Retrospective analysis of dog study data from food and color additive petitions
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Previous studies have identified combat exposure and combat traumatic experience as problematic drinking risk factors. Increasing evidence suggests that opioid use increases the risk of alcohol use disorder. This study investigated the association between opioid prescription use after injury and (1) alcohol use disorder and (2) severity of alcohol use disorder among deployed military servicemembers. Deidentified health records data of 9,029 deployed servicemembers from a retrospective cohort study were analyzed. Data were randomly selected from the Department of Defense Trauma Registry and included servicemembers with combat injuries during deployment in Iraq or Afghanistan (2002–2016). Pharmacy records and International Classification of Diseases, Ninth and Tenth Revision diagnosis codes were used. Three groups were identified (no opioid prescription use, nonpersistent opioid prescription use, and persistent opioid prescription use) and were compared on the basis of alcohol use disorder risk using Cox proportional hazard models. Data analyses were performed in 2021. Of the 9,029 servicemembers with combat injury, 2,262 developed alcohol use disorder (1,322 developed severe alcohol use disorder). Compared with no opioid prescription use, increased alcohol use disorder risk was associated with persistent opioid prescription use, with a hazard ratio of 1.13 (95% CI=1.02, 1.26). After covariate adjustment, increased risk remained statistically significant (hazards ratio=1.24; 95% CI=1.10, 1.39). There was no significant difference in alcohol use disorder risk between no opioid prescription use and nonpersistent opioid prescription use. The risk of severe alcohol use disorder did not vary by opioid use among servicemembers with alcohol use disorder diagnosis. Furthermore, the findings of the study suggest that the incidence of alcohol use disorder was higher among injured servicemembers with persistent opioid prescription use than among those without opioid use. If replicated in prospective studies, the findings highlight the need for clinicians to consider the current and history of alcohol use of patients in initiating treatment involving opioids.
Objectives/Hypothesis: To establish comprehensive transcriptomic profiles of cholesteatoma perimatrix tissue and granulation tissue from chronic otitis media (COM) that did not develop cholesteatoma, which can indicate molecular pathways involved in the cholesteatoma perimatrix pathology and invasiveness. Study Design: Retrospective Case Series. Methods: Transcriptome data were obtained from cholesteatoma perimatrix tissue and COM granulation tissue by an Illumina iScan microarray. Differentially expressed genes (DEGs) were subsequently analyzed using both bioinformatical functional annotation and network analysis. Expression of candidate genes (MMP9 and LCN2) was validated by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) on a larger group of samples. Results: Analysis of the transcriptome led to the identification of 169 differentially expressed genes between investigated tissues. Bioinformatic analysis suggested that most significant biological processes involving DEGs were previously described in cholesteatoma pathology. Network analysis identified ERBB2, TFAP2A, and TP63 as major hubs of the DEGs molecular network. Furthermore, it was observed that the cellular component most significantly enriched in DEGs was extracellular space containing 47 DEGs. Using qRT-PCR, it was confirmed that mRNA levels of the major extracellular hub (MMP9) are increased, whereas its interacting molecule (LCN2) mRNA levels were decreased in cholesteatoma perimatrix tissue compared to COM granulation tissue. Conclusions: The current study approach offers an overall look at molecular mechanisms that describe the cholesteatoma entity by focusing exclusively on the perimatrix processes in comparison to COM granulation tissue. The observed differences in gene expression between cholesteatoma perimatrix and COM granulation tissue could suggest novel markers potentially influenced by the perimatrix–matrix molecular interplay, which is not present in COM without cholesteatoma. Level of Evidence: NA. Laryngoscope, 130:E220–E227, 2020. © 2019 The American Laryngological, Rhinological and Otological Society, Inc.
