International journal of epidemiology最新文献

{"title":"Neonatal sepsis definitions for randomised-controlled trials: challenges and approaches.","authors":"Chiara Minotti, Louise F Hill, Michelle N Clements, Wolfgang Stohr, Ann Sarah Walker, Julia A Bielicki","doi":"10.1093/ije/dyag154","DOIUrl":"https://doi.org/10.1093/ije/dyag154","url":null,"abstract":"","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"55 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When air pollution meets comorbidities: evidence on the causal effect of PM2.5 on COVID-19 hospitalizations and deaths.","authors":"Carla Morvan, Johanna Lepeule, Emmanuelle Lavaine","doi":"10.1093/ije/dyag152","DOIUrl":"https://doi.org/10.1093/ije/dyag152","url":null,"abstract":"<p><strong>Background: </strong>Despite growing evidence on the health effects of air pollution, few studies have examined its impact on COVID-19 hospitalizations and deaths, and none have explicitly accounted for preexisting comorbidities in a causal framework. This study addresses this gap by investigating the relationship between PM2.5 exposure and COVID-19 severity. We place particular emphasis on the role of comorbidities, which can increase vulnerability to COVID-19 and may interact with air pollution exposure.</p><p><strong>Methods: </strong>We use an exhaustive dataset covering the entire French territory over 2020-1, totaling more than 3.5 million weekly observations. The data include information on COVID-19 mortality and hospitalizations, disaggregated by age, sex, and municipality, along with detailed records on preexisting conditions. To address endogeneity, we employ a two-stage least squares approach, using wind direction as an instrument for local PM2.5 concentrations.</p><p><strong>Results: </strong>We find no significant effect of PM2.5 exposure on COVID-19 mortality or hospitalizations among individuals without preexisting conditions. However, when accounting for comorbidities, a 10 μg/m3 increase in PM 2.5 was associated with higher COVID-19 mortality rates (1.5 per 100 000, 95% CI: 0.8-2.2), particularly among patients with respiratory (0.9 per 100 000, 95% CI: 0.4-1.4), and cardiovascular diseases (0.6 per 100 000, 95% CI: 0.1-1.1).</p><p><strong>Conclusions: </strong>These findings underscore the importance of incorporating comorbidities when assessing the health effects of air pollution during a pandemic. Our results also show that the effects of PM2.5 are driven by the oldest age groups, who are both more vulnerable to COVID-19 and more likely to have comorbidities.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"55 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elucidating the proteomic pathways linking childhood body mass index with type 2 diabetes: a Mendelian randomization and recall-by-genotype study.","authors":"Siyu Chen, Yiwen Liang, Shan Luo, Jie Zheng, Satoshi Yoshiji, Grace M Power, Zikun Xu, Stephen Burgess, Benjamin John Cowling, Hugh Simon Lam, Albert Martin Li, Gabriel Matthew Leung, Catherine Mary Schooling, Shiu Lun Au Yeung","doi":"10.1093/ije/dyag165","DOIUrl":"https://doi.org/10.1093/ije/dyag165","url":null,"abstract":"<p><strong>Background: </strong>Increased childhood adiposity contributes to higher type 2 diabetes (T2D) risk, but the underlying mechanisms remain unclear. Furthermore, whether these mechanistic pathways are shared across ethnic groups has not been explored.</p><p><strong>Methods: </strong>We conducted a two-step Mendelian randomization (MR) using European-based summary statistics from genome-wide association studies of childhood body mass index (BMI) (n = 61 111), adulthood proteomics (n = 35 559), and later life T2D (cases: 242 283; controls: 1 569 734). We also conducted a recall-by-genotype (RbG) study in a Chinese birth cohort (n = 250) to assess whether childhood BMI was associated with the identified proteomic signals in an East Asian population. Analyses included multi-instrument MR methods (inverse variance weighted and MR-Egger) and, for single-instrument proteins, cis-MR using the Wald ratio, with colocalization validation. Multiple testing was adjusted using false discovery rate (FDR).