Prevalence of reported suicidal ideation by quarter of internship and baseline intern suicidal ideation status.

Prevalence rates calculated among interns in the 2012–2015 cohorts (n = 4,336). SI = suicidal ideation.</p

Logistic mixed effects multiple regression models predicting suicidal ideation during internship.

Notes: Models include observations from the 2012–2014 cohorts (n = 2,293). Intern variables were self-reported. BASE = Model includes baseline predictors of suicidal ideation; BASE+PRIOR = Model includes base + prior quarter predictors of suicidal ideation; BASE+PRIOR+CUR = Model includes base+prior+current quarter predictors of suicidal ideation; No SI Cov. = Model includes base+prior+current quarter predictors of suicidal ideation except for baseline and prior quarter suicidal ideation; SI = suicidal ideation. For continuous variables other than “Months since Start of Internship,” the odds ratio represents the change in the odds of suicidal ideation associated with a one standard deviation increase from the mean of the independent variable. Depressive symptom score was assessed via the Patient Health Questionnaire-8. Anxiety symptom score was assessed via the General Anxiety Disorder-7. Neuroticism score was assessed via the NEO-Five Factor Inventory. Early Family Environment score was assessed via the Risky Families Questionnaire.</p

Logistic mixed effects multiple regression analysis predicting current quarter suicidal ideation from intern mental health, demographics, and internship characteristics.

Logistic mixed effects multiple regression analysis predicting current quarter suicidal ideation from intern mental health, demographics, and internship characteristics.</p

Descriptive univariable analysis of suicidal ideation during internship and its association with intern demographics and baseline mental health, 2012–2014 cohorts training set.

Notes: Participants included in the above table were incoming first-year resident physicians (interns) that were assessed through the prospective cohort Intern Health Study. All interns in the table had complete baseline data and data for all tested explanatory variables over one set of consecutive internship quarter-intervals. Intern characteristics were self-reported. SI = suicidal ideation; SD = standard deviation. aNo reported SI during internship. bNumber of unique subjects in the given data set. cp-value for Pearson’s chi-squared test of independence. dAssessed via the NEO-Five Factor Inventory. ep-value for the Satterthwaite two-sample t-test. fAssessed via the Patient Health Questionnaire-8. gAssessed via the General Anxiety Disorder-7. (PDF)</p

Receiver Operating Characteristic curves for prediction models of suicidal ideation during internship.

Notes: Receiver Operating Characteristic curves were calculated for the 2015 cohort test set (n = 2,043) by applying prediction models constructed from the 2012–2014 cohorts training set (n = 2,293). The grey reference diagonal line represents the area under the curve value (AUC) of 0.50 (the expected discriminatory ability of a model that discriminates subjects randomly); SI = suicidal ideation; BASE = Model includes baseline predictors of suicidal ideation; BASE+PRIOR = Model includes base + prior quarter predictors of suicidal ideation; BASE+PRIOR+CUR = Model includes base+prior+current quarter predictors of suicidal ideation; No SI Cov. = Model includes base+prior+current quarter predictors of suicidal ideation except for baseline and prior quarter suicidal ideation.</p

Baseline characteristics of Intern Health Study participants entering residency programs across specialties in the 2012–2014 (<i>n</i> = 2,293) or 2015 (<i>n</i> = 2,043) academic years.

Baseline characteristics of Intern Health Study participants entering residency programs across specialties in the 2012–2014 (n = 2,293) or 2015 (n = 2,043) academic years.</p

Risk of suicidal ideation during internship across all observations by prediction model.

Notes: Risk curves calculated for 2015 cohort test set by applying prediction models of suicidal ideation during internship constructed from 2012–2014 cohorts training set. For each risk curve, observations are ordered from highest risk of SI during internship to lowest risk of SI during internship. The rug plot underneath each risk curve indicates observations with suicidal ideation. SI = suicidal ideation; BASE = Model includes baseline predictors of suicidal ideation; BASE+PRIOR = Model includes base + prior quarter predictors of suicidal ideation; BASE+PRIOR+CUR = Model includes base+prior+current quarter predictors of suicidal ideation; No SI Covariates = Model includes base+prior+current quarter predictors of suicidal ideation except for baseline and prior quarter suicidal ideation. (PDF)</p

Four generalized estimating equation models based on 13 baseline clinical/demographic and 4 structural variables per model.

Pr(>|W|) represents the Wald statistic of the model parameter.</p

Table_1_Prenatal Cadmium Exposure Is Negatively Associated With Adiposity in Girls Not Boys During Adolescence.DOCX

Introduction: Cadmium is a pervasive toxic metal that remains a public health concern and exposure in early life has been associated with growth deficits in infancy and childhood. Growth during adolescence also may be sensitive to effects of cadmium exposure, given the changes in distribution of lean and adipose tissue that vary by sex during puberty. This study examines whether prenatal and concurrent cadmium exposures are associated with adiposity measures at ages 8–15 years in a well-characterized birth cohort.Methods: The sample included 185 participants from the ELEMENT birth cohorts in Mexico City with complete data on urinary cadmium exposures, anthropometry and covariates [child age and sex, household socioeconomic status, and maternal smoking history and body mass index (BMI)]. Maternal third trimester and adolescent urines were analyzed for cadmium using an Inductively Coupled Plasma Mass Spectrometer. Trained personnel obtained anthropometry including height, weight, waist circumference and subscapular, suprailiac, and triceps skinfold thickness. BMI z-scores for age and sex were calculated using the World Health Organization's reference standard. Linear regression models were used to estimate the association of prenatal and concurrent urinary cadmium levels with adolescent anthropometry, adjusting for covariates.Results: Among 87 males and 98 females, median age was 10 years (IQR 9 –11 years). Pregnant women and children had median urinary cadmium concentrations of 0.19 μg/L (IQR 0.12– 0.27 μg/L) and 0.14 μg/L (IQR 0.11– 0.18 μg/L), respectively. Regression models showed inverse relationships between prenatal cadmium exposure and adolescent adiposity. An IQR increase in prenatal cadmium was associated with percent decreases in BMI z-score (−27%, p = 0.01), waist circumference (−3%, p = 0.01), and subscapular (−11%, p = 0.01), suprailiac (−11%, p = 0.02), and triceps (−8%, p Conclusions: Prenatal cadmium exposure was negatively associated with measures of both abdominal and peripheral adiposity in girls, but not in boys. These results emphasize the sex-dependent effects of in utero cadmium exposure on adiposity in adolescence.</p

Time-course of change in eGFR over follow-up.

All eGFR values used in the analysis are plotted and a smoothed curve fitted to the entire cohort to reflect overall time-related change in eGFR. The eGFR is fit to the study times using kernel density estimation (with λ = 0.77). The linear fit slope is -3.36 mL/min/1.73m2/year.</p