behavioral therapy (CBT), mindfulness-based therapies, acceptance and commitment therapy, and psychodrama psychotherapies. There is good evidence-base for anxiety reduction using CBT approaches, but with mixed results for mindfulness-based therapies. Other therapeutic approaches were under researched. Most randomized control trials examined anxiety as a secondary measure. There was a paucity of interventions for anxiety subtypes. Secondarily, studies revealed the consistent exclusion of PD patients with cognitive concerns, an importance of care partner involvement, and a growing interest in remote delivery of psychotherapy interventions. Person-centered anxiety interventions tailored for PD patients, including those with cognitive concerns, and trials exploring modalities other than CBT, warrant future investigations. Practitioners should consider PD-specific anxiety symptoms and cognitive concerns when treating anxiety. Key distinctions between therapeutic modalities, therapy settings and delivery methods should guide treatment planning. [ABSTRACT FROM AUTHOR]
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- 2024
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- View/download PDF
8. Review of: "Public Health Student Internship: An Opportunity to Explore System, Self, and Society"
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Mitchell, Leander K., primary
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- 2023
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9. Long-term air pollution exposure and malignant intracranial tumours of the central nervous system: a pooled analysis of six European cohorts
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Hvidtfeldt, UA, Chen, J, Rodopoulou, S, Strak, M, De Hoogh, K, Andersen, ZJ, Bellander, T, Brandt, J, Fecht, D, Forastiere, F, Gulliver, J, Hertel, O, Hoffmann, B, Katsouyanni, K, Ketzel, M, Leander, K, Magnusson, PKE, Nagel, G, Pershagen, G, Rizzuto, D, Samoli, E, So, R, Stafoggia, M, Tjønneland, A, Weinmayr, G, Wolf, K, Zhang, J, Zitt, E, Brunekreef, B, Hoek, G, and Raaschou-Nielsen, O
- Abstract
BACKGROUND: Risk factors for malignant tumours of the central nervous system (CNS) are largely unknown. METHODS: We pooled six European cohorts (N = 302,493) and assessed the association between residential exposure to nitrogen dioxide (NO2), fine particles (PM2.5), black carbon (BC), ozone (O3) and eight elemental components of PM2.5 (copper, iron, potassium, nickel, sulfur, silicon, vanadium, and zinc) and malignant intracranial CNS tumours defined according to the International Classification of Diseases ICD-9/ICD-10 codes 192.1/C70.0, 191.0-191.9/C71.0-C71.9, 192.0/C72.2-C72.5. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area-level. RESULTS: During 5,497,514 person-years of follow-up (average 18.2 years), we observed 623 malignant CNS tumours. The results of the fully adjusted linear analyses showed a hazard ratio (95% confidence interval) of 1.07 (0.95, 1.21) per 10 μg/m³ NO2, 1.17 (0.96, 1.41) per 5 μg/m³ PM2.5, 1.10 (0.97, 1.25) per 0.5 10-5m-1 BC, and 0.99 (0.84, 1.17) per 10 μg/m³ O3. CONCLUSIONS: We observed indications of an association between exposure to NO2, PM2.5, and BC and tumours of the CNS. The PM elements were not consistently associated with CNS tumour incidence.
- Published
- 2023
10. National Survey on the Impact of COVID-19 on the Mental Health of Australian Residential Aged Care Residents and Staff
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Helen Almond, Viviana M. Wuthrich, Harry Lovelock, Leander K. Mitchell, Colleen Doyle, Frances Batchelor, Sunil Bhar, Steven Savvas, Maja Nedeljkovic, and Aida Brydon
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2019-20 coronavirus outbreak ,Health (social science) ,Social Psychology ,Coronavirus disease 2019 (COVID-19) ,SARS-CoV-2 ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Australia ,COVID-19 ,Mental health ,Clinical Psychology ,Distress ,Mental Health ,Environmental health ,Humans ,Medicine ,Aged care ,Geriatrics and Gerontology ,business ,Pandemics ,Gerontology ,Aged - Abstract
This study is the first to obtain data on the prevalence of, contributors to, and supports required for, pandemic-related distress within the residential aged care sector in Australia. A nested mixed-methods approach was used to examine aged care leaders' opinions about the impact of COVID-19 on the mental health of aged care residents and staff.A total of 288 senior staff of Australian residential aged care facilities (care managers, clinical care coordinators, and lifestyle team leaders; mean age = 52.7 years,On average, nearly half of their residents experienced loneliness (41%) and a third experienced anxiety in response to COVID-19 (33%). The most frequently noted contributors to poor mental health among residents were restrictions to recreational outings and watching news coverage relating to COVID-19. Participants emphasized the need for increased access to counseling services and improved mental health training amongst staff. Residential care staff were similarly impacted by the pandemic. More than a third of staff were reported as anxious (36%) and 20% depressed, in response to COVID-19. Staff were worried about introducing COVID-19 into their facility and were impacted by news coverage of COVID-19. Staff would feel supported by financial assistance and by increased staff-resident ratios.Senior staff perceive that the mental health of Australian aged care residents and staff was negatively impacted by the COVID-19 pandemic. The most noted contributors were identified, as was the mental health support for aged care communities.This study provides government and policymakers with clear intervention targets for supporting the sector. Clinicians can support residential aged care communities by providing on-site or telehealth counseling, and upskill and train residential aged care staff on how to respond to the emotional needs of residents in response to COVID-19.
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- 2021
11. A Copper Cage‐Complex as Mimic of the pMMO Cu C Site
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Sarah C. Bete, Leander K. May, Philipp Woite, Michael Roemelt, and Matthias Otte
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General Chemistry ,Catalysis - Published
- 2022
12. Ein Kupfer‐Käfig‐Komplex als Nachahmung der pMMO Cu C ‐Seite
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Sarah C. Bete, Leander K. May, Philipp Woite, Michael Roemelt, and Matthias Otte
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General Medicine - Published
- 2022
13. Phenomenology of anxiety in people living with mild to moderate dementia: A conceptual meta-ethnographic review
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Pacas Fronza, Gabriela, primary, Liddle, Jacki, additional, Mitchell, Leander K., additional, Byrne, Gerard J., additional, Pachana, Nancy A., additional, and Dissanayaka, Nadeeka N., additional
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- 2022
- Full Text
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14. Ein Kupfer‐Käfig‐Komplex als Nachahmung der pMMO Cu C ‐Seite
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Bete, Sarah C., primary, May, Leander K., additional, Woite, Philipp, additional, Roemelt, Michael, additional, and Otte, Matthias, additional
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- 2022
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15. A Copper Cage‐Complex as Mimic of the pMMO Cu C Site
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Bete, Sarah C., primary, May, Leander K., additional, Woite, Philipp, additional, Roemelt, Michael, additional, and Otte, Matthias, additional
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- 2022
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16. Associations of Polymorphisms in the Peroxisome Proliferator-Activated Receptor Gamma Coactivator-1 Alpha Gene With Subsequent Coronary Heart Disease : An Individual-Level Meta-Analysis
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Schillemans, T., Tragante, V., Maitusong, B., Gigante, B., Cresci, S., Laguzzi, F., Vikstrom, M., Richards, M., Pilbrow, A., Cameron, V., Foco, L., Doughty, R.N., Kuukasjarvi, P., Allayee, H., Hartiala, J.A., Tang, W.H.W., Lyytikainen, L.P., Nikus, K., Laurikka, J.O., Srinivasan, S., Mordi, I.R., Trompet, S., Kraaijeveld, A., Setten, J. van, Gijsberts, C.M., Maitland-van der Zee, A.H., Saely, C.H., Gong, Y., Johnson, J.A., Cooper-DeHoff, R.M., Pepine, C.J., Casu, G., Leiherer, A., Drexel, H., Horne, B.D., Laan, S.W. van der, Marziliano, N., Hazen, S.L., Sinisalo, J., Kahonen, M., Lehtimaki, T., Lang, C.C., Burkhardt, R., Scholz, M., Jukema, J.W., Eriksson, N., Akerblom, A., James, S., Held, C., Hagstrom, E., Spertus, J.A., Algra, A., Faire, U. de, Akesson, A., Asselbergs, F.W., Patel, R.S., Leander, K., HUS Heart and Lung Center, Department of Medicine, Clinicum, University of Helsinki, Pulmonology, Paediatric Pulmonology, APH - Personalized Medicine, ACS - Heart failure & arrhythmias, Tampere University, Department of Clinical Chemistry, Clinical Medicine, and TAYS Heart Centre
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RISK ,ARCHITECTURE ,Kardiologi ,HYPERTENSION ,PGC-1-ALPHA ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,VARIANT ,1184 Genetics, developmental biology, physiology ,meta-analysis ,PGC-1 ,cohort studies ,PGC1-ALPHA ,PPARGC1A ,GLY482SER POLYMORPHISM ,ARTERY-DISEASE ,Cardiac and Cardiovascular Systems ,3111 Biomedicine ,PPAR-GAMMA ,coronary heart disease ,polymorphisms ,SNPs - Abstract
Contains fulltext : 283506.pdf (Publisher’s version ) (Open Access) Background: The knowledge of factors influencing disease progression in patients with established coronary heart disease (CHD) is still relatively limited. One potential pathway is related to peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PPARGC1A), a transcription factor linked to energy metabolism which may play a role in the heart function. Thus, its associations with subsequent CHD events remain unclear. We aimed to investigate the effect of three different SNPs in the PPARGC1A gene on the risk of subsequent CHD in a population with established CHD. Methods: We employed an individual-level meta-analysis using 23 studies from the GENetIcs of sUbSequent Coronary Heart Disease (GENIUS-CHD) consortium, which included participants (n = 80,900) with either acute coronary syndrome, stable CHD, or a mixture of both at baseline. Three variants in the PPARGC1A gene (rs8192678, G482S; rs7672915, intron 2; and rs3755863, T528T) were tested for their associations with subsequent events during the follow-up using a Cox proportional hazards model adjusted for age and sex. The primary outcome was subsequent CHD death or myocardial infarction (CHD death/myocardial infarction). Stratified analyses of the participant or study characteristics as well as additional analyses for secondary outcomes of specific cardiovascular disease diagnoses and all-cause death were also performed. Results: Meta-analysis revealed no significant association between any of the three variants in the PPARGC1A gene and the primary outcome of CHD death/myocardial infarction among those with established CHD at baseline: rs8192678, hazard ratio (HR): 1.01, 95% confidence interval (CI) 0.98-1.05 and rs7672915, HR: 0.97, 95% CI 0.94-1.00; rs3755863, HR: 1.02, 95% CI 0.99-1.06. Similarly, no significant associations were observed for any of the secondary outcomes. The results from stratified analyses showed null results, except for significant inverse associations between rs7672915 (intron 2) and the primary outcome among 1) individuals aged ≥65, 2) individuals with renal impairment, and 3) antiplatelet users. Conclusion: We found no clear associations between polymorphisms in the PPARGC1A gene and subsequent CHD events in patients with established CHD at baseline.
