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arXiv 2024年

作者： Kinney, Adrienne C. Barrera, Roberto Lega, Joceline Interdisciplinary Program in Applied Mathematics The University of Arizona TucsonAZ85721 United States Department of Mathematics The University of Arizona TucsonAZ85721 United States Department of Epidemiology and Biostatistics The University of Arizona TucsonAZ85721 United States BIO5 Institute The University of Arizona TucsonAZ85721 United States Entomology and Ecology Activity Dengue Branch Centers for Disease Control and Prevention 1324 Calle Cañada Puerto Rico San Juan00920 Puerto Rico

We present a method to convert weather data into probabilistic forecasts of Aedes aegypti abundance. The approach, which relies on the Aedes-AI suite of neural networks, produces weekly point predictions with corresponding uncertainty estimates. Once calibrated on past trap and weather data, the model is designed to use weather forecasts to estimate future trap catches. We demonstrate that when reliable input data are used, the resulting predictions have high skill. This technique may therefore be used to supplement vector surveillance efforts or identify periods of elevated risk for vector-borne disease outbreaks. © 2024, CC BY.

关键词： Prediction models

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Associations of long-term exposure to fine particulate matter and its constituents with gynecologic cancer incidence:A prospective cohort study from Beijing

Medicine Plus

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Medicine Plus 2024年第4期1卷 41-51页

作者： Jinting Guo Lei Yang Ning Kang Ning Wang Xi Zhang Shuo Liu Huichao Li Lili Cao Min Gao Tao Xue Tong Zhu Jiafu Ji Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics/Ministry of Education Key Laboratory of Epidemiology of Major Diseases(PKU) School of Public HealthPeking University Health Science CentreBeijing 100191China Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Beijing Office for Cancer Prevention and ControlPeking University Cancer Hospital and InstituteBeijing 100142China Peking University Cancer Hospital(Inner Mongolia Campus)/Affiliated Cancer Hospital of Inner Mongolia Medical University Inner Mongolia Cancer CenterHohhot 010020China Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department of Gynecologic OncologyPeking University Cancer Hospital and InstituteBeijing 100142China Advanced Institute of Information Technology Peking UniversityHangzhou 311215China State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management Center for Environment and HealthPeking UniversityBeijing 100871China College of Environmental Sciences and Engineering Peking UniversityBeijing 100871China State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers Beijing Key Laboratory of Carcinogenesis and Translational ResearchGastrointestinal Cancer CenterPeking University Cancer Hospital and InstituteBeijing 100142China

Background:There is limited evidence of the association between long-term exposure to particulate matter with aerodynamic diameter≤2.5μm (fine particulate matter,PM_(2.5)) and gynecologic cancer incidence,particularly in developing countries with high air pollution *** present study aimed to investigate the associations of long-term exposure to PM_(2.5)and its constituents with the incidence of gynecologic cancer,and to identify the primary ***:A total of 85,500 women from the National Urban cancer Screening program in Beijing (2013-2019) were included.5-year average concentrations of PM_(2.5)mass and its constituents,namely carbon black (BC),ammonium (NH_(4)^(+)),nitrate (NO_(3)^(-)),organic matter (OM),and sulfate (SO_(4)^(2-)),were obtained from the Tracking Air Pollution in China (TAP) *** proportional hazard models were used to analyze the association between long-term exposure to PM_(2.5)and its constituents and gynecologic cancer *** exposure models,including quantile-based gcomputation (Qgcomp) and explanatory machine learning model (SHapley Additive exPlanations,SHAP),were used to assess the effect of each ***:During a mean follow-up of 6.22 years,524 participants were diagnosed with gynecologic *** adjusted hazard ratios (HRs) for gynecologic cancer incidence associated with 1 standard deviation (SD) increment was 1.10 (95%CI:1.00-1.22) for PM_(2.5),1.12 (95%CI:1.01-1.23) for BC,1.11 (95%CI:1.00-1.23) for NH_(4)^(+),1.12 (95%CI:1.01-1.23) for OM,1.12 (95%CI:1.01-1.23) for SO_(4)^(2-),and1.08 (95%CI:0.98-1.19) for NO_(3)^(-).The Qgcomp model indicated the association between a mixture of PM_(2.5)constituents and gynecologic cancer incidence,with the weights assigned to BC (61.6%),SO_(4)^(2-)(35.9%),and NO_(3)^(-)(2.5%) in the positive *** SHAP model showed that SO_(4)^(2-)was the most important constituent,with the mean|SHAP|value of 0.0322,followed by BC (0.0270),OM (0.0232),NO_(

