Joona Maaranen, Timo T Hugg, Inês Paciência, Maritta S Jaakkola, Jouni J K Jaakkola, Aino K Rantala
{"title":"Home dampness and molds and occurrence of respiratory tract infections in the first 27 years of life: The Espoo Cohort Study.","authors":"Joona Maaranen, Timo T Hugg, Inês Paciência, Maritta S Jaakkola, Jouni J K Jaakkola, Aino K Rantala","doi":"10.1093/aje/kwaf200","DOIUrl":"https://doi.org/10.1093/aje/kwaf200","url":null,"abstract":"<p><p>The role of residential dampness and molds in the occurrence of respiratory tract infections is not well understood. We assessed the relations between cumulative lifetime and time-specific dampness and mold exposures and the occurrence of upper and lower respiratory tract infections (URTI and LRTI) from pregnancy to 27 years of age in the prospective population-based Espoo Cohort Study (n=2,567). We assessed three questionnaire-based reports of residential exposure to water damage, moisture on the surfaces, visible mold and mold odor, and incidence rates of URTI and LRTI when children were 1-6, 7-13, and 21-27 years. We estimated adjusted incidence rate differences (aIRD) and ratios (aIRR) with their 95% confidence intervals (CI). According to all the data combined from three follow-ups, home exposure to dampness and mold increased the risk of URTIs (aIRR 1.15; 95% CI 1.10, 1.21) and LRTIs (aIRR 1.47; 95% CI 1.21, 1.79). An exposure-response pattern was observed, with each additional exposure time point particularly associated with an increased risk of LRTIs due to water damage (aIRR 2.13; 1.32-3.44) and mold odor (aIRR 2.04; 1.22,3.43). The occurrence of respiratory tract infections was associated with both presence and duration of residential dampness and mold exposure.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022674","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}
Massimiliano Russo, Sushama Kattinakere Sreedhara, Joshua Smith, Sharon E Davis, Judith C Maro, Thomas Deramus, Joyce Lii, Jie Yang, Rishi Desai, José J Hernández-Muñoz, Yong Ma, Youjin Wang, Jamal T Jones, Shirley V Wang
{"title":"Electronic Health Record (EHR) Enhanced Signal Detection Using Tree-Based Scan Statistic Methods.","authors":"Massimiliano Russo, Sushama Kattinakere Sreedhara, Joshua Smith, Sharon E Davis, Judith C Maro, Thomas Deramus, Joyce Lii, Jie Yang, Rishi Desai, José J Hernández-Muñoz, Yong Ma, Youjin Wang, Jamal T Jones, Shirley V Wang","doi":"10.1093/aje/kwaf199","DOIUrl":"https://doi.org/10.1093/aje/kwaf199","url":null,"abstract":"<p><p>Tree-based scan statistics (TBSS) are data mining methods that screen thousands of hierarchically related health outcomes to detect unsuspected adverse drug effects. TBSS traditionally analyze claims data with outcomes defined via diagnosis codes. TBSS have not been previously applied to rich clinical information in Electronic Health Records (EHR). We developed approaches for integrating EHR data in TBSS analyses, including outcomes derived from natural language processing (NLP) applied to clinical notes and laboratory results, related via multipath hierarchical structures. We consider four settings that sequentially add sources of outcomes to the TBSS tree: 1) diagnosis code, 2) NLP-derived outcomes, 3) binary outcomes from lab results, and 4) continuous lab results. In a comparative cohort study involving second-generation sulfonylureas (SUs) and dipeptidyl peptidase 4 (DPP-4) inhibitors among adults with type-2 diabetes, with an a priori expected signal of hypoglycemia, diagnosis code data showed no statistical alerts for inpatient or emergency department settings. Adding NLP-derived outcomes resulted in an alert for \"Headaches\" (p=0.047), a nonspecific symptom of hypoglycemia. Progressively adding binary and continuous lab results produced the same alert. Integrating EHR in TBSS can be useful for the detection of safety signals for further investigation.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013669","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}
Vahé Nafilyan, Augustin de Coulon, Mauricio Avendano