Abstract Background The interaction between cancer diagnoses and COVID‐19 infection and outcomes is unclear. We leveraged a state‐wide, multi‐institutional database to assess cancer‐related risk factors for poor COVID‐19 outcomes. Methods We conducted a retrospective cohort study using the University of California Health COVID Research Dataset, which includes electronic health data of patients tested for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) at 17 California medical centers. We identified adults tested for SARS‐CoV‐2 from 2/1/2020–12/31/2020 and selected a cohort of patients with cancer. We obtained demographic, clinical, cancer type, and antineoplastic therapy data. The primary outcome was hospitalization within 30d after the first positive SARS‐CoV‐2 test. Secondary outcomes were SARS‐CoV‐2 positivity and severe COVID‐19 (intensive care, mechanical ventilation, or death within 30d after the first positive test). We used multivariable logistic regression to identify cancer‐related factors associated with outcomes. Results We identified 409,462 patients undergoing SARS‐CoV‐2 testing. Of 49,918 patients with cancer, 1781 (3.6%) tested positive. Patients with cancer were less likely to test positive (RR 0.70, 95% CI: 0.67–0.74, p < 0.001). Among the 1781 SARS‐CoV‐2‐positive patients with cancer, BCR/ABL‐negative myeloproliferative neoplasms (RR 2.15, 95% CI: 1.25–3.41, p = 0.007), venetoclax (RR 2.96, 95% CI: 1.14–5.66, p = 0.028), and methotrexate (RR 2.72, 95% CI: 1.10–5.19, p = 0.032) were associated with greater hospitalization risk. Cancer and therapy types were not associated with severe COVID‐19. Conclusions In this large, diverse cohort, cancer was associated with a decreased risk of SARS‐CoV‐2 positivity. Patients with BCR/ABL‐negative myeloproliferative neoplasm or receiving methotrexate or venetoclax may be at increased risk of hospitalization following SARS‐CoV‐2 infection. Mechanistic and comparative studies are needed to validate findings.
Objectives To validate stage nodal (N)3 of the 8th edition American Joint Committee on Cancer (AJCC) staging system for nasopharyngeal carcinoma (NPC). Methods This retrospective cohort study extracted NPC patients from the Surveillance, Epidemiology, and End Results database between 2004 and 2016. Pathologically confirmed patients with complete data of level IV, N3a, and N3b lymph node metastasis were investigated. The included patients were divided into level IV, N3a, and N3b groups. Five‐year overall survival (OS) and cancer‐specific survival (CSS) were compared among the three groups. Results A total of 693 patients were included: 285 (41.13%) patients in the level IV group, 124 (17.89%) patients in the N3a group, and 284 (40.98%) patients in the N3b group. The 5‐year OS (57.1%, 55.0%, and 55.2%) and CSS (64.4%, 63.5%, and 64.4%) were not different among the level IV, N3a, and N3b groups. Multivariate regression analysis revealed that N stage was not an independent prognostic factor for OS (hazard ratio [HR] = 1.03, 95% confidence interval [CI]: 0.91–1.17; P = .65) or CSS (HR = 1.03, 95% CI: 0.89–1.19; P = .70). Conclusion Stage N3 of the 8th edition AJCC staging system for NPC is reasonable. Level of Evidence III Laryngoscope , 131:535–540, 2021
Objective: To understand how chronic exposure to industrial air pollution is associated with male fertility through semen parameters. Design: Retrospective cohort study. Subjects: Men in the Subfertility, Health and Assisted Reproduction cohort who underwent a semen analysis 2005-2017 with ≥1 measured semen parameter (N=21,563). Intervention(s): Residential histories for each man were constructed using locations from administrative records linked through the Utah Population Database. Industrial facilities with air emissions of nine endocrine disrupting compound chemical classes were identified from the Environmental Protection Agency Risk-Screening Environmental Indicators microdata. Chemical levels were linked with residential histories for the 5 years prior to each semen analysis. Main Outcome Measures: Semen analyses were classified as azoospermic or oligozoospermic (< 15 M/mL) using World Health Organization cutoffs for concentration. Bulk semen parameters such as concentration, total count, ejaculate volume, total motility, total motile count, and total progressive motile count were also measured. Multivariable regression models with robust standard errors were used to associate exposure quartiles for each of the nine chemical classes with each semen parameter, adjusting for age, race, and ethnicity, as well as neighborhood socioeconomic disadvantage. Results: After adjustment for demographic covariates, several chemical classes were associated with azoospermia and decreased total motility and volume. For exposure in the 4th relative to 1st quartile, significant associations were observed for acrylonitrile (β total motility = -0.87 pp), aromatic hydrocarbons (odds ratio [OR]azoospermia = 1.53; β volume = -0.14 mL), dioxins (OR azoospermia = 1.31; β volume = -0.09 mL; β total motility = -2.65 pp), heavy metals (β total motility = -2.78pp), organic solvents (OR azoospermia = 1.75; β volume = -0.10 mL), organochlorines (OR azoospermia = 2.09; β volume = -0.12 mL), phthalates (OR azoospermia = 1.44; β volume = -0.09 mL; β total motility = -1.21 pp), and silver particles (OR azoospermia = 1.64; β volume = -0.11 mL). All semen parameters significantly decreased with increasing socioeconomic disadvantage. Men who lived in the most disadvantaged areas had concentration, volume, and total motility of 6.70 M/mL, 0.13 mL, and 1.79 pp lower, respectively. Count, motile count, and total progressive motile count all decreased by 30–34 M.