关键词： Ambient air pollution PM_(2.5)constituents Gynecologic cancer Mixture exposure Cohort study

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Assessment of postoperative practices and discharge recommendations after radical prostatectomy

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Urologic Oncology: Seminars and Original Investigations 2025年

作者： Melão, Bárbara Vieira Lima Aguiar Assel, Melissa Pere, Maria Nalavenkata, Sunny Touijer, Karim A. Laudone, Vincent P. Lin, Daniel W. Rivas, Juan Gomez Bjartell, Anders Carlsson, Sigrid V. Department of Urology University of São Paulo São Paulo Brazil Department of Epidemiology & Biostatistics Memorial Sloan Kettering Cancer Center New York NY United States Department of Surgery (Urology Service) Memorial Sloan Kettering Cancer Center New York NY United States Cancer Prevention Program Public Health Sciences Fred Hutchinson Cancer Center Seattle WA United States Department of Urology University of Washington Seattle WA United States Department of Urology Hospital Clínico San Carlos Madrid Spain Department of Translational Medicine Division of Urological Cancers Medical Faculty Lund University Lund Sweden Department of Urology Skåne University Hospital Malmö Sweden Department of Urology Sahlgrenska Academy at Gothenburg University Gothenburg Sweden

Purpose: Consistent, accurate postoperative guidance is crucial for early recovery and patient satisfaction in urology, especially for radical prostatectomy (RP) patients. However, patients often receive inconsistent information, highlighting the need for standardized, evidence-based postoperative care guidelines. Materials and Methods: We conducted a comprehensive review and evaluation of current postoperative practices for RP. This involved (1) reviewing existing discharge information at Josie Robertson Surgery Center, Memorial Sloan Kettering cancer Center to identify areas of improvement;(2) systematically evaluating inconsistencies in discharge instructions and their impact on patient care;(3) distributing an anonymous survey to urologists in the US and Europe via REDCap to gather insights into global postoperative care practices. The survey included questions on various aspects of postoperative care, such as catheter use, medication regimens, dietary restrictions, and physical activity guidelines. Results: We received 247 survey responses. Despite some consensus on certain postoperative practices and recommendations, significant variability existed, underscoring the lack of standardized guidelines. Notable differences were observed between US and European cohorts, particularly in postoperative length of stay and discharge practices. Only 1.4% of US responders discharged patients 3 or more days postsurgery compared to 46% in Europe. Variability was also noted in recommendations for erectile function medications and postoperative activity restrictions. Conclusion: This study underscores the significant variability in postoperative care recommendations for RP and the urgent need for standardized, evidence-based guidelines. Implementing such guidelines will enhance patient recovery, satisfaction, and overall outcomes, improving postoperative care across various surgical procedures. © 2025 Elsevier Inc.

关键词： Evidence-based medicine Postoperative care Prostatectomy

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The Associations between Lung cancer Incidence and Long-Term Exposure to Fine Particulate Matterand its Constituents

SSRN

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SSRN 2024年

作者： Hu, Jinlong Yang, Lei Kang, Ning Wang, Ning Zhang, Xi Liu, Shuo Li, Huichao Xue, Tao Ji, Jia-Fu Zhu, Tong College of Environmental Sciences and Engineering Peking University Beijing China Key Laboratory of Carcinogenesis and Translational Research Ministry of Education/Beijing Beijing Office for Cancer Prevention and Control Peking University Cancer Hospital & Institute Beijing100142 China Peking University Cancer Hospital Affiliated Cancer Hospital of Inner Mongolia Medical University Inner Mongolia Cancer Center Inner Mongolia Campus Hohhot010020 China Institute of Reproductive and Child Health National Health Commission Key Laboratory of Reproductive Health Department of Epidemiology and Biostatistics Ministry of Education Key Laboratory of Epidemiology of Major Diseases PKU School of Public Health Peking University Health Science Centre Beijing China Advanced Institute of Information Technology Peking University Hangzhou China State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management Center for Environment and Health Peking University Beijing China Department of Gastrointestinal Surgery III China