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- 2022
17. A Systematic Review of Psychotherapy Approaches for Anxiety in Parkinson's Disease
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Amy Roper, Gabriela Pacas Fronza, Roseanne D. Dobkin, Sherry A. Beaudreau, Leander K. Mitchell, Nancy A. Pachana, Karthick Thangavelu, and Nadeeka N. Dissanayaka
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Clinical Psychology ,Health (social science) ,Social Psychology ,Geriatrics and Gerontology ,Gerontology - Abstract
Anxiety is common in Parkinson's disease (PD), negatively impacting daily functioning and quality of life in PD patients and their families. This systematic review evaluates the effectiveness of different psychotherapeutic approaches for reducing anxiety in PD and provides recommendations for clinical practise.Following PRISMA guidelines, 36 studies were included and risk of bias was evaluated.We identified cognitive behavioral therapy (CBT), mindfulness-based therapies, acceptance and commitment therapy, and psychodrama psychotherapies. There is good evidence-base for anxiety reduction using CBT approaches, but with mixed results for mindfulness-based therapies. Other therapeutic approaches were under researched. Most randomized control trials examined anxiety as a secondary measure. There was a paucity of interventions for anxiety subtypes. Secondarily, studies revealed the consistent exclusion of PD patients with cognitive concerns, an importance of care partner involvement, and a growing interest in remote delivery of psychotherapy interventions.Person-centered anxiety interventions tailored for PD patients, including those with cognitive concerns, and trials exploring modalities other than CBT, warrant future investigations.Practitioners should consider PD-specific anxiety symptoms and cognitive concerns when treating anxiety. Key distinctions between therapeutic modalities, therapy settings and delivery methods should guide treatment planning.
- Published
- 2022
18. Anxiety disorders are associated with verbal memory impairment in patients with Parkinson's disease without dementia
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Dissanayaka, Nadeeka N, Forbes, Elana J, Yang, Ji Hyun J, Pourzinal, Dana, O'Sullivan, John D, Mitchell, Leander K, Copland, David A, McMahon, Katie L, Byrne, Gerard J, Dissanayaka, Nadeeka N, Forbes, Elana J, Yang, Ji Hyun J, Pourzinal, Dana, O'Sullivan, John D, Mitchell, Leander K, Copland, David A, McMahon, Katie L, and Byrne, Gerard J
- Abstract
INTRODUCTION: Preliminary evidence has demonstrated a link between anxiety and memory impairment in Parkinson's disease (PD). This study further investigated this association using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for anxiety disorders and a standardized cognitive test battery.METHODS: A convenience sample of 89 PD patients without dementia was recruited from neurology outpatient clinics. A cross-sectional design was applied. Participants completed two semi-structured interviews. The first interview diagnosed DSM-5 anxiety disorders, unspecified anxiety disorder, and no anxiety. The second interview applied a neurocognitive test battery comprising two tests for each domain. Logistic regression models compared cognitive characteristics associated with anxiety disorders to no anxiety.RESULTS: Clinically significant anxiety was associated with immediate verbal memory impairment compared to the no anxiety group (OR, 95% CI 0.52, 0.30-0.89; p = 0.018), controlling for sex and age. The anxiety disorders group demonstrated immediate (OR, 95% CI 0.46, 0.26-0.83; p = 0.010) and delayed (OR, 95% CI 0.63, 0.40-0.99; p = 0.047) verbal memory impairments compared to those without anxiety, controlling for sex and age. This association remained for immediate (OR, 95% CI 0.43, 0.22-0.84; p = 0.013), but not delayed verbal memory impairment (OR, 95% CI 0.65, 0.39-1.06; p = 0.081) when additionally controlling for disease severity, education and levodopa dose.CONCLUSION: These findings present first evidence that anxiety disorders are associated with verbal memory impairment in PD and have implications for the management and treatment of anxiety in PD.
- Published
- 2022
19. A Systematic Review of Psychotherapy Approaches for Anxiety in Parkinson’s Disease
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Roper, Amy, primary, Pacas Fronza, Gabriela, additional, Dobkin, Roseanne D., additional, Beaudreau, Sherry A., additional, Mitchell, Leander K., additional, Pachana, Nancy A., additional, Thangavelu, Karthick, additional, and Dissanayaka, Nadeeka N., additional
- Published
- 2022
- Full Text
- View/download PDF
20. Caring for a loved one with Parkinson's disease: the role of coping styles and relationship quality
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Angeline Zhang, Leander K. Mitchell, Nancy A. Pachana, Ji Hyun J. Yang, Tiffany R. Au, Gerard J. Byrne, John D. O’Sullivan, and Nadeeka N. Dissanayaka
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Psychiatry and Mental health ,Clinical Psychology ,Cross-Sectional Studies ,Caregivers ,Surveys and Questionnaires ,Adaptation, Psychological ,Humans ,Parkinson Disease ,Geriatrics and Gerontology ,Gerontology - Abstract
Objective:Informal carers play an essential role in the care of individuals with Parkinson’s disease (PD). This role, however, is often fraught with difficulties, including emotional, physical, and financial. Coping styles and relationship quality have been hypothesized to influence the impact of stressors. The aim of this study is to examine the relationship between carers’ coping style, relationship quality, and carer burden.Design:Cross-sectional.Participants:Thirty-nine PD patient carer dyads were included in the study.Measurements:Participants completed self-rated questionnaires including the Dyadic Adjustment Scale, Zarit Burden Interview, and Brief Coping Orientation to Problems Experienced Inventory.Results:Correlational analyses found significant and positive correlation between carer burden and all three coping styles (problem-focused, emotion-focused, and dysfunctional). There was also a moderate association between carers’ perceived relationship quality and satisfaction and carer burden. Regression analyses found that carer’s gender, severity of PD, relationship quality, emotion-focused, and dysfunctional coping styles did not predict carer burden. Conversely, problem-focused coping style predicted carer burden.Conclusion:The results highlight that there is no perfect way to react and care for a loved one and serves as important information for practitioners who design and implement interventions.
- Published
- 2022
21. The Journey of Bereavement
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Leander K. Mitchell
- Published
- 2022
22. Supplemental Material - Phenomenology of anxiety in people living with mild to moderate dementia: A conceptual meta-ethnographic review
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Pacas Fronza, Gabriela, Liddle, Jacki, Mitchell, Leander K., Byrne, Gerard J., Pachana, Nancy A., and Dissanayaka, Nadeeka N.
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111099 Nursing not elsewhere classified ,111708 Health and Community Services ,FOS: Clinical medicine ,FOS: Political science ,FOS: Health sciences ,160512 Social Policy ,110308 Geriatrics and Gerontology - Abstract
Supplemental Material for Phenomenology of anxiety in people living with mild to moderate dementia: A conceptual meta-ethnographic review by Gabriela Pacas Fronza, Jacki Liddle, Leander K. Mitchell, Gerard J. Byrne, Nancy A. Pachana, and Nadeeka N. Dissanayaka in Dementia
- Published
- 2022
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23. Caring for a loved one with Parkinson’s disease: the role of coping styles and relationship quality
- Author
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Zhang, Angeline, primary, Mitchell, Leander K., additional, Pachana, Nancy A., additional, Yang, Ji Hyun J., additional, Au, Tiffany R., additional, Byrne, Gerard J., additional, O’Sullivan, John D., additional, and Dissanayaka, Nadeeka N., additional
- Published
- 2022
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24. A Copper Cage‐Complex as Mimic of the pMMO CuC Site.
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Bete, Sarah C., May, Leander K., Woite, Philipp, Roemelt, Michael, and Otte, Matthias
- Subjects
- *
OXIDATION of water , *COPPER , *CATALYTIC oxidation , *OXIDATION states , *COPPER analysis , *BIOMIMETIC synthesis , *UBIQUINONES - Abstract
The active site of particulate methane monooxygenase (pMMO) and its mechanism of action are not known. Recently, the CuC site emerged as a potential active site, but to date it lacks any study on biomimetic resemblance of the coordination environment provided by the enzyme. Here, the synthesis of a cage ligand providing such an environment is reported. Copper is incorporated, and coordination occurs by the two imidazole and one carboxylate group offered by the ligand. Depending on the oxidation state, it can adopt different coordination modes, as evidenced by the solid‐state structures and computational investigation. The copper(I) state readily reacts with dioxygen and thereby undergoes CH activation. Moreover, the catalytic aerobic oxidation of hydroquinones as ubiquinol mimics is shown. Clean one‐electron oxidation occurs under mild conditions and EPR analysis of the copper(II) state in the presence of water reveals striking similarities to the data obtained from pMMO. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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25. Designing Virtual Reality Assisted Psychotherapy for Anxiety in Older Adults Living with Parkinson's Disease: Integrating Literature for Scoping.
- Author
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Thangavelu, Karthick, Hayward, Joshua A., Pachana, Nancy A., Byrne, Gerard J., Mitchell, Leander K., Wallis, Guy M., Au, Tiffany R., and Dissanayaka, Nadeeka N.
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ANXIETY treatment ,THERAPEUTICS ,VIRTUAL reality ,SYSTEMATIC reviews ,PHYSICAL therapy ,POSTURAL balance ,GAIT disorders ,COGNITIVE rehabilitation ,TREATMENT effectiveness ,PARKINSON'S disease ,LITERATURE reviews ,PSYCHOTHERAPY ,OLD age - Abstract
Objective: This review integrates literature to discuss the potential use of virtual reality (VR) in treatment of anxiety in Parkinson's disease (PD) and inform next steps. Methods: A systematic search was performed to identify studies of VR use in PD, using four databases. Data were reported in accordance to the Preferred Reporting Items for Systematic reviews and Meta-Analyzes extension for Scoping Reviews (PRISMA-ScR). Results: Thirty-two studies met the inclusion criteria with four VR studies from the same study group directly assessing the effects of anxiety on motor symptoms in PD. Primary studies implementing a VR protocol in PD identified focus areas of understanding and alleviating freezing of gait (FOG), balance training, and cognitive and motor rehabilitation, and informed design considerations. Conclusion: VR in PD studies suggested established feasibility. With appropriate design considerations, a VR based protocol could improve anxiety outcomes in PD. Clinical implications: VR in PD provides control of a patient's field of view, which can be exploited to induce specific responses, provide visual feedback, analysis of patient actions, and introduce safe challenges in the context of training. VR assisted Cognitive Behavioral Therapy (CBT) tailored to suit subtypes of anxiety disorders in PD have the potential to improve the efficacy and effectiveness of psychotherapy in PD. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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26. Feasibility and Acceptability of a Videoconferencing CBT Intervention for Anxiety in People with Parkinson’s Disease.
- Author
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Roper, Amy, Brooks, Deborah, Mitchell, Leander K., Pachana, Nancy A., Au, Tiffany R., Byrne, Gerard J., O’Sullivan, John D., and Dissanayaka, Nadeeka N.
- Abstract
ObjectivesMethodsResultsConclusionsClinical implicationsIn people with Parkinson’s disease (PwPD), non-motor symptoms such as anxiety are common and have negative impacts on their quality of life. There are currently few interventions that address anxiety in PwPD, and access to diagnosis and treatment is often limited for those living in rural areas. The aim of this study was to evaluate the feasibility and acceptability of a telehealth videoconferencing CBT intervention for anxiety in PwPD.A pre- and post-test feasibility study (
N = 10) was conducted and evaluated utilizing the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance).Lack of access to the internet and videoconferencing technology were identified as barriers to participation. Physical health issues also impacted recruitment and retention. Non-completers were significantly older and less likely to have a carer involved in the intervention. Clinician adoption of the intervention was low while participant acceptability of videoconferencing technology varied and required carer support.Providing access to technology and support to overcome technological issues, as well as telehealth training for clinicians, are recommended in future studies to improve recruitment, retention, and implementation.Identification of barriers and facilitators provides future studies with the knowledge to tailorize their program to better suit PwPD. [ABSTRACT FROM AUTHOR]- Published
- 2024
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27. Biomarkers of Dairy Fat Intake, Incident Cardiovascular Disease, and All-Cause Mortality: A Systematic Review and Meta-analysis.
