196 research outputs found
Colorectal cancer screening and subsequent incidence of colorectal cancer: Results from the 45 and Up Study
Objective: To investigate the association of colorectal cancer (CRC) screening history and subsequent incidence of CRC in New South Wales, Australia. Design, setting and participants: A total of 196 464 people from NSW recruited to the 45 and Up Study,
Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence
This study finds that up to two-thirds of deaths in current smokers in Australia can be attributed to smoking.
Abstract
Background
The smoking epidemic in Australia is characterised by historic levels of prolonged smoking, heavy smoking, very high levels of long-term cessation, and low current smoking prevalence, with 13% of adults reporting that they smoked daily in 2013. Large-scale quantitative evidence on the relationship of tobacco smoking to mortality in Australia is not available despite the potential to provide independent international evidence about the contemporary risks of smoking.
Methods
This is a prospective study of 204,953 individuals aged ≥45 years sampled from the general population of New South Wales, Australia, who joined the 45 and Up Study from 2006–2009, with linked questionnaire, hospitalisation, and mortality data to mid-2012 and with no history of cancer (other than melanoma and non-melanoma skin cancer), heart disease, stroke, or thrombosis. Hazard ratios (described here as relative risks, RRs) for all-cause mortality among current and past smokers compared to never-smokers were estimated, adjusting for age, education, income, region of residence, alcohol, and body mass index.
Results
Overall, 5,593 deaths accrued during follow-up (874,120 person-years; mean: 4.26 years); 7.7% of participants were current smokers and 34.1% past smokers at baseline. Compared to never-smokers, the adjusted RR (95% CI) of mortality was 2.96 (2.69–3.25) in current smokers and was similar in men (2.82 (2.49–3.19)) and women (3.08 (2.63–3.60)) and according to birth cohort. Mortality RRs increased with increasing smoking intensity, with around two- and four-fold increases in mortality in current smokers of ≤14 (mean 10/day) and ≥25 cigarettes/day, respectively, compared to never-smokers. Among past smokers, mortality diminished gradually with increasing time since cessation and did not differ significantly from never-smokers in those quitting prior to age 45. Current smokers are estimated to die an average of 10 years earlier than non-smokers.
Conclusions
In Australia, up to two-thirds of deaths in current smokers can be attributed to smoking. Cessation reduces mortality compared with continuing to smoke, with cessation earlier in life resulting in greater reductions
Risk factors for erectile dysfunction in a cohort of 108 477 Australian men
Objectives: To quantify relationships between erectile dysfunction (ED), ageing and health and lifestyle factors for men aged 45 years and older. Design: Cross-sectional, population-based study seeking data on health, sociodemographic and lifestyle facto
Identifying incident colorectal and lung cancer cases in health service utilisation databases in Australia: a validation study
Data from centralised, population-based statutory cancer registries are generally considered the 'gold standard' for confirming incident cases of cancer. When these are not available, or more current information is needed, hospital or other routinely collected population-level data may be feasible alternative sources. We aimed to determine the validity of various methods using routinely collected administrative health data for ascertaining incident cases of colorectal or lung cancer in participants from the 45 and Up Study in New South Wales (NSW), Australia.
METHODS:
For 266,844 participants in the 45 and Up Study (recruited 2006-2009) ascertainment of incident colorectal or lung cancers was assessed using diagnosis and treatment records in linked administrative health datasets (hospital, emergency department, Medicare and pharmaceutical claims, death records). This was compared with ascertainment via the NSW Cancer Registry (NSWCR, the 'gold standard') for a period for which both data sources were available for participants.
RESULTS:
A total of 2253 colorectal and 1019 lung cancers were recorded for study participants in the NSWCR over the period 2006-2010. A diagnosis of primary cancer recorded in the statewide Admitted Patient Data Collection identified the majority of NSWCR colorectal and lung cancers, with sensitivities and positive predictive values (PPV) of 95% and 91% for colorectal cancer and 81% and 85% for lung cancer, respectively. Using additional information on lung cancer deaths from death records increased sensitivity to 84% (PPV 83%) for lung cancer, but did not improve ascertainment of colorectal cancers. Hospital procedure codes for colorectal cancer surgery identified cases with sensitivity 81% and PPV 54%. No other individual indicator had sensitivity >50% or PPV >65% for either cancer type and no combination of indicators increased both the sensitivity and PPV above that achieved using the hospital cancer diagnosis data. All specificities were close to 100%; 95% confidence intervals for sensitivity and PPV were generally +/-2%.