Background: Associations between long-term exposure to ambient fine particulate matter (PM2.5) and the incidence of lung cancer are well-known, but the roles of individual PM2.5 constituents [black carbon (BC), ammonium (NH4+), nitrate (NO3−), organic matter (OM), and inorganic sulfate (SO42−)] remain unclear. This study aims to specify the associations between PM2.5 constituents and lung cancer ***: Based on a prospective cohort of 142,980 people in Beijing, a Cox proportional hazards model was utilized to explore possible linear associations of the mass concentrations of PM2.5 and its constituents with lung cancer incidence. We also used weighted quantile sum (WQS), quantile-based g-computation (Qgcomp), and SHapley Additive exPlanations (SHAP) methods to specify the impacts of various exposure ***: Increased concentrations of PM2.5 and its five constituents were significantly associated with an increased incidence of lung cancer. The hazard ratios (HRs) and 95% confidence intervals (CIs) per 1-μg/m3 increase in the 5-year average concentrations were 1.01 (95% CI: 1.00, 1.02) for PM2.5, 1.23 (95% CI: 1.06, 1.42) for BC, 1.15 (95% CI: 1.04, 1.27) for NH4+, 1.08 (95% CI: 1.02, 1.16) for NO3−, 1.04 (95% CI: 1.01, 1.06) for OM, and 1.08 (95% CI: 1.03, 1.15) for SO42−. BC was robustly identified as the key constituent that explained the association between PM2.5 and lung cancer: both the WQS and Qgcomp models assigned the highest weight to BC (WQS weight: 60%, and Qgcomp positive weight: 48%). On SHAP analysis using a random forest model, BC exhibited the second-highest feature importance score (0.021).Conclusions: Using a prospective cohort, this study showed significant associations of lung cancer with PM2.5 and its constituents. The chemical profile affected the carcinogenicity of PM2.5. Reduction of BC by controlling its sources, such as fossil fuel usage and biomass burning, would effectively prevent PM2.5-related lung cancer. © 2024, Th

关键词： Additives

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Effect of Antidepressants Use on cancer Morbidity and Mortality: A Propensity Score-Matched Longitudinal Cohort Study

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Journal of affective disorders 2025年 387卷 119554页

作者： Yue Ma Jing He Chen-Yang Li Fu-Bin Liu Yao-Gang Wang Feng-Ju Song Department of Epidemiology and Biostatistics Key Laboratory of Molecular Cancer Epidemiology Key Laboratory of Prevention and Control of Major Diseases in the Population Ministry of Education National Clinical Research Center for Cancer Tianjin's Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital Tianjin Medical University Tianjin 300060 China Department of Epidemiology Harvard T. H. Chan School of Public Health Boston MA United States. Department of Epidemiology and Biostatistics Key Laboratory of Molecular Cancer Epidemiology Key Laboratory of Prevention and Control of Major Diseases in the Population Ministry of Education National Clinical Research Center for Cancer Tianjin's Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital Tianjin Medical University Tianjin 300060 China. School of Public Health Tianjin Medical University Tianjin 300070 China School of Integrative Medicine Public Health Science and Engineering College Tianjin University of Traditional Chinese Medicine Tianjin 301617 China National Institute of Health Data Science at Peking University Peking University Beijing China. Electronic address: YaogangWang@***. Department of Epidemiology and Biostatistics Key Laboratory of Molecular Cancer Epidemiology Key Laboratory of Prevention and Control of Major Diseases in the Population Ministry of Education National Clinical Research Center for Cancer Tianjin's Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital Tianjin Medical University Tianjin 300060 China. Electronic address: songfengju@***.

