Early- Life Determinants of the Age at Menarche.

Menarche, the first menstrual period, is a recognizable marker of puberty. The timing of menarche has important public health ramifications because an early age at menarche is associated with breast and endometrial cancers, obesity, type II diabetes, cardiovascular disease, and all-cause mortality. Secular trends and between-country variability in age at menarche suggest that the onset of puberty is responsive to changing environmental conditions. Nevertheless, the specific environmental factors that influence age at menarche remain largely unidentified. In this dissertation we first examined sociodemographic influences on recent trends in age at menarche using nationally-representative data from Colombia, finding that there was a recent ongoing negative trend in the age at menarche, most pronounced in higher socioeconomic status girls and among those living in urban areas. In the second aim we utilized the nationally representative dataset to examine the role of prenatal factors including season and altitude on menarche. We found that a higher number of gestation days exposed to the rainy season was related to an earlier age at menarche whereas a higher altitude of residence was related to a later age at menarche. We also noted that the association between gestation days exposed to the rainy season and altitude was only apparent among girls living in altitudes ≥2000 m. Finally, in the third aim we examined the relation between childhood red meat intake frequency and age at menarche in a longitudinal study among 456 school-aged girls from Bogotá, Colombia. We found that higher red meat intake frequency at 5-12 y was associated with an earlier age at menarche. We also incidentally discovered that higher frequency of tuna/sardine intake during childhood was related to later ages at menarche. In summation, this dissertation research shows that the age at menarche is responsive to early life environmental correlates including changing socioeconomic conditions, perinatal climate and geographic factors, and diet during childhood. This provides impetus to elucidate the specific mechanisms underlying these associations, which could ultimately lead to interventions aimed at promoting optimal pubertal development.PhDEpidemiological ScienceUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/120685/1/janerica_1.pd

Changes in fruit and vegetable consumption in relation to changes in sleep characteristics over a 3-month period among young adults

OBJECTIVE: To evaluate whether increases in fruit and vegetable (FV) consumption were associated with concomitant changes in insomnia symptoms, sleep duration, and quality. DESIGN: Secondary longitudinal analysis of a randomized trial, baseline to 3 months. SETTING: Integrated health care systems in Detroit, Michigan and Danville, Pennsylvania. PARTICIPANTS: About 1165 young adults who were low consumers of FV (/day) at baseline. INTERVENTION: Online 3-arm program designed to increase FV consumption. MEASUREMENTS: We categorized FV changes into 4 categories: no change or decrease, 1 serving increase, 2 serving increase, and 3 or more serving increase. We then compared the changes in chronic insomnia classification (yes or no), sleep duration, quality, and time to fall asleep (all self-reported) across the FV change categories. Analyses were both overall and stratified by gender, adjusting for potential confounders (depression, physical activity, education, children, and study site). RESULTS: Average age ± SD was 26 ± 2.8 years (71% women). At 3-month follow-up, participants on average increased FV intake by 1.2 ± 1.4 servings. Women who increased FV intake by 3+ servings showed improvements in insomnia symptoms (2-fold higher odds of improvement; 95% CI 1.1 to 3.6), sleep quality (0.2-point higher sleep quality score; 95% CI -0.01, 0.3), and time to fall asleep (4.2 minutes; 95% CI -8, 0) compared to women who did not change or decreased their FV intake. Associations were not as apparent among men. CONCLUSION: Young women with low consumption of FV may experience improvements in insomnia-related sleep difficulties by increasing their consumption of FV

