Epidemiology Commons^™

Implementation Of Risk Prediction And Stratification Approaches For Ageing Populations In Australian Healthcare: A Systematic Review, Leanne Greene, Jacob Brain, Belinda Brown, Claire V. Burley, Elissa Burton, Zhongyang Guan, Bronwyn Myers, Katherine Ride, Serena Sabatini, Mario Siervo, Abay Woday Tadesse, Eugene Yee Hing Tang, Blossom C.L. Stephan, Jennifer Dunne

Research outputs 2022 to 2026

Despite widespread development of prognostic risk stratification tools, their implementation in Australian healthcare remains poorly characterised. This review identified tools implemented for adults aged ≥40 years and examined their real-world use. Following PRISMA and SWiM guidelines, MEDLINE, EMBASE, Web of Science, PsycINFO, and CINAHL Plus were searched from inception to 20th February 2026. Eligible studies reported implementation of a risk stratification tool in Australian healthcare and health, functional, or implementation outcomes. The Mixed Methods Appraisal Tool assessed study quality. Of 7115 records screened, 21 studies were included across primary care, hospitals, residential aged care, and community services. Interventions included electronic …

Baseline Body Mass Index Category And Incident Treated Hypertension In Australian Men: A Linked Prospective Cohort Study Using Pbs/Mbs Data, Ebenezer Afrifa-Yamoah

Research outputs 2022 to 2026

Background: Excess adiposity is a major modifiable risk factor for hypertension; however, the incremental prognostic value of body mass index (BMI) beyond standard predictors remains unclear. We examined the associations between baseline BMI category and incident treated hypertension, and assessed whether BMI improved risk prediction.

Methods: Data were obtained from the Ten to Men longitudinal study (2013–2024) linked to Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) records. The cohort comprised 12,742 men aged ≥ 18 years without treated hypertension at baseline, followed for 133,038 person-years. Adjusted Cox proportional hazards models were fitted. Discrimination, calibration, decision curve analysis, E-values, …

Prevalence And Molecular Types Of Clostridioides (Clostridium) Difficile On Australian Retail Vegetables And Household Surfaces, Deirdre A. Collins, Su Chen Lim, Jessica Chisholm, Molly Lattin, Linda Selvey, Simon Reid, Thomas V. Riley

Research outputs 2022 to 2026

Objectives: Community-onset Clostridioides (Clostridium) difficile infection (CDI) has risen to >80 % of all CDI cases in Australia. High prevalence of C. difficile contamination has been reported in many community sources including retail root vegetables. Household surfaces may become contaminated with C. difficile when storing and handling contaminated vegetables. This study aimed to determine the prevalence and molecular types of C. difficile present on retail root vegetables and household surfaces. Methods: From April 2023 to March 2024, retail potatoes (n = 255) and onions (n = 305) were sampled at 3-monthly intervals. Environmental samples were collected from homes of householders …

Imbalances In Circulating Monocyte And High-Density Lipoprotein Cholesterol Exacerbates The Residual Risk Of Incident Myocardial Infarction Beyond Ldl-C: A Real-Life, Prospective Cohort Study, Dan Wu, Yulong Lan, Xiong Ding, Lois Balmer, Xingang Li, Wei Wang, Shouling Wu, Youren Chen

Research outputs 2022 to 2026

Background: A sustained oversupply of monocytes and markedly decreased levels of high-density lipoprotein cholesterol (HDL-C) are notable in high-risk groups with residual cardiovascular risk, despite aggressive low-density lipoprotein cholesterol (LDL-C) lowering. This study aimed to explore whether an imbalance in circulating monocyte and HDL-C levels accounts for the residual risk of incident myocardial infarction (MI) within optimal LDL-C levels. Methods: A total of 48,522 participants free of cardiovascular diseases from a real-life, prospective cohort (Kailuan study) were included. The monocyte count, HDL-C level and monocyte-to-HDL-C ratio (MHR), calculated as time-averaged cumulative and baseline values, were used as the exposures. Time-to-event …