</p><p><strong>Results: </strong>Higher genetically predicted childhood BMI was associated with 1299 proteins (FDR-adjusted P < .05), of which 36 proteins were associated with higher T2D risk. Six proteins were supported by colocalization (PPH4 > 80%). Genetically predicted higher childhood BMI was positively associated with GCKR, RBP1, ENTPD6, and GST A1-1, and inversely associated with PRSS27 and SHBG. The proportion of the BMI-T2D effect mediated by these proteins ranged from 1.87% to 12.92%. However, only SHBG was replicated in Asians in the RbG study.</p><p><strong>Conclusions: </strong>Our study identified putative actionable proteins that could reduce the elevated T2D risk attributable to childhood adiposity in Europeans, but their relevance in Asian populations requires further investigation.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"55 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating lead time and overdiagnosis in cancer screening programmes: the MOCCI method.","authors":"Bor Vratanar, Maja Pohar Perme","doi":"10.1093/ije/dyag167","DOIUrl":"https://doi.org/10.1093/ije/dyag167","url":null,"abstract":"<p><strong>Background: </strong>Cancer screening enables earlier cancer diagnosis and treatment. The interval between cancer diagnosis by screening and the symptomatic detection in the absence of screening is termed lead time. If a patient's tumour, detected by screening, would never surface clinically, the patient is considered overdiagnosed. Estimating these quantities is crucial for evaluating cancer screening programmes.</p><p><strong>Development: </strong>We developed MOCCI (Minimizing Observed and Counterfactual Cancer Incidence), a novel parametric method for estimating the lead time distribution. MOCCI compares age- and calendar-stratified cancer incidence between individuals invited to screening and those not invited and estimates the lead time distribution that minimizes the incidence difference between the two groups. The probability of overdiagnosis is then estimated by comparing the model-predicted lead time with the time to death from other causes.</p><p><strong>Application: </strong>In an application to the Slovenian breast cancer screening programme, we estimated that 30% (95% confidence interval [CI], 20% to 39%) of screen-detected cases were non-progressive and 33% (95% CI, 25% to 43%) were overdiagnosed; assuming an exponential lead time distribution for progressive cancers, the mean lead time was 1.8 years (95% CI, 1.3 to 2.9).</p><p><strong>Conclusions: </strong>This study proposes a new method for estimating lead time and overdiagnosis. The proposed method (a) can accommodate various lead time distributions, (b) yields a lead time distribution that is aligned with the observed excess incidence arising from screening, and (c) enables the separation of different sources of overdiagnosis. The method provides stable estimates when sample sizes are large and the assumed lead time model is simple.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"55 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to extreme temperatures may increase the risk of preterm birth: findings from a contemporary US cohort.","authors":"Neil J Perkins, Siddharth Rawat, Elizabeth A DeVilbiss, Elizabeth H Scholl, Taylor Petty, Brian Kidd, Deepak Mav, Shyamal D Peddada, Jagteshwar Grewal","doi":"10.1093/ije/dyag145","DOIUrl":"10.1093/ije/dyag145","url":null,"abstract":"<p><strong>Background: </strong>The frequency and severity of extreme temperatures have been increasing and are expected to continue to escalate in the coming decades. Relationships between extreme temperatures and early deliveries are not well understood.</p><p><strong>Methods: </strong>Data were obtained from 201 759 pregnancies with gestational age (GA) of >27 weeks in the Consortium on Safe Labor retrospective cohort study from 19 hospitals across the USA for 2002-8. Location-specific bulk temperatures were obtained from the Parameter-Elevation Regressions on Independent Slopes Model (4-km resolution), from which participants were linked to minimum, maximum, and mean daily temperatures across each day of pregnancy. Days were categorized for each site as cold (both minimum and maximum temperatures ≤ 20th percentile), hot (both minimum and maximum temperatures ≥ 80th percentile), or neither for each pregnancy. Cold and hot days were then analysed individually or as the proportion within specific pregnancy windows by using Cox regression and fetuses-at-risk logistic regression models.