Dietary patterns associated with dental caries in adults in the United States

ObjectivesDental caries experience, which affects 91% of US adults, is a consequence of a carious process influenced by diet. Although individual foods have been implicated, we hypothesized that dietary patterns might be important predictors of caries presence.MethodsWe analysed data from 4467 people ≥18 years old participating in the 2013‐2014 National Health and Nutrition Examination Survey, a nationally representative sample of the US population. Data from 24‐hour dietary recalls were classified into standard food categories and reduced to three dietary patterns using principal components (PCs) analysis. We used regression to model the log‐transformed decayed, missing and filled teeth (DMFT) score and the prevalence of any caries experience by quartiles of PC scores, controlling for potential confounders. Dietary patterns differed by age with respect to dental caries so 18‐30‐year‐olds (n = 1074) and >30‐year‐olds (n = 3393) were analysed separately.ResultsSimilar dietary patterns existed among individuals aged 18‐30 and >30 years, but the prevalence of DMFT score >0 and the median of DMFT was greater in those >30:78.7% (95% CI: 76.1, 81.3) vs 92.6% (95% CI: 91.4, 93.7) and 4 (95% CI: 4, 5) vs 12 DMFT (95% CI: 11, 13), respectively. In those 18‐30, no dietary pattern was associated with greater prevalence or severity of dental caries experience. Among those >30, the prevalence of DMFT>0 was higher by 2% for those in each subsequent quartile of a diet high in sugar‐sweetened beverages and sandwiches (adjusted PR: 1.02, 95% CI: 1.001, 1.03)—thus, the prevalence of dental caries experience was 6% higher among those in the uppermost quartile than in the lowest quartile. For every subsequent quartile in the same pattern, there was a 1.98% higher (95% CI: 0.15, 3.85) DMFT score. However, analysis using the two strongest loading food groups from any of the PCs did not identify any predictors of caries experience.ConclusionsDietary patterns were associated with the prevalence of dental caries experience, with differing findings by age. Although effect sizes were small, the population impact may be substantial. While food groups high in sugar were associated with caries prevalence and severity, associations were more apparent in the context of overall diet. Prospective studies are needed to confirm whether particular dietary patterns are causally related to the development of dental caries.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154279/1/cdoe12509_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154279/2/cdoe12509.pd

Associations of essential worker status, sex, lifestyle behaviors, and moods: Findings from a sample of working adults in the United States during the early stages of the COVID-19 pandemic

COVID-19 profoundly impacted the world by causing disruptions in the global job markets due to business closures to support physical distancing in the earliest stages of the pandemic. To maintain basic societal function in the early stages of the pandemic, workers were classified based on the nature of their employment responsibilities as essential (i.e., continued working outside the home) and non-essential (i.e., required to work from home). Using a cross-sectional design, this study identified the lifestyle behaviors (sleep, diet, physical activity) and mood among US workers. An internet-based survey was used to collect data from US adults from April 13 to May 4, 2020. Survey questions focused on sleep, diet, physical activity, mood, grit, mental workload, and hours worked. Descriptive and inferential statistics were used to describe differences in outcomes of interest across a 4-category variable combining sex and essential worker status (i.e., male essential, male non-essential, female essential, and female non-essential). The sample of 631 US adults (mean age = 35.99±12.17) was primarily female (72%), employed full-time (80.5%), and had at least a bachelor’s degree (85.8%). Statistically significant differences were observed between groups based on sleep, diet, physical activity, and mood. While sex-based differences were identified between lifestyle factors and moods, both male and female essential workers slept better, were more physically active, and reported better moods than their non-essential counterparts. Findings suggest that sex and work status may have impacted physical and mental health during the earliest stages of COVID-19. The associated long-term consequences of work responsibilities during the earliest stages of the pandemic remain unknown and require further study