{"title":"The impact of depressive symptoms on cognitive function in early old age: A longitudinal fixed-effect study.","authors":"Vahé Nafilyan, Augustin de Coulon, Mauricio Avendano","doi":"10.1093/aje/kwaf187","DOIUrl":"https://doi.org/10.1093/aje/kwaf187","url":null,"abstract":"<p><p>Depression is associated with cognitive decline, but the causal nature of this association in early old age has not yet been established. We examined the impact of depressive symptoms on changes in cognitive function using data from 27,315 adults aged 50-65 in the Survey of Health, Ageing and Retirement in Europe (SHARE) followed for 8 years (2010/2011 -2017/2018), using fixed effect models. Results suggest that an increase in depressive symptoms is associated with a significant decline in overall cognitive function (β =-0.069, 95% Confidence Interval (CI) -0.082 to -0.057), episodic memory (β =-0.052, 95% CI -0.065 to -0.038), working memory (β =-0.075, 95% CI -0.091 to -0.059) and verbal fluency (β =-0.039, 95% CI -0.043 to -0.016). Symptoms capturing difficulties to concentrate, loss of appetite, loss of enjoyment, loss of interest, pessimism, sleep problems and suicidality have stronger effects that depressed mood symptoms such as sadness and tearfulness. Results are robust to an expanded set of controls and to an instrumental variable approach for depressive symptoms. Findings provide novel evidence of a potentially causal relationship between depressive symptoms and cognitive function in early old age.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999438","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}
Marnie Downes, Meredith O'Connor, Craig A Olsson, David Burgner, Sharon Goldfeld, Elizabeth A Spry, George Patton, Margarita Moreno-Betancur
{"title":"Causal inference in multi-cohort studies using the target trial framework to identify and minimize sources of bias.","authors":"Marnie Downes, Meredith O'Connor, Craig A Olsson, David Burgner, Sharon Goldfeld, Elizabeth A Spry, George Patton, Margarita Moreno-Betancur","doi":"10.1093/aje/kwae405","DOIUrl":"10.1093/aje/kwae405","url":null,"abstract":"<p><p>Longitudinal cohort studies, which follow a group of individuals over time, provide the opportunity to examine the causal effects of complex exposures on long-term health outcomes. Utilizing data from multiple cohorts has the potential to add further benefit by improving the precision of estimates through data pooling and by allowing examination of effect heterogeneity through replication of analyses across cohorts. However, the interpretation of findings can be complicated by biases that may be compounded when pooling data or contribute to discrepant findings when analyses are replicated. The \"target trial\" is a powerful tool for guiding causal inference in single-cohort studies. Here we extend this conceptual framework to address the specific challenges that can arise in the multi-cohort setting. By representing a clear definition of the target estimand, the target trial provides a central point of reference against which biases arising in each cohort and from data pooling can be systematically assessed. Consequently, analyses can be designed to reduce these biases and the resulting findings appropriately interpreted in light of potential remaining biases. We use a case study to demonstrate the framework and its potential to strengthen causal inference in multi-cohort studies through improved analysis design and clarity in the interpretation of findings.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"2685-2697"},"PeriodicalIF":4.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492831","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":"Prenatal exposure to residential greenness, fetal growth, and birth outcomes: a cohort study in New York City.","authors":"Seulkee Heo, Yelena Afanasyeva, Mengling Liu, Shilpi Mehta-Lee, Wenqing Yang, Leonardo Trasande, Michelle L Bell, Akhgar Ghassabian","doi":"10.1093/aje/kwae436","DOIUrl":"10.1093/aje/kwae436","url":null,"abstract":"<p><p>Findings for greenspace's impacts on birth outcomes are largely dependent on vegetation indexes. Examinations are needed for various greenspace indicators given varying pathways for fetal development. This prospective cohort study assessed the impacts of prenatal greenspace exposure on preterm birth (PTB), term low birthweight (TLBW), birthweight, and estimated fetal weight (EFW) for pregnant women in the New York City area, 2016-2023 (n = 2765). Longitudinal greenspace exposure was measured for residential histories during pregnancy using the enhanced vegetation index for 1000 m buffers and four park metrics, namely, the total number, sum of area, and the accessibility of parks within residential buffers (500 m) and the distance to the closest park. Multivariable regression models were used to estimate the associations for quartiles of exposure (with the first quartile [Q1] as reference). Greenspace exposure was not associated with TLBW, birthweight, or EFW. Odds ratios of PTB for the Q2, Q3, and Q4 enhanced vegetation index exposure groups compared to the Q1 group were 0.65 (95% CI, 0.43-0.98), 0.51 (95% CI, 0.32-0.80), and 0.56 (95% CI, 0.35-0.90), respectively. Preterm birth risks decreased in higher exposure groups (Q2-Q4) of the total park number. Results indicate the benefits of prenatal greenspace exposure for fetal maturity and neonatal outcomes.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"2621-2630"},"PeriodicalIF":4.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674877","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}
