99951
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Wang Y, Feng Y, Han M, Duan Z, Wilson A, Fish J, Sun S, Chen R. Methods of attempted suicide and risk factors in LGBTQ+ youth. Child Abuse Negl 2021; 122:105352. [PMID: 34655994 DOI: 10.1016/j.chiabu.2021.105352] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/25/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND This study aimed to identify patterns of attempted suicide methods and risk factors in lesbian, gay, bisexual, transgender, queer and other gender/sexual minority (LGBTQ+) youth by comparing them to non-LGBTQ+ youth. METHODS A total of 9281 Chinese college students completed the study, 8313 participants were included in the analysis of which 1032 were LGBTQ+ youth and 7281 were non-LGBTQ+ youth. Sociodemographic information was collected along with several scales and self-report items. This included anxiety scores using the Generalized Anxiety Disorder (GAD)-7, depression scores using the Patient Health Questionnaire (PHQ)-9, mania score using the Altman Self-Rating Mania (ASRM), Childhood Trauma Questionnaire (CTQ), and Intimate Partner Violence (IPV) victimization using the World Health Organization's definition. Self-report items were used to further collect history of non-fatal self-injurious behaviors, parents' related risk factors, history of suicide attempts, and methods of attempted suicide. RESULTS The prevalence of attempted suicide in LGBTQ+ youth was 4.2%, which in comparison was more than four times higher than non-LGBTQ+ youth. LGBTQ+ youth 19-22 years old were at a significantly higher risk of attempting suicide than non-LGBTQ+ youth. The most common method of attempted suicide was cutting of the wrist, followed by jumping from a high height. There were some common suicide risk factors that were similar between LGBTQ+ and non-LGBTQ+ youth, such as living in a rural area, having a history of a psychiatric disorder, and having a history of non-fatal self-injurious behaviors. The associated increased risk factors for LGBTQ+ youth were having a higher score for CTQ-emotional abuse and CTQ-sexual abuse. LIMITATION The causality of risk factors to attempted suicide cannot be assumed due to the cross-sectional nature of the survey. Also, due to the relatively small sample size within the subgroups, we did not assess LGBTQ+ youth separately according to the different sexuality groups. CONCLUSION LGBTQ+ youth showed a higher prevalence of attempted suicide when compared to their heterosexual peers. Emotional and sexual abuse showed higher rates among LGBTQ+ youth, the cumulative effects of childhood trauma might explain the difficulties in developing healthy coping styles.
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Affiliation(s)
- Yuanyuan Wang
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Yi Feng
- Mental Health Center, Central University of Finance and Economics, Beijing, China; School of Psychology, Beijing Normal University, Beijing, China
| | - Meng Han
- Department of Medical Psychology, The School of Health Humanities, Peking University, Beijing, China; Vanke School of Public Health, Tsinghua University, Beijing, China.
| | - Zhizhou Duan
- Preventive health service, Jiangxi Provincial People's Hospital, Affiliated People's Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Julie Fish
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Shufang Sun
- Brown University School of Public Health, Department of Behavioral and Social Sciences, International Health Institute, US
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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99952
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Waller R, Powell T, Rodriguez Y, Corbett N, Perlstein S, White LK, Barzilay R, Wagner NJ. The Impact of the COVID-19 Pandemic on Children's Conduct Problems and Callous-Unemotional Traits. Child Psychiatry Hum Dev 2021; 52:1012-1023. [PMID: 33405026 PMCID: PMC7786862 DOI: 10.1007/s10578-020-01109-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2020] [Indexed: 01/06/2023]
Abstract
The COVID-19 pandemic has dramatically altered family life, but whether family exposures to and worries about the COVID-19 pandemic has impacted child conduct problems (CP) and callous-unemotional (CU) traits is unknown. Thus, we evaluated 303 parents (Mage = 38.04; SD = 5.21; 92.4% biological mothers) and children (Mage = 6.43; SD = 2.13; 51.8% female) during a four-month period early in the pandemic. We examined associations between parental exposures to COVID-19, parental worries about the pandemic, harsh and warm parenting practices, and child CP and CU traits. Although more parental worries were not directly related to parenting practices, more worry about COVID-19 was specifically related to higher levels of child CP, particularly parental worries about themselves or family members contracting the virus. Our findings add to a growing literature demonstrating the burden that the pandemic has placed on families and its implications for children's mental health.
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Affiliation(s)
- Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Tralucia Powell
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA
| | - Yuheiry Rodriguez
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Natalie Corbett
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Samantha Perlstein
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Lauren K White
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Ran Barzilay
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Nicholas J Wagner
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA.
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99953
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Kollmannsberger C, Britten CD, Olszanski AJ, Walker JA, Zang W, Willard MD, Radtke DB, Farrington DL, Bell-McGuinn KM, Patnaik A. A phase 1 study of LY3076226, a fibroblast growth factor receptor 3 (FGFR3) antibody-drug conjugate, in patients with advanced or metastatic cancer. Invest New Drugs 2021; 39:1613-1623. [PMID: 34264412 DOI: 10.1007/s10637-021-01146-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/24/2021] [Indexed: 01/02/2023]
Abstract
Background We report a Phase 1 study of LY3076226, an antibody-drug conjugate composed of human IgG1 monoclonal antibody against the human FGFR3 attached with a cleavable linker to the maytansine derivative DM4 in patients with advanced or metastatic cancer. Methods This study was comprised of two parts: (A) dose escalation in patients with advanced or metastatic cancer and (B) dose expansion in patients with urothelial carcinoma with locally determined FGFR3 alterations. The dose range of LY3076226 tested was 0.2-5.0 mg/kg as an intravenous infusion on Day 1 of each 21-day cycle. The primary objective was to determine a recommended phase 2 dose (RP2D). Results Twenty-five patients were enrolled (Part A: 22, Part B: 3) and received ≥ 1 dose of LY3076226. No dose-limiting toxicities were reported. LY3076226 was generally well tolerated; most of the toxicities were Grade 1 or 2. Two patients experienced treatment-related Grade 3 toxicity (embolism and decreased platelet count). Four patients experienced serious adverse events (not treatment-related), all in Part A. Dose-proportional exposure was observed, with an estimated half-life of 2-7 days. No responses were seen with LY3076226 treatment. Stable disease persisting for > 6 months was observed in 1 patient receiving 3.2 mg/kg of LY3076226. Conclusion The study demonstrates acceptable safety and tolerability of LY3076226 up to the 5.0 mg/kg dose. Recruitment was stopped due to pipeline prioritization. Dose escalation of LY3076226 beyond 5.0 mg/kg in patients with advanced tumors may be possible. The trial was registered on August 19, 2015 under identifier NCT02529553 with ClinicalTrials.gov.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Female
- Humans
- Male
- Middle Aged
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/pharmacokinetics
- Area Under Curve
- Dose-Response Relationship, Drug
- Half-Life
- Immunoconjugates/administration & dosage
- Immunoconjugates/adverse effects
- Immunoconjugates/pharmacokinetics
- Immunoconjugates/therapeutic use
- Maximum Tolerated Dose
- Maytansine/administration & dosage
- Maytansine/adverse effects
- Maytansine/pharmacokinetics
- Metabolic Clearance Rate
- Neoplasms/drug therapy
- Neoplasms/pathology
- Receptor, Fibroblast Growth Factor, Type 3/antagonists & inhibitors
- Urologic Neoplasms/drug therapy
- Urologic Neoplasms/pathology
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/pharmacokinetics
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Affiliation(s)
| | - Carolyn D Britten
- Formely With Medical, University of South Carolina, Charleston, SC, USA
| | | | | | - Wei Zang
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | | | | | | | - Amita Patnaik
- START (South Texas Accelerated Research Therapeutics), San Antonio, USA
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99954
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Cooper R, Shkolnikov VM, Kudryavtsev AV, Malyutina S, Ryabikov A, Arnesdatter Hopstock L, Johansson J, Cook S, Leon DA, Strand BH. Between-study differences in grip strength: a comparison of Norwegian and Russian adults aged 40-69 years. J Cachexia Sarcopenia Muscle 2021; 12:2091-2100. [PMID: 34605224 PMCID: PMC8718040 DOI: 10.1002/jcsm.12816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 08/03/2021] [Accepted: 08/31/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Identifying individuals with low grip strength is an initial step in many operational definitions of sarcopenia. As evidence indicates that contemporaneous Russian populations may have lower mean levels of grip strength than other populations in northern Europe, we aimed to: compare grip strength in Russian and Norwegian populations by age and sex; investigate whether height, body mass index, education, smoking status, alcohol use and health status explain observed differences and; examine implications for case-finding low muscle strength. METHODS We used harmonized cross-sectional data on grip strength and covariates for participants aged 40-69 years from the Russian Know Your Heart study (KYH) (n = 3833) and the seventh survey of the Norwegian Tromsø Study (n = 5598). Maximum grip strength (kg) was assessed using the same protocol and device in both studies. Grip strength by age, sex and study was modelled using linear regression and between-study differences were predicted from these models. Sex-specific age-standardized differences in grip strength and in prevalence of low muscle strength were estimated using the European population standard of 2013. RESULTS Normal ranges of maximum grip strength in both studies combined were 33.8 to 67.0 kg in men and 18.7 to 40.1 kg in women. Mean grip strength was higher among Tromsø than KYH study participants and this difference did not vary markedly by age or sex. Adjustment for covariates, most notably height, attenuated between-study differences but these differences were still evident at younger ages. For example, estimated between-study differences in mean grip strength in fully adjusted models were 2.2 kg [95% confidence interval (CI) 1.4, 3.1] at 40 years and 1.0 kg (95% CI 0.5, 1.5) at 65 years in men (age × study interaction P = 0.09) and 1.1 kg (95% CI 0.4, 1.9) at age 40 years and -0.2 kg (95% CI -0.7, 0.3) at 65 years in women (age × study interaction P < 0.01). CONCLUSIONS We found between-study differences in mean grip strength that are likely to translate into greater future risk of sarcopenia and poorer prospects of healthy ageing for Russian than Norwegian study participants. For example, the average Russian participant had a similar level of grip strength to a Norwegian participant 7 years older. Our findings suggest these differences may have their origins in childhood highlighting the need to consider interventions in early life to prevent sarcopenia.
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Affiliation(s)
- Rachel Cooper
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research CentreManchester Metropolitan UniversityManchesterUK
| | - Vladimir M. Shkolnikov
- International Laboratory for Population and HealthNational Research University Higher School of EconomicsMoscowRussia
- Laboratory of Demographic DataMax Planck Institute for Demographic ResearchRostockGermany
| | - Alexander V. Kudryavtsev
- Northern State Medical UniversityArkhangelskRussian Federation
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and GeneticsSiberian Branch of Russian Academy of SciencesNovosibirskRussia
- Novosibirsk State Medical UniversityNovosibirskRussia
| | - Andrew Ryabikov
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and GeneticsSiberian Branch of Russian Academy of SciencesNovosibirskRussia
- Novosibirsk State Medical UniversityNovosibirskRussia
| | | | - Jonas Johansson
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
| | - Sarah Cook
- Faculty of Epidemiology and Population HealthLondon School of Hygiene & Tropical MedicineLondonUK
- National Heart and Lung InstituteImperial College LondonLondonUK
| | - David A. Leon
- International Laboratory for Population and HealthNational Research University Higher School of EconomicsMoscowRussia
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
- Faculty of Epidemiology and Population HealthLondon School of Hygiene & Tropical MedicineLondonUK
| | - Bjørn Heine Strand
- Norwegian Institute of Public HealthOsloNorway
- Norwegian National Advisory Unit on Ageing and HealthVestfold Hospital TrustTønsbergNorway
- Department of Geriatric MedicineOslo University HospitalOsloNorway
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99955
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Abu-Raddad LJ, Chemaitelly H, Ayoub HH, Coyle P, Malek JA, Ahmed AA, Mohamoud YA, Younuskunju S, Tang P, Al Kanaani Z, Al Kuwari E, Butt AA, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul Rahim HF, Nasrallah GK, Yassine HM, Al Kuwari MG, Al Romaihi HE, Al-Thani MH, Al Khal A, Bertollini R. Introduction and expansion of the SARS-CoV-2 B.1.1.7 variant and reinfections in Qatar: A nationally representative cohort study. PLoS Med 2021; 18:e1003879. [PMID: 34914711 PMCID: PMC8726501 DOI: 10.1371/journal.pmed.1003879] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 01/04/2022] [Accepted: 11/30/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The epidemiology of the SARS-CoV-2 B.1.1.7 (or Alpha) variant is insufficiently understood. This study's objective was to describe the introduction and expansion of this variant in Qatar and to estimate the efficacy of natural infection against reinfection with this variant. METHODS AND FINDINGS Reinfections with the B.1.1.7 variant and variants of unknown status were investigated in a national cohort of 158,608 individuals with prior PCR-confirmed infections and a national cohort of 42,848 antibody-positive individuals. Infections with B.1.1.7 and variants of unknown status were also investigated in a national comparator cohort of 132,701 antibody-negative individuals. B.1.1.7 was first identified in Qatar on 25 December 2020. Sudden, large B.1.1.7 epidemic expansion was observed starting on 18 January 2021, triggering the onset of epidemic's second wave, 7 months after the first wave. B.1.1.7 was about 60% more infectious than the original (wild-type) circulating variants. Among persons with a prior PCR-confirmed infection, the efficacy of natural infection against reinfection was estimated to be 97.5% (95% CI: 95.7% to 98.6%) for B.1.1.7 and 92.2% (95% CI: 90.6% to 93.5%) for variants of unknown status. Among antibody-positive persons, the efficacy of natural infection against reinfection was estimated to be 97.0% (95% CI: 92.5% to 98.7%) for B.1.1.7 and 94.2% (95% CI: 91.8% to 96.0%) for variants of unknown status. A main limitation of this study is assessment of reinfections based on documented PCR-confirmed reinfections, but other reinfections could have occurred and gone undocumented. CONCLUSIONS In this study, we observed that introduction of B.1.1.7 into a naïve population can create a major epidemic wave, but natural immunity in those previously infected was strongly associated with limited incidence of reinfection by B.1.1.7 or other variants.
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Affiliation(s)
- Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, United States of America
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
| | - Houssein H. Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Peter Coyle
- Hamad Medical Corporation, Doha, Qatar
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Wellcome–Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom
| | - Joel A. Malek
- Genomics Laboratory, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
- Department of Genetic Medicine, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
| | - Ayeda A. Ahmed
- Genomics Laboratory, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
| | - Yasmin A. Mohamoud
- Genomics Laboratory, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
| | - Shameem Younuskunju
- Genomics Laboratory, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | | | | | - Adeel A. Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, United States of America
- Hamad Medical Corporation, Doha, Qatar
| | | | | | | | | | | | - Gheyath K. Nasrallah
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Hadi M. Yassine
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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99956
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Kurani SS, Lampman MA, Funni SA, Giblon RE, Inselman JW, Shah ND, Allen S, Rushlow D, McCoy RG. Association Between Area-Level Socioeconomic Deprivation and Diabetes Care Quality in US Primary Care Practices. JAMA Netw Open 2021; 4:e2138438. [PMID: 34964856 PMCID: PMC8717098 DOI: 10.1001/jamanetworkopen.2021.38438] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE Diabetes management operates under a complex interrelationship between behavioral, social, and economic factors that affect a patient's ability to self-manage and access care. OBJECTIVE To examine the association between 2 complementary area-based metrics, area deprivation index (ADI) score and rurality, and optimal diabetes care. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study analyzed the electronic health records of patients who were receiving care at any of the 75 Mayo Clinic or Mayo Clinic Health System primary care practices in Minnesota, Iowa, and Wisconsin in 2019. Participants were adults with diabetes aged 18 to 75 years. All data were abstracted and analyzed between June 1 and November 30, 2020. MAIN OUTCOMES AND MEASURES The primary outcome was the attainment of all 5 components of the D5 metric of optimal diabetes care: glycemic control (hemoglobin A1c <8.0%), blood pressure (BP) control (systolic BP <140 mm Hg and diastolic BP <90 mm Hg), lipid control (use of statin therapy according to recommended guidelines), aspirin use (for patients with ischemic vascular disease), and no tobacco use. The proportion of patients receiving optimal diabetes care was calculated as a function of block group-level ADI score (a composite measure of 17 US Census indicators) and zip code-level rurality (calculated using Rural-Urban Commuting Area codes). Odds of achieving the D5 metric and its components were assessed using logistic regression that was adjusted for demographic characteristics, coronary artery disease history, and primary care team specialty. RESULTS Among the 31 934 patients included in the study (mean [SD] age, 59 [11.7] years; 17 645 men [55.3%]), 13 138 (41.1%) achieved the D5 metric of optimal diabetes care. Overall, 4090 patients (12.8%) resided in the least deprived quintile (quintile 1) of block groups and 1614 (5.1%) lived in the most deprived quintile (quintile 5), while 9193 patients (28.8%) lived in rural areas and 2299 (7.2%) in highly rural areas. The odds of meeting the D5 metric were lower for individuals residing in quintile 5 vs quintile 1 block groups (odds ratio [OR], 0.72; 95% CI, 0.67-0.78). Patients residing in rural (OR, 0.84; 95% CI, 0.73-0.97) and highly rural (OR, 0.81; 95% CI, 0.72-0.91) zip codes were also less likely to attain the D5 metric compared with those in urban areas. CONCLUSIONS AND RELEVANCE This cross-sectional study found that patients living in more deprived and rural areas were significantly less likely to attain high-quality diabetes care compared with those living in less deprived and urban areas. The results call for geographically targeted population health management efforts by health systems, public health agencies, and payers.
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Affiliation(s)
- Shaheen Shiraz Kurani
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Michelle A. Lampman
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Shealeigh A. Funni
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Rachel E. Giblon
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
| | - Jonathan W. Inselman
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Nilay D. Shah
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Summer Allen
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
- Department of Family Medicine, Mayo Clinic, Rochester, Minnesota
| | - David Rushlow
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
- Department of Family Medicine, Mayo Clinic, Rochester, Minnesota
| | - Rozalina G. McCoy
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
- Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota
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99957
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Edmunds JS, Ivie CL, Ott EP, Jacob DW, Baker SE, Harper JL, Manrique-Acevedo CM, Limberg JK. Sex differences in the effect of acute intermittent hypoxia on respiratory modulation of sympathetic activity. Am J Physiol Regul Integr Comp Physiol 2021; 321:R903-R911. [PMID: 34668438 PMCID: PMC8714811 DOI: 10.1152/ajpregu.00042.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 10/01/2021] [Accepted: 10/18/2021] [Indexed: 01/12/2023]
Abstract
Sex-related differences in respiratory modulation of sympathetic activity have been observed in rodent models of sleep apnea [intermittent hypoxia (IH)]. In light of sex disparities in the respiratory response to acute IH in humans as well as changes in respiratory modulation of muscle sympathetic nerve activity (MSNA) in clinical sleep apnea, we examined sex-related differences in respiratory modulation of MSNA following acute IH. We hypothesized that respiratory modulation of MSNA would be altered in both male and female participants after IH; however, the respiratory patterning of MSNA following IH would be sex specific. Heart rate, MSNA, and respiration were evaluated in healthy male (n = 21, 30 ± 5 yr) and female (n = 10, 28 ± 5 yr) participants during normoxic rest before and after 30 min of IH. Respiratory modulation of MSNA was assessed by fitting polynomials to cross-correlation histograms constructed between sympathetic spikes and respiration. MSNA was elevated after IH in male (20 ± 6 to 24 ± 8 bursts/min) and female (19 ± 8 to 22 ± 10 bursts/min) participants (P < 0.01). Both male and female participants exhibited respiratory modulation of MSNA (P < 0.01); however, the pattern differed by sex. After IH, modulation of MSNA within the breath was reduced in male participants (P = 0.03) but increased in female participants (P = 0.02). Both male and female adults exhibit changes in respiratory patterning of MSNA after acute IH; however, this pattern differs by sex. These data support sex disparities in respiratory modulation of MSNA and may have implications for conditions such as sleep apnea.
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Affiliation(s)
- Jane S Edmunds
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Clayton L Ivie
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Elizabeth P Ott
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Dain W Jacob
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Sarah E Baker
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
| | - Jennifer L Harper
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Camila M Manrique-Acevedo
- Department of Medicine, University of Missouri, Columbia, Missouri
- Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
| | - Jacqueline K Limberg
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
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99958
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Tomczyk CP, Anderson M, Petit KM, Savage JL, Covassin T. Vestibular/Ocular Motor Screening Assessment Outcomes After Sport-Related Concussion in High School and Collegiate Athletes. J Athl Train 2021; 56:1285-1291. [PMID: 34911074 PMCID: PMC8675312 DOI: 10.4085/1062-6050-0588.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Vestibular and ocular motor assessment is an emerging clinical assessment for patients with sport-related concussion (SRC). The increased use of these assessments by clinicians calls for the examination of outcomes that may affect clinical practice. OBJECTIVE To compare vestibular and ocular motor impairments in high school and collegiate athletes within 72 hours of SRC and examine the distribution of impairments in these populations based on pre-established clinical cutoff scores. DESIGN Cross-sectional study. SETTING High school and collegiate athletics. PATIENTS OR OTHER PARTICIPANTS Data were collected from 110 athletes (high school: n = 47, age = 15.40 ± 1.35 years; college: n = 63, age = 19.46 ± 1.28 years) within 72 hours of sustaining an SRC. MAIN OUTCOME MEASURE(S) Total and change scores were calculated for the Vestibular/Ocular Motor Screening (VOMS) tool, along with average near point of convergence (NPC) distance. Separate Mann-Whitney U tests were used to compare group differences, and χ2 analyses were used to examine the proportion of athletes with scores greater than clinical cutoff scores for all VOMS outputs. The α level was set a priori at .05. RESULTS No differences were found between high school and collegiate athletes for VOMS total and change scores and NPC distance. A larger proportion of the sample had scores greater than the cutoff for all total scores (P < .001) and change scores in horizontal vestibulo-ocular reflex (59.01%; P < .001), vertical vestibulo-ocular reflex (60.91%; P < .001), and visual motion sensitivity (60.91%; P < .001). However, a larger proportion demonstrated smooth pursuit change scores (85.45%; P < .001) and NPC distances (73.64%; P = .01) that were less than the cutoff scores. CONCLUSIONS During the acute phase of SRC, high school and collegiate athletes presented with similar vestibular and ocular motor impairments as measured using the VOMS, but vestibular tasks appeared to cause greater symptom provocation. Lastly, VOMS change scores may offer more clinical utility compared with total scores in assessing specific impairments after SRC.
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Affiliation(s)
| | - Morgan Anderson
- Department of Kinesiology, Michigan State University, East Lansing
| | - Kyle M. Petit
- School of Health Sciences, University of Mary, Bismarck, ND
| | | | - Tracey Covassin
- Department of Kinesiology, Michigan State University, East Lansing
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99959
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Homayounieh F, Digumarthy S, Ebrahimian S, Rueckel J, Hoppe BF, Sabel BO, Conjeti S, Ridder K, Sistermanns M, Wang L, Preuhs A, Ghesu F, Mansoor A, Moghbel M, Botwin A, Singh R, Cartmell S, Patti J, Huemmer C, Fieselmann A, Joerger C, Mirshahzadeh N, Muse V, Kalra M. An Artificial Intelligence-Based Chest X-ray Model on Human Nodule Detection Accuracy From a Multicenter Study. JAMA Netw Open 2021; 4:e2141096. [PMID: 34964851 PMCID: PMC8717119 DOI: 10.1001/jamanetworkopen.2021.41096] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
IMPORTANCE Most early lung cancers present as pulmonary nodules on imaging, but these can be easily missed on chest radiographs. OBJECTIVE To assess if a novel artificial intelligence (AI) algorithm can help detect pulmonary nodules on radiographs at different levels of detection difficulty. DESIGN, SETTING, AND PARTICIPANTS This diagnostic study included 100 posteroanterior chest radiograph images taken between 2000 and 2010 of adult patients from an ambulatory health care center in Germany and a lung image database in the US. Included images were selected to represent nodules with different levels of detection difficulties (from easy to difficult), and comprised both normal and nonnormal control. EXPOSURES All images were processed with a novel AI algorithm, the AI Rad Companion Chest X-ray. Two thoracic radiologists established the ground truth and 9 test radiologists from Germany and the US independently reviewed all images in 2 sessions (unaided and AI-aided mode) with at least a 1-month washout period. MAIN OUTCOMES AND MEASURES Each test radiologist recorded the presence of 5 findings (pulmonary nodules, atelectasis, consolidation, pneumothorax, and pleural effusion) and their level of confidence for detecting the individual finding on a scale of 1 to 10 (1 representing lowest confidence; 10, highest confidence). The analyzed metrics for nodules included sensitivity, specificity, accuracy, and receiver operating characteristics curve area under the curve (AUC). RESULTS Images from 100 patients were included, with a mean (SD) age of 55 (20) years and including 64 men and 36 women. Mean detection accuracy across the 9 radiologists improved by 6.4% (95% CI, 2.3% to 10.6%) with AI-aided interpretation compared with unaided interpretation. Partial AUCs within the effective interval range of 0 to 0.2 false positive rate improved by 5.6% (95% CI, -1.4% to 12.0%) with AI-aided interpretation. Junior radiologists saw greater improvement in sensitivity for nodule detection with AI-aided interpretation as compared with their senior counterparts (12%; 95% CI, 4% to 19% vs 9%; 95% CI, 1% to 17%) while senior radiologists experienced similar improvement in specificity (4%; 95% CI, -2% to 9%) as compared with junior radiologists (4%; 95% CI, -3% to 5%). CONCLUSIONS AND RELEVANCE In this diagnostic study, an AI algorithm was associated with improved detection of pulmonary nodules on chest radiographs compared with unaided interpretation for different levels of detection difficulty and for readers with different experience.
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Affiliation(s)
- Fatemeh Homayounieh
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Subba Digumarthy
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Shadi Ebrahimian
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Johannes Rueckel
- Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Boj Friedrich Hoppe
- Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Bastian Oliver Sabel
- Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | | | - Karsten Ridder
- Medizinisches Versorgungszentrum Professor Uhlenbrock & Partner
| | | | | | | | | | | | - Mateen Moghbel
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ariel Botwin
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ramandeep Singh
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Samuel Cartmell
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - John Patti
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | | | | | - Victorine Muse
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mannudeep Kalra
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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99960
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Chen Y, Tang W, Zhu X, Zhang L, Zhu Y, Xiao H, Xu J, Fang Y, Li X, Tang C, Shi J. Nuclear receptor binding SET domain protein 1 promotes epithelial-mesenchymal transition in paclitaxel-resistant breast cancer cells via regulating nuclear factor kappa B and F-box and leucine-rich repeat protein 11. Bioengineered 2021; 12:11506-11519. [PMID: 34905470 PMCID: PMC8810193 DOI: 10.1080/21655979.2021.2009963] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 12/25/2022] Open
Abstract
Breast cancer (BC) is regarded as the major cause of cancer-associated deaths in women. Paclitaxel exerts a critical impact on the chemotherapy of BC, but the resistance to paclitaxel becomes a great obstacle in treating the disease. It is reported that noncoding RNA nuclear receptor binding SET domain protein 1 (NSD1) plays a significant role in drug resistance; however, the special role of NSD1 in paclitaxel-resistant BC is unclear. Human BC cell line MCF-7 was used to establish paclitaxel-resistant BC cells (MCF-7/PR). Reverse transcription quantitative polymerase chain reaction (RT-qPCR) displayed that NSD1 and F-box and leucine-rich repeat protein 11 (FBXL11) were highly expressed in BC tissues. Western blotting was utilized for protein level assessment. Cell counting kit-8 (CCK-8), Transwell, wound healing assays, and animal experiments were conducted to examine the influence of NSD1 or FBXL11 on the malignant behaviors of BC in vitro and in vivo, respectively. Transfected MCF-7/PR cells were injected subcutaneously into BALB/c nude mice with or without treatment of paclitaxel. The nuclear factor kappa B (NF-kB) activity was evaluated by the luciferase reporter assay. Results showed that NSD1 knockdown inhibited the epithelial-mesenchymal transition (EMT), migration and invasiveness of BC in vitro, which was rescued by FBXL11 overexpression. Furthermore, NSD1 silencing promoted paclitaxel sensitivity of paclitaxel-resistant BC cells and suppressed tumor growth and paclitaxel resistance in vivo. NSD1 knockdown reduced NF-kB activity, while FBXL11 inhibition markedly increased NF-kB activity. Collectively, NSD1 facilitates the EMT, migration and invasion in paclitaxel-resistant BC cells via regulating NF-kB and FBXL11.
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Affiliation(s)
- Yi Chen
- Department of Oncology, Nanjing Pukou Central Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Weiwei Tang
- Hepatobiliary/Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Living Donor Transplantation, Chinese Academy of Medical Sciences, Nanjing, Jiangsu, China
| | - Xuedan Zhu
- Department of Oncology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lele Zhang
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yinxing Zhu
- Department of Oncology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hua Xiao
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jin Xu
- Department of Thyroid and Mammary Gland Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yueyu Fang
- Department of Oncology, Nanjing Pukou Central Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiao Li
- Department of Thyroid and Mammary Gland Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Cuiju Tang
- Department of Oncology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Junfeng Shi
- Department of Oncology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
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99961
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Abstract
Cerebral ischemic stroke (CIS) is extremely harmful, and its treatment should be underpinned by understanding its pathogenic mechanism. This study was designed to determine the involvement of miR-155 in CIS development via the TLR4/MyD88 signaling pathway. First, we quantified serum miR-155 in patients with CIS and healthy individuals, and found high expression of miR-155 in such patients and a decrease in it in the patients after therapy (P < 0.05). Serum miR-155 demonstrated a favorable function in predicting the development and prognosis of CIS (P < 0.001). We also conducted a mouse assay, and found that knocking out miR-155 can improve the neurological function of mice and suppress protein TLR4 and MyD88 (all P < 0.05). Finally, we carried out a cell assay, and found enhancement in the activity of SH-SY5Y cells, decrease in their apoptosis, and protein TLR4 and MyD88 in them after suppression of miR-155 (all P < 0.05). Furthermore, we also found complete reverse by TLR4/MyD88 pathway inhibitor on the influence of increasing miR-155 on cells (P > 0.05). Therefore, with an increase in cases with CIS, miR-155 takes a part in the development of cell damage by activating TLR4/MyD88, and it is probably the key to diagnosing and treating CIS.
