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Examining the independent and joint effects of genomic and exposomic liabilities for schizophrenia across the psychosis spectrum
- L.-K. Pries, G. A. Dal Ferro, J. van Os, P. Delespaul, G. Kenis, B. D. Lin, J. J. Luykx, A. L. Richards, B. Akdede, T. Binbay, V. Altınyazar, B. Yalınçetin, G. Gümüş-Akay, B. Cihan, H. Soygür, H. Ulaş, E. Şahin Cankurtaran, S. Ulusoy Kaymak, M. M. Mihaljevic, S. Andric Petrovic, T. Mirjanic, M. Bernardo, G. Mezquida, S. Amoretti, J. Bobes, P. A. Saiz, M. Paz García-Portilla, J. Sanjuan, E. J. Aguilar, J. L. Santos, E. Jiménez-López, M. Arrojo, A. Carracedo, G. López, J. González-Peñas, M. Parellada, N. P. Maric, C. Atbaşoğlu, A. Ucok, K. Alptekin, M. Can Saka, Genetic Risk and Outcome of Psychosis (GROUP) investigators, C. Arango, M. O'Donovan, S. Tosato, B. P. F. Rutten, S. Guloksuz
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 29 / 2020
- Published online by Cambridge University Press:
- 17 November 2020, e182
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Aims
Psychosis spectrum disorder has a complex pathoetiology characterised by interacting environmental and genetic vulnerabilities. The present study aims to investigate the role of gene–environment interaction using aggregate scores of genetic (polygenic risk score for schizophrenia (PRS-SCZ)) and environment liability for schizophrenia (exposome score for schizophrenia (ES-SCZ)) across the psychosis continuum.
MethodsThe sample consisted of 1699 patients, 1753 unaffected siblings, and 1542 healthy comparison participants. The Structured Interview for Schizotypy-Revised (SIS-R) was administered to analyse scores of total, positive, and negative schizotypy in siblings and healthy comparison participants. The PRS-SCZ was trained using the Psychiatric Genomics Consortiums results and the ES-SCZ was calculated guided by the approach validated in a previous report in the current data set. Regression models were applied to test the independent and joint effects of PRS-SCZ and ES-SCZ (adjusted for age, sex, and ancestry using 10 principal components).
ResultsBoth genetic and environmental vulnerability were associated with case-control status. Furthermore, there was evidence for additive interaction between binary modes of PRS-SCZ and ES-SCZ (above 75% of the control distribution) increasing the odds for schizophrenia spectrum diagnosis (relative excess risk due to interaction = 6.79, [95% confidential interval (CI) 3.32, 10.26], p < 0.001). Sensitivity analyses using continuous PRS-SCZ and ES-SCZ confirmed gene–environment interaction (relative excess risk due to interaction = 1.80 [95% CI 1.01, 3.32], p = 0.004). In siblings and healthy comparison participants, PRS-SCZ and ES-SCZ were associated with all SIS-R dimensions and evidence was found for an interaction between PRS-SCZ and ES-SCZ on the total (B = 0.006 [95% CI 0.003, 0.009], p < 0.001), positive (B = 0.006 [95% CI, 0.002, 0.009], p = 0.002), and negative (B = 0.006, [95% CI 0.004, 0.009], p < 0.001) schizotypy dimensions.
ConclusionsThe interplay between exposome load and schizophrenia genetic liability contributing to psychosis across the spectrum of expression provide further empirical support to the notion of aetiological continuity underlying an extended psychosis phenotype.
Using different physical activity measurements in eight European countries. Results of the European Physical Activity Surveillance System (EUPASS) time series survey
- A Rütten, H Ziemainz, F Schena, T Stahl, M Stiggelbout, Y Vanden Auweele, A Vuillemin, J Welshman
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- Journal:
- Public Health Nutrition / Volume 6 / Issue 4 / June 2003
- Published online by Cambridge University Press:
- 02 January 2007, pp. 371-376
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Objectives:
The European Physical Activity Surveillance System (EUPASS) research project compared several physical activity (PA) measures (including the International Physical Activity Questionnaire (IPAQ)) in a time series survey in eight countries of the European Union. The present paper describes first results provided by the different instruments regarding PA participation, frequency and duration, both at the European and national levels. The purpose of the present study is to explore and compare the specific quality and usefulness of different indicators rather than to provide valid and reliable prevalence data. Thus, the main focus is on discussion of the methodological implications of the results presented.
Methods:A time series survey based on computer-aided telephone interviewing (CATI) was carried out in eight European countries over a six-month period. The study provided for about 100 realised interviews per month in each country (i.e. ~600 per country). Descriptive statistical analysis was used to: (1) report IPAQ results on vigorous, moderate and light PA and sitting, as well as on the overall measure of calories expenditure (MET min−1), in the different countries; (2) compare these results with national PA indicators tested in EUPASS; and (3) compare IPAQ results with other European studies.