Prevalence And Trends Of Coexisting Forms Of Malnutrition And Its Associated Factors Among Children Aged 6–59 Months In South And Southeast Asia, 1996–2022: A Cross-Sectional Time Series Study, Wenjie Guo, Maggie Zgambo, Sanmei Chen, Yoko Shimpuku

Research outputs 2022 to 2026

Background: South and Southeast Asia face severe malnutrition in children under five, with coexisting forms of malnutrition (CFM) exacerbating mortality risks and posing greater challenges than isolated forms of malnutrition. We aimed to assess the prevalence, trends, and factors of CFM among children aged 6–59 months in South and Southeast Asian countries and the entire region. Methods: We used anthropometric and hemoglobin data from 515,170 children aged 6–59 months in seven low- and middle-income South and Southeast Asian countries, based on Demographic and Health Surveys conducted between 1996 and 2022. Weighted multivariable logistic regression was performed to identify the sociodemographic …

Trends And Determinants Of Early Neonatal Mortality In Ethiopia: Evidence From The Ethiopian Demographic And Health Survey Data, Tsion Mulat Tebeje, Beminate Lemma Seifu, Yordanos Sisay Asgedom, Kusse Urmale Mare, Zufan Alamrie Asmare, Hiwot Altaye Asebe, Abdu Hailu Shibeshi, Afework Alemu Lombebo, Kebede Gemeda Sabo, Bezawit Melak Fente, Bizunesh Fantahun Kase

Research outputs 2022 to 2026

Background: Early neonatal mortality (ENM) accounts for three-fourths of all neonatal deaths and one-third of overall child mortality. While previous studies have primarily focused on neonatal and under-five mortality, ENM has received comparatively less attention. This study aims to address this gap by analyzing trends and identifying factors associated with ENM in Ethiopia. Methods: Data from the Ethiopian Demographic and Health Survey (EDHS) conducted between 2005 and 2016 were analyzed, comprising a total weighted sample of 22,310 participants. To account for the hierarchical structure of the EDHS data, a mixed-effects binary logistic regression model was applied to identify associated factors. …

Exploring And Validating Associations Between Six Systemic Inflammatory Indices And Ischemic Stroke In A Middle-Aged And Old Chinese Population, Yulu Zheng, Zheng Guo, Jingzheng Wang, Zhiyuan Wu, Xiaolin Chen, Yahong Zhu, Guangle Shan, Haifeng Hou, Xingang Li

Research outputs 2022 to 2026

Background: Inflammation and maladaptive immune mechanisms have been substantiated as integral components in the critical pathological processes of the injury cascade in ischemic stroke (IS). This study aimed to explore the associations between six systemic inflammatory indices and IS in a Chinese population. Methods: This was a case-control study based on the retrospective review of electronic medical records from two hospitals in Shandong Province, China. Systemic inflammatory indices, including the systemic inflammation response index (SIRI), systemic immune inflammation index (SII), pan-immune-inflammation value (PIV), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and lymphocyte monocyte ratio (LMR), were calculated. Logistic regression …

Feasibility Of Home-Based Urine Collection In Children Under 5 Years In The Origins Birth Cohort Study: Mixed Method Protocol And Sample Completion Results, Courtney D.A. Kidd, Najma A. Moumin, Andrea Macrae, Tim J. Green, Desiree T. Silva, Susan L. Prescott, Nina D’Vaz

Research outputs 2022 to 2026

Background: Urine is an attractive biospecimen for nutritional status and population health surveys. It is an excellent non-invasive alternative to blood for appropriate biomarkers in young children and is suitable for home-based collection, enabling representative collections across a population. However, the bulk of literature in this population is restricted to collection in primary care settings. Feasibility of home-based collection at scale has not been tested. Here, we describe a mixed method approach to collect urine samples in a large cohort study with children under 5 years. Methods: The ORIGINS Project is an ongoing birth cohort investigating early life influences on …