OBJECTIVE:To investigate the association between antidepressant use and cancer risk in a large prospective cohort. METHODS:A prospective cohort study involving participants without cancer or cardiovascular disease at baseline in the UK Biobank. Antidepressant users were matched to non-users using propensity score matching (PSM). The primary outcomes included overall cancer morbidity and mortality, with site-specific cancer morbidity as a secondary outcome. RESULTS:The median follow-up was 13.6 years. Of the 421,529 participants, 26,796 were antidepressant users, and 394,733 were non-users. After 1:1 PSM, 26,372 matched pairs were identified. Antidepressant use was associated with a reduced risk of overall cancer morbidity (HR 0.89, 95 % CI 0.85-0.94), particularly for CRC (HR 0.75, 95 % CI 0.65-0.86), and a lower risk of cancer-related mortality (HR 0.91, 95 % CI 0.84-0.99) compared to nonusers. Among antidepressant subtypes, selective serotonin reuptake inhibitors (SSRIs) were associated with a lower risk of overall cancer morbidity, especially fluoxetine, citalopram, and sertraline. SSRIs were also associated with a reduced risk of cancer-related mortality, particularly fluoxetine and citalopram. However, tricyclic antidepressants (TCAs) were linked to an increased risk of cancer-related mortality (HR 1.19, 95 % CI 1.07-1.32), especially for amitriptyline. CONCLUSION:The use of antidepressants, particularly SSRIs, was associated with a lower risk of cancer morbidity and mortality, whereas the use of TCAs, such as amitriptyline, was linked to an increased risk of cancer-related mortality. Although causal relationships cannot be established, these findings should be interpreted with caution and warrant further investigation.

关键词： Antidepressant cancer morbidity Cohort Mortality Propensity score

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Hair product use and urinary biomarker concentrations of non-persistent endocrine disrupting chemicals among reproductive-aged Black women

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Chemosphere 2024年 361卷 142442页

作者： Schildroth, Samantha Geller, Ruth J. Wesselink, Amelia K. Lovett, Sharonda M. Bethea, Traci N. Claus Henn, Birgit Harmon, Quaker E. Taylor, Kyla M. Calafat, Antonia M. Wegienka, Ganesa Gaston, Symielle A. Baird, Donna D. Wise, Lauren A. Department of Epidemiology Boston University School of Public Health BostonMA United States Office of Minority Health & Health Disparities Research Georgetown Lombardi Comprehensive Cancer Institute Washington DC United States Department of Environmental Health Boston University School of Public Health BostonMA United States National Institute of Environmental Health Sciences DurhamNC United States National Toxicology Program National Institute of Environmental Health Sciences NC United States Division of Laboratory Sciences Centers for Disease Control and Prevention AtlantaGA United States Henry Ford Health System Detroit MI United States

Background: Studies have shown an association between hair product use and adverse health outcomes. Scientists have hypothesized that exposure to endocrine-disrupting chemicals (EDCs) drives these associations, but few studies have directly evaluated associations between hair product use and biomarkers of EDCs. Even more limited are studies of Black women, who frequently use EDC-containing products (e.g., hair relaxers). Objective: We estimated associations between hair product use and EDC biomarker concentrations. Methods: We leveraged cross-sectional data from the Study of Environment, Lifestyle, and Fibroids, a cohort of females aged 23–34 years who self-identified as Black/African American from the Detroit-metropolitan area (USA;n = 425). On structured questionnaires, participants reported their past 24-h and past 12-month use of hair products, including relaxers/straighteners/perms, styling products, moisturizers, oils, and hair food. We quantified urinary concentrations of 19 phthalate/phthalate alternative metabolites, 7 phenols, and 4 parabens using high performance liquid chromatography isotope dilution tandem mass spectrometry. EDC biomarker concentrations were creatinine-adjusted and natural log-transformed. We used multivariable linear regression to estimate mean percent differences in EDC biomarker concentrations and 95% confidence intervals (CIs) associated with hair product use, adjusting for sociodemographic confounders. Results: Hair product use was associated with greater concentrations of multiple EDC biomarkers. Notably, use of hair products in the previous 24 h (compared with non-use) was associated with 16.2% (95% CI = 0.7%, 35.9%), 35.0% (95% CI = 2.6%, 77.6%), and 32.3% (95% CI = 8.8%, 92.0%) higher concentrations of mono-isobutyl phthalate, methyl paraben, and ethyl paraben, respectively. Use of hair relaxers/straighteners/perms, styling products, moisturizers, oils, and hair food in the past 12 months was also associated with higher concent

关键词： Phenols

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Journal of Inflammation Research 2021年 14卷 1437-1445页