Hailey R Banack, Matthew P Fox, Robert W Platt, Michael D Garber, Xiaojuan Li, Jonathan Schildcrout, Ellicott C Matthay
{"title":"Modern sources of controls in case-control studies.","authors":"Hailey R Banack, Matthew P Fox, Robert W Platt, Michael D Garber, Xiaojuan Li, Jonathan Schildcrout, Ellicott C Matthay","doi":"10.1093/aje/kwae437","DOIUrl":"10.1093/aje/kwae437","url":null,"abstract":"<p><p>In 1992, Wacholder et al. developed a theoretical framework for case-control studies to minimize bias in control selection. They described 3 comparability principles (study base, deconfounding, and comparable accuracy) to reduce the potential for selection bias, confounding, and information bias in case-control studies. Wacholder et al. explained how these principles apply to traditional sources of control participants for case-control studies, including population controls, hospital controls, controls from a medical practice, friend or relative controls, and deceased controls. The goal of the present article is to extend this seminal work on case-control studies by providing a modern perspective on sources of control participants. Today, there are many more potential sources of control participants s for case-control studies than there were in the 1990s. This is due to technological advances in computing power, internet access, and availability of \"big data\" resources. These advances have vastly expanded the quantity and diversity of data available for case-control studies. We discuss control selection from electronic health records, health insurance claims databases, publicly available online data sources, and social media-based data. We focus on practical considerations for unbiased control selection, emphasizing the strengths and weaknesses of each modern source of controls for case-control studies.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"2631-2640"},"PeriodicalIF":4.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142714925","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":"Correction to: Omics feature selection with the extended SIS R package: identification of a body mass index epigenetic multimarker in the Strong Heart Study.","authors":"","doi":"10.1093/aje/kwaf121","DOIUrl":"10.1093/aje/kwaf121","url":null,"abstract":"","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"2758"},"PeriodicalIF":4.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300988","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}
Izzy Chiu, Moranda Tate, Dillon Trujillo, Bow Suprasert, Alex Marr, Sean Arayasirikul, Erin C Wilson, Henry F Raymond, Willi McFarland
{"title":"Sample composition and HIV prevention indicator differences using physical vs virtual venue recruitment of men who have sex with men in San Francisco.","authors":"Izzy Chiu, Moranda Tate, Dillon Trujillo, Bow Suprasert, Alex Marr, Sean Arayasirikul, Erin C Wilson, Henry F Raymond, Willi McFarland","doi":"10.1093/aje/kwae443","DOIUrl":"10.1093/aje/kwae443","url":null,"abstract":"<p><p>During the COVID-19 pandemic, the sampling method for the National HIV Behavioral Surveillance (NHBS) in San Francisco changed from physical venue time-location sampling (TLS) to online or virtual venue TLS for men who have sex with men (MSM). We present differences in the samples of MSM recruited using physical venue TLS in 2017 and virtual venue TLS in 2021. We further assess changes in preventive and risk behaviors from 2017 to 2021 after controlling for differences in the sample compositions with multivariable Poisson models using generalized linear models with robust standard errors. Both sampling methods exceeded their targeted sample size of 500 (physical venue TLS n = 502, virtual venue TLS n = 505). Compared to physical venue TLS, the virtual venue TLS sample had fewer persons experiencing homelessness and incarceration, and more persons with health insurance and postgraduate degrees. After adjusting for these differences and age, race, and employment status, pre-exposure prophylaxis use increased from 2017 to 2021. The use of several noninjection drugs also increased, namely marijuana, poppers, ketamine, psilocybin, and LSD. We found virtual venue recruitment of MSM to be a viable approach for tracking trends in HIV-related behaviors, with notable appeal given possible future pandemic lockdowns of physical venues and changing socialization patterns.