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Bhat, S., Trieu, K., Dai, Z., Leander, K., Gigante, B., Qian, F., Korat, A., Sun, Q., Pan, X., Laguzzi, F., Cederholm, T., de Faire, U., Hellénius, M., Wu, J., Risérus, U., and Marklund, M.
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MORTALITY , *CARDIOVASCULAR diseases , *BIOMARKERS , *FAT - Published
- 2021
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28. Menopausal Vasomotor Symptoms and Subclinical Atherosclerotic Cardiovascular Disease: A Population-Based Study.
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Nilsson S, Qvick A, Henriksson M, Lawesson SS, Holm AS, and Leander K
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- Humans, Female, Middle Aged, Cross-Sectional Studies, Menopause, Severity of Illness Index, Surveys and Questionnaires, Risk Factors, Asymptomatic Diseases, Vasomotor System physiopathology, Plaque, Atherosclerotic epidemiology, Vascular Calcification epidemiology, Vascular Calcification diagnostic imaging, Logistic Models, Computed Tomography Angiography, Coronary Angiography, Hot Flashes epidemiology, Hot Flashes physiopathology, Coronary Artery Disease epidemiology, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease physiopathology, Coronary Artery Disease diagnosis, Carotid Artery Diseases epidemiology, Carotid Artery Diseases diagnostic imaging, Carotid Artery Diseases physiopathology
- Abstract
Background: Menopausal vasomotor symptoms (VMS) are increasingly emphasized as a potentially important cardiovascular risk factor, but their role is still unclear. We assessed the association between VMS and subclinical atherosclerotic cardiovascular disease in peri- and postmenopausal women., Methods and Results: Using a cross-sectional study design, questionnaire data were collected from a population-based sample of women aged 50 to 64. The questionnaire asked whether menopause was/is associated with bothersome VMS. A 4-point severity scale was used: (1) never, (2) mild, (3) moderate, and (4) severe. The VMS duration and time of onset were also assessed. Associations with subclinical atherosclerotic cardiovascular disease, detected via coronary computed tomography angiography, coronary artery calcium score, and carotid ultrasound were assessed using the outcome variables "any coronary atherosclerosis," "segmental involvement score >3," "coronary artery calcium score >100," and "any carotid plaque," using logistic regression. Covariate adjustments included socioeconomic, lifestyle, and clinical factors. Of 2995 women, 14.2% reported ever severe, 18.1% ever moderate, and 67.7% ever mild/never VMS. Using the latter as reference, ever severe VMS were significantly associated with coronary computed tomography angiography-detected coronary atherosclerosis (multivariable adjusted odds ratio, 1.33 [95% CI, 1.02-1.72]). Corresponding results for ever severe VMS persisting >5 years or beginning before the final menstrual period were 1.50 (95% CI, 1.07-2.11) and 1.66 (95% CI, 1.10-2.50), respectively. No significant association was observed with segmental involvement score >3, coronary artery calcium score >100, or with any carotid plaque., Conclusions: Ever occurring severe, but not moderate, VMS were significantly associated with subclinical coronary computed tomography angiography-detected atherosclerosis, independent of a broad range of cardiovascular risk factors and especially in case of long durations or early onset.
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- 2024
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29. Sex differences in prevalence and characteristics of imaging detected atherosclerosis - a population-based study.
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Swahn E, Sederholm Lawesson S, Alfredsson J, Fredrikson M, Angerås O, Duvernoy O, Engström G, Eriksson MJ, Fagman E, Johansson B, Johnson L, Johnston N, Ljungberg J, Mannila M, Nordendahl M, Oldgren J, Omerovic E, Ostenfeld E, Persson M, Rosengren A, Skoglund Larsson L, Sundström J, Söderberg M, Östgren CJ, Leander K, and Jernberg T
- Abstract
Aims: Men are more likely to suffer a myocardial infarction than women, but population-based studies on sex differences in imaging detected atherosclerosis are lacking. The aims were to assess sex differences in prevalence of imaging detected coronary and carotid atherosclerosis, as well as multivariable adjusted associations between sex and atherosclerosis., Methods and Results: Participants aged 50-65, recruited from the general population to the Swedish Cardiopulmonary bioImage Study (SCAPIS), were included in this population-based cross-sectional study. Comprehensive diagnostics, including coronary computed tomography angiography and carotid ultrasound, were performed. The image findings were any coronary atherosclerosis, coronary stenosis ≥50%, segment involvement score (SIS) ≥4, coronary artery calcium score (CACS) ≥100, and any ultrasound-detected carotid plaque.In 25,580 participants (50% women), men had more hypertension (20.3% vs 17.0%), hyperlipidaemia (9.0% vs 5.5%), and diabetes (8.5% vs 4.7%). The prevalence was 56.2% vs 29.5% for any coronary atherosclerosis (p<0.01), 9.0% vs 2.3% for coronary stenosis ≥50% (p<0.01), 20.2% vs 5.3% for SIS≥4 (p<0.01), 18.2% vs 5.6% for CACS≥100 (p<0.01), and 60.9% vs 48.7% for carotid plaque (p<0.01), in men vs women, respectively. Multivariable adjustment only marginally changed these associations: odds ratios [OR] (95% confidence interval [CI]): 2.75 (2.53-2.99) for coronary atherosclerosis, 2.88 (2.40-3.45) for coronary stenosis ≥50%, 3.99 (3.50-4.55) for SIS≥4, 3.29 (2.88-3.75), for CACS≥100, and 1.57 (1.45-1.70) for carotid plaque., Conclusion: Men had higher prevalence of imaging detected carotid and coronary atherosclerosis with prevalence in women aged 65 corresponding to men 10-14 years younger. The associations remained after extensive multivariable adjustment., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2024
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30. Long-term exposure to transportation noise and obesity: A pooled analysis of eleven Nordic cohorts.
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Persson Å, Pyko A, Stucki L, Ögren M, Åkesson A, Oudin A, Tjønneland A, Rosengren A, Segersson D, Rizzuto D, Helte E, Andersson EM, Aasvang GM, Gudjonsdottir H, Selander J, Christensen JH, Leander K, Mattisson K, Eneroth K, Barregard L, Stockfelt L, Albin M, Simonsen MK, Spanne M, Roswall N, Tiittanen P, Molnár P, Ljungman PLS, Männistö S, Yli-Tuomi T, Cole-Hunter T, Lanki T, Lim YH, Andersen ZJ, Sørensen M, Pershagen G, and Eriksson C
- Abstract
Background: Available evidence suggests a link between exposure to transportation noise and an increased risk of obesity. We aimed to assess exposure-response functions for long-term residential exposure to road traffic, railway and aircraft noise, and markers of obesity., Methods: Our cross-sectional study is based on pooled data from 11 Nordic cohorts, including up to 162,639 individuals with either measured (69.2%) or self-reported obesity data. Residential exposure to transportation noise was estimated as a time-weighted average L
den 5 years before recruitment. Adjusted linear and logistic regression models were fitted to assess beta coefficients and odds ratios (OR) with 95% confidence intervals (CI) for body mass index, overweight, and obesity, as well as for waist circumference and central obesity. Furthermore, natural splines were fitted to assess the shape of the exposure-response functions., Results: For road traffic noise, the OR for obesity was 1.06 (95% CI = 1.03, 1.08) and for central obesity 1.03 (95% CI = 1.01, 1.05) per 10 dB Lden . Thresholds were observed at around 50-55 and 55-60 dB Lden , respectively, above which there was an approximate 10% risk increase per 10 dB Lden increment for both outcomes. However, linear associations only occurred in participants with measured obesity markers and were strongly influenced by the largest cohort. Similar risk estimates as for road traffic noise were found for railway noise, with no clear thresholds. For aircraft noise, results were uncertain due to the low number of exposed participants., Conclusion: Our results support an association between road traffic and railway noise and obesity., Competing Interests: The authors declare that they have no conflicts of interest with regard to the content of this report., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The Environmental Epidemiology. All rights reserved.)- Published
- 2024
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31. Long-term exposure to air pollution and chronic kidney disease-associated mortality-Results from the pooled cohort of the European multicentre ELAPSE-study.
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Kadelbach P, Weinmayr G, Chen J, Jaensch A, Rodopoulou S, Strak M, de Hoogh K, Andersen ZJ, Bellander T, Brandt J, Cesaroni G, Fecht D, Forastiere F, Gulliver J, Hertel O, Hoffmann B, Hvidtfeldt UA, Katsouyanni K, Ketzel M, Leander K, Ljungman P, Magnusson PKE, Pershagen G, Rizzuto D, Samoli E, Severi G, Stafoggia M, Tjønneland A, Vermeulen R, Peters A, Wolf K, Raaschou-Nielsen O, Brunekreef B, Hoek G, Zitt E, and Nagel G
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- Humans, Male, Female, Europe epidemiology, Middle Aged, Aged, Cohort Studies, Particulate Matter analysis, Particulate Matter adverse effects, Adult, Renal Insufficiency, Chronic mortality, Renal Insufficiency, Chronic epidemiology, Renal Insufficiency, Chronic chemically induced, Air Pollution adverse effects, Air Pollution analysis, Air Pollutants analysis, Air Pollutants adverse effects, Environmental Exposure adverse effects
- Abstract
Despite the known link between air pollution and cause-specific mortality, its relation to chronic kidney disease (CKD)-associated mortality is understudied. Therefore, we investigated the association between long-term exposure to air pollution and CKD-related mortality in a large multicentre population-based European cohort. Cohort data were linked to local mortality registry data. CKD-death was defined as ICD10 codes N18-N19 or corresponding ICD9 codes. Mean annual exposure at participant's home address was determined with fine spatial resolution exposure models for nitrogen dioxide (NO
2 ), black carbon (BC), ozone (O3 ), particulate matter ≤2.5 μm (PM2.5 ) and several elemental constituents of PM2.5 . Cox regression models were adjusted for age, sex, cohort, calendar year of recruitment, smoking status, marital status, employment status and neighbourhood mean income. Over a mean follow-up time of 20.4 years, 313 of 289,564 persons died from CKD. Associations were positive for PM2.5 (hazard ratio (HR) with 95% confidence interval (CI) of 1.31 (1.03-1.66) per 5 μg/m3 , BC (1.26 (1.03-1.53) per 0.5 × 10- 5 /m), NO2 (1.13 (0.93-1.38) per 10 μg/m3 ) and inverse for O3 (0.71 (0.54-0.93) per 10 μg/m3 ). Results were robust to further covariate adjustment. Exclusion of the largest sub-cohort contributing 226 cases, led to null associations. Among the elemental constituents, Cu, Fe, K, Ni, S and Zn, representing different sources including traffic, biomass and oil burning and secondary pollutants, were associated with CKD-related mortality. In conclusion, our results suggest an association between air pollution from different sources and CKD-related mortality., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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32. Long-term exposure to air pollution and incidence of gastric and the upper aerodigestive tract cancers in a pooled European cohort: The ELAPSE project.