作者： Chen, Wen Mo’Ez Al-Islam, E. Luigi, Faris Nicola Haifa, Bragazzi Algahtani, M.S. Jahrami, Zahra Saif Ahmed Shivappa, Nitin Hebert, James R. Jahrami, Haitham Department of Psychiatry Xiamen Xianyue Hospital Xiamen 361000 China Department of Clinical Nutrition and Dietetics College of Health Sciences/Research Institute for Medical and Health Sciences (RIMHS) University of Sharjah Sharjah United Arab Emirates Laboratory for Industrial and Applied Mathematics (LIAM) Department of Mathematics and Statistics York University Toronto ON Canada College of Medicine and Medical Sciences Arabian Gulf University Manama Bahrain Renewal and Reward Center Dammam Saudi Arabia Ministry of Health Manama Bahrain Bahraini Association for Intellectual Disabilities and Autism Sanad Bahrain Cancer Prevention and Control Program University of South Carolina Columbia 29208 SC United States Department of Epidemiology and Biostatistics Arnold School of Public Health University of South Carolina Columbia SC United States

Purpose: This case-control study aimed to examine the association between the inflammation potential of the diet and depression. Patients and Methods: Ninety-six patients with major depression disorder were matched with 96 age-and sex-matched healthy controls. Energy-adjusted DII (E-DII™) scores were calculated based on the participants’ responses to a detailed nutritional assessment using a quantitative food frequency questionnaire. Descriptive results were reported. Logistic regression was used to estimate odds ratios and 95% confidence intervals associated with E-DII scores and depression adjusting for covariates including age, sex, body mass index, comorbidities, level of education, and employment. Results: The mean E-DII score of participants in the study was 1.32±1.08, indicating a generally pro-inflammatory diet. Patients with depression had elevated E-DII scores compared to age-and sex-matched controls with E-DII scores of 1.72± 1.09 vs 0.90±0.90, respectively (P=0.001). Results of logistic regression analysis revealed that patients with depression were nearly three times more likely to be in the extreme ends of pro-inflammatory diet (OR 2.75;95% CI 1.82–4.15). Conclusion: Adult Bahraini patients with depression have higher dietary inflammation potential compared to the general population controls. Further research is needed to confirm these results and provide effective interventions to reduce the burden of this dietary inflammation. © 2021 Chen et al.

关键词： Arabian population groups Case-control study Depression Inflammation Mental health

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Genetically predicted circulating concentrations of micronutrients and risk of colorectal cancer among individuals of European descent: a Mendelian randomization study (vol 113, pg 1490, 2021)

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AMERICAN JOURNAL OF CLINICAL NUTRITION 2021年第6期113卷 1715-1715页

作者： Tsilidis, K. K. Department of Hygiene and Epidemiology University of Ioannina School of Medicine Ioannina Greece Department of Epidemiology and Biostatistics School of Public Health Imperial College London London United Kingdom Section of Nutrition and Metabolism International Agency for Research on Cancer Lyon France Department of Population Health Sciences Bristol Medical School University of Bristol Bristol United Kingdom Medical Research Council Integrative Epidemiology Unit Department of Population Health Sciences Bristol Medical School University of Bristol Bristol United Kingdom University Hospitals Bristol National Health Service Foundation Trust National Institute for Health Research Bristol Biomedical Research Centre University of Bristol Bristol United Kingdom Medical Research Council Biostatistics Unit School of Clinical Medicine University of Cambridge Cambridge United Kingdom Department of Preventive Medicine and Community Health The University of Texas Medical Branch Galveston TX USA Nuffield Department of Population Health University of Oxford Oxford United Kingdom Division of Human Nutrition and Health Wageningen University & Research Wageningen Netherlands Division of Cancer Epidemiology and Genetics National Cancer Institute NIH Bethesda MD USA Division of Clinical Epidemiology and Aging Research German Cancer Research Center (DKFZ) Heidelberg Germany Medical Genetics Service University Hospital Center (CHU) Nantes Nantes France Leeds Institute of Cancer and Pathology University of Leeds Leeds United Kingdom Huntsman Cancer Institute University of Utah Salt Lake City UT USA Department of Population Health Sciences University of Utah Salt Lake City UT USA Division of Preventive Oncology German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg Germany German Cancer Consortium (DKTK) German Cancer Research Center (DKFZ) Heidelberg Germany Institute for Health Research Kaiser Permanente Colorado Denver CO USA Be

