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Kejser Patton posted an update 9 days ago
The heightened risk of death and severe injuries was markedly apparent among male patients.
Childhood brain structure is impacted by both preterm birth and socioeconomic status (SES), yet the specific influence of each factor during the newborn period remains a mystery.
To explore the relationship between birth gestational age (GA) and socioeconomic status (SES) on neonatal brain structure, we hypothesize that GA and SES are correlated with brain morphology; that the link between SES and brain structure varies based on gestational age; and that how SES is measured influences the observed associations between SES and neonatal brain morphology.
Participants for this cohort study, recruited from November 2016 to September 2021, were all sourced from a single UK-based research center. The study sample included 170 infants identified as extremely and very preterm, plus 91 full-term or near-term infants. Subjects with major congenital malformations, chromosomal abnormalities, congenital infections, cystic periventricular leukomalacia, hemorrhagic parenchymal infarction, and posthemorrhagic ventricular dilatation were excluded from the study.
Neighborhood-level socioeconomic status (using the Scottish Index of Multiple Deprivation), family-level socioeconomic status (using parental education and occupation), and subjective socioeconomic status (using the World Health Organization Quality of Life measure) for assessing birth gestational age.
At term-equivalent ages, assessments were made of brain volume (85 parcels) and five cortical morphology measures: gyrification index, thickness, sulcal depth, curvature, and surface area. For preterm infants, this was a median of 40 weeks, 5 days , and for full-term infants, 42 weeks .
The research cohort included 170 extremely and very preterm infants (male: 95 ; Asian: 4 of 166 ; White: 145 of 166 ) and 91 full-term or near-term infants (male: 50 ; Asian: 3 of 86 ; White: 78 of 86 ). The median (range) birth gestational ages were 30 weeks, 0 days (22 weeks, 1 day to 32 weeks, 6 days) and 39 weeks, 4 days (36 weeks, 3 days to 42 weeks, 1 day), respectively. Adjusted analyses revealed a more substantial link between gestational age at birth and brain volume (27 out of 85 regions exhibiting a 318% proportion increase, ranging from -0.020 to 0.024) than either neighborhood or family socioeconomic status. Neighborhood socioeconomic status was associated with a significantly smaller proportion of brain volume changes (1 of 85 regions, 12%); p=0.017; 95% confidence interval, -0.016 to 0.050. Similarly, family socioeconomic status (maternal education affecting 4 regions , ranging from 0.009 to 0.015, and maternal occupation affecting just 1 region , p=0.006; 95% confidence interval, 0.002 to 0.011) displayed a less pronounced effect. A relationship exists between GA and both family-level and subjective SES measures, impacting regional brain volumes. Cortical surface area (0.010 ) and gyrification index (0.016 ) were found to be associated with gestational age at birth; however, no socioeconomic status (SES) measure correlated with cortical measurements.
A cohort study of UK infants indicated associations between birth gestational age (GA) and socioeconomic status (SES) and neonatal brain morphology, with low GA exhibiting more extensive associations with neonatal brain structure compared to SES. More research is necessary to understand the processes by which both gestational age and socioeconomic status impact early brain development.
Birth gestational age (GA) and socioeconomic status (SES) demonstrated correlations with neonatal brain morphology in this UK infant cohort study; however, low gestational age (GA) demonstrated a more widespread effect on various neonatal brain structures compared to SES. To better understand the mechanisms driving the link between gestational age and socioeconomic status and early brain development, further work is essential.
Long-term cancer survivors from childhood might encounter a higher chance of acquiring new neurocognitive difficulties and a deterioration in function as they progress through their adult years.
An exploration of whether elderly survivors of childhood cancer report a greater incidence of newly developed neurocognitive impairments compared to their siblings, and to identify risk factors for such impairments.
Adult survivors of childhood cancer from the Childhood Cancer Survivor Study, along with their siblings as a control group, comprised the cohort studied. Survivors included in the initial cohort had diagnoses falling between January 1, 1970, and December 31, 1986, and possessed longitudinal neurocognitive assessment data. This research examined how frequently new neurocognitive impairment emerged, comparing data from the initial 234-year mark post-diagnosis and a 350-year follow-up assessment. Over the period extending from January 2021 to May 2022, the analysis was conducted.
Information regarding cancer treatment exposures was derived from the patient’s medical records. Using Common Terminology Criteria for Adverse Events version 403, a grading system was applied to chronic health conditions.
