It has long been known that relatively high-dose ionising radiation exposure (> 1 Gy) can induce cataract, but there has been no evidence that this occurs at low doses (< 100 mGy). To assess low-dose risk, participants from the US Radiologic Technologists Study, a large, prospective cohort, were followed from date of mailed questionnaire survey completed during 1994-1998 to the earliest of self-reported diagnosis of cataract/cataract surgery, cancer other than non-melanoma skin, or date of last survey (up to end 2014). Cox proportional hazards models with age as timescale were used, adjusted for a priori selected cataract risk factors (diabetes, body mass index, smoking history, race, sex, birth year, cumulative UVB radiant exposure). 12,336 out of 67,246 eligible technologists reported a history of diagnosis of cataract during 832,479 person years of follow-up, and 5509 from 67,709 eligible technologists reported undergoing cataract surgery with 888,420 person years of follow-up. The mean cumulative estimated 5-year lagged eye-lens absorbed dose from occupational radiation exposures was 55.7 mGy (interquartile range 23.6-69.0 mGy). Five-year lagged occupational radiation exposure was strongly associated with self-reported cataract, with an excess hazard ratio/mGy of 0.69 × 10 (95% CI 0.27 × 10 to 1.16 × 10, p < 0.001). Cataract risk remained statistically significant (p = 0.030) when analysis was restricted to < 100 mGy cumulative occupational radiation exposure to the eye lens. A non-significantly increased excess hazard ratio/mGy of 0.34 × 10 (95% CI - 0.19 × 10 to 0.97 × 10, p = 0.221) was observed for cataract surgery. Our results suggest that there is excess risk for cataract associated with radiation exposure from low-dose and low dose-rate occupational exposures.

Background Prior studies have examined the independent influence of mothers’ weight status or childs’ weight status on parents’ use of specific feeding practices (i.e., restriction, pressure-to-eat). However, studies have not examined the mutual influence of parents' and adolescents' weight status on parents' feeding practices. This study examines the relationship between parent/adolescent weight status concordance and discordance and parent feeding practices. Methods Data from two linked population-based studies, EAT 2010 and F-EAT, were used for cross-sectional analysis. Mothers and fathers (n = 3,252; 63% females; mean age = 42.6 years) and adolescents (n = 2,153; 54% females; mean age = 14.4 years) were socio-economically and racially/ethnically diverse. Anthropometric assessments and surveys were completed at school by adolescents and surveys were completed at home by parents. Results Parents used the highest levels of pressure-to-eat feeding practices when parents and adolescents were both nonoverweight compared to all other combinations of concordant and discordant parent/adolescent weight status categories. Additionally, parents used the highest levels of food restriction when parents and adolescents were both overweight/obese compared to all other combinations of concordant and discordant parent/adolescent weight status categories. Sensitivity analyses with two parent households revealed similar patterns. Conclusions Results suggest that parents used parent feeding practices in response to both their adolescent’s and their own weight status. Results may inform health care providers and public health interventionists which parent/adolescent dyads are at highest risk for experiencing food restriction or pressure-to-eat parent feeding practices in the home environment and who to target in interventions.

Smoking is associated with shorter leucocyte telomere length (LTL), a biomarker of increased morbidity and reduced longevity. This association is widely interpreted as evidence that smoking causes accelerated LTL attrition in adulthood, but the evidence for this is inconsistent. We analysed the association between smoking and LTL dynamics in 18 longitudinal cohorts. The dataset included data from 12 579 adults (4678 current smokers and 7901 non-smokers) over a mean follow-up interval of 8.6 years. Meta-analysis confirmed a cross-sectional difference in LTL between smokers and non-smokers, with mean LTL 84.61 bp shorter in smokers (95% CI: 22.62 to 146.61). However, LTL attrition was only 0.51 bp yr −1 faster in smokers than in non-smokers (95% CI: −2.09 to 1.08), a difference that equates to only 1.32% of the estimated age-related loss of 38.33 bp yr −1 . Assuming a linear effect of smoking, 167 years of smoking would be required to generate the observed cross-sectional difference in LTL. Therefore, the difference in LTL between smokers and non-smokers is extremely unlikely to be explained by a linear, causal effect of smoking. Selective adoption, whereby individuals with short telomeres are more likely to start smoking, needs to be considered as a more plausible explanation for the observed pattern of telomere dynamics.