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Affiliation(s)
- Wei Chen
- Department of Neurology, Linhai Second People’s Hospital, Taizhou, 317016, Zhejiang, China
| | - Lingtong Wang
- Department of Neurology, Linhai Second People’s Hospital, Taizhou, 317016, Zhejiang, China
| | - Zhaoping Liu
- Department of rehabilitation medicine, Chenzhou first people’s Hospital (the First Affiliated Hospital of Xiangnan University), Chenzhou, 423000, Hunan, PR China
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99962
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Jiang C, Shi X, Yi D, Wang R, Xu F, Guan W, Sang J. Long non-coding RNA anti-differentiation non-coding RNA affects proliferation, invasion, and migration of breast cancer cells by targeting miR-331. Bioengineered 2021; 12:12236-12245. [PMID: 34783641 PMCID: PMC8810111 DOI: 10.1080/21655979.2021.2005989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/01/2022] Open
Abstract
We aimed to evaluate the effects of long-chain non-coding RNA (lncRNA) anti-differentiation non-coding RNA (ANCR) on the proliferation, invasion, and migration of breast cancer cells by targeting miR-331. Forty-eight breast cancer and paracancerous tissue samples were collected. LncRNA ANCR expressions in breast cancer and adjacent tissues, human breast cancer cells and mammary epithelial cells, and miR-331 expressions in interfering cell line MDA-MB-231 (MCF-7)-shANCR, negative control MDA-MB-231 (MCF-7)-shNC and blank control MDA-MB-231 (MCF-7) were detected by real-time quantitative PCR. The correlations between lncRNA ANCR expression and clinicopathological characteristics were analyzed. Cell proliferation was detected by MTT and colony formation assays. Invasion and migration were tested by Transwell and scratch assays, respectively. The targeting relationship between ANCR and miR-331 was analyzed using the TargetScan database, and their interaction was studied using a dual-luciferase reporter assay. The expression of lncRNA ANCR in breast cancer tissue was significantly lower than that in adjacent normal tissue (p < 0.05). LncRNA ANCR was lowly expressed in various human breast cancer cell lines, being lowest in high-metastatic cell line (MDA-MB-231HM) (p < 0.05). Silencing lncRNA ANCR significantly enhanced the proliferation and invasion capacities of breast cancer cells, and promoted their tumor formation abilities in nude mice (p < 0.05). ANCR bound miR-331 targetedly, and the former negatively regulated the expression of the latter. LncRNA ANCR is lowly expressed upon breast cancer, and inhibits cell proliferation, invasion, and migration in vitro and in vivo. LncRNA ANCR exerts antitumor effects by targetedly binding miR-331 and then inhibiting its expression.
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Affiliation(s)
- Chaoyu Jiang
- Department of General Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Zhongshan Road, Nanjing, Jiangsu Province, China
| | - Xianbiao Shi
- Department of General Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Zhongshan Road, Nanjing, Jiangsu Province, China
| | - Dandan Yi
- Department of General Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Zhongshan Road, Nanjing, Jiangsu Province, China
| | - Ru Wang
- Department of General Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Zhongshan Road, Nanjing, Jiangsu Province, China
| | - Fazhan Xu
- Department of General Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Zhongshan Road, Nanjing, Jiangsu Province, China
| | - Wenxian Guan
- Department of General Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Zhongshan Road, Nanjing, Jiangsu Province, China
| | - Jianfeng Sang
- Department of General Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Zhongshan Road, Nanjing, Jiangsu Province, China
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99963
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Bou Chebl R, Geha M, Assaf M, Kattouf N, Haidar S, Abdeldaem K, Halawi N, Khamis M, Makki M, Tamim H, Abou Dagher G. The prognostic value of the lactate/albumin ratio for predicting mortality in septic patients presenting to the emergency department: a prospective study. Ann Med 2021; 53:2268-2277. [PMID: 34854770 PMCID: PMC8648034 DOI: 10.1080/07853890.2021.2009125] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/16/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Lactate/albumin (L/A) ratio is a biomarker in sepsis that has been shown to outperform lactate. This prospective study aims to validate the superior prognostic value of the L/A ratio to lactate in sepsis and septic shock. METHODS Prospective cohort conducted from September 2018 till February 2021 on adult patients presenting to the Emergency Department (ED) at a tertiary care centre with sepsis or septic shock. The primary outcome was the prognostic value of the L/A ratio compared to lactate with regards to mortality. RESULTS A total of 939 septic patients were included throughout the study period. A total of 236 patients developed septic shock. The AUC value of the L/A ratio in septic patients was 0.65 (95% CI 0.61-0.70) and was higher than that of lactate alone 0.60 (95% CI 0.55-0.64) with a p < .0001. The optimal L/A ratio cut-off threshold that separated survivors from non-survivors was found to be 0.115 for all septic patients. The AUC of the L/A ratio was significantly higher for patients with a lactate ≥2 mmol/L: 0.69 (95% CI 0.64-0.74) versus 0.60 (95% CI 0.54-0.66) with a p < .0001 as well as for patients with an albumin level less than 30 g/L (AUC = 0.69 95% CI= 0.62-0.75 vs AUC= 0.66 95% CI= 0.59-0.73, p = .04). Among septic shock patients there was no statically significant difference in the AUC value of the L/A ratio compared to lactate (0.53 95% CI 0.45-0.61 vs 0.50 95% CI 0.43-0.58 respectively with a p-value = .11). CONCLUSIONS The L/A ratio is a better predictor of in-patient mortality than lactate in sepsis patients. This superiority was not found in the septic shock subgroup. Our results encourage the use of the ratio early in the ED as a superior prognostic tool in sepsis patients.Key messagesWe aimed to assess the prognostic usefulness of the Lactate/Albumin ratio compared to lactate alone in septic and septic shock patients.The L/A ratio proved to be a better predictor of in-patient mortality than lactate alone in sepsis patients. This pattern also applies across various subgroups in our study (malignancy, diabetics, age above 65, lactate level less than 2 mmol/L, albumin less than 30 g/L). Our results favour the use of the L/A ratio over lactate alone in patients with sepsis and the previously mentioned subgroups.Our results do not favour the use of the ratio instead of lactate in septic shock patients as there was no statistically significant difference between the AUCs of the ratio and lactate alone.
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Affiliation(s)
- Ralphe Bou Chebl
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Mirabelle Geha
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Mohamad Assaf
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Nadim Kattouf
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Saadeddine Haidar
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Karim Abdeldaem
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Nour Halawi
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Mohamed Khamis
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Maha Makki
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Gilbert Abou Dagher
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
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99964
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Luong TC, Pham TTM, Nguyen MH, Do AQ, Pham LV, Nguyen HC, Nguyen HC, Ha TH, Dao HK, Trinh MV, Do TV, Nguyen HQ, Nguyen TTP, Tran CQ, Tran KV, Duong TT, Pham HX, Do TT, Nguyen PB, Tra AL, Phan DT, Do BN, Duong TV. Fear, anxiety and depression among pregnant women during COVID-19 pandemic: impacts of healthy eating behaviour and health literacy. Ann Med 2021; 53:2120-2131. [PMID: 34761972 PMCID: PMC8592601 DOI: 10.1080/07853890.2021.2001044] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/27/2021] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has been influencing people's psychological health, especially in pregnant women. We aimed to examine associated factors of fear of COVID-19, anxiety and depression among pregnant women during the pandemic where the impacts of healthy eating behaviour (HES) and health literacy (HL) were emphasized. METHODS A cross-sectional study was conducted between 14 February 2020 and 31 May 2020 in 18 health centres and hospitals across Vietnam. Data of 518 pregnant women were analysed, including socio-demographics, pregnant-related factors, HES, HL, health-related behaviours, fear of COVID-19 scale (FCoV-19S), anxiety (using the generalized anxiety disorder (GAD-7)) and depression (using the patient health questionnaire with 9 items (PHQ-9)). Regression analysis was utilized to explore the associations. RESULTS Pregnant women with higher scores of HES and HL had lower likelihood of anxiety (odds ratio, OR, 0.79; 95% confidence interval (95%CI), 0.73, 0.87; p < .001; and OR, 0.94; 95%CI, 0.90, 0.99; p = .018) and depression (OR, 0.84; 95%CI, 0.78, 0.91; p < .001; and OR, 0.96; 95%CI, 0.91, 0.99; p = .044), respectively. Pregnant women being employed had a lower FCoV-19S score (regression coefficient, B, -1.46; 95%CI, -2.51, -0.40; p = .007). Besides, other significant predictors of anxiety were eating healthier during the pandemic, unchanged or more physical activity, elevated gestational age and smoking. Other significant predictors of depression were eating healthier during the pandemic, elevated gestational age and smoking. CONCLUSIONS Among others, HES and HL had positive impacts on protecting pregnant women against anxiety and depression. Improving HES and HL should be addressed as a strategic approach to improve reproductive health during the pandemic.KEY MESSAGEThe COVID-19 pandemic influences antenatal mental disorders with the higher level as opposed to that before the pandemic.Healthy eating behaviour and better health literacy (HL) had critical roles in lowering prenatal anxiety and depression during the COVID-19 crisis.Strategic approaches for improving healthy eating and HL should be recommended for protecting pregnant women from mental health problems during the pandemic.
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Affiliation(s)
- Thuc C. Luong
- Department of Cardiology, Cardiovascular Center, Military Hospital 103, Hanoi, Vietnam
- Director Office, Military Hospital 103, Hanoi, Vietnam
| | - Thu T. M. Pham
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Minh H. Nguyen
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Anh Q. Do
- International Ph.D. Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Obstetrics and Gynecology, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Linh V. Pham
- Department of Pulmonary and Cardiovascular Diseases, Hai Phong University of Medicine and Pharmacy Hospital, Hai Phong, Vietnam
- Director Office, Hai Phong University of Medicine and Pharmacy Hospital, Hai Phong, Vietnam
| | - Hoang C. Nguyen
- Director Office, Thai Nguyen National Hospital, Thai Nguyen, Vietnam
- President Office, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Huu C. Nguyen
- Director Office, E Hospital, Hanoi, Vietnam
- Department of Thoracic and Cardiovascular Surgery, E Hospital, Hanoi, Vietnam
| | - Tung H. Ha
- Director Office, General Hospital of Agricultural, Hanoi, Vietnam
| | - Hung K. Dao
- Director Office, Bac Ninh Obstetrics and Pediatrics Hospital, Bac Ninh, Vietnam
| | - Manh V. Trinh
- Director Office, Quang Ninh General Hospital, Quang Ninh, Vietnam
| | - Thinh V. Do
- Director Office, Bai Chay Hospital, Quang Ninh, Vietnam
| | - Hung Q. Nguyen
- Director Office, Quang Ninh Obstetrics and Pediatrics Hospital, Quang Ninh, Vietnam
| | - Thao T. P. Nguyen
- Health Management Training Institute, University of Medicine and Pharmacy, Hue University, Thua Thien Hue, Vietnam
| | - Cuong Q. Tran
- Director Office, Thu Duc District Health Center, Ho Chi Minh City, Vietnam
- Faculty of Health, Mekong University, Vinh Long, Vietnam
| | - Khanh V. Tran
- Director Office, Le Van Thinh Hospital (previously Hospital District 2), Ho Chi Minh City, Vietnam
| | - Trang T. Duong
- Nursing Office, Tan Phu District Hospital, Ho Chi Minh City, Vietnam
| | - Hai X. Pham
- Director Office, Thu Duc District Health Center, Ho Chi Minh City, Vietnam
| | - Thao T. Do
- Department of Oral Pathology and Periodontology, Faculty of Odonto-Stomatology, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | | | - Anh L. Tra
- Department of Rehabilitation & Physiotherapy, Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam
| | - Dung T. Phan
- Nursing Office, Thien An Obstetrics and Gynecology Hospital, Hanoi, Vietnam
- Faculty of Nursing, Hanoi University of Business and Technology, Hanoi, Vietnam
| | - Binh N. Do
- Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam
- Division of Military Science, Military Hospital 103, Hanoi, Vietnam
| | - Tuyen Van Duong
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
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99965
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Reinhart A, Malzkorn B, Döing C, Beyer I, Jünger J, Bosse HM. Undergraduate medical education amid COVID-19: a qualitative analysis of enablers and barriers to acquiring competencies in distant learning using focus groups. Med Educ Online 2021; 26:1940765. [PMID: 34128776 PMCID: PMC8208109 DOI: 10.1080/10872981.2021.1940765] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Due to comprehensive social distancing measures related to the COVID-19 pandemic, medical faculties worldwide have made a virtue of necessity in resorting to online teaching. Medical faculties grapple with how to convey clinical competencies to students in this context. There is a need for research not only to map but also to explain the effect of these secondary measures on students' learning and mental wellbeing. During a period of ongoing comprehensive social distancing measures in Germany, we translated a competency-based curriculum including obstetrics, paediatrics, and human genetics to an e-learning course based on online patient and teacher encounters. In our qualitative study on students' and teachers' views, we identify potential enablers and drivers as well as barriers and challenges to undergraduate medical education under lockdown. In summer 2020, we conducted six focus group interviews to investigate medical students' and teachers' perspectives, experiences and attitudes. All focus groups were videotaped, transcribed verbatim and coded. To guide our deductive and inductive analysis, we applied the theoretical framework of Regmi and Jones. Content analysis was performed in a multi-perspective group. We identified five major themes contributing to a successful use of clinical competency-based e-learning under lockdown: Communication (with teachers, students, and patients), Mental wellbeing, Structure and self-organization, Technical issues, and Learning and commitment. We discuss enablers and potential barriers within all themes and their overlap and link them in an explanatory model. In our setting, students and teachers find e-learning holds strong potential and especially in times of COVID-19 it is greatly appreciated. We broaden the understanding of the impact of distant learning on acquiring competencies, on attitudes, and on mental wellbeing. Our model may serve for a thoughtful, necessary transition to future e-learning and hybrid programs for a competency-based medical education with ongoing social distancing measures.
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Affiliation(s)
- Anika Reinhart
- Department of General Paediatrics, Neonatology, and Paediatric Cardiology, Düsseldorf University Department (UKD), Heinrich-Heine-University, Düsseldorf, Germany
| | - Bastian Malzkorn
- Medical Didactics Office, Medical Faculty of the Heinrich-Heine-University, Heinrich-Heine-University, Düsseldorf, Germany
| | - Carsten Döing
- Department of General Paediatrics, Neonatology, and Paediatric Cardiology, Düsseldorf University Department (UKD), Heinrich-Heine-University, Düsseldorf, Germany
| | - Ines Beyer
- Department of Obstetrics and Gynaecology, Düsseldorf University Department (UKD), Heinrich-Heine-University, Düsseldorf, Germany
| | - Jana Jünger
- The German National Institute for State Examinations in Medicine, Pharmacy and Psychotherapy, Mainz, Germany
| | - Hans Martin Bosse
- Department of General Paediatrics, Neonatology, and Paediatric Cardiology, Düsseldorf University Department (UKD), Heinrich-Heine-University, Düsseldorf, Germany
- CONTACT Hans Martin Bosse Department of General Paediatrics, Neonatology and Paediatric Cardiology, Düsseldorf University Department (UKD), Heinrich-Heine-University, Moorenstrasse 5, Düsseldorf, D-40225, Germany
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99966
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Xiong W, Phillips MR, Wang Z, Zhang Y, Cheng HG, Link BG. Stigma and discrimination associated with mental illness and other stigmatizing conditions in China using two cultural-sensitive measures of stigma: interpersonal distance and occupational restrictiveness. Psychol Med 2021; 51:2804-2813. [PMID: 32482176 DOI: 10.1017/s0033291720001439] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Reducing stigma is a perennial target of mental health advocates, but effectively addressing stigma relies on the ability to correctly understand and accurately measure culture-specific and location-specific components of stigma and discrimination. METHODS We developed two culture-sensitive measures that assess the core components of stigma. The 40-item Interpersonal Distance Scale (IDS) asks respondents about their willingness to establish four different types of relationships with individuals with 10 target conditions, including five mental health-related conditions and five comparison conditions. The 40-item Occupational Restrictiveness Scale (ORS) asks respondents how suitable it is for individuals with the 10 conditions to assume four different types of occupations. The scales - which take 15 min to complete - were administered as part of a 2013 survey in Ningxia Province, China to a representative sample of 2425 adult community members. RESULTS IDS and ORS differentiated the level of stigma between the 10 conditions. Of the total, 81% of respondents were unwilling to have interpersonal relationships with individuals with mental health-related conditions and 91% considered them unsuitable for various occupations. Substantial differences in attitudes about the five mental health-related conditions suggest that there is no community consensus about what constitutes a 'mental illness'. CONCLUSIONS Selection of comparison conditions, types of social relationships, and types of occupations considered by the IDS and ORS make it possible to develop culture-sensitive and cohort-specific measures of interpersonal distance and occupational restrictiveness that can be used to compare the level and type of stigma associated with different conditions and to monitor changes in stigma over time.
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Affiliation(s)
- Wei Xiong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Departments of Psychiatry and Epidemiology, Columbia University, NY, USA
| | - Zhizhong Wang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Yuhong Zhang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Hui G Cheng
- Department of Epidemiology & Biostatistics, Michigan State University, MI, USA
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99967
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Senefeld JW, Johnson PW, Kunze KL, Bloch EM, van Helmond N, Golafshar MA, Klassen SA, Klompas AM, Sexton MA, Diaz Soto JC, Grossman BJ, Tobian AAR, Goel R, Wiggins CC, Bruno KA, van Buskirk CM, Stubbs JR, Winters JL, Casadevall A, Paneth NS, Shaz BH, Petersen MM, Sachais BS, Buras MR, Wieczorek MA, Russoniello B, Dumont LJ, Baker SE, Vassallo RR, Shepherd JRA, Young PP, Verdun NC, Marks P, Haley NR, Rea RF, Katz L, Herasevich V, Waxman DA, Whelan ER, Bergman A, Clayburn AJ, Grabowski MK, Larson KF, Ripoll JG, Andersen KJ, Vogt MNP, Dennis JJ, Regimbal RJ, Bauer PR, Blair JE, Buchholtz ZA, Pletsch MC, Wright K, Greenshields JT, Joyner MJ, Wright RS, Carter RE, Fairweather D. Access to and safety of COVID-19 convalescent plasma in the United States Expanded Access Program: A national registry study. PLoS Med 2021; 18:e1003872. [PMID: 34928960 PMCID: PMC8730442 DOI: 10.1371/journal.pmed.1003872] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 01/05/2022] [Accepted: 11/18/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The United States (US) Expanded Access Program (EAP) to coronavirus disease 2019 (COVID-19) convalescent plasma was initiated in response to the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. While randomized clinical trials were in various stages of development and enrollment, there was an urgent need for widespread access to potential therapeutic agents. The objective of this study is to report on the demographic, geographical, and chronological characteristics of patients in the EAP, and key safety metrics following transfusion of COVID-19 convalescent plasma. METHODS AND FINDINGS Mayo Clinic served as the central institutional review board for all participating facilities, and any US physician could participate as a local physician-principal investigator. Eligible patients were hospitalized, were aged 18 years or older, and had-or were at risk of progression to-severe or life-threatening COVID-19; eligible patients were enrolled through the EAP central website. Blood collection facilities rapidly implemented programs to collect convalescent plasma for hospitalized patients with COVID-19. Demographic and clinical characteristics of all enrolled patients in the EAP were summarized. Temporal patterns in access to COVID-19 convalescent plasma were investigated by comparing daily and weekly changes in EAP enrollment in response to changes in infection rate at the state level. Geographical analyses on access to convalescent plasma included assessing EAP enrollment in all national hospital referral regions, as well as assessing enrollment in metropolitan areas and less populated areas that did not have access to COVID-19 clinical trials. From April 3 to August 23, 2020, 105,717 hospitalized patients with severe or life-threatening COVID-19 were enrolled in the EAP. The majority of patients were 60 years of age or older (57.8%), were male (58.4%), and had overweight or obesity (83.8%). There was substantial inclusion of minorities and underserved populations: 46.4% of patients were of a race other than white, and 37.2% of patients were of Hispanic ethnicity. Chronologically and geographically, increases in the number of both enrollments and transfusions in the EAP closely followed confirmed infections across all 50 states. Nearly all national hospital referral regions enrolled and transfused patients in the EAP, including both in metropolitan and in less populated areas. The incidence of serious adverse events was objectively low (<1%), and the overall crude 30-day mortality rate was 25.2% (95% CI, 25.0% to 25.5%). This registry study was limited by the observational and pragmatic study design that did not include a control or comparator group; thus, the data should not be used to infer definitive treatment effects. CONCLUSIONS These results suggest that the EAP provided widespread access to COVID-19 convalescent plasma in all 50 states, including for underserved racial and ethnic minority populations. The study design of the EAP may serve as a model for future efforts when broad access to a treatment is needed in response to an emerging infectious disease. TRIAL REGISTRATION ClinicalTrials.gov NCT#: NCT04338360.
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Affiliation(s)
- Jonathon W. Senefeld
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Patrick W. Johnson
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Katie L. Kunze
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona, United States of America
| | - Evan M. Bloch
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Noud van Helmond
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Anesthesiology, Cooper Medical School of Rowan University, Cooper University Health Care, Camden, New Jersey, United States of America
| | - Michael A. Golafshar
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona, United States of America
| | - Stephen A. Klassen
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Allan M. Klompas
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Matthew A. Sexton
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Juan C. Diaz Soto
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Brenda J. Grossman
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, United States of America
| | - Aaron A. R. Tobian
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Ruchika Goel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, United States of America
- ImpactLife, Davenport, Iowa, United States of America
| | - Chad C. Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Katelyn A. Bruno
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Camille M. van Buskirk
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - James R. Stubbs
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Jeffrey L. Winters
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Nigel S. Paneth
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, United States of America
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Beth H. Shaz
- Department of Pathology, Duke University, Durham, North Carolina, United States of America
| | - Molly M. Petersen
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona, United States of America
| | - Bruce S. Sachais
- New York Blood Center Enterprises, New York City, New York, United States of America
| | - Matthew R. Buras
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona, United States of America
| | - Mikolaj A. Wieczorek
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Benjamin Russoniello
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Larry J. Dumont
- Vitalant Research Institute, Denver, Colorado, United States of America
- University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Sarah E. Baker
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | | | - John R. A. Shepherd
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Pampee P. Young
- American Red Cross, Washington, District of Columbia, United States of America
| | - Nicole C. Verdun
- Center for Biologics Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Peter Marks
- Center for Biologics Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - N. Rebecca Haley
- Bloodworks Northwest, Seattle, Washington, United States of America
| | - Robert F. Rea
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Louis Katz
- ImpactLife, Davenport, Iowa, United States of America
| | - Vitaly Herasevich
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Dan A. Waxman
- Versiti, Indianapolis, Indiana, United States of America
| | - Emily R. Whelan
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Aviv Bergman
- Department of Systems and Computational Biology, Albert Einstein College of Medicine, New York City, New York, United States of America
| | - Andrew J. Clayburn
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Mary Kathryn Grabowski
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Kathryn F. Larson
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Juan G. Ripoll
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Kylie J. Andersen
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Matthew N. P. Vogt
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Joshua J. Dennis
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Riley J. Regimbal
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Philippe R. Bauer
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Janis E. Blair
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Zachary A. Buchholtz
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Michaela C. Pletsch
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Katherine Wright
- School of Sustainability, Arizona State University, Tempe, Arizona, United States of America
| | - Joel T. Greenshields
- Department of Kinesiology, Indiana University, Bloomington, Indiana, United States of America
| | - Michael J. Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - R. Scott Wright
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Rickey E. Carter
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida, United States of America
| | - DeLisa Fairweather
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, United States of America
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99968
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Del Giorno R, Troiani C, Gabutti S, Stefanelli K, Gabutti L. Comparing oscillometric and tonometric methods to assess pulse wave velocity: a population-based study. Ann Med 2021; 53:1-16. [PMID: 32729734 PMCID: PMC7877928 DOI: 10.1080/07853890.2020.1794538] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 07/07/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Oscillometric pulse wave velocity (o-PWV) represents an attractive, non invasive and non operator-dependent method to estimate arterial stiffness. Tonometric carotid-femoral measurements (cf-PWV),are considered the gold-standard for non-invasive aortic stiffness assessment. To date, no studies in the general population comparing the two methods have been performed. METHODS AND RESULTS 1162 subjects were analysed. O-PWV and cf-PWV showed a mean difference of -0.31 m/sec(p ≤ 0.001). No significant differences between cf-PWV and o-PWVs were observed in patients without cardiovascular risk factors. The Bland and Altman analysis showed a moderate agreement between 24 h-o-PWV and cf-PWV (mean difference -0.99, LoA 4.23 to -6.22m/s). O-PWVs underestimate and overestimate arterial stiffness under and over 50 years respectively(p ≤ 0.001). Systolic blood pressure (SBP) and age differently impact cf-PWV and in office o-PWV variability (r2 0.35 and 0.88 respectively). In younger subjects a strong relationship between o-PWV and SBP reducing as age increases was found. Analysing the impact of age, an opposite trend was noticed. CONCLUSIONS Oscillometric PWV estimates provide reliable values in the general population. An o-PWV tendency to underestimate arterial stiffness in younger subjects and in subjects with diseases known to increase arterial stiffness and to overestimate it with increasing age was found, even if scarcely relevant in clinical perspective. Overall the present findings underline an acceptable and satisfactory agreement between oscillometric and tonometric methods for the PWV assessment. KEY MESSAGES Oscillometric and tonometric PWV estimates showed a good and satisfactory agreement in the general population, above all in subjects without cardiovascular risk factors or a documented vascular damage. In comparison with tonometric values, oscillometric PWV estimates showed, however, the tendency to underestimate arterial stiffness in younger subjects and to overestimate it with increasing age, while diverging when diseases known to increase arterial stiffness are present. The magnitude of differences in PWV estimates between tonometric and oscillometric methods found in the general population appears most likely not to be significant in everyday clinical practice.
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Affiliation(s)
- Rosaria Del Giorno
- Department of Internal Medicine, Clinical Research Unit, Regional Hospital of Bellinzona and Valli, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Institute of Biomedicine, University of Southern Switzerland, Lugano, Switzerland
| | - Chiara Troiani
- Department of Internal Medicine, Clinical Research Unit, Regional Hospital of Bellinzona and Valli, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Sofia Gabutti
- Department of Internal Medicine, Clinical Research Unit, Regional Hospital of Bellinzona and Valli, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Kevyn Stefanelli
- Department of Social Sciences and Economics, Sapienza University of Rome, Rome, Italy
| | - Luca Gabutti
- Department of Internal Medicine, Clinical Research Unit, Regional Hospital of Bellinzona and Valli, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Institute of Biomedicine, University of Southern Switzerland, Lugano, Switzerland
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99969
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Semenza DC, Testa A, Turanovic JJ. Trajectories of violent victimization over the life course: Implications for mental and physical health. Adv Life Course Res 2021; 50:100436. [PMID: 36661291 DOI: 10.1016/j.alcr.2021.100436] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/02/2021] [Accepted: 08/12/2021] [Indexed: 06/17/2023]
Abstract
Violent victimization experiences correspond to an array of negative consequences including poorer mental and physical health. Drawing on life course theories of stress proliferation and well-being, we use four waves of data from the Add Health study to identify pathways of violent victimization from adolescence through young adulthood using group-based trajectory modeling. We then assess the influence of victimization trajectory membership on a range of subsequent health outcomes including depression, PTSD, clinical and subclinical symptoms, and self-rated health. Our results show those with increasing experiences of victimization in young adulthood are at greatest risk for poor health outcomes. Notably, trajectories marked by violent victimization limited in adolescence are not associated with any indicators of poor health. Black individuals and males are at particular risk for membership in victimization trajectories with the greatest risk for future negative health outcomes. Our findings demonstrate that violent victimization occurs via heterogeneous patterns over the life course with significant consequences for well-being and broader health disparities among adults.
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Affiliation(s)
- Daniel C Semenza
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University - Camden, United States.
| | - Alexander Testa
- Department of Criminology & Criminal Justice, The University of Texas at San Antonio, United States
| | - Jillian J Turanovic
- College of Criminology and Criminal Justice, Florida State University, United States
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99970
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Cunningham TJ, Fields EC, Garcia SM, Kensinger EA. The relation between age and experienced stress, worry, affect, and depression during the spring 2020 phase of the COVID-19 pandemic in the United States. Emotion 2021; 21:1660-1670. [PMID: 34138584 DOI: 10.1037/emo0000982] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Advanced age is often associated with increased emotional well-being, with older adults reporting more positive and less negative affect than younger adults. Here, we test whether this pattern held during the initial outbreak of the COVID-19 pandemic that disproportionately put older adults at risk. We additionally examine potential moderating effects of daily activity and social connectedness, which have been shown to benefit mental health across the life span. We regularly assessed a large sample of adults ages 18-89 using online surveys. As preregistered for this report (https://osf.io/tb4qv), we focus on self-reported measures of affect, depression, stress, and worry as well as self-reported daily activity and perception of social isolation during two time windows for adults in the United States: early (mid-March to early April) and later (mid-April to early May) periods during the spring phase of the pandemic. Increased age benefited emotional well-being for multiple metrics during both time windows assessed. Furthermore, the results confirmed that exercise and perception of social connectedness can buffer against negative mental health outcomes across all ages, although the beneficial effects of age remained even when controlling for these influences. The one exception was worry about one's own health: Once exercise and social connectedness were controlled, increased age was associated with more worry. The results overall suggest that, at least among adults with access to technology, older age was associated with greater resilience during the spring phase of the pandemic. Thus, increased resilience of older adults demonstrated previously extends to the context of the onset of a pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | - Eric C Fields
- Department of Psychology and Neuroscience, Boston College
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99971
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Hougen I, Whitlock RH, Komenda P, Rigatto C, Clemens KK, Tangri N. Safety of add-on sulfonylurea therapy in patients with type 2 diabetes using metformin: a population-based real-world study. BMJ Open Diabetes Res Care 2021; 9:9/2/e002352. [PMID: 34969692 PMCID: PMC8718392 DOI: 10.1136/bmjdrc-2021-002352] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/26/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Metformin is the initial oral antihyperglycemic agent (OHA) of choice for most patients with type 2 diabetes (T2D). However, more than one agent is often required for optimal glucose control. As the choice of preferred second OHAs is less well defined, we sought to compare the real-world safety of sulfonylureas to other OHAs as add-on therapy to metformin in patients with T2D. RESEARCH DESIGN AND METHODS This retrospective cohort study included adults in Manitoba, Canada with T2D from 2006 to 2017. Using a new-user design, we divided patients who started on metformin into two groups: add-on therapy with a sulfonylurea and add-on therapy with a different OHA. Outcomes included all-cause mortality, cardiovascular events, and major hypoglycemic episodes. We calculated propensity scores and applied inverse probability of treatment weights to each individual. We compared groups using Cox proportional hazards regression and explored differences in HRs between pre-2008 (acarbose, meglitinides, and thiazolidinediones) and post-2008 (dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, and sodium-glucose linked transporter-2 inhibitors) OHAs. RESULTS Our cohort included 32 576 individuals (28 077 metformin plus sulfonylurea and 4499 metformin plus 'other'). Patients newly prescribed a sulfonylurea in the setting of metformin had a higher risk of all-cause mortality (HR 1.44, 95% CI 1.12 to 1.84, p=0.005) and major hypoglycemic episodes (HR 2.78, 95% CI 1.66 to 4.66, p<0.001) than those prescribed an 'other' OHA. No differences in cardiovascular events were observed (HR 0.99, 95% CI 0.81 to 1.22, p=0.92). In subgroup analyses, mortality and cardiovascular event risk was higher in patients prescribed sulfonylureas versus post-2008 OHAs. CONCLUSIONS Sulfonylureas as add-on therapy to metformin are associated with increased risk of all-cause mortality and major hypoglycemic episodes compared with 'other' OHAs. Post hoc analysis suggests newer OHAs may be preferred to sulfonylureas as second-line therapy for glycemic control.