Objective: To assess mortality in family members of men seeking fertility assessment. Subfertility serves as a biomarker for overall somatic health, and poor semen quality is associated with increased risk of hospitalization and mortality from chronic conditions. However, it is unclear if these risks extend to family members of men with low sperm count. Design: Retrospective cohort study. Subjects: Family members, up to third-degree relatives, of men in the Subfertility, Health and Assisted Reproduction and the Environment cohort who underwent a semen analysis as part of a fertility assessment 1996–2017. Relatives of men with a recorded total sperm count who lived in Utah for ≥1 year 1904–2017 were included in the analysis (N = 22,280 families). Exposure: Individuals were classified by family membership. Families were classified as relatives of azoospermic (0M), oligozoospermic (<39M), or normozoospermic (≥39M) men. The average total sperm count of the proband (male relative) with fertility assessment was also included as a continuous exposure measure. Main Outcome Measures: The main outcomes were all-cause and cause-specific mortality risk by sex, age, and degree of relation: first-, second-, and third-degree. Cox proportional hazard models were used to test the association between fertility classification and mortality, controlling for sex, race/ethnicity, and birth year. Results: A total of 666,437 relatives of men with fertility assessment (N deaths = 183,974) were included in the analysis. Relative to normozoospermia families, all-cause mortality risk increased in oligozoospermia families (hazard ratio [HR] oligozoospermia , 1.03; 95% confidence interval [CI], 1.01–1.05). Close relatives, first- (HR oligozoospermia , 1.17; 95% CI, 1.07–1.28) and second-degree relatives (HR azoospermia , 1.11; 95% CI, 1.04–1.20; HR oligozoospermia , 1.05; 95% CI,1.01–1.09), of azoospermic and oligozoospermic men had the highest all-cause and cause-specific mortality risk, including death attributed to cardiovascular disease or congenital birth conditions. Conclusion: Our results suggest that familial all-cause and cause-specific mortality risk differ by fertility phenotype. Families of azoospermic and oligozoospermic men showed significantly increased risk, particularly for close relatives. This study provides further evidence that shared genetic and/or environmental factors could influence both fertility and somatic health.
This retrospective cohort study aimed to determine whether adjuvant radiation therapy increases the risk of cardiac toxicity in Asian women with breast cancer, with a focus on patient-specific factors.
This study introduces a survey instrument to collect retrospective life-course events, focusing on residential relocation, and it utilizes the survey to evaluate determinants of residential mobility. Here, the survey consists of seven modules collecting information about household structure and household demographics, latest residential relocation, current and previous home, employment, education, vehicle ownership, and travel behavior. The time window of the life-course calendar in the survey is customized according to the latest residential relocation as an anchor point to assist with memory recollection and balance the required input from participants. The survey is used to collect data from a sample of 514 respondents in Sydney, Australia, and another sample of 404 respondents in Chicago, Illinois, in the US. The Cox proportional hazard model is used to analyze residential mobility. The results show primary school commencement is a salient determinant of residential relocation, but its impact is significantly higher in Chicago compared to Sydney.