Source-Specific Nitrate Intake And Incident Dementia In The Danish Diet, Cancer And Health Study, Catherine P. Bondonno, Pratik Pokharel, Dorit Wielandt Erichsen, Liezhou Zhong, Jörg Schullehner, Cecilie Kyrø, Kirsten Frederiksen, Peter Fjeldstad Hendriksen, Frederik Dalgaard, Lauren C. Blekkenhorst, Stephanie R. Rainey-Smith, Samantha L. Gardener, Torben Sigsgaard, Ole Raaschou-Nielsen, Anne Tjønneland, Jonathan M. Hodgson, Christina C. Dahm, Anja Olsen, Nicola P. Bondonno

Research outputs 2022 to 2026

Introduction: Dietary nitrate, through conversion to nitric oxide, which supports vascular and nervous system function, may lower dementia risk but may also form neurodegenerative N-nitrosamines, depending on the nitrate source. Methods: We investigated associations between source-specific nitrate and nitrite intake and incident and early-onset dementia (< 65 years) in 54,804 dementia-free participants from the Danish Diet, Cancer and Health Cohort Study over ∼27 years. Nitrate and nitrite intakes were derived from food frequency questionnaires and nitrate and nitrite databases. Results: Higher plant-sourced nitrate intake was non-linearly associated with lower rates of incident dementia (fifth vs first quintile hazard ratio 95% confidence interval: 0.90 [0.83, 0.98]), while increased risk was seen for higher intakes of animal-sourced, additive-permitted meat-sourced, and tap water-sourced nitrate. Similar associations were seen for source-specific nitrite intake and were more pronounced for early-onset dementia. No clear effect modification was observed. Discussion: These findings highlight the importance of nitrate source in dementia risk and warrant further investigation. Highlights: Plant nitrate is associated with a lower risk of incident and early-onset dementia. Animal and tap water nitrate are associated with an increased risk of dementia. Encouraging consumption of plant-based nitrate sources may lower risk of dementia.

Cardiac Arrest Events On Australian Beaches, David Reid, Kye Bostwick, Jasmin C. Lawes, Ogilvie Thom, Ned Douglas

Research outputs 2022 to 2026

Background: Surf Life Saving Australia (SLSA) members respond to cardiac arrests near their patrolling location and have successfully resuscitated many community members over the years. In addition, members often act as first responders to cardiac arrest events in community settings, workplaces or through applications such as GoodSAM®. The outcomes achieved are not known after an update to resuscitation guidelines. Objective: We aimed to analyse Surf Life Saving Australia data on cardiopulmonary resuscitation (CPR) and describe the epidemiology and outcomes of cardiac arrest on Australian beaches and factors associated with survival after CPR. Methods: Using SLSA's national Incident Reporting Database held …

Tissue-Specific Distribution Of Microplastics In Human Blood And Carotid Plaques: A Paired Sample Analysis, Cancan Cui, Zheng Guo, Yanxi Liu, Ning Han, Jiayin Song, Yuanmei Chen, Yulu Zheng, Chen Sheng, Lois Balmer, Haibin Li, Rui Liu, Lin Liu, Jianshi Du, Zhiyuan Wu

Research outputs 2022 to 2026

Backgrounds: Microplastics (MPs) have been increasingly detected in human tissues, raising concerns about their role in cardiovascular disease. However, their distribution in matched blood and vascular tissues, such as atherosclerotic plaques, remains poorly understood. Methods: Paired blood and carotid plaque samples were analyzed for 12 polymer types of MPs using pyrolysis–gas chromatography–mass spectrometry among twenty patients undergoing carotid endarterectomy. Results: The mean concentration of total MPs was 75.2 μg/g in blood and 432.9 μg/g in plaque. Polyethylene (PE) dominated blood samples (46.5 %), followed by polyvinyl chloride (PVC, 16.8 %) and styrene-butadiene rubber (SBR, 16.3 %). In plaques, MPs were …

Clostridioides (Clostridium) Difficile In Children And Adolescents In The Community In Cambodia, Lengsea Eng, Paul Turner, Kefyalew Addis Alene, Deirdre A. Collins, Su Chen Lim, Pisey Tan, Sona Soeng, Dylorng Hun, Sotera Yohn, Sarim Vong, Archie C.A. Clements, Thomas V. Riley

Research outputs 2022 to 2026

Background: Clostridioides (Clostridium) difficile transmission between community and healthcare settings has been increasingly reported. We aimed to identify the prevalence and molecular epidemiology of C. difficile colonising adolescents and non-hospitalised children in Cambodia. Methods: Stool samples were collected from 266 students at the University of Health Sciences (UHS) in Phnom Penh, between July and August 2022, and 246 children ≥1 year old visiting the outpatient department (OPD) at Angkor Hospital for Children in Siem Reap, between January and August 2022. C. difficile culture, toxin gene detection and PCR ribotyping were performed. Results: Overall, C. difficile was recovered from 07/266 specimens …

Changes In The Contributions Of Risk Factors To Under-Five Mortality In Low- And Lower-Middle-Income Countries (1997-2022): An Analysis Of Demographic And Health Survey Data, Bereket Kefale, Jonine Jancey, Amanuel T. Gebremedhin, Gavin Pereira, Gizachew A. Tessema

Research outputs 2022 to 2026

Background: Under-five mortality (U5M) is a critical public health challenge in low- and lower-middle-income countries (LLMICs), where over 90% of global deaths occur. Despite progress, the changing contributions of risk factors to U5M in LLMICs remain unexplored.

Mrthods: We analysed Demographic and Health Survey (DHS) data from 24 LLMICs across two periods: 1997-2005 and 2016-2022. We included 139,890 live births in 1997-2005 and 319,034 in 2016-2022. A mixed-effects robust Poisson regression model with a log link function was employed to identify risk factors of U5M in each period. Population-attributable fractions (PAFs) were calculated and compared to investigate changes in the …

Changing Age Profile And Incidence Of Injecting Drug Use Initiation Among People In Australia Who Inject Drugs: Evidence From Two National Repeated Cross-Sectional Studies, Olivia Price, Lisa Maher, Amy Peacock, Farzaneh Zolala, Louisa Degenhardt, Paul Dietze, Sarah Larney, Seraina Agramunt, Samantha Colledge-Frisby, Bradley Mathers, Dan Lewer, Rachel Sutherland

Research outputs 2022 to 2026

Background: The age of people who inject drugs appears to be increasing in some high-income countries. We aimed to explore trends in the age of people injecting and recently starting to inject drugs in Australia, and to model incidence of initiation over time. Methods: We obtained data from the Illicit Drug Reporting System (IDRS) and the Australian Needle Syringe Program Survey (ANSPS), which comprise annual cross-sectional surveys with people who inject drugs (2000–2019). Outcome measures were current age, age of initiation, and time since initiation (both surveys), and drug first injected (IDRS only). We estimated time trends in age using …

Opportunistic Measurement Of Sagittal Abdominal Diameter With Bone Densitometry Predicts Death And Cardiovascular Events, William D. Leslie, Fatima Zarzour, Lisa M. Lix, Neil Binkley, Joshua R. Lewis, John T. Schousboe

Research outputs 2022 to 2026

Supine sagittal abdominal diameter (SAD), also known as abdominal height, has been proposed as a simple measure for assessing abdominal adiposity. We aimed to determine whether SAD from DXA performed for osteoporosis assessment predicts major adverse cardiovascular events (MACEs) using the population-based DXA registry for the Province of Manitoba, Canada. The study population comprised 72 974 individuals aged 40 yr and older with baseline DXA assessment between February 1999 and March 2018. Incident MACE (composite of all-cause mortality, acute myocardial infarction [MI], non-hemorrhagic stroke) was ascertained from linked healthcare databases. During mean 8.4 yr follow-up (611 862 person-years), 14 457 …

Sedentary Leisure Behaviour, Physical Activity, And Gastroesophageal Reflux Disease: Evidence From A Mendelian Randomization Analysis, Shan Lu, Yahong Zhu, Mingyu Cui, Zheng Guo, Xingang Li, Ying Song

Research outputs 2022 to 2026

Background and Aims: Gastroesophageal reflux disease (GERD) is common worldwide. Although associations between sedentary behaviour (LSBs), physical activity (PAs), and GERD have been reported, their causal relationships remain unclear. This study uses Mendelian randomization (MR) to examine these associations with GERD. Methods: Genetic instruments from the UK Biobank and other consortia were utilized to assess the causal relationship between LSBs, PAs, and GERD. Causal analyses employed inverse variance weighted (IVW), weighted-median (WM), and MR-Egger regression. Sensitivity analyses included Cochran's Q test, MR-Egger intercept test, leave-one-out analysis, and funnel plot assessment. Outliers were detected using MR-PRESSO and Radial MR. A risk …

Interdisciplinary Research Among Tourism, Public Health, And Global Health: A Promising Stream Focusing On Populations With Suboptimal Health Status, Jun Wen, Fangli Hu, Danni Zheng, Haifeng Hou, Wei Wang

Research outputs 2022 to 2026

Research suggests that approximately 75% of the world's population suffers from suboptimal health status, meaning these individuals often feel unwell but have no clearly diagnosable conditions. Suboptimal health status, originating from traditional Chinese medicine, signifies an intermediate state between health and disease. Tourism has been deemed beneficial for personal health and general well-being. More recently, it has been proposed as a non-pharmacological intervention for individuals with dementia, given its potential contributions to health promotion and disease prevention/treatment. Yet, the tourism literature has paid scarce attention to populations with suboptimal health status, even as an aging society becomes inevitable. This paper …

Automated Abdominal Aortic Calcification And Major Adverse Cardiovascular Events In People Undergoing Osteoporosis Screening: The Manitoba Bone Mineral Density Registry, Cassandra Smith, Marc Sim, Zaid Ilyas, Syed Zulqarnain Gilani, David Suter, Siobhan Reid, Barret A. Monchka, Mohammed Jafari Jozani, Gemma Figtree, John T. Schousboe, Joshua R. Lewis, William D. Leslie

Research outputs 2022 to 2026

Vertebral fracture assessment (VFA) images from bone density machines enable the automated machine learning assessment of abdominal aortic calcification (ML-AAC), a marker of cardiovascular disease (CVD) risk. The objective of this study was to describe the risk of a major adverse cardiovascular event (MACE, from linked health records) in patients attending routine bone mineral density (BMD) testing and meeting specific criteria based on age, BMD, height loss, or glucocorticoid use have a VFA in the Manitoba BMD Registry. The cohort included 10 250 individuals (mean age 75.5 yr, 94% women without CVD) with VFA (February 2010 to March 2017). ML-AAC24 …

Association Between Joint Exposure To Ambient Air Pollutants And Carotid Plaque: The Mediating Role Of Cardiometabolic Risk Factors, Yunfei Li, Ze Han, Xiaoyu Zhao, Yueruijing Liu, Zhiyuan Wu, Jinqi Wang, Xia Li, Xiuhua Guo, Lixin Tao

Research outputs 2022 to 2026

Background: Research has shown that exposure to joint air pollution is related to atherosclerosis, but little evidence has been found for carotid plaques. Our objective is to assess the association between exposure to joint air pollutants and carotid plaque and explore the mediating role of cardiometabolic factors in this relationship. Methods: The Beijing Health Management Cohort (BMHC) study followed participants recruited from 2013 to 2014 until December 31, 2020. All participants underwent carotid ultrasound and were free of carotid plaque at baseline. A satellite-based land-use regression (LUR) model was applied to estimate air pollution exposure. The joint exposure to air …

Epidemiological Principles In Claims Of Causality: An Enquiry Into Repetitive Head Impacts (Rhi) And Chronic Traumatic Encephalopathy (Cte), Lauren V. Fortington, J. David Cassidy, Rudolph J. Castellani, Andrew J. Gardner, Andrew S. Mcintosh, Michael Austen, Zachary Yukio Kerr, Kenneth L. Quarrie