</p><p><strong>Results: </strong>Detrimental relations in fetuses-at-risk models were consistently observed between exposure to chronic cold and chronic heat and early delivery: odds ratio (ORcold)= 1.66, 1.40, and 1.16; ORheat = 1.20, 1.13, and 1.32 for early-preterm (GA < 34 weeks), preterm (34 ≤ GA < 37 weeks), and early-term (37 ≤ GA < 39), respectively. Associations for exposures in Trimesters 1 and 2 were mixed but clearly more detrimental in Trimester 1. The likelihood of early delivery increased with daily exposure to extreme temperatures after 27 weeks.</p><p><strong>Conclusion: </strong>Future work should seek to elucidate the underlying mechanisms and to validate these findings by using more recent diverse global data.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"55 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The New Modern Medicine: Disease, Evidence, and Epidemiological Medicine, by Jonathan Fuller","authors":"Alex Broadbent","doi":"10.1093/ije/dyag147","DOIUrl":"https://doi.org/10.1093/ije/dyag147","url":null,"abstract":"","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"12 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Data Resource Profile: The National Dental Centre Singapore Oral Disease Registry (NDCS-ODR).","authors":"Marco Aurélio Peres, Pinyan Liu, John Rong Hao Tay","doi":"10.1093/ije/dyag171","DOIUrl":"https://doi.org/10.1093/ije/dyag171","url":null,"abstract":"","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"55 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripubertal pregnancies and associations with health and developmental outcomes in offspring during late adolescence and adulthood: sibling-comparison register study.","authors":"Vasudha Ahuja, Ayako Hiyoshi, Helena Backman, David Simmons, Scott Montgomery","doi":"10.1093/ije/dyag153","DOIUrl":"10.1093/ije/dyag153","url":null,"abstract":"<p><strong>Background: </strong>We examined the association of peripubertal pregnancies with long-term health and developmental outcomes in adult offspring and strengthened causal inference using sibling-comparison methods.</p><p><strong>Methods: </strong>Using linked Swedish register data from 1964 to 2018, we conducted a cohort study to estimate associations of pregnancies before age 16 years compared with pregnancies between ages 16 and 25 years, with body mass index (BMI), systolic blood pressure (SBP), cognitive function, and stress resilience among 943 444 male offspring aged 17-21 years in the Military Conscription Register. We further assessed associations with type 2 diabetes (T2D), depression, and anxiety among 2 461 510 male and female offspring aged 18-73 years using population-wide registers. Linear, multinomial, and survival models were used. Sibling fixed-effect models were used to account for unmeasured confounding shared among siblings.</p><p><strong>Results: </strong>Offspring from pregnancies before age 16 years compared with pregnancies between ages 16 and 25 years had lower SBP (β - 1.12; 95% confidence interval [CI] - 1.97 to -0.26), poorer cognitive function (β  - 0.54; 95% CI -0.67 to -0.40), and poorer stress resilience (β -0.24; 95% CI -0.38, -0.10). There was no increased risk of being underweight or overweight compared with normal weight. There was a lower risk of anxiety (hazard ratio 0.87; 95% CI 0.80 to 0.95) and no increased risk of T2D or depression. Sibling-comparison analyses attenuated deleterious associations to null or reversed them and amplified associations with markers of better health.</p><p><strong>Conclusion: </strong>Pregnancies before age 16 years may not be causally associated with adverse long-term health and developmental outcomes in adolescent and adult offspring. The adverse associations in conventional analyses appear attributable to shared familial characteristics.