Results:First, the scores for the different PA categories as well as for the overall measure of calories expenditure provided by the IPAQ appeared rather high compared with previous studies and public health recommendations. Second, the different PA measurements used in EUPASS provided completely different results. For example, national indicators used in Germany and The Netherlands to date neither corresponded in absolute values (e.g. means of PA or sitting) nor correlated with the IPAQ in any significant way. Third, comparing EU countries, the ranking for vigorous, moderate and light activities by use of the IPAQ differed from that of other European studies. For example, in the present analysis, German respondents generally showed higher scores for PA than the Finns and the Dutch, while, in contrast, findings from other studies ranked Finland before The Netherlands and Germany.
Conclusions:The present analysis highlights some methodological implications of the IPAQ instrument. Among other things, differences in overall scores for PA as well as in the ranking of nations between the present results using IPAQ and other measures and studies may partly be due to the concepts of PA behind the measurements. Further analysis should investigate if the range of PA-related categories provided by the IPAQ is fully appropriate to measure all relevant daily activities; it may also consider the public health implications of mixing up different contexts of PA (e.g. work, leisure-time, transportation) in the IPAQ short version.
Physical activity monitoring in Europe. The European Physical Activity Surveillance System (EUPASS) approach and indicator testing
- A Rütten, A Vuillemin, WTM Ooijendijk, F Schena, M Sjöström, T Stahl, Y Vanden Auweele, J Welshman, H Ziemainz
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- Journal:
- Public Health Nutrition / Volume 6 / Issue 4 / June 2003
- Published online by Cambridge University Press:
- 02 January 2007, pp. 377-384
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Objectives:
The main objective of this paper is to describe the approach and specific findings of the European Physical Activity Surveillance System (EUPASS) research project. In particular, the analysis presented aims at testing the reliability, comparability and predictive power of different sets of physical activity (PA) indicators.
Design:First, a panel study based on computer-aided telephone interview (CATI) was designed to report PA data of a representative, selected group of about 100 persons per country at three points in time. Second, a CATI time series survey was carried out with the goal of realising about 100 interviews per month over six consecutive months.
Setting:The project was carried out in eight European countries to support the development of the European Union's (EU) Health Monitoring Programme.
Subjects:Random population samples (subjects aged 18 years and older) were drawn from each participating country.
Results:While many PA indicators used in EU countries to date as well as the psychosocial and environmental measures tested in the present study had acceptable to good reliability coefficients, the test–retest reliability scores of the International Physical Activity Questionnaire (IPAQ) version tested (the short (last 7 days) telephone interview IPAQ; IPAQ-S7T) were rather low. The comparability between extant national PA items and the IPAQ-S7T was low for all countries. The strongest predictors of perceived health were the psychosocial and environmental PA indicators.
Conclusions:According to the results of the present study, more research is needed to further investigate and improve the quality of the IPAQ. In addition, the specific predictive power of the tested psychosocial and environmental PA indicators on perceived health should be of particular interest for designing health surveillance activities in the future.
Anaesthesia for advanced rectal cancer patients treated with combined major resections and intraoperative radiotherapy
- G. H. H. Mannaerts, A. A. J. Van Zundert, V. C. H. Meeusen, H. Martijn, H. J. T. Rutten
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- Journal:
- European Journal of Anaesthesiology / Volume 19 / Issue 10 / October 2002
- Published online by Cambridge University Press:
- 16 August 2006, pp. 742-748
- Print publication:
- October 2002
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Background and objective: Multimodality treatment for patients with locally advanced primary or locally recurrent rectal cancer, including high-dose preoperative external beam radiotherapy, extensive surgery and intraoperative radiation therapy, decreases the local recurrence rates and improves survival. During this aggressive operation, the anaesthesiologist is faced with potential problems such as major transfusion requirements, hypothermia, intraoperative position changes, the need to transport the patient to the intraoperative radiation therapy applicator, and the risks associated with remote monitoring of the patient during the 10 min intraoperative radiation therapy application. The anaesthetic management and perioperative results were evaluated for the anaesthetic results and the complications.
Methods: One-hundred-and-six patients undergoing the multimodality treatment between February 1994 and March 2000 for locally advanced primary (n = 50) and locally recurrent rectal cancer (n = 56) were retrospectively evaluated for their anaesthetic results and complications.
Results: All patients were operated upon using a combination of general and epidural anaesthesia. The average duration of anaesthesia was 6 (range 3–10.5) h and the mean blood loss 3.6 (range 0.4–14) L. All patients recovered well from anaesthesia. Two patients (2%) died in the intensive care unit (34 and 48 days postoperatively) because of adult respiratory distress syndrome following postoperative haemorrhage. Severe haemorrhage during or after the operation was significantly related with the development of adult respiratory distress syndrome (P < 0.0001).
Conclusions: With adequate preoperative assessment and optimalization of the patient's condition, maintaining peroperative haemodynamic stability with the help of adequate remote monitoring, early and fast transfusion, and multidisciplinary communication, anaesthetic complications can be minimized.