Searched for: school:SOM
Department/Unit:Population Health
The regulation of endocrine-disrupting chemicals to minimize their impact on health
Duh-Leong, Carol; Maffini, Maricel V; Kassotis, Christopher D; Vandenberg, Laura N; Trasande, Leonardo
Endocrine-disrupting chemicals (EDCs) are substances generated by human industrial activities that are detrimental to human health through their effects on the endocrine system. The global societal and economic burden posed by EDCs is substantial. Poorly defined or unenforced policies can increase human exposure to EDCs, thereby contributing to human disease, disability and economic damage. Researchers have shown that policies and interventions implemented at both individual and government levels have the potential to reduce exposure to EDCs. This Review describes a set of evidence-based policy actions to manage, minimize or even eliminate the widespread use of these chemicals and better protect human health and society. A number of specific challenges exist: defining, identifying and prioritizing EDCs; considering the non-linear or non-monotonic properties of EDCs; accounting for EDC exposure effects that are latent and do not appear until later in life; and updating testing paradigms to reflect 'real-world' mixtures of chemicals and cumulative exposure. A sound strategy also requires partnering with health-care providers to integrate strategies to prevent EDC exposure in clinical care. Critical next steps include addressing EDCs within global policy frameworks by integrating EDC exposure prevention into emerging climate policy.
PMID: 37553404
ISSN: 1759-5037
CID: 5593962
The Plant-based Prescription: How Dietary Change Can Improve Both Urological and Planetary Health [Editorial]
Cole, Alexander P; Gupta, Natasha; Loeb, Stacy
In this editorial, we discuss the relationship between meat consumption and many major urological conditions (eg, prostate cancer, kidney stones, urinary tract infections) and how dietary choices could simultaneously benefit genitourinary health and the environment, which in turn will have downstream impacts on public health.
PMID: 37451898
ISSN: 1873-7560
CID: 5537942
Intergenerational Transmission of Maternal Childhood Maltreatment Prior to Birth: Effects on Human Fetal Amygdala Functional Connectivity
van den Heuvel, Marion I; Monk, Catherine; Hendrix, Cassandra L; Hect, Jasmine; Lee, Seonjoo; Feng, Tianshu; Thomason, Moriah E
OBJECTIVE:Childhood maltreatment (CM) is a potent risk factor for developing psychopathology later in life. Accumulating research suggests that the influence is not limited to the exposed individual but may also be transmitted across generations. In this study, we examine the effect of CM in pregnant women on fetal amygdala-cortical function, prior to postnatal influences. METHOD/METHODS:Healthy pregnant women (N = 89) completed fetal resting-state functional magnetic resonance imaging (rsfMRI) scans between the late second trimester and birth. Women were primarily from low socioeconomic status households with relatively high CM. Mothers completed questionnaires prospectively evaluating prenatal psychosocial health and retrospectively evaluating trauma from their own childhood. Voxelwise functional connectivity was calculated from bilateral amygdala masks. RESULTS:Connectivity of the amygdala network was relatively higher to left frontal areas (prefrontal cortex and premotor) and relatively lower to right premotor area and brainstem areas in fetuses of mothers exposed to higher CM. These associations persisted after controlling for maternal socioeconomic status, maternal prenatal distress, measures of fetal motion, and gestational age at the time of scan and at birth. CONCLUSION/CONCLUSIONS:Pregnant women's experiences of CM are associated with offspring brain development in utero. The strongest effects were found in the left hemisphere, potentially indicating lateralization of the effects of maternal CM on the fetal brain. This study suggests that the time frame of the Developmental Origins of Health and Disease research should be extended to exposures from mothers' childhood, and indicates that the intergenerational transmission of trauma may occur prior to birth.
PMID: 37245707
ISSN: 1527-5418
CID: 5543102
Friends as Informal Educators: The Role of Peer Relationships in Promotion of Sexual Health Services among College Students
Muraleetharan, Veena; Brault, Marie A
This ethnographic study of one United States university's sexual health resources explores the role of peer relationships in sexual health promotion to understand how these relationships shaped students' interactions with campus sexual health resources. Through analysis of seventeen semi-structured interviews with students, five policy interviews with providers and university personnel, and participant-observation of peer health educator training, the authors examine how trust in peer relationships can serve as a form of social capital to influence sexual health information sharing. The article introduces the term "peer administrator" to describe student actors who sit at the intersection of friend and official resource and explores the importance of these mentoring relationships for sexual health promotion. The analysis also considers how more individualistic models of public health promotion limit the impact of peer relationships and concludes with a discussion of how universities might imagine new forms of sexual health promotion among students.
