Relationship Between Occupational Noise and Hypertension in Modern Enterprise Workers: A Case–Control Study

Objective Many epidemiological studies have reported an association between occupational noise exposure and hypertension among workers, but have failed to obtain conclusive results. Thus we aimed to assess whether there is a relationship between hypertension and occupational noise. Methods This study adopted a case–control design to verified the relationship of occupational noise and hypertension. This study included 1527 subjects (case group, 509 individuals; control group, 1018 individuals) from a modern automobile manufacturing company. The information includes the general characteristics, occupational factors, and data collected from physical examination, hematology and serology testing. Two-sample t-tests, The Chi-square test, the Ridit analysis method were used for comparing variables. A non-conditional logistic regression model was used for multivariate analysis based on single factor analysis. Results Toxin exposure was found to be a risk factor for the occurrence of hypertension in workers who were exposed to noise in modern enterprises (OR=3.45).Heart rate was significantly different between the case and control groups (OR=5.98). Occupational noise exposure is a risk factor for hypertension, and the risk of hypertension for people exposed to noise intensity ≥80 dB is 2.23 times (95% CI 1.62–3.06) higher than that for people exposed to noise intensity <80 dB. Conclusions Occupational noise exposure is an independent risk factor for hypertension. it can be used to direct the new criteria of noise exposure limit to protect worker’s health.

Immunosuppression and COVID-19 infection in British Columbia: Protocol for a linkage study of population-based administrative and self-reported survey data

Introduction Cases of the novel coronavirus disease (COVID-19) continue to spread around the world even one year after the declaration of a global pandemic. Those with weakened immune systems, due to immunosuppressive medications or disease, may be at higher risk of COVID-19. This includes individuals with autoimmune diseases, cancer, transplants, and dialysis patients. Assessing the risk and outcomes of COVID-19 in this population has been challenging. While administrative databases provide data with minimal selection and recall bias, clinical and behavioral data is lacking. To address this, we are collecting self-reported survey data from a randomly selected subsample with and without COVID-19, which will be linked to administrative health data, to better quantify the risk of COVID-19 infection associated with immunosuppression. Methods and analysis Using administrative and laboratory data from British Columbia (BC), Canada, we established a population-based case-control study of all individuals who tested positive for SARS-CoV-2. Each case was matched to 40 randomly selected individuals from two control groups: individuals who tested negative for SARS-CoV-2 (i.e., negative controls) and untested individuals from the general population (i.e., untested controls). We will contact 1000 individuals from each group to complete a survey co-designed with patient partners. A conditional logistic regression model will adjust for potential confounders and effect modifiers. We will examine the odds of COVID-19 infection according to immunosuppressive medication or disease type. To adjust for relevant confounders and effect modifiers not available in administrative data, the survey will include questions on behavioural variables that influence probability of being tested, acquiring COVID-19, and experiencing severe outcomes. Ethics and dissemination This study has received approval from the University of British Columbia Clinical Research Ethics Board [H20-01914]. Findings will be disseminated through scientific conferences, open access peer-reviewed journals, COVID-19 research repositories and dissemination channels used by our patient partners.

Evaluation of DNA Methylation at Birth in Monozygotic Twin Pairs Discordant for Acute Lymphoblastic Leukemia