Research outputs 2022 to 2026

Determining whether repetitive head impacts (RHI) cause the development of chronic traumatic encephalopathy (CTE)-neuropathological change (NC) and whether pathological changes cause clinical syndromes are topics of considerable interest to the global sports medicine community. In 2022, an article was published that used the Bradford Hill criteria to evaluate the claim that RHI cause CTE. The publication garnered international media attention and has since been promoted as definitive proof that causality has been established. Our counterpoint presents an appraisal of the published article in terms of the claims made and the scientific literature used in developing those claims. We conclude that …

Association Between Hypertension And Dementia Risk In Low- And Middle-Income Countries: A Systematic Review, Josephine E. Lindhout, Marieke P. Hoevenaar-Blom, Jan Willem Van Dalen, Manshu Song, Dong Lin, Wei Wang, Edo Richard, Eric P. Moll Van Charante, Tessa Van Middelaar

Research outputs 2022 to 2026

Background: Dementia prevalence is rising most rapidly in low- and middle-income countries (LMICs), yet most evidence on risk factors such as hypertension stems from high-income settings. In LMICs, hypertension may have a greater impact due to its high prevalence and poor control. We systematically reviewed evidence on the association between blood pressure and dementia and cognition in LMICs, and compared findings across regions. Methods: We searched PubMed, Embase, PsycINFO, and Global Index Medicus and reviewed reference lists for relevant studies. We included longitudinal studies (follow-up ≥6 months) from LMICs on the association between systolic blood pressure or hypertension and incident …

Gestational Age–Specific Prevalence Of Preeclampsia Among Pregnant Women In Ghana: A Hospital-Based Retrospective Observational Study, Wina Ivy Ofori Boadu, Enoch Odame Anto, Akua Benewaah Asamoah, Ezekiel Ansah, Godfred Yawson Scott, Emmanuel Ekow Korsah, Joseph Frimpong, Valentine Christian Kodzo Tsatsu Tamakloe, Michael Nyantakyi, Agartha Odame Anto, Emmanuel Timmy Donkoh, Kwame Ofori Boadu, Richard Vikpebah Duneeh, Frederick Ayensu, Christian Obirikorang

Research outputs 2022 to 2026

Background: Preeclampsia is responsible for a significant rate of maternal morbidity and mortality worldwide. Gestational age as a risk factor has a significant impact on fetal outcomes in pregnancies affected by preeclampsia. However, to our knowledge, no study has identified the gestational age–specific prevalence of preeclampsia in Ghana. Thus, this study ascertained the gestational age–specific prevalence of preeclampsia as well as its associated factors. Methods: A hospital-based retrospective observational study was conducted by reviewing data collected from the maternal birth register on 619 pregnant women who delivered at the facility from 1st January 2021 to 31st December 2021. Results: Out …

Associations Between Flavonoid-Rich Food And Flavonoid Intakes And Incident Unhealthy Aging Outcomes In Older United States Males And Females, Nicola P. Bondonno, Yan Lydia Liu, Francine Grodstein, Eric B. Rimm, Aedín Cassidy

Research outputs 2022 to 2026

Background: Our knowledge of the importance of flavonoid-rich foods in preventing unhealthy aging across its different domains is limited. Objectives: This study aimed to examine prospective associations between flavonoid-rich food and flavonoid intakes and indicators of unhealthy aging, namely frailty, impaired physical function, and poor mental health. Methods: We followed up 62,743 females and 23,687 males, all aged ≥60 y, from the Nurses’ Health Study (1990–2014) and Health Professionals Follow-up Study (2006–2018), respectively. Both time-updated and change in intakes of a flavodiet score (an aggregate of intakes of major flavonoid-rich foods and beverages) and individual flavonoid-rich foods and beverages and …