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Nagel G, Chen J, Jaensch A, Skodda L, Rodopoulou S, Strak M, de Hoogh K, Andersen ZJ, Bellander T, Brandt J, Fecht D, Forastiere F, Gulliver J, Hertel O, Hoffmann B, Hvidtfeldt UA, Katsouyanni K, Ketzel M, Leander K, Magnusson PKE, Pershagen G, Rizzuto D, Samoli E, Severi G, Stafoggia M, Tjønneland A, Vermeulen RCH, Wolf K, Zitt E, Brunekreef B, Hoek G, Raaschou-Nielsen O, and Weinmayr G
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- Humans, Particulate Matter adverse effects, Particulate Matter analysis, Nitrogen Dioxide adverse effects, Incidence, Environmental Exposure adverse effects, Stomach Neoplasms epidemiology, Stomach Neoplasms etiology, Air Pollution adverse effects, Air Pollution analysis, Air Pollutants adverse effects, Air Pollutants analysis
- Abstract
Air pollution has been shown to significantly impact human health including cancer. Gastric and upper aerodigestive tract (UADT) cancers are common and increased risk has been associated with smoking and occupational exposures. However, the association with air pollution remains unclear. We pooled European subcohorts (N = 287,576 participants for gastric and N = 297,406 for UADT analyses) and investigated the association between residential exposure to fine particles (PM
2.5 ), nitrogen dioxide (NO2 ), black carbon (BC) and ozone in the warm season (O3w ) with gastric and UADT cancer. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area-level. During 5,305,133 and 5,434,843 person-years, 872 gastric and 1139 UADT incident cancer cases were observed, respectively. For gastric cancer, we found no association with PM2.5 , NO2 and BC while for UADT the hazard ratios (95% confidence interval) were 1.15 (95% CI: 1.00-1.33) per 5 μg/m3 increase in PM2.5 , 1.19 (1.08-1.30) per 10 μg/m3 increase in NO2 , 1.14 (1.04-1.26) per 0.5 × 10-5 m-1 increase in BC and 0.81 (0.72-0.92) per 10 μg/m3 increase in O3w . We found no association between long-term ambient air pollution exposure and incidence of gastric cancer, while for long-term exposure to PM2.5 , NO2 and BC increased incidence of UADT cancer was observed., (© 2024 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)- Published
- 2024
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33. Long-term exposure to several constituents and sources of PM 2.5 is associated with incidence of upper aerodigestive tract cancers but not gastric cancer: Results from the large pooled European cohort of the ELAPSE project.
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Weinmayr G, Chen J, Jaensch A, Skodda L, Rodopoulou S, Strak M, de Hoogh K, Andersen ZJ, Bellander T, Brandt J, Fecht D, Forastiere F, Gulliver J, Hertel O, Hoffmann B, Hvidtfeldt UA, Katsouyanni K, Ketzel M, Leander K, Magnusson PKE, Pershagen G, Rizzuto D, Samoli E, Severi G, Stafoggia M, Tjønneland A, Vermeulen R, Wolf K, Zitt E, Brunekreef B, Thurston G, Hoek G, Raaschou-Nielsen O, and Nagel G
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- Humans, Particulate Matter analysis, Incidence, Environmental Exposure analysis, Stomach Neoplasms chemically induced, Stomach Neoplasms epidemiology, Air Pollution analysis, Air Pollutants analysis
- Abstract
It is unclear whether cancers of the upper aerodigestive tract (UADT) and gastric cancer are related to air pollution, due to few studies with inconsistent results. The effects of particulate matter (PM) may vary across locations due to different source contributions and related PM compositions, and it is not clear which PM constituents/sources are most relevant from a consideration of overall mass concentration alone. We therefore investigated the association of UADT and gastric cancers with PM
2.5 elemental constituents and sources components indicative of different sources within a large multicentre population based epidemiological study. Cohorts with at least 10 cases per cohort led to ten and eight cohorts from five countries contributing to UADT- and gastric cancer analysis, respectively. Outcome ascertainment was based on cancer registry data or data of comparable quality. We assigned home address exposure to eight elemental constituents (Cu, Fe, K, Ni, S, Si, V and Zn) estimated from Europe-wide exposure models, and five source components identified by absolute principal component analysis (APCA). Cox regression models were run with age as time scale, stratified for sex and cohort and adjusted for relevant individual and neighbourhood level confounders. We observed 1139 UADT and 872 gastric cancer cases during a mean follow-up of 18.3 and 18.5 years, respectively. UADT cancer incidence was associated with all constituents except K in single element analyses. After adjustment for NO2 , only Ni and V remained associated with UADT. Residual oil combustion and traffic source components were associated with UADT cancer persisting in the multiple source model. No associations were found for any of the elements or source components and gastric cancer incidence. Our results indicate an association of several PM constituents indicative of different sources with UADT but not gastric cancer incidence with the most robust evidence for traffic and residual oil combustion., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)- Published
- 2024
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34. Long-term exposure to ambient air pollution and risk of leukemia and lymphoma in a pooled European cohort.
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Taj T, Chen J, Rodopoulou S, Strak M, de Hoogh K, Poulsen AH, Andersen ZJ, Bellander T, Brandt J, Zitt E, Fecht D, Forastiere F, Gulliver J, Hertel O, Hoffmann B, Hvidtfeldt UA, Jørgensen JT, Katsouyanni K, Ketzel M, Lager A, Leander K, Liu S, Ljungman P, Severi G, Besson C, Magnusson PKE, Nagel G, Pershagen G, Peters A, Rizzuto D, Samoli E, Sørensen M, Stafoggia M, Tjønneland A, Weinmayr G, Wolf K, Brunekreef B, Hoek G, and Raaschou-Nielsen O
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- Adult, Female, Humans, Male, Nitrogen Dioxide analysis, Environmental Exposure adverse effects, Environmental Exposure analysis, Particulate Matter analysis, Potassium analysis, Air Pollution adverse effects, Air Pollution analysis, Environmental Pollutants analysis, Leukemia chemically induced, Leukemia epidemiology, Lymphoma chemically induced, Lymphoma epidemiology, Air Pollutants analysis
- Abstract
Leukemia and lymphoma are the two most common forms of hematologic malignancy, and their etiology is largely unknown. Pathophysiological mechanisms suggest a possible association with air pollution, but little empirical evidence is available. We aimed to investigate the association between long-term residential exposure to outdoor air pollution and risk of leukemia and lymphoma. We pooled data from four cohorts from three European countries as part of the "Effects of Low-level Air Pollution: a Study in Europe" (ELAPSE) collaboration. We used Europe-wide land use regression models to assess annual mean concentrations of fine particulate matter (PM
2.5 ), nitrogen dioxide (NO2 ), black carbon (BC) and ozone (O3 ) at residences. We also estimated concentrations of PM2.5 elemental components: copper (Cu), iron (Fe), zinc (Zn); sulfur (S); nickel (Ni), vanadium (V), silicon (Si) and potassium (K). We applied Cox proportional hazards models to investigate the associations. Among the study population of 247,436 individuals, 760 leukemia and 1122 lymphoma cases were diagnosed during 4,656,140 person-years of follow-up. The results showed a leukemia hazard ratio (HR) of 1.13 (95% confidence intervals [CI]: 1.01-1.26) per 10 μg/m3 NO2 , which was robust in two-pollutant models and consistent across the four cohorts and according to smoking status. Sex-specific analyses suggested that this association was confined to the male population. Further, the results showed increased lymphoma HRs for PM2.5 (HR = 1.16; 95% CI: 1.02-1.34) and potassium content of PM2.5 , which were consistent in two-pollutant models and according to sex. Our results suggest that air pollution at the residence may be associated with adult leukemia and lymphoma., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)- Published
- 2024
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35. Publisher Correction: Determinants of exposure to acrylamide in European children and adults based on urinary biomarkers: results from the "European Human Biomonitoring Initiative" HBM4EU participating studies.
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F Fernández S, Poteser M, Govarts E, Pardo O, Coscollà C, Schettgen T, Vogel N, Weber T, Murawski A, Kolossa-Gehring M, Rüther M, Schmidt P, Namorado S, Van Nieuwenhuyse A, Appenzeller B, Ólafsdóttir K, Halldorsson TI, Haug LS, Thomsen C, Barbone F, Mariuz M, Rosolen V, Rambaud L, Riou M, Göen T, Nübler S, Schäfer M, Zarrabi KHA, Sepai O, Martin LR, Schoeters G, Gilles L, Leander K, Moshammer H, Akesson A, and Laguzzi F
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- 2024
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36. Role of Polyunsaturated Fat in Modifying Cardiovascular Risk Associated With Family History of Cardiovascular Disease: Pooled De Novo Results From 15 Observational Studies.
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Laguzzi F, Åkesson A, Marklund M, Qian F, Gigante B, Bartz TM, Bassett JK, Birukov A, Campos H, Hirakawa Y, Imamura F, Jäger S, Lankinen M, Murphy RA, Senn M, Tanaka T, Tintle N, Virtanen JK, Yamagishi K, Allison M, Brouwer IA, De Faire U, Eiriksdottir G, Ferrucci L, Forouhi NG, Geleijnse JM, Hodge AM, Kimura H, Laakso M, Risérus U, van Westing AC, Bandinelli S, Baylin A, Giles GG, Gudnason V, Iso H, Lemaitre RN, Ninomiya T, Post WS, Psaty BM, Salonen JT, Schulze MB, Tsai MY, Uusitupa M, Wareham NJ, Oh SW, Wood AC, Harris WS, Siscovick D, Mozaffarian D, and Leander K
- Subjects
- Animals, Risk Factors, Docosahexaenoic Acids, Biomarkers, Fatty Acids, Omega-3, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases genetics
- Abstract
Background: It is unknown whether dietary intake of polyunsaturated fatty acids (PUFA) modifies the cardiovascular disease (CVD) risk associated with a family history of CVD. We assessed interactions between biomarkers of low PUFA intake and a family history in relation to long-term CVD risk in a large consortium., Methods: Blood and tissue PUFA data from 40 885 CVD-free adults were assessed. PUFA levels ≤25th percentile were considered to reflect low intake of linoleic, alpha-linolenic, and eicosapentaenoic/docosahexaenoic acids (EPA/DHA). Family history was defined as having ≥1 first-degree relative who experienced a CVD event. Relative risks with 95% CI of CVD were estimated using Cox regression and meta-analyzed. Interactions were assessed by analyzing product terms and calculating relative excess risk due to interaction., Results: After multivariable adjustments, a significant interaction between low EPA/DHA and family history was observed (product term pooled RR, 1.09 [95% CI, 1.02-1.16]; P =0.01). The pooled relative risk of CVD associated with the combined exposure to low EPA/DHA, and family history was 1.41 (95% CI, 1.30-1.54), whereas it was 1.25 (95% CI, 1.16-1.33) for family history alone and 1.06 (95% CI, 0.98-1.14) for EPA/DHA alone, compared with those with neither exposure. The relative excess risk due to interaction results indicated no interactions., Conclusions: A significant interaction between biomarkers of low EPA/DHA intake, but not the other PUFA, and a family history was observed. This novel finding might suggest a need to emphasize the benefit of consuming oily fish for individuals with a family history of CVD., Competing Interests: Disclosures Dr Murphy reports having worked as a consultant for Pharmavite (until 2021). The remaining authors have reported no relationships relevant to the contents of this article. Dr Psaty serves on the steering committee of the Yale Open Data Access Project, funded by Johnson and Johnson.
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- 2024
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37. Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies.
