A systematic review and meta-analysis of time-sensitive exposure to particulate matter 2.5 and risk of aortic disease
Bibliographic record
Abstract
<h2>Abstract</h2><h3>Objective</h3> To systematically review the evidence linking air pollution exposure, particularly PM2.5, with acute and chronic aortic diseases including dissection, aneurysm formation, and rupture. <h3>Methods</h3> A literature search was conducted in August 2024 across Pubmed, Web of Science, Cochrane Library, and ProQuest Central, in accordance with PRISMA guidelines. Inclusion criteria comprised observational, interventional, cross-sectional, and ecological human studies that examined the association between air pollution and aortic disease and reported risk estimates with 95% confidence intervals. Eight studies were included after screening 1,935 articles. Quality was assessed using the Newcastle-Ottawa Scale. Three studies reporting relative risks for acute aortic dissection associated with short-term PM2.5 exposure on lag days 0-2 were selected for a meta-analysis. Using a random-effects model with restricted maximum likelihood (REML), pooled log-transformed RRs and 95% confidence intervals were calculated. Heterogeneity was assessed via I<sup>2</sup> statistic and Cochran's Q test. <h3>Results</h3> A total of 931,537 patients were represented. A random-effects meta-analysis of three studies examining same-day (lag 0) PM2.5 exposure and acute aortic dissection showed a significant association (RR = 1.12, 95% CI: 1.10–1.15; p < .0001), with moderate heterogeneity (I<sup>2</sup> = 35.2%). On lag day 1, the association remained significant (RR = 1.10, 95% CI: 1.03–1.18; p=.0068), though substantial heterogeneity was observed (I<sup>2</sup> = 88.3%). By lag day 2, the association was no longer statistically significant (RR = 1.06, 95% CI: 0.94–1.19; p=.32), and heterogeneity remained high (I<sup>2</sup> = 90.3%). Three studies assessed chronic PM2.5 exposure and found significant associations with abdominal aortic aneurysm formation (HR = 1.21, 95% CI: 1.16–1.27), rupture (RR = 1.9, 95% CI: 1.42–2.10), and hospital admissions due to thoracic abdominal aneurysms (RR = 1.301, 95% CI: 1.280–1.310). <h3>Conclusions</h3> Consistent findings across studies indicate that both acute and chronic PM2.5 exposure are associated with increased risks of acute aortic dissection and aneurysmal disease. PM2.5 may be a modifiable environmental risk factor for aortic pathology, highlighting the need for future mechanistic and longitudinal investigations.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.007 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".