Automated Abdominal Aortic Calcification Scoring From Vertebral Fracture Assessment Images And Fall-Associated Hospitalisations: The Manitoba Bone Mineral Density Registry, Marc Sim, Abadi K. Gebre, Jack Dalla Via, Siobhan Reid, Mohammad Jafari Jozani, Douglas Kimelman, Barret A. Monchka, Syed Zulqarnain Gilani, Zaid Ilyas, Cassandra Smith, David Suter, John T. Schousboe, Joshua R. Lewis, William D. Leslie

Research outputs 2022 to 2026

Abdominal aortic calcification (AAC), a subclinical measure of cardiovascular disease (CVD) that can be assessed on vertebral fracture assessment (VFA) images during osteoporosis screening, is reported to be a falls risk factor. A limitation to incorporating AAC clinically is that its scoring requires trained experts and is time-consuming. We examined if our machine learning (ML) algorithm for AAC (ML-AAC24) is associated with a higher fall-associated hospitalisation risk in the Manitoba Bone Mineral Density (BMD) Registry. A total of 8565 individuals (94.0% female, age 75.7 ± 6.8 years) who had a BMD and VFA image from DXA between February 2010 and …

The Impact Of Armed Conflicts On Hiv Treatment Outcomes In Sub-Saharan Africa: A Systematic Review And Meta-Analysis, Hafte Kahsay Kebede, Hailay Abrha Gesesew, Amanuel Tesfay Gebremedhin, Paul Ward

Research outputs 2022 to 2026

Background: Despite the fact that Sub-Saharan Africa bears a disproportionate burden of armed conflicts and HIV infection, there has been inadequate synthesis of the impact of armed conflict on HIV treatment outcomes. We summarized the available evidence on the impact of armed conflicts on HIV treatment outcomes in Sub-Saharan Africa from 2002 to 2022. Methods: We searched four databases; MEDLINE, PubMed, CINHAL, and Scopus. We also explored grey literature sources and reviewed the bibliographies of all articles to identify any additional relevant studies. We included quantitative studies published in English from January 1, 2002 to December 30, 2022 that reported …

Cohort Profile: The Origins Pregnancy And Birth Cohort, Jacqueline Davis, Zenobia Talati, Sarah Whalan, Wesley Billingham, Nina D'Vaz, Lisa Gibson, Susan L. Prescott, Desiree T. Silva

Research outputs 2022 to 2026

No abstract provided.

Associations Of Metabolic Changes And Polygenic Risk Scores With Cardiovascular Outcomes And All-Cause Mortality Across Bmi Categories: A Prospective Cohort Study, Cancan Li, Xiaoni Meng, Jie Zhang, Haotian Wang, Huimin Lu, Meiling Cao, Shengzhi Sun, Youxin Wang

Research outputs 2022 to 2026

Background: Associations between metabolic status and metabolic changes with the risk of cardiovascular outcomes have been reported. However, the role of genetic susceptibility underlying these associations remains unexplored. We aimed to examine how metabolic status, metabolic transitions, and genetic susceptibility collectively impact cardiovascular outcomes and all-cause mortality across diverse body mass index (BMI) categories. Methods: In our analysis of the UK Biobank, we included a total of 481,576 participants (mean age: 56.55; male: 45.9%) at baseline. Metabolically healthy (MH) status was defined by the presence of < 3 abnormal components (waist circumstance, blood pressure, blood glucose, triglycerides, and high-density lipoprotein cholesterol). Normal weight, overweight, and obesity were defined as 18.5 ≤ BMI < 25 kg/m2, 25 ≤ BMI < 30 kg/m2, and BMI ≥ 30 kg/m2, respectively. Genetic predisposition was estimated using the polygenic risk score (PRS). Cox regressions were performed to evaluate the associations of metabolic status, metabolic transitions, and PRS with cardiovascular outcomes and all-cause mortality across BMI categories. Results: During a median follow-up of 14.38 years, 31,883 (7.3%) all-cause deaths, 8133 (1.8%) cardiovascular disease (CVD) deaths, and 67,260 (14.8%) CVD cases were documented. Among those with a high PRS, individuals classified as metabolically healthy overweight had the lowest risk of all-cause mortality (hazard ratios [HR] 0.70; 95% confidence interval [CI] 0.65, 0.76) and CVD mortality (HR 0.57; 95% CI 0.50, 0.64) compared to those who were metabolically unhealthy obesity, with the beneficial associations appearing to be greater in the moderate and low PRS groups. Individuals who were metabolically healthy normal weight had the lowest risk of CVD morbidity (HR 0.54; 95% CI 0.51, 0.57). Furthermore, the inverse associations of metabolic status and PRS with cardiovascular outcomes and all-cause mortality across BMI categories were more pronounced among individuals younger than 65 years (Pinteraction < 0.05). Additionally, the combined protective effects of metabolic transitions and PRS on these outcomes among BMI categories were observed. Conclusions: MH status and a low PRS are associated with a lower risk of adverse cardiovascular outcomes and all-cause mortality across all BMI categories. This protective effect is particularly pronounced in individuals younger than 65 years. Further research is required to confirm these findings in diverse populations and to investigate the underlying mechanisms involved. Graphical abstract: (Figure presented.)