CONCLUSIONS:
In NSW, identifying new cases of colorectal and lung cancer from administrative health datasets, such as hospital records, is a feasible alternative when cancer registry data are not available. However, the strengths and limitations of the different data sources should be borne in mind
Tobacco smoking changes during the first pre-vaccination phases of the COVID-19 pandemic: A systematic review and meta-analysis
Background:
Globally, tobacco smoking remains the largest preventable cause of premature death. The COVID-19 pandemic has forced nations to take unprecedented measures, including ‘lockdowns’ that might impact tobacco smoking behaviour. We performed a systematic review and meta-analyses to assess smoking behaviour changes during the early pre-vaccination phases of the COVID-19 pandemic in 2020.
Methods:
We searched Medline/Embase/PsycINFO/BioRxiv/MedRxiv/SSRN databases (January–November 2020) for published and pre-print articles that reported specific smoking behaviour changes or intentions after the onset of the COVID-19 pandemic. We used random-effects models to pool prevalence ratios comparing the prevalence of smoking during and before the pandemic, and the prevalence of smoking behaviour changes during the pandemic. The PROSPERO registration number for this systematic review was CRD42020206383.
Findings:
31 studies were included in meta-analyses, with smoking data for 269,164 participants across 24 countries. The proportion of people smoking during the pandemic was lower than that before, with a pooled prevalence ratio of 0·87 (95%CI:0·79–0·97). Among people who smoke, 21% (95%CI:14–30%) smoked less, 27% (95%CI:22–32%) smoked more, 50% (95%CI:41%-58%) had unchanged smoking and 4% (95%CI:1–9%) reported quitting smoking. Among people who did not smoke, 2% (95%CI:1–3%) started smoking during the pandemic. Heterogeneity was high in all meta-analyses and so the pooled estimates should be interpreted with caution (I2\u3e91% and p-heterogeneity\u3c0·001). Almost all studies were at high risk of bias due to use of non-representative samples, non-response bias, and utilisation of non-validated questions.
Interpretation:
Smoking behaviour changes during the first phases of the COVID-19 pandemic in 2020 were highly mixed. Meta-analyses indicated that there was a relative reduction in overall smoking prevalence during the pandemic, while similar proportions of people who smoke smoked more or smoked less, although heterogeneity was high. Implementation of evidence-based tobacco control policies and programs, including tobacco cessation services, have an important role in ensuring that the COVID-19 pandemic does not exacerbate the smoking pandemic and associated adverse health outcomes
In-Depth Characterisation of Retinal Pigment Epithelium (RPE) Cells Derived from Human Induced Pluripotent Stem Cells (hiPSC)
Induced pluripotent stem cell (iPSC)-derived retinal pigment epithelium (RPE) has widely been appreciated as a promising tool to model human ocular disease emanating from primary RPE pathology. Here, we describe the successful reprogramming of adult human dermal fibroblasts to iPSCs and their differentiation to pure expandable RPE cells with structural and functional features characteristic for native RPE. Fibroblast cultures were established from skin biopsy material and subsequently reprogrammed following polycistronic lentiviral transduction with OCT4, SOX2, KLF4 and L-Myc. Fibroblast-derived iPSCs showed typical morphology, chromosomal integrity and a distinctive stem cell marker profile. Subsequent differentiation resulted in expandable pigmented hexagonal RPE cells. The cells revealed stable RNA expression of mature RPE markers RPE65, RLBP and BEST1. Immunolabelling verified localisation of BEST1 at the basolateral plasma membrane, and scanning electron microscopy showed typical microvilli at the apical side of iPSC-derived RPE cells. Transepithelial resistance was maintained at high levels during cell culture indicating functional formation of tight junctions. Secretion capacity was demonstrated for VEGF-A. Feeding of porcine photoreceptor outer segments revealed the proper ability of these cells for phagocytosis. IPSC-derived RPE cells largely maintained these properties after cryopreservation. Together, our study underlines that adult dermal fibroblasts can serve as a valuable resource for iPSC-derived RPE with characteristics highly reminiscent of true RPE cells. This will allow its broad application to establish cellular models for RPE-related human diseases
The Northern HIPASS catalogue - Data presentation, completeness and reliability measures
The Northern HIPASS catalogue (NHICAT) is the northern extension of the
HIPASS catalogue, HICAT (Meyer et al. 2004). This extension adds the sky area
between the declination range of +2 deg < dec. < +25.5 deg to HICAT's
declination range of -90 deg < dec. < +2 deg. HIPASS is a blind HI survey using
the Parkes Radio Telescope covering 71% of the sky (including this northern
extension) and a heliocentric velocity range of -1,280 km/s to 12,700 km/s .