Abstract Aim To investigate the incidence of major congenital malformations in Japanese women with pregestational diabetes, and to determine the cutoff value of hemoglobin A1c (HbA1c) in the first trimester associated with congenital malformations. Methods This retrospective cohort study included singleton pregnancies in Japanese women with pregestational diabetes, including type 1 and type 2 diabetes, and specific types of diabetes due to other causes. The primary outcome was the incidence of major congenital malformations. The secondary outcome was the incidence of all congenital malformations. The cutoff value of HbA1c for congenital malformations was calculated using receiver operating characteristic curve analysis. The adjusted odds ratios (aOR) of major congenital malformations were calculated using multiple logistic regression analyses. Results This study enrolled 292 patients, including 132 (45.2%) with type 1 diabetes, 156 (53.4%) with type 2 diabetes, and 4 (1.4%) with other specific types. The incidence rates of major congenital malformations and all congenital malformations were 7.2% (21/292) and 12.7% (37/292), respectively. The cutoff value of HbA1c in the first trimester for major malformations and for all congenital malformations was 6.5%. HbA1c ≥ 6.5% was significantly associated with major malformations (aOR 3.5; 95% confidence interval: 1.2–12.6; p = 0.018). Conclusion The incidence of major congenital malformations significantly increased in pregnant Japanese women with HbA1c values of 6.5% or higher. The recommended HbA1c value during the first trimester used in other countries can be applied to pregnant Japanese women.
Background: Bronchiectasis is a chronic lung condition frequently associated with nontuberculous mycobacteria pulmonary (NTM) disease. Persons with these conditions are at increased risk of mortality. Patient reported outcome (PRO) instruments and the 6-minute walk test (6MWT) have been shown to predict mortality for several lung conditions, but these measures have not been fully evaluated for bronchiectasis and NTM. Methods: We conducted a retrospective cohort study among adult patients enrolled in a natural history study of bronchiectasis at the National Heart, Lung, and Blood Institute. Electronic medical records were queried for demographic, clinical, microbiologic, radiographic, and PRO instrument data: St. George’s Respiratory Questionnaire (SGRQ), Medical Research Council Dyspnea Scale, and the Pulmonary Symptom Severity Score (PSSS). The study baseline date was defined as the patient’s first visit after January 1st, 2015 with a SGRQ or 6MWT completed. Follow-up was defined as the interval between the study baseline visit and date of death or December 31st, 2019. Sex-stratified Cox proportional-hazards regression was conducted to identify predictors of mortality. Separate models were run for each PRO and 6MWT measure, controlling for age, body mass index (BMI), fibrocavitary disease status, and M. abscessus infection. Results: In multivariable Cox proportional-hazards regression models, the PSSS-severity (aHR 1.29, 95% CI 1.04–1.59), the 6MWT total distance walked (aHR 0.938, 95% CI 0.896–0.981) and distance saturation product (aHR 0.930, 95% CI 0.887–0.974) independently predicted mortality. In addition, BMI was significantly predictive of mortality in all models. Conclusions: The 6MWT and a PRO instrument capturing symptom severity are independently predictive of mortality in our cohort of bronchiectasis patients.
Objectives: Of the Social Determinants of Health (SDoH), we evaluated socioeconomic and neighborhood-related factors which may affect children with medical complexity (CMC) admitted to a Pediatric Intensive Care Unit (PICU) in Shelby County, Tennessee with severe sepsis and their association with PICU length of stay (LOS). We hypothesized that census tract-level socioeconomic and neighborhood factors were associated with prolonged PICU LOS in CMC admitted with severe sepsis in the underserved community. Methods: This single-center retrospective observational study included CMC living in Shelby County, Tennessee admitted to the ICU with severe sepsis over an 18-month period. Severe sepsis CMC patients were identified using an existing algorithm incorporated into the electronic medical record at a freestanding children's hospital. SDoH information was collected and analyzed using patient records and publicly available census-tract level data, with ICU length of stay as the primary outcome. Results: 83 encounters representing 73 patients were included in the analysis. The median PICU LOS was 9.04 days (IQR 3.99–20.35). The population was 53% male with a median age of 4.1 years (IQR 1.96–12.02). There were 57 Black/African American patients (68.7%) and 85.5% had public insurance. Based on census tract-level data, about half (49.4%) of the CMC severe sepsis population lived in census tracts classified as suffering from high social vulnerability. There were no statistically significant relationships between any socioeconomic and neighborhood level factors and PICU LOS. Conclusion: Pediatric CMC severe sepsis patients admitted to the PICU do not have prolonged lengths of ICU stay related to socioeconomic and neighborhood-level SDoH at our center. A larger sample with the use of individual-level screening would need to be evaluated for associations between social determinants of health and PICU outcomes of these patients.
The U.S. Department of Energy (DOE) has implemented bioremediation strategies for chlorinated volatile organic compounds (cVOCs) for more than three decades across multiple contaminated groundwater sites. A retrospective analysis conducted by the Savannah River National Laboratory (SRNL) and collaborating field sites evaluated the design, performance, and outcomes of bioremediation projects at DOE’s Savannah River, Hanford, Idaho, Mound, and Pinellas sites. This retrospective was based on a series of case studies, leveraging historical documentation and site interviews. Technical approaches employed at the various sites were explored, including active bioremediation, enhanced attenuation (EA), and monitored natural attenuation, with specific sub-sections discussing anaerobic, aerobic, and combined anaerobic-aerobic strategies. Each case study includes detailed descriptions of the site-specific conditions, deployment strategies, regulatory considerations, metrics, and performance. Key findings include general cost savings compared to traditional remedies such as pump and treat (P&T), significant success in applying enhanced attenuation to transition remedies toward a passive site management strategy, and documentation of robust subsurface microbial communities at most sites limiting the need for bioaugmentation. Challenges highlighted in the study include underperformance due to poor amendment delivery in low-permeability zones and unfavorable biogeochemical conditions, emphasizing the importance of site-specific designs. Cost analysis across DOE sites suggests bioremediation may offer long-term economic benefits. The retrospective study underscores valuable lessons that can help inform current and future bioremediation efforts.
In a combined retrospective and prospective study, human salivary glands were investigated after radiation treatment for head and neck cancers. The aim was to assess acinar cell loss and morphologic changes after radiation therapy and to determine whether irradiated salivary glands have regenerative potential.
BACKGROUND:We previously established a 53-gene prognostic signature for overall survival (OS) of gastric cancer patients. This retrospective multi-center study aimed to develop a clinically applicable gene expression detection assay and to investigate the prognostic value of this signature. METHODS:A TCGA gastric adenocarcinoma cohort (TCGA-STAD) was used for comparing 53-gene signature with other gene signatures. A high-throughput mRNA hybridization gene expression assay was developed to quantify the expression of 53-genes in formalin-fixed paraffin-embedded tissues of 540 patients enrolled from three hospitals. 180 patents were randomly selected from two hospitals to build a prognostic prediction model based on the 53-gene signature using leave-p-out (one-third out) cross-validation method together with Cox regression and Kaplan-Meier analysis, and the model was assessed on three validation cohorts. FINDINGS:In the evaluation phase, studies based on TCGA-STAD showed that the 53-gene signature was significantly superior to other three prognostic signatures and was independent of TCGA molecular subtypes and clinical factors. For clinical validation and utility, the prognostic scores were generated using the newly developed assay, which was reliable and sensitive, in 100 sampling training sets and were significantly associated with OS in 100 sampling validation sets. The scores were significantly associated with OS in three independent and combined validation cohorts, and in patients with stages II and III/IV. The multivariate Cox regression demonstrated that the prognostic power of the score was independent of clinical factors, consistent with those findings in the TCGA dataset. Finally, patients with good prognostic scores exhibited significantly a better 5-year OS rate from adjuvant FOLFOX chemotherapy after surgery than from other chemotherapies. INTERPRETATION:The 53-gene prognostic score system is clinically applicable for predicting the OS of patients independent of clinical factors in gastric cancers, which could also be a promising predictive biomarker for FOLFOX regimen. FUNDING:Chinese National Science and Technology, National Natural Science Foundation and Natural Science Foundation of Jiangsu Province.