Dual-Trajectory Of Tyg Levels And Lifestyle Scores And Their Associations With Ischemic Stroke In A Non-Diabetic Population: A Cohort Study, Hui Zhou, Xiong Ding, Yulong Lan, Wei Fang, Xiaojie Yuan, Yan Tian, Shuohua Chen, Shouling Wu, Dan Wu

Research outputs 2022 to 2026

Background: The Triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, has been implicated in the risk of ischemic stroke. However, the interplay between TyG levels, lifestyle factors, and their collective impact on stroke risk in non-diabetic populations remains inadequately explored. This study aims to evaluate the association of ischemic stroke with the joint development of the TyG index and lifestyle in the non-diabetic population. Methods: In this prospective cohort study, data was collected across three consecutive biennial surveys of the Kailuan Study from 2006 to 2011. The dual-trajectory model was used to determine the temporal development of TyG levels …

Association Between Inflammatory Bowel Disease And Cancer Risk: Evidence Triangulation From Genetic Correlation, Mendelian Randomization, And Colocalization Analyses Across East Asian And European Populations, Di Liu, Meiling Cao, Haotian Wang, Weijie Cao, Chenguang Zheng, Yun Li, Youxin Wang

Research outputs 2022 to 2026

Background: Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), has been associated with several cancer risks in observational studies, but the observed associations have been inconsistent and may face the bias of confounding and reverse causality. The potential causal relationships between IBD and the risk of cancers remain largely unclear. Methods: We performed genome-wide linkage disequilibrium score regression (LDSC), standard two-sample Mendelian randomization (MR), and colocalization analyses using summary genome-wide association study (GWAS) data across East Asian and European populations to evaluate the causal relationships between IBD and cancers. Sensitivity analyses for the MR approach …

Impact Of Quality Of Care On Outcomes In Survivors Of Stroke With Aphasia: A Linked Registry And Hospital Data Observational Study, Tharshanah Thayabaranathan, Sarah J. Wallace, Joosup Kim, Monique F. Kilkenny, Muideen T. Olaiya, Nadine E. Andrew, Emily Brogan, Caroline Baker, Erin Godecke, David A. Copland, Miranda L. Rose, Mulugeta M. Birhanu, Dominique A. Cadilhac

Research outputs 2022 to 2026

Background: The impact of hospital care quality on patient outcomes in post-stroke aphasia remains unclear. We investigated the impact of nationally-endorsed acute stroke treatments on outcomes post-stroke, by aphasia status. Methods: Patient-level data from the Australian Stroke Clinical Registry (2009–2013) linked to national deaths, hospital emergency presentations and admissions data were used. Aphasia was identified for the index stroke event (ICD-10 diagnosis code R47.0). Impact of receiving an optimal stroke care bundle (stroke unit care, antihypertensive medication at discharge and discharge care plan) and an acute ischemic stroke (AIS) care bundle (stroke unit care, intravenous thrombolysis and aspirin within 48 …