PMCID:10730011
PMID: 34284679
ISSN: 2752-5368
CID: 5652952
Circulating Proteins and Mortality in CKD: A Proteomics Study of the AASK and ARIC Cohorts
Srialluri, Nityasree; Surapaneni, Aditya; Schlosser, Pascal; Chen, Teresa K; Schmidt, Insa M; Rhee, Eugene P; Coresh, Josef; Grams, Morgan E
RATIONALE & OBJECTIVE/UNASSIGNED:Proteomics could provide pathophysiologic insight into the increased risk of mortality in patients with chronic kidney disease (CKD). This study aimed to investigate associations between the circulating proteome and all-cause mortality among patients with CKD. STUDY DESIGN/UNASSIGNED:Observational cohort study. SETTING & PARTICIPANTS/UNASSIGNED:Primary analysis in 703 participants in the African American Study of Kidney Disease and Hypertension (AASK) and validation in 1,628 participants with CKD in the Atherosclerosis Risk in Communities (ARIC) study who attended visit 5. EXPOSURE/UNASSIGNED:Circulating proteins. OUTCOME/UNASSIGNED:All-cause mortality. ANALYTICAL APPROACH/UNASSIGNED:Among AASK participants, we evaluated the associations of 6,790 circulating proteins with all-cause mortality using multivariable Cox proportional hazards models. Proteins with significant associations were further studied in ARIC Visit 5 participants with CKD. RESULTS/UNASSIGNED:-microglobulin, spondin-1, and N-terminal pro-brain natriuretic peptide) were available in the ARIC data, with all 3 significantly associated with death in ARIC. LIMITATIONS/UNASSIGNED:Possibility of unmeasured confounding. Cause of death was not known. CONCLUSIONS/UNASSIGNED:Using large-scale proteomic analysis, proteins were reproducibly associated with mortality in 2 cohorts of participants with CKD. PLAIN-LANGUAGE SUMMARY/UNASSIGNED:-microglobulin, spondin-1, and N-terminal pro-brain natriuretic peptide (BNP)) were also measured in ARIC and were significantly associated with death. Additional studies assessing biomarkers associated with mortality among patients with CKD are needed to evaluate their use in clinical practice.
PMCID:10498294
PMID: 37711886
ISSN: 2590-0595
CID: 5583272
A vision for safer food contact materials: Public health concerns as drivers for improved testing
Muncke, Jane; Andersson, Anna-Maria; Backhaus, Thomas; Belcher, Scott M; Boucher, Justin M; Carney Almroth, Bethanie; Collins, Terrence J; Geueke, Birgit; Groh, Ksenia J; Heindel, Jerrold J; von Hippel, Frank A; Legler, Juliette; Maffini, Maricel V; Martin, Olwenn V; Peterson Myers, John; Nadal, Angel; Nerin, Cristina; Soto, Ana M; Trasande, Leonardo; Vandenberg, Laura N; Wagner, Martin; Zimmermann, Lisa; Thomas Zoeller, R; Scheringer, Martin
Food contact materials (FCMs) and food contact articles are ubiquitous in today's globalized food system. Chemicals migrate from FCMs into foodstuffs, so called food contact chemicals (FCCs), but current regulatory requirements do not sufficiently protect public health from hazardous FCCs because only individual substances used to make FCMs are tested and mostly only for genotoxicity while endocrine disruption and other hazard properties are disregarded. Indeed, FCMs are a known source of a wide range of hazardous chemicals, and they likely contribute to highly prevalent non-communicable diseases. FCMs can also include non-intentionally added substances (NIAS), which often are unknown and therefore not subject to risk assessment. To address these important shortcomings, we outline how the safety of FCMs may be improved by (1) testing the overall migrate, including (unknown) NIAS, of finished food contact articles, and (2) expanding toxicological testing beyond genotoxicity to multiple endpoints associated with non-communicable diseases relevant to human health. To identify mechanistic endpoints for testing, we group chronic health outcomes associated with chemical exposure into Six Clusters of Disease (SCOD) and we propose that finished food contact articles should be tested for their impacts on these SCOD. Research should focus on developing robust, relevant, and sensitive in-vitro assays based on mechanistic information linked to the SCOD, e.g., through Adverse Outcome Pathways (AOPs) or Key Characteristics of Toxicants. Implementing this vision will improve prevention of chronic diseases that are associated with hazardous chemical exposures, including from FCMs.
