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At least 307 records · Page 17

Chemical mixture exposure patterns and obesity among U.S. adults in NHANES 2005–2012

The effect of chemical exposure on obesity has raised great concerns. Real-world chemical exposure always imposes mixture impacts, however their exposure patterns and the corresponding associations with obesity have not been fully evaluated. To discover obesity-related mixed chemical exposure patterns in the general U.S. population. Sparse Decompositional Regression (SDR), a model adapted from sparse representation learning technique, was developed to identify exposure patterns of chemical mixtures with exclusion (non-targeted model) and inclusion (targeted model) of health outcomes. We assessed the relationships between the identified chemical mixture patterns and obesity-related indexes. We also conducted a comprehensive evaluation of this SDR model by comparing to the existing models, including generalized linear regression model (GLM), principal component analysis (PCA), and Bayesian kernel machine regression (BKMR). Eight core exposure patterns were identified using the non-targeted SDR model. Patterns of high levels of MEP, high levels of naphthalene metabolites (ΣOH-Nap), and a pattern of high exposure levels of MCOP, MCNP, and MCPP were positively associated with obesity. Patterns of high levels of BP3, and a pattern of higher mixed levels of MPB, PPB, and MEP were found to have negative associations. Associations were strengthened using the targeted SDR model. In the single chemical analysis by GLM, BP3, MBP, PPB, MCOP, and MCNP showed significant associations with obesity or body indexes. The SDR model exceeded the performance of PCA in pattern identification. Both SDR and BKMR identified a positive contribution of ΣOH-Nap and MCOP, as well as a negative contribution of BP3 and PPB to obesity. Our study identified five core exposure patterns of chemical mixtures significantly associated with obesity using the newly developed SDR model. The SDR model could open a new avenue for assessing health effects of environmental mixture contaminants.

54 ENVIRONMENTAL SCIENCES↗

Impacts of exposure to black carbon, elemental carbon, and ultrafine particles from indoor and outdoor sources on blood pressure in adults: A review of epidemiological evidence

Highlights: • Thirty publications were identified and reviewed. • Existing evidence supports a positive association between BC/EC and blood pressure. • Evidence is less clear for the relationship between UFPs and blood pressure. • Studies of indoor exposures are limited. Ambient particulate air pollution is known to have detrimental effects on cardiovascular health but less is known about the specific effects of black carbon or elemental carbon (BC/EC) and ultrafine particles (UFP).

54 ENVIRONMENTAL SCIENCES↗

Long-term exposure to residential green and blue spaces and anxiety and depression in adults: A cross-sectional study

Highlights: • Increasing surrounding greenness associated with reduced odds of use of benzodiazepines. • Access to major green spaces was associated with self-reported history of depression. • Air pollution and noise explained a proportion of the associations observed. • No associations between blue spaces and mental health outcomes were observed. • The present study suggests a potential protective role of green spaces on mental health. Although exposure to natural outdoor environments has been consistently associated with improved perceived general health, available evidence on a protective association between this exposure and specific mental health disorders such as depression and anxiety is still limited.

54 ENVIRONMENTAL SCIENCES↗

Sources of household air pollution: The association with lung function and respiratory symptoms in middle-aged adult

Highlights: • Sources of air pollution (such as mould and window condensation in the household) have been linked to respiratory symptoms. • Mould in the household was associated with poorer respiratory function. • Even non-asthmatic people were affected by mould exposure. • Measurement of indoor air pollution is complex because of the many sources of exposure, and so these results need to be confirmed. The objective of the present study was to investigate the relationship between sources of household air pollution, respiratory symptoms and lung function.

54 ENVIRONMENTAL SCIENCES↗

Hallmarks of Alzheimer disease are evolving relentlessly in Metropolitan Mexico City infants, children and young adults. APOE4 carriers have higher suicide risk and higher odds of reaching NFT stage V at ≤ 40 years of age

Highlights: • Exposures to fine particulate matter (PM{sub 2.5}) are associated with Alzheimer's disease(AD) risk. • AD starts in the brainstem of children. • AD hallmarks are present in 202/203 CDMX residents ages 11 months to 40 years. • APOE4 carriers have 4.92 times higher suicide odds versus APOE3. • Highly oxidative, ubiquitous nanoparticles are a plausible path into AD pathogenesis. Exposures to fine particulate matter (PM{sub 2.5}) and ozone (O{sub 3}) above USEPA standards are associated with Alzheimer's disease (AD) risk. Metropolitan Mexico City (MMC) residents have life time exposures to PM{sub 2.5} and O{sub 3} above USEPA standards. We investigated AD intra and extracellular protein aggregates and ultrastructural neurovascular pathology in 203 MMC residents age 25.36 ± 9.23 y. Immunohistochemical methods were used to identify AT8 hyperphosphorilated tau (Htau) and 4G8 (amyloid β 17-24). Primary outcomes: staging of Htau and amyloid, per decade and cumulative PM{sub 2.5} (CPM{sub 2.5}) above standard. Apolipoprotein E allele 4 (APOE4), age and cause of death were secondary outcomes. Subcortical pretangle stage b was identified in an 11month old baby. Cortical tau pre-tangles, neurofibrillary tangles (NFT) Stages I-II, amyloid phases 1–2, Htau in substantia nigrae, auditory, oculomotor, trigeminal and autonomic systems were identified by the 2nd decade. Progression to NFT stages III-V was present in 24.8% of 30–40 y old subjects. APOE4 carriers have 4.92 times higher suicide odds (p = 0.0006), and 23.6 times higher odds of NFT V (p < 0.0001) v APOE4 non-carriers having similar CPM{sub 2.5} exposure and age. Age (p = 0.0062) and CPM{sub 2.5} (p = 0.0178) were significant for developing NFT V. Combustion-derived nanoparticles were associated with early and progressive damage to the neurovascular unit. Alzheimer's disease starting in the brainstem of young children and affecting 99.5% of young urbanites is a serious health crisis. Air pollution control should be prioritised. Childhood relentless Htau makes a fundamental target for neuroprotective interventions and the first two decades are critical. We recommend the concept of preclinical AD be revised and emphasize the need to define paediatric environmental, nutritional, metabolic and genetic risk factor interactions of paramount importance to prevent AD. AD evolving from childhood is threating the wellbeing of our children and future generations.

54 ENVIRONMENTAL SCIENCES↗

Multiple pathways link urban green- and bluespace to mental health in young adults

Highlights: • Green/bluespace might support mental health. • We examined pathways underlying the effect. • Increased greenspace supported mental health through indirect pathways. • Bluespace was not clearly associated with mental health. A growing body of scientific literature indicates that urban green- and bluespace support mental health; however, little research has attempted to address the complexities in likely interrelations among the pathways through which benefits plausibly are realized.

54 ENVIRONMENTAL SCIENCES↗

Exploring the association between polycyclic aromatic hydrocarbons and diabetes among adults in the United States

Highlights: • High levels of exposure to PAHs are positively associated with diabetes. • These effects are heterogeneous when stratified by body mass index. • Positive associations were seen among normal weight and obese individuals. • The general population has the highest exposure to 2-hydroxynaphthalene. To explore the association between polycyclic aromatic hydrocarbons (PAHs) and diabetes and to determine whether effects are heterogeneous when examined by body mass index (BMI).

54 ENVIRONMENTAL SCIENCES↗

A minimal set of physiomarkers in continuous high frequency data streams predict adult sepsis onset earlier

Purpose: We report that sepsis is a life-threatening condition with high mortality rates and expensive treatment costs. To improve short- and long-term outcomes, it is critical to detect at-risk sepsis patients at an early stage. Methods: A data-set consisting of high-frequency physiological data from 1161 critically ill patients was analyzed. 377 patients had developed sepsis, and had data at least 3 h prior to the onset of sepsis. A random forest classifier was trained to discriminate between sepsis and non-sepsis patients in real-time using a total of 132 features extracted from a moving time-window. The model was trained on 80% of the patients and was tested on the remaining 20% of the patients, for two observational periods of lengths 3 and 6 h prior to onset.Results: The model that used continuous physiological data alone resulted in sensitivity and F1 score of up to 80% and 67% one hour before sepsis onset. On average, these models were able to predict sepsis 294.19 ± 6.50 min (5 h) before the onset. Conclusions: Lastly, the use of machine learning algorithms on continuous streams of physiological data can allow for early identification of at-risk patients in real-time with high accuracy.

59 BASIC BIOLOGICAL SCIENCES↗

Quality of Survival and Growth in Children and Young Adults in the PNET4 European Controlled Trial of Hyperfractionated Versus Conventional Radiation Therapy for Standard-Risk Medulloblastoma

Purpose: To compare quality of survival in “standard-risk” medulloblastoma after hyperfractionated radiation therapy of the central nervous system with that after standard radiation therapy, combined with a chemotherapy regimen common to both treatment arms, in the PNET4 randomised controlled trial. Methods and Materials: Participants in the PNET4 trial and their parents/caregivers in 7 participating anonymized countries completed standardized questionnaires in their own language on executive function, health status, behavior, health-related quality of life, and medical, educational, employment, and social information. Pre- and postoperative neurologic status and serial heights and weights were also recorded. Results: Data were provided by 151 of 244 eligible survivors (62%) at a median age at assessment of 15.2 years and median interval from diagnosis of 5.8 years. Compared with standard radiation therapy, hyperfractionated radiation therapy was associated with lower (ie, better) z-scores for executive function in all participants (mean intergroup difference 0.48 SDs, 95% confidence interval 0.16-0.81, P=.004), but health status, behavioral difficulties, and health-related quality of life z-scores were similar in the 2 treatment arms. Data on hearing impairment were equivocal. Hyperfractionated radiation therapy was also associated with greater decrement in height z-scores (mean intergroup difference 0.43 SDs, 95% confidence interval 0.10-0.76, P=.011). Conclusions: Hyperfractionated radiation therapy was associated with better executive function and worse growth but without accompanying change in health status, behavior, or quality of life.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Patterns of Involved-Field Radiation Therapy Protocol Deviations in Pediatric Versus Adolescent and Young Adults With Hodgkin Lymphoma: A Report From the Children's Oncology Group AHOD0031

The presented protocol for pediatric intermediate-risk Hodgkin lymphoma evaluated the use of a dose-intensive chemotherapy regimen (ABVE-PC [doxorubicin, bleomycin, vincristine, etoposide, cyclophosphamide, prednisone]) with response-based therapy augmentation (addition of DECA [dexamethasone, etoposide, cisplatin, cytarabine]) or therapy reduction (elimination of radiation).

62 RADIOLOGY AND NUCLEAR MEDICINE↗