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Affiliation(s)
- Ingrid Hougen
- Department of Internal Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada
| | - Reid H Whitlock
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
| | - Paul Komenda
- Department of Internal Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
| | - Claudio Rigatto
- Department of Internal Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
| | - Kristin K Clemens
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Navdeep Tangri
- Department of Internal Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
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99972
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Le Bert N, Chia WN, Wan WY, Teo AKJ, Chong SZR, Tan N, Tan DSC, Chia A, Tan IB, Kunasegaran K, Chua QX, Abdad MY, Ng ASH, Vasoo S, Ang JXL, Lee MS, Sun L, Fang J, Zhu F, Cook AR, Aw TC, Huang J, Tam C, Lee FS, Clapham H, Goh EJK, Peou MSS, Tan SP, Ong SK, Wang LF, Bertoletti A, Hsu LY, Ong BC. Widely heterogeneous humoral and cellular immunity after mild SARS-CoV-2 infection in a homogeneous population of healthy young men. Emerg Microbes Infect 2021; 10:2141-2150. [PMID: 34709140 PMCID: PMC8604544 DOI: 10.1080/22221751.2021.1999777] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 10/11/2021] [Accepted: 10/26/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND We studied humoral and cellular responses against SARS-CoV-2 longitudinally in a homogeneous population of healthy young/middle-aged men of South Asian ethnicity with mild COVID-19. METHODS In total, we recruited 994 men (median age: 34 years) post-COVID-19 diagnosis. Repeated cross-sectional surveys were conducted between May 2020 and January 2021 at six time points - day 28 (n = 327), day 80 (n = 202), day 105 (n = 294), day 140 (n = 172), day 180 (n = 758), and day 280 (n = 311). Three commercial assays were used to detect anti-nucleoprotein (NP) and neutralizing antibodies. T cell response specific for Spike, Membrane and NP SARS-CoV-2 proteins was tested in 85 patients at day 105, 180, and 280. RESULTS All serological tests displayed different kinetics of progressive antibody reduction while the frequency of T cells specific for different structural SARS-CoV-2 proteins was stable over time. Both showed a marked heterogeneity of magnitude among the studied cohort. Comparatively, cellular responses lasted longer than humoral responses and were still detectable nine months after infection in the individuals who lost antibody detection. Correlation between T cell frequencies and all antibodies was lost over time. CONCLUSION Humoral and cellular immunity against SARS-CoV-2 is induced with differing kinetics of persistence in those with mild disease. The magnitude of T cells and antibodies is highly heterogeneous in a homogeneous study population. These observations have implications for COVID-19 surveillance, vaccination strategies, and post-pandemic planning.
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Affiliation(s)
- Nina Le Bert
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Wan Ni Chia
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Wei Yee Wan
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
| | - Alvin Kuo Jing Teo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | - Nicole Tan
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | | | - Adeline Chia
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Iain Beehuat Tan
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- National Cancer Centre, Singapore, Singapore
- Genome Institute of Singapore, Singapore, Singapore
| | - Kamini Kunasegaran
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | | | - Mohammad Yazid Abdad
- National Centre for Infectious Diseases, Singapore, Singapore
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Thailand
| | | | - Shawn Vasoo
- National Centre for Infectious Diseases, Singapore, Singapore
| | | | | | - Louisa Sun
- Alexandra Hospital, Singapore, Singapore
| | - Jinyan Fang
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Feng Zhu
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Alex R. Cook
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | | | - Clarence Tam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | - Hannah Clapham
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | | | | | | | - Lin-Fa Wang
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Antonio Bertoletti
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Li Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Singapore Centre for Environmental Life Sciences Engineering, National University of Singapore, Singapore, Singapore
| | - Biauw Chi Ong
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Sengkang General Hospital, Singapore, Singapore
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99973
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Gaston SA, Atere-Roberts J, Ward J, Slopen NB, Forde AT, Sandler DP, Williams DR, Jackson CL. Experiences With Everyday and Major Forms of Racial/Ethnic Discrimination and Type 2 Diabetes Risk Among White, Black, and Hispanic/Latina Women: Findings From the Sister Study. Am J Epidemiol 2021; 190:2552-2562. [PMID: 34215871 DOI: 10.1093/aje/kwab189] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 01/22/2023] Open
Abstract
Racial/ethnic discrimination may contribute to the risk of type 2 diabetes mellitus (T2DM), but few studies have prospectively examined this relationship among racially/ethnically diverse populations. We analyzed prospective data from 33,833 eligible Sister Study participants enrolled from 2003 to 2009. In a follow-up questionnaire (2008-2012), participants reported their lifetime experiences of everyday and major forms of racial/ethnic discrimination. Self-reported physician diagnoses of T2DM were ascertained through September 2017. Hazard ratios and 95% confidence intervals were estimated using Cox proportional hazards models, overall and by race/ethnicity. Mean age at enrollment was 54.9 (standard deviation, 8.8) years; 90% of participants self-identified as non-Hispanic (NH) White, 7% as NH Black, and 3% as Hispanic/Latina. Over an average of 7 years of follow-up, there were 1,167 incident cases of T2DM. NH Black women most frequently reported everyday (75%) and major (51%) racial/ethnic discrimination (vs. 4% and 2% of NH White women, respectively, and 32% and 16% of Hispanic/Latina women, respectively). While everyday discrimination was not associated with T2DM risk, experiencing major discrimination was marginally associated with higher T2DM risk overall (hazard ratio = 1.26, 95% confidence interval: 0.99, 1.61) after adjustment for sociodemographic characteristics and body mass index. Associations were similar across racial/ethnic groups; however, racial/ethnic discrimination was more frequently reported among racial/ethnic minority women. Antidiscrimination efforts may help mitigate racial/ethnic disparities in T2DM risk.
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99974
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Rué-Queralt J, Glomb K, Pascucci D, Tourbier S, Carboni M, Vulliémoz S, Plomp G, Hagmann P. The connectome spectrum as a canonical basis for a sparse representation of fast brain activity. Neuroimage 2021; 244:118611. [PMID: 34560267 DOI: 10.1016/j.neuroimage.2021.118611] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/28/2021] [Accepted: 09/20/2021] [Indexed: 11/18/2022] Open
Abstract
The functional organization of neural processes is constrained by the brain's intrinsic structural connectivity, i.e., the connectome. Here, we explore how structural connectivity can improve the representation of brain activity signals and their dynamics. Using a multi-modal imaging dataset (electroencephalography, structural MRI, and diffusion MRI), we represent electrical brain activity at the cortical surface as a time-varying composition of harmonic modes of structural connectivity. These harmonic modes are known as connectome harmonics. Here we describe brain activity signal as a time-varying combination of connectome harmonics. We term this description as the connectome spectrum of the signal. We found that: first, the brain activity signal is represented more compactly by the connectome spectrum than by the traditional area-based representation; second, the connectome spectrum characterizes fast brain dynamics in terms of signal broadcasting profile, revealing different temporal regimes of integration and segregation that are consistent across participants. And last, the connectome spectrum characterizes fast brain dynamics with fewer degrees of freedom than area-based signal representations. Specifically, we show that a smaller number of dimensions capture the differences between low-level and high-level visual processing in the connectome spectrum. Also, we demonstrate that connectome harmonics capture more sensitively the topological properties of brain activity. In summary, this work provides statistical, functional, and topological evidence indicating that the description of brain activity in terms of structural connectivity fosters a more comprehensive understanding of large-scale dynamic neural functioning.
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Affiliation(s)
- Joan Rué-Queralt
- Connectomics Lab, Department of Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland; Perceptual Networks Group, Dept. of Psychology, University of Fribourg, Fribourg, Switzerland.
| | - Katharina Glomb
- Connectomics Lab, Department of Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | | | - Sébastien Tourbier
- Connectomics Lab, Department of Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Margherita Carboni
- EEG and Epilepsy, Neurology, University Hospital of Geneva and University of Geneva, Geneva, Switzerland; Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland
| | - Serge Vulliémoz
- Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland
| | - Gijs Plomp
- Perceptual Networks Group, Dept. of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Patric Hagmann
- Connectomics Lab, Department of Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
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99975
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Tao H, O'Neil A, Paxton RJ, Wang W, Deng X, Wang J, Wang Y, Jia Y, Nie J. Sleep duration and risk of all-cause and disease-specific mortality in adult cancer survivors. J Evid Based Med 2021; 14:272-274. [PMID: 34647687 DOI: 10.1111/jebm.12451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 06/17/2021] [Accepted: 09/13/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Huan Tao
- Department of Hematology and Research Laboratory of Hematology, West China Hospital, Sichuan University, China
| | - Adrienne O'Neil
- The Centre for Innovation in Mental and Physical Health and Clinical Treatment, Deakin University, Geelong, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Raheem J Paxton
- Department of Community Medicine and Population Health, The University of Alabama, Tuscaloosa, Alabama
| | - Wei Wang
- School of Mathematical Sciences, Shanghai Jiao Tong University, Shanghai, China
| | - Xiang Deng
- Department of statistics, School of applied mathematics and physics, Beijing University of Technology, Beijing, China
| | - Junfeng Wang
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Yafeng Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yongqian Jia
- Department of Hematology and Research Laboratory of Hematology, West China Hospital, Sichuan University, China
| | - Jing Nie
- Department of Sociology & Institute for Empirical Social Science Research, School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, China
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99976
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Schats R. Cribriotic lesions in archaeological human skeletal remains. Prevalence, co-occurrence, and association in medieval and early modern Netherlands. Int J Paleopathol 2021; 35:81-89. [PMID: 34757296 DOI: 10.1016/j.ijpp.2021.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/22/2021] [Accepted: 10/18/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This paper studies the prevalence, co-occurrence, and association of cribra orbitalia, cribra humeri, and cribra femora to contribute to the complex debate on cribriotic lesions and their relationship with one another. MATERIALS 179 adults and 53 non-adults from the medieval/early modern Netherlands (800-1600 CE) for whom all three lesions could be observed are included in this study. METHODS Presence or absence of cribriotic lesions was studied macroscopically. Prevalence, co-occurrence, and association of lesions and their link to sex and age-at-death were assessed. RESULTS A clear link between prevalence of the lesions and age-at-death is found. Co-occurrence and association of all three lesions is uncommon. There is a significant moderate correlation for cribra humeri-femora in non-adults. CONCLUSIONS Lesion prevalence is connected to age-at-death. However, while a similar age distribution and associations between pairs of lesions are noted, due to limited co-occurrence of the three lesions, the presence of a 'cribrous syndrome' cannot supported. SIGNIFICANCE This is the first study investigating the prevalence, co-occurrence and association of cribra orbitalia, cribra humeri, and cribra femora in non-adults and adults contributing to discussions about the nature and the much-debated aetiology of these commonly encountered skeletal lesions. LIMITATIONS The number of non-adults in this study is limited, potentially obscuring meaningful patterns, as the cribrous lesions are significantly more common in younger individuals. SUGGESTIONS FOR FURTHER RESEARCH More research into the prevalence of the post-cranial lesions and their co-occurrence as well as into bone growth and remodelling is warranted.
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Affiliation(s)
- Rachel Schats
- Leiden University, Faculty of Archaeology, Laboratory for Human Osteoarchaeology, Einsteinweg 2, 2333CC Leiden, The Netherlands.
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99977
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Tanenbaum ML, Ngo J, Hanes SJ, Basina M, Buckingham BA, Hessler D, Maahs DM, Mulvaney S, Hood KK. ONBOARD: A Feasibility Study of a Telehealth-Based Continuous Glucose Monitoring Adoption Intervention for Adults with Type 1 Diabetes. Diabetes Technol Ther 2021; 23:818-827. [PMID: 34270351 PMCID: PMC8819504 DOI: 10.1089/dia.2021.0198] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background: Continuous glucose monitoring (CGM) can improve glycemic control for adults with type 1 diabetes (T1D) but certain barriers interfere with consistent use including cost, data overload, alarm fatigue, physical discomfort, and unwanted social attention. This pilot study aimed to examine feasibility and acceptability of a behavioral intervention, ONBOARD (Overcoming Barriers and Obstacles to Adopting Diabetes Devices) to support adults with T1D in optimizing CGM use. Methods: Adults (18-50 years) with T1D in their first year of CGM use were invited to participate in a tailored, multicomponent telehealth-based intervention delivered over four 60-min sessions every 2-3 weeks. Participants completed surveys (demographics; diabetes distress, Diabetes Distress Scale for adults with type 1 diabetes; satisfaction with program) and provided CGM data at baseline and postintervention (3 months). Data were analyzed using paired t-tests and Wilcoxon signed-rank tests. Results: Twenty-two participants (age = 30.95 ± 8.32 years; 59% women; 91% non-Hispanic; 86% White, 5% Black, 9% other; 73% pump users) completed the study. ONBOARD demonstrated acceptability and a high rate of retention. Moderate effect sizes were found for reductions in diabetes distress (P = 0.01, r = -0.37) and increases in daytime spent in target range (70-180 mg/dL: P = 0.03, r = -0.35). There were no significant increases in hypoglycemia. Conclusions: Findings show preliminary evidence of feasibility, acceptability, and efficacy of ONBOARD for supporting adults with T1D in optimizing CGM use while alleviating diabetes distress. Further research is needed to examine ONBOARD in a larger sample over a longer period.