Background The literature on associations of circulating concentrations of minerals and vitamins with risk of colorectal cancer is limited and inconsistent. Evidence from randomized controlled trials (RCTs) to support the efficacy of dietary modification or nutrient supplementation for colorectal cancer prevention is also *** To complement observational and RCT findings, we investigated associations of genetically predicted concentrations of 11 micronutrients (β-carotene, calcium, copper, folate, iron, magnesium, phosphorus, selenium, vitamin B-6, vitamin B-12, and zinc) with colorectal cancer risk using Mendelian randomization (MR).Methods Two-sample MR was conducted using 58,221 individuals with colorectal cancer and 67,694 controls from the Genetics and epidemiology of Colorectal cancer Consortium, Colorectal cancer Transdisciplinary Study, and Colon cancer Family Registry. Inverse variance-weighted MR analyses were performed with sensitivity analyses to assess the impact of potential violations of MR *** Nominally significant associations were noted for genetically predicted iron concentration and higher risk of colon cancer [ORs per SD (ORSD): 1.08; 95% CI: 1.00, 1.17; P value = 0.05] and similarly for proximal colon cancer, and for vitamin B-12 concentration and higher risk of colorectal cancer (ORSD: 1.12; 95% CI: 1.03, 1.21; P value = 0.01) and similarly for colon cancer. A nominally significant association was also noted for genetically predicted selenium concentration and lower risk of colon cancer (ORSD: 0.98; 95% CI: 0.96, 1.00; P value = 0.05) and similarly for distal colon cancer. These associations were robust to sensitivity analyses. Nominally significant inverse associations were observed for zinc and risk of colorectal and distal colon cancers, but sensitivity analyses could not be performed. None of these findings survived correction for multiple testing. Genetically predicted concentrations of β-carotene, calcium, c

关键词： Mendelian randomization genes nutrition supplements colorectal cancer

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Uncovering the Genetics of Poor and Exceptional Survivorship after Unrelated Donor Allogeneic Hematopoietic Cell Transplantation (HCT)

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Blood 2024年 144卷 930-930页

作者： Angel Earle Pankhil Shah Susan E. Steck Jiajia Zhang Nadine El Kalach Lara E. Sucheston-Campbell Stephen R. Spellman Marcelo C. Pasquini Meilun He Qianqian Zhu Theresa E. Hahn Alyssa I Clay-Gilmour Department of Epidemiology and Biostatistics University of South Carolina Winnsboro SC Department of Epidemiology and Biostatistics | Arnold School of Public Health University of South Carolina Lexington SC Department of Epidemiology and Biostatistics University of South Carolina Columbia SC College of Pharmacy The Ohio State University Pleasanton CA Center for International Blood and Marrow Transplant Research Minneapolis MN Center for International Blood and Marrow Transplant Research Medical College of Wisconsin Milwaukee WI CIBMTR® (Center for International Blood and Marrow Transplant Research) NMDP Minneapolis MN Department of Biostatistics and Bioinformatics Roswell Park Comprehensive Cancer Center Buffalo NY Cancer Prevention and Control Roswell Park Comprehensive Cancer Center Buffalo NY

Introduction: A previous genome-wide association study (GWAS) investigated joint and independent genetic factors in recipients and donors contributing to death in the first year after unrelated donor HCT (DISCOVeRY-BMT study, PMID: 34746714). The current study leveraged DISCOVeRY-BMT data to identify non-human leukocyte antigen (HLA) genetic factors related to poor and exceptional survivorship after allogeneic HCT. Methods: DISCOVeRY-BMT, a collaboration with the Center for International Blood and Marrow Transplant Research (CIBMTR) consists of 2 cohorts of acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), and myelodysplastic syndrome (MDS) patients treated 2000-2011 and their ≥8/8 HLA-matched unrelated donors. Standard genotyping using the Illumina OmniExpress BeadChip and quality control were performed. Imputation used the Trans-Omics in Precision Medicine (TOPMed) Imputation Server (GRCh38). Given 80% of patients who survive 24 months post-HCT survive to 10 years (PMID: 28232372), we categorized patients who were alive with <120 but >24 months follow-up as exceptional survivors. Standard and poor survivors are those who died between 24-120 months post-HCT and <24 months post-HCT, respectively. GWAS was performed with additive multivariable logistic-Firth hybrid regression models adjusting for age at HCT, sex, cohort, disease (AML, ALL, MDS), disease status (early or advanced), year of HCT, and principal components. Summary statistics and median survival in months were calculated in R.4.4.1. P < 5 × 10⁻⁸ denoted genome-wide significance. Results: Study sample consisted of 2886 European ancestry recipients, with survivors comprising 32% exceptional (N=937, median survival=142 months), 15% standard (N=441, median survival=47 months), and 53% poor (N=1508, median survival=5 months). Distributions by disease (17-21% ALL, 60-62% AML, 18-21% MDS) were similar in exceptional, standard, and poor survivor cases. Exceptional survivor cases had slightly highe