Newly presented neurocognitive impairment, evident at the subsequent evaluation but not present at the initial assessment, was the primary endpoint. This was determined by a score within the worst 10% of the sibling cohort’s results. The Childhood Cancer Survivor Study Neurocognitive questionnaire’s use enabled impairment assessment. Health behaviors, treatment, and health conditions were investigated for their associations with neurocognitive impairment using generalized linear models, with relative risks (RRs) and 95% confidence intervals (CIs) used to quantify these associations.
The study cohort was composed of 2375 survivors of childhood cancer. Their mean age at evaluation was 318 years (SD 75 years), and the number of women in the cohort was 1298 (546% of the total). This cohort included patients with acute lymphoblastic leukemia (ALL, 1316 participants), central nervous system (CNS) tumors (488 participants), and Hodgkin lymphoma (HL, 571 participants). In the study, 232 siblings were examined, the average (standard deviation) age at assessment being 342 (84) years, including 134 women (representing 578% of the sample). Of survivors without memory problems at the start, a higher proportion developed memory issues later on, relative to their siblings, specifically 78% (95% CI, 43%-114%). New-onset memory difficulties were observed to be correlated with concurrent radiation therapy (CRT) in individuals who had previously survived central nervous system (CNS) tumors (relative risk, 197; 95% confidence interval, 133-290). Similarly, among acute lymphoblastic leukemia (ALL) survivors who did not receive concurrent radiation therapy (CRT), alkylator chemotherapy exceeding 8000 mg/m2 was linked to a significantly higher risk of experiencing new memory problems (relative risk, 280; 95% confidence interval, 128-612). The effect of CRT on new memory problems in CNS survivors was mediated by concomitant neurological conditions. Smoking, low educational attainment, and insufficient physical activity were correlated with a heightened likelihood of developing new-onset memory problems.
Survivors of childhood cancer, as adults, demonstrate a heightened vulnerability to memory decline linked to modifiable risk factors discernible during their initial treatment period.
Early identification of modifiable risk factors during childhood cancer survivorship reveals a heightened risk of later-onset memory impairment in adult survivors.
Evidence points towards a potential elevated risk of depression among fathers in the postpartum period, with approximately one in ten fathers experiencing depression in the year after birth; yet, details surrounding their antidepressant treatment during this vulnerable time remain unclear. vtp50469 inhibitor Comparatively, direct comparisons involving antidepressant treatment and men who haven’t recently become fathers are limited.
To investigate if becoming a new father was associated with a heightened probability of men undergoing antidepressant treatment.
Employing UK primary care electronic health records from the IQVIA Medical Research Database, this study examined a cohort. Participants included males aged 15 to 55 years who had a child in the year preceding the study period, spanning January 2007 to December 2016, and they were compared to a maximum of five childless men from the same year. Analysis of data spanned the period from January 2022 to March 2023.
A child’s birth in the preceding year was found documented in linked primary care records, using a family identification number.
Antidepressant initiation within a year of childbirth, or, for childless men, a year after the index date, constituted the primary outcome. To explore the associations of cohort, age group, social deprivation, history of antidepressant treatment, and calendar year with having an antidepressant prescription in the year after the index date, prevalence risk rates (PPRs) were incorporated within a random-effects Poisson regression analysis.
In the analysis, 90,736 men who had children last year were included, alongside a comparative group of 453,632 men. In this study, 463,879 men (an 852% increase) were aged between 25 and 44 years. The number of men in the least deprived areas (130,277 men, a 239% increase) was greater than the number residing in the most deprived areas (72,268 men, a 133% increase). In the year following the birth of a child, 4439 men (49%) received at least one antidepressant prescription, whereas 26,646 men (59%) who did not have a child during that same period did not. Following the application of corrective measures, the difference in antidepressant treatment between the groups became indistinguishable (adjusted PRR , 101; 95% CI, 0.98-1.04). Among fathers, those who had received antidepressant treatment shortly before becoming parents exhibited a markedly elevated probability of receiving subsequent antidepressant treatment after the birth, in comparison with fathers who had not received such treatment (adjusted prevalence ratio, 3.231; 95% confidence interval, 3.037-3.438). Fathers inhabiting the most disadvantaged communities were 18% more inclined to have an antidepressant prescription compared to their counterparts in the least deprived areas, as demonstrated by an adjusted prevalence ratio of 1.18 (95% CI, 1.07-1.30).
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