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Affiliation(s)
- Molly L. Tanenbaum
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
- Stanford Diabetes Research Center, Stanford, California, USA
- Address correspondence to: Molly L. Tanenbaum, PhD, Center for Academic Medicine, Division of Endocrinology and Diabetes, MC 5660, Department of Pediatrics, Stanford University School of Medicine, 453 Quarry Road, Palo Alto, CA 94304-5660, USA
| | - Jessica Ngo
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Sarah J. Hanes
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Marina Basina
- Stanford Diabetes Research Center, Stanford, California, USA
- Division of Endocrinology, Gerontology and Metabolism, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Bruce A. Buckingham
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
- Stanford Diabetes Research Center, Stanford, California, USA
| | - Danielle Hessler
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California, USA
| | - David M. Maahs
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
- Stanford Diabetes Research Center, Stanford, California, USA
| | - Shelagh Mulvaney
- Center for Diabetes Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- School of Nursing, Vanderbilt University, Nashville, Tennessee, USA
| | - Korey K. Hood
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
- Stanford Diabetes Research Center, Stanford, California, USA
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99978
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Abstract
BACKGROUND Loneliness is known to be associated with both poorer physical and mental health, being associated with increased mortality. Responses throughout the world to the current COVID-19 pandemic all incorporate varying degrees of social distancing and isolation. There is an imperative to provide a timely review and synthesis of the impact of COVID-19 on loneliness in the general population. METHODS PubMed was searched using the key terms 'COVID-19', 'coronavirus', 'SARS-COV2' and 'loneliness'. Fifty-four articles were identified and screened against the inclusion criteria. The inclusion criteria stipulated that the study needed to incorporate a measure of loneliness with participants being drawn from the general adult population. Twenty-four studies met the inclusion criteria. RESULTS The key data extracted from the 24 reviewed studies are presented and summarised with a focus on key demographics of participants, the research designs utilised, the measures of loneliness employed and the other variables assessed in the studies. Overall, the findings indicate that loneliness has been a significant issue during the current COVID-19 pandemic and loneliness is positively associated with mental health symptoms. However, there were inconsistencies in the results evident across studies. CONCLUSION To our knowledge, this is the first systematic review of research investigating loneliness during the current COVID-19 pandemic in the general adult population. Despite the inconsistencies evident in some of the results across the studies, it is clearly apparent that loneliness is having an impact on the mental health and wellbeing of the general adult population. Furthermore, it is apparent that the current COVID-19 pandemic has had an impact on loneliness in the general adult population and that loneliness is significantly positively associated with mental illness symptomatology. Thus, there is an imperative to address loneliness through public policy and interventions. The limitations of this review are noted and directions given for future research.
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Affiliation(s)
- Nagesh Pai
- Graduate Medicine, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Shae-Leigh Vella
- Graduate Medicine, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
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99979
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Ryan P, Furniss A, Breslin K, Everhart R, Hanratty R, Rice J. Assessing and Augmenting Predictive Models for Hospital Readmissions With Novel Variables in an Urban Safety-net Population. Med Care 2021; 59:1107-1114. [PMID: 34593712 DOI: 10.1097/mlr.0000000000001653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The performance of existing predictive models of readmissions, such as the LACE, LACE+, and Epic models, is not established in urban safety-net populations. We assessed previously validated predictive models of readmission performance in a socially complex, urban safety-net population, and if augmentation with additional variables such as the Area Deprivation Index, mental health diagnoses, and housing access improves prediction. Through the addition of new variables, we introduce the LACE-social determinants of health (SDH) model. METHODS This retrospective cohort study included adult admissions from July 1, 2016, to June 30, 2018, at a single urban safety-net health system, assessing the performance of the LACE, LACE+, and Epic models in predicting 30-day, unplanned rehospitalization. The LACE-SDH development is presented through logistic regression. Predictive model performance was compared using C-statistics. RESULTS A total of 16,540 patients met the inclusion criteria. Within the validation cohort (n=8314), the Epic model performed the best (C-statistic=0.71, P<0.05), compared with LACE-SDH (0.67), LACE (0.65), and LACE+ (0.61). The variables most associated with readmissions were (odds ratio, 95% confidence interval) against medical advice discharge (3.19, 2.28-4.45), mental health diagnosis (2.06, 1.72-2.47), and health care utilization (1.94, 1.47-2.55). CONCLUSIONS The Epic model performed the best in our sample but requires the use of the Epic Electronic Health Record. The LACE-SDH performed significantly better than the LACE and LACE+ models when applied to a safety-net population, demonstrating the importance of accounting for socioeconomic stressors, mental health, and health care utilization in assessing readmission risk in urban safety-net patients.
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Affiliation(s)
- Patrick Ryan
- Department of General Internal Medicine
- Ambulatory Care Services, Community Health Services, Denver Health & Hospital Authority, Denver
- Department of General Internal Medicine, University of Colorado School of Medicine, Anschutz Medical Campus
| | - Anna Furniss
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus
| | - Kristin Breslin
- Ambulatory Care Services, Community Health Services, Denver Health & Hospital Authority, Denver
| | - Rachel Everhart
- Ambulatory Care Services, Community Health Services, Denver Health & Hospital Authority, Denver
- Department of General Internal Medicine, University of Colorado School of Medicine, Anschutz Medical Campus
| | - Rebecca Hanratty
- Department of General Internal Medicine
- Ambulatory Care Services, Community Health Services, Denver Health & Hospital Authority, Denver
- Department of General Internal Medicine, University of Colorado School of Medicine, Anschutz Medical Campus
| | - John Rice
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
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99980
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Rasool M, Carracedo A, Sibiany A, Al-Sayes F, Karim S, Haque A, Natesan Pushparaj P, Asif M, Achakzai NM. Discovery of a novel and a rare Kristen rat sarcoma viral oncogene homolog (KRAS) gene mutation in colorectal cancer patients. Bioengineered 2021; 12:5099-5109. [PMID: 34369256 PMCID: PMC8806922 DOI: 10.1080/21655979.2021.1960715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 01/05/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most important causes of morbidity and mortality in the developed world and is gradually more frequent in the developing world including Saudi Arabia. According to the Saudi Cancer Registry report 2015, CRC is the most common cancer in men (14.9%) and the second most prevalent cancer. Oncogenic mutations in the KRAS gene play a central role in tumorigenesis and are mutated in 30-40% of all CRC patients. To explore the prevalence of KRAS gene mutations in the Saudi population, we collected 80 CRC tumor tissues and sequenced the KRAS gene using automated sequencing technologies. The chromatograms presented mutations in 26 patients (32.5%) in four different codons, that is, 12, 13, 17, and 31. Most of the mutations were identified in codon 12 in 16 patients (61.5% of all mutations). We identified a novel mutation c.51 G>A in codon 17, where serine was substituted by arginine (S17R) in four patients. We also identified a very rare mutation, c.91 G>A, in which glutamic acid was replaced by lysine (E31K) in three patients. In conclusion, our findings further the knowledge about KRAS mutations in different ethnic groups is indispensable to fully understand their role in the development and progression of CRC.
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Affiliation(s)
- Mahmood Rasool
- Center of Excellence in Genomic Medicine Research, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Angel Carracedo
- Genomic Medicine Group, University of Santiago De Compostela, Spain
| | | | - Faten Al-Sayes
- Faculty of Medicine, KAUH, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sajjad Karim
- Center of Excellence in Genomic Medicine Research, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Absarul Haque
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- King Fahd Medical Research Center, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Peter Natesan Pushparaj
- Center of Excellence in Genomic Medicine Research, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Muhammad Asif
- ORIC, Department of Biotechnology, Buitems, Quetta, Pakistan
| | - Niaz M. Achakzai
- Department of Molecular Biology, City Medical Complex, Kabul, Afghanistan
- Department of Molecular Biology, DNA Section, Legal Medicine Directorate, Ministry of Public Health, Kabul, Afghanistan
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99981
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Heidari Z, Moudi B, Sheibak N, Asemi-Rad A, Keikha N, Mahmoudzadeh-Sagheb H, Ghasemi M. Interleukin 22 Expression During the Implantation Window in the Endometrium of Women with Unexplained Recurrent Pregnancy Loss and Unexplained Infertility Compared to Healthy Parturient Individuals. J Interferon Cytokine Res 2021; 41:461-468. [PMID: 34935487 DOI: 10.1089/jir.2021.0160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We evaluated the expression of interleukin-22 (IL-22) in the endometrium of women with unexplained recurrent pregnancy loss (uRPL) and unexplained infertility (UI) compared to the women with normal pregnancies. Endometrial tissues were collected from 20 women with UI, 20 women with uRPL, and 24 healthy women as a control group. Immunohistochemical expression and gene expression of IL-22 were analyzed by immunohistochemistry (IHC) and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) methods. The controls showed lower IL-22 expression than the uRPL group (P > 0.05) using PCR. It was also found that patients with UI had lower levels of IL-22 expression compared to the uRPL group (P > 0.05). Although IL-22 expression in the endometrium of patients with UI was higher than the control group, this difference was not statistically significant (P < 0.05). IL-22 immunoreactivity was observed in the endometrial glands and stromal tissues using IHC. We found the lowest IL-22 expression in the control group and the highest in uRPL samples (P < 0.05). Our findings suggest that a significant increase in IL-22 expression in uRPL patients may affect fertility and pregnancy outcomes or even have a considerable impact on immune function deficits. Further studies on the critical function of IL-22 during pregnancy are suggested.
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Affiliation(s)
- Zahra Heidari
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
- Department of Histology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Bita Moudi
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
- Department of Histology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Nadia Sheibak
- Department of Histology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Azam Asemi-Rad
- Department of Anatomical Sciences, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Narjes Keikha
- Moloud Infertility Center, Ali ibn Abi Taleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hamidreza Mahmoudzadeh-Sagheb
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
- Department of Histology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Marzieh Ghasemi
- Moloud Infertility Center, Ali ibn Abi Taleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
- Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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99982
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Landro Carla Daffunchio Guillermo Cambiaggi Gustavo Galatro Horacio Caviglia ME, Daffunchio C, Cambiaggi G, Galatro GG, Caviglia H. Platelet-rich plasma vs platelet-rich plasma plus hyaluronic acid for haemophilic knee arthropathy treatment. Acta Orthop Belg 2021; 87:705-712. [PMID: 35172437 DOI: 10.52628/87.4.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Repeated joint bleeding leads to chronic synovitis, cartilage damage and bone alterations which result in haemophilic arthropathy and are associated with pain, functional impairment and poor quality of life. There are evidence that Hyaluronic Acid (HA) and Platelet-rich Plasma (PRP) have different mechanisms of action in the treatment of arthropathy for this reason we decided to use both components. The aim of this study is to compare, the efficacy, safety and duration of a single intra-articular injection of PRP against PRP+HA for pain, bleeding episodes and joint health, in the same patient with bilateral hemophilic knee arthropathy. Twenty-one men patients (42 knee joints) were treated with intra- articular injections of PRP or PRP+HA. All of them were haemophilia type A severe. The mean age was 36.6 years (21-72). All patients were evaluated for: Haemophilia Joint Health Score (HJHS), pain (VAS), the number of bleeding episodes (BE) in the last 30 days, before treatment, at three and six months after treatment. Statistically significant improvement were shown for both knee joints at three and six months after treatment for VAS and BE (P < 0.00001). The HJHS score did not significantly improve for either knee in the 6-month period after injection. A single PRP or PRP+HA injection is safe and effective in treating haemophilic arthropathy of the knee for up to 6 months follow-up, reducing pain, bleeding episodes and delaying total knee arthroplasty.
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99983
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Al-Hadidi SH, Alhussain H, Abdel Hadi H, Johar A, Yassine HM, Al Thani AA, Eltai NO. The Spectrum of Antibiotic Prescribing During COVID-19 Pandemic: A Systematic Literature Review. Microb Drug Resist 2021; 27:1705-1725. [PMID: 34077290 PMCID: PMC8713256 DOI: 10.1089/mdr.2020.0619] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objectives: Over the last decades, there has been a significant increase in antimicrobial prescribing and consumption associated with the development of patients' adverse events and antimicrobial resistance (AMR) to the point of becoming a global priority. This study aims at evaluating antibiotic prescribing during COVID-19 pandemic from November 2019 to December 2020. Materials and Methods: A systematic review was conducted primarily through the NCBI database, using PRISMA guidelines to identify relevant literature for the period between November 1, 2019 and December 19, 2020, using the keywords: COVID-19 OR SARS-Cov-2 AND antibiotics restricted to the English language excluding nonclinical articles. Five hundred twenty-seven titles were identified; all articles fulfilling the study criteria were included, 133 through the NCBI, and 8 through Google Scholar with a combined total of 141 studies. The patient's spectrum included all ages from neonates to elderly with all associated comorbidities, including immune suppression. Results: Of 28,093 patients included in the combined studies, 58.7% received antibiotics (16,490/28,093), ranging from 1.3% to 100% coverage. Antibiotics coverage was less in children (57%) than in adults with comorbidities (75%). Broad-spectrum antibiotics were prescribed presumptively without pathogen identifications, which might contribute to adverse outcomes. Conclusions: During the COVID-19 pandemic, there has been a significant and wide range of antibiotic prescribing in patients affected by the disease, particularly in adults with underlying comorbidities, despite the paucity of evidence of associated bacterial infections. The current practice might increase patients' immediate and long-term risks of adverse events, susceptibility to secondary infections as well as aggravating AMR.
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Affiliation(s)
| | | | - Hamad Abdel Hadi
- Infectious Disease Division, Communicable Diseases Centre, Hamad Medical Corporation, Doha, Qatar
| | | | | | | | - Nahla O. Eltai
- Biomedical Research Center, Qatar University, Doha, Qatar
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99984
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Bonner CP, Fisher CB, Carney T, Browne FA, Gichane MW, Howard BN, Turner L, Wechsberg WM. "Because all mothers is not the same": The development and implementation of an in loco parentis informed consent procedure to enroll adolescent girls and young women to participate in HIV research. J Adolesc 2021; 93:234-244. [PMID: 34896961 PMCID: PMC10916742 DOI: 10.1016/j.adolescence.2021.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/12/2021] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION South Africa has one of the highest incidences of HIV among adolescent girls and young women (AGW), ages 15-24, and recent research has focused on developing interventions for HIV prevention. However, the South African National Health Act requires those under 18 years of age to obtain a guardian's permission to participate in research. Limiting research enrolment to AGYW who can obtain guardian consent may lead to non-representative findings. Therefore, innovative, inclusive consent approaches that protect AGYW from the risks of research are needed. METHODS This report details the development and implementation of an approach called the in loco parentis (in place of parent) consent procedure. In loco parentis consent provides a vehicle for adolescent participation that protects adolescents from potential social harms. The in loco parentis consent procedure does not seek to obtain independent minor consent but seeks to obtain permission for the minor to participate in research from a trusted adult who is not a minor's parent or legal guardian. This report also qualitatively explores the experiences of 31 AGYW who were recruited into a behavioral HIV prevention study using this method. RESULTS Findings suggest that the in loco parentis consent procedure is a feasible and acceptable method to inclusively AGYW in HIV research. CONCLUSIONS The in loco parentis procedure may provide a more inclusive strategy to recruit AGYW for HIV research to increase the generalizability of findings.