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Frailty and Other Factors Associated With Early Outcomes in Middle-to Older Age Trauma Patients: A Prospective Cohort Study

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American Journal of Geriatric Psychiatry 2024年第2期32卷 244-255页

作者： Yeh, Tian-Shin Kang, Jiunn-Horng Littlejohns, Thomas J. Wu, Chia-Chieh Chen, Jin-Hua Piravej, Krisna Chiu, Wen-Ta Lam, Carlos Department of Physical Medicine and Rehabilitation School of Medicine College of Medicine Taipei Medical University Taipei Taiwan Department of Physical Medicine and Rehabilitation Wan Fang Hospital Taipei Medical University Taipei Taiwan Department of Epidemiology and Nutrition Harvard T. H. Chan School of Public Health Harvard University Boston MA United States Department of Physical Medicine and Rehabilitation National Taiwan University Hospital Taipei Taiwan Department of Physical Medicine and Rehabilitation College of Medicine National Taiwan University Taipei Taiwan Department of Physical Medicine and Rehabilitation Taipei Medical University Hospital Taipei Taiwan Graduate Institute of Nanomedicine and Medical Engineering College of Biomedical Engineering Taipei Medical University Taipei Taiwan International Ph.D. Program in Medicine College of Medicine Taipei Medical University Taipei Taiwan Professional Master Program in Artificial Intelligence in Medicine College of Medicine Taipei Medical University Taipei Taiwan Nuffield Department of Population Health University of Oxford Oxford United Kingdom Emergency Department Wan Fang Hospital Taipei Medical University Taipei Taiwan Department of Emergency School of Medicine College of Medicine Taipei Medical University Taipei Taiwan Graduate Institute of Data Science College of Management Taipei Medical University Taipei Taiwan Institutional Research Center Office of Data Science Taipei Medical University Taipei Taiwan Biostatistics Center Department of Medical Research Wan Fang Hospital Taipei Medical University Taipei Taiwan Department of Rehabilitation Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand Department of Chula Neuroscience Center King Chulalongkorn Memorial Hospital Bangkok Thailand Graduate Institute of Injury Prevention and Control College of Public Health Taipei Medical University Taipei Taiwan AHMC Health System Alhambra CA United States

Objectives: To prospectively investigate associations of frailty and other predictor variables with functional recovery and health outcomes in middle-aged and older patients with trauma. Design: Single-center prospective cohort study. Setting: Emergency department of Wan Fang Hospital in Taiwan. Participants: Trauma patients aged 45 and older. Measurements: Frailty was assessed with the Clinical Frailty Scale (CFS). Injury mechanisms, pre-existing diseases, and fracture locations were recorded at baseline. The primary outcome was functional recovery assessed using the Barthel Index (BI). Secondary outcomes were new care needs, unscheduled return visits, and falls 3 months postinjury. Results: A total of 588 participants were included in the final analysis. For every one-point increase in the CFS, the multivariable-adjusted odds ratio (OR, 95% confidence interval [CI]) of failure to retain the preinjury BI was 1.34 (1.16–1.55);associations were consistent across levels of age and injury severities. Significant joint associations of frailty and age with poor functional recovery were observed. CFS was also associated with new care needs (OR for every one-point increase, 1.36, 95% CI, 1.17–1.58), unscheduled return visits (OR 1.26, 95% CI, 1.04–1.51), and falls (OR 1.23, 95% CI, 1.01–1.51). Other variables associated with failure to retain preinjury BI included road traffic accident and presence of hip fracture. Conclusion: Frailty was significantly associated with poor functional and health outcomes regardless of injury severity in middle-aged and older patients with trauma. Injury mechanisms and fracture locations were also significant predictors of functional recovery postinjury. © 2023 American Association for Geriatric Psychiatry

关键词： Clinical Frailty Scale Frailty functional recovery injury middle-to older age

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