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"55 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total moderate-to-vigorous physical activity across the adult life course and the risk of invasive ovarian cancer.","authors":"Jennifer A Ritonja, Sreenath Madathil, Belinda Nicolau, Lisa Leung, Vikki Ho, Michal Abrahamowicz, Anita Koushik","doi":"10.1093/ije/dyag160","DOIUrl":"10.1093/ije/dyag160","url":null,"abstract":"<p><strong>Background: </strong>Previous research on moderate-to-vigorous physical activity (MVPA) and ovarian cancer risk have shown inconsistent results. Most studies measured recreational MVPA once during late adulthood, which does not consider the way in which timing may differently influence risk or account for MVPA from other activities. Life-course epidemiology models (critical-period, sensitive-period, and accumulation) can evaluate whether the timing and cumulative burden of total MVPA across the lifespan influences risk. Here, we identify which model best describes the association between total MVPA, encompassing recreational, occupational, household, and transportation activities, and invasive ovarian cancer risk.</p><p><strong>Methods: </strong>A population-based case-control study of ovarian cancer in Montreal, Canada (2011-16) included 268 invasive cases and 668 controls aged ≥52 years. Total MVPA was determined by using recalled information on the frequency and duration of various physical activities across adulthood. A Bayesian relevant life course exposure model was used to estimate the relative importance of total MVPA, represented as average energy expenditure in units of metabolic equivalent (MET)-hours/week, during three pre-specified periods (early reproductive years, late reproductive years/perimenopause, and postmenopause) on invasive ovarian cancer risk.</p><p><strong>Results: </strong>The lifetime-effect odds ratio comparing ≥50 vs <50 MET-hours/week across adulthood was 0.59 (95% credible interval: 0.35-0.93). MVPA during late reproductive years/perimenopause showed the highest relative importance, suggesting that this may be a sensitive period. Associations were similar for serous and non-serous subtypes.</p><p><strong>Conclusion: </strong>Our results support that higher MVPA across the adult life course is associated with a reduced invasive ovarian cancer risk and mid-adulthood, represented by late reproductive years/perimenopause, may be a sensitive period.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"55 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13524439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality and childhood residence near the radiologically contaminated Coldwater Creek, St. Louis, Missouri.","authors":"Michael Leung, Justin G Farmer, Ian W Tang, Joyce J Y Lin, Lorelei Mucci, Murray A Mittleman, Kaleigh McAlaine, Joseph J Mangano, Marc G Weisskopf","doi":"10.1093/ije/dyag166","DOIUrl":"10.1093/ije/dyag166","url":null,"abstract":"<p><strong>Background: </strong>Under the top-secret Manhattan Project, improperly stored radioactive byproducts from the processing of uranium contaminated Coldwater Creek in north St. Louis County, Missouri. We used the original 1958 Baby Tooth Survey (BTS) linked with the National Death Index (NDI) to investigate whether childhood residential proximity to the creek, as a proxy for radiation exposure, was associated with mortality.</p><p><strong>Methods: </strong>There were 43 876 eligible participants from the BTS (those outside Greater St. Louis and/or had incomplete covariates were excluded). In December 2023, the NDI was searched for BTS participants who had died. We estimated the hazard ratio (HR) and 95% confidence intervals between distance to Coldwater Creek (per 10 km) and mortality (all-cause, cancer, and cardiovascular disease) adjusting for sex, birth year, and census tract-level socioeconomic indicators.</p><p><strong>Results: </strong>Living closer to Coldwater Creek was associated with a higher rate of all-cause mortality (HR: 1.05; 95% CI: 1.01-1.09; P = .01). There was suggestive evidence of an increased rate for cancer mortality: any cancer (HR: 1.06; 95% CI: 1.00-1.14; P = .06), solid cancer (HR: 1.07, 95% CI: 1.00-1.16; P = .06) and radiosensitive cancer (HR: 1.10; 95% CI: 1.00-1.21; P = .05). There was no association with non-radiosensitive cancer and cardiovascular mortality.</p><p><strong>Conclusions: </strong>Our study provides new data that suggest living near Coldwater Creek in childhood was positively associated with the rate of all-cause mortality, and to a lesser extent cancer mortality, but not cardiovascular disease mortality. However, these findings should be interpreted cautiously given the lack of data on internal radiation exposure and individual socioeconomic status.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"55 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}