11051
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Non-Preferred Work and the Incidence of Spinal Pain and Psychological Distress-A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910051. [PMID: 34639355 PMCID: PMC8508031 DOI: 10.3390/ijerph181910051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/24/2022]
Abstract
Mental illness and psychological distress are global concerns. This study aimed to investigate the association between having non-preferred work and the incidence of spinal pain, psychological distress, and spinal pain with concurrent psychological distress, and if associations are modified by sleep disturbance. A prospective study of 4285 participants 23-62 years old was conducted, from years 2007 to 2010. Participants reported their work situation as preferred/non-preferred regarding profession/workplace with a high/low possibility to change. Psychological distress was measured with the General Health Questionnaire 12 and spinal pain with questions about neck/back pain. Binominal regression analyses calculated relative risk (RR) with 95% confidence interval (CI). Non-preferred work with a low possibility to change was associated with a higher incidence of spinal pain (RR 1.8; 95% CI 1.2-2.6) and psychological distress (RR 1.8; 95% CI 1.4-2.4) compared to preferred work. The RR was 1.4 (95% CI 0.9-2.1) for spinal pain and 1.3 (95% CI 1.0-1.7) for psychological distress among those with a high possibility to change. Non-preferred work yielded a higher incidence of spinal pain with concurrent psychological distress (RR 1.9; 95% CI 1.0-3.7). Sleep disturbance did not modify associations. A replication based on newer data is needed to confirm the results. In conclusion, non-preferred work is associated with a higher incidence of spinal pain and psychological distress, especially if the possibility to change job is low.
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11052
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Haas R, Busija L, Gorelik A, O'Connor DA, Pearce C, Mazza D, Buchbinder R. Patterns of care for people presenting to Australian general practice with musculoskeletal complaints based on routinely collected data: protocol for an observational cohort study using the Population Level Analysis and Reporting (POLAR) database. BMJ Open 2021; 11:e055528. [PMID: 34561264 PMCID: PMC8475141 DOI: 10.1136/bmjopen-2021-055528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/06/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION General practice is integral to the Australian healthcare system. Outcome Health's POpulation Level Analysis and Reporting (POLAR) database uses de-identified electronic health records to analyse general practice data in Australia. Previous studies using routinely collected health data for research have not consistently reported the codes and algorithms used to describe the population, exposures, interventions and outcomes in sufficient detail to allow replication. This paper reports a study protocol investigating patterns of care for people presenting with musculoskeletal conditions to general practice in Victoria, Australia. Its focus is on the systematic approach used to classify and select eligible records from the POLAR database to facilitate replication. This will be useful for other researchers using routinely collected health data for research. METHODS AND ANALYSIS This is a retrospective cohort study. Patient-related data will be obtained through electronic health records from a subset of general practices across three primary health networks (PHN) in southeastern Victoria. Data for patients with a low back, neck, shoulder and/or knee condition and who received at least one general practitioner (GP) face-to-face consultation between 1 January 2014 and 31 December 2018 will be included. Data quality checks will be conducted to exclude patients with poor data recording and/or non-continuous follow-up. Relational data files with eligible and valid records will be merged to select the study cohort and the GP care received (consultations, imaging requests, prescriptions and referrals) between diagnosis and 31 December 2018. Number and characteristics of patients and GPs, and number, type and timing of imaging requests, prescriptions for pain relief and referrals to other health providers will be investigated. ETHICS AND DISSEMINATION Ethics approval was obtained from the Cabrini and Monash University Human Research Ethics Committees (Reference Numbers 02-21-01-19 and 16975, respectively). Study findings will be reported to Outcome Health, participating PHNs, disseminated in academic journals and presented in conferences.
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Affiliation(s)
- Romi Haas
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Monash-Cabrini Department of Musculoskeletal Health and Clinical Epidemiology, Cabrini Health, Malvern, Victoria, Australia
| | - Ljoudmila Busija
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alexandra Gorelik
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Monash-Cabrini Department of Musculoskeletal Health and Clinical Epidemiology, Cabrini Health, Malvern, Victoria, Australia
| | - Denise A O'Connor
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Monash-Cabrini Department of Musculoskeletal Health and Clinical Epidemiology, Cabrini Health, Malvern, Victoria, Australia
| | | | - Danielle Mazza
- Department of General Practice, Monash University, Notting Hill, Victoria, Australia
| | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Monash-Cabrini Department of Musculoskeletal Health and Clinical Epidemiology, Cabrini Health, Malvern, Victoria, Australia
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11053
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Chen Q, Liu Y, Chen L, Chen J, Yang T, Cheng Q, Li T. Vitamin A Levels Among Pre-School Children of Central and Western China. Front Public Health 2021; 9:694106. [PMID: 34552903 PMCID: PMC8450327 DOI: 10.3389/fpubh.2021.694106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/09/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate vitamin A deficiency of pre-school children in central and western China for developing strategies to prevent and control vitamin A deficiency (VAD) among children. Design: From November 2018 to September 2019, a total of 2,194 healthy children aged 2-6 years were enrolled. Serum retinol levels in the children were detected by liquid-phase tandem mass spectrometry. In addition, social demographic and dietary questionnaires were collected through interviews with children's caregivers. Setting: The participants were enrolled in 12 cities or their subordinate jurisdictions in the central and western regions of China. Participants: Two thousand one hundred and ninety four healthy children aged 2-6 years old. Results: Overall, 35.51% (779/2,194) of the children were found to be vitamin A insufficient (VAI, serum retinol < 1.05 μmol/L). Elder children had a higher risk to suffer from VAI, with proportions of 25.00% (87/348), 28.92% (142/491), 38.38% (256/667), and 42.73% (294/688) among children aged 2, 3, 4, and 5 years, respectively. Vitamin A levels were also positively correlated with per capita income (AOR = 1.18) and regional economic level (0.71), and the frequency of milk intake (0.91). Conclusions: The incidence of VAI was higher among children aged 2-6 years, and the incidence of VAI increases with age. VA levels were positively correlated with levels of economic development in the family and region. So prevention strategies for VAD need to focus on pre-school children, especially dairy intake and developing regions.
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Affiliation(s)
- Qian Chen
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
| | - Yongfang Liu
- Department of Nutrition, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Li Chen
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
| | - Jie Chen
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
| | - Ting Yang
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
| | - Qian Cheng
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
| | - Tingyu Li
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
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11054
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Pengpid S, Peltzer K. Prevalence and associated factors of self-reported ischaemic heart disease and/or stroke: a cross-sectional nationally representative community-based study of adults in Malawi in 2017. BMJ Open 2021; 11:e048167. [PMID: 34556509 PMCID: PMC8461691 DOI: 10.1136/bmjopen-2020-048167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE This study aimed to assess the prevalence and associated factors of self-reported ischaemic heart disease (IHD) and/or stroke among adults in Malawi. DESIGN Population-based cross-sectional study. SETTING Nationally representative sample of general adult population in Malawi. PARTICIPANTS The sample included 4187 persons aged 18-69 years (32 years of median age) that participated in the '2017 Malawi STEPwise Approach to Non-Communicable Disease Risk-Factor Surveillance survey.' PRIMARY AND SECONDARY OUTCOME MEASURES Self-reported history of IHD and/or stroke, along with biological, behavioural, psychosocial stress and sociodemographic covariates. Multivariable logistic regression calculated OR with 95% CI for IHD and/or stroke. RESULTS The prevalence of IHD and/or stroke was 6.5%, 4.4% among men and 8.4% among women. In adjusted logistic regression analysis, older age (50-69 years) (adjusted OR (AOR) 3.49, 95% CI 1.75 to 6.94), female sex (AOR 2.09, 95% CI 1.45 to 3.01), Chewa speaking (AOR 4.62, 95% CI 1.32 to 16.22), English speaking (AOR 5.63, 95% CI 1.43 to 22.19), suicidal ideation, plan and/or attempt (AOR 1.87, 95% CI 1.11 to 3.13) and sedentary behaviour (AOR 2.00, 95% CI 1.12 to 3.59) were associated with IHD and/or stroke. In addition, in unadjusted analysis, non-paid or unemployed, urban residence, overweight, obesity and having hypertension were associated with IHD and/or stroke. CONCLUSIONS Almost 1 in 10 women and 1 in 20 men aged 18-69 years had IHD and/or stroke in Malawi. Several risk and protective factors were found that can be targeted in population health interventions.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Nakhon Pathom, Thailand
- Department of Research Administration and Development, University of Limpopo, Sovenga, Limpopo, South Africa
| | - Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Sovenga, Limpopo, South Africa
- Department of Psychology, Asia University, Taichung, Taiwan
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11055
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Hoffmann B, Boogaard H, de Nazelle A, Andersen ZJ, Abramson M, Brauer M, Brunekreef B, Forastiere F, Huang W, Kan H, Kaufman JD, Katsouyanni K, Krzyzanowski M, Kuenzli N, Laden F, Nieuwenhuijsen M, Mustapha A, Powell P, Rice M, Roca-Barceló A, Roscoe CJ, Soares A, Straif K, Thurston G. WHO Air Quality Guidelines 2021-Aiming for Healthier Air for all: A Joint Statement by Medical, Public Health, Scientific Societies and Patient Representative Organisations. Int J Public Health 2021; 66:1604465. [PMID: 34630006 PMCID: PMC8494774 DOI: 10.3389/ijph.2021.1604465] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 12/16/2022] Open
Affiliation(s)
- Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Medical School, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | | | | | - Zorana J Andersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Michael Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | | | - Wei Huang
- Department of Occupational and Environmental Health, Peking University, Beijing, China
| | - Haidong Kan
- School of Public Health, Fudan University, Shanghai, China
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
| | - Klea Katsouyanni
- Imperial College London, London, United Kingdom
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Nino Kuenzli
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
| | - Francine Laden
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | | | - Adetoun Mustapha
- Imperial College London, London, United Kingdom
- Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Pippa Powell
- European Lung Foundation, Sheffield, United Kingdom
| | - Mary Rice
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | | | | | - Agnes Soares
- Pan American Health Organization, Washington D.C., DC, United States
| | - Kurt Straif
- Boston College, Chestnut Hill, MA, United States
| | - George Thurston
- Department of Population Health, New York University School of Medicine, New York City, NY, United States
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11056
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Wu Y, Zhao D, Guo J, Lai Y, Chen L, Jin S, Huang Y. Economic Burden of Depressive Symptoms Conditions among Middle-Aged and Elderly People with Hypertension in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910009. [PMID: 34639308 PMCID: PMC8508275 DOI: 10.3390/ijerph181910009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/11/2021] [Accepted: 09/18/2021] [Indexed: 12/21/2022]
Abstract
People with hypertension are more prone to incur depressive symptoms, while depressive symptoms have an obvious influence on the healthy functioning, treatment, and management of hypertensive patients. However, there have been limited studies on the association between depression and the economic burden of hypertension. We used data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) to estimate the additional annual direct and indirect economic burden of depressive symptoms among middle-aged and elderly hypertensive patients with a multivariable regression model. The depressive symptoms were associated with substantial additional direct and indirect economic burden. Compared with non-co-MHDS (non-co-morbid hypertension and depressive symptoms) patients, the direct economic burden of lower co-MHDS (co-morbid hypertension and depressive symptoms) patients and higher co-MHDS patients increased 1887.4 CNY and 5508.4 CNY, respectively. For indirect economic burden, the lower co-MHDS patients increased 331.2 CNY and the higher co-MHDS patients increased 636.8 CNY. Both direct and indirect economic burden were incremental with the aggravation of depressive symptoms. The results showed depressive symptoms increased total healthcare costs by increasing the utilization and expenditure of primary healthcare services. Depressive symptoms also led to economic loss of productivity, especially for agricultural workers. This study highlights the importance of mental healthcare for hypertensive patients.
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Affiliation(s)
- Yun Wu
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China; (Y.W.); (D.Z.); (J.G.); (L.C.); (S.J.)
| | - Dongbao Zhao
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China; (Y.W.); (D.Z.); (J.G.); (L.C.); (S.J.)
| | - Jianwei Guo
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China; (Y.W.); (D.Z.); (J.G.); (L.C.); (S.J.)
| | - Yingsi Lai
- Department of Health Medical Statistics, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China;
| | - Lijin Chen
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China; (Y.W.); (D.Z.); (J.G.); (L.C.); (S.J.)
| | - Sihui Jin
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China; (Y.W.); (D.Z.); (J.G.); (L.C.); (S.J.)
| | - Yixiang Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China; (Y.W.); (D.Z.); (J.G.); (L.C.); (S.J.)
- Correspondence: ; Tel.: +86-022-87333239
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11057
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Hassanipour S, Ghaem H, Seif M, Fararouei M, Sabetian G, Paydar S. Which criteria is a better predictor of ICU admission in trauma patients? An artificial neural network approach. Surgeon 2021; 20:e175-e186. [PMID: 34563451 DOI: 10.1016/j.surge.2021.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/02/2021] [Accepted: 08/19/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE One of the most critical concerns in the intensive care unit (ICU) section is identifying the best criteria for entering patients to this part. This study aimed to predict the best compatible criteria for entering trauma patients in the ICU section. METHOD The present study was a historical cohort study. The data were collected from 2448 trauma patients referring to Shahid Rajaee Hospital between January 2015 and January 2017 in Shiraz, Iran. The artificial neural network (ANN) models with cross-validation and logistic regression (LR) with a backward method was used for data analysis. The final analysis was performed on a total of 958 patients who were transferred to the ICU section. RESULTS Based on the present results, the motor component of the GCS score at each cutoff point had the highest importance. The results also showed better performance for the AUC and accuracy rate for ANN compared with LR. CONCLUSION The most critical indicators in predicting the optimal use of ICU services in this study were the Motor component of the GCS. Results revealed that the ANN had a better performance than the LR in predicting the main outcomes of the traumatic patients in both the accuracy and AUC index. Trauma section surgeons and ICU specialists will benefit from this study's results and can assist them in making decisions to predict the patient outcomes before entering the ICU.
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Affiliation(s)
- Soheil Hassanipour
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Haleh Ghaem
- Research Center for Health Sciences, Institute of Health, Non-communicable Diseases Research Center, Epidemiology Department, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Golnar Sabetian
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahram Paydar
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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11058
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Ma X, Zhu L, Kurche JS, Xiao H, Dai H, Wang C. Global and regional burden of interstitial lung disease and pulmonary sarcoidosis from 1990 to 2019: results from the Global Burden of Disease study 2019. Thorax 2021; 77:596-605. [PMID: 34556551 DOI: 10.1136/thoraxjnl-2020-216732] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 08/10/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Interstitial lung disease (ILD) and pulmonary sarcoidosis are common respiratory diseases with a heterogeneous distribution worldwide. The global burden and temporal trends of ILD and sarcoidosis are rarely explored. METHODS Using the classification 'ILD and pulmonary sarcoidosis' from the Global Burden of Disease 2019 dataset, we described the age-standardised rates of incidence, mortality, disability-adjusted life-years (DALYs), and their average annual percentage change from 1990 to 2019 by sex, Sociodemographic Index (SDI) and region. RESULTS In 2019, the global incidence and mortality of ILD and pulmonary sarcoidosis were 24.2 million and 169 833 cases, respectively. From 1990 to 2019, the global incidence, deaths and DALYs due to ILD and pulmonary sarcoidosis increased by 118.6%, 166.63% and 122.87% respectively. The global incidence of ILD and pulmonary sarcoidosis was higher in men and was mainly concentrated among persons aged 70‒79 of both sexes. Significant regional differences could be seen in the disease burden of ILD and pulmonary sarcoidosis: since 2006, high-SDI regions had higher age-standardised incidence rates but lower age-standardised death rates compared with the low-SDI regions. CONCLUSIONS Our study suggests the incidence, mortality and DALYs from ILD and pulmonary sarcoidosis are increasing globally. To reduce the ongoing burden of this condition, early diagnosis and treatment are vital, and more targeted and specific strategies should be established in high-burden regions. Differences in incidence and mortality across regions may reflect the influence of genetic, environmental, diagnostic, pharmacotherapeutic, and health system factors.
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Affiliation(s)
- Xiaoqian Ma
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Capital Medical University, Beijing, China.,National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, Beijing, China.,State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, National Centre for Respiratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lili Zhu
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Capital Medical University, Beijing, China.,National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, Beijing, China
| | - Jonathan S Kurche
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Huijuan Xiao
- National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, Beijing, China.,Department of Pulmonary and Critical Care Medicine, China-Japan Friendship School of Clinical Medicine, Peking University, Beijing, Beijing, China
| | - Huaping Dai
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Capital Medical University, Beijing, China .,National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, Beijing, China
| | - Chen Wang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Capital Medical University, Beijing, China .,National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, Beijing, China.,Department of Pulmonary and Critical Care Medicine, China-Japan Friendship School of Clinical Medicine, Peking University, Beijing, Beijing, China.,Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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11059
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Garmany A, Yamada S, Terzic A. Longevity leap: mind the healthspan gap. NPJ Regen Med 2021; 6:57. [PMID: 34556664 PMCID: PMC8460831 DOI: 10.1038/s41536-021-00169-5] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 09/02/2021] [Indexed: 02/08/2023] Open
Abstract
Life expectancy has increased by three decades since the mid-twentieth century. Parallel healthspan expansion has however not followed, largely impeded by the pandemic of chronic diseases afflicting a growing older population. The lag in quality of life is a recognized challenge that calls for prioritization of disease-free longevity. Contemporary communal, clinical and research trends aspiring to extend the health horizon are here outlined in the context of an evolving epidemiology. A shared action integrating public and societal endeavors with emerging interventions that target age-related multimorbidity and frailty is needed. A multidimensional buildout of a curative perspective, boosted by modern anti-senescent and regenerative technology with augmented decision making, would require dedicated resources and cost-effective validation to responsibly bridge the healthspan-lifespan gap for a future of equitable global wellbeing.
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Affiliation(s)
- Armin Garmany
- Center for Regenerative Medicine, Marriott Family Comprehensive Cardiac Regenerative Medicine, Marriott Heart Disease Research Program, Van Cleve Cardiac Regenerative Medicine Program, Mayo Clinic, Rochester, MN, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
- Mayo Clinic Alix School of Medicine, Regenerative Sciences Track, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, USA
| | - Satsuki Yamada
- Center for Regenerative Medicine, Marriott Family Comprehensive Cardiac Regenerative Medicine, Marriott Heart Disease Research Program, Van Cleve Cardiac Regenerative Medicine Program, Mayo Clinic, Rochester, MN, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Andre Terzic
- Center for Regenerative Medicine, Marriott Family Comprehensive Cardiac Regenerative Medicine, Marriott Heart Disease Research Program, Van Cleve Cardiac Regenerative Medicine Program, Mayo Clinic, Rochester, MN, USA.
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA.
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA.
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11060
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Cuschieri S, Grech S. Insight into the Occurrence of Common Non-communicable Diseases at a Population Level and the Potential Impact During the Coronavirus Pandemic - a Need for a Syndemic Healthcare Approach? SN COMPREHENSIVE CLINICAL MEDICINE 2021; 3:2393-2400. [PMID: 34568765 PMCID: PMC8455231 DOI: 10.1007/s42399-021-01064-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 12/27/2022]
Abstract
People suffering from non-communicable diseases (NCDs) are at an increased risk for severe Covid-19. The aim was to determine the burden of common NCDs at a population level, assess Covid-19 impact while exploring whether a syndemic approach is merited to deal with NCDs and Covid-19. Baseline data from a Malta national representative survey. Individuals with type 2 diabetes (T2DM), hypertension, cardiovascular disease, dyslipidaemia and overweight-obese status were considered. Prevalence for single disease and multimorbidity were used to estimate population burden. Covid-19 impact at a population level was estimated through local Covid-19 infectivity rates. Years of life lost (YLL) and mortality rate were calculated using Covid-19 data and compared to corresponding NCDs data reported by global burden of disease (GBD) study. Half the study population (n = 3947) had a single NCD while a third had multimorbidity. Of these, 6.55% were estimated to be at risk of Covid-19 and require admission. Covid-19 YLL over 12 months was 5228.54 years, which is higher than the estimated YLL for hypertension and T2DM by GBD study for Malta. Health systems and policies should be re-focused to accommodate both Covid-19 and NCDs simultaneously through a targeted syndemic approach with primary healthcare playing a central role. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s42399-021-01064-2.
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Affiliation(s)
- Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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11061
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Kariuki S, Wairimu C, Mbae C. Antimicrobial Resistance in endemic enteric infections in Kenya and the region, and efforts towards addressing the challenges. J Infect Dis 2021; 224:S883-S889. [PMID: 34550365 PMCID: PMC8687050 DOI: 10.1093/infdis/jiab457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Resistance to commonly available antimicrobials is a major threat to the fight against endemic bacterial diseases in sub-Saharan Africa, with a majority of the population unable to afford alternative effective antimicrobial options for management of these diseases. Diseases such as typhoid, cholera, and invasive nontyphoidal Salmonella are among the key enteric infections endemic in most parts of sub-Saharan Africa, especially in displaced populations and among the urban populations living in overcrowded informal settlements. Here, we explore the prevalence and the genomic epidemiology of these infections and the growing problem of multidrug resistance, including emerging resistance to the last line of treatment for these infections. Prevalence rates to commonly available antimicrobials, including ampicillin, chloramphenicol, cotrimoxazole, and tetracycline, now range between 65% and 80%, while 15%–20% of recently studied isolates show reduced susceptibility to fluoroquinolones and emerging resistance to extended-spectrum β-lactams mediated by the CTX-M-15 gene carried on a highly mobile genetic element. The high prevalence of multidrug-resistant isolates including resistance to reserve antibiotics, calls for enhanced control and management options. It will be important for governments in the region to enhance the implementation of national action plans, as guided by the global action plan championed by the World Health Organization, to combat the threat of antimicrobial resistance. However, to yield meaningful results, these efforts will require a strong commitment and enhancement at all levels of healthcare in order. In addition, the use of World Health Organization–approved vaccines in the short to medium term and improvement of water and sanitation in the long term will reduce the burden of disease and antimicrobial resistance in the region.
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Affiliation(s)
- Samuel Kariuki
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
- Correspondence: Samuel Kariuki, Centre for Microbiology Research, Kenya Medical Research Institute, Kenya, Off Mbagathi Road, PO Box 54840-00200, Nairobi, Kenya (); ()
| | - Celestine Wairimu
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Cecilia Mbae
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
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11062
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Ashton LM, Morgan PJ, Grounds JA, Young MD, Rayward AT, Barnes AT, Pollock ER, Kennedy SL, Saunders KL, Collins CE. Dietary Outcomes of the 'Healthy Youngsters, Healthy Dads' Randomised Controlled Trial. Nutrients 2021; 13:3306. [PMID: 34684307 PMCID: PMC8541030 DOI: 10.3390/nu13103306] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/10/2021] [Accepted: 09/20/2021] [Indexed: 11/24/2022] Open
Abstract
(1) Background: The effect of fathers on dietary intake in preschool-aged children is under-explored. The aims were to: (i) evaluate the efficacy of a family-based lifestyle intervention, Healthy Youngsters, Healthy Dads, on change in dietary intake in fathers and their preschool-aged children post-intervention (10 weeks) and at 9 months follow-up compared to a waitlist control group and (ii) investigate associations in father-child dietary intakes. (2) Methods: Linear mixed models estimated group-by-time effects for all dietary outcomes, measured by food frequency questionnaires. Cohen's d determined effect sizes, while correlation tests determined associations in father-child dietary intakes. (3) Results: For children, medium group-by-time effects sizes were identified at 10 weeks for sodium intake (d = 0.38) and percentage energy from core foods (d = 0.43), energy-dense, nutrient-poor (EDNP) foods (d = 0.43) and prepacked snacks (d = 0.45). These findings were sustained at 9 months follow-up. For fathers, medium to large, group-by-time effect sizes were identified at 10 weeks for energy intake (d = 0.55), sodium intake (d = 0.64) and percentage energy from core foods (d = 0.49), EDNP foods (d = 0.49), and confectionary (d = 0.36). For all of these dietary variables, except sodium, effects were sustained at 9 months. Moderate to strong associations existed in father-child dietary intakes for some of the dietary variables. (4) Conclusions: Although further research is required, this study provides preliminary support for targeting fathers as agents of change to improve dietary intakes in their preschool-aged children.
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Affiliation(s)
- Lee M. Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (L.M.A.); (C.E.C.)
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- School of Psychology, College of Engineering, Science and Environment, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Philip J. Morgan
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Jacqueline A. Grounds
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Myles D. Young
- School of Psychology, College of Engineering, Science and Environment, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia;
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Anna T. Rayward
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Alyce T. Barnes
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Emma R. Pollock
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Stevie-Lee Kennedy
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Kristen L. Saunders
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (L.M.A.); (C.E.C.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
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11063
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Tam HL, Wong EML, Cheung K, Chung SF. Effectiveness of Text Messaging Interventions on Blood Pressure Control Among Patients With Hypertension: Systematic Review of Randomized Controlled Trials. JMIR Mhealth Uhealth 2021; 9:e24527. [PMID: 34550078 PMCID: PMC8495578 DOI: 10.2196/24527] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/04/2021] [Accepted: 08/05/2021] [Indexed: 01/26/2023] Open
Abstract
Background Controlling blood pressure (BP) is an international health concern, and high BP is a major contributor to cardiovascular disease mortality. Evidence has shown that educational interventions directed at patients potentially improve BP control and adherence to medications and lifestyle modifications. In addition, a text messaging intervention has a potential effect on BP control; however, the dosage of a text messaging intervention has not been determined in previous reviews, resulting in difficult application in practice. Objective This review aimed to identify the effectiveness of a text messaging intervention on hypertension management with a specific focus on the dosage of text messaging and the type of additional interventions with text messaging. Methods A systematic review was conducted and reported on in accordance with PRISMA guideline. Participants were aged 18 years and older and diagnosed with primary hypertension. The included studies used text messaging as a component of the intervention. We searched for randomized controlled trials published until June 30, 2020, from the following health-related electronic databases: Embase, Medline, CINAHL Complete, PsycINFO, and Scopus. Data were extracted for qualitative synthesis and meta-analysis. The Physiotherapy Evidence Database Scale was used to assess the methodological quality of each study, and the quality of the included studies was assessed independently by two authors. Results Twelve studies met the inclusion criteria. The overall methodological quality was fair (mean score 5.75). The frequency of text message delivery varied from daily to biweekly. Health education was identified in 4 studies as an additional intervention with text messaging. The overall results showed that the text messaging intervention significantly reduced systolic BP (SBP) but not diastolic BP (DBP). There was no significant difference in BP reduction between studies that lasted 6 months or less and those that lasted more than 7 months. Seven studies that lasted 6 months or less involving 1428 patients with hypertension were pooled for further meta-analysis. Text messages delivered at a lower frequency (once per week or less) had a small effect on SBP reduction (effect size 0.35, P<.01) and DBP reduction (effect size 0.28, P=.01). In addition, the use of a text messaging intervention halved the odds of uncontrolled BP among patients with hypertension in 6 months (odds ratio 0.46, P=.02). Conclusions This review found that a text messaging intervention was effective in BP control. One-way text messaging delivered in a weekly manner was suggested to be effective and required fewer resources. Future studies should use different forms of text message and be integrated into other interventions to improve adherence behaviors and BP control among patients with hypertension.
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Affiliation(s)
- Hon Lon Tam
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China (Hong Kong).,Kiang Wu Nursing College of Macau, Macau, Macao
| | | | - Kin Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
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11064
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Gao Y, Liu X. Secular Trends in the Incidence of and Mortality Due to Alzheimer's Disease and Other Forms of Dementia in China From 1990 to 2019: An Age-Period-Cohort Study and Joinpoint Analysis. Front Aging Neurosci 2021; 13:709156. [PMID: 34539380 PMCID: PMC8446521 DOI: 10.3389/fnagi.2021.709156] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022] Open
Abstract
Background The number of individuals with dementia is increasing, which negatively affects families, communities, and health care systems worldwide. The changes in the incidence of and mortality due to Alzheimer’s disease and other forms of dementia at the national level in China have remained unknown over the past three decades. Methods Following the general analytical strategy used in the Global Burden of Disease Study (GBD) 2019, the age- and sex-specific incidence and mortality rates for dementia in China were analyzed. Trends in the incidence of and mortality due to dementia from 1990 to 2019 were assessed by joinpoint regression analysis. The effects of age, period and cohort on the incidence of and mortality due to dementia were estimated by an age-period-cohort model. Results The age-standardized incidence and mortality rates per 100,000 population were 103.83 (95% UI, 87.93–118.87) and 23.32 (95% UI, 5.66–61.31), respectively, for dementia in 2019. From 1990 to 2019, a significant average annual percentage change (AAPC) in the age-standardized incidence rate was observed in both males [0.49% (95% CI, 0.43–0.55%)] and females [0.31% (95% CI, 0.24–0.38%)], and the age-standardized mortality rate significantly increased in males [0.42% (95% CI, 0.31–0.53%)]. The population aged 55–59 years had the highest AAPC in the incidence of dementia [0.87% (95% CI, 0.81–0.93%)]. The age effect showed that the relative risks (RRs) of incident dementia and dementia-associated mortality increased with age among males and females, and individuals aged 60 years and older had significantly higher RRs. The RR of incident dementia increased with time, and the RR started to substantially increase in 2009. The cohort effect showed that the incidence decreased in successive birth cohorts. Conclusion Alzheimer’s disease and other forms of dementia continue to become more common among males and females in China, and the associated mortality rate in males significantly increased from 1990 to 2019. Early interventions should be implemented to reduce the burden of dementia on individuals at high risk in China.
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Affiliation(s)
- Yongliang Gao
- Department of Neurology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiaonan Liu
- Department of Neurological Function Examination, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
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11065
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Fang Z, Chen XY, Lou LX, Yao K. Socio-economic disparity in visual impairment from cataract. Int J Ophthalmol 2021; 14:1310-1314. [PMID: 34540604 DOI: 10.18240/ijo.2021.09.03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/07/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the association of visual impairment from cataract with human development index (HDI) by years lived with disability (YLDs). METHODS Published data on national age-standardized YLD rates caused by cataract and national HDIs in 2019 were obtained. Age-standardized YLD rates from 1990 to 2019 were analyzed to explore cataract burden among patients with different income levels. Age-standardized YLD rates in different HDI groups were compared by different degrees of visual impairment. Association between national age-standardized YLD rates and HDI in 2019 was analyzed. RESULTS The age-standardized YLD rates of populations with visual impairment or blindness due to cataract declined from 1990 to 2019, especially among those with lower middle income. Multiple comparison tests revealed that countries with low HDI had significantly higher age-standardized YLD rates of blindness due to cataract than those with high and very high HDI (P<0.001). The age-standardized YLD rates of populations with blindness (β=-0.588, P<0.001), severe vision loss (β=-0.378, P<0.001), and moderate vision loss (β=-0.389, P<0.001) inversely correlated with HDI. CONCLUSION Age-standardized YLD rates caused by cataract have declined since 1990. The burden of visual impairment due to cataract inversely correlate with national socioeconomic development and is more concentrated in countries with low HDI than those with high HDI, especially among the blind. These findings highlight the need to provide additional cataract services and cataract surgery coverage to developing countries to decrease the burden of avoidable blindness caused by cataract.
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Affiliation(s)
- Zhi Fang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China.,Eye Institute of Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Xin-Yi Chen
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China.,Eye Institute of Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Li-Xia Lou
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China.,Eye Institute of Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China.,Eye Institute of Zhejiang University, Hangzhou 310009, Zhejiang Province, China
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11066
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Mohr W, Rädke A, Afi A, Edvardsson D, Mühlichen F, Platen M, Roes M, Michalowsky B, Hoffmann W. Key Intervention Categories to Provide Person-Centered Dementia Care: A Systematic Review of Person-Centered Interventions. J Alzheimers Dis 2021; 84:343-366. [PMID: 34542075 PMCID: PMC8609709 DOI: 10.3233/jad-210647] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Person-centered care (PCC) is an important concept in many countries’ national guidelines and dementia plans. Key intervention categories, i.e., a taxonomy of person-centered (PC)-interventions, to provide person-centered dementia care, are difficult to identify from literature. Objective: This systematic review aimed to identify and categorize published PC-interventions into key intervention categories to guide the provision of person-centered dementia care. Methods: Conduct of this systematic review followed Cochrane guidelines. A search of the dimensions ‘Dementia’, ‘Person-Centered Care’, and ‘Intervention’ combined was performed in PubMed, EMBASE, and Web of Science. Study selection was based on 2-stage screening against eligibility criteria, limited to controlled study designs. Information about interventions and outcomes was extracted into an “Effects Table”. The identified PC-interventions were categorized in intervention categories to provide person-centered dementia care. Results: Searches identified 1,806 records. 19 studies were included. These covered a range of psychosocial interventions, oftentimes multi-component interventions, which followed heterogeneous approaches. Studies were conducted in long-term care/hospital settings. Nine key intervention categories were identified: social contact, physical activities, cognitive training, sensory enhancement, daily living assistance, life history oriented emotional support, training and support for professional caregivers, environmental adjustments, and care organization. Conclusion: Our findings provide a current overview of published PC-interventions in dementia, which followed heterogeneous approaches under the PCC-concept. The heterogeneity made it challenging to identify a well-defined concept of PCC and common key intervention categories. An effectiveness-evaluation of “PC” - including “relationship-centered”-interventions may be valuable, to assess whether an explicit focus on relationships around PCC-interventions yields an added benefit. PROSPERO-ID: CRD42021225084.
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Affiliation(s)
- Wiebke Mohr
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Anika Rädke
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Adel Afi
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - David Edvardsson
- Department of Nursing, Umeaa University, Umeaa, Sweden.,School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| | - Franka Mühlichen
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Moritz Platen
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Martina Roes
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Witten, Witten, Germany
| | - Bernhard Michalowsky
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany.,Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany
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11067
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Koutsaliaris IK, Moschonas IC, Pechlivani LM, Tsouka AN, Tselepis AD. Inflammation, Oxidative Stress, Vascular Aging And Atherosclerotic Ischemic Stroke. Curr Med Chem 2021; 29:5496-5509. [PMID: 34547993 DOI: 10.2174/0929867328666210921161711] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/11/2021] [Accepted: 08/18/2021] [Indexed: 11/22/2022]
Abstract
Vascular aging is a crucial risk factor for atherosclerotic ischemic stroke. Vascular aging is characterized by oxidative stress, endothelial dysfunction, inflammation, intimal and media thickening, as well as the gradual development of arterial stiffness, among other pathophysiological features. Regarding oxidative stress, increased concentration of reactive oxygen and nitrogen species is linked to atherosclerotic ischemic stroke in vascular aging. Additionally, oxidative stress is associated with an inflammatory response. Inflammation is related to aging through the "inflammaging" theory, which is characterized by decreased ability to cope with a variety of stressors, in combination with an increased pro-inflammatory state. Vascular aging is correlated with changes in cerebral arteries that are considered predictors of the risk for atherosclerotic ischemic stroke. The aim of the present review is to present the role of oxidative stress and inflammation in vascular aging, as well as their involvement in atherosclerotic ischemic stroke.
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Affiliation(s)
- Ioannis K Koutsaliaris
- Atherothrombosis Research Centre/Laboratory of Biochemistry, Department of Chemistry, University of Ioannina, 45110, Ioannina. Greece
| | - Iraklis C Moschonas
- Atherothrombosis Research Centre/Laboratory of Biochemistry, Department of Chemistry, University of Ioannina, 45110, Ioannina. Greece
| | - Louisa M Pechlivani
- Atherothrombosis Research Centre/Laboratory of Biochemistry, Department of Chemistry, University of Ioannina, 45110, Ioannina. Greece
| | - Aikaterini N Tsouka
- Atherothrombosis Research Centre/Laboratory of Biochemistry, Department of Chemistry, University of Ioannina, 45110, Ioannina. Greece
| | - Alexandros D Tselepis
- Atherothrombosis Research Centre/Laboratory of Biochemistry, Department of Chemistry, University of Ioannina, 45110, Ioannina. Greece
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11068
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de Melo Castro Deligne L, Rocha MCB, Malta DC, Naghavi M, de Azeredo Passos VM. The burden of neck pain in Brazil: estimates from the global burden of disease study 2019. BMC Musculoskelet Disord 2021; 22:811. [PMID: 34548044 PMCID: PMC8456636 DOI: 10.1186/s12891-021-04675-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 08/21/2021] [Indexed: 12/03/2022] Open
Abstract
Background This study analyzed neck pain estimates in Brazil and its states between 2000 and 2019, in view of the country’s lacking epidemiological data. Methods An analysis was performed of the GBD 2019 estimates by location, sex, and age, per 100,000 population, with uncertainty intervals (95% UI). Brazilian estimates were compared to global, Mexican, English, and American rates. Results Global, Brazilian, and Mexican prevalence numbers were statistically homogeneous and stable in the period. Throughout the period analyzed in the study, Brazilian neck pain prevalence (2241.9; 95%UI 1770.5–2870.6) did not show statistical differences when compared to global (2696.5; 95%UI 2177.0–3375.2) or Mexican (1595.9; 95%UI 1258.9–2058.8) estimates. Estimates observed in the USA (5123.29; 95%UI 4268.35–6170.35) and England (4612.5; 95%UI 3668.8–5830.3) were significantly higher. In 2019, when compared to the USA and England, age-standardized prevalences were lower globally, in Brazil, and in Mexico. Prevalences in Brazilian states were similar, being that Roraima (1915.9; 95%UI 1506.5–2443.1) and the Federal District (1932.05; 95%UI 1515.1–2462.7) presented the lowest and highest values respectively. The exception was the state of São Paulo (3326.5; 95%UI 2609.6–4275.5). There was no statistical difference by sex, but the prevalence tended to increase with aging. In 2019, the Brazilian prevalence was 2478.6 (95% UI 1791.0–3503.8), 5017.2 (95%UI 3257.26–7483.8), and 4293.4 (95% UI 2898,8–6343.9), for those aged 15 to 49, 50 to 69, and 70+ years. There was no statistical difference among the YLDs in all locations and times. Conclusions Brazil is going through a fast-paced process of populational aging; a higher prevalence of neck pain in middle-aged individuals and the elderly highlights the need for lifelong prevention initiatives. The higher rates observed among higher-income populations and the homogeneity of the Brazilian estimates suggest a lack of robust epidemiological data in lower-income countries.
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Affiliation(s)
| | | | - Deborah Carvalho Malta
- School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mohsen Naghavi
- Institute of Health Metrics and Evaluation, Washington University, Seattle, USA
| | - Valéria Maria de Azeredo Passos
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. .,School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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11069
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Curiel-Montero F, Alburquerque-Sendín F, Fernández-de-las-Peñas C, Rodrigues-de-Souza DP. Has the Phase of the Menstrual Cycle Been Considered in Studies Investigating Pressure Pain Sensitivity in Migraine and Tension-Type Headache: A Scoping Review. Brain Sci 2021; 11:1251. [PMID: 34573271 PMCID: PMC8472201 DOI: 10.3390/brainsci11091251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/13/2021] [Accepted: 09/18/2021] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE The aim of this scoping review was to identify if the phase of the menstrual cycle was considered in observational studies comparing pressure pain sensitivity between women with migraine or tension-type headache (TTH) and headache-free women. METHODS A systematic electronic literature search in PubMed, Medline, Web of Science, Scopus, and CINAHL databases was conducted. Observational studies including one or more groups with TTH and/or migraine comparing pressure pain thresholds (PPTs) were included. The methodological quality (risk of bias) was assessed with the Newcastle-Ottawa Scale. Authors, objectives, inclusion/exclusion criteria, size sample, female sample, tool to assess PPTs, mean age, and the use of any medication were extracted and analyzed independently by two authors. RESULTS From a total of 1404 and 1832 identified articles for TTH and migraine, 30 and 18 studies satisfied the criteria and were included. Nineteen (63.4%) studies assessing TTH patients and eleven (61.1%) assessing migraine patients showed a high risk of bias. The most common flaws were attributed to improper selection of control and control over other additional factors. Based on the systematic review, just one study including TTH and one including migraine patients considered the menstrual cycle. CONCLUSION The results of this scoping review identified that the phase of the menstrual cycle has been rarely considered in studies investigating sensitivity to pressure pain in primary headaches, such as TTH or migraine, although there is evidence showing the relevance of the phase of the menstrual cycle in pain perception.
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Affiliation(s)
- Francisca Curiel-Montero
- Department of Nursing, Pharmacology and Physical Therapy, Universidad de Córdoba, 14004 Córdoba, Spain; (F.C.-M.); (F.A.-S.); (D.P.R.-d.-S.)
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Universidad de Córdoba, 14004 Córdoba, Spain; (F.C.-M.); (F.A.-S.); (D.P.R.-d.-S.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Daiana P. Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Universidad de Córdoba, 14004 Córdoba, Spain; (F.C.-M.); (F.A.-S.); (D.P.R.-d.-S.)
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11070
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Zhuang L, Ge Y, Zong X, Yang Q, Zhang R, Fan Q, Tao R. High Proteoglycan Decorin Levels Are Associated With Acute Coronary Syndrome and Provoke an Imbalanced Inflammatory Response. Front Physiol 2021; 12:746377. [PMID: 34621191 PMCID: PMC8490816 DOI: 10.3389/fphys.2021.746377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Aims: Acute coronary syndrome (ACS) has become one of the most common causes of disability. It is thus important to identify ACS early in the disease course of patients using novel biomarkers for prompt management. Decorin (DCN) was well-acknowledged for its effect on collagen fibrillogenesis and maintaining tissue integrity. Additionally, DCN could release as secreted proteoglycan under pathological conditions. Hence, we aimed to determine the relationship between serum DCN concentration and ACS. Methods: A total of 388 patients who underwent coronary angiography (CAG) in the cardiovascular center of Ruijin Hospital between June 2016 and December 2017 were enrolled in this study. Blood samples were drawn during CAG surgery to determine the serum DCN level of patients with ACS (n = 210) and control subjects (n = 178) using enzyme-linked immunosorbent assay. Results: We found that the serum DCN levels of ACS patients were elevated compared with those of the control subjects (13.59 ± 0.50 vs. 13.17 ± 0.38, respectively, p < 0.001). Furthermore, the serum DCN level, after being adjusted with other cardiovascular factors, was independently associated with ACS. Moreover, an increased serum DCN level was positively correlated with the number of white blood cells and the level of high-sensitivity C-reactive protein (R = 0.3 and 0.11, respectively). Mechanistically, DCN might have elicited an imbalanced inflammatory response during cardiac ischemia by suppressing the expression of anti-inflammatory genes. Conclusion: Serum DCN is a novel biomarker of ACS and contributes to the increased inflammatory response in ischemic heart disease.
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Affiliation(s)
- Lingfang Zhuang
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yulong Ge
- Department of Cardiology, School of Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao Zong
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Yang
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruiyan Zhang
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qin Fan
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Tao
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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11071
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Effects of Air Pollutants on Airway Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189905. [PMID: 34574829 PMCID: PMC8465980 DOI: 10.3390/ijerph18189905] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/13/2021] [Accepted: 09/16/2021] [Indexed: 12/15/2022]
Abstract
Air pollutants include toxic particles and gases emitted in large quantities from many different combustible materials. They also include particulate matter (PM) and ozone, and biological contaminants, such as viruses and bacteria, which can penetrate the human airway and reach the bloodstream, triggering airway inflammation, dysfunction, and fibrosis. Pollutants that accumulate in the lungs exacerbate symptoms of respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD). Asthma, a heterogeneous disease with complex pathological mechanisms, is characterized by particular symptoms such as shortness of breath, a tight chest, coughing, and wheezing. Patients with COPD often experience exacerbations and worsening of symptoms, which may result in hospitalization and disease progression. PM varies in terms of composition, and can include solid and liquid particles of various sizes. PM concentrations are higher in urban areas. Ozone is one of the most toxic photochemical air pollutants. In general, air pollution decreases quality of life and life expectancy. It exacerbates acute and chronic respiratory symptoms in patients with chronic airway diseases, and increases the morbidity and risk of hospitalization associated with respiratory diseases. However, the mechanisms underlying these effects remain unclear. Therefore, we reviewed the impact of air pollutants on airway diseases such as asthma and COPD, focusing on their underlying mechanisms.
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11072
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Al Bawab AQ, Al-Qerem W, Abusara O, Alkhatib N, Mansour M, Horne R. What Are the Factors Associated with Nonadherence to Medications in Patients with Chronic Diseases? Healthcare (Basel) 2021; 9:1237. [PMID: 34575011 PMCID: PMC8469667 DOI: 10.3390/healthcare9091237] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/29/2021] [Accepted: 09/08/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Adherence to medications is very crucial for an optimized clinical outcome in the management of chronic diseases. Beliefs about medications and other factors can significantly affect adherence to chronic medications. The objective of the present research was to identify the associated factors of adherence to medication in Jordanian patients with chronic diseases utilizing a stepwise binary logistical regression model. Methods: A cross-sectional study was carried out between November 2018 and March 2020. The participants were reached from secondary and tertiary care setting clinics in Jordan. The recruited patients were asked to report their attitudes of adherence to medications and beliefs about medications via filling out the MARS-5 and BMQ-specific tools. Sociodemographic data were also collected from the recruited patients and included in the regression model. A stepwise binary logistical regression model was applied to identify the associated factors of adherence to chronic medications in the tested sample. Results: A total of 485 patients who met the inclusion criteria were recruited. The mean age of the participants was 57.14 (age ranged from 22 to 82 years). Around 39% of the participants were older than 65 years. Most of the patients were either hypertensive or diabetic (35.7% and 32.2%, respectively). The logistic regression model indicated that necessity beliefs are strongly associated with adherence (OR 4.22), while concerns beliefs, dosage frequency and having medical insurance were negatively associated with adherence (OR 0.73, 0.74 and 0.26, respectively), with a p-value ≤ 0.05. Conclusions: Both the MARS-5 and BMQ-specific questionnaires were applied successfully on the tested sample. Better attention should be paid to the logistic regression model variables that were associated with adherence in order to guarantee optimal treatment outcomes in the treatment of chronic diseases.
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Affiliation(s)
- Abdel Qader Al Bawab
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan; (W.A.-Q.); (O.A.); (N.A.); (M.M.)
| | - Walid Al-Qerem
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan; (W.A.-Q.); (O.A.); (N.A.); (M.M.)
| | - Osama Abusara
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan; (W.A.-Q.); (O.A.); (N.A.); (M.M.)
| | - Nimer Alkhatib
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan; (W.A.-Q.); (O.A.); (N.A.); (M.M.)
| | - Maha Mansour
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan; (W.A.-Q.); (O.A.); (N.A.); (M.M.)
| | - Robert Horne
- Centre for Behavioral Medicine, UCL School of Pharmacy, University College London, London WC1H 9JP, UK;
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11073
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Oyama K, Giugliano RP, Tang M, Bonaca MP, Saver JL, Murphy SA, Ruzza A, Keech AC, Sever PS, Sabatine MS, Bergmark BA. Effect of evolocumab on acute arterial events across all vascular territories : results from the FOURIER trial. Eur Heart J 2021; 42:4821-4829. [PMID: 34537830 DOI: 10.1093/eurheartj/ehab604] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/09/2021] [Accepted: 08/20/2021] [Indexed: 12/31/2022] Open
Abstract
AIMS We assessed the impact of the proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitor evolocumab on acute arterial events across all vascular territories, including coronary, cerebrovascular, and peripheral vascular beds, in patients with established atherosclerotic cardiovascular disease (ASCVD). METHODS AND RESULTS In the FOURIER trial, 27 564 patients with stable ASCVD on statin therapy were randomly assigned to evolocumab or placebo. Acute arterial events were a composite of acute coronary (coronary heart disease death, myocardial infarction, or urgent coronary revascularization), cerebrovascular (ischaemic stroke, transient ischaemic attack, or urgent cerebral revascularization), or peripheral vascular (acute limb ischaemia, major amputation, or urgent peripheral revascularization) events. Of the 2210 first acute arterial events, 74% were coronary, 22% were cerebrovascular, and 4% were peripheral vascular. Evolocumab reduced first acute arterial events by 19% (hazard ratio [HR] 0.81 [95% confidence interval 0.74-0.88]; P < 0.001), with significant individual reductions in acute coronary (HR 0.83 [0.75-0.91]), cerebrovascular (HR 0.77 [0.65-0.92]), and peripheral vascular (HR 0.58 [0.38-0.88]) events. There were 3437 total events (first plus recurrent), with evolocumab reducing total events by 24% (incidence rate ratio 0.76 [0.69-0.85]). The magnitude of reduction in acute arterial events with evolocumab numerically increased over time, with a 16% reduction (HR 0.84 [0.75-0.95]) in the first year followed by a 24% reduction (HR 0.76 [0.67-0.85]) thereafter. CONCLUSION The addition of the PCSK9 inhibitor evolocumab to statin therapy reduced acute arterial events across all vascular territories with a robust effect over time, indicating a pan-vascular impact of aggressive lipid-lowering therapy on these acute and clinically meaningful events. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT01764633.
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Affiliation(s)
- Kazuma Oyama
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Suite 7022, Boston, MA 02115, USA
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Robert P Giugliano
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Suite 7022, Boston, MA 02115, USA
| | - Minao Tang
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Suite 7022, Boston, MA 02115, USA
| | - Marc P Bonaca
- CPC Clinical Research, Department of Medicine, University of Colorado Anschutz School of Medicine, 2115 N. Scranton St., Suite 2040 Aurora, CO 80045, USA
| | - Jeffrey L Saver
- Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine at UCLA, 710 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Sabina A Murphy
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Suite 7022, Boston, MA 02115, USA
| | - Andrea Ruzza
- Amgen, 1 Amgen Center Drive, Thousand Oaks, CA 91320, USA
| | - Anthony C Keech
- National Health and Medical Research Council Clinical Trials Centre, Sydney Medical School, University of Sydney, Level 6, Medical Foundation Building, 92-94 Parramatta Road, Camperdown, NSW 2050, Australia
| | - Peter S Sever
- International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, 59 North Wharf Road, London W2 1LA, UK
| | - Marc S Sabatine
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Suite 7022, Boston, MA 02115, USA
| | - Brian A Bergmark
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Suite 7022, Boston, MA 02115, USA
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11074
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Zhao X, Wang Z, Wu Y, Cai H. Application of an indocyanine green-mediated fluorescence imaging navigation system in detecting mice tumors. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1238. [PMID: 34532375 PMCID: PMC8421949 DOI: 10.21037/atm-21-3050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/14/2021] [Indexed: 12/24/2022]
Abstract
Background Surgical operation plays an important role in the treatment of cancer. The success of the operation lies in the complete removal of the primary and disseminated tumor tissue while preserving the normal tissue. The development of optical molecular image navigation technology has provided a new option for intraoperative tumor visualization. In this study, a fluorescence imaging navigation system was used to detect the diameter of mice tumors and provide experimental evidence for the further development of digital diagnosis and treatment equipment. Methods The minimum detection concentration in vitro of the fluorescence imaging navigation system for indocyanine green (ICG) was first detected, then 120 female Institute of Cancer Research (ICR) mice and 120 female BALB/c nude mice were randomly divided into three groups by weight, high-dose (H, 4 mg/kg), middle-dose (M, 2 mg/kg), and low-dose (L, 1 mg/kg) groups of ICG solution. After inoculating solid tumors, high, medium, and low doses of ICG were injected via the tail vein, and the tumor diameter was measured by a fluorescence imaging navigation system and vernier caliper within 24 hours of injection. Results The minimum detectable diameter of the system could reach 0.2 mm compared with the vernier caliper, and the actual measurement error was within 0.2 mm. Conclusions A fluorescence imaging navigation system has high accuracy and sensitivity in the application of tumor detection, which may assist the clinical diagnosis and treatment of tumors.
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Affiliation(s)
- Xueyan Zhao
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Ziyu Wang
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Yulin Wu
- Nanjing Nuoyuan Medical Devices Co., Ltd., Nanjing, China
| | - Huiming Cai
- Nanjing Nuoyuan Medical Devices Co., Ltd., Nanjing, China
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11075
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Feng L, Kong L, Dong X, Lai X, Zhang D, Ren B, Liu S, Xie X, Li C, Song Y, Du Y, Cao K, Zhang C, Gao Y. China Stroke Registry for Patients With Traditional Chinese Medicine (CASES-TCM): Rationale and Design of a Prospective, Multicenter, Observational Study. Front Pharmacol 2021; 12:743883. [PMID: 34531755 PMCID: PMC8438566 DOI: 10.3389/fphar.2021.743883] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/23/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Given the complexity of stroke treatment and the current widespread use of traditional Chinese medicine (TCM) in the absence of robust, large, long-term effectiveness and safety studies, and the lack of nationwide epidemiology and clinical characteristics of patients with stroke receiving TCM treatment, the acquisition of data from longitudinal cohorts is essential. We intend to generate the major clinical characteristics of patients with stroke who receive TCM treatment and to investigate the effectiveness and safety of TCM in the Chinese population. Methods: The China Stroke Registry for Patients with Traditional Chinese Medicine (CASES-TCM) study is a prospective, multicenter, observational disease registry aiming to register 20,000 hospitalized patients. Eligible adult patients with clearly diagnosed acute ischemic stroke or intracerebral hemorrhage within 7 days of symptom onset will be consecutively registered from 126 participating sites across China. Baseline data will be recorded, and all patients will be regularly followed up at 3, 6, 12, and 24 months after stroke onset. Collected data will be entered into a web-based system with high-level data security. The primary outcomes include the distribution of scores on the modified Rankin Scale at the 3-months follow-up, and recurrent stroke events within the 12-months follow-up. Conclusion: To our knowledge, the CASES-TCM study is the first and largest nationwide registry to document comprehensive data on TCM treatment in patients with acute stroke. The findings of this study will be valuable to improve our knowledge about TCM treatment for patients with stroke and its subsequent outcomes in the actual clinical setting, consequently facilitating and standardizing the optimization of individualized interventions with TCM for stroke prevention and treatment in China. Study registration: This study was registered with Clinicaltrials.gov (URL: https://clinicaltrials.gov/, Unique identifier: NCT04921397).
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Affiliation(s)
- Luda Feng
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Lingbo Kong
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Xinglu Dong
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Xinxing Lai
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China.,Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Dandan Zhang
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Beida Ren
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Shen Liu
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaolong Xie
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Chuanpeng Li
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Yuebo Song
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Yawei Du
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Kegang Cao
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China.,Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Chi Zhang
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China.,Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Gao
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China.,Chinese Medicine Key Research Room of Brain Disorders Syndrome and Treatment of the National Administration of Traditional Chinese Medicine, Beijing, China
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11076
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Chow CK, Atkins ER, Hillis GS, Nelson MR, Reid CM, Schlaich MP, Hay P, Rogers K, Billot L, Burke M, Chalmers J, Neal B, Patel A, Usherwood T, Webster R, Rodgers A. Initial treatment with a single pill containing quadruple combination of quarter doses of blood pressure medicines versus standard dose monotherapy in patients with hypertension (QUARTET): a phase 3, randomised, double-blind, active-controlled trial. Lancet 2021; 398:1043-1052. [PMID: 34469767 DOI: 10.1016/s0140-6736(21)01922-x] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Treatment inertia is a recognised barrier to blood pressure control, and simpler, more effective treatment strategies are needed. We hypothesised that a hypertension management strategy starting with a single pill containing ultra-low-dose quadruple combination therapy would be more effective than a strategy of starting with monotherapy. METHODS QUARTET was a multicentre, double-blind, parallel-