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O'Keefe JH, Tintle NL, Harris WS, O'Keefe EL, Sala-Vila A, Attia J, Garg GM, Hure A, Bork CS, Schmidt EB, Venø SK, Chien KL, Chen YA, Egert S, Feldreich TR, Ärnlöv J, Lind L, Forouhi NG, Geleijnse JM, Pertiwi K, Imamura F, de Mello Laaksonen V, Uusitupa WM, Tuomilehto J, Laakso M, Lankinen MA, Laurin D, Carmichael PH, Lindsay J, Leander K, Laguzzi F, Swenson BR, Longstreth WT, Manson JE, Mora S, Cook NR, Marklund M, Melo van Lent D, Murphy R, Gudnason V, Ninomiya T, Hirakawa Y, Qian F, Sun Q, Hu F, Ardisson Korat AV, Risérus U, Lázaro I, Samieri C, Le Goff M, Helmer C, Steur M, Voortman T, Ikram MK, Tanaka T, Das JK, Ferrucci L, Bandinelli S, Tsai M, Guan W, Garg P, Verschuren WMM, Boer JMA, Biokstra A, Virtanen J, Wagner M, Westra J, Albuisson L, Yamagishi K, Siscovick DS, Lemaitre RN, and Mozaffarian D
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- Humans, Prospective Studies, Eicosapentaenoic Acid, Docosahexaenoic Acids, Risk Factors, Hemorrhagic Stroke epidemiology, Fatty Acids, Omega-3, Stroke epidemiology, Ischemic Stroke
- Abstract
Background: The effect of marine omega-3 PUFAs on risk of stroke remains unclear., Methods: We investigated the associations between circulating and tissue omega-3 PUFA levels and incident stroke (total, ischemic, and hemorrhagic) in 29 international prospective cohorts. Each site conducted a de novo individual-level analysis using a prespecified analytical protocol with defined exposures, covariates, analytical methods, and outcomes; the harmonized data from the studies were then centrally pooled. Multivariable-adjusted HRs and 95% CIs across omega-3 PUFA quintiles were computed for each stroke outcome., Results: Among 183 291 study participants, there were 10 561 total strokes, 8220 ischemic strokes, and 1142 hemorrhagic strokes recorded over a median of 14.3 years follow-up. For eicosapentaenoic acid, comparing quintile 5 (Q5, highest) with quintile 1 (Q1, lowest), total stroke incidence was 17% lower (HR, 0.83 [CI, 0.76-0.91]; P <0.0001), and ischemic stroke was 18% lower (HR, 0.82 [CI, 0.74-0.91]; P <0.0001). For docosahexaenoic acid, comparing Q5 with Q1, there was a 12% lower incidence of total stroke (HR, 0.88 [CI, 0.81-0.96]; P =0.0001) and a 14% lower incidence of ischemic stroke (HR, 0.86 [CI, 0.78-0.95]; P =0.0001). Neither eicosapentaenoic acid nor docosahexaenoic acid was associated with a risk for hemorrhagic stroke. These associations were not modified by either baseline history of AF or prevalent CVD., Conclusions: Higher omega-3 PUFA levels are associated with lower risks of total and ischemic stroke but have no association with hemorrhagic stroke., Competing Interests: Disclosures Dr O’Keefe reports major ownership interest in Cardiotabs. Dr Harris reports minor ownership interest in Omegaquant Analytics, LLC. Dr Sala-Vila reports travel and grant support from California Walnut Commission. Dr Mora reports compensation for consultant services from Quest Diagnostics. Dr Murphy reports compensation from Pharmavite for consultant services. Dr Bork reports grants from Karen Elise Jensens Fond. Dr Ärnlöv reports compensation from Astellas Pharma for other services; compensation from Boehringer Ingelheim for consultant services; compensation from AstraZeneca for other services; and compensation from Novartis for other services. Dr Geleijnse reports grants from National Institutes of Health to other; grants from Upfield Europe BV to other; and grants from The Dutch Heart Foundation to other. Dr Manson reports grants from National Institutes of Health and compensation from National Institutes of Health for other services. Dr Mora reports compensation from Pfizer for consultant services; employment by Brigham and Women’s Hospital; grants from National Institute of Diabetes and Digestive and Kidney Diseases; and grants from National Heart, Lung, and Blood Institute. Dr Melo van Lent reports grants from National Institutes of Health and grants from Alzheimer’s Association. Dr Mozaffarian reports grants from Rockefeller Foundation; compensation from Beren Therapeutics for other services; stock holdings in HumanCo; compensation from January Inc. for other services; compensation from Filtricine for other services; compensation from Perfect Day for other services; compensation from Tiny Organics for other services; grants from Bill and Melinda Gates Foundation; compensation from Calibrate for other services; grants from Vail Innovative Global Research; grants from Kaiser Permanente Fund at East Bay Community Foundation; compensation from DayTwo for other services; compensation from Instacart health for other services; compensation from Season Health for other services; grants from National Institutes of Health; compensation from Barilla for consultant services; stock holdings in Calibrate; compensation from Kaiser Permanente Fund for other services; compensation from HumanCo for other services
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- 2024
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38. Integrating the United Nations sustainable development goals into higher education globally: a scoping review.
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Amorós Molina Á, Helldén D, Alfvén T, Niemi M, Leander K, Nordenstedt H, Rehn C, Ndejjo R, Wanyenze R, and Biermann O
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- Humans, Students, United Nations, Universities, Goals, Sustainable Development, Income
- Abstract
Background: In 2015, the United Nations adopted the 2030 Agenda for Sustainable Development, including the 17 Sustainable Development Goals (SDGs). Higher education institutions have a role in raising awareness and building skills among future professionals for implementing the SDGs. This review describes how the SDGs have been integrated into higher education globally., Objectives: Determine how have the SDGs been integrated into higher education globally. Describe the differences in the integration of the SDGs in higher education across high-income countries (HICs) and low- and middle-income countries (LMICs)., Methods: Following a scoping review methodology, we searched Medline, Web of Science, Global Health, and Educational Resources Information Center, as well as websites of key institutions including universities, identifying peer-reviewed articles and grey literature published between September 2015 and December 2021., Results: We identified 20 articles and 38 grey literature sources. Since 2018, the number of publications about the topic has been increasing. The SDGs were most frequently included in bachelor-level education and disciplines such as engineering and technology; humanities and social sciences; business, administration, and economics. Methods of integrating the SDGs into higher education included workshops, courses, lectures, and other means. Workshops and courses were the most frequent. The methods of integration varied in high-income countries compared to low- and middle-income countries. High-income countries seemed to follow a more academic approach to the SDGs while low- and middle-income countries integrate the SDGs with the aim to solve real-world problems., Conclusion: This study provides examples of progress in integrating the SDGs into higher education. Such progress has been skewed to high-income countries, bachelor-level initiatives, and certain disciplines. To advance the integration of the SDGs, lessons learned from universities globally should be shared broadly, equitable partnerships formed, and students engaged, while simultaneously increasing funding for these processes.
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- 2023
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39. Multiple myeloma risk in relation to long-term air pollution exposure - A pooled analysis of four European cohorts.
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Hvidtfeldt UA, Chen J, Rodopoulou S, Strak M, de Hoogh K, Andersen ZJ, Bellander T, Brandt J, Forastiere F, Brynedal B, Hertel O, Hoffmann B, Katsouyanni K, Ketzel M, Leander K, Magnusson PKE, Nagel G, Pershagen G, Rizzuto D, Samoli E, So R, Stafoggia M, Tjønneland A, Weinmayr G, Wolf K, Zitt E, Brunekreef B, Hoek G, and Raaschou-Nielsen O
- Subjects
- Humans, Cohort Studies, Environmental Exposure adverse effects, Environmental Exposure analysis, Nitrogen Dioxide toxicity, Nitrogen Dioxide analysis, Particulate Matter analysis, Air Pollutants toxicity, Air Pollutants analysis, Air Pollution adverse effects, Air Pollution analysis, Multiple Myeloma chemically induced, Multiple Myeloma epidemiology
- Abstract
Background: Air pollution is a growing concern worldwide, with significant impacts on human health. Multiple myeloma is a type of blood cancer with increasing incidence. Studies have linked air pollution exposure to various types of cancer, including leukemia and lymphoma, however, the relationship with multiple myeloma incidence has not been extensively investigated., Methods: We pooled four European cohorts (N = 234,803) and assessed the association between residential exposure to nitrogen dioxide (NO
2 ), fine particles (PM2.5 ), black carbon (BC), and ozone (O3 ) and multiple myeloma. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area-level., Results: During 4,415,817 person-years of follow-up (average 18.8 years), we observed 404 cases of multiple myeloma. The results of the fully adjusted linear analyses showed hazard ratios (95% confidence interval) of 0.99 (0.84, 1.16) per 10 μg/m³ NO2 , 1.04 (0.82, 1.33) per 5 μg/m³ PM2.5 , 0.99 (0.84, 1.18) per 0.5 10-5 m-1 BCE, and 1.11 (0.87, 1.41) per 10 μg/m³ O3 ., Conclusions: We did not observe an association between long-term ambient air pollution exposure and incidence of multiple myeloma., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)- Published
- 2023
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40. Determinants of exposure to acrylamide in European children and adults based on urinary biomarkers: results from the "European Human Biomonitoring Initiative" HBM4EU participating studies.
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F Fernández S, Poteser M, Govarts E, Pardo O, Coscollà C, Schettgen T, Vogel N, Weber T, Murawski A, Kolossa-Gehring M, Rüther M, Schmidt P, Namorado S, Van Nieuwenhuyse A, Appenzeller B, Ólafsdóttir K, Halldorsson TI, Haug LS, Thomsen C, Barbone F, Mariuz M, Rosolen V, Rambaud L, Riou M, Göen T, Nübler S, Schäfer M, Zarrabi KHA, Sepai O, Martin LR, Schoeters G, Gilles L, Leander K, Moshammer H, Akesson A, and Laguzzi F
- Subjects
- Adolescent, Humans, Adult, Child, Child, Preschool, Young Adult, Middle Aged, Creatinine, Biomarkers, Surveys and Questionnaires, Biological Monitoring, Acrylamide toxicity
- Abstract
Little is known about exposure determinants of acrylamide (AA), a genotoxic food-processing contaminant, in Europe. We assessed determinants of AA exposure, measured by urinary mercapturic acids of AA (AAMA) and glycidamide (GAMA), its main metabolite, in 3157 children/adolescents and 1297 adults in the European Human Biomonitoring Initiative. Harmonized individual-level questionnaires data and quality assured measurements of AAMA and GAMA (urine collection: 2014-2021), the short-term validated biomarkers of AA exposure, were obtained from four studies (Italy, France, Germany, and Norway) in children/adolescents (age range: 3-18 years) and six studies (Portugal, Spain, France, Germany, Luxembourg, and Iceland) in adults (age range: 20-45 years). Multivariable-adjusted pooled quantile regressions were employed to assess median differences (β coefficients) with 95% confidence intervals (95% CI) in AAMA and GAMA (µg/g creatinine) in relation to exposure determinants. Southern European studies had higher AAMA than Northern studies. In children/adolescents, we observed significant lower AA associated with high socioeconomic status (AAMA:β = - 9.1 µg/g creatinine, 95% CI - 15.8, - 2.4; GAMA: β = - 3.4 µg/g creatinine, 95% CI - 4.7, - 2.2), living in rural areas (AAMA:β = - 4.7 µg/g creatinine, 95% CI - 8.6, - 0.8; GAMA:β = - 1.1 µg/g creatinine, 95% CI - 1.9, - 0.4) and increasing age (AAMA:β = - 1.9 µg/g creatinine, 95% CI - 2.4, - 1.4; GAMA:β = - 0.7 µg/g creatinine, 95% CI - 0.8, - 0.6). In adults, higher AAMA was also associated with high consumption of fried potatoes whereas lower AAMA was associated with higher body-mass-index. Based on this large-scale study, several potential determinants of AA exposure were identified in children/adolescents and adults in European countries., (© 2023. The Author(s).)
