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Risk of Mortality in Family Members of Men Seeking Fertility Assessment

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.

Male fertility

Predictive analytics to direct clinical attention to complex patients with elevated suicide risk: enhancement of the Veterans Health Administration REACH VET model

Suicide is a major public health concern, particularly among Veterans. The U.S. Department of Veterans Affairs Veterans Health Administration (VHA) employs the Recovery Engagement and Coordination for Health–Veterans Enhanced Treatment (REACH VET) model to prioritise high-risk patients for targeted clinical attention. REACH VET 1.0 (RV 1.0) was developed on 2008–2011 data. To reflect changes in clinical practice and populations, VHA updated it to REACH VET 2.0 (RV 2.0). This study describes its development and validation. RV 2.0 used longitudinal data from 7,248,170 VHA patients (4,967 suicide deaths) in 2018–2019, with 650 time-varying demographic, clinical and area-level predictors derived from a 2-year lookback (2016–2019). An ensemble of Elastic-Net logistic regression models was trained on 2018 data and evaluated monthly at the population level in 2019, focusing on the top 0.1% intervention risk tier. Analyses assessed model discrimination, suicide detection, risk concentration, subgroup consistency (sex, age and race/ethnicity) and performance relative to RV 1.0 using the same percentile-based risk strata. RV 2.0 outperformed RV 1.0 across all risk strata, with better discrimination (C-statistic 0.76 vs 0.69) and consistent performance across demographic subgroups. Within the top 0.1% of predicted risk, RV 2.0 identified more deaths, higher suicide rates and greater mortality risk concentration both when averaged across the 12 monthly 2019 test sets (5.6 vs 3.6; 83.6 vs 53.7 per 100,000 person-years; 21.0 vs 14.1) and when annualised for 2019 (67 vs 43; 2.7% vs 1.7%; 1,003 vs 644 per 100,000 person-years; 26.7 vs 17.1). RV 2.0 improves suicide risk stratification among Veterans, demonstrating better performance and consistent prediction across subgroups and highlighting the need for regular model updates and evaluation.

Peluso, Alina [Oak Ridge National Laboratory (ORNL

2009 Interstate 95 Express Phase 1A Survey

# 2009 Interstate 95 Express Phase 1A Survey The 2009 Phase 1A Survey focused on commuters using Interstate 95 express lanes between downtown Miami and the Golden Glades Interchange in Florida. Survey participants answered questions about their trip's purpose, frequency, and mode as well as demographics such as their age, race/ethnicity, and income. It also asked if and why or why not they had used Interstate 95 before and/or after the installation of two high-occupancy toll lanes, if they were satisfied with the upgrade, and about their related perceptions of safety. ## Data Collection Agency The survey was conducted by and for the Florida Department of Transportation. ## Survey Methodology The survey was conducted online in May 2009. ## Survey Records, Data, and Documentation Survey records include 9,156 participants.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI

2009 Interstate 95 Express Phase 1A Survey

# 2009 Interstate 95 Express Phase 1A Survey The 2009 Phase 1A Survey focused on commuters using Interstate 95 express lanes between downtown Miami and the Golden Glades Interchange in Florida. Survey participants answered questions about their trip's purpose, frequency, and mode as well as demographics such as their age, race/ethnicity, and income. It also asked if and why or why not they had used Interstate 95 before and/or after the installation of two high-occupancy toll lanes, if they were satisfied with the upgrade, and about their related perceptions of safety. ## Data Collection Agency The survey was conducted by and for the Florida Department of Transportation. ## Survey Methodology The survey was conducted online in May 2009. ## Survey Records, Data, and Documentation Survey records include 9,156 participants.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI

2009 Interstate 95 Express Phase 1A Survey

# 2009 Interstate 95 Express Phase 1A Survey The 2009 Phase 1A Survey focused on commuters using Interstate 95 express lanes between downtown Miami and the Golden Glades Interchange in Florida. Survey participants answered questions about their trip's purpose, frequency, and mode as well as demographics such as their age, race/ethnicity, and income. It also asked if and why or why not they had used Interstate 95 before and/or after the installation of two high-occupancy toll lanes, if they were satisfied with the upgrade, and about their related perceptions of safety. ## Data Collection Agency The survey was conducted by and for the Florida Department of Transportation. ## Survey Methodology The survey was conducted online in May 2009. ## Survey Records, Data, and Documentation Survey records include 9,156 participants.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI

2009 Interstate 95 Express Phase 1A Survey

# 2009 Interstate 95 Express Phase 1A Survey The 2009 Phase 1A Survey focused on commuters using Interstate 95 express lanes between downtown Miami and the Golden Glades Interchange in Florida. Survey participants answered questions about their trip's purpose, frequency, and mode as well as demographics such as their age, race/ethnicity, and income. It also asked if and why or why not they had used Interstate 95 before and/or after the installation of two high-occupancy toll lanes, if they were satisfied with the upgrade, and about their related perceptions of safety. ## Data Collection Agency The survey was conducted by and for the Florida Department of Transportation. ## Survey Methodology The survey was conducted online in May 2009. ## Survey Records, Data, and Documentation Survey records include 9,156 participants.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI

2009 Interstate 95 Express Phase 1A Survey

# 2009 Interstate 95 Express Phase 1A Survey The 2009 Phase 1A Survey focused on commuters using Interstate 95 express lanes between downtown Miami and the Golden Glades Interchange in Florida. Survey participants answered questions about their trip's purpose, frequency, and mode as well as demographics such as their age, race/ethnicity, and income. It also asked if and why or why not they had used Interstate 95 before and/or after the installation of two high-occupancy toll lanes, if they were satisfied with the upgrade, and about their related perceptions of safety. ## Data Collection Agency The survey was conducted by and for the Florida Department of Transportation. ## Survey Methodology The survey was conducted online in May 2009. ## Survey Records, Data, and Documentation Survey records include 9,156 participants.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI

2009 Interstate 95 Express Phase 1A Survey

# 2009 Interstate 95 Express Phase 1A Survey The 2009 Phase 1A Survey focused on commuters using Interstate 95 express lanes between downtown Miami and the Golden Glades Interchange in Florida. Survey participants answered questions about their trip's purpose, frequency, and mode as well as demographics such as their age, race/ethnicity, and income. It also asked if and why or why not they had used Interstate 95 before and/or after the installation of two high-occupancy toll lanes, if they were satisfied with the upgrade, and about their related perceptions of safety. ## Data Collection Agency The survey was conducted by and for the Florida Department of Transportation. ## Survey Methodology The survey was conducted online in May 2009. ## Survey Records, Data, and Documentation Survey records include 9,156 participants.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI

2009 Interstate 95 Express Phase 1A Survey

# 2009 Interstate 95 Express Phase 1A Survey The 2009 Phase 1A Survey focused on commuters using Interstate 95 express lanes between downtown Miami and the Golden Glades Interchange in Florida. Survey participants answered questions about their trip's purpose, frequency, and mode as well as demographics such as their age, race/ethnicity, and income. It also asked if and why or why not they had used Interstate 95 before and/or after the installation of two high-occupancy toll lanes, if they were satisfied with the upgrade, and about their related perceptions of safety. ## Data Collection Agency The survey was conducted by and for the Florida Department of Transportation. ## Survey Methodology The survey was conducted online in May 2009. ## Survey Records, Data, and Documentation Survey records include 9,156 participants.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI

2009 Interstate 95 Express Phase 1A Survey

# 2009 Interstate 95 Express Phase 1A Survey The 2009 Phase 1A Survey focused on commuters using Interstate 95 express lanes between downtown Miami and the Golden Glades Interchange in Florida. Survey participants answered questions about their trip's purpose, frequency, and mode as well as demographics such as their age, race/ethnicity, and income. It also asked if and why or why not they had used Interstate 95 before and/or after the installation of two high-occupancy toll lanes, if they were satisfied with the upgrade, and about their related perceptions of safety. ## Data Collection Agency The survey was conducted by and for the Florida Department of Transportation. ## Survey Methodology The survey was conducted online in May 2009. ## Survey Records, Data, and Documentation Survey records include 9,156 participants.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI

2009 Interstate 95 Express Phase 1A Survey

# 2009 Interstate 95 Express Phase 1A Survey The 2009 Phase 1A Survey focused on commuters using Interstate 95 express lanes between downtown Miami and the Golden Glades Interchange in Florida. Survey participants answered questions about their trip's purpose, frequency, and mode as well as demographics such as their age, race/ethnicity, and income. It also asked if and why or why not they had used Interstate 95 before and/or after the installation of two high-occupancy toll lanes, if they were satisfied with the upgrade, and about their related perceptions of safety. ## Data Collection Agency The survey was conducted by and for the Florida Department of Transportation. ## Survey Methodology The survey was conducted online in May 2009. ## Survey Records, Data, and Documentation Survey records include 9,156 participants.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI

2009 Interstate 95 Express Phase 1A Survey

# 2009 Interstate 95 Express Phase 1A Survey The 2009 Phase 1A Survey focused on commuters using Interstate 95 express lanes between downtown Miami and the Golden Glades Interchange in Florida. Survey participants answered questions about their trip's purpose, frequency, and mode as well as demographics such as their age, race/ethnicity, and income. It also asked if and why or why not they had used Interstate 95 before and/or after the installation of two high-occupancy toll lanes, if they were satisfied with the upgrade, and about their related perceptions of safety. ## Data Collection Agency The survey was conducted by and for the Florida Department of Transportation. ## Survey Methodology The survey was conducted online in May 2009. ## Survey Records, Data, and Documentation Survey records include 9,156 participants.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI

2009 Interstate 95 Express Phase 1A Survey

# 2009 Interstate 95 Express Phase 1A Survey The 2009 Phase 1A Survey focused on commuters using Interstate 95 express lanes between downtown Miami and the Golden Glades Interchange in Florida. Survey participants answered questions about their trip's purpose, frequency, and mode as well as demographics such as their age, race/ethnicity, and income. It also asked if and why or why not they had used Interstate 95 before and/or after the installation of two high-occupancy toll lanes, if they were satisfied with the upgrade, and about their related perceptions of safety. ## Data Collection Agency The survey was conducted by and for the Florida Department of Transportation. ## Survey Methodology The survey was conducted online in May 2009. ## Survey Records, Data, and Documentation Survey records include 9,156 participants.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI