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Neeteson NJ, Bugbird AR, Burt LA, Boyd SK. Statistical investigation of interdependence of trabecular microarchitectural parameters from micro-computed tomography. Bone 2024; 187:117144. [PMID: 38834103 DOI: 10.1016/j.bone.2024.117144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 05/25/2024] [Accepted: 06/01/2024] [Indexed: 06/06/2024]
Abstract
Standard microarchitectural analysis of bone using micro-computed tomography produces a large number of parameters that quantify the structure of the trabecular network. Analyses that perform statistical tests on many parameters are at elevated risk of making Type I errors. However, when multiple testing correction procedures are applied, the risk of Type II errors is elevated if the parameters being tested are strongly correlated. In this article, we argue that four commonly used trabecular microarchitectural parameters (thickness, separation, number, and bone volume fraction) are interdependent and describe only two independent properties of the trabecular network. We first derive theoretical relationships between the parameters based on their geometric definitions. Then, we analyze these relationships with an aggregated in vivo dataset with 2987 images from 1434 participants and a synthetically generated dataset with 144 images using principal component analysis (PCA) and linear regression analysis. With PCA, when trabecular thickness, separation, number, and bone volume fraction are combined, we find that 92 % to 97 % of the total variance in the data is explained by the first two principal components. With linear regressions, we find high coefficients of determination (0.827-0.994) and fitted coefficients within expected ranges. These findings suggest that to maximize statistical power in future studies, only two of trabecular thickness, separation, number and bone volume fraction should be used for statistical testing.
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Affiliation(s)
- Nathan J Neeteson
- Department of Biomedical Engineering, University of Calgary, Calgary, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
| | - Annabel R Bugbird
- Department of Biomedical Engineering, University of Calgary, Calgary, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
| | - Lauren A Burt
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada; Department of Radiology, University of Calgary, Calgary, Canada
| | - Steven K Boyd
- Department of Biomedical Engineering, University of Calgary, Calgary, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada; Department of Radiology, University of Calgary, Calgary, Canada.
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Cunha C, Rodrigues P, Voss G, Martinez-Pecino R, Delerue-Matos A. Association between formal social participation and cognitive function in middle-aged and older adults: a longitudinal study using SHARE data. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:932-955. [PMID: 38402630 DOI: 10.1080/13825585.2024.2315769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/14/2023] [Indexed: 02/27/2024]
Abstract
Formal social participation significantly impacts health and well-being, potentially mitigating cognitive decline, although not consistently across all studies. Existing research often focuses solely on baseline participation levels, and age-related differences have primarily been explored among the Asian population. Therefore, this longitudinal study aims to assess the association between formal social participation and cognition across different age groups in individuals aged 50+ living in Europe and Israel, while capturing the dynamic nature of formal social participation. We use data from three waves (four, six, and eight) of the Survey of Health, Ageing, and Retirement in Europe (SHARE), comprising 85,601 respondents. Linear mixed-effects models were applied. The results show that participation in formal social activities mitigates cognitive decline in middle-aged and older adults, especially among those aged 70 to 79 and 80+. These findings support the need for social policies promoting formal social activities, for lasting cognitive health benefits.
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Affiliation(s)
- Cláudia Cunha
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, Braga, Portugal
| | - Paula Rodrigues
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, Braga, Portugal
| | - Gina Voss
- Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Alice Delerue-Matos
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, Braga, Portugal
- Department of Sociology, Institute of Social Sciences, University of Minho, Braga, Portugal
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Zhang X, Zhang J, Shang Z, Duan Y, Du Y, Kan B, Yang S. Linear and non-linear relationships between body fat mass distribution and bone mineral density in adults: The NHANES, 2011-2018. Prev Med 2024; 186:108092. [PMID: 39117151 DOI: 10.1016/j.ypmed.2024.108092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 08/03/2024] [Accepted: 08/04/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE The relationship between body fat mass and bone mineral density (BMD) remains controversial. This research aimed to explore the linear or non-linear relationship between body fat mass and BMD among adults in the United States. METHODS This cross-sectional study identified adults aged 18 years or older in the National Health and Nutrition Examination Survey from 2011 to 2018. After adjusting for covariates, linear relationships between body fat mass and BMD in different genders were tested by generalized linear models, and potential non-linear relationships were explored by generalized additive models and piecewise linear regression models. RESULTS The research included 4691 (57.9% of the total sample) males and 3417 (42.1% the of total sample) females. In both males and females, we found a negative association between android or total body fat mass and lumbar spine BMD and a positive association between appendicular, android, gynoid, or total body fat mass and whole body BMD (all P < 0.05). The relationships between body fat mass in all regions and lumbar spine BMD were U-shaped in males and inverted U-shaped in females (all Pnon-linear < 0.05). Inverted U-shaped relationships existed between body fat mass in all regions and whole body BMD in females (all Pnon-linear < 0.05). CONCLUSIONS Body fat mass was negatively and linearly associated with lumbar spine BMD, but positively associated with whole body BMD. Body fat mass had a U-shaped relationship with lumbar spine BMD in males and an inverted U-shaped association with lumbar spine and whole body BMD in females.
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Affiliation(s)
- Xiaohua Zhang
- Department of Endocrinology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China; Department of Epidemiology and Biostatistics, Jilin University, Changchun, Jilin, China
| | - Juan Zhang
- Department of Epidemiology and Biostatistics, Jilin University, Changchun, Jilin, China
| | - Zhaoyue Shang
- Department of Epidemiology and Biostatistics, Jilin University, Changchun, Jilin, China
| | - Yanlin Duan
- Department of Epidemiology and Biostatistics, Jilin University, Changchun, Jilin, China
| | - Yongliang Du
- Department of Epidemiology and Biostatistics, Jilin University, Changchun, Jilin, China
| | - Bo Kan
- Department of Clinical Laboratory, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Shuman Yang
- Department of Endocrinology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China; Department of Epidemiology and Biostatistics, Jilin University, Changchun, Jilin, China.
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Milani GJ, Damasceno LT, Tiguman GMB, Aguiar PM. Assessment of the implementation of pharmacist prescribing: Challenges and pathways for ambulatory practice. Res Social Adm Pharm 2024; 20:870-879. [PMID: 38762366 DOI: 10.1016/j.sapharm.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/27/2024] [Accepted: 05/07/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Prescribing by pharmacists is an increasingly common practice worldwide. In Brazil regulation of this practice began in 2013, and the practice remains unexplored as a research topic. OBJECTIVE We aimed to explore and gain insights into pharmacist prescribing practices in Brazil and assessing pharmacist's perceptions of their training and preparedness to prescribe medications. METHODS A cross-sectional survey was conducted between October 2022 and March 2023 via convenience sampling. Data were collected using an online questionnaire covering sociodemographic issues, academic training, prescribing practices, and perceptions regarding the provision of pharmacist prescribing in ambulatory care. Exploratory descriptive analysis and Poisson regression were performed to estimate the associations between pharmacist characteristics and their practices in prescribing medicines. RESULTS Among the 305 valid responses, 58.7% of the outpatient pharmacists stated that they had not prescribed any medication in the previous three years. Over-the-counter medication prescriptions were most common (42.0%). Only 4.6% of respondents had prescribed prescription-only medicines provided through collaborative agreement, with 2.6% reporting that they had adjusted doses, and 2.3% played a role in prescription renewal. Pharmacists living in Northeast regions tended to be more active prescribers (PR = 1.42; 95%CI 1.03-2.18), whereas those in primary healthcare (PR = 0.61; 95%CI 0.39-0.96) and self-declared Black pharmacists (PR = 0.30; 95%CI 0.10-0.97) prescribed less. Respondents strongly believed in the pharmacist's role as a prescriber, although they remained ambivalent regarding their responsibility for patient outcomes. Progress barriers include infrastructure gaps and strained relationships with physicians. CONCLUSIONS This study suggests that pharmacists in Brazil predominantly prescribe over-the-counter medications, and variations in setting, region, and race can influence prescribing by pharmacist in ambulatory care.
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Huang Y, Huang X, Zhong L, Yang J. Glycated haemoglobin index is a new predictor for all-cause mortality and cardiovascular mortality in the adults. Sci Rep 2024; 14:19629. [PMID: 39179628 PMCID: PMC11343730 DOI: 10.1038/s41598-024-70666-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 08/20/2024] [Indexed: 08/26/2024] Open
Abstract
Glycosylated haemoglobin index (HGI) has been shown to correlate with the prognosis of metabolic diseases, but the relationship with mortality remains unclear. This study included 18,285 US adults who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. During the median follow-up period of 115 months, a total of 2572 all-cause deaths and 671 cardiovascular disease (CVD) deaths occurred. The restricted cubic spline revealed a U-shaped correlation between HGI and all-cause and CVD mortality. After adjusting for all covariates, the optimal inflection point values in all-cause and CVD deaths were 0.17 and 0.02, respectively. In the left side of the inflection point, the risk of all-cause mortality and CVD mortality decreased by approximately 24% (HR 0.76, 95% CI 0.69, 0.84) and 25% (HR 0.75, 95% CI 0.60, 0.96) with the increase in HGI. Conversely, in the right of the inflection point, an increase of 1 unit in the HGI was linked with a 17% (HR 1.17, 95% CI 1.07, 1.27) and 31% (HR 1.31, 95% CI 1.15, 1.49) increase in all-cause and CVD mortality. Our study showed that HGI is an important tool for predicting the risk of all-cause mortality and CVD death in US adults and there is a U-shaped relationship between HGI and mortality.
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Affiliation(s)
- Yi Huang
- School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, China
| | - Xiantao Huang
- Department of Cardiovascular Medicine, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Lingyun Zhong
- School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, China.
| | - Jingqi Yang
- Department of Cardiovascular Medicine, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China.
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Barker PC, Yamarik RL, Adeyemi O, Cuthel AM, Flannery M, Siman N, Goldfeld KS, Grudzen CR. Predictors of Specialty Outpatient Palliative Care Utilization Among Persons with Serious Illness. J Pain Symptom Manage 2024:S0885-3924(24)00924-2. [PMID: 39179000 DOI: 10.1016/j.jpainsymman.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 08/01/2024] [Accepted: 08/06/2024] [Indexed: 08/26/2024]
Abstract
CONTEXT Outpatient Palliative Care (OPC) benefits persons living with serious illness, yet barriers exist in utilization. OBJECTIVES To identify factors associated with OPC clinic utilization. METHODS Emergency Medicine Palliative Care Access is a multicenter, randomized control trial comparing two models of palliative care for patients recruited from the Emergency Department (ED): nurse-led telephonic case management and OPC (one visit a month for 6 months). Patients were aged 50+ with advanced cancer or end-stage organ failure and recruited from 19 EDs. Using a mixed effects hurdle model, we analyzed patient, provider, clinic and healthcare system factors associated with OPC utilization. RESULTS Among the 603 patients randomized to OPC, about half (53.6%) of patients attended at least one clinic visit. Those with less than high school education were less likely to attend an initial visit than those with a college degree or higher (aOR 0.44; CI 0.23, 0.85), as were patients who required considerable assistance (aOR 0.45; CI 0.25, 0.82) or had congestive heart failure only (aOR 0.46; CI 0.26, 0.81). Those with higher symptom burden had a higher attendance at the initial visit (aOR 1.05; CI 1.00, 1.10). Reduced follow up visit rates were demonstrated for those of older age (aRR 0.90; CI 0.82, 0.98), female sex (aRR 0.84; CI 0.71, 0.99), and those that were never married (aRR 0.62; CI 0.52, 0.87). CONCLUSION Efforts to improve OPC utilization should focus on those with lower education, more functional limitations, older age, female sex, and those with less social support. TRIAL REGISTRATION CLINICALTRIALS. GOV IDENTIFIER NCT03325985.
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Affiliation(s)
| | | | - Oluwaseun Adeyemi
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
| | - Allison M Cuthel
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA.
| | - Mara Flannery
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
| | - Nina Siman
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
| | - Keith S Goldfeld
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Corita R Grudzen
- Division of Supportive and Acute Care Services, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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He S, Lu S, Yu C, Kuang M, Qiu J, Sheng G, Zou Y. The newly proposed plasma-glycosylated hemoglobin A1c/High-Density lipoprotein cholesterol ratio serves as a simple and practical indicator for screening metabolic associated fatty liver disease: an observational study based on a physical examination population. BMC Gastroenterol 2024; 24:274. [PMID: 39160462 PMCID: PMC11331873 DOI: 10.1186/s12876-024-03362-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 08/08/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Glycotoxicity and lipotoxicity are key pathophysiological mechanisms underlying the development of metabolic associated fatty liver disease (MAFLD). The primary objective of this study is to investigate the association between the newly proposed Plasma-Glycosylated Hemoglobin A1c/High-Density Lipoprotein Cholesterol Ratio (HbA1c/HDL-C ratio) and the risk of MAFLD. METHODS A study population of 14,251 individuals undergoing health examinations was included. The association between the HbA1c/HDL-C ratio and MAFLD was analyzed using multivariable logistic regression and restricted cubic spline (RCS) analysis. Exploratory analyses were conducted to assess variations in this association across subgroups stratified by gender, age, body mass index (BMI), exercise habits, drinking status, and smoking status. The discriminatory value of the HbA1c/HDL-C ratio and its components for screening MAFLD was evaluated using receiver operating characteristic (ROC) curves. RESULTS A total of 1,982 (13.91%) subjects were diagnosed with MAFLD. After adjusting for confounding factors, we found a significant positive association between the HbA1c/HDL-C ratio and MAFLD [odds ratio (OR) 1.34, 95% confidence interval (CI): 1.25, 1.44]. No significant differences in this association were observed across all subgroups (All P for interaction > 0.05). Furthermore, through RCS analysis, we observed a nonlinear positive correlation between the HbA1c/HDL-C ratio and MAFLD (P for non-linearity < 0.001), with a potential threshold effect point (approximately 3 for the HbA1c/HDL-C ratio). Beyond this threshold point, the slope of the MAFLD prevalence curve increased rapidly. Additionally, in further ROC analysis, we found that for the identification of MAFLD, the HbA1c/HDL-C ratio was significantly superior to HbA1c and HDL-C, with an area under the curve (AUC) and optimal threshold of 0.81 and 4.08, respectively. CONCLUSIONS Our findings suggest that the newly proposed HbA1c/HDL-C ratio serves as a simple and practical indicator for assessing MAFLD, exhibiting well-discriminatory performance in screening for MAFLD.
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Affiliation(s)
- Shiming He
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
| | - Song Lu
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
| | - Changhui Yu
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
| | - Maobin Kuang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
| | - Jiajun Qiu
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
| | - Guotai Sheng
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China.
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China.
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China.
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Mwatenga SA, Musa AA, Muturi MW, Musyoki AM. Prevalence and associated factors of TB and HIV coinfections among adult inmates with presumptive pulmonary TB in a Kenyan prison. Trop Med Health 2024; 52:54. [PMID: 39148132 PMCID: PMC11328499 DOI: 10.1186/s41182-024-00623-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 08/04/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Tuberculosis (TB) is more than ten times higher in prisons compared to the general population, and HIV-infected persons are at increased risk of developing active TB and death. In the World Health Organization (WHO) African region, however, where the TB and HIV coinfections are highest, and prisons rarely factored in national disease surveillance, epidemiological data to inform TB control interventions in correctional facilities is limited. In this study, we assessed the prevalence of TB and HIV coinfections, as well as the factors associated with coinfections in our study setting. METHODS This was a prospective cross-sectional study among 157 adult (≥ 18 years) prisoners presenting with symptoms of pulmonary TB at Shimo La Tewa Prison, Kenya, between January and June 2023. The study excluded those with a history of anti-TB drugs use or on treatment follow-up and collected demographic and clinical characteristics data using a questionnaire. Sputum samples were collected and processed immediately using Xpert® MTB/RIF assay or stored at 4 °C for three (3) days in case of delay. RESULTS The overall prevalence of TB among inmates with presumptive pulmonary TB was 10.2%, 95% CI 6.37-16.91% (16/157), HIV 19.1%, 95% CI 13.73-25.97% (30/157). All the TB cases were positive for HIV (16/16, 100%), translating to TB/HIV coinfection of 10.2%, 95% CI 6.37-16.91% (16/157), and there was no rifampicin resistance. TB and HIV coinfection cases were found among underweight (100%, 16/16) prisoners. The independent factors associated with TB and HIV coinfections were education level (adjusted OR = 0.17, p = 0.007), smoking history (adjusted OR = 3.01, p = 0.009) and illegal drug use history (adjusted OR = 4.55, p = 0.044). CONCLUSION We report a high prevalence of pulmonary TB and HIV coinfections among adult inmates with presumptive pulmonary TB in Kenya, with education level, smoking status, and illegal drug use as the independent factors associated with the coinfection. The authority should take measures to protect HIV-positive prisoners from TB, focusing on education, nutrition, smoking, and illegal drug use.
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Affiliation(s)
- Suleiman Athuman Mwatenga
- Department of Medical Laboratory Sciences, Moi County Referral Hospital, P.O. Box 18-80300, Voi, Kenya
- Department of Medical Laboratory Sciences, Kenyatta University, P.O. Box 43844-00100, Nairobi, Kenya
| | - Ali A Musa
- Clinical Laboratory, Msambweni County Referral Hospital, P.O. Box 8-80404, Msambweni, Kenya
| | - Margaret W Muturi
- Department of Medical Laboratory Sciences, Moi County Referral Hospital, P.O. Box 18-80300, Voi, Kenya
| | - Abednego Moki Musyoki
- Department of Medical Laboratory Sciences, Kenyatta University, P.O. Box 43844-00100, Nairobi, Kenya.
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Hemler SL, Sommerich CM, Correia JC, Pataky Z. User perceptions of intelligent offloading diabetic footwear. Front Endocrinol (Lausanne) 2024; 15:1380525. [PMID: 39170738 PMCID: PMC11335636 DOI: 10.3389/fendo.2024.1380525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 07/15/2024] [Indexed: 08/23/2024] Open
Abstract
Aims Adherence to therapeutic footwear is vital for effective diabetic foot ulcer prevention and treatment. Understanding the key adherence factors and potential barriers is important for footwear design and implementation. Our team is creating intelligent offloading footwear to prevent lower extremity amputations in people living with diabetes (PLwD). This exploratory study assessed the ability of the established Unified Theory of Acceptance and Use of Technology (UTAUT) model to predict behavioral intention to use or recommend this intelligent offloading footwear by PLwD, caregivers of PLwD, or medical professionals treating PLwD. Methods Online and paper questionnaires were implemented to assess the impact of the UTAUT model factors (performance expectancy, effort expectancy, social influence, facilitating conditions) and psychosocial factors (attitude, anxiety, self-efficacy) on the overall behavioral intention to use the footwear. Furthermore, factors influencing potential acceptance and rejection of the footwear were explored. Results Patients (4.0/5) and medical professionals (4.1/5) showed a behavioral intention to "agree" to use or recommend the footwear when it becomes available. Structural equation modeling showed that the UTAUT constructed model may not be the best indicator for behavioral intention here based on a lack of statistical significance. However, the logistic regression modeling showed that the social influence for PLwD (p=0.004) and the attitude toward the footwear for medical professionals (p=0.001) may be the most important when designing and implementing the footwear, though several other factors (performance expectancy, effort expectancy, facilitating conditions, and self-efficacy) were also important for one or both of these populations. Additionally, cost and clinician support were shown to be important factors influencing potential acceptance of the footwear. Conclusions The study found promising intention to use the intelligent footwear in the future. This highlights the need to continue future development and implementation of the footwear to incorporate these results, thus improving the likelihood of high adherence of the footwear.
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Affiliation(s)
- Sarah L. Hemler
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Unit of Therapeutic Patient Education, WHO Collaborating Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Carolyn M. Sommerich
- Department of Integrated Systems Engineering, The Ohio State University, Columbus, OH, United States
| | - Jorge C. Correia
- Unit of Therapeutic Patient Education, WHO Collaborating Centre, Geneva University Hospitals, Geneva, Switzerland
- Faculty Diabetes Centre, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Zoltan Pataky
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Unit of Therapeutic Patient Education, WHO Collaborating Centre, Geneva University Hospitals, Geneva, Switzerland
- Faculty Diabetes Centre, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Li W, Shen C, Kong W, Zhou X, Fan H, Zhang Y, Liu Z, Zheng L. Association between the triglyceride glucose-body mass index and future cardiovascular disease risk in a population with Cardiovascular-Kidney-Metabolic syndrome stage 0-3: a nationwide prospective cohort study. Cardiovasc Diabetol 2024; 23:292. [PMID: 39113004 PMCID: PMC11308445 DOI: 10.1186/s12933-024-02352-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 07/06/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND The American Heart Association (AHA) has recently introduced the concept of Cardiovascular-Kidney-Metabolic (CKM) syndrome, which is the result of an increasing emphasis on the interplay of metabolic, renal and cardiovascular diseases (CVD). Furthermore, there is substantial evidence of a correlation between the triglyceride glucose-body mass index (TyG-BMI ) and CVD as an assessment of insulin resistance (IR). However, it remains unknown whether this correlation exists in population with CKM syndrome. METHODS All data for this study were obtained from the China Health and Retirement Longitudinal Study (CHARLS). The exposure was the participants' TyG-BMI at baseline, which was calculated using a combination of triglycerides (TG), fasting blood glucose (FBG) and body mass index (BMI). The primary outcome was CVD, which were determined by the use of a standardised questionnaire during follow-up. To examine the relationship between TyG-BMI and CVD incidence in population with CKM syndrome, both Cox regression analyses and restricted cubic spline (RCS) regression analyses were performed. RESULTS A total of 7376 participants were included in the final analysis. Of these, 1139, 1515, 1839, and 2883 were in CKM syndrome stages 0, 1, 2, and 3, respectively, at baseline. The gender distribution was 52.62% female, and the mean age was 59.17 ± 9.28 (years). The results of the fully adjusted COX regression analyses indicated that there was a 6.5% increase in the risk of developing CVD for each 10-unit increase in TyG-BMI,95% confidence interval (CI):1.041-1.090. The RCS regression analyses demonstrated a positive linear association between TyG-BMI and the incidence of CVD in the CKM syndrome population (P for overall < 0.001, P for nonlinear = 0.355). CONCLUSIONS This cohort study demonstrated a positive linear association between TyG-BMI index and increased CVD incidence in a population with CKM syndrome stage 0-3. This finding suggests that enhanced assessment of TyG-BMI index may provide a more convenient and effective tool for individuals at risk for CVD in CKM syndrome stage 0-3.
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Affiliation(s)
- Weipeng Li
- Shanghai Heart Failure Research Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Epidemiology and Public Health, Tongji University School of Medicine, Shanghai, China
| | - Chaonan Shen
- Shanghai Heart Failure Research Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Epidemiology and Public Health, Tongji University School of Medicine, Shanghai, China
| | - Weiya Kong
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xiaohui Zhou
- Shanghai Heart Failure Research Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Huimin Fan
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Integrated Traditional Chinese and Western Medicine for Cardiovascular Chronic Diseases, Tongji University School of Medicine, Shanghai, 200120, China
| | - Yuzhen Zhang
- Shanghai Heart Failure Research Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Zhongmin Liu
- Shanghai Heart Failure Research Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Liang Zheng
- Shanghai Heart Failure Research Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
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Perez AV, Viana MV, Dall'Orto Thomazini L, Loss SH, de Machado FCR, do Nascimento AG, Kropidlofscky AP, Gerchman F, Leitão CB, Rech TH, Pellegrini JAS. BMI and mortality in critically ill patients with COVID-19: another brick in the wall of the obesity paradox. Obesity (Silver Spring) 2024; 32:1474-1482. [PMID: 38946013 DOI: 10.1002/oby.24069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/22/2024] [Accepted: 05/02/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE The objective of this study was to assess the existence of the obesity paradox in patients with COVID-19 admitted to the intensive care unit. METHODS This was a multicentric retrospective cohort study including individuals aged 18 years or older admitted to the intensive care unit with SARS-CoV-2. Data were obtained from electronic medical records. The primary outcome was in-hospital mortality. Multiple logistic regression and restricted cubic splines analyses were conducted to assess the association between BMI and mortality. RESULTS From March 2020 to December 2021, 977 patients met the inclusion criteria, and 868 were included in the analysis. Obesity was identified in 382 patients (44%). Patients with obesity more often underwent prone positioning (42% vs. 28%; p < 0.001), although they used less vasoactive medications (57% vs. 68%; p < 0.001). The overall in-hospital mortality was 48%, with 44% observed in the subgroup of individuals with obesity and 50% in those without obesity (p = 0.06). Patients with BMI < 25 kg/m2 had the highest mortality. CONCLUSIONS Obesity was not associated with higher mortality rates in critically ill patients with COVID-19. Moreover, patients with BMI < 25 kg/m2 had a higher mortality rate compared with those in higher BMI categories.
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Affiliation(s)
- Amanda Vilaverde Perez
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Marina Verçoza Viana
- Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Sérgio Henrique Loss
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | | | | | - Fernando Gerchman
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Cristiane Bauermann Leitão
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tatiana Helena Rech
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - José Augusto Santos Pellegrini
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Shioya A, Takata M, Kumagai M, Hoshi D, Han J, Oyama T, Haba Y, Morioka E, Inokuchi M, Noguchi M, Yamada S. Periarterial or perivenous invasion is an independent indicator of lymph node metastasis in invasive breast carcinoma of no special type. Pathol Res Pract 2024; 260:155407. [PMID: 38936093 DOI: 10.1016/j.prp.2024.155407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/05/2024] [Accepted: 06/12/2024] [Indexed: 06/29/2024]
Abstract
Pathological diagnosis of breast cancer often includes cases of lymph node metastases without lymphatic or lymphovascular invasion by the primary tumor. In this study, to resolve this discrepancy, we designed a sensitive method to detect lymphatic invasion and correlate it with lymph node metastasis. Elastica van Gieson (EVG) staining and D2-40 immunohistochemistry revealed the abundant distribution of lymphatic vessels around blood vessels in the mammary tissue in close proximity to the elastic fibers around the arteries and veins. Based on the histological location of the blood and lymphatic vessels, we hypothesized that, in breast cancer, perivascular invasion is similar to lymphatic invasion and correlates with the presence of lymph node metastasis. Using EVG staining, perivascular invasion was histologically classified into periarterial invasion (periA), perivenous invasion (periV), and periarterial or perivenous invasion (periA/V). We tested our method and compared it to other methods commonly used for identifying lymphatic invasion in 105 patients with invasive breast carcinoma of no special type (IBC-NST) who received minimal preoperative therapy. The correlation between perivascular invasion and lymph node metastasis in these patients was statistically analyzed, including findings related to lymphatic invasion, such as retractile artifacts and perineural invasion. PeriA, periV, and periA/V showed significant correlations with lymph node metastasis. PeriA/V had high sensitivity and negative predictive value. The odds ratio (OR) for periV was significantly high in the univariate analysis, while the ORs for periA/V, retraction artifacts, and perineural invasion were significantly high in both the univariate and multivariate analyses. In particular, periA/V revealed a strong correlation with lymph node metastasis (OR: 61.8). These findings indicate that the IBC-NST periA/V ratio is a sensitive pointer of lymphatic invasion and could be an independent and reliable indicator of lymph node metastasis.
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Affiliation(s)
- Akihiro Shioya
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, Japan.
| | - Mao Takata
- Department of Pathology, Kanazawa Medical University Hospital, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, Japan
| | - Motona Kumagai
- Department of Pathophysiological and Experimental Pathology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, Japan
| | - Daisuke Hoshi
- Department of Oncologic Pathology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, Japan
| | - Jia Han
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, Japan
| | - Takeru Oyama
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, Japan
| | - Yusuke Haba
- Department of Breast and Endocrine Surgery, Breast Center, Kanazawa Medical University Hospital, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, Japan
| | - Emi Morioka
- Department of Breast and Endocrine Surgery, Breast Center, Kanazawa Medical University Hospital, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, Japan
| | - Masafumi Inokuchi
- Department of Breast and Endocrine Surgery, Breast Center, Kanazawa Medical University Hospital, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, Japan
| | - Masakuni Noguchi
- Department of Breast and Endocrine Surgery, Breast Center, Kanazawa Medical University Hospital, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, Japan
| | - Sohsuke Yamada
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, Japan
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Shumski EJ, Eagle SR, Kontos AP, Bazarian JJ, Caccese JB, Chrisman SPD, Clugston JR, McAllister TW, McCrea M, Broglio SP, Lynall RC, Schmidt JD. The Interval Between Concussions Does Not Influence Time to Asymptomatic or Return to Play: A CARE Consortium Study. Sports Med 2024; 54:2185-2197. [PMID: 38671175 DOI: 10.1007/s40279-024-02015-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION The purpose of this study was to determine if the time interval between two concussive events influences the number of days to asymptomatic status, days to return to play, or performance on common post-concussion assessments following the second concussion. METHODS Data from 448 collegiate athletes and service academy cadets with two concussions (time between concussions: median 295.0 days [interquartile range: 125.0-438.2]), 40.0% female) were analyzed from Concussion Assessment Research and Education (CARE) Consortium institutions between 2014 and 2020. Days between concussions was the primary predictor variable. Primary outcome measures included time to asymptomatic and time to return to play following the second concussion. Secondary outcome measures included total number of symptoms, total symptom severity, Balance Error Scoring System total score, and Standardized Assessment of Concussion total score within 48 h of their second concussion. RESULTS Time between concussions did not significantly contribute to the multivariate time to asymptomatic (p = 0.390), time to return to play (p = 0.859), or the secondary outcomes (p-range = 0.165-0.477) models. Time to asymptomatic (p = 0.619) or return to play (p = 0.524) did not differ between same-season and different-season concussions. Sex significantly contributed to the return to play (p = 0.005) multivariate model. Delayed symptom onset and immediate removal from play/competition significantly contributed to the total number of symptoms (p = 0.001, p = 0.014) and symptom severity (p = 0.011, p = 0.022) multivariate models. CONCLUSION These results suggest that in a population with a large period between injuries, the time between concussions may not be relevant to clinical recovery.
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Affiliation(s)
- Eric J Shumski
- UGA Concussion Research Laboratory, Department of Kinesiology, Ramsey Student Center, University of Georgia, 330 River Rd., Athens, GA, 30602, USA.
| | - Shawn R Eagle
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anthony P Kontos
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jeffrey J Bazarian
- Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Jaclyn B Caccese
- The Ohio State University Chronic Brain Injury Program, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sara P D Chrisman
- Division of Adolescent Medicine, University of Washington, Seattle, USA
| | - James R Clugston
- Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, USA
| | - Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
| | - Robert C Lynall
- UGA Concussion Research Laboratory, Department of Kinesiology, Ramsey Student Center, University of Georgia, 330 River Rd., Athens, GA, 30602, USA
| | - Julianne D Schmidt
- UGA Concussion Research Laboratory, Department of Kinesiology, Ramsey Student Center, University of Georgia, 330 River Rd., Athens, GA, 30602, USA
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Wang C, Qi W, Yang T, Jiao L, Chen Q, Huang K, Yu F, Geldsetzer P, Bärnighausen T, Chen S. The care cascade of chronic obstructive pulmonary disease in China: a cross-sectional study of individual-level data at enrolment into the national 'Happy Breathing' Programme. EClinicalMedicine 2024; 74:102597. [PMID: 39114273 PMCID: PMC11305216 DOI: 10.1016/j.eclinm.2024.102597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 08/10/2024] Open
Abstract
Background Understanding the chronic obstructive pulmonary disease (COPD) care cascade is crucial for identifying where and when to intervene to improve COPD outcomes. We aimed to determine the proportion of patients with COPD seeking care in China's health system who are lost at each stage of the COPD care cascade and how the patterns of loss vary across geographical regions and population groups. Methods From November 3, 2018, to April 22, 2021, we used individual-level patient data from the national Chinese 'Happy Breathing' Programme, which aims to identify patients with COPD and provide appropriate care. COPD was defined as a post-bronchodilator ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC) <0.70. We calculated the proportions of individuals who, at enrolment into the 'Happy Breathing' Programme, (i) had ever undergone a pulmonary function test, (ii) had been diagnosed with COPD in the past, (iii) were currently on treatment for COPD, and (iv) had achieved control of their COPD. We examined the association between reaching each stage of the care cascade and individual patient characteristics as well as regional-level economic development and available resources in the health system using multilevel regression. Findings Among the 29,201 patients with COPD in the 'Happy Breathing' Programme, 41.0% (95% confidence interval [CI]: 40.4-41.6%) had ever been tested for COPD, 17.6% (95% CI: 17.1-18.0%) had previously been diagnosed with COPD, 8.5% (95% CI: 8.2-8.8%) were currently on treatment for COPD, 4.6% (95% CI: 4.3-4.8%) of patients had mild or no exacerbations in the prior year, and 3.9% (95% CI: 3.7-4.2%) of patients had suffered no exacerbations in the prior year. On average, patients living in the cities of Beijing, Wuhan, and Yinchuan had progressed further along the COPD care cascade than patients living in Daqing and Luoyang. Using multilevel regression, we found that young age, rural residence, and low regional per-capita GDP were significantly associated with larger losses at each stage of the COPD care cascade. Interpretation Substantial proportions of patients with COPD are lost at each stage of the COPD care cascade in the Chinese health system. The largest losses occur during the initial stages of the cascade, when diagnosis first occurs. New policies and interventions are required to boost COPD care, especially screening and diagnosis, in the Chinese health system to reduce this large disease burden. Funding This work was supported by Major Programme of National Natural Science Foundation of China (82090011), CAMS Innovation Fund for Medical Sciences (CIFMS) (2021-I2M-1-049), and Horizon Europe (HORIZON-MSCA-2021-SE-01; project number 101086139-PoPMeD-SuSDeV). TB was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt professorship award.
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Affiliation(s)
- Chen Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China–Japan Friendship Hospital, Beijing, China
| | - Weiran Qi
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ting Yang
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China–Japan Friendship Hospital, Beijing, China
| | - Lirui Jiao
- Columbia Mailman School of Public Health, New York, USA
| | - Qiushi Chen
- The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, PA, USA
| | - Ke Huang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China–Japan Friendship Hospital, Beijing, China
| | - Fengyun Yu
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Pascal Geldsetzer
- Chan Zuckerberg Biohub, San Francisco, CA, USA
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Till Bärnighausen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
| | - Simiao Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
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15
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Zvolensky MJ, Shepherd JM, Clausen BK, Robison J, Cano MÁ, de Dios M, Correa-Fernández V. Posttraumatic stress and probable post traumatic stress disorder as it relates to smoking behavior and beliefs among trauma exposed hispanic persons who smoke. J Behav Med 2024; 47:581-594. [PMID: 38409553 DOI: 10.1007/s10865-024-00480-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/09/2024] [Indexed: 02/28/2024]
Abstract
There has been little scientific effort to evaluate the associations between cigarette smoking and cessation-related constructs and exposure to traumatic events, posttraumatic stress, and Posttraumatic Stress Disorder (PTSD) symptoms among Hispanic persons who smoke in the United States (US). Such trauma-related factors may pose unique difficulties for Hispanic persons who smoke and possess a desire to quit. As such, the present investigation sought to fill this gap in the literature and examine posttraumatic stress and probable PTSD in terms of their relations with several clinically significant smoking constructs among trauma-exposed Hispanic persons who smoke from the United States. Participants included 228 Spanish-speaking Hispanic persons who endorsed prior traumatic event exposure and smoked combustible cigarettes daily (58.3% female, Mage= 32.1 years, SD = 9.65). Results indicated that posttraumatic stress symptoms were related to increased cigarette dependence, perceived barriers for smoking cessation, and more severe problems when trying to quit with effect sizes ranging from small to moderate in adjusted models. Additionally, Hispanic persons who smoke with probable PTSD compared to those without probable PTSD showcased a statistically effect for perceived barriers for cessation (p < .008) and a severity of problems when trying to quit (p < .001). No effect was evident for cigarette dependence after alpha correction. Overall, the present study offers novel empirical evidence related to the role of posttraumatic stress symptoms and PTSD among Hispanic persons who smoke in the US. Such findings highlight the need to expand this line of research to better understand the role of posttraumatic stress and PTSD among Hispanic persons who smoke which can inform smoking cessation treatments for Hispanic persons who smoke experiencing trauma-related symptomology.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA.
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- HEALTH Institute, University of Houston, Houston, TX, USA.
| | - Justin M Shepherd
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA
| | - Bryce K Clausen
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA
| | - Jillian Robison
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA
| | - Miguel Ángel Cano
- Peter O'Donnell Jr. School of Public Health, The University of Texas Southwestern Medical Center, Dallas, USA
| | - Marcel de Dios
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
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Kakish H, Sun J, Ammori JB, Hoehn RS, Rothermel LD. First-line Immunotherapy for Metastatic Merkel Cell Carcinoma: Analysis of Real-world Survival Data and Practice Patterns. Am J Clin Oncol 2024; 47:357-362. [PMID: 38587336 DOI: 10.1097/coc.0000000000001098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
OBJECTIVES Immune checkpoint inhibitors are a promising new therapy for advanced Merkel Cell Carcinoma (MCC). We investigated real-world utilization and survival outcomes of first-line immunotherapies in a contemporary cohort. METHODS Using the National Cancer Database (NCDB), we identified 759 patients with MCC between 2015 and 2020 with stage IV disease and known status of first-line systemic therapy. Univariable and multivariable analyses were used to determine predictors of immunotherapy usage. Overall survival (OS) was compared for patients receiving immunotherapy, chemotherapy, or no systemic therapies. RESULTS We identified 759 patients meeting our inclusion criteria: 329 patients received immunotherapy, 161 received chemotherapy, and 269 received no systemic therapy. Adjusting for demographic, clinical, and facility factors, high facility volume significantly predicted first-line immunotherapy use (OR 1.99; P =0.017). Median OS was 16.2, 12.3, and 8.7 months, among patients who received immunotherapy, chemotherapy, or no systemic therapy, respectively ( P <0.001). On Cox multivariable survival analysis, first-line immunotherapy treatment (HR=0.79, P =0.041) and treatment at high-volume centers (HR=0.58, P =0.004) were associated with improved OS. CONCLUSIONS Consistent with clinical trial results, first-line immunotherapy associated with improvement in median overall survival for patients with stage IV MCC, significantly outperforming chemotherapy in this real-world cohort. Treatment at high-volume centers associated with first-line immunotherapy utilization suggesting that familiarity with this rare disease is important to achieving optimal outcomes for metastatic MCC.
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Affiliation(s)
- Hanna Kakish
- Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - James Sun
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | - John B Ammori
- Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Richard S Hoehn
- Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Luke D Rothermel
- Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, OH
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Kim JH, Kim O, Cho M, Jeong H, Dan H. Associations of anxiety and fatigue with hazardous occupational conditions of Korean nurses in early pregnancy: A cross-sectional study. Int J Nurs Pract 2024; 30:e13232. [PMID: 38273459 DOI: 10.1111/ijn.13232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 09/15/2023] [Accepted: 12/05/2023] [Indexed: 01/27/2024]
Abstract
AIM To identify occupational conditions associated with anxiety and fatigue among Korean nurses in early pregnancy. BACKGROUND Pregnant nurses, like non-pregnant hospital nurses, are exposed to dangerous and stressful work environments, which can affect fatigue and anxiety. DESIGN AND METHODS This cross-sectional study enrolled 1490 nurses who participated in the early pregnancy module in the Korea Nurses' Health Study between 2014 and 2020. Hierarchical linear regression analyses were employed to identify the factors associated with anxiety and fatigue among nurses in early pregnancy. RESULTS One-fifth of participants were working night shifts, and more than two-thirds were working overtime. When using antineoplastic drugs and disinfectants, the rate of use of protective equipment varied depending on the size of the hospital. Working overtime and lifting heavy objects were associated with increased anxiety and fatigue among nurses. CONCLUSION Overtime work was associated with both anxiety and fatigue among pregnant nurses. Pregnant hospital nurses were exposed to both night shift and overtime work. Therefore, hospital managers should improve hazardous working environments to protect the health of nurses in early pregnancy and their fetuses.
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Affiliation(s)
- Jung-Hee Kim
- College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
| | - Oksoo Kim
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | - Mijung Cho
- Department of Nursing, Hallym Polytechnic University, Chuncheon, Republic of Korea
| | - Hyunseon Jeong
- College of Nursing, Seoul Women's College of Nursing, Seoul, Republic of Korea
| | - Hyunju Dan
- Department of Nursing, Hwasung Medi-Science University, Hwasung-si, Kyunggi-do, Republic of Korea
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18
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Dy CJ, Brogan DM, Lee SK, Desai MJ, Loeffler BJ, Tuffaha SH. The Influence of Psychosocial Factors on Disability and Expected Improvement Before Surgery for Adult Traumatic Brachial Plexus Injury. J Hand Surg Am 2024; 49:729-735. [PMID: 37498270 PMCID: PMC10818022 DOI: 10.1016/j.jhsa.2023.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 05/11/2023] [Accepted: 05/24/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE Psychosocial factors influence pain and recovery after extremity trauma and may be targets for early intervention. This may be of particular interest for patients with adult traumatic brachial plexus injury (BPI), given the broad and devastating impact of the injury. We hypothesized that there would be an association between depressive symptoms, anxiety, and pain interference with preoperative disability and expectations for improvement after BPI surgery. METHODS We enrolled 34 patients into a prospective multicenter cohort study for those undergoing surgery for adult traumatic BPI. Before surgery, participants completed Patient-Reported Outcome Measurement Information System scales for pain interference, anxiety, and depressive symptoms, and a validated BPI-specific measure of disability and expected improvement. We performed Pearson correlation analysis between pain interference, anxiety symptoms, and depressive symptoms with (A) disability and (B) expected improvement. We created separate linear regression models for (A) disability and (B) expected improvement including adjustment for severity of plexus injury, age, sex, and race. RESULTS Among 34 patients, there was a moderate, statistically significant, correlation between preoperative depressive symptoms and higher disability. This remained significant in a linear regression model adjusted for severity of plexus injury, age, sex, and race. There was no association between severity of plexus injury and disability. Depressive symptoms also were moderately, but significantly, correlated with higher expected improvement. This remained significant in a linear regression model adjusted for severity of plexus injury, age, sex, and race. CONCLUSIONS Depressive symptoms are associated with greater disability and higher expected improvement before BPI surgery. Screening for depressive symptoms can help BPI teams identify patients who would benefit from early referral to mental health specialists and tailor appropriate expectations counseling for functional recovery. We did not find an association between severity of BPI and patient-reported disability, suggesting either that the scale may lack validity or that the sample is biased. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic II.
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Affiliation(s)
- Christopher J Dy
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO.
| | - David M Brogan
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO
| | - Steve K Lee
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY
| | - Mihir J Desai
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | | | - Sami H Tuffaha
- Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, MD
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Kang J, Kim J, Lee J, Yeo H, Hwang Y, Lee S, Jeon S, Kim SJ. Sleep Inertia and Its Associates in Shift and Non-Shift Workers. Psychiatry Investig 2024; 21:905-911. [PMID: 39086166 PMCID: PMC11321878 DOI: 10.30773/pi.2024.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 06/02/2024] [Accepted: 06/13/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVE We investigated the difference in sleep inertia between shift workers (SWs) and non-shift workers (NSWs) and the effects of depressive symptoms, sleepiness, insomnia, and chronotype on sleep inertia in SWs and NSWs. METHODS Altogether, 4,561 SWs (2,142 men and 2,419 women, aged 36.99±9.84 years) and 2,093 NSWs (999 men and 1,094 women, aged 37.80±9.73 years) participated in the current study. All participants completed the Sleep Inertia Questionnaire (SIQ), Epidemiological Studies Depression Scale (CESD), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and Morningness-Eveningness Questionnaire (MEQ) through an online survey. RESULTS SWs reported higher SIQ scores than NSWs after controlling for CESD, ESS, ISI, or MEQ. The CESD, ESS, ISI, and MEQ predicted SIQ in both SWs and NSWs. The effects of CESD and MEQ on SIQ were stronger in SWs and NSWs, respectively. The indirect effects of CESD and MEQ on SIQ via ESS were significantly moderated by work schedules. CONCLUSION SWs showed higher sleep inertia than NSWs. The effect of chronotypes on sleep inertia was more prominent in NSWs than in SWs. However, the effect of depressive symptoms on sleep inertia was more prominent in SWs than in NSWs. Moreover, the effect of depressive symptoms or chronotypes on sleep inertia was mediated by sleepiness, and such indirect effects were significantly different among the participants stratified by work schedules.
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Affiliation(s)
- Juseung Kang
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jichul Kim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | | | - Hyewon Yeo
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yunjee Hwang
- Department of Brain & Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Somi Lee
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
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20
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Choi SW, Jeon KS. Relationship between job challenge and job performance in the Korean Army: The mediating effect of learning agility and the moderating effect of job autonomy. MILITARY PSYCHOLOGY 2024:1-13. [PMID: 39083364 DOI: 10.1080/08995605.2024.2376963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 07/01/2024] [Indexed: 08/02/2024]
Abstract
This study aims to identify the relationship among job challenge, learning agility, job autonomy, and job performance based on job demand-resources model. In particular, this study examined the mediating role of learning agility in the relationship between Job challenge and job performance, which has rarely been conducted. Furthermore, the moderating effect of job autonomy as job resource was explored. The data collected were from army officers and noncommissioned officers (NCO) of the Korean Army (N = 425). We hypothesized that there is a positive relationship among Job challenge and learning agility, Job challenge and job performance, the mediating role of learning agility in the relationship between Job challenge and job performance, and the moderating role of job autonomy. As predicted, we found that Job challenge was positively related to learning agility and job performance. We also found a mediating effect of learning agility on the relationship between Job challenge and job performance. Furthermore, job autonomy moderated the positive relationship between Job challenge and learning agility, although the moderating effect of job autonomy between Job challenge and job performance was not significant. Finally, the indirect relationship between Job challenge and job performance, via learning agility, was stronger for the higher job autonomy group than for the lower job autonomy group. The, theoretical and practical contributions and suggestions for future studies on learning agility and job characteristics are discussed.
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Affiliation(s)
- Soon-Won Choi
- Department of Military Studies, Sangji University, Wonju, Korea
| | - Ki-Seok Jeon
- School of Integrated National Security, Chungnam National University, Daejeon, Korea
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21
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Lu H, Yu C, Yu X, Yang D, Yu S, Xia L, Lin Y, Yang B, Wu Y, Li G. Effects of Bony Pelvic and Prostate Dimensions on Surgical Difficulty of Robot-Assisted Radical Prostatectomy: An Original Study and Meta-analysis. Ann Surg Oncol 2024:10.1245/s10434-024-15769-w. [PMID: 39080137 DOI: 10.1245/s10434-024-15769-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/25/2024] [Indexed: 08/09/2024]
Abstract
BACKGROUND Due to the deep location of the prostate within the pelvic cavity, procedures of robot-assisted radical prostatectomy (RARP) might be challenged by the prostate size and the limited pelvic cavity space. This study aimed to investigate the roles of bony pelvic and prostate dimensions in RARP procedures by an original study coupled with a meta-analysis. METHODS In the original study, patients undergoing multiport RARP between 2021 and 2022 were consecutively assessed. The associations of anatomic features with operative time (OT), estimated blood loss (EBL), and positive surgical margin (PSM) were evaluated using linear and logistic regression analyses as well as restricted cubic spline (RCS) analysis. Based on machine-learning algorithms, this study established predictive models for surgical difficulty and interpreted the model using SHapley Additive exPlanation (SHAP). In the meta-analysis, three databases were searched for eligible studies. Quantitative syntheses were subsequently performed. RESULTS Overall, 219 patients were enrolled in the original study. Prostate volume (PV) and the prostate volume-to-pelvic cavity index (PCI) ratio (PV-to-PCI ratio) were significantly associated with longer OT (P < 0.05). In the RCS models, U-shaped associations were observed between the prostate anteroposterior diameter (PAD) and OT, and between the prostate height (PH) and EBL, and an L-shaped association was observed between the anteroposterior diameter of the pelvic inlet (API) and EBL. The XGBoost model was superior to the logistic regression model in predicting prolonged OT. The meta-analysis demonstrated that greater PV was significantly associated with longer OT (β = 0.20; 95% confidence interval [CI] 0.12-0.27; odds ratio [OR] = 1.05; 95% CI 1.00-1.11), and a smaller PV could increase the risk of PSM (OR = 0.82; 95% CI 0.77-0.88). CONCLUSIONS A large prostate within a narrow and deep pelvis might suggest increased surgical difficulty of RARP. The size of the pelvic inlet also had a great impact on RARP. For PAD and PH, there seemed to be an optimal range with the lowest surgical difficulty. Machine-learning models based on the XGBoost algorithm could be successfully applied to predict the surgical difficulty of RARP.
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Affiliation(s)
- Haohua Lu
- Department of Urology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Chenhao Yu
- Department of Urology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaojing Yu
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Dexin Yang
- Department of Toxicology of School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shicheng Yu
- Department of Urology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Liqun Xia
- Department of Urology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yudong Lin
- Department of Urology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Bowen Yang
- Department of Urology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yihua Wu
- Department of Toxicology of School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
| | - Gonghui Li
- Department of Urology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
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Liu L, Li L, Zhou J, Ye Q, Meng D, Xu G. Machine learning-based prediction model of lower extremity deep vein thrombosis after stroke. J Thromb Thrombolysis 2024:10.1007/s11239-024-03010-0. [PMID: 39068348 DOI: 10.1007/s11239-024-03010-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/02/2024] [Indexed: 07/30/2024]
Abstract
This study aimed to apply machine learning (ML) techniques to develop and validate a risk prediction model for post-stroke lower extremity deep vein thrombosis (DVT) based on patients' limb function, activities of daily living (ADL), clinical laboratory indicators, and DVT preventive measures. We retrospectively analyzed 620 stroke patients. Eight ML models-logistic regression (LR), support vector machine (SVM), random forest (RF), decision tree (DT), neural network (NN), extreme gradient boosting (XGBoost), Bayesian (NB), and K-nearest neighbor (KNN)-were used to build the model. These models were extensively evaluated using ROC curves, AUC, PR curves, PRAUC, accuracy, sensitivity, specificity, and clinical decision curves (DCA). Shapley's additive explanation (SHAP) was used to determine feature importance. Finally, based on the optimal ML algorithm, different functional feature set models were compared with the Padua scale to select the best feature set model. Our results indicated that the RF algorithm demonstrated superior performance in various evaluation metrics, including AUC (0.74/0.73), PRAUC (0.58/0.58), accuracy (0.75/0.77), and sensitivity (0.78/0.80) in both the training set and test set. DCA analysis revealed that the RF model had the highest clinical net benefit. SHAP analysis showed that D-dimer had the most significant influence on DVT, followed by age, Brunnstrom stage (lower limb), prothrombin time (PT), and mobility ability. The RF algorithm can predict post-stroke DVT to guide clinical practice.
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Affiliation(s)
- Lingling Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, No.300, Guangzhou Road, Nanjing, 210029, China
| | - Liping Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, No.300, Guangzhou Road, Nanjing, 210029, China
| | - Juan Zhou
- Department of Ultrasonography, The First Affiliated Hospital of Nanjing Medical University, No.300, Guangzhou Road, Nanjing, 210029, China
| | - Qian Ye
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, No.300, Guangzhou Road, Nanjing, 210029, China
| | - Dianhuai Meng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, No.300, Guangzhou Road, Nanjing, 210029, China.
| | - Guangxu Xu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, No.300, Guangzhou Road, Nanjing, 210029, China.
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Singh BK, Khatri RB. Determinants of wealth-related inequalities in full vaccination coverage among children in Nepal: a decomposition analysis of nationally representative household survey data. BMC Public Health 2024; 24:1990. [PMID: 39054494 PMCID: PMC11270921 DOI: 10.1186/s12889-024-19456-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 07/11/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Over the past two decades, child health indicators in Nepal have improved significantly at the national level. Yet, this progress hasn't been uniform across various population subsets. This study identified the determinants associated with childhood full vaccination, assessed wealth-related inequalities, and delved into the key factors driving this inequality. METHODS Data for this study were taken from the most recent nationally representative Nepal Demographic and Health Survey 2022. A total of 959 children aged 12-23 months who had received routine childhood basic antigens as per the national immunisation program were considered for analysis. Binary logistic regression models were conducted to identify the associated factors with outcome variable (uptake of full vaccination). The concentration curve and Erreygers normalized concentration index were used to assess inequality in full vaccination. Household wealth quintile index scores were used to measure wealth-related inequality and decomposition analysis was conducted to identify determinants explaining wealth-related inequality in the uptake of childhood vaccination. RESULTS The coverage of full vaccination among children was 79.8% at national level. Several factors, including maternal health service utilisation variables (e.g., antenatal care, institutional delivery), financial challenges related to visiting health facilities, and mothers' awareness of health mother group meetings within their ward, were associated with the uptake of full vaccination coverage among children. The concentration curve was below the line of equality, and the relative Erreygers normalized concentration index was 0.090, indicating that full vaccination was disproportionately higher among children from wealthy groups. The decomposition analysis identified institutional delivery (20.21%), the money needed to visit health facilities (14.25%), maternal education (16.79%), maternal age (8.53%), and caste (3.03%) were important contributors to wealth related inequalities in childhood full vaccination uptake. CONCLUSIONS There was notable wealth-related inequality in full vaccine uptake among children in Nepal. Multisectoral actions involving responsible stakeholders are pivotal in reducing the inequalities, including promoting access to maternal health services and improving educational attainment among mothers from socioeconomically disadvantaged communities.
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Affiliation(s)
- Barun Kumar Singh
- Health Nutrition Education and Agriculture Research Development, Saptari, Nepal.
| | - Resham B Khatri
- School of Public Health, University of Queensland, Brisbane, Australia
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Lalancette A, Garneau É, Cochrane A, Wilson MA. Body-object interaction ratings for 3600 French nouns. Behav Res Methods 2024:10.3758/s13428-024-02466-5. [PMID: 39048859 DOI: 10.3758/s13428-024-02466-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 07/27/2024]
Abstract
Body-object interaction (BOI) measures the ease with which the human body can interact with the concept represented by a word. This research focuses on two main objectives: first, to establish French norms for the psycholinguistic variable BOI, and second, to investigate the contribution of BOI to language processing in French. We collected BOI ratings for 3600 French nouns from participants through an online platform. The inter- and intrastudy reliability of these new ratings indicate that the ratings are robust. We then aimed to determine the role of BOI in word recognition. A hierarchical regression analysis was conducted using lexical decision reaction times (RTs) as the dependent variable. BOI was found to be a significant predictor of lexical decision latencies, beyond the contribution of word length, frequency, orthographic distinctiveness, and imageability. Contrary to previous findings in English, higher BOI values were associated with longer RTs in French, indicating an inhibitory effect of BOI on French word processing. Methodological differences may account for this divergent result. Taken together, the results of this study show the independent contribution of BOI to word recognition in French. This supports the notion that sensorimotor information is a crucial component of language processing. By providing a reliable and sizable BOI database for French nouns, we offer a valuable resource for psycholinguistic and language processing research. This research underscores the complex relationship between language, cognition, and sensorimotor experiences, advancing our comprehension of language processing mechanisms.
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Affiliation(s)
- Audrey Lalancette
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Cirris), 525 boul. Wilfrid-Hamel, Québec, Québec, G1M2S8, Canada
- École des sciences de la réadaptation, Faculté de médecine, Université Laval, 1050 avenue de la Médecine, Québec, Québec, G1V0A6, Canada
| | - Élisabeth Garneau
- École des sciences de la réadaptation, Faculté de médecine, Université Laval, 1050 avenue de la Médecine, Québec, Québec, G1V0A6, Canada
| | - Alice Cochrane
- École des sciences de la réadaptation, Faculté de médecine, Université Laval, 1050 avenue de la Médecine, Québec, Québec, G1V0A6, Canada
| | - Maximiliano A Wilson
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Cirris), 525 boul. Wilfrid-Hamel, Québec, Québec, G1M2S8, Canada.
- École des sciences de la réadaptation, Faculté de médecine, Université Laval, 1050 avenue de la Médecine, Québec, Québec, G1V0A6, Canada.
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Barbry A, Lerebourg L, Racil G, Jlid MC, Coquart J. Valid and accurate simple equation to predict 3,000-m steeplechase performance. Front Sports Act Living 2024; 6:1402792. [PMID: 39114084 PMCID: PMC11303135 DOI: 10.3389/fspor.2024.1402792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 07/10/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Predict running performances is very important for athletes and trainers. Sport researchers have therefore developed certain tools to predict running performances, but only in non-obstacle races. This study aimed to develop and test the validity and accuracy of an equation for predicting 3,000-m steeplechase performance (PerfSteeple ). Methods The official rankings of French runners for the 3,000-m track-running (Perf3000 ) and 3,000-m steeplechase events were examined. Age, height and body mass were collected. From 146 included athletes, two groups were randomly composed: one comprising 80% of the sample (n = 117) to develop a simple equation to predict PerfSteeple (i.e., development group) and the other comprising the remaining 20% (n = 29) to test the validity and accuracy of the developed prediction equation (i.e., cross-validation group). Results The simple prediction equation included Perf3000 and age: P e r f S t e e p l e = - 57 , 165 + 1 , 147 × P e r f 3000 + 0 , 955 × a g e . No significant difference was noted between the actual and predicted performances. Predicted performances were significantly correlated with the actual ones, with a very high correlation coefficient (p < 0.001; r = 0.929). Bias and 95% limits of agreement were -5 ± 24 s, i.e., -0.8 ± 7.6%. In 95 of 100 new predictions, the difference between actual and predicted performance would be less or equal to-5 ± 24 s. Discussion The study confirms the validity and accuracy of the equation for predicting PerfSteeple . Predictions using this simple equation may be used in training and competitions for athletes and coaches. PerfSteeple = -57,165 + 1,147 X Perf3000 + 0,955 X age.
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Affiliation(s)
- Alexis Barbry
- Centre d’Études des Transformations des Activités Physiques et Sportives, Normandie University, UNIROUEN, Rouen, France
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France
- LAMHESS Lab, Université Côte d’Azur, Nice, France
| | - Lucie Lerebourg
- Centre d’Études des Transformations des Activités Physiques et Sportives, Normandie University, UNIROUEN, Rouen, France
- Orthodynamica Center, Mathilde Hospital 2, Rouen, France
| | - Ghazi Racil
- Higher Institute of Sport ansd Physical Education of Ksar Saïd, University of Manouba, Tunis, Tunisia
| | - Mohamed Chedly Jlid
- Higher Institute of Sport ansd Physical Education of Ksar Saïd, University of Manouba, Tunis, Tunisia
| | - Jérémy Coquart
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France
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Muli S, Schnermann ME, Merdas M, Rattner J, Achaintre D, Perrar I, Goerdten J, Alexy U, Scalbert A, Schmid M, Floegel A, Keski-Rahkonen P, Oluwagbemigun K, Nöthlings U. Metabolomics signatures of sweetened beverages and added sugar are related to anthropometric measures of adiposity in young individuals: results from a cohort study. Am J Clin Nutr 2024:S0002-9165(24)00644-0. [PMID: 39059709 DOI: 10.1016/j.ajcnut.2024.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 07/11/2024] [Accepted: 07/22/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND The associations of sweetened beverages (SBs) and added sugar (AS) intake with adiposity are still debated. Metabolomics could provide insights into the mechanisms linking their intake to adiposity. OBJECTIVES We aimed to identify metabolomics biomarkers of intake of low- and no-calorie sweetened beverages (LNCSBs), sugar-sweetened beverages (SSBs), and ASs and to investigate their associations with body mass index, body fat percentage, and waist circumference. METHODS We analyzed 3 data sets from the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) cohort study, of children who provided 2 urine samples (n = 297), adolescents who provided a single urine sample (n = 339), and young adults who provided a single plasma sample (n = 195). Urine and plasma were analyzed using untargeted metabolomics. Dietary intakes were assessed using 3-d weighed dietary records. The random forest, partial least squares, and least absolute shrinkage and selection operator were jointly used for metabolite selection. We examined associations of intakes with metabolites and anthropometric measures using linear and mixed-effects regression. RESULTS In adolescents, LNCSB were positively associated with acesulfame (β: 0.0012; 95% confidence interval [CI]: 0.0006, 0.0019) and saccharin (β: 0.0009; 95% CI: 0.0002, 0.0015). In children, the association was observed with saccharin (β: 0.0016; 95% CI: 0.0005, 0.0027). In urine and plasma, SSBs were positively associated with 1-methylxanthine (β: 0.0005; 95% CI: 0.0003, 0.0008; and β: 0.0010, 95% CI 0.0004, 0.0015, respectively) and 5-acetylamino-6-amino-3-methyluracil (β: 0.0005; 95% CI: 0.0002, 0.0008; and β: 0.0009; 95% CI: 0.0003, 0.0014, respectively). AS was associated with urinary sucrose (β: 0.0095; 95% CI: 0.0069, 0.0121) in adolescents. Some of the food-related metabolomics profiles were also associated with adiposity measures. CONCLUSIONS We identified SBs- and AS-related metabolites, which may be important for understanding the interplay between these intakes and adiposity in young individuals.
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Affiliation(s)
- Samuel Muli
- Unit of Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany.
| | - Maike E Schnermann
- Unit of Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Mira Merdas
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Jodi Rattner
- International Agency for Research on Cancer (IARC), Lyon, France
| | - David Achaintre
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Ines Perrar
- Unit of Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Jantje Goerdten
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology (BIPS), Bremen, Germany
| | - Ute Alexy
- Unit of Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | | | - Matthias Schmid
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, Bonn, Germany
| | - Anna Floegel
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology (BIPS), Bremen, Germany; Section of Dietetics, Faculty of Agriculture and Food Sciences, Hochschule Neubrandenburg, Neubrandenburg, Germany
| | | | - Kolade Oluwagbemigun
- Unit of Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Ute Nöthlings
- Unit of Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
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Baran K, Barczak B, Kloskowski A. Modeling lignin extraction with ionic liquids using machine learning approach. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 935:173234. [PMID: 38768717 DOI: 10.1016/j.scitotenv.2024.173234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 04/25/2024] [Accepted: 05/12/2024] [Indexed: 05/22/2024]
Abstract
Lignin, next to cellulose, is the second most common natural biopolymer on Earth, containing a third of the organic carbon in the biosphere. For many years, lignin was perceived as waste when obtaining cellulose and hemicellulose and used as a biofuel for the production of bioenergy. However, recently, lignin has been considered a renewable raw material for the production of chemicals and materials to replace petrochemical resources. In this context, an increasing demand for high-quality lignin is to be expected. It is, therefore, essential to optimize the technological processes of obtaining it from natural sources, such as biomass. In this work, an investigation of the use of machine learning-based quantitative structure-property relationship (QSPR) modeling for the preliminary processing of lignin recovery from herbaceous biomass using ionic liquids (ILs) is described. Training of the models using experimental data collected from original publications on the topic is assumed, and molecular descriptors of the ionic liquids are used to represent structural information. The study explores the impact of both ILs' chemical structure and process parameters on the efficiency of lignin recovery from different bio sources. The findings give an insight into the extraction process and could serve as a foundation for further design of efficient and selective processes for lignin recovery using ionic liquids, which can have significant implications for producing biofuels, chemicals, and materials.
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Affiliation(s)
- Karol Baran
- Department of Physical Chemistry, Faculty of Chemistry, Gdansk University of Technology, Narutowicza 11/12, 80-233 Gdansk, Poland.
| | - Beata Barczak
- Department of Energy Conversion and Storage, Faculty of Chemistry, Gdansk University of Technology, Narutowicza 11/12, 80-233 Gdansk, Poland
| | - Adam Kloskowski
- Department of Physical Chemistry, Faculty of Chemistry, Gdansk University of Technology, Narutowicza 11/12, 80-233 Gdansk, Poland
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Overbeek MF, Rutters F, Nieuwdorp M, Davids M, van Valkengoed I, Galenkamp H, van den Born BJ, Beulens JWJ, Muilwijk M. Plasma sphingolipids mediate the association between gut microbiome composition and type 2 diabetes risk in the HELIUS cohort: a case-cohort study. BMJ Open Diabetes Res Care 2024; 12:e004180. [PMID: 39025794 PMCID: PMC11261679 DOI: 10.1136/bmjdrc-2024-004180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 07/05/2024] [Indexed: 07/20/2024] Open
Abstract
INTRODUCTION The association between the gut microbiome and incident type 2 diabetes (T2D) is potentially partly mediated through sphingolipids, however these possible mediating mechanisms have not been investigated. We examined whether sphingolipids mediate the association between gut microbiome and T2D, using data from the Healthy Life in an Urban Setting study. RESEARCH DESIGN AND METHODS Participants were of Dutch or South-Asian Surinamese ethnicity, aged 18-70 years, and without T2D at baseline. A case-cohort design (subcohort n=176, cases incident T2D n=36) was used. The exposure was measured by 16S rRNA sequencing (gut microbiome) and mediator by targeted metabolomics (sphingolipids). Dimensionality reduction was achieved by principle component analysis and Shannon diversity. Cox regression and procrustes analyses were used to assess the association between gut microbiome and T2D and sphingolipids and T2D, and between gut microbiome and sphingolipids, respectively. Mediation was tested familywise using mediation analysis with permutation testing and Bonferroni correction. RESULTS Our study confirmed associations between gut microbiome and T2D and sphingolipids and T2D. Additionally, we showed that the gut microbiome was associated with sphingolipids. The association between gut microbiome and T2D was partly mediated by a sphingolipid principal component, which represents a dominance of ceramide species over more complex sphingolipids (HR 1.17; 95% CI 1.08 to 1.28; proportional explained 48%), and by Shannon diversity (HR 0.97; 95% CI 0.95 to 0.99; proportional explained 24.8%). CONCLUSIONS These data suggest that sphingolipids mediate the association between microbiome and T2D risk. Future research is needed to confirm observed findings and elucidate causality on a molecular level.
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Affiliation(s)
- Martin F Overbeek
- Epidemiology and Data Science, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
| | - Femke Rutters
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - Max Nieuwdorp
- Vascular Medicine, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| | - Mark Davids
- Internal Medicine, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| | | | - Henrike Galenkamp
- Public Health, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| | | | - Joline W J Beulens
- Epidemiology & Data Science, Amsterdam UMC Locatie VUMC, Amsterdam, The Netherlands
| | - Mirthe Muilwijk
- Epidemiology and Data Science, Amsterdam UMC, Amsterdam, The Netherlands
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Bie D, Li Y, Wang H, Liu Q, Dou D, Jia Y, Yuan S, Li Q, Wang J, Yan F. Relationship between intra-operative urine output and postoperative acute kidney injury in paediatric cardiac surgery: A retrospective cohort study. Eur J Anaesthesiol 2024:00003643-990000000-00204. [PMID: 39021216 DOI: 10.1097/eja.0000000000002044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
BACKGROUND Intra-operative urine output (UO) has been shown to predict postoperative acute kidney injury (AKI) in adults; however, its significance in children undergoing cardiac surgery remains unknown. OBJECTIVE To explore the association between intra-operative UO and postoperative AKI in children with congenital heart disease. DESIGN A retrospective observational study. SETTING A tertiary hospital. PATIENTS Children aged >28 days and <6 years who underwent cardiac surgery at Fuwai Hospital from 1 April 2022 to 30 August 2022. MAIN OUTCOME MEASURES AKI was identified by the highest serum creatinine value within postoperative 7 days using Kidney Disease Improving Global Outcomes (KDIGO) criteria. RESULTS In total, 1184 children were included. The incidence of AKI was 23.1% (273/1184), of which 17.7% (209/1184) were stage 1, 4.2% (50/1184) were stage 2, and others were stage 3 (1.2%, 14/1184). Intra-operative UO was calculated by dividing the total intra-operative urine volume by the duration of surgery and the actual body weight measured before surgery. There was no significant difference in median [range] intra-operative UO between the AKI and non-AKI groups (2.6 [1.4 to 5.4] and 2.7 [1.4 to 4.9], respectively, P = 0.791), and multivariate logistic regression analyses showed that intra-operative UO was not associated with postoperative AKI [adjusted odds ratio (OR) 0.971; 95% confidence interval (CI), 0.930 to 1.014; P = 0.182]. Regarding the clinical importance of severe forms of AKI, we further explored the association between intra-operative UO and postoperative moderate-to-severe AKI (adjusted OR 0.914; 95% CI, 0.838 to 0.998; P = 0.046). CONCLUSIONS Intra-operative UO was not associated with postoperative AKI during paediatric cardiac surgery. However, we found a significant association between UO and postoperative moderate-to-severe AKI. This suggests that reductions in intra-operative urine output below a specific threshold may be associated with postoperative renal dysfunction. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT05489263.
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Affiliation(s)
- Dongyun Bie
- From the Department of Anaesthesiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (DB, YL, HW, QL, DD, YJ, SY, JW, FY), and Medical Research and Biometrics Centre, National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (QL)
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Visoki E, Moore TM, Zhang X, Tran KT, Ly C, Gataviņš MM, DiDomenico GE, Brogan L, Fein JA, Warrier V, Guloksuz S, Barzilay R. Classification of Suicide Attempt Risk Using Environmental and Lifestyle Factors in 3 Large Youth Cohorts. JAMA Psychiatry 2024:2821270. [PMID: 39018056 PMCID: PMC11255979 DOI: 10.1001/jamapsychiatry.2024.1887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/30/2024] [Indexed: 07/18/2024]
Abstract
Importance Suicide is the third-leading cause of death among US adolescents. Environmental and lifestyle factors influence suicidal behavior and can inform risk classification, yet quantifying and incorporating them in risk assessment presents a significant challenge for reproducibility and clinical translation. Objective To quantify the aggregate contribution of environmental and lifestyle factors to youth suicide attempt risk classification. Design, Setting, and Participants This was a cohort study in 3 youth samples: 2 national longitudinal cohorts from the US and the UK and 1 clinical cohort from a tertiary pediatric US hospital. An exposome-wide association study (ExWAS) approach was used to identify risk and protective factors and compute aggregate exposomic scores. Logistic regression models were applied to test associations and model fit of exposomic scores with suicide attempts in independent data. Youth from the Adolescent Brain Cognitive Development (ABCD) study, the UK Millennium Cohort Study (MCS), and the Children's Hospital of Philadelphia emergency department (CHOP-ED) were included in the study. Exposures A single-weighted exposomic score that sums significant risk and protective environmental/lifestyle factors. Main Outcome and Measure Self-reported suicide attempt. Results A total of 40 364 youth were included in this analysis: 11 564 from the ABCD study (3 waves of assessment; mean [SD] age, 12.0 [0.7] years; 6034 male [52.2%]; 344 attempted suicide [3.0%]; 1154 environmental/lifestyle factors were included in the ABCD study), 9000 from the MCS cohort (mean [SD] age, 17.2 [0.3] years; 4593 female [51.0%]; 661 attempted suicide [7.3%]; 2864 environmental/lifestyle factors were included in the MCS cohort), and 19 800 from the CHOP-ED cohort (mean [SD] age, 15.3 [1.5] years; 12 937 female [65.3%]; 2051 attempted suicide [10.4%]; 36 environmental/lifestyle factors were included in the CHOP-ED cohort). In the ABCD discovery subsample, ExWAS identified 99 risk and protective exposures significantly associated with suicide attempt. A single weighted exposomic score that sums significant risk and protective exposures was associated with suicide attempt in an independent ABCD testing subsample (odds ratio [OR], 2.2; 95% CI, 2.0-2.6; P < .001) and explained 17.6% of the variance (based on regression pseudo-R2) in suicide attempt over and above that explained by age, sex, race, and ethnicity (2.8%) and by family history of suicide (6.3%). Findings were consistent in the MCS and CHOP-ED cohorts (explaining 22.6% and 19.3% of the variance in suicide attempt, respectively) despite clinical, demographic, and exposure differences. In all cohorts, compared with youth at the median quintile of the exposomic score, youth at the top fifth quintile were substantially more likely to have made a suicide attempt (OR, 4.3; 95% CI, 2.6-7.2 in the ABCD study; OR, 3.8; 95% CI, 2.7-5.3 in the MCS cohort; OR, 5.8; 95% CI, 4.7-7.1 in the CHOP-ED cohort). Conclusions and Relevance Results suggest that exposomic scores of suicide attempt provided a generalizable method for risk classification that can be applied in diverse samples from clinical or population settings.
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Affiliation(s)
- Elina Visoki
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania
- Lifespan Brain Institute of CHOP and Penn Medicine, Philadelphia, Pennsylvania
| | - Tyler M. Moore
- Lifespan Brain Institute of CHOP and Penn Medicine, Philadelphia, Pennsylvania
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Xinhe Zhang
- Cambridge University, Cambridge, United Kingdom
| | - Kate T. Tran
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania
- Lifespan Brain Institute of CHOP and Penn Medicine, Philadelphia, Pennsylvania
| | - Christina Ly
- Lifespan Brain Institute of CHOP and Penn Medicine, Philadelphia, Pennsylvania
| | - Mārtiņš M. Gataviņš
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania
- Lifespan Brain Institute of CHOP and Penn Medicine, Philadelphia, Pennsylvania
| | - Grace E. DiDomenico
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania
- Lifespan Brain Institute of CHOP and Penn Medicine, Philadelphia, Pennsylvania
| | - Leah Brogan
- Center for Violence Prevention, Children’s Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania
| | - Joel A. Fein
- Center for Violence Prevention, Children’s Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | | | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Ran Barzilay
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania
- Lifespan Brain Institute of CHOP and Penn Medicine, Philadelphia, Pennsylvania
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Tan YB, Tay EH, Shahwan S, Zhang Y, Sambasivam R, Subramaniam M. Associations between parental bonding and health-related quality of life in a clinical sample of youths aged 14-35 years in Singapore. Singapore Med J 2024:00077293-990000000-00127. [PMID: 38993101 DOI: 10.4103/singaporemedj.smj-2023-223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/15/2024] [Indexed: 07/13/2024]
Abstract
INTRODUCTION Individuals with psychiatric disorders tend to report having poorer bonds with their parents during their early years. These individuals often experience lower quality of life as well. This study investigated the associations between aspects of parental bonding and health-related quality of life (HRQOL) in a clinical sample of youths. It was hypothesised that high parental care and low parental overprotectiveness would be associated with higher levels of HRQOL. METHODS Data were obtained from a larger cross-sectional study. The sample consisted of 400 psychiatric outpatients: 191 patients aged 14-21 (mean ± standard deviation 18.1 ± 2.22) years and 209 patients aged 22-35 (28.0 ± 4.33) years. The Parental Bonding Instrument was used to measure parental care and overprotectiveness. Short Form-12 measured physical health (physical component summary [PCS]) and mental health (mental component summary [MCS]) components of HRQOL, and the 8-item Patient Health Questionnaire assessed depressive symptoms. These scales and a sociodemographic form were self-administered. Multivariable linear regression was used for analysis. RESULTS About half of the sample reported affectionless control for mothers (46.6%) and fathers (45.9%). After controlling for sociodemographic variables, no significant relationship was found between aspects of parental bonding and PCS scores. Maternal care was associated with MCS scores (β = 0.32, P < 0.01) and PHQ-8 scores (β = -0.12, P < 0.05). CONCLUSION Our results suggest that youths who experienced quality care from their mothers exhibit better mental health functioning despite their clinical diagnoses, which suggests that early maternal care exerts an overall long-term protective effect. Early parental education that promotes positive parenting practices could improve the overall HRQOL of individuals in adulthood despite their clinical diagnoses.
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Affiliation(s)
- Yoke Boon Tan
- Research Division, Institute of Mental Health, Singapore
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Matsumoto K, Yamamoto Y, Shiroyama T, Kuge T, Mori M, Tamiya M, Kinehara Y, Tamiya A, Suzuki H, Tobita S, Ueno K, Niki T, Nagatomo I, Takeda Y, Kumanogoh A. Risk Stratification According to Baseline and Early Change in Neutrophil-to-Lymphocyte Ratio in Advanced Non-Small Cell Lung Cancer Treated with Chemoimmunotherapy: A Multicenter Real-World Study. Target Oncol 2024:10.1007/s11523-024-01084-7. [PMID: 38990462 DOI: 10.1007/s11523-024-01084-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Chemoimmunotherapy is a standard treatment for advanced non-small-cell lung cancer (NSCLC). However, data on clinical predictive factors remain scarce. OBJECTIVE We aim to identify clinical biomarkers in patients undergoing chemoimmunotherapy. METHODS This multicenter, real-world cohort study included chemonaive patients who underwent chemoimmunotherapy between December 2018 and May 2022. Multivariate analysis was used to determine associations between survival outcomes and patient background, including baseline neutrophil-to-lymphocyte ratio (NLR) and its dynamic change (ΔNLR). To further investigate the clinical significance of NLR, patients were classified based on their peripheral immune status, defined by a combination of NLR and ΔNLR. RESULTS The study included 280 patients with 30.1 months of median follow-up. Multivariate analysis revealed that older individuals, poor performance status, tumor proportion score < 1%, liver metastasis, baseline NLR ≥ 5, and ΔNLR ≥ 0 independently correlated significantly with shorter progression-free and overall survival (OS). Patients with high peripheral immune status (defined as NLR <5 and ΔNLR < 0) significantly improved long-term survival (2-year OS rate of 58.3%), whereas those with low peripheral immune status (defined as NLR ≥ 5 and ΔNLR ≥ 0) had extremely poor outcomes (2-year OS rate of 5.6%). Safety profiles did not differ significantly in terms of severe adverse events and treatment-related death rates despite the patients' peripheral immune status (P = 0.46 and 0.63, respectively). CONCLUSIONS Our study provides real-world evidence regarding clinical prognostic factors for the efficacy of chemoimmunotherapy. The combined assessment of baseline NLR and ΔNLR could facilitate the identification of patients who are likely to achieve a durable response from chemoimmunotherapy.
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Affiliation(s)
- Kinnosuke Matsumoto
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Yuji Yamamoto
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Takayuki Shiroyama
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
| | - Tomoki Kuge
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Toyonaka, Japan
| | - Masahide Mori
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Toyonaka, Japan
| | - Motohiro Tamiya
- Department of Respiratory Medicine, Osaka International Cancer Institute, Osaka, Japan
| | - Yuhei Kinehara
- Department of Respiratory Medicine and Clinical Immunology, Nippon Life Hospital, Osaka, Japan
| | - Akihiro Tamiya
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino, Japan
| | - Satoshi Tobita
- Department of Respiratory Medicine, Osaka General Medical Center, Osaka, Japan
| | - Kiyonobu Ueno
- Department of Respiratory Medicine, Osaka General Medical Center, Osaka, Japan
| | - Toshie Niki
- Department of Respiratory Medicine, Nishinomiya Municipal Central Hospital, Nishinomiya, Japan
| | - Izumi Nagatomo
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Yoshito Takeda
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Atsushi Kumanogoh
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
- Department of Immunopathology, World Premier International (WPI), Immunology Frontier Research Center (iFReC), Osaka University, Suita, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, Suita, Japan
- Center for Infectious Diseases for Education and Research (CiDER), Osaka University, Suita, Osaka, Japan
- Japan Agency for Medical Research and Development-Core Research for Evolutional Science and Technology (AMED-CREST), Osaka University, Suita, Japan
- Center for Advanced Modalities and DDS (CAMaD), Osaka University, Suita, Japan
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Aluh DO, Diaz-Milanes D, Azeredo-Lopes S, Barbosa S, Santos-Dias M, Silva M, Grigaitė U, Pedrosa B, Velosa A, Cardoso G, Caldas-de-Almeida JM. Coercion in Psychiatry: Exploring the Subjective Experience of Coercion Among Patients in Five Portuguese Psychiatric Departments. J Behav Health Serv Res 2024:10.1007/s11414-024-09890-7. [PMID: 38987414 DOI: 10.1007/s11414-024-09890-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2024] [Indexed: 07/12/2024]
Abstract
The subjective experience of coercion may have a more significant impact on clinical outcomes than formal coercive measures. This study aimed to investigate the subjective experience of coercion among patients on admission in Portuguese psychiatric departments by assessing their perceived coercion, procedural justice, and negative pressures during admission. The study also investigated whether this subjective experience of coercion changed with time during admission, and the predictors of this change. Validated instruments, including the McArthur Admission Experience Survey (AES) and the Client Assessment of Treatment Scale, were used to collect information from 208 adults admitted to five public psychiatric inpatient departments in rural and urban regions of Portugal. About a third (32.24%, n = 49) of the sample had a legal involuntary admission status, while more than a third of them perceived their admission to be involuntary (40.13%, n = 61). The subjective experience of coercion was significantly higher among people who perceived their admission to be involuntary compared to people who perceived their admission to be voluntary (Median = 10, IQR = 5.5 vs. Median = 3, IQR = 6; p < 0.001). Satisfaction with their care was significantly inversely correlated with the subjective experience of coercion (p < 0.01). The changes in the subjective experience of coercion at the second assessment were predicted by the perceived admission status rather than the legal admission status, and the initial procedural justice (p < 0.05). The study findings highlight the importance of improving procedural justice in psychiatric admissions, regardless of the legal status of admission.
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Affiliation(s)
- Deborah Oyine Aluh
- Lisbon Institute of Global Mental Health, Lisbon, Portugal.
- Comprehensive Health Research Centre (Chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal.
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria Nsukka, Nsukka, Nigeria.
| | - Diego Diaz-Milanes
- Department of Quantitative Methods, Universidad Loyola Andalusia, Seville, Spain
- Health Research Institute, University of Canberra, Canberra, ACT, Australia
| | - Sofia Azeredo-Lopes
- NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
- Department of Statistics and Operational Research, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Sofia Barbosa
- Unidade de Internamento Do Serviço de Psiquiatria E Saúde Mental de Adultos - Departamento de Saúde Mental Do Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Margarida Santos-Dias
- Lisbon Institute of Global Mental Health, Lisbon, Portugal
- Comprehensive Health Research Centre (Chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Manuela Silva
- Lisbon Institute of Global Mental Health, Lisbon, Portugal
- Comprehensive Health Research Centre (Chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Ugnė Grigaitė
- Lisbon Institute of Global Mental Health, Lisbon, Portugal
- Comprehensive Health Research Centre (Chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Barbara Pedrosa
- Lisbon Institute of Global Mental Health, Lisbon, Portugal
- Comprehensive Health Research Centre (Chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Ana Velosa
- Serviço de Psiquiatria E Saúde Mental de Adultos, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Graça Cardoso
- Lisbon Institute of Global Mental Health, Lisbon, Portugal
- Comprehensive Health Research Centre (Chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - José Miguel Caldas-de-Almeida
- Lisbon Institute of Global Mental Health, Lisbon, Portugal
- Comprehensive Health Research Centre (Chrc), NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
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Gupta DK, Pramanick S, Singh AK. Vulnerability assessment of aerosol and climate variability for rice and maize yield using EO datasets for sustainable agriculture over India. ENVIRONMENTAL MONITORING AND ASSESSMENT 2024; 196:714. [PMID: 38976077 DOI: 10.1007/s10661-024-12862-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 06/26/2024] [Indexed: 07/09/2024]
Abstract
Human-generated aerosol pollution gradually modifies the atmospheric chemical and physical attributes, resulting in significant changes in weather patterns and detrimental effects on agricultural yields. The current study assesses the loss in agricultural productivity due to weather and anthropogenic aerosol variations for rice and maize crops through the analysis of time series data of India spanning from 1998 to 2019. The average values of meteorological variables like maximum temperature (TMAX), minimum temperature (TMIN), rainfall, and relative humidity, as well as aerosol optical depth (AOD), have also shown an increasing tendency, while the average values of soil moisture and fraction of absorbed photosynthetically active radiation (FAPAR) have followed a decreasing trend over that period. This study's primary finding is that unusual variations in weather variables like maximum and minimum temperature, rainfall, relative humidity, soil moisture, and FAPAR resulted in a reduction in rice and maize yield of approximately (2.55%, 2.92%, 2.778%, 4.84%, 2.90%, and 2.82%) and (5.12%, 6.57%, 6.93%, 6.54%, 4.97%, and 5.84%), respectively. However, the increase in aerosol pollution is also responsible for the reduction of rice and maize yield by 7.9% and 8.8%, respectively. In summary, the study presents definitive proof of the detrimental effect of weather, FAPAR, and AOD variability on the yield of rice and maize in India during the study period. Meanwhile, a time series analysis of rice and maize yields revealed an increasing trend, with rates of 0.888 million tons/year and 0.561 million tons/year, respectively, due to the adoption of increasingly advanced agricultural techniques, the best fertilizer and irrigation, climate-resilient varieties, and other factors. Looking ahead, the ongoing challenge is to devise effective long-term strategies to combat air pollution caused by aerosols and to address its adverse effects on agricultural production and food security.
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Affiliation(s)
- Dileep Kumar Gupta
- Department of Physics, Institute of Science, Banaras Hindu University, Varanasi, 221005, India
| | - Subhajit Pramanick
- Department of Physics, Institute of Science, Banaras Hindu University, Varanasi, 221005, India
| | - Abhay Kumar Singh
- Department of Physics, Institute of Science, Banaras Hindu University, Varanasi, 221005, India.
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Andica C, Kamagata K, Takabayashi K, Mahemuti Z, Hagiwara A, Aoki S. Reduced Diffusivity along Perivascular Spaces on MR Imaging Associated with Younger Age of First Use and Cognitive Impairment in Recreational Marijuana Users. AJNR Am J Neuroradiol 2024; 45:912-919. [PMID: 38383055 DOI: 10.3174/ajnr.a8215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/20/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND AND PURPOSE The impairment of the glymphatic system, a perivascular network crucial for brain waste clearance, has been linked to cognitive impairment, potentially attributed to the accumulation of brain waste. Although marijuana use has been associated with poorer cognitive performance, particularly in adolescents, its influence on the glymphatic system remains unexplored. This study evaluated the influence of the age of first marijuana use and the total number of lifetime uses on the glymphatic system, measured using the index of DTI along the perivascular space (DTI-ALPS). Furthermore, we explored the correlation between glymphatic clearance and cognitive performance among marijuana users. MATERIALS AND METHODS In this study, 125 individuals who reported using marijuana at least once in their lifetime (43 men; mean age, 28.60 [SD, 3.84] years) and 125 individuals with zero lifetime cannabis use (nonusers; 44 men; mean age, 28.82 [SD, 3.56] years) were assessed. ALPS indices of all study participants were calculated using 3T diffusion MR imaging data (b = 1000 s/mm2). RESULTS After we adjusted for age, sex, education years, Pittsburgh Sleep Quality Index, alcohol use, tobacco use, and intracranial volume, our analysis using a univariate General Linear Model revealed no significant difference in the ALPS index among nonusers and marijuana users with different ages of first use or various frequencies of lifetime usage. However, in marijuana users, multiple linear regression analyses showed associations between a lower ALPS index and earlier age of first marijuana use (standardized β, -0.20; P = .041), lower accuracy in the working memory 0-back task (standardized β, 0.20; P = .042), and fewer correct responses in the Fluid Intelligence Test (standardized β, 0.19; P = .045). CONCLUSIONS This study shows the potential use of DTI-ALPS as a noninvasive indirect indicator of the glymphatic clearance in young adults. Our findings show novel adverse effects of younger age at first use of marijuana on the glymphatic system function, which is associated with impaired working memory and fluid intelligence. Gaining insight into the alterations in glymphatic function following marijuana use could initiate novel strategies to reduce the risk of cognitive impairment.
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Affiliation(s)
- Christina Andica
- From the Department of Radiology (C.A., K.K., K.T., Z.M., A.H., S.A.), Juntendo University Graduate School of Medicine, Tokyo, Japan
- Faculty of Health Data Science (C.A., S.A.), Juntendo University, Chiba, Japan
| | - Koji Kamagata
- From the Department of Radiology (C.A., K.K., K.T., Z.M., A.H., S.A.), Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kaito Takabayashi
- From the Department of Radiology (C.A., K.K., K.T., Z.M., A.H., S.A.), Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Zaimire Mahemuti
- From the Department of Radiology (C.A., K.K., K.T., Z.M., A.H., S.A.), Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akifumi Hagiwara
- From the Department of Radiology (C.A., K.K., K.T., Z.M., A.H., S.A.), Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- From the Department of Radiology (C.A., K.K., K.T., Z.M., A.H., S.A.), Juntendo University Graduate School of Medicine, Tokyo, Japan
- Faculty of Health Data Science (C.A., S.A.), Juntendo University, Chiba, Japan
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Xiang Y, Wang Y, Deng Y, Wang T, Chen J, He M. Independent and joint associations of multiple metals exposure with vital capacity index: a cross-sectional study in Chinese children and adolescents. Int Arch Occup Environ Health 2024:10.1007/s00420-024-02085-9. [PMID: 38969801 DOI: 10.1007/s00420-024-02085-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 06/25/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVE The current study aimed to explore the relationships between urinary metals and vital capacity index (VCI) in 380 children and adolescents in Northeast China using a variety of statistical methods. METHODS A cross-sectional survey was conducted among 380 children and adolescents in Liaoning Province, China. To assess the relationships between urinary metals and VCI, Elastic-net (ENET) regression, multivariate linear regression, weighted quantile sum (WQS), bayesian kernel machine regression (BKMR) and quantile-based g computation (qgcomp) were adopted. RESULTS The ENET model selected magnesium (Mg), vanadium (V), manganese (Mn), arsenic (As), tin (Sn) and lead (Pb) as crucial elements. In multiple linear regression, we observed urinary Pb, Mn was negatively correlated with VCI individually in both total study population and adolescents (all p values < 0.05) in the adjustment model. The WQS indices were negatively related with VCI in total study population (β=-3.19, 95%CI: -6.07, -0.30) and adolescents (β=-3.46, 95%CI: -6.58, -0.35). The highest weight in total study population was Pb (38.80%), in adolescents was Mn (35.10%). In the qgcomp, Pb (31.90%), Mn (27.20%) were the major negative contributors to the association in the total population (β=-3.51, 95%CI: -6.29, -0.74). As (42.50%), Mn (39.90%) were the main negative contributors (β=-3.95, 95% CI: -6.68, -1.22) among adolescents. The results of BKMR were basically consistent with WQS and qgcomp analyses. CONCLUSIONS Our results indicated that Pb and Mn were priority toxic materials on VCI. The cumulative effect of metals was negatively related to VCI, and this relationship was more pronounced in adolescents.
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Affiliation(s)
- Yuting Xiang
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Yuting Wang
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Ye Deng
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Tianyun Wang
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Jiamei Chen
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Miao He
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China.
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention, Ministry of Education, China Medical University, Shenyang, 110122, China.
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Hu J, Yang H, Yu M, Yu C, Qiu J, Xie G, Sheng G, Kuang M, Zou Y. Admission blood glucose and 30-day mortality in patients with acute decompensated heart failure: prognostic significance in individuals with and without diabetes. Front Endocrinol (Lausanne) 2024; 15:1403452. [PMID: 39036046 PMCID: PMC11257984 DOI: 10.3389/fendo.2024.1403452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 06/24/2024] [Indexed: 07/23/2024] Open
Abstract
Objective Diabetes is a significant risk factor for acute heart failure, associated with an increased risk of mortality. This study aims to analyze the prognostic significance of admission blood glucose (ABG) on 30-day mortality in Chinese patients with acute decompensated heart failure (ADHF), with or without diabetes. Methods This retrospective study included 1,462 participants from the JX-ADHF1 cohort established between January 2019 to December 2022. We conducted multivariate cox regression, restricted cubic spline, receiver operating characteristic curve analysis, and mediation analysis to explore the association and potential mechanistic pathways (inflammation, oxidative stress, and nutrition) between ABG and 30-day mortality in ADHF patients, with and without diabetes. Results During the 30-day follow-up, we recorded 20 (5.36%) deaths in diabetic subjects and 33 (3.03%) in non-diabetics. Multivariate Cox regression revealed that ABG was independently associated with 30-day mortality in ADHF patients, with a stronger association in diabetics than non-diabetics (hazard ratio: Model 1: 1.71 vs 1.16; Model 2: 1.26 vs 1.19; Model 3: 1.65 vs 1.37; Model 4: 1.76 vs 1.33). Further restricted cubic spline analysis indicated a U-shaped relationship between ABG and 30-day mortality in non-diabetic ADHF patients (P for non-linearity < 0.001), with the lowest risk at ABG levels approximately between 5-7 mmol/L. Additionally, receiver operating characteristic analysis demonstrated that ABG had a higher predictive accuracy for 30-day mortality in diabetics (area under curve = 0.8751), with an optimal threshold of 13.95mmol/L. Finally, mediation analysis indicated a significant role of inflammation in ABG-related 30-day mortality in ADHF, accounting for 11.15% and 8.77% of the effect in diabetics and non-diabetics, respectively (P-value of proportion mediate < 0.05). Conclusion Our study confirms that ABG is a vital indicator for assessing and predicting 30-day mortality risk in ADHF patients with diabetes. For ADHF patients, both with and without diabetes, our evidence suggests that physicians should be alert and closely monitor any changes in patient conditions when ABG exceeds 13.95 mmol/L for those with diabetes and 7.05 mmol/L for those without. Timely adjustments in therapeutic strategies, including endocrine and anti-inflammatory treatments, are advisable.
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Affiliation(s)
- Jing Hu
- Department of Cardiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Hongyi Yang
- Department of Ultrasound, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Meng Yu
- Department of Cardiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Changhui Yu
- Department of Cardiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Jiajun Qiu
- Department of Cardiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Guobo Xie
- Department of Cardiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Guotai Sheng
- Department of Cardiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Maobin Kuang
- Department of Cardiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
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Kloprogge SES, Lachmipersad RMMR, Katier NN, Mailuhu AKEA, van Vooren JJ, van Ochten JMJ, Bindels PJEP, Bierma-Zeinstra SMAS, van Middelkoop MM. Prognostic factors and the value of radiographic osteoarthritis for persistent complaints after referral for ankle radiography. Semin Arthritis Rheum 2024; 68:152487. [PMID: 38996495 DOI: 10.1016/j.semarthrit.2024.152487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 06/04/2024] [Accepted: 06/06/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND Ankle symptoms are a common reason to consult the general practitioner and often persist for years. In a population referred for ankle radiography, the prevalence of radiographic osteoarthritis (OA) is substantial, but its additional predictive value for persistent symptoms is unknown. Therefore, we examined the prognosis of symptoms 2-3 years after referral for ankle radiography, assessed clinical prognostic factors, and the additional predictive value of radiographic OA for persistent ankle complaints. METHODS We included 893 adults referred for ankle radiography and studied the following candidate prognostic factors at baseline: age, sex, body mass index (BMI), referral for chronic complaints (>3 months), pain during activity (NRS-11) and presence of stiffness and functional loss as predominant symptom. X-rays were scored for radiographic OA. After 2-3 years participants were invited for a follow-up questionnaire including persistence of ankle complaints. To assess prognostic factors for persistent complaints, uni- and multivariable logistic regression were used. RESULTS Of the 194 responders at follow-up, ankle complaints persisted in 71(36.6 %). BMI (OR 1.08; 95 % CI 1.01-1.15), stiffness as predominant symptom (OR 1.69; 95 % CI 0.89-3.21), and chronic complaints (OR 2.84; 95 % CI 1.45-5.57) were in the initial model for persistent complaints (AUC=0.69). After adding radiographic OA (OR 2.36; 95 % CI 1.01-5.50), the AUC of the final model became 0.70. CONCLUSION Ankle complaints persist in a considerable proportion of patients 2-3 years after referral for ankle radiography. BMI, chronic complaints and radiographic OA are prognostic factors for persistent complaints, but the additional predictive value of radiographic OA on top of clinical factors is negligible.
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Affiliation(s)
- S E Sabine Kloprogge
- Department of General Practice, Erasmus MC Medical University Center Rotterdam, the Netherlands.
| | | | - N Nienke Katier
- Department of radiology, Albert Schweitzer Hospital Dordrecht, the Netherlands
| | - A K E Adinda Mailuhu
- Department of General Practice, Erasmus MC Medical University Center Rotterdam, the Netherlands
| | | | - J M John van Ochten
- Department of General Practice, Erasmus MC Medical University Center Rotterdam, the Netherlands
| | - P J E Patrick Bindels
- Department of General Practice, Erasmus MC Medical University Center Rotterdam, the Netherlands
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Tachino J, Demetriades AK, Peul W, Nakao S, Katayama Y, Tanaka K, Kitamura T, Hirose T, Kiyohara K, Umemura Y, Kiguchi T, Ojima M, Ishida K, Oda J. Effects of Concomitant Traumatic Spinal Cord and Brain Injury on In-Hospital Mortality: A Retrospective Analysis of a Nationwide Trauma Registry in Japan. J Neurotrauma 2024. [PMID: 38877809 DOI: 10.1089/neu.2024.0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024] Open
Abstract
Isolated traumatic spinal cord injury (t-SCI) and traumatic brain injury (TBI) represent significant public health concerns, resulting in long-term disabilities and necessitating sophisticated care, particularly when occurring concurrently. The impact of these combined injuries, while crucial in trauma management, on clinical, socioeconomic, and health care outcomes is largely unknown. To address this gap, our secondary retrospective cohort study used data from the Japan Trauma Data Bank, covering patients enrolled over a 13-year period (2006-2018), to elucidate the effects of concurrent t-SCI and TBI on in-hospital mortality. Data on patient demographics, injury characteristics, treatment modalities, and outcomes were analyzed. Multivariate logistic regression analysis was performed to examine prognostic variables associated with in-hospital mortality, including interaction terms between t-SCI severity and TBI presence. This study included 91,983 patients with neurotrauma, with a median age of 62 years (69.7% men). Among the patients, 9,018 (9.8%) died in the hospital. Concomitant t-SCI and TBI occurred in 2,954 (3.2%) patients. t-SCI only occurred in 9,590 (10.4%) patients, whereas TBI only occurred in the majority of these cases (79,439, 86.4%). Multivariate logistic regression analysis revealed age; sex; total number of comorbidities; systolic blood pressure at presentation; Glasgow coma scale score at presentation; and Abbreviated Injury Scale (AIS) scores for head, face, chest, abdomen, cervical-SCI, thoracic-SCI, and lumbar-SCI as significant independent factors for in-hospital mortality. The odds ratio of cervical-SCI × head AIS as an interaction term was 0.85 (95% confidence interval: 0.77-0.95), indicating a negative interaction. In conclusion, we identified 12 factors associated with in-hospital mortality in patients with t-SCI. In addition, the negative interaction between cervical t-SCI and TBI suggests that the presence of t-SCI in patients with TBI may be underestimated. This study highlights the importance of early recognition and comprehensive management of these complex trauma conditions while considering the possibility of concomitant t-SCI in patients with TBI.
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Affiliation(s)
- Jotaro Tachino
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Andreas K Demetriades
- University Neurosurgical Center Holland, Leiden University Medical Centre, Leiden-The Hague, The Netherlands
- Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
- Department of Neurosurgery, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Wilco Peul
- University Neurosurgical Center Holland, Leiden University Medical Centre, Leiden-The Hague, The Netherlands
- Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Shunichiro Nakao
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yusuke Katayama
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kenta Tanaka
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomoya Hirose
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kosuke Kiyohara
- Department of Food Science, Faculty of Home Economics, Otsuma Women's University Tokyo, Tokyo, Japan
| | - Yutaka Umemura
- Department of Emergency and Critical Care, Osaka General Medical Center, Osaka, Japan
| | - Takeyuki Kiguchi
- Department of Emergency and Critical Care, Osaka General Medical Center, Osaka, Japan
| | - Masahiro Ojima
- Department of Acute Medicine and Critical Care Medical Center, Osaka National Hospital, National Hospital Organization, Osaka, Japan
| | - Kenichiro Ishida
- Department of Acute Medicine and Critical Care Medical Center, Osaka National Hospital, National Hospital Organization, Osaka, Japan
| | - Jun Oda
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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Zhu J, Shan Y, Li Y, Xu X, Wu X, Xue Y, Gao G. Random forest-based prediction of intracranial hypertension in patients with traumatic brain injury. Intensive Care Med Exp 2024; 12:58. [PMID: 38954280 PMCID: PMC11219663 DOI: 10.1186/s40635-024-00643-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 06/17/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Treatment and prevention of intracranial hypertension (IH) to minimize secondary brain injury are central to the neurocritical care management of traumatic brain injury (TBI). Predicting the onset of IH in advance allows for a more aggressive prophylactic treatment. This study aimed to develop random forest (RF) models for predicting IH events in TBI patients. METHODS We analyzed prospectively collected data from patients admitted to the intensive care unit with invasive intracranial pressure (ICP) monitoring. Patients with persistent ICP > 22 mmHg in the early postoperative period (first 6 h) were excluded to focus on IH events that had not yet occurred. ICP-related data from the initial 6 h were used to extract linear (ICP, cerebral perfusion pressure, pressure reactivity index, and cerebrospinal fluid compensatory reserve index) and nonlinear features (complexity of ICP and cerebral perfusion pressure). IH was defined as ICP > 22 mmHg for > 5 min, and severe IH (SIH) as ICP > 22 mmHg for > 1 h during the subsequent ICP monitoring period. RF models were then developed using baseline characteristics (age, sex, and initial Glasgow Coma Scale score) along with linear and nonlinear features. Fivefold cross-validation was performed to avoid overfitting. RESULTS The study included 69 patients. Forty-three patients (62.3%) experienced an IH event, of whom 30 (43%) progressed to SIH. The median time to IH events was 9.83 h, and to SIH events, it was 11.22 h. The RF model showed acceptable performance in predicting IH with an area under the curve (AUC) of 0.76 and excellent performance in predicting SIH (AUC = 0.84). Cross-validation analysis confirmed the stability of the results. CONCLUSIONS The presented RF model can forecast subsequent IH events, particularly severe ones, in TBI patients using ICP data from the early postoperative period. It provides researchers and clinicians with a potentially predictive pathway and framework that could help triage patients requiring more intensive neurological treatment at an early stage.
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Affiliation(s)
- Jun Zhu
- Department of Neurosurgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Yingchi Shan
- Department of Neurosurgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Yihua Li
- Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Xuxu Xu
- Department of Neurosurgery, Minhang Hospital Fudan University, Shanghai, 201199, China
| | - Xiang Wu
- Department of Neurosurgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Yajun Xue
- Department of Neurosurgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China.
| | - Guoyi Gao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
- Neurotrauma Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, 100070, China.
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Wu Y, Sinclair G, Avanasi R, Pecquet A. Physiologically based kinetic (PBK) modeling of propiconazole using a machine learning-enhanced read-across approach for interspecies extrapolation. ENVIRONMENT INTERNATIONAL 2024; 189:108804. [PMID: 38857551 DOI: 10.1016/j.envint.2024.108804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 06/12/2024]
Abstract
A significant challenge in the traditional human health risk assessment of agrochemicals is the uncertainty in quantifying the interspecies differences between animal models and humans. To work toward a more accurate and animal-free risk determination, new approaches such as physiologically based kinetic (PBK) modeling have been used to perform dosimetry extrapolation from animals to humans. However, the regulatory use and acceptance of PBK modeling is limited for chemicals that lack in vivo animal pharmacokinetic (PK) data, given the inability to evaluate models. To address these challenges, this study developed PBK models in the absence of in vivo PK data for the fungicide propiconazole, an activator of constitutive androstane receptor (CAR)/pregnane X receptor (PXR). A fit-for-purpose read-across approach was integrated with hierarchical clustering - an unsupervised machine learning algorithm, to bridge the knowledge gap. The integration allowed the incorporation of a broad spectrum of attributes for analog consideration, and enabled the analog selection in a simple, reproducible, and objective manner. The applicability was evaluated and demonstrated using penconazole (source) and three pseudo-unknown target chemicals (epoxiconazole, tebuconazole and triadimefon). Applying this machine learning-enhanced read-across approach, difenoconazole was selected as the most appropriate analog for propiconazole. A mouse PBK model was developed and evaluated for difenoconazole (source), with the mode of action of CAR/PXR activation incorporated to simulate the in vivo autoinduction of metabolism. The difenoconazole mouse model then served as a template for constructing the propiconazole mouse model. A parallelogram approach was subsequently applied to develop the propiconazole rat and human models, enabling a quantitative assessment of interspecies differences in dosimetry. This integrated approach represents a substantial advancement toward refining risk assessment of propiconazole within the framework of animal alternative safety assessment strategies.
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Affiliation(s)
- Yaoxing Wu
- Product Safety, Syngenta Crop Protection LLC, Greensboro NC 27409, USA.
| | - Gabriel Sinclair
- Product Safety, Syngenta Crop Protection LLC, Greensboro NC 27409, USA
| | | | - Alison Pecquet
- Product Safety, Syngenta Crop Protection LLC, Greensboro NC 27409, USA
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Souza IND, Figueiredo PHS, Silva KLS, Ávila MR, Oliveira LFFD, Almeida ILGI, Silva WT, Lacerda ACR, Mendonça VA, Costa HS. Factors associated with clinical severity in chronic venous disease: The role of functional parameters. J Bodyw Mov Ther 2024; 39:258-262. [PMID: 38876636 DOI: 10.1016/j.jbmt.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/26/2023] [Accepted: 03/06/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION Chronic venous disease (CVD) is a highly prevalent disease that presents a wide spectrum of clinical expressions due to abnormalities in the venous system. Patients often have major functional changes that can limit daily activities. However, the functional factors associated with the severity of the disease remain poorly understood. OBJECTIVE To identify the functional factors associated with CVD severity. METHODS Seventy-five patients with CVD (92.0% females, 49.6 ± 13.3 years) were evaluated through clinical examination, lower limb perimetry, ankle range of motion (AROM), and lower limb muscle strength by the Heel Rise test, and Sit-to-stand test. Patients were stratified according to the disease severity as mild (telangiectasia, varicose veins, or edema in the lower limbs) or severe CVD (trophic changes or venous ulcer). RESULTS Patients with severe CVD (n = 13) were older (p = 0.002), predominantly male (p = 0.007), with reduced AROM in dorsiflexion (p = 0.028) and inversion (p = 0.009), reduced lower limb strength by the Heel Rise test (p = 0.040), and greater circumference of the calf (p = 0.020), ankle (p = 0.003), and plantar arch (p = 0.041) when compared to mild CVD (n = 62). Advanced age, male sex, lower ankle range of motion in dorsiflexion, and greater ankle and plantar arch circumferences were associated with CVD severity. However, the ankle circumference (OR 1.258, 95% CI: 1.008-1.570; p = 0.042), together with advanced age and male sex, was the only functional variable that remained independently associated with CVD severity. CONCLUSION The increased ankle circumference was a determinant of the CVD severity and may assist in risk stratification and guide treatment goals in this population.
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Affiliation(s)
- Iara Nepomuceno de Souza
- Physiotherapy Department, Biological and Health Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Pedro Henrique Scheidt Figueiredo
- Physiotherapy Department, Biological and Health Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Keity Lamary Souza Silva
- Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Matheus Ribeiro Ávila
- Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Lucas Fróis Fernandes de Oliveira
- Physiotherapy Department, Biological and Health Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Igor Lucas Geraldo Izalino Almeida
- Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Whesley Tanor Silva
- Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Physiotherapy Department, Biological and Health Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Vanessa Amaral Mendonça
- Physiotherapy Department, Biological and Health Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Henrique Silveira Costa
- Physiotherapy Department, Biological and Health Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil.
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Numakura K, Sekine Y, Osawa T, Naito S, Tokairin O, Muto Y, Sobu R, Kobayashi M, Sasagawa H, Yamamoto R, Nara T, Saito M, Narita S, Akashi H, Tsuchiya N, Shinohara N, Habuchi T. The lymphocyte-to-monocyte ratio as a significant inflammatory marker associated with survival of patients with metastatic renal cell carcinoma treated using nivolumab plus ipilimumab therapy. Int J Clin Oncol 2024; 29:1019-1026. [PMID: 38797782 DOI: 10.1007/s10147-024-02538-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 04/14/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Nivolumab plus ipilimumab (NIVO + IPI) is the first-line treatment for patients with metastatic renal cell carcinoma (mRCC). While approximately 40% of patients treated with NIVO + IPI achieve a durable response, 20% develop primary resistance with severe consequences. Therefore, there is a clinical need for criteria to select patients suitable for NIVO + IPI therapy to optimize its therapeutic efficacy. Accordingly, our aim was to evaluate the association between candidate biomarkers measured before treatment initiation and survival. METHODS This was a multi-institutional, retrospective, cohort study of 183 patients with mRCC treated with systematic therapies between August 2015 and July 2023. Of these, 112 received NIVO + IPI as first-line therapy: mean age, 68 years; men, 83.0% (n = 93), and clear cell histology, 80.4% (n = 90). Univariable and multivariable analyses were used to evaluate associations between biomarkers and survival. RESULTS On univariate analysis, high C-reactive protein and systemic index, a high neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio, and a low lymphocyte-to-monocyte ratio (LMR) were associated with shorter overall survival (OS). On multivariable analysis, a LMR ≤ 3 was retained as an independent factor associated to shorter OS with the highest accuracy (C-index, 0.656; hazard ratio, 7.042; 95% confidence interval, 2.0-25.0; p = 0.002). CONCLUSION A low LMR may identify patients who would be candidate for NIVO + IPI therapy for mRCC.
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Affiliation(s)
- Kazuyuki Numakura
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
| | - Yuya Sekine
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Takahiro Osawa
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Sei Naito
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ojiro Tokairin
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Yumina Muto
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Ryuta Sobu
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Mizuki Kobayashi
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Hajime Sasagawa
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Ryohei Yamamoto
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Taketoshi Nara
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Mitsuru Saito
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Shintaro Narita
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Hideo Akashi
- Department of Anatomy, Akita University Graduate School of Medicine, Akita, Japan
| | - Norihiko Tsuchiya
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Nobuo Shinohara
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
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Pätzmann N, O'Dwyer PJ, Beránek J, Kuentz M, Griffin BT. Predictive computational models for assessing the impact of co-milling on drug dissolution. Eur J Pharm Sci 2024; 198:106780. [PMID: 38697312 DOI: 10.1016/j.ejps.2024.106780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 04/12/2024] [Accepted: 04/27/2024] [Indexed: 05/04/2024]
Abstract
Co-milling is an effective technique for improving dissolution rate limited absorption characteristics of poorly water-soluble drugs. However, there is a scarcity of models available to forecast the magnitude of dissolution rate improvement caused by co-milling. Therefore, this study endeavoured to quantitatively predict the increase in dissolution by co-milling based on drug properties. Using a biorelevant dissolution setup, a series of 29 structurally diverse and crystalline drugs were screened in co-milled and physically blended mixtures with Polyvinylpyrrolidone K25. Co-Milling Dissolution Ratios after 15 min (COMDR15 min) and 60 min (COMDR60 min) drug release were predicted by variable selection in the framework of a partial least squares (PLS) regression. The model forecasts the COMDR15 min (R2 = 0.82 and Q2 = 0.77) and COMDR60 min (R2 = 0.87 and Q2 = 0.84) with small differences in root mean square errors of training and test sets by selecting four drug properties. Based on three of these selected variables, applicable multiple linear regression equations were developed with a high predictive power of R2 = 0.83 (COMDR15 min) and R2 = 0.84 (COMDR60 min). The most influential predictor variable was the median drug particle size before milling, followed by the calculated drug logD6.5 value, the calculated molecular descriptor Kappa 3 and the apparent solubility of drugs after 24 h dissolution. The study demonstrates the feasibility of forecasting the dissolution rate improvements of poorly water-solube drugs through co-milling. These models can be applied as computational tools to guide formulation in early stage development.
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Affiliation(s)
- Nicolas Pätzmann
- School of Pharmacy, University College Cork, Cork, Ireland; Department Preformulation and Biopharmacy, Zentiva, k.s., Prague, Czechia
| | | | - Josef Beránek
- Department Preformulation and Biopharmacy, Zentiva, k.s., Prague, Czechia
| | - Martin Kuentz
- Institute of Pharma Technology, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland
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Uwumiro FE, Anighoro SO, Bojerenu MM, Akpabio NN, Asogwa SU, Okpujie V, Alemenzohu H, Ufuah OD, Okoro MC, Kanu IM, Ayantoyinbo T, Lawal RA. Preventive Antibiotic Use and Complications After Endoscopic Retrograde Cholangiopancreatography in Patients Hospitalized for Primary Sclerosing Cholangitis. Cureus 2024; 16:e64429. [PMID: 39131042 PMCID: PMC11317107 DOI: 10.7759/cureus.64429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND The American Society for Gastrointestinal Endoscopy recommends prophylactic antibiotics before endoscopic retrograde cholangiopancreatography (ERCP) in primary sclerosing cholangitis (PSC). We assessed the impact of this approach on the incidence of post-ERCP outcomes using nationwide data. METHODS Using 2015-2021 Nationwide Inpatient Sample data and relevant ICD-10 codes, we analyzed adult hospitalizations for PSC who underwent ERCP, with and without antibiotic prophylaxis. Hierarchical multivariate logistic regression analysis was used to assess the association between prophylactic antibiotic use and post-ERCP complications including sepsis, acute cholangitis, and acute pancreatitis. RESULTS We analyzed 32,972 hospitalizations for PSC involving ERCP, with 12,891 admissions (39.1%) receiving antibiotics before ERCP (cases) and 20,081 (60.9%) serving as controls. Cases were older than controls (mean age: 64.2 ± 8.6 vs. 61.3 ± 6.1 years; P = 0.020). Compared with controls, hospitalizations with antibiotic prophylaxis had a higher male population (7,541 (58.5%) vs. 11,265 (56.1%); P < 0.001) and higher comorbidity burden (Charlson comorbidity index score of ≥2: 5,867 (45.5%) of cases vs. 8,996 (44.8%) of controls; P = 0.01). Incidence of post-ERCP septicemia was 19.1% (6,275) with 2,935 incidences (22.8%) among cases compared with 3,340 (16.6%) among controls. Antibiotic prophylaxis did not significantly improve the odds of septicemia (aOR: 0.85; 95% CI: 0.77 - 1.09; P = 0.179). Approximately 2,271 (6.9%) cases of acute cholangitis and 5,625 (17.1%) cases of acute post-ERCP pancreatitis were recorded. After adjustments for multiple variables, no significant difference was observed in the odds of cholangitis (aOR: 0.87; 95% CI: 0.98 - 1.45; P = 0.08). However, antibiotic prophylaxis was correlated with a statistically significant reduction in the odds ratio of acute post-ERCP pancreatitis (aOR: 0.61; 95% CI: 0.57 - 0.66; P < 0.001). CONCLUSION The use of antibiotic prophylaxis in hospitalizations with PSC was correlated with a significant reduction in the odds of post-ERCP pancreatitis. Antibiotic prophylaxis did not improve the odds of post-ERCP sepsis or cholangitis. Prophylactic use of antibiotics should be individualized, considering both their anti-infective benefits and potential impact on the biochemical markers of liver disease.
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Affiliation(s)
| | - Solomon O Anighoro
- General Medicine, St. Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, GBR
| | - Michael M Bojerenu
- Internal Medicine, St. Barnabas Hospital SBH Heath System, New York, USA
| | - Nsikan N Akpabio
- Medicine and Surgery, Bingham University Teaching Hospital, Jos, NGA
| | - Samuel U Asogwa
- Internal Medicine, London North West University Healthcare NHS Trust, Harrow, GBR
| | | | - Hillary Alemenzohu
- Internal Medicine, College of Medicine, University of Ibadan, Ibadan, NGA
| | | | - Miracle C Okoro
- Internal Medicine, Imo State University College of Medicine, Owerri, NGA
| | | | - Tosin Ayantoyinbo
- Internal Medicine, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Ogun State, NGA
| | - Ridwan A Lawal
- Internal Medicine, College of Medicine, University of Lagos, Lagos, NGA
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Achour J, Abulizi D, Makinson A, Arvieux C, Bonnet F, Goujard C, Lambert O, Slama L, Blain H, Meyer L, Allavena C. One-Year Frailty Transitions Among Persons With HIV Aged 70 Years or Older on Antiretroviral Treatment. Open Forum Infect Dis 2024; 11:ofae229. [PMID: 38966850 PMCID: PMC11222971 DOI: 10.1093/ofid/ofae229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/24/2024] [Indexed: 07/06/2024] Open
Abstract
Background People with HIV (PWH) are aging. Frailty is an age-related condition predictive of hospitalization and mortality. Here, we assessed the frequency and factors associated with frailty transitions at 1-year follow-up in elderly PWH. Methods Five hundred eight PWH aged 70 years or older who were on antiretroviral treatment were included in the French multicenter SEPTAVIH study in 2019-2020. Participants were classified as robust, prefrail, or frail according to Fried frailty phenotype at baseline and at 1 year. Logistic regression models were used to evaluate socioeconomic and medical factors associated with transition between frailty states. Models were adjusted for gender, age at baseline, education, and period of HIV diagnosis (before vs after 1996). Results Seventeen PWH died during the 1-year follow-up. Of the remaining 491 PWH (median age, 73 years), frailty status worsened for 18% of participants and improved for 14% at 1 year. Advanced age, baseline CD4+ T-cell count <350 cells/mm3, and type 2 diabetes were associated with transition from prefrailty to frailty (adjusted odds ratio [aOR], 1.10 per 1-year positive difference; 95% CI, 1.01-1.20; aOR, 3.05; 95% CI, 1.14-8.18; and aOR, 2.63; 95% CI, 1.05-6.57; respectively). Being female was associated with more frequent improvement from prefrailty to robustness (aOR, 2.50; 95% CI, 1.09-5.55). Conclusions Preventing frailty in elderly PWH is a long-term problem, beginning with the early diagnosis of HIV infection and the management of comorbidities.
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Affiliation(s)
- Jannett Achour
- INSERM CESP, U1018, Paris-Saclay University, Le Kremlin-Bicêtre, France
- Public Health Department, Bicêtre University Hospital, AP-HP, Le Kremlin-Bicêtre, France
| | - Diane Abulizi
- INSERM CESP, U1018, Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - Alain Makinson
- Infectious Diseases Department, Montpellier University Hospital, Montpellier, France
| | - Cédric Arvieux
- Infectious Diseases Department, Rennes University Hospital, Rennes, France
| | - Fabrice Bonnet
- Internal Medicine Department, Bordeaux University Hospital, Bordeaux, France
| | - Cécile Goujard
- INSERM CESP, U1018, Paris-Saclay University, Le Kremlin-Bicêtre, France
- Internal Medicine Department, Bicêtre University Hospital, AP-HP, Le Kremlin-Bicêtre, France
| | - Oriane Lambert
- INSERM CESP, U1018, Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - Laurence Slama
- Infectious Diseases Department, Hôtel-Dieu Hospital, AP-HP, Paris, France
| | - Hubert Blain
- Geriatrics Department, Montpellier University Hospital, Montpellier, France
| | - Laurence Meyer
- INSERM CESP, U1018, Paris-Saclay University, Le Kremlin-Bicêtre, France
- Public Health Department, Bicêtre University Hospital, AP-HP, Le Kremlin-Bicêtre, France
| | - Clotilde Allavena
- INSERM, EA1413, Nantes, France
- Infectious Diseases Department, Nantes University Hospital, Nantes, France
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Ho LYW, Lai CYY, Lai CKY, Ng SSM. Fatigue predicts level of community integration in people with stroke. Top Stroke Rehabil 2024; 31:464-473. [PMID: 38176421 DOI: 10.1080/10749357.2023.2298536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND The independent predictive power of fatigue for community integration has not been investigated, although there is an increasing amount of literature that recognizes the importance of fatigue in people with stroke. OBJECTIVES To examine the correlation between community integration and fatigue, walking endurance, and fear of falling; and to quantify the relative contribution of fatigue to community integration in people with stroke. METHODS This was a cross-sectional study with 75 community-dwelling people with stroke. Data were collected using the Community Integration Measure (CIM), Fatigue Assessment Scale (FAS), 6-minute walk test (6MWT), and Survey of Activities and Fear of Falling in the Elderly (SAFE). Multiple linear regressions (forced entry method) were used to quantify the relative power of the FAS score to predict community integration in a model covering distance in the 6MWT and the SAFE score. RESULTS After controlling for age, the CIM score significantly correlated with the scores for FAS (r=-0.48, p < 0.001), 6MWT distance (r = 0.24, p = 0.039), and SAFE (r=-0.39, p = 0.001). The entire model, including age, FAS score, 6MWT distance, and SAFE score, explained 26.1% of the variance in the CIM scores (F [4, 70] = 7.52, p < 0.001). The FAS scores independently explained 10.6% of the variance in the CIM scores. CONCLUSIONS This study suggests that fatigue is an independent predictor of community integration among people with stroke, taking into account walking endurance and fear of falling.
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Affiliation(s)
- Lily Y W Ho
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Cynthia Y Y Lai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Claudia K Y Lai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Chanda P, Chirwa M, Mwale AT, Nakazwe KC, Kabembo IM, Nkole B. Perceived Social Support and Health Care Spending as Moderators in the Association of Traditional Bullying Perpetration with Traditional Bullying and Cyberbullying Victimisation among Adolescents in 27 European Countries: A Multilevel Cross-National Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:863. [PMID: 39063440 PMCID: PMC11276897 DOI: 10.3390/ijerph21070863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024]
Abstract
Existing research has documented the association between bullying perpetration and bullying victimisation. However, it is still unclear how different sources of social support moderate the association between bullying perpetration and bullying victimisation at a cross-national level. Using multilevel binary logistic regression models, this study examined the moderating role of public health care spending and perceived social support (i.e., family and teacher support) in the association between traditional bullying perpetration and victimisation by traditional bullying and cyberbullying among adolescents across 27 European countries. Country-level data were combined with 2017/18 Health Behaviour in School-aged Children (HBSC) survey data from 162,792 adolescents (11-, 13-, and 15-year-olds) in 27 European countries. Results showed that adolescents who perpetrated traditional bullying had a higher likelihood of being victimised by traditional bullying and cyberbullying than adolescents who did not bully others. Results also indicated that the magnitude of the positive association between traditional bullying perpetration and victimisation by traditional bullying and cyberbullying was mitigated among adolescents with more family, teacher, and public health care support. These findings support the notion that multilayered systems of social support could play a vital role in bullying prevention and intervention strategies to address bullying among adolescents.
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Affiliation(s)
- Patrick Chanda
- Department of Social Work and Sociology, School of Humanities and Social Sciences, University of Zambia, Great East Road Campus, Lusaka P.O. Box 32379, Zambia; (P.C.); (A.T.M.); (I.M.K.)
- School of Graduate Studies, Lingnan University, 8 Castle Peak Road, Tuen Mun, Hong Kong, China
| | - Masauso Chirwa
- Department of Social Work and Sociology, School of Humanities and Social Sciences, University of Zambia, Great East Road Campus, Lusaka P.O. Box 32379, Zambia; (P.C.); (A.T.M.); (I.M.K.)
- Department of Social Policy and Social Security Studies, Hochschule Bonn-Rhein-Sieg University of Applied Sciences, Grantham Allee 20, 53757 Sankt Augustin, Germany
| | - Ackson Tyson Mwale
- Department of Social Work and Sociology, School of Humanities and Social Sciences, University of Zambia, Great East Road Campus, Lusaka P.O. Box 32379, Zambia; (P.C.); (A.T.M.); (I.M.K.)
| | - Kalunga Cindy Nakazwe
- Department of Psychology, School of Humanities and Social Sciences, University of Zambia, Great East Road Campus, Lusaka P.O. Box 32379, Zambia;
| | - Ireen Manase Kabembo
- Department of Social Work and Sociology, School of Humanities and Social Sciences, University of Zambia, Great East Road Campus, Lusaka P.O. Box 32379, Zambia; (P.C.); (A.T.M.); (I.M.K.)
- Department of Sociology and Social Policy, Lingnan University, 8 Castle Peak Road, Tuen Mun, Hong Kong, China
| | - Bruce Nkole
- Ministry of Education, Kasama P.O. Box 410175, Zambia;
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Qiu J, Huang X, Kuang M, Yang R, Li J, Sheng G, Zou Y. Lipoprotein Combine Index as a Better Marker for NAFLD Identification Than Traditional Lipid Parameters. Diabetes Metab Syndr Obes 2024; 17:2583-2595. [PMID: 38946912 PMCID: PMC11214567 DOI: 10.2147/dmso.s462181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 06/20/2024] [Indexed: 07/02/2024] Open
Abstract
Purpose The association between traditional lipid parameters and non-alcoholic fatty liver disease (NAFLD) has been extensively discussed. This study aims to evaluate and compare the lipoprotein combine index (LCI) and traditional lipid parameters [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)] to identify NAFLD. Patients and Methods The analysis included 14,251 participants from the NAfld in the Gifu Area, Longitudinal Analysis (NAGALA). Logistic regression models were employed to calculate standardized odds ratios (ORs) and 95% confidence intervals (CIs) for assessing and comparing the association of LCI and traditional lipid parameters with NAFLD. Additionally, receiver operating characteristic (ROC) curves were used to calculate the area under the curve (AUC) for LCI and traditional lipid parameters in identifying NAFLD. Results After adjusting for various confounders, we found that LCI was positively associated with NAFLD (OR=2.25, 95% CI 1.92-2.63), and this association was stronger than that of traditional lipid parameters [OR: TC1.23, TG1.73 LDL-C1.10]. Further subgroup analyses revealed that the association of LCI with NAFLD was stronger than other traditional lipid parameters in all subgroups, including men and women, overweight/obese [body mass index (BMI)≥25 kg/m2] and non-obese (BMI<25 kg/m2), and older (age≥45 years) and younger (age<45 years) participants. Additionally, ROC analysis indicated that LCI (AUC=0.8118) had significantly higher accuracy (All DeLong P<0.05) in identifying NAFLD compared to traditional lipid parameters (AUC: TC0.6309; TG0.7969; LDL-C0.6941); HDL-C0.7587). Sensitivity analysis further confirmed the robustness of the study findings. Conclusion This study revealed for the first time a positive correlation between LCI and NAFLD. Compared to traditional lipid parameters, LCI has a higher correlation with NAFLD. Additionally, further ROC analysis demonstrated that LCI had higher accuracy in identifying NAFLD compared to traditional lipid parameters, suggesting that LCI may be a better marker for NAFLD identification than traditional lipid parameters.
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Affiliation(s)
- Jiajun Qiu
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, People’s Republic of China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, People’s Republic of China
- Jiangxi Cardiovascular Research Institute, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, People’s Republic of China
| | - Xin Huang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, People’s Republic of China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, People’s Republic of China
- Jiangxi Cardiovascular Research Institute, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, People’s Republic of China
| | - Maobin Kuang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, People’s Republic of China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, People’s Republic of China
- Jiangxi Cardiovascular Research Institute, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, People’s Republic of China
| | - Ruijuan Yang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, People’s Republic of China
- Department of Endocrinology, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, People’s Republic of China
| | - Jiachong Li
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, People’s Republic of China
| | - Guotai Sheng
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, People’s Republic of China
- Jiangxi Provincial Geriatric Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, People’s Republic of China
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, People’s Republic of China
- Jiangxi Cardiovascular Research Institute, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, People’s Republic of China
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Liberty IA, Septadina IS, Mariana, Novita E, Amalia R, Ananingsih ES, Hasyim H, Hanifah L. The characteristics and risk of obesity central and concomitant impaired fasting glucose: Findings from a cross-sectional study. PLoS One 2024; 19:e0305604. [PMID: 38917085 PMCID: PMC11198825 DOI: 10.1371/journal.pone.0305604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 06/03/2024] [Indexed: 06/27/2024] Open
Abstract
INTRODUCTION Obesity is associated with concomitant chronic conditions. An early metabolic consequence of obesity is disruption of glucose and insulin homeostasis. One of the consequences is impaired fasting glucose (IFG). Visceral fat is metabolically more harmful than subcutaneous fat, but few information is available regarding the association between the risk of abnormal glucose in increased waist circumference. METHODS This study is based on a cross sectional of 1,381 population-based from Palembang, Indonesia. The eligibility requirements subject were to be older than 18 and consent to taking fasting glucose and lipid profile tests as well as physical exams measuring their body weight, height, blood pressure, abdominal circumference, and waist circumference. RESULTS The number of subjects consisting of 798 noncentral obesity with normoglycemia, 376 central obesity with normoglycemia, and 207 central obesity with concomitant IFG. The prevalence central obesity with concomitant IFG was 35.51%. In subjects with central obesity, there were significant differences in proportions based on sex, age, marital status, education, and occupation. In multivariate analysis show that the risk factors that contribute to having a significant association with central obesity with concomitant IFG are sex (female), age (>40 years), blood pressure (hypertension), and HDL-C <50 mg/dL (p<0.001). The analysis also founded that there was a significant difference in the dietary pattern of sweet foods (p = 0.018), sweet drinks (p = 0.002), soft drinks (p = 0.001) and smoking habit (p<0.001) between subjects with obesity central and concomitant IFG compared to subjects with noncentral obesity. The majority of subjects with obesity central and concomitant IFG had consuming these risky foods >6 times/week. CONCLUSION The prevalence of central obesity with IFG is quite high. There are significant differences in the characteristics, lipid profile, blood pressure, dietary pattern, and smoking habit of central obesity with concomitant IFG was confirmed in this population-based observational study.
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Affiliation(s)
- Iche Andriyani Liberty
- Department of Public Health and Community Medicine, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
| | - Indri Seta Septadina
- Department of Anatomy, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
| | - Mariana
- Department of Public Health and Community Medicine, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
| | - Emma Novita
- Department of Anatomy, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
| | - Resi Amalia
- Faculty of Medicine, Universitas Muhammadiyah, Palembang, Indonesia
| | | | - Hamzah Hasyim
- Faculty of Public Health, Universitas Sriwijaya, Palembang, Indonesia
| | - Laily Hanifah
- Universitas Pembangunan Nasional Veteran Jakarta, Jakarta, Indonesia
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