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- 2023
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41. Gene-educational attainment interactions in a multi-population genome-wide meta-analysis identify novel lipid loci.
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de Las Fuentes L, Schwander KL, Brown MR, Bentley AR, Winkler TW, Sung YJ, Munroe PB, Miller CL, Aschard H, Aslibekyan S, Bartz TM, Bielak LF, Chai JF, Cheng CY, Dorajoo R, Feitosa MF, Guo X, Hartwig FP, Horimoto A, Kolčić I, Lim E, Liu Y, Manning AK, Marten J, Musani SK, Noordam R, Padmanabhan S, Rankinen T, Richard MA, Ridker PM, Smith AV, Vojinovic D, Zonderman AB, Alver M, Boissel M, Christensen K, Freedman BI, Gao C, Giulianini F, Harris SE, He M, Hsu FC, Kühnel B, Laguzzi F, Li X, Lyytikäinen LP, Nolte IM, Poveda A, Rauramaa R, Riaz M, Robino A, Sofer T, Takeuchi F, Tayo BO, van der Most PJ, Verweij N, Ware EB, Weiss S, Wen W, Yanek LR, Zhan Y, Amin N, Arking DE, Ballantyne C, Boerwinkle E, Brody JA, Broeckel U, Campbell A, Canouil M, Chai X, Chen YI, Chen X, Chitrala KN, Concas MP, de Faire U, de Mutsert R, de Silva HJ, de Vries PS, Do A, Faul JD, Fisher V, Floyd JS, Forrester T, Friedlander Y, Girotto G, Gu CC, Hallmans G, Heikkinen S, Heng CK, Homuth G, Hunt S, Ikram MA, Jacobs DR Jr, Kavousi M, Khor CC, Kilpeläinen TO, Koh WP, Komulainen P, Langefeld CD, Liang J, Liu K, Liu J, Lohman K, Mägi R, Manichaikul AW, McKenzie CA, Meitinger T, Milaneschi Y, Nauck M, Nelson CP, O'Connell JR, Palmer ND, Pereira AC, Perls T, Peters A, Polašek O, Raitakari OT, Rice K, Rice TK, Rich SS, Sabanayagam C, Schreiner PJ, Shu XO, Sidney S, Sims M, Smith JA, Starr JM, Strauch K, Tai ES, Taylor KD, Tsai MY, Uitterlinden AG, van Heemst D, Waldenberger M, Wang YX, Wei WB, Wilson G, Xuan D, Yao J, Yu C, Yuan JM, Zhao W, Becker DM, Bonnefond A, Bowden DW, Cooper RS, Deary IJ, Divers J, Esko T, Franks PW, Froguel P, Gieger C, Jonas JB, Kato N, Lakka TA, Leander K, Lehtimäki T, Magnusson PKE, North KE, Ntalla I, Penninx B, Samani NJ, Snieder H, Spedicati B, van der Harst P, Völzke H, Wagenknecht LE, Weir DR, Wojczynski MK, Wu T, Zheng W, Zhu X, Bouchard C, Chasman DI, Evans MK, Fox ER, Gudnason V, Hayward C, Horta BL, Kardia SLR, Krieger JE, Mook-Kanamori DO, Peyser PA, Province MM, Psaty BM, Rudan I, Sim X, Smith BH, van Dam RM, van Duijn CM, Wong TY, Arnett DK, Rao DC, Gauderman J, Liu CT, Morrison AC, Rotter JI, and Fornage M
- Abstract
Introduction: Educational attainment, widely used in epidemiologic studies as a surrogate for socioeconomic status, is a predictor of cardiovascular health outcomes. Methods: A two-stage genome-wide meta-analysis of low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglyceride (TG) levels was performed while accounting for gene-educational attainment interactions in up to 226,315 individuals from five population groups. We considered two educational attainment variables: "Some College" (yes/no, for any education beyond high school) and "Graduated College" (yes/no, for completing a 4-year college degree). Genome-wide significant ( p < 5 × 10
-8 ) and suggestive ( p < 1 × 10-6 ) variants were identified in Stage 1 (in up to 108,784 individuals) through genome-wide analysis, and those variants were followed up in Stage 2 studies (in up to 117,531 individuals). Results: In combined analysis of Stages 1 and 2, we identified 18 novel lipid loci (nine for LDL, seven for HDL, and two for TG) by two degree-of-freedom (2 DF) joint tests of main and interaction effects. Four loci showed significant interaction with educational attainment. Two loci were significant only in cross-population analyses. Several loci include genes with known or suggested roles in adipose ( FOXP1, MBOAT4, SKP2, STIM1, STX4 ), brain ( BRI3, FILIP1, FOXP1, LINC00290, LMTK2, MBOAT4, MYO6, SENP6, SRGAP3, STIM1, TMEM167A, TMEM30A ), and liver ( BRI3, FOXP1 ) biology, highlighting the potential importance of brain-adipose-liver communication in the regulation of lipid metabolism. An investigation of the potential druggability of genes in identified loci resulted in five gene targets shown to interact with drugs approved by the Food and Drug Administration, including genes with roles in adipose and brain tissue. Discussion: Genome-wide interaction analysis of educational attainment identified novel lipid loci not previously detected by analyses limited to main genetic effects., Competing Interests: IN is now employed by Celgene. BMP serves on the Steering Committee of the Yale Open Data Access Project funded by Johnson & Johnson. SA is employed by and holds equity in 23andMe, Inc. Authors BK, MW, and CGa were employed by Helmholtz Zentrum München. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 de las Fuentes, Schwander, Brown, Bentley, Winkler, Sung, Munroe, Miller, Aschard, Aslibekyan, Bartz, Bielak, Chai, Cheng, Dorajoo, Feitosa, Guo, Hartwig, Horimoto, Kolčić, Lim, Liu, Manning, Marten, Musani, Noordam, Padmanabhan, Rankinen, Richard, Ridker, Smith, Vojinovic, Zonderman, Alver, Boissel, Christensen, Freedman, Gao, Giulianini, Harris, He, Hsu, Kühnel, Laguzzi, Li, Lyytikäinen, Nolte, Poveda, Rauramaa, Riaz, Robino, Sofer, Takeuchi, Tayo, van der Most, Verweij, Ware, Weiss, Wen, Yanek, Zhan, Amin, Arking, Ballantyne, Boerwinkle, Brody, Broeckel, Campbell, Canouil, Chai, Ida Chen, Chen, Chitrala, Concas, de Faire, de Mutsert, de Silva, de Vries, Do, Faul, Fisher, Floyd, Forrester, Friedlander, Girotto, Gu, Hallmans, Heikkinen, Heng, Homuth, Hunt, Ikram, Jacobs, Kavousi, Khor, Kilpeläinen, Koh, Komulainen, Langefeld, Liang, Liu, Liu, Lohman, Mägi, Manichaikul, McKenzie, Meitinger, Milaneschi, Nauck, Nelson, O’Connell, Palmer, Pereira, Perls, Peters, Polašek, Raitakari, Rice, Rice, Rich, Sabanayagam, Schreiner, Shu, Sidney, Sims, Smith, Starr, Strauch, Tai, Taylor, Tsai, Uitterlinden, van Heemst, Waldenberger, Wang, Wei, Wilson, Xuan, Yao, Yu, Yuan, Zhao, Becker, Bonnefond, Bowden, Cooper, Deary, Divers, Esko, Franks, Froguel, Gieger, Jonas, Kato, Lakka, Leander, Lehtimäki, Magnusson, North, Ntalla, Penninx, Samani, Snieder, Spedicati, van der Harst, Völzke, Wagenknecht, Weir, Wojczynski, Wu, Zheng, Zhu, Bouchard, Chasman, Evans, Fox, Gudnason, Hayward, Horta, Kardia, Krieger, Mook-Kanamori, Peyser, Province, Psaty, Rudan, Sim, Smith, van Dam, van Duijn, Wong, Arnett, Rao, Gauderman, Liu, Morrison, Rotter and Fornage.)- Published
- 2023
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42. n-6 fatty acid biomarkers and incident atrial fibrillation: an individual participant-level pooled analysis of 11 international prospective studies.
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Garg PK, Guan W, Nomura S, Weir NL, Tintle N, Virtanen JK, Hirakawa Y, Qian F, Sun Q, Rimm E, Lemaitre RN, Jensen PN, Heckbert SR, Imamura F, Steur M, Leander K, Laguzzi F, Voortman T, Ninomiya T, Mozaffarian D, Harris WS, Siscovick DS, and Tsai MY
- Subjects
- Adult, Humans, Prospective Studies, Risk Factors, Fatty Acids, Unsaturated, Linoleic Acid, Arachidonic Acid, Biomarkers, Incidence, Fatty Acids, Omega-6, Atrial Fibrillation diagnosis, Atrial Fibrillation epidemiology
- Abstract
Background: The presence of atrial fibrillation (AF) is associated with an over 2-fold increased risk of stroke, heart failure, and cardiovascular mortality. Long chain n-6 PUFAs have been suggested to have a variety of beneficial biologic effects that may reduce AF development; however, prior studies evaluating this relationship are limited., Objectives: We prospectively evaluated the association between circulating levels of linoleic acid (LA) and arachidonic acid (AA) with incident AF., Methods: We used participant-level data from a global consortium of 11 prospective cohort studies with measurements of LA and AA in adults (aged ≥18 y). Participating studies conducted de novo analyses using a prespecified analytical plan with harmonized definitions for exposures, outcomes, covariates, and subgroups. Associations were pooled using inverse-variance weighted meta-analysis., Results: Among 41,335 participants, 6173 incident cases of AF were ascertained, with median follow-up time of 14 y. In multivariable analysis, per interquintile range (difference between the 10th and 90th percentiles for each fatty acid), circulating n-6 levels were not associated with incident AF. For LA, the hazard ratio per interquintile range was 0.96 (95% confidence interval [CI]: 0.89, 1.04), and for AA, 1.02 (95% CI: 0.94, 1.10), with little evidence of heterogeneity between cohorts. Associations were similarly nonsignificant across subgroups of age, race, and biomarker fraction., Conclusions: Biomarkers of n-6 fatty acids including LA and AA are not associated with incident AF. These findings suggest that overall effects of n-6 PUFAs on influencing AF development are neutral., Competing Interests: Conflict of interest The authors report no conflicts of interest., (Copyright © 2023 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)
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- 2023
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43. Antibodies against malondialdehyde among 60-year-olds: prediction of cardiovascular disease.