PMID: 37758599
ISSN: 1873-6750
CID: 5611292
Is it time for health equity-specific metrics? [Editorial]
Joseph, Kathie-Ann
PMID: 37423781
ISSN: 1879-1883
CID: 5537322
Surveillance of Xylazine Use and Poisonings Is Needed-Without Blind Spots
Palamar, Joseph J; Goldberger, Bruce A
PMID: 37812778
ISSN: 1539-3704
CID: 5604742
Discordance Between Creatinine-Based and Cystatin C-Based Estimated GFR: Interpretation According to Performance Compared to Measured GFR
Wang, Yeli; Adingwupu, Ogechi M; Shlipak, Michael G; Doria, Alessandro; Estrella, Michelle M; Froissart, Marc; Gudnason, Vilmundur; Grubb, Anders; Kalil, Roberto; Mauer, Michael; Rossing, Peter; Seegmiller, Jesse; Coresh, Josef; Levey, Andrew S; Inker, Lesley A
RATIONALE & OBJECTIVE/UNASSIGNED:Use of cystatin C in addition to creatinine to estimate glomerular filtration rate (estimated glomerular filtration rate based on cystatin C [eGFRcys] and estimated glomerular filtration rate based on creatinine [eGFRcr], respectively) is increasing. When eGFRcr and eGFRcys are discordant, it is not known which is more accurate, leading to uncertainty in clinical decision making. STUDY DESIGN/UNASSIGNED:Cross-sectional analysis. SETTING & PARTICIPANTS/UNASSIGNED:Four thousand fifty participants with measured glomerular filtration rate (mGFR) from 12 studies in North America and Europe. EXPOSURES/UNASSIGNED:Serum creatinine and serum cystatin C. OUTCOMES/UNASSIGNED:Performance of creatinine-based and cystatin C-based glomerular filtration rate estimating equations compared to mGFR. ANALYTICAL APPROACH/UNASSIGNED:(negative, concordant, and positive groups, respectively). We compared bias (median of mGFR minus eGFR) and the percentage of eGFR within 30% of mGFR. RESULTS/UNASSIGNED:), with opposite results in the positive eGFRdiff group. In both negative and positive eGFRdiff groups, eGFRcr-cys was more accurate than either eGFRcr or eGFRcys. These results were largely consistent across age, sex, race, and body mass index. LIMITATIONS/UNASSIGNED:Few participants with major comorbid conditions. CONCLUSIONS/UNASSIGNED:Discordant eGFRcr and eGFRcys are common. eGFR using the combination of creatinine and cystatin C provides the most accurate estimates among persons with discordant eGFRcr or eGFRcys.
PMCID:10518599
PMID: 37753251
ISSN: 2590-0595
CID: 5583302
Ethical, legal, and social implications of genetic risk prediction for multifactorial disease: a narrative review identifying concerns about interpretation and use of polygenic scores
Chapman, Carolyn Riley
Advances in genomics have enabled the development of polygenic scores (PGS), sometimes called polygenic risk scores, in the context of multifactorial diseases and disorders such as cancer, cardiovascular disease, and schizophrenia. PGS estimate an individual's genetic predisposition, as compared to other members of a population, for conditions which are influenced by both genetic and environmental factors. There is significant interest in using genetic risk prediction afforded through PGS in public health, clinical care, and research settings, yet many acknowledge the need to thoughtfully consider and address ethical, legal, and social implications (ELSI). To contribute to this effort, this paper reports on a narrative review of the literature, with the aim of identifying and categorizing ELSI relating to genetic risk prediction in the context of multifactorial disease, which have been raised by scholars in the field. Ninety-two articles, spanning from 1977 to 2021, met the inclusion criteria for this study. Identified ELSI included potential benefits, challenges and risks that focused on concerns about interpretation and use, and ethical obligations to maximize benefits, minimize risks, promote justice, and support autonomy. This research will support geneticists, clinicians, genetic counselors, patients, patient advocates, and policymakers in recognizing and addressing ethical concerns associated with PGS; it will also guide future empirical and normative research.
PMID: 36529843
ISSN: 1868-310x
CID: 5394912