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Affiliation(s)
- Courtney Peasant Bonner
- Substance Use, Gender, and Applied Research Program, RTI International, Atlanta, GA, USA; Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | | | - Tara Carney
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Felicia A Browne
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| | - Margaret W Gichane
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| | - Brittni N Howard
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| | - Leslie Turner
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| | - Wendee M Wechsberg
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA; Department of Psychology, North Carolina State University, Raleigh, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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99985
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Carlyle M, Constable T, Walter ZC, Wilson J, Newland G, Hides L. Cannabis-induced dysphoria/paranoia mediates the link between childhood trauma and psychotic-like experiences in young cannabis users. Schizophr Res 2021; 238:178-184. [PMID: 34717186 DOI: 10.1016/j.schres.2021.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/13/2021] [Accepted: 10/17/2021] [Indexed: 01/22/2023]
Abstract
Childhood trauma (abuse and neglect) is a major risk factor for cannabis use disorder and psychotic-spectrum disorders. Psychotic-like experiences (PLEs) in young people who use cannabis may be an early indicator of psychosis risk following cannabis use. We examined whether (i) childhood trauma moderates the association between cannabis use and PLEs, (ii) the association between childhood trauma and cannabis use is mediated by subjective effects of cannabis (euphoria and dysphoria/paranoia), and (iii) the association between childhood trauma and PLEs is also mediated by these subjective effects. Participants were 2630 cannabis users (aged 16-25) recruited online. They were asked to complete a cross-sectional survey measuring cannabis and other substance use, childhood trauma, PLEs, and the subjective effects of cannabis (euphoria and dysphoria/paranoia). A significant interaction indicated that the effect of cannabis on PLE frequency was stronger for individuals with more severe childhood trauma. Childhood trauma was also associated with greater cannabis use and PLE frequency, both of which were mediated by subjective dysphoria/paranoia when using the drug. This suggests childhood trauma is associated with greater PLEs in young people who use cannabis, which may be linked with an increased susceptibility to the dysphoric/paranoid subjective effects when using the drug. Childhood trauma should be addressed early in young people who use cannabis to mitigate the psychosis-associated harms of the drug.
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Affiliation(s)
- Molly Carlyle
- Lives Lived Well research group, School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia; National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia.
| | - Toby Constable
- Lives Lived Well research group, School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Zoe C Walter
- Lives Lived Well research group, School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia; National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Joanna Wilson
- Lives Lived Well research group, School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Grace Newland
- Lives Lived Well research group, School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia; National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Leanne Hides
- Lives Lived Well research group, School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia; National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
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99986
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Bugaj TJ, Heilborn M, Terhoeven V, Kaisinger S, Nagy E, Friederich HC, Nikendei C. What do Final Year Medical Students in Germany know and think about Climate Change? - The ClimAttitude Study. Med Educ Online 2021; 26:1917037. [PMID: 33886438 PMCID: PMC8079051 DOI: 10.1080/10872981.2021.1917037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Climate change (CC) is adversely affecting human health and will become far more dangerous in the future, if no substantial measures are taken. Young people in particular are taking an energetic stand for CC awareness. Some CC experts argue that medical doctors are especially well positioned to inform about the impact of CC on public health, as it is well established that they are among the most trusted members of society. However, medical doctors seem to be unsure of their role in addressing CC. This study aimed to investigate future doctors´, i.e., final year medical students´ (FYMS), attitudes towards CC and their personal role in CC education and health care. A questionnaire was developed to examine (1) the expected consequences of CC for FYMS, (2) their perceived individual responsibility, and their attitudes towards an additional (3) professional responsibility. To examine the climate-questionnaire's component correlations, we ran a factor analysis using oblique (promax) rotation and conducted a one-way ANOVA with repeated measures to compare the mean scores of the factors. Data are presented as mean ± SD or percentage, as appropriate. n = 65 FYMS (response rate: 87%) were participating and all of them completed the questionnaire. Items of the factor professional responsibility showed the lowest level of agreement (47.2 ± 21.2), while the 2 other factors showed higher levels of agreement (expected consequences (75.6 ± 18.4), individual responsibility (75.1 ± 20.6). Future doctors at Heidelberg University Hospital are well-informed about the expected health consequences of CC. They recognize human contributions to CC and make personal decisions to mitigate the impact. However, the opinion that they have a professional responsibility as physicians to patients or society in regard to CC is weaker. Specific teaching could help to change the way future doctors see their role and responsibility in tackling CC.
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Affiliation(s)
- Till Johannes Bugaj
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
- CONTACT Till Johannes Bugaj Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Inf 410, HeidelbergD-69120, Germany
| | - Marie Heilborn
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
| | - Valentin Terhoeven
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
| | - Simon Kaisinger
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
| | - Ede Nagy
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
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99987
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Tanvir EM, Komarova T, Comino E, Sumner R, Whitfield KM, Shaw PN. Effects of storage conditions on the stability and distribution of clinical trace elements in whole blood and plasma: Application of ICP-MS. J Trace Elem Med Biol 2021; 68:126804. [PMID: 34111708 DOI: 10.1016/j.jtemb.2021.126804] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/29/2021] [Accepted: 06/02/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Knowledge of trace element stability during sample handling and preservation is a prerequisite to produce reliable test results in clinical trace element analysis. METHOD An alkaline dissolution method has been developed using inductively coupled plasma mass spectrometry to quantify eighteen trace element concentrations: vanadium, chromium, manganese, cobalt, nickel, copper, zinc, arsenic, selenium, bromine, molybdenum, cadmium, antimony, iodine, mercury, thallium, lead, and bismuth in human blood, using a small sample volume of 0.1 mL. The study evaluated the comparative effects of storage conditions on the stability of nutritionally essential and non-essential elements in human blood and plasma samples stored at three different temperatures (4 °C, -20 °C and -80 °C) over a one-year period, and analysed at multiple time points. The distribution of these elements between whole blood and plasma and their distribution relationships are illustrated using blood samples from 66 adult donors in Queensland. RESULTS The refrigeration and freezing of blood and plasma specimens proved to be suitable storage conditions for many of the trace elements for periods up to six months, with essentially unchanged concentrations. Substantially consistent recoveries were obtained by preserving specimens at -20 °C for up to one year. Ultra-freezing of the specimens at -80 °C did not improve stability; but appeared to result in adsorption and/or precipitation of some elements, accompanied by a longer sample thawing time. A population sample study revealed significant differences between the blood and plasma concentrations of six essential elements and their relationships also varied significantly for different elements. CONCLUSION Blood and plasma specimens can be reliably stored at 4 °C for six months or kept frozen at -20 °C up to one year to obtain high quality test results of trace elements.
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Affiliation(s)
- E M Tanvir
- School of Pharmacy, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Tatiana Komarova
- Inorganic Chemistry, Queensland Health Forensic and Scientific Services, Coopers Plains, Queensland 4108, Australia
| | - Eva Comino
- Inorganic Chemistry, Queensland Health Forensic and Scientific Services, Coopers Plains, Queensland 4108, Australia
| | - Ronald Sumner
- Inorganic Chemistry, Queensland Health Forensic and Scientific Services, Coopers Plains, Queensland 4108, Australia
| | - Karen M Whitfield
- School of Pharmacy, The University of Queensland, St Lucia, Queensland 4072, Australia; Pharmacy Department, Royal Brisbane and Women's Hospital, Metro North Health Services District, Herston, Queensland 4029, Australia
| | - P Nicholas Shaw
- School of Pharmacy, The University of Queensland, St Lucia, Queensland 4072, Australia.
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99988
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Im SH, Jang DK, Kim H, Park SK, Han KD. Long-term mortality in patients with moyamoya angiopathy according to stroke presentation type in South Korea. Acta Neurochir (Wien) 2021; 163:3473-3481. [PMID: 34427768 DOI: 10.1007/s00701-021-04959-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/29/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Incidence, prevalence, and long-term survival outcomes in patients with moyamoya angiopathy (MMA) according to stroke presentation type and age group have not been clearly elucidated. METHODS We investigated mortality in patients with MMA (moyamoya disease, probable moyamoya disease, moyamoya syndrome) of whose International Classification Disease 10 code was I67.5 from 2006 to 2015 using the Korean National Health Insurance database. MMA at diagnosis was classified into 3 types (ischemic, hemorrhagic, and asymptomatic or else) according to stroke presentation. Survival analysis was performed according to stroke presentation type and age group (< 15 years and ≥ 15 years) using the Kaplan-Meier method. RESULTS There were 12,146 newly diagnosed moyamoya cases, with a female-to-male ratio of 1.81; the ischemic type was identified in 3671 (30.2%) patients, the hemorrhagic type in 2449 (20.2%) patients, and the asymptomatic or else type in 6026 (49.6%) patients. The mean age at diagnosis according to stroke presentation was 33.1 (± 14.8) years in asymptomatic or else type, 41.2 (± 17.3) years in ischemic type, and 45.4 (± 14.3) years in hemorrhagic type (P < 0.001). The 10-year survival rates in ischemic-, hemorrhagic-, and asymptomatic or else-type patients were 88.9%, 76.3%, and 94.3%, respectively (log-rank test; P < 0.001). Pediatric MMA (< 15 years) and adult MMA (≥ 15 years) showed different survival curves according to stroke presentation type (log-rank test; P = 0.017, P < 0.001, respectively). CONCLUSIONS Our study showed that moyamoya patients had different diagnosis ages and distinct survival courses according to stroke presentation type. Adult moyamoya patients with hemorrhagic presentation had the worst survival outcomes.
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Affiliation(s)
- Sang-Hyuk Im
- Department of Neurosurgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Kyu Jang
- Department of Neurosurgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
- Department of Neurosurgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 56, Dongsu-ro, Bupyeong-gu, Incheon, 21431, Republic of Korea.
| | - Hoon Kim
- Department of Neurosurgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang-Kyu Park
- Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Kyung-Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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99989
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Aslan K, Kasapoglu I, Cakir C, Avci B, Uncu G. Supernumerary embryos, do they show the cycle success in a fresh embryo transfer? A retrospective analysis. Gynecol Endocrinol 2021; 37:1107-1110. [PMID: 34232093 DOI: 10.1080/09513590.2021.1946502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To determine the predictive value of cryopreserved embryos during single fresh blastocyst transfer. METHODS This retrospective cohort study was conducted at a tertiary university hospital ART center. Patients who underwent a single fresh blastocyst transfer were selected from the electronic database. Patients with diminished ovarian reserve, uterine pathology, advanced age (>40 years) were excluded from the study. Patients were divided into two groups. Group A consisted of patients with only one available embryo for the fresh transfer. Group B consisted of patients with cryopreserved embryos apart from the fresh transferred embryo. Demographic and embryology parameters, pregnancy results were compared. RESULTS Demographic values, ovarian reserve parameters were comparable between groups. The number of the picked-up oocyte, metaphase-2 oocyte, and two-pronucleus embryo was lower in Group A. Positive pregnancy rates were two-fold higher in Group B (23.4% vs. 50.9% p < .01). Pregnancy results did not change depending on the number of cryopreserved embryos in Group B. CONCLUSION According to our results, the presence of cryopreserved embryos results in higher pregnancy rates in patients with fresh blastocyst embryo transfer independent from the woman's age and ovarian reserve. Thus, these results may help us to predict the implantation rate before embryo transfer.
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Affiliation(s)
- Kiper Aslan
- Department of Obstetrics & Gynecology, ART Center, Bursa Uludag University School of Medicine, Gorukle, Turkey
| | - Isil Kasapoglu
- Department of Obstetrics & Gynecology, ART Center, Bursa Uludag University School of Medicine, Gorukle, Turkey
| | - Cihan Cakir
- Department of Histology & Embryology, Bursa Uludag University School of Medicine, Gorukle, Turkey
| | - Berrin Avci
- Department of Histology & Embryology, Bursa Uludag University School of Medicine, Gorukle, Turkey
| | - Gurkan Uncu
- Department of Obstetrics & Gynecology, ART Center, Bursa Uludag University School of Medicine, Gorukle, Turkey
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99990
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Alghafari WT, Attar AA, Alghanmi AA, Alolayan DA, Alamri NA, Alqarni SA, Alsahafi AM, Arfaoui L. Responses of consumers with food allergy to the new allergen-labelling legislation in Saudi Arabia: a preliminary survey. Public Health Nutr 2021; 24:5941-5952. [PMID: 34108066 DOI: 10.1017/s1368980021002500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Preventing a food allergy reaction depends primarily on eliminating allergens from the diet. In October 2019, the Saudi Food and Drug Authority (SFDA) introduced new legislation requiring food establishments providing and selling non-prepacked foods to state the presence of the top fourteen food allergens on their menus. The current study aimed to assess the allergen-labelling knowledge, practices, preferences and perceptions towards the new SFDA allergen-labelling legislation among consumers with food allergy in Saudi Arabia. DESIGN Observational cross-sectional study using an online questionnaire. SETTING Saudi Arabia; February - March 2020. PARTICIPANTS Residents of Saudi Arabia with food allergy (n 427), aged 18-70 years. RESULTS Among participants, only 28·1 % knew that there were governmental regulations in Saudi Arabia regarding food-allergen labelling and approximately two-thirds (67 %) check labels on prepacked food products for allergens. The majority of the participants preferred food products carrying safety statements (84·1 %) and symbols (80·1 %). A total of 47·1 % were aware that regulations in Saudi Arabia require allergens to be declared in ingredient lists, while 51·3 % were aware that advisory allergen labelling is not required by law. Only 26·2 % were aware of the new SFDA legislation regarding provision of allergen information by food establishments. However, the majority (94·4 %) were supportive of the new legislation, and most of them were more likely to eat at restaurants that reported allergen information for food items on the menu. CONCLUSIONS The new SFDA food allergen-labelling legislation needs to be more widely and effectively disseminated to increase the level of awareness among adults with food allergy in Saudi Arabia.
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Affiliation(s)
- Wejdan T Alghafari
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah21589, Saudi Arabia
| | - Atheer A Attar
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah21589, Saudi Arabia
| | - Afnan A Alghanmi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah21589, Saudi Arabia
| | - Danah A Alolayan
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah21589, Saudi Arabia
| | - Nehal A Alamri
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah21589, Saudi Arabia
| | - Sara A Alqarni
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah21589, Saudi Arabia
| | - Athear M Alsahafi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah21589, Saudi Arabia
| | - Leila Arfaoui
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah21589, Saudi Arabia
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99991
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Bako AT, Pan AP, Potter T, Meeks JR, Caínzos-Achirica M, Woo D, Vahidy FS. Demographic Characteristics and Clinical Outcomes of Asian American and Pacific Islander Patients With Primary Intracerebral Hemorrhage. JAMA Netw Open 2021; 4:e2138786. [PMID: 34905011 PMCID: PMC8672230 DOI: 10.1001/jamanetworkopen.2021.38786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This cross-sectional study analyzes the 15-year demographic, incidence, hospitalization, and case fatality data of Asian American and Pacific Islander adults with intracerebral hemorrhage.
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Affiliation(s)
| | - Alan P. Pan
- Center for Outcomes Research, Houston Methodist, Houston, Texas
| | - Thomas Potter
- Center for Outcomes Research, Houston Methodist, Houston, Texas
| | | | - Miguel Caínzos-Achirica
- Division of Prevention and Wellness, Department of Cardiology, DeBakey Heart and Vascular Center, Houston Methodist, Houston, Texas
| | - Daniel Woo
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio
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99992
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Abstract
Previous research in the Middle East and North Africa has revealed justifying attitudes toward wife beating among adults, but little is known about adolescent attitudes and its predictors. Therefore, the purpose of the present study was to examine theoretically relevant predictors of supportive attitudes toward wife beating among adolescents in Jordan. Due to limited evidence on the role of gender, potential differences between girls and boys were explored. A total of 856 students (455 female) from 14 secondary schools in Amman, the capital city of Jordan, participated in the cross-sectional study which was conducted during normal school hours. Religiosity, beliefs regarding control of female sexuality, moral neutralization of aggression, and parental harsh discipline were assessed to predict attitudes toward wife beating, controlling for sociodemographic variables. Acceptance rates of wife beating ranged between 6.1% and 50.5%. Hierarchical regression analysis showed that beliefs supporting control of female sexuality, moral neutralization of aggression, and paternal harsh discipline predicted supportive attitudes toward wife beating, but religiosity and maternal harsh discipline did not. Separate analyses for each gender yielded that maternal harsh discipline was a significant predictor of wife beating attitudes for girls, but not for boys, whereas paternal harsh discipline was a significant predictor for boys, but not for girls. Furthermore, beliefs regarding female sexuality and moral neutralization of aggression mediated the relationship between religiosity and wife beating attitudes. Policy measures and intervention efforts targeting particularly harsh discipline and sociocultural beliefs are sorely needed to address this issue in Jordanian society.