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Samal SK, Leander K, Vikström M, Griesbaum L, de Faire U, and Frostegård J
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- Male, Female, Humans, Middle Aged, Malondialdehyde, Immunoglobulin G, Angina Pectoris, Cardiovascular Diseases epidemiology, Diabetes Mellitus, Type 2, Myocardial Infarction epidemiology
- Abstract
Malondialdehyde (MDA) is generated in oxidized LDL. It forms covalent protein adducts, and is recognized by antibodies (anti-MDA). We previously studied IgM anti-MDA, and here we focus on IgG, IgG1 and IgG2 anti-MDA in predicting cardiovascular disease (CVD). We determined, by ELISA, anti-MDA in a 7-year follow-up of 60-year-old men and women from Stockholm County (2039 men, 2193 women). We identified 210 incident CVD cases (defined as new events of myocardial infarction (MI), and hospitalization for angina pectoris) and ischemic stroke, and 620 age- and sex-matched controls. IgG anti-MDA was not associated with CVD. Median values only differed significantly for IgG1 anti-MDA among men, with lower levels among cases than controls (p = 0.039). High IgG1 anti-MDA (above 75th percentile) was inversely associated with CVD risk after adjustment for smoking, body mass index, type 2 diabetes, hyperlipidemia, and hypertension, (OR and 95% CI: 0.59; 0.40-0.89). After stratification by sex, this association emerged in men (OR and 95% CI: 0.46; 0.27-0.77), but not in women. IgG2 anti-MDA were associated with protection in the whole group and among men though weaker than IgG1 anti-MDA. IgG2 anti-MDA above the 75th percentile was associated with an increased risk of MI/angina in women (OR and 95% CI: 2.57; (1.08-6.16)). IgG1 and less so IgG2 anti-MDA are protection markers for CVD and MI/angina in the whole group and among men. However, IgG2 anti-MDA was a risk marker for MI/angina among women. These findings could have implications for both prediction and therapy., (© 2023. Springer Nature Limited.)
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- 2023
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44. Blood Levels of Organochlorine Contaminants Mixtures and Cardiovascular Disease.
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Donat-Vargas C, Schillemans T, Kiviranta H, Rantakokko P, de Faire U, Arrebola JP, Wolk A, Leander K, and Åkesson A
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- Humans, Female, Aged, Male, Case-Control Studies, Prospective Studies, Cardiovascular Diseases chemically induced, Cardiovascular Diseases epidemiology, Myocardial Infarction, Ischemic Stroke
- Abstract
Importance: Cardiovascular toxic effects derived from high exposures to individual organochlorine compounds are well documented. However, there is no evidence on low but continuous exposure to combined organochlorine compounds in the general population., Objective: To evaluate the association of combined exposure to several organochlorine compounds, including organochlorine pesticides and polychlorinated biphenyls, with incident cardiovascular disease (CVD) in the general population., Design, Setting, and Participants: This prospective nested case-control study included data from 2 cohorts: the Swedish Mammography Cohort-Clinical (SMC-C) and the Cohort of 60-Year-Olds (60YO), with matched case-control pairs based on age, sex, and sample date. Baseline blood sampling occurred from November 2003 to September 2009 (SMC-C) and from August 1997 to March 1999 (60YO), with follow-up through December 2017 (SMC-C) and December 2014 (60YO). Participants with myocardial infarction or ischemic stroke were matched with controls for composite CVD evaluation. Data were analyzed from September 2020 to May 2023., Exposures: A total of 25 organochlorine compounds were measured in blood at baseline by gas chromatography-triple quadrupole mass spectrometry. For 7 compounds, more than 75% of the samples were lower than the limit of detection and not included., Main Outcomes and Measures: Incident cases of primary myocardial infarction and ischemic stroke were ascertained via linkage to the National Patient Register (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes I21 and I63). The quantile-based g-computation method was used to estimate the association between the combined exposure to several organochlorine compounds and composite CVD., Results: Of 1528 included participants, 1024 (67.0%) were female, and the mean (SD) age was 72 (7.0) years in the SMC-C and 61 (0.1) years in the 60YO. The odds ratio of composite CVD was 1.71 (95% CI, 1.11-2.64) per 1-quartile increment of total organochlorine compounds mixture. Organochlorinated pesticides were the largest contributors, and β-hexachlorocyclohexane and transnonachlor had the highest impact. Most of the outcome was not explained by disturbances in the main cardiometabolic risk factors, ie, high body mass index, hypertension, lipid alteration, or diabetes., Conclusions and Relevance: In this prospective nested case-control study, participants with higher exposures to organochlorines had an increased probability of experiencing a cardiovascular event, the major cause of death worldwide. Measures may be required to reduce these exposures.
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- 2023
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45. Long-term air pollution exposure and malignant intracranial tumours of the central nervous system: a pooled analysis of six European cohorts.
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Hvidtfeldt UA, Chen J, Rodopoulou S, Strak M, de Hoogh K, Andersen ZJ, Bellander T, Brandt J, Fecht D, Forastiere F, Gulliver J, Hertel O, Hoffmann B, Katsouyanni K, Ketzel M, Leander K, Magnusson PKE, Nagel G, Pershagen G, Rizzuto D, Samoli E, So R, Stafoggia M, Tjønneland A, Weinmayr G, Wolf K, Zhang J, Zitt E, Brunekreef B, Hoek G, and Raaschou-Nielsen O
- Subjects
- Humans, Particulate Matter adverse effects, Nitrogen Dioxide, Environmental Exposure adverse effects, Air Pollution adverse effects, Ozone, Brain Neoplasms epidemiology, Brain Neoplasms etiology, Air Pollutants adverse effects
- Abstract
Background: Risk factors for malignant tumours of the central nervous system (CNS) are largely unknown., Methods: We pooled six European cohorts (N = 302,493) and assessed the association between residential exposure to nitrogen dioxide (NO
2 ), fine particles (PM2.5 ), black carbon (BC), ozone (O3 ) and eight elemental components of PM2.5 (copper, iron, potassium, nickel, sulfur, silicon, vanadium, and zinc) and malignant intracranial CNS tumours defined according to the International Classification of Diseases ICD-9/ICD-10 codes 192.1/C70.0, 191.0-191.9/C71.0-C71.9, 192.0/C72.2-C72.5. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area-level., Results: During 5,497,514 person-years of follow-up (average 18.2 years), we observed 623 malignant CNS tumours. The results of the fully adjusted linear analyses showed a hazard ratio (95% confidence interval) of 1.07 (0.95, 1.21) per 10 μg/m³ NO2 , 1.17 (0.96, 1.41) per 5 μg/m³ PM2.5 , 1.10 (0.97, 1.25) per 0.5 10-5 m-1 BC, and 0.99 (0.84, 1.17) per 10 μg/m³ O3 ., Conclusions: We observed indications of an association between exposure to NO2 , PM2.5 , and BC and tumours of the CNS. The PM elements were not consistently associated with CNS tumour incidence., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)- Published
- 2023
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46. Exposure to long-term source-specific transportation noise and incident breast cancer: A pooled study of eight Nordic cohorts.
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Thacher JD, Oudin A, Flanagan E, Mattisson K, Albin M, Roswall N, Pyko A, Aasvang GM, Andersen ZJ, Borgquist S, Brandt J, Broberg K, Cole-Hunter T, Eriksson C, Eneroth K, Gudjonsdottir H, Helte E, Ketzel M, Lanki T, Lim YH, Leander K, Ljungman P, Manjer J, Männistö S, Raaschou-Nielsen O, Pershagen G, Rizzuto D, Sandsveden M, Selander J, Simonsen MK, Stucki L, Spanne M, Stockfelt L, Tjønneland A, Yli-Tuomi T, Tiittanen P, Valencia VH, Ögren M, Åkesson A, and Sørensen M
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- Humans, Female, Cohort Studies, Risk Factors, Prospective Studies, Environmental Exposure adverse effects, Environmental Exposure analysis, Noise, Transportation adverse effects, Breast Neoplasms epidemiology, Breast Neoplasms etiology
- Abstract
Background: Environmental noise is an important environmental exposure that can affect health. An association between transportation noise and breast cancer incidence has been suggested, although current evidence is limited. We investigated the pooled association between long-term exposure to transportation noise and breast cancer incidence., Methods: Pooled data from eight Nordic cohorts provided a study population of 111,492 women. Road, railway, and aircraft noise were modelled at residential addresses. Breast cancer incidence (all, estrogen receptor (ER) positive, and ER negative) was derived from cancer registries. Hazard ratios (HR) were estimated using Cox Proportional Hazards Models, adjusting main models for sociodemographic and lifestyle variables together with long-term exposure to air pollution., Results: A total of 93,859 women were included in the analyses, of whom 5,875 developed breast cancer. The median (5th-95th percentile) 5-year residential road traffic noise was 54.8 (40.0-67.8) dB Lden, and among those exposed, the median railway noise was 51.0 (41.2-65.8) dB Lden. We observed a pooled HR for breast cancer (95 % confidence interval (CI)) of 1.03 (0.99-1.06) per 10 dB increase in 5-year mean exposure to road traffic noise, and 1.03 (95 % CI: 0.96-1.11) for railway noise, after adjustment for lifestyle and sociodemographic covariates. HRs remained unchanged in analyses with further adjustment for PM
2.5 and attenuated when adjusted for NO2 (HRs from 1.02 to 1.01), in analyses using the same sample. For aircraft noise, no association was observed. The associations did not vary by ER status for any noise source. In analyses using <60 dB as a cutoff, we found HRs of 1.08 (0.99-1.18) for road traffic and 1.19 (0.95-1.49) for railway noise., Conclusions: We found weak associations between road and railway noise and breast cancer risk. More high-quality prospective studies are needed, particularly among those exposed to railway and aircraft noise before conclusions regarding noise as a risk factor for breast cancer can be made., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)- Published
- 2023
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47. Omega-3 Fatty Acid Biomarkers and Incident Atrial Fibrillation.