The entire Virgo Cluster region has been observed in the Northern HIPASS. The
galaxy catalogue, NHICAT, contains 1002 sources with v_hel > 300 km/s . Sources
with -300 km/s < v_hel < 300 km/s were excluded to avoid contamination by
Galactic emission. In total, the entire HIPASS survey has found 5317 galaxies
identified purely by their HI content. The full galaxy catalogue is
publicly-available at .Comment: 12 pages, accepted for publication by MNRA
Examination of Late Palaeolithic archaeological sites in northern Europe for the preservation of cryptotephra layers
We report the first major study of cryptotephra (non-visible volcanic ash layers) on Late Palaeolithic archaeological sites in northern Europe. Examination of 34 sites dating from the Last Termination reveals seven with identifiable cryptotephra layers. Preservation is observed in minerogenic and organic deposits, although tephra is more common in organic sediments. Cryptotephra layers normally occur stratigraphically above or below the archaeology. Nearby off-site palaeoclimate archives (peat bogs and lakes <0.3 km distant) were better locations for detecting tephra. However in most cases the archaeology can only be correlated indirectly with such cryptotephras. Patterns affecting the presence/absence of cryptotephra include geographic position of sites relative to the emitting volcanic centre; the influence of past atmospherics on the quantity, direction and patterns of cryptotephra transport; the nature and timing of local site sedimentation; sampling considerations and subsequent taphonomic processes. Overall, while tephrostratigraphy has the potential to improve significantly the chronology of such sites many limiting factors currently impacts the successful application
Risk factors for acute respiratory tract infections in general practitioner patients in The Netherlands: a case-control study
<p>Abstract</p> <p>Background</p> <p>Acute respiratory tract infections (ARTI) are an important public health problem. Improved identification of risk factors might enable targeted intervention. Therefore we carried out a case-control study with the aim of identifying environmental risk factors for ARTI consultations in the Dutch general population.</p> <p>Methods</p> <p>A subset of patients visiting their GP in the period of 2000–2003 with an ARTI (cases) and age-matched controls (visiting for other complaints) were included in a case-control study. They were asked to complete a questionnaire about potential risk factors. Conditional logistic regression was used to calculate odds ratio's (OR) and 95% confidence intervals (CI) to estimate the independent effect of potential risk factors.</p> <p>Results</p> <p>A total of 493 matched pairs of case and control subjects were enrolled. Exposure to persons with respiratory complaints, both inside and outside the household, was found to be an independent risk factor for visiting a GP with an ARTI (respectively OR<sub>adj </sub>= 1.9 and OR<sub>adj </sub>= 3.7). Participants exposed to dampness or mould at home (OR<sub>adj</sub>=0.5) were significantly less likely to visit their GP. In accordance with the general risk of consultations for ARTI, participants with a laboratory-confirmed ARTI who were exposed to persons with respiratory complaints outside the household were also significantly more likely to visit their GP (OR<sub>adj</sub>=2.5).</p> <p>Conclusion</p> <p>This study confirmed that heterogeneity in the general population as well as in pathogens causing ARTI makes it complicated to detect associations between potential risk factors and respiratory infections. Whereas it may be difficult to intervene on the risk posed by exposure to persons with respiratory complaints, transmission of ARTI in the general population might be reduced by improved hygienic conditions.</p
Cancer screening among migrants in an Australian cohort; cross-sectional analyses from the 45 and Up Study
<p>Abstract</p> <p>Background</p> <p>Limited evidence suggests that people from non-English speaking backgrounds in Australia have lower than average rates of participation in cancer screening programs. The objective of this study was to examine the distribution of bowel, breast and prostate cancer test use by place of birth and years since migration in a large population-based cohort study in Australia.</p> <p>Methods</p> <p>In 2006, screening status, country of birth and other demographic and health related factors were ascertained by self-completed questionnaire among 31,401 (16,126 women and 15,275 men) participants aged 50 or over from the 45 and Up Study in New South Wales.</p> <p>Results</p> <p>35% of women and 39% of men reported having a bowel cancer test and 57% of men reported having a prostate specific antigen (PSA) test, in the previous 5 years. 72% of women reported having screening mammography in the previous 2 years. Compared to Australian-born women, women from East Asia, Southeast Asia, Continental Western Europe, and North Africa/Middle East had significantly lower rates of bowel testing, with odds ratios (OR; 95%CI) ranging from 0.5 (0.4–0.7) to 0.7 (0.6–0.9); migrants from East Asia (0.5, 0.3–0.7) and North Africa/Middle East (0.5, 0.3–0.9) had significantly lower rates of mammography. Compared to Australian-born men, bowel cancer testing was significantly lower among men from all regions of Asia (OR, 95%CI ranging from 0.4, 0.3–0.6 to 0.6, 0.5–0.9) and Continental Europe (OR, 95%CI ranging from 0.4, 0.3–0.7 to 0.7, 0.6–0.9). Only men from East Asia had significantly lower PSA testing rates than Australian-born men (0.4, 0.3–0.6). As the number of years lived in Australia increased, cancer test use among migrants approached Australian-born rates.</p> <p>Conclusion</p> <p>Certain migrant groups within the population may require targeted intervention to improve their uptake of cancer screening, particularly screening for bowel cancer.</p
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