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"2650-2658"},"PeriodicalIF":4.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823533","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":"The importance and challenges of using natural experiments to evaluate the health effects of housing policy: a commentary on Schwartz and Chu's \"Do laws protecting tenants' health work?: Implied warranties of habitability and respiratory health\".","authors":"Rebecca Bentley, Kate Mason","doi":"10.1093/aje/kwaf134","DOIUrl":"10.1093/aje/kwaf134","url":null,"abstract":"<p><p>Housing policy remains underutilized as a lever for better population health. This commentary discusses the intersection of housing policy and population health, focusing on the use of natural experiments to evaluate the health effects of housing policies. We consider Schwartz and Chu's paper (Am J Epidemiol. XXXX;XXX(XX):XXXX-XXXX) in which they employ a natural experiment approach to quantifying health impacts of habitability warrants: state-based housing policy aimed at protecting renters in the United States. The paper's null findings highlight the complexities of evaluating health effects of housing policies. Findings could be explained by policy failure, that is, habitability warranties place the burden on tenants to act, requiring them to invest resources and potentially risk their tenancy to address suboptimal living conditions. Methodological challenges could also contribute including limited sample sizes, reliance on self-reported data, and potential confounding factors. We argue that failure to optimize housing policies for health outcomes leads to missed opportunities to improve population health using prevention strategies, potentially widening existing health inequalities. This review underscores the need for continued research into the health impacts of housing policies, advocating for a shift toward health-centric policy evaluation to better leverage housing as a key social determinant of health.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"2755-2757"},"PeriodicalIF":4.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511405","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}
Maricar Ordonez, Dayoung Bae, Melissa Wong, Adam M Leventhal, Hongying D Dai, Junhan Cho
{"title":"Association of discrimination experiences with rapid subsequent changes in anxiety and depressive symptoms in US adults during the COVID-19 pandemic.","authors":"Maricar Ordonez, Dayoung Bae, Melissa Wong, Adam M Leventhal, Hongying D Dai, Junhan Cho","doi":"10.1093/aje/kwae433","DOIUrl":"10.1093/aje/kwae433","url":null,"abstract":"<p><p>This study explores how discrimination experiences during the COVID-19 pandemic relate to anxiety and depressive symptoms in US adults. Using a national representative intensive longitudinal survey, the study evaluates rapid subsequent changes in anxiety and depression when individuals undergo heightened discrimination beyond their usual experiences. The study used 23 survey time points, primarily with 2-week intervals, from the Understanding America Study (n = 8198). Time-varying and time-lagged associations between discrimination experiences and anxiety and depression were modeled using multilevel logistic random-effect repeated-measures regression models. The results showed that discrimination experiences were associated with moderate-to-severe anxiety and depressive symptoms, as well as more than 1 comorbid psychological distress symptom (adjusted odds ratios [AORs], 1.10-1.13). The association remained significant regardless of interindividual differences in exposure to discrimination. Non-Hispanic Blacks, Asians, and other race/ethnicities exhibited stronger associations between discrimination and psychological distress (AORs, 1.63-1.93) compared to Hispanic and White respondents (AORs, 1.13-1.25). Our findings suggest that individuals experience a rapid deterioration in their emotional well-being when subjected to heightened levels of discrimination beyond their typical experiences.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"2600-2607"},"PeriodicalIF":4.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674874","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}