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Influence Risk (influence + risk)
Selected AbstractsDo Muscle Mass, Muscle Density, Strength, and Physical Function Similarly Influence Risk of Hospitalization in Older Adults?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2009Peggy Mannen Cawthon PhD OBJECTIVES: To examine the association between strength, function, lean mass, muscle density, and risk of hospitalization. DESIGN: Prospective cohort study. SETTING: Two U.S. clinical centers. PARTICIPANTS: Adults aged 70 to 80 (N=3,011) from the Health, Aging and Body Composition Study. MEASUREMENTS: Measurements were of grip strength, knee extension strength, lean mass, walking speed, and chair stand pace. Thigh computed tomography scans assessed muscle area and density (a proxy for muscle fat infiltration). Hospitalizations were confirmed by local review of medical records. Negative binomial regression models estimated incident rate ratios (IRRs) of hospitalization for race- and sex-specific quartiles of each muscle and function parameter separately. Multivariate models adjusted for age, body mass index, health status, and coexisting medical conditions. RESULTS: During an average 4.7 years of follow-up, 1,678 (55.7%) participants experienced one or more hospitalizations. Participants in the lowest quartile of muscle density were more likely to be subsequently hospitalized (multivariate IRR=1.47, 95% confidence interval (CI)=1.24,1.73) than those in the highest quartile. Similarly, participants with the weakest grip strength were at greater risk of hospitalization (multivariate IRR=1.52, 95% CI=1.30,1.78, Q1 vs. Q4). Comparable results were seen for knee strength, walking pace, and chair stands pace. Lean mass and muscle area were not associated with risk of hospitalization. CONCLUSION: Weak strength, poor function, and low muscle density, but not muscle size or lean mass, were associated with greater risk of hospitalization. Interventions to reduce the disease burden associated with sarcopenia should focus on increasing muscle strength and improving physical function rather than simply increasing lean mass. [source] Analysis of Genetically Complex EpilepsiesEPILEPSIA, Issue 2005Ruth Ottman Summary:, During the last decade, great progress has been made in the discovery of genes that influence risk for epilepsy. However, these gene discoveries have been in epilepsies with Mendelian modes of inheritance, which comprise only a tiny fraction of all epilepsy. Most people with epilepsy have no affected relatives, suggesting that the great majority of all epilepsies are genetically complex: multiple genes contribute to their etiology, none of which has a major effect on disease risk. Gene discovery in the genetically complex epilepsies is a formidable task. It is unclear which epilepsy phenotypes are most advantageous to study, and chromosomal localization and mutation detection are much more difficult than in Mendelian epilepsies. Association studies are very promising for the identification of complex epilepsy genes, but we are still in the earliest stages of their application in the epilepsies. Future studies should employ very large sample sizes to ensure adequate statistical power, clinical phenotyping methods of the highest quality, designs and analytic techniques that control for population stratification, and state-of-the-art molecular methods. Collaborative studies are essential to achieve these goals. [source] Expectancy and Risk for Alcoholism: The Unfortunate Exploitation of a Fundamental Characteristic of Neurobehavioral AdaptationALCOHOLISM, Issue 5 2002Mark S. Goldman Psychological investigations of alcohol expectancies over the last 20 years, using primarily verbal techniques, have strongly supported expectancies as an important mediator of biological and environmental antecedent variables that influence risk for alcohol use and abuse. At the same time, rapid developments in neuroscience, cognitive science, affective science, computer science, and genetics proved to be compatible with the concept of expectancy and, in some cases, used this concept directly. By using four principles that bear on the integration of knowledge in the biological and behavioral sciences,consilience, conservation, contingency, and emergence,these developments are merged into an integrated explanation of alcoholism and other addictions. In this framework, expectancy is seen as a functional approach to adaptation and survival that has been manifested in multiple biological systems with different structures and processes. Understood in this context, addiction is not a unique behavioral problem or special pathology distinct from the neurobehavioral substrate that governs all behavior, but is rather a natural (albeit unfortunate) consequence of these same processes. The ultimate intent is to weave a working heuristic that ties together findings from molecular and molar levels of inquiry and thereby might help direct future research. Such integration is critical in the multifaceted study of addictions. [source] Periconceptional nutrient intakes and risks of conotruncal heart defects,BIRTH DEFECTS RESEARCH, Issue 3 2010Gary M. Shaw Abstract BACKGROUND Few inquiries into periconceptional nutrition, other than folate, and risk of heart defects exist. We investigated the observed association between conotruncal heart defects and periconceptional vitamin use, as well as potential associations with other dietary nutrients. METHODS Data derived from a population-based, case-control study of fetuses and liveborn infants among California births between July 1999 and June 2004; 76% of eligible case mothers and 77% of eligible control mothers were interviewed. Cases included 140 with d-transposition of great arteries (dTGA), and 163 with tetralogy of Fallot (TOF). Total number of controls was 698. Use of vitamins was elicited by questionnaire for the periconceptional period. Dietary nutrient intake was elicited by a well-known food frequency questionnaire. RESULTS The odds ratio for dTGA associated with supplemental vitamin use was 1.0 (95% confidence interval [CI], 0.7,1.5) and for TOF was 0.9 (95% CI, 0.6,1.3). We observed increased risks associated with lower dietary intakes of linoleic acid, total carbohydrate, and fructose for dTGA, whereas decreased risks were observed for lower intakes of total protein and methionine for TOF. Lower dietary intake of several micronutrients,namely folate, niacin, riboflavin, and vitamins B12, A, and E, even after simultaneous adjustment for other studied nutrients,was associated with increased risk of dTGA but not TOF. These associations were observed among women who did not use vitamin supplements periconceptionally. Analytic consideration of several potential confounders did not reveal alternative interpretations of the results. CONCLUSION Evidence continues to accumulate to show that nutrients, particularly folate, influence risks of structural birth defects. Our results extend observations that other nutrients may also be important in heart development. Birth Defects Research (Part A), 2010. © 2010 Wiley-Liss, Inc. [source] |