ObjectiveTo examine whether and how parents’ and adolescent siblings’ weight and weight-related behaviors are correlated. Results will inform which family members may be important to include in adolescent obesity prevention interventions.Design and MethodsData from two linked population-based studies, EAT 2010 and F-EAT, were used for cross-sectional analyses. Parents (n=58; 91% females; mean age=41.7 years) and adolescent siblings (sibling #1 n=58, 50% girls, mean age=14.3 years; sibling #2 n=58, 64% Girls, mean age=14.8) were socioeconomically and racially/ethnically diverse.ResultsSome weight-related behaviors between adolescent siblings were significantly positively correlated (i.e., fast food consumption, breakfast frequency, sedentary patterns, p<0.05). There were no significant correlations between parent weight and weight-related behaviors and adolescent siblings’ same behaviors. Some of the significant correlations found between adolescent siblings’ weight-related behaviors were statistically different from correlations between parents’ and adolescent siblings’ weight-related behaviors.ConclusionsAlthough not consistently, adolescent siblings’ weight-related behaviors were significantly correlated as compared to parents’ and adolescent siblings’ weight-related behaviors. It may be important to consider including siblings in adolescent obesity prevention interventions or in recommendations healthcare providers give to adolescents regarding their weight and weight-related behaviors.

Introduction Few studies have examined concordance/discordance between caregivers to identify whether caregivers see familial and parental factors in the home environment similarly or differently and whether the agreement or disagreement is related to adolescent obesity risk. Answers to these questions are important and may inform whether family-based childhood obesity interventions need to target both parents. Objective The main objective of the study is to examine whether and how parental concordance/discordance on factors in the home environment (e.g., importance of family meals, parent feeding practices, encouraging child physical activity, limit setting on child screen time) are associated with adolescent health behaviors and weight status. Design Data from two linked population-based studies were used in cross-sectional analyses. Linear regression models examined associations between parental concordance/discordance on home environment factors and adolescents’ health behaviors and weight status. Participant/Settings Racially/ethnically and socioeconomically diverse adolescents (n=1,052; 54% girls; mean age = 14.3 years) and their parents (n=2,104; 52% female; mean age = 41.0 years) from Minneapolis and St. Paul, Minnesota participated in the study. Anthropometric assessments and surveys were completed at school by adolescents and surveys were completed at home by parents. Results Parental concordance on home environment factors was high for some factors (e.g., 68% concordance on not pressuring adolescent to eat) and low for other factors (e.g., 2% concordance on parent engaging in physically activity with child 4+ hours/week). Parental concordance on positive home environment factors (e.g., frequency of family meals) was associated with more adolescent healthful eating patterns and hours of physical activity (p < 0.05), but not consistently. When parents were discordant, adolescents had higher consumption of fast food and more unhealthy weight control behaviors (p < 0.05), but not consistently. Conclusions Results suggest there is some degree of parental concordance on home environment factors, however the results were inconsistent and approximately one third of parents were discordant on these factors. Future research is needed to further examine the role of parental concordance/discordance on adolescent health behaviors and weight status.

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Key Points Question Is the implementation of the Medicare national coverage determination (NCD) associated with use of next-generation sequencing by insurance and racial and ethnic categories? Findings In this cohort study of 92 687 patients with lung, breast, colon, and skin cancer, NCD implementation was associated with a slower rate of increase in next-generation sequencing use for patients with patient assistance programs compared with Medicare beneficiaries. Implementation of the NCD was not associated with narrowing of racial and ethnic disparities among Medicare beneficiaries alone or the overall insured population. Meaning These findings suggest that implementation of the Medicare NCD for next-generation sequencing did not result in equal increased use across insurance types or racial and ethnic groups.

BackgroundPatients with chronic kidney disease (CKD) are at increased risk for heart failure (HF). We aimed to investigate differences in proteins associated with HF hospitalizations among patients with and without CKD in the Heart and Soul Study.Methods and resultsWe measured 1068 unique plasma proteins from baseline samples of 974 participants in The Heart and Soul Study who were followed for HF hospitalization over a median of 7 years. We sequentially applied forest regression and Cox survival analyses to select prognostic proteins. Among participants with CKD, four proteins were associated with HF at Bonferroni-level significance (p<2.5x10-4): Angiopoietin-2 (HR[95%CI] 1.45[1.33, 1.59]), Spondin-1 (HR[95%CI] 1.13 [1.06, 1.20]), tartrate-resistant acid phosphatase type 5 (HR[95%CI] 0.65[0.53, 0.78]) and neurogenis locus notch homolog protein 1 (NOTCH1) (HR[95%CI] 0.67[0.55, 0.80]). These associations persisted at p<0.01 after adjustment for age, estimated glomerular filtration and history of HF. CKD was a significant interaction term in the associations of NOTCH1 and Spondin-1 with HF. Pathway analysis showed a trend for higher representation of the Cardiac Hypertrophy and Complement/Coagulation pathways among proteins prognostic of HF in the CKD sub-group.ConclusionsThese results suggest that markers of heart failure differ between patients with and without CKD. Further research is needed to validate novel markers in cohorts of patients with CKD and adjudicated HF events.