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  1. Wood C, Barron D, Smyth N
    PMID: 31726784 DOI: 10.3390/ijerph16224443
    Both nature exposure and green exercise (GE) can improve health. However, there are no scales examining frequency of engagement; or that consider interaction with nature. There are also no scales assessing these variables during childhood. The aim of this study was to develop a modified (NES-II) and retrospective (RNES-II) version of the Nature Exposure Scale to incorporate GE and to examine their factor structure and reliability. Exploratory factor analysis (EFA) explored the factor structure of the scales; followed by confirmatory factor analysis to confirm the model fit. Fit indices for the one factor five item NES-II and RNES-II models identified by EFA were poor. Use of modification indices resulted in a good model fit; NES-II: χ(5, n = 385) = 2.638; χnormed = 0.879; CFI= 1.000; RMSEA < 0.001 with 90%CI = 0.000-0.082; SRMR = 0.009; AIC = 36.638. RNES-II: χ(2, n = 385) = 7.149; χnormed = 3.574; CFI = 0.995; RMSEA = 0.082 with 90%CI = 0.023-0.151; SRMR = 0.015; AIC = 43.149. Both models demonstrated very good reliability (α = 0.84; 89 respectively). These findings indicate that the scales can be used to assess current and retrospective nature exposure. However, due to the removal of item one, the authors recommend that the scales be named the 'intentional nature exposure scale' and 'retrospective intentional nature exposure scale'.
  2. Machiela MJ, Hofmann JN, Carreras-Torres R, Brown KM, Johansson M, Wang Z, et al.
    Eur Urol, 2017 Nov;72(5):747-754.
    PMID: 28797570 DOI: 10.1016/j.eururo.2017.07.015
    BACKGROUND: Relative telomere length in peripheral blood leukocytes has been evaluated as a potential biomarker for renal cell carcinoma (RCC) risk in several studies, with conflicting findings.

    OBJECTIVE: We performed an analysis of genetic variants associated with leukocyte telomere length to assess the relationship between telomere length and RCC risk using Mendelian randomization, an approach unaffected by biases from temporal variability and reverse causation that might have affected earlier investigations.

    DESIGN, SETTING, AND PARTICIPANTS: Genotypes from nine telomere length-associated variants for 10 784 cases and 20 406 cancer-free controls from six genome-wide association studies (GWAS) of RCC were aggregated into a weighted genetic risk score (GRS) predictive of leukocyte telomere length.

    OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Odds ratios (ORs) relating the GRS and RCC risk were computed in individual GWAS datasets and combined by meta-analysis.

    RESULTS AND LIMITATIONS: Longer genetically inferred telomere length was associated with an increased risk of RCC (OR=2.07 per predicted kilobase increase, 95% confidence interval [CI]:=1.70-2.53, p<0.0001). As a sensitivity analysis, we excluded two telomere length variants in linkage disequilibrium (R2>0.5) with GWAS-identified RCC risk variants (rs10936599 and rs9420907) from the telomere length GRS; despite this exclusion, a statistically significant association between the GRS and RCC risk persisted (OR=1.73, 95% CI=1.36-2.21, p<0.0001). Exploratory analyses for individual histologic subtypes suggested comparable associations with the telomere length GRS for clear cell (N=5573, OR=1.93, 95% CI=1.50-2.49, p<0.0001), papillary (N=573, OR=1.96, 95% CI=1.01-3.81, p=0.046), and chromophobe RCC (N=203, OR=2.37, 95% CI=0.78-7.17, p=0.13).

    CONCLUSIONS: Our investigation adds to the growing body of evidence indicating some aspect of longer telomere length is important for RCC risk.

    PATIENT SUMMARY: Telomeres are segments of DNA at chromosome ends that maintain chromosomal stability. Our study investigated the relationship between genetic variants associated with telomere length and renal cell carcinoma risk. We found evidence suggesting individuals with inherited predisposition to longer telomere length are at increased risk of developing renal cell carcinoma.

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