Background: Aberrant patterns of DNA methylation constitute a key feature of pediatric acute lymphoblastic leukemia (ALL) at diagnosis, however its role as a predisposing or early contributor to the development of ALL remains unknown. We employed a discordant monozygotic twin model to identify epigenetic variation associated with future development of pediatric ALL through evaluation of DNA methylation at birth. Methods: Twin pairs discordant for the development of pediatric ALL were identified using linked data from the California Cancer Registry and California Birth Statistical Master File spanning from 1989 to 2015. Archived dried neonatal blood spots were obtained from 86 same-gender twin pairs with available materials from the California Biobank Program. Following isolation of genomic DNA from DBS samples, monozygosity was confirmed in 43 of 86 twin pairs through an identity-by-descent analysis from a genome-wide SNP-array. Epigenome-wide DNA methylation assessment of the 43 discordant monozygotic twin pairs was conducted using the Illumina Infinium MethylationEPIC BeadChip kit (Illumina, San Diego, CA, USA). Data preprocessing and quality control measures were conducted in R, using SeSAMe for data normalization. Two twin pairs were omitted due to failure to pass quality control measures. Within-pair analysis was conducted through identification of array probes with absolute differences in methylation beta values greater than 15% between case and control siblings of a twin pair unit. Differentially methylated probes (DMP) were identified using a conditional logistic regression model accounting for array-specific variation, nucleated cell proportions, and appropriate control for the paired nature of the dataset. Differentially methylated regions (DMR) were defined by regional correlation of p-values from the conditional logistic regression model. Gene set enrichment analysis was conducted on significant probes identified through the within pair and regression analysis. Results: The discordant twin cohort (n = 41 pairs) included 24 female and 17 male pairs. Median gestational age was 258 days, ranging from 184 to 306 days. Age of diagnosis in the case twin ranged from &lt;1 to 23 years (median = 5). There was no significant association between birthweight and case status (paired Wilcoxon signed rank test p = 0.22). No significant differences in nucleated cell proportions were identified in deconvolution analysis. Within-pair analysis identified a total of 18,001 probes with absolute methylation variation greater than 15% across the 41 twin pairs, with 3,984 recurrently variable across more than one pair. Gene ontology analysis of these recurrently variable sites revealed an enrichment of immune-related processes in 7 of the top 15 terms with nominal p-value &lt;0.05, though no terms were significant after correction for multiple comparisons. Conditional logistic regression was conducted on 37 twin pairs, with T-cell cases (n=4) omitted to improve data resolution. This resulted in 240 significant DMPs with p-values below an FDR threshold of 0.05. Of these significant probes, 20 associate with genes previously reported to have altered DNA methylation in ALL at diagnosis. Regional analysis identified 10 significant DMRs with adjusted p-values below 0.05, with the top association encompassing a 454bp region on chromosome 6 located near TRIM39-RPP21 (adjusted p-value 2.39e-05). Notably, conditional regression analysis revealed a significant negative bias in coefficients (409,812 of 710,010 probes, binomial exact test p &lt;2.2e-16), indicating a global tendency toward hypomethylation in cases compared to unaffected siblings (Figure 1). The strength of this bias was greater in probes associated with open sea regions compared to those in island regions, as well as promoter-associated probes. Conclusions: This novel analysis of DNA methylation at birth in ALL-discordant monozygotic twins identified sites of differential methylation associated with immune regulation. In addition, these results provide evidence of an association between global DNA hypomethylation and future development of ALL in one member of a genetically identical twin pair. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Association between Osteoporosis and Low Hemoglobin Levels: A Nested Case–Control Study Using a National Health Screening Cohort

An association between anemia and an increased risk of osteoporosis has been suggested. The goal of this study was to estimate the association of hemoglobin (Hb) level with osteoporosis. A total of 69,760 osteoporosis patients aged ≥ 40 years old from the Korean National Health Insurance Service Health Screening Cohort were enrolled. From an identical cohort database, 69,760 comparison participants were randomly selected. Hb levels before the onset of osteoporosis were evaluated. The association of Hb level with osteoporosis was analyzed using a conditional logistic regression model adjusted for obesity, smoking status, alcohol consumption, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, and the Charlson comorbidity index score. Fifteen percent of the osteoporosis group and 14.17% of the comparison group had anemia. The Hb level was associated with 0.98-fold lower odds for osteoporosis (95% confidence intervals = 0.97–0.99, p < 0.001). A low Hb level was associated with a high risk of osteoporosis in the adult population. There was a consistent association between a low Hb level and osteoporosis in patients with comorbidities.