Since 2000, corn ethanol production in the USA has increased significantly – from 1.6 to 15 billion gallons (6.1 to 57 billion liters) – due to supportive biofuel policies. In this study, we conduct a retrospective analysis of the changes in US corn ethanol greenhouse gas emission intensity, sometimes known as carbon intensity (CI), over the 15 years from 2005 to 2019. Our analysis shows a significant decrease in CI: from 58 to 45 gCO 2 e/MJ of corn ethanol (a 23% reduction). This is due to several factors. Corn grain yield has increased continuously, reaching 168 bushels/acre (10.5 metric tons/ha, a 15% increase) while fertilizer inputs per acre have remained constant, resulting in decreased intensities of fertilizer inputs (e.g., 7% and 18% reduction in nitrogen and potash use per bushel of corn grain harvested, respectively). A 6.5% increase in ethanol yield, from 2.70 to 2.86 gal/bushel corn (0.402 to 0.427 L kg -1 corn), and a 24% reduction in ethanol plant energy use, from 32 000 to 25 000 Btu/gal ethanol (9.0 to 6.9 MJ L -1 ethanol) also helped reduce the CI. The total GHG emission reduction benefits through the reduction in the CI and increased ethanol production volume are estimated at 140 million metric tons (MMT) from 2005 to 2019 in the ethanol industry. Displacement of petroleum gasoline by corn ethanol in the transportation fuel market resulted in a total GHG emission reduction benefit of 544 MMT CO 2 e during the period 2005 to 2019.
Machine learning (ML) applications in hydrological forecasting are increasingly prevalent and show great potential. However, many previous studies have only evaluated performance through reanalysis or retrospective simulations compared to simplified baselines. This study provides the first assessment of ML performance against actual operational forecasting systems operated by the California Nevada River Forecast Center (CNRFC), which combines the Community Hydrologic Prediction System (CHPS) with forecasters-in-the-loop. Results demonstrate that forecasters-in-the-loop systems consistently outperform ML models in both general forecasts and flood alerting across lead times up to 96 hr, even when ML models use observed forcings, while CNRFC operational process relies on biased weather forecasts. Our analysis reveals that forecaster expertise maintains forecast reliability despite inaccurate precipitation inputs, with human-guided systems showing superior performance degradation characteristics at extended lead times. These findings highlight the irreplaceable value of human expertise in operational forecasting and caution against overstating current ML capabilities in real-world applications.
Abstract Wildfire frequency has increased in the Western US over recent decades, driven by climate change and a legacy of forest management practices. Consequently, human structures, health, and life are increasingly at risk due to wildfires. Furthermore, wildfire smoke presents a growing hazard for regional and national air quality. In response, many scientific tools have been developed to study and forecast wildfire behavior, or test interventions that may mitigate risk. In this study, we present a retrospective analysis of 1 month of the 2020 Northern California wildfire season, when many wildfires with varying environments and behavior impacted regional air quality. We simulated this period using a coupled numerical weather prediction model with online atmospheric chemistry, and compare two approaches to representing smoke emissions: an online fire spread model driven by remotely sensed fire arrival times and a biomass burning emissions inventory. First, we quantify the differences in smoke emissions and timing of fire activity, and characterize the subsequent impact on estimates of smoke emissions. Next, we compare the simulated smoke to surface observations and remotely sensed smoke; we find that despite differences in the simulated smoke surface concentrations, the two models achieve similar levels of accuracy. We present a detailed comparison between the performance and relative strengths of both approaches, and discuss potential refinements that could further improve future simulations of wildfire smoke. Finally, we characterize the interactions between smoke and meteorology during this event, and discuss the implications that increases in regional smoke may have on future meteorological conditions.