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Qian F, Tintle N, Jensen PN, Lemaitre RN, Imamura F, Feldreich TR, Nomura SO, Guan W, Laguzzi F, Kim E, Virtanen JK, Steur M, Bork CS, Hirakawa Y, O'Donoghue ML, Sala-Vila A, Ardisson Korat AV, Sun Q, Rimm EB, Psaty BM, Heckbert SR, Forouhi NG, Wareham NJ, Marklund M, Risérus U, Lind L, Ärnlöv J, Garg P, Tsai MY, Pankow J, Misialek JR, Gigante B, Leander K, Pester JA, Albert CM, Kavousi M, Ikram A, Voortman T, Schmidt EB, Ninomiya T, Morrow DA, Bayés-Genís A, O'Keefe JH, Ong KL, Wu JHY, Mozaffarian D, Harris WS, and Siscovick DS
- Subjects
- Humans, Biomarkers, Docosahexaenoic Acids, Eicosapentaenoic Acid, Prospective Studies, Risk Factors, Atrial Fibrillation diagnosis, Atrial Fibrillation epidemiology, Fatty Acids, Omega-3
- Abstract
Background: The relationship between omega-3 fatty acids and atrial fibrillation (AF) remains controversial., Objectives: This study aimed to determine the prospective associations of blood or adipose tissue levels of eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) with incident AF., Methods: We used participant-level data from a global consortium of 17 prospective cohort studies, each with baseline data on blood or adipose tissue omega-3 fatty acid levels and AF outcomes. Each participating study conducted a de novo analyses using a prespecified analytical plan with harmonized definitions for exposures, outcome, covariates, and subgroups. Associations were pooled using inverse-variance weighted meta-analysis., Results: Among 54,799 participants from 17 cohorts, 7,720 incident cases of AF were ascertained after a median 13.3 years of follow-up. In multivariable analysis, EPA levels were not associated with incident AF, HR per interquintile range (ie, the difference between the 90th and 10th percentiles) was 1.00 (95% CI: 0.95-1.05). HRs for higher levels of DPA, DHA, and EPA+DHA, were 0.89 (95% CI: 0.83-0.95), 0.90 (95% CI: 0.85-0.96), and 0.93 (95% CI: 0.87-0.99), respectively., Conclusions: In vivo levels of omega-3 fatty acids including EPA, DPA, DHA, and EPA+DHA were not associated with increased risk of incident AF. Our data suggest the safety of habitual dietary intakes of omega-3 fatty acids with respect to AF risk. Coupled with the known benefits of these fatty acids in the prevention of adverse coronary events, our study suggests that current dietary guidelines recommending fish/omega-3 fatty acid consumption can be maintained., Competing Interests: Funding Support and Author Disclosures The Fatty Acid Research Institute retrospectively provided a small honorarium to a subset of the analysts who participated in this study, but it had no role in the design, analysis, manuscript writing, nor decision to submit for publication. Detailed funding information for the individual cohorts can be found in the Supplemental Appendix, specifically Supplemental Table 4. None of the funders/sponsors played any role in the collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. Dr O'Donoghue is a member of the TIMI Study Group, which has received institutional research grant support through Brigham and Women’s Hospital from Amgen, Novartis, Janssen, and AstraZeneca; and has received consulting fees from Amgen, Novartis, Janssen, and AstraZeneca. Dr Albert has received consulting fees from Boston Scientific, Medtronic, Novartis, and Element Science. Dr Morrow is a member of the TIMI Study group, which has received institutional research grant support through Brigham and Women’s Hospital from Abbott Laboratories, Amgen, Anthos Therapeutics, Arca Biopharma, AstraZeneca, Bayer HealthCare Pharmaceuticals, Inc, Daiichi-Sankyo, Eisai, Intarcia, Janssen, Merck, Novartis, Pfizer, Quark Pharmaceuticals, Regeneron, Roche, Siemens, The Medicines Company, and Zora Biosciences; and has received consulting fees from ARCA, InCarda, Inflammatix, Merck, Novartis, and Roche Diagnostics. Dr O’Keefe has a major ownership interest in Cardiotabs (a company that markets supplements including omega-3). Dr Mozaffarian, outside of the submitted work, has received research funding from the Gates Foundation, The Rockefeller Foundation, and the Vail Institute for Global Research; has received personal fees from Acasti Pharma, Barilla, Danone, and Motif FoodWorks; has served on the scientific advisory board of Beren Therapeutics, Brightseed, Calibrate, DayTwo (ended June 20, 2023), Elysium Health, Filtricine, Foodome, HumanCo, January Inc, Perfect Day, Season, and Tiny Organics; has stock ownership in Calibrate and HumanCo; and has chapter royalties from UpToDate. Dr Harris holds stock in OmegaQuant Analytics, LLC (a laboratory that offers blood fatty acid testing); and is on the Scientific Advisory Boards for the Schiff Institute Science and Innovation, Synspira, and the Seafood Nutrition Partnership. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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48. Cross-Sectional Gene-Smoking Interaction Analysis in Relation to Subclinical Atherosclerosis-Results From the IMPROVE Study.
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Maitusong B, Laguzzi F, Strawbridge RJ, Baldassarre D, Veglia F, Humphries SE, Savonen K, Kurl S, Pirro M, Smit AJ, Giral P, Silveira A, Tremoli E, Hamsten A, de Faire U, Gigante B, and Leander K
- Subjects
- Male, Humans, Female, Carotid Intima-Media Thickness, Cross-Sectional Studies, Risk Factors, Smoking adverse effects, Smoking epidemiology, Atherosclerosis genetics
- Abstract
Background: Smoking is associated with carotid intima-media thickness (C-IMT). However, knowledge about how genetics may influence this association is limited. We aimed to perform nonhypothesis driven gene-smoking interaction analyses to identify potential genetic variants, among those included in immune and metabolic platforms, that may modify the effect of smoking on carotid intima-media thickness., Methods: We used baseline data from 1551 men and 1700 women, aged 55 to 79, included in a European multi-center study. Carotid intima-media thickness maximum, the maximum of values measured at different locations of the carotid tree, was dichotomized with cut point values ≥75, respectively. Genetic data were retrieved through use of the Illumina Cardio-Metabo- and Immuno- Chips. Gene-smoking interactions were evaluated through calculations of Synergy index (S). After adjustments for multiple testing, P values of <2.4×10
-7 for S were considered significant. The models were adjusted for age, sex, education, physical activity, type of diet, and population stratification., Results: Our screening of 207 586 SNPs available for analysis, resulted in the identification of 47 significant gene-smoking synergistic interactions in relation to carotid intima-media thickness maximum. Among the significant SNPs, 28 were in protein coding genes, 2 in noncoding RNA and the remaining 17 in intergenic regions., Conclusions: Through nonhypothesis-driven analyses of gene-smoking interactions, several significant results were observed. These may stimulate further research on the role of specific genes in the process that determines the effect of smoking habits on the development of carotid atherosclerosis., Competing Interests: Disclosures None.- Published
- 2023
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49. Long-term exposure to traffic noise and risk of incident colon cancer: A pooled study of eleven Nordic cohorts.
- Author
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Roswall N, Thacher JD, Ögren M, Pyko A, Åkesson A, Oudin A, Tjønneland A, Rosengren A, Poulsen AH, Eriksson C, Segersson D, Rizzuto D, Helte E, Andersson EM, Aasvang GM, Gudjonsdottir H, Khan J, Selander J, Christensen JH, Brandt J, Leander K, Mattisson K, Eneroth K, Stucki L, Barregard L, Stockfelt L, Albin M, Simonsen MK, Spanne M, Jousilahti P, Tiittanen P, Molnàr P, Ljungman PLS, Yli-Tuomi T, Cole-Hunter T, Lanki T, Hvidtfeldt UA, Lim YH, Andersen ZJ, Pershagen G, and Sørensen M
- Subjects
- Humans, Cohort Studies, Risk Factors, Environmental Exposure analysis, Denmark epidemiology, Noise, Transportation, Air Pollution, Colonic Neoplasms
- Abstract
Background Colon cancer incidence is rising globally, and factors pertaining to urbanization have been proposed involved in this development. Traffic noise may increase colon cancer risk by causing sleep disturbance and stress, thereby inducing known colon cancer risk-factors, e.g. obesity, diabetes, physical inactivity, and alcohol consumption, but few studies have examined this. Objectives The objective of this study was to investigate the association between traffic noise and colon cancer (all, proximal, distal) in a pooled population of 11 Nordic cohorts, totaling 155,203 persons. Methods We identified residential address history and estimated road, railway, and aircraft noise, as well as air pollution, for all addresses, using similar exposure models across cohorts. Colon cancer cases were identified through national registries. We analyzed data using Cox Proportional Hazards Models, adjusting main models for harmonized sociodemographic and lifestyle data. Results During follow-up (median 18.8 years), 2757 colon cancer cases developed. We found a hazard ratio (HR) of 1.05 (95% confidence interval (CI): 0.99-1.10) per 10-dB higher 5-year mean time-weighted road traffic noise. In sub-type analyses, the association seemed confined to distal colon cancer: HR 1.06 (95% CI: 0.98-1.14). Railway and aircraft noise was not associated with colon cancer, albeit there was some indication in sub-type analyses that railway noise may also be associated with distal colon cancer. In interaction-analyses, the association between road traffic noise and colon cancer was strongest among obese persons and those with high NO
2 -exposure. Discussion A prominent study strength is the large population with harmonized data across eleven cohorts, and the complete address-history during follow-up. However, each cohort estimated noise independently, and only at the most exposed façade, which may introduce exposure misclassification. Despite this, the results of this pooled study suggest that traffic noise may be a risk factor for colon cancer, especially of distal origin., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)- Published
- 2023
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50. Association Between History of Adverse Pregnancy Outcomes and Coronary Artery Disease Assessed by Coronary Computed Tomography Angiography.
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Sederholm Lawesson S, Swahn E, Pihlsgård M, Andersson T, Angerås O, Bacsovics Brolin E, Bergdahl E, Blomberg M, Christersson C, Gonçalves I, Gunnarsson OS, Jernberg T, Johnston N, Leander K, Lilliecreutz C, Pehrson M, Rosengren A, Sandström A, Sandström A, Sarno G, Själander S, Svanvik T, Thunström E, Wikström AK, and Timpka S
- Subjects
- Aged, Female, Humans, Middle Aged, Cardiovascular Diseases diagnostic imaging, Cardiovascular Diseases epidemiology, Constriction, Pathologic epidemiology, Cross-Sectional Studies, Diabetes, Gestational epidemiology, Hypertension, Pregnancy-Induced epidemiology, Pre-Eclampsia epidemiology, Premature Birth epidemiology, Risk Factors, Sweden epidemiology, Computed Tomography Angiography, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease epidemiology, Pregnancy Outcome epidemiology, Pregnancy Complications epidemiology
- Abstract
Importance: Adverse pregnancy outcomes are recognized risk enhancers for cardiovascular disease, but the prevalence of subclinical coronary atherosclerosis after these conditions is unknown., Objective: To assess associations between history of adverse pregnancy outcomes and coronary artery disease assessed by coronary computed tomography angiography screening., Design, Setting, and Participants: Cross-sectional study of a population-based cohort of women in Sweden (n = 10 528) with 1 or more deliveries in 1973 or later, ascertained via the Swedish National Medical Birth Register, who subsequently participated in the Swedish Cardiopulmonary Bioimage Study at age 50 to 65 (median, 57.3) years in 2013-2018. Delivery data were prospectively collected., Exposures: Adverse pregnancy outcomes, including preeclampsia, gestational hypertension, preterm delivery, small-for-gestational-age infant, and gestational diabetes. The reference category included women with no history of these exposures., Main Outcomes and Measures: Coronary computed tomography angiography indexes, including any coronary atherosclerosis, significant stenosis, noncalcified plaque, segment involvement score of 4 or greater, and coronary artery calcium score greater than 100., Results: A median 29.6 (IQR, 25.0-34.9) years after first registered delivery, 18.9% of women had a history of adverse pregnancy outcomes, with specific pregnancy histories ranging from 1.4% (gestational diabetes) to 9.5% (preterm delivery). The prevalence of any coronary atherosclerosis in women with a history of any adverse pregnancy outcome was 32.1% (95% CI, 30.0%-34.2%), which was significantly higher (prevalence difference, 3.8% [95% CI, 1.6%-6.1%]; prevalence ratio, 1.14 [95% CI, 1.06-1.22]) compared with reference women. History of gestational hypertension and preeclampsia were both significantly associated with higher and similar prevalence of all outcome indexes. For preeclampsia, the highest prevalence difference was observed for any coronary atherosclerosis (prevalence difference, 8.0% [95% CI, 3.7%-12.3%]; prevalence ratio, 1.28 [95% CI, 1.14-1.45]), and the highest prevalence ratio was observed for significant stenosis (prevalence difference, 3.1% [95% CI, 1.1%-5.1%]; prevalence ratio, 2.46 [95% CI, 1.65-3.67]). In adjusted models, odds ratios for preeclampsia ranged from 1.31 (95% CI, 1.07-1.61) for any coronary atherosclerosis to 2.21 (95% CI, 1.42-3.44) for significant stenosis. Similar associations were observed for history of preeclampsia or gestational hypertension among women with low predicted cardiovascular risk., Conclusions and Relevance: Among Swedish women undergoing coronary computed tomography angiography screening, there was a statistically significant association between history of adverse pregnancy outcomes and image-identified coronary artery disease, including among women estimated to be at low cardiovascular disease risk. Further research is needed to understand the clinical importance of these associations.
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- 2023
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