Association between statin use and the risks of glaucoma in Australia: a 10-year cohort study

SynopsisIn a cohort of middle-aged and elderly Australians, we found that long-term statin use was associated with a higher risk of glaucoma onset. As to subtypes of statins, the increased risk was only found in rosuvastatin users.PurposeTo investigate the relationship between statin use and glaucoma onset in a 10-year longitudinal study.MethodsThis nested case–control study was based on data from a large-scale cohort of Australians aged over 45 years old. Medication exposure was identified by claims records from the Pharmaceutical Benefits Scheme during the follow-up period (2009–2016). The onset of glaucoma was defined as the people with at least three claims of antiglaucoma medications. Controls matched by age, gender and cardiovascular diseases were selected from participants without prescription of antiglaucoma medications. A conditional logistic regression model was used to assess the association between statin use and glaucoma onset.ResultsThe proportion of statin users was higher in the case group (40.5%) than that in the control group (38.4%). After adjusting for baseline characteristics and longitudinal claims records, statin use was not associated with glaucoma onset (OR 1.04, 95% CI 0.97 to 1.11). However, an increased risk of glaucoma onset was observed in participants with a longer duration of statin use (>3 years vs <1 year: OR 1.12, 95% CI 1.04 to 1.21). With respect to specific types of statins, participants taking rosuvastatin were more likely to suffer from glaucoma (OR 1.11, 95%CI 1.01 to 1.22). The use of other statins was not significantly associated with glaucoma onset.ConclusionsLong-term statin use was found to be associated with a higher risk of glaucoma onset in this study. Regarding specific types of statins, the increased risk of glaucoma onset was only observed in users of rosuvastatin.

Frailty predicts failure to discharge patients home from a subacute-care unit: a 3-year Italian experience

Background The primary purpose of Subacute Care Units (SCU) is to decongest acute hospital wards and facilitate the return of older patients to home. Aims We analyzed the clinical characteristics and outcomes of patients admitted to an Italian SCU, and we explored factors associated with discharge to locations other than home (outcome). Methods This retrospective observational cohort study was conducted at a medium-sized suburban hospital, enrolling all patients consecutively admitted to one SCU from October 2017 to February 2020. We collected demographics, cause of admission, comorbidities, cognition, Barthel Index (BI), nutritional status, Clinical Frailty Scale (CFS), length of stay, and discharge destination. Delirium was screened with the 4AT score. We adopted a multivariable conditional logistic regression model to identify the factors associated with the outcome. Results Frail subjects accounted for 58.6% of 406 patients (mean age 78.2 years, SD 11.6), while 61% were classified as functionally dependent. More than half of patients had relevant comorbidity, approximately 80% had a poor nutritional status, and 25% had pre-existing dementia. The overall prevalence of delirium was 14.5%. Most patients came from a hospital setting; recurrent reasons for admission were infections (70.5%) and heart failure (12.7%). Having a urinary bladder catheter at discharge, being overtly frail (CFS > 8), and low BI score were factors independently associated with not being discharged home. Discussion and conclusion The routine assessment of frailty, as expressed by the CFS, may help redirecting the patients eligible for SCU admission.

Malaria Elimination in Unguja Island Zanzibar: Individual Risk Factors for Continued Transmission.

Introduction: To achieve malaria elimination, understanding of the individual risk factors for malaria infection is critical to inform strategic planning and implementation. To address this, a community-based individual risk-factor study was conducted in Unguja Island Zanzibar.Methods: A matched case control study with a sample size of 103 cases and 309 controls was conducted in Unguja Island. Malaria cases from health facilities were reported via Unstructured Supplementary Service Data (USSD) mobile phones to a central database, after which an SMS alert was sent to the District Malaria Surveillance Officer’s (DMSO) mobile phone. DMSO followed up index cases up to household level and performed malaria test on all household members using rapid diagnostic tests (mRDT). Family members tested negative were considered as controls. Both cases and controls were interviewed with the same questionnaire. Data were analyzed using Epi-info version 3.5.1 using conditional logistic regression model. Results: The findings revealed that chance of malaria infection was higher among individuals who travelled outside Zanzibar [AOR = 60.47, 95% CI 15.73 - 232.44], who spend their time in outdoor activities during the night [AOR = 8.53, 95% CI 1.96 - 37.11], whose rooms were not sprayed with indoor residual spray (IRS) [AOR= 29.60, 95% CI 2.68 - 326.49] and those who did not have a bed net [AOR=16.25, 95% CI 3.32 - 79.50].Conclusion: Travel outside Zanzibar, outdoors activities during the night, lack of access to malaria interventions (IRS or bed nets) were the risk factors for malaria infection in Unguja. Ministry of Health should set a mechanism of encouraging people who travel to malaria endemic areas to attend the nearby health facility for malaria screening. Sensitizing people on using protective gear during the night and ensuring good coverage of malaria interventions would reduce the risk of malaria in Unguja Zanzibar.