Sleep and Diet in Urban Pregnant African American Women

ABSTRACT Objective: Sleep disturbances during pregnancy are associated with gestational diabetes and excessive weight gain. Diet could potentially play a role in these relationships, yet examinations of sleep and diet in African American pregnant populations are scarce. Methods: The study population includes pregnant African American women from Detroit, MI (n=53). At the baseline study visit during late pregnancy, women were surveyed about typical bed and wake times, as well as usual food intake via a dietary screener. Sleep measures examined included time in bed and sleep midpoint (median of going to bed and wake time). Composite dietary measures included estimated fruit and vegetable (FV), dairy, and added sugar intake. Linear regression models were used to evaluate associations between sleep and dietary measures, adjusting for potential confounders. Results: On average, women with shorter time in bed (\u3c8 hours compared to ≥8 hours) had one cup/day higher intake of fruits and vegetables (95% CI 0.10 to 1.83), driven by the individual items tomato sauce, salsa, and fruit juice. Delayed sleep timing (a midpoint\u3e2:45 AM compared to midpoint≤2:45 AM) was associated with 0.78 cup/day lower fruit and vegetable intake (95% CI -1.67 to 0.12), mostly driven by whole fruit and vegetables (e.g. string beans, peas, corn rather than salad or cooked dried beans). Later midpoint was also associated with lower dairy intake (0.41 fewer servings/day; 95% CI -0.78 to -0.04), particularly milk. Shorter time in bed was associated with higher pastry intake, and delayed sleep timing was associated with lower pastry intake. Conclusions: Sleep characteristics were uniquely associated with diet in pregnant women

Blood levels of lead and dental caries in permanent teeth

ObjectivesThe purpose of this study was to determine whether there is an association between lead exposure within the ages of 1- 4- years and dental caries in the permanent dentition between ages 9- 17 among Mexican youth.MethodsData were collected for the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) cohort from a group of 490 children born and reared in Mexico City. Among ages 1- 4- years, blood lead levels were measured in micrograms of lead per deciliter of blood (μg/dL) and the presence of caries in adolescence was determined using the International Caries and Detection and Assessment System (ICDAS). The relationship between blood levels of lead and decayed, missing, or filled surfaces (DMFS) was examined using negative binomial regression. Covariates were selected based on previous studies and included age, gender, socioeconomic status, oral hygiene, body mass index, and diet. The nonlinear relationship between lead and DMFS was examined using smoothing splines.ResultsThe mean overall blood lead level (BLL) was 4.83- μg/dL (S.D. of 2.2). The mean overall caries level (DMFS) was 4.1. No statistically significant association was found between early childhood blood lead levels and dental caries in adolescence.ConclusionThis study shows a lack of association between exposure to lead between the ages of 1- 4- years of age and dental caries in permanent dentition later in life. Other covariates, such as age and sugar consumption, appeared to play a more prominent role in caries development.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163870/1/jphd12384.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163870/2/jphd12384_am.pd

Features Constituting Actionable COVID-19 Dashboards:Descriptive Assessment and Expert Appraisal of 158 Public Web-Based COVID-19 Dashboards

Background: Since the outbreak of COVID-19, the development of dashboards as dynamic, visual tools for communicating COVID-19 data has surged worldwide. Dashboards can inform decision-making and support behavior change. To do so, they must be actionable. The features that constitute an actionable dashboard in the context of the COVID-19 pandemic have not been rigorously assessed. Objective: The aim of this study is to explore the characteristics of public web-based COVID-19 dashboards by assessing their purpose and users (“why”), content and data (“what”), and analyses and displays (“how” they communicate COVID-19 data), and ultimately to appraise the common features of highly actionable dashboards. Methods: We conducted a descriptive assessment and scoring using nominal group technique with an international panel of experts (n=17) on a global sample of COVID-19 dashboards in July 2020. The sequence of steps included multimethod sampling of dashboards; development and piloting of an assessment tool; data extraction and an initial round of actionability scoring; a workshop based on a preliminary analysis of the results; and reconsideration of actionability scores followed by joint determination of common features of highly actionable dashboards. We used descriptive statistics and thematic analysis to explore the findings by research question. Results: A total of 158 dashboards from 53 countries were assessed. Dashboards were predominately developed by government authorities (100/158, 63.0%) and were national (93/158, 58.9%) in scope. We found that only 20 of the 158 dashboards (12.7%) stated both their primary purpose and intended audience. Nearly all dashboards reported epidemiological indicators (155/158, 98.1%), followed by health system management indicators (85/158, 53.8%), whereas indicators on social and economic impact and behavioral insights were the least reported (7/158, 4.4% and 2/158, 1.3%, respectively). Approximately a quarter of the dashboards (39/158, 24.7%) did not report their data sources. The dashboards predominately reported time trends and disaggregated data by two geographic levels and by age and sex. The dashboards used an average of 2.2 types of displays (SD 0.86); these were mostly graphs and maps, followed by tables. To support data interpretation, color-coding was common (93/158, 89.4%), although only one-fifth of the dashboards (31/158, 19.6%) included text explaining the quality and meaning of the data. In total, 20/158 dashboards (12.7%) were appraised as highly actionable, and seven common features were identified between them. Actionable COVID-19 dashboards (1) know their audience and information needs; (2) manage the type, volume, and flow of displayed information; (3) report data sources and methods clearly; (4) link time trends to policy decisions; (5) provide data that are “close to home”; (6) break down the population into relevant subgroups; and (7) use storytelling and visual cues. Conclusions: COVID-19 dashboards are diverse in the why, what, and how by which they communicate insights on the pandemic and support data-driven decision-making. To leverage their full potential, dashboard developers should consider adopting the seven actionability features identified

Blogs de Ciência da Unicamp: divulgação científica por docentes e pesquisadores

RESUMO: Existe uma demanda crescente no Brasil por informações sobre ciência, e, dadas as características potencializadoras da Web 2.0 para o aprendizado, são necessárias ações de engajamento e capacitação de pesquisadores para o uso dos blogs, aproximando assim a ciência do público emgeral, alinhando divulgação científica, comunicação e as tecnologias, para que, através de um processo de educação informal, seja desenvolvida uma cultura científica para além do espaço da academia. Este artigo apresenta resultados preliminares, coletados durante a implantação de uma proposta de desenvolvimento de plataforma tecnológica, com o objetivo de estimular o uso de blogs de divulgação científica por docentes e pesquisadores. Ele apresenta também detalhes de implantação do modelo, discussão teórica que fundamenta a proposta, descrição das etapas e as perspectivas de futuro. Aimplantação se deu em uma instituição de ensino superior do Brasil, já que, neste país, são estas que produzem pesquisa, ensino e extensão, e geram conhecimento de ponta e inovação. Nos Estados Unidos, já é comum a utilização de blogs como ferramenta de divulgação de ciência por pesquisadores, mas aqui essa atividade ainda é incipiente. É apresentada uma breve discussão sobre aimplantação desse projeto, sobre como a plataforma tecnológica escolhida (blogs) poderia auxiliar nos esforços de divulgação científica, e também as etapas de implementação dessa ferramenta dentro de uma comunidade de docentes e pesquisadores, com os respectivos dados coletados e as análisesrealizadas até o momento

Primrose syndrome: Characterization of the phenotype in 42 patients

Primrose syndrome (PS; MIM# 259050) is characterized by intellectual disability (ID), macrocephaly, unusual facial features (frontal bossing, deeply set eyes, down-slanting palpebral fissures), calcified external ears, sparse body hair and distal muscle wasting. The syndrome is caused by de novo heterozygous missense variants in ZBTB20. Most of the 29 published patients are adults as characteristics appear more recognizable with age. We present 13 hitherto unpublished individuals and summarize the clinical and molecular findings in all 42 patients. Several signs and symptoms of PS develop during childhood, but the cardinal features, such as calcification of the external ears, cystic bone lesions, muscle wasting, and contractures typically develop between 10 and 16 years of age. Biochemically, anemia and increased alpha-fetoprotein levels are often present. Two adult males with PS developed a testicular tumor. Although PS should be regarded as a progressive entity, there are no indications that cognition becomes more impaired with age. No obvious genotype-phenotype correlation is present. A subgroup of patients with ZBTB20 variants may be associated with mild, nonspecific ID. Metabolic investigations suggest a disturbed mitochondrial fatty acid oxidation. We suggest a regular surveillance in all adult males with PS until it is clear whether or not there is a truly elevated risk of testicular cancer.This article is freely available via Open Access. Click on the Publisher URL to access it via the publisher's site.published version, accepted version (12 month embargo) submitted versio