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Affiliation(s)
| | - Pelin Gul
- University of Twente, Enschede, The Netherlands
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99993
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Young LB, Timko C, Pulido RD, Tyler KA, Beaumont C, Grant KM. Traumatic Childhood Experiences and Posttraumatic Stress Disorder Among Veterans in Substance Use Disorder Treatment. J Interpers Violence 2021; 36:NP12665-NP12685. [PMID: 31984835 DOI: 10.1177/0886260519900937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Posttraumatic stress disorder (PTSD) dramatically increases the risk of both substance use disorder (SUD) and suicide in veterans. Military-related trauma, however, may not be the only or most significant trauma experienced by veterans. Trauma exposure is high among those joining the military. This study sought to identify the prevalence of five types of childhood trauma (emotional, physical, and sexual abuse and emotional and physical neglect) and three adult trauma symptom clusters (intrusive thoughts, avoidance, and hyperarousal) among veterans seeking SUD treatment and to clarify the associations between types of trauma and specific symptom clusters. Veterans at three Veterans Affairs (VA) SUD treatment facilities in the Midwest completed surveys at treatment entry (n1 = 195) and at 6-month follow-up (n2 = 138). Measures included the Childhood Trauma Questionnaire-Short Form and the PTSD Checklist, either a military or a civilian version, depending on whether the most traumatic event occurred in or out of the military. The prevalence of childhood trauma was high, ranging from 40.5% experiencing physical abuse down to 22.8% experiencing sexual abuse. At baseline, 60.2% of the military trauma group met criteria for PTSD, compared with 33.9% of the civilian trauma group, a significant difference, χ2(1, N = 195) = 14.46, p < .01. Childhood emotional and physical abuse were moderately associated with intrusion and hyperarousal in the military trauma group, but in the civilian trauma group a broader spectrum of childhood traumas were associated with a broader array of symptom clusters, including avoidance. At follow-up, symptoms improved and were less associated with childhood trauma. These findings illuminate the persistence of effects of childhood trauma and recommend more targeted PTSD treatments.
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Affiliation(s)
| | - Christine Timko
- VA Palo Alto Health Care System, Menlo Park, CA, USA
- Stanford University School of Medicine, Palo Alto, CA, USA
| | | | | | - Cynthia Beaumont
- VA Nebraska-Western Iowa Health Care System, Omaha, USA
- University of Nebraska Medical Center, Omaha, USA
| | - Kathleen M Grant
- VA Nebraska-Western Iowa Health Care System, Omaha, USA
- University of Nebraska Medical Center, Omaha, USA
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99994
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Perera S, Swartz A. "An Unchanging God in a Changing World": Sexual Practice and Decision-Making among Christian Women in South Africa. J Relig Health 2021; 60:4045-4060. [PMID: 34115264 PMCID: PMC8840811 DOI: 10.1007/s10943-021-01305-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/05/2021] [Indexed: 06/12/2023]
Abstract
This study explored the relationship between sexual health and religion among young, Pentecostal Christian women navigating the transition to adulthood in Khayelitsha township, in the City of Capetown, South Africa. Between February and August 2019, eleven semi-structured interviews and three focus group discussions were conducted. Thematic analysis and discourse analysis were used to analyse the data collected. The study found that the relationship between sexual health and religion was complex and multifaceted, shaped by the religious dichotomisation of "right" and "wrong", socio-economic constraints and culture. Despite the perceived decline of religious influence on the sexual and social lives of youth, religion continues to play an instrumental role in shaping the dreams, aspirations and lifestyles of young people, especially as they transition to adulthood. We argue therefore, that religion is a significant spiritual and cultural resource that young women use to develop their sexual and social identities, although it cannot always be equated with their sexual practice or decision-making related to sexual health. In the light of this, churches should still be seen as key partners in the fight against HIV as their involvement can act as a stabilising force for young people dealing with poverty and uncertainty. Church engagement with young people should offer programmes that include but are not limited to sexual health.
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Affiliation(s)
- Shehani Perera
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
| | - Alison Swartz
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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99995
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Musilova I, Elias P, Stranik J, Matejkova A, Kacerovsky M. Transvaginal three-dimensional ultrasound imaging of fetal pelvis to detect anorectal malformation during second trimester. Ultrasound Obstet Gynecol 2021; 58:945-946. [PMID: 33502057 DOI: 10.1002/uog.23598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/14/2021] [Accepted: 01/18/2021] [Indexed: 06/12/2023]
Affiliation(s)
- I Musilova
- Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine in Hradec Kralove, University Hospital in Hradec Kralove, Hradec Kralove, Czech Republic
| | - P Elias
- Department of Radiology, Charles University in Prague, Faculty of Medicine in Hradec Kralove, University Hospital in Hradec Kralove, Hradec Kralove, Czech Republic
| | - J Stranik
- Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine in Hradec Kralove, University Hospital in Hradec Kralove, Hradec Kralove, Czech Republic
| | - A Matejkova
- Fingerland's Department of Pathology, Charles University of Prague, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - M Kacerovsky
- Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine in Hradec Kralove, University Hospital in Hradec Kralove, Hradec Kralove, Czech Republic
- Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
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99996
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Cui L, Zhang X, Han ZR. Perceived Child Difficultness, Emotion Dysregulation, and Emotion-Related Parenting among Chinese Parents. Fam Process 2021; 60:1403-1417. [PMID: 33544435 DOI: 10.1111/famp.12638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study investigated the integrative effects of parents' perceptions of child difficultness and parental emotion dysregulation on emotion-related parenting among a group of Chinese parents of school-age children. One hundred and fifty parent-child dyads (121 biological mothers and 29 biological fathers as primary caregivers; Mage = 39.22 years) from urban Beijing, China participated in the study. Parents reported on their own emotion dysregulation and their children's difficultness, as well as their emotion socialization practices. Children (Mage = 8.54 years; ranged from 6 to 12 years) reported on their parents' use of psychological control strategies. Main and interactive effects were tested using path analysis. Results indicated that parents' perceived child difficultness was negatively associated with supportive reactions to children's expression of negative emotions, and parental emotion dysregulation was positively associated with unsupportive reactions. When parents perceived their children to be difficult and also reported emotion regulation difficulties of their own, they showed the highest levels of psychological control (child reports). These findings suggest differential effects of parent cognition and emotion on supportive and unsupportive reactions to children's negative emotions. Both cognition and emotion play important roles in relation to parents' use of psychological control.
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Affiliation(s)
- Lixian Cui
- Division of Arts and Sciences, NYU Shanghai, Shanghai, China
- NYU-ECNU Institute for Social Development at NYU Shanghai, Shanghai, China
| | - Xutong Zhang
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Zhuo Rachel Han
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
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99997
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Heredia C, Lockie RG, Lynn SK, Pamukoff DN. Comparison of Lower Extremity Kinematics during the Overhead Deep Squat by Functional Movement Screen Score. J Sports Sci Med 2021; 20:759-765. [PMID: 35321135 PMCID: PMC8488845 DOI: 10.52082/jssm.2021.759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 09/15/2021] [Indexed: 06/08/2023]
Abstract
It is unclear if the Functional Movement Screen (FMS) scoring criteria identify kinematics that have been associated with lower extremity injury risk. The purpose was to compare lower extremity kinematics of the overhead deep squat (OHDS) during the FMS between individuals who were grouped on FMS scoring. Forty-five adults who were free of injury and without knowledge of the FMS or its scoring criteria (males = 19, females = 26; height = 1.68 0.08 m; mass = 70.7 7 13.0 kg). Three-dimensional lower extremity kinematics during an OHDS were measured using a motion capture system. One-way MANOVA was used to compare kinematic outcomes (peak hip flexion angle, hip adduction angle, knee flexion angle, knee abduction angle, knee internal rotation angle, and ankle dorsiflexion angle) between FMS groups. Those who scored a 3 had greater peak hip flexion angle (F2,42 = 8.75; p = 0.001), knee flexion angle (F2,42 = 13.53; p = 0.001), knee internal rotation angle (F2,42 = 12.91; p = 0.001), and dorsiflexion angle (F2,42 = 9.00; p = 0.001) compared to those who scored a 2 or a 1. However, no differences were found in any outcome between those who scored a 2 and those who scored a 1, or in frontal plane hip or knee kinematics. FMS scoring for the OHDS identified differences in squat depth, which was characterized by larger peak hip, knee, and dorsi- flexion angles in those who scored a 3 compared with those who scored 2 or 1. However, no differences were found between those who scored a 2 or 1, and caution is recommended when interpreting these scores. Despite a different FMS score, few differences were observed in frontal or transverse plane hip and knee kinematics, and other tasks may be needed to assess frontal plane kinematics.
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Affiliation(s)
- Caitlyn Heredia
- Northern Arizona University, Phoenix Biomedical Campus, Department of Athletic Training; Phoenix, AZ, USA
| | - Robert G Lockie
- California State University, Fullerton, Department of Kinesiology, Fullerton CA, USA
| | - Scott K Lynn
- California State University, Fullerton, Department of Kinesiology, Fullerton CA, USA
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99998
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Ghanouni P, Quirke S, Blok J, Casey A. Independent living in adults with autism spectrum disorder: Stakeholders' perspectives and experiences. Res Dev Disabil 2021; 119:104085. [PMID: 34600352 DOI: 10.1016/j.ridd.2021.104085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
UNLABELLED Independent living is a basic human right that enables individuals with disabilities to determine where they live, who they live with and what kind of support that they receive. Limited research exists regarding the challenges that adults with autism spectrum disorder (ASD) may face when attempting to live independently. Given the importance of independent living for adults with ASD, this study aimed to examine the perspectives of stakeholders about independent living among adults with ASD. METHODS We recruited a total of 19 stakeholders including adults with ASD and parents of adults with ASD from Canadian provinces. In-depth, semi-structured interviews were conducted to identify factors affecting independent living among adults with ASD. Interviews were transcribed and analyzed using thematic analysis to identify overarching themes. RESULTS Three themes emerged in our findings, including: a) Psychophysical stability and daily living; b) Financial management and planning; and c) Integrated community living and independence. CONCLUSION The findings from this study suggest that adults with ASD face several challenges related to independent living. Factors related to psychophysical stability and daily living, financial management, and integrated community living and housing were all found to influence the ability of adults with ASD to live independently. By exploring stakeholders' perspectives of independent living for adults with ASD, this study provides some insight that can help inform the development of programs and services to facilitate independent living for adults with ASD.
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Affiliation(s)
- Parisa Ghanouni
- Department of Occupational Therapy, Dalhousie University, Halifax, Canada.
| | - Stephanie Quirke
- Department of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Jennifer Blok
- Department of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Amanda Casey
- Department of Human Kinetics, St. Francis Xavier University, Canada
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99999
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Mora-Peris B, Keegan MR, Penchala SD, Vera JH, Underwood J, Khan M, Herrera C, Fuchs D, Boasso A, Khoo S, Winston A. Cerebral function parameters in people with HIV switching integrase inhibitors: a randomized controlled trial. HIV Res Clin Pract 2021; 22:151-159. [PMID: 34743666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background: Different antiretroviral therapies (ARTs) may have differing effects on central nervous system (CNS) function. We assessed CNS pharmacodynamic effects of switching integrase inhibitors in people-with-HIV (PWH).Methods: PWH on tenofovir-DF/emtricitabine plus raltegravir 400 mg twice daily with suppressed plasma HIV RNA and without overt neuropsychiatric symptoms were randomly allocated on a 1:2 basis to remain on raltegravir or switch to dolutegravir 50 mg once daily for 120 days. Pharmacodynamic parameters assessed included cognitive function (z-score of 7 domains), patient-reported outcome measures (PROMs; PHQ-9 and Beck's depression questionnaires), cerebral metabolite ratios measured by proton magnetic resonance spectroscopy (H1-MRS) and plasma and cerebrospinal fluid (CSF) HIV RNA. Pharmacokinetic parameters were also assessed in plasma and CSF. Changes and factors associated with changes in pharmacodynamics parameters were assessed.Results:In 20 subjects (19 male, 14 white ethnicity, median age 43 years (IQR: 11.5) and CD4 + count 717 (SD: 298) cells/µL), over 120 days there were no statistically significant changes in cognitive function [mean z-score difference (95%CI) -0.004 (-0.38/0.37); p = 0.98], PROMs [PHQ-9 median score change: 0 in control arm, -0.5 switch arm (p = 0.57); Beck's depression questionnaire: -1.5 control arm, -1.0 switch arm (p = 0.38)], nor cerebral metabolite ratios between study arms. CSF HIV RNA was <5 copies/mL at baseline and day 120 in all subjects. Geometric mean pre-dose CSF dolutegravir concentration was 7.6 ng/mL (95% CI: 5.2-11.1).Conclusions:Switching integrase inhibitor in virologically suppressed PWH without overt neuropsychiatric symptoms resulted in no significant changes in an extensive panel of CNS pharmacodynamics parameters.
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Affiliation(s)
- Borja Mora-Peris
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Michael R Keegan
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | | | - Jaime H Vera
- Brighton and Sussex Medical School, Brighton, UK
| | - Jonathan Underwood
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Maryam Khan
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Carolina Herrera
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Dietmar Fuchs
- Centre for Chemistry and Biomedicine, Innsbruck Medical University, Innsbruck, Austria
| | - Adriano Boasso
- Centre for Immunology and Vaccinology, Imperial College London, London, UK
| | - Saye Khoo
- Department of Pharmacology, University of Liverpool, Liverpool, UK
| | - Alan Winston
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
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100000
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Li C, Gilleskie DB. The influence of endogenous behaviors among social pairs: Social interaction effects of smoking. J Health Econ 2021; 80:102547. [PMID: 34758413 DOI: 10.1016/j.jhealeco.2021.102547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 09/27/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
We model the observed smoking outcomes of an individual and her social contact - a spouse, friend, sibling, parent or adult child - as a simultaneous move game with complete information. We allow an individual's smoking behavior to depend on her previous behavior and carefully account for observed and unobserved heterogeneity. Our econometric model addresses simultaneity, homophily, health endogeneity, non-random attrition, and multiplicity of equilibria together. Using network data from the Framingham Heart Study, we find smaller social interaction effects among spouses and friends than Christakis and Fowler (2008) who pioneered such exploration with these data. We also find that social interaction impacts of the endogenous behaviors of siblings or a parent and an adult child are not statistically significant after disentangling them from homophily. In addition, we find that the effects of social contacts' cardiovascular disease shocks on individual smoking behavior are not statistically significant.
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Affiliation(s)
| | - Donna B Gilleskie
- Department of Economics, University of North Carolina at Chapel Hill, USA.
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