A Conditional Logistic Regression Model for Analyzing Unemployment Rates in West Java

Unemployment is a critical problem faced by developing countries. It is a complex problem which creates other social and economic problems such as poverty, economic gaps, and crimes. This paper discusses the determinant factors of unemployment rates based on empirical data using the conditional logistic regression model. The model was used to analyze matched pair data using gender, age and residence as matching factors. The result showed that household status, marriage status, as well as levels of education were the determinant factors of a person being unemployed in West Java. It is also shown that the conditional logistic regression outperformed the standard logistic regression for analyzing the cause of unemployment.

Association between Previous Statin Use and Alzheimer’s Disease: A Nested Case-Control Study Using a National Health Screening Cohort

A number of studies report the incidence of Alzheimer’s disease (AD) in patients taking statins, but the results are inconsistent. (1) Background: The present study investigated the cross-sectional association between previous statin use and the risk of AD development in Korean residents. (2) Methods: We used the Korean National Health Insurance Service-National Sample Cohort; 17,172 AD patients were matched by age, gender, income, and region of residence with 68,688 control participants at a ratio of 1:4. We used a multiple conditional logistic regression model to analyse the association between the number of days of statin use and AD occurrence. Further analyses were performed to identify whether this association is maintained for different ages, genders, socioeconomic status groups, and covariates. (3) Results: The odds ratio, which was adjusted for potential confounders, for the days of statin use per year in the AD group compared to the control group was 0.95 (95% confidence interval = 0.92–0.98; p = 0.003). The number of days of statin use in the AD group was significantly smaller in the subgroups of non-smokers and individuals with normal weight, alcohol consumption less than once a week, total cholesterol level below 200 mg/dL, systolic blood pressure below 140, diastolic blood pressure below 90, and fasting blood glucose below 100 mg/dL. (4) Conclusions: Our results suggest that statin use prevents the occurrence of AD. The effects of statin use in preventing AD may be greater in individuals at relatively low risk.

Association between coffee and green tea intake and pneumonia among the Japanese elderly: a case-control study

A large prospective cohort study in the United States examined the association between coffee intake and overall and cause-specific mortality and showed a inverse association between pneumonia and influenza deaths and coffee intake. In Japan, the mortality rate of pneumonia in elderly people is high, and its prevention is an important issue. The present study investigated the association between coffee and green tea intake and pneumonia among the elderly. The design was a hospital-based case control study. The cases were patients over 65 years old newly diagnosed as pneumonia. As a control, patients with the same sex and age (range of 5 years) who visited the same medical institution around the same time (within 2 months after examination of the case) for a disease other than pneumonia were selected. There were two controls per case. Odds ratio (OR) and 95% confidence interval (CI) for pneumonia of coffee and green tea intake during the past month were calculated using a conditional logistic regression model. A total of 199 cases and 374 controls were enrolled. When compared to those who do not drink coffee, the OR for pneumonia of those who drink less than one cup of coffee per day was 0.69 (95% CI 0.39–1.21), OR of those who drink one cup was 0.67 (0.38–1.18), and OR of those who drink two or more cups was 0.50 (0.28–0.88) (Trend p = 0.024). No association was found between pneumonia and green tea consumption. This study suggested a preventive association between coffee intake over 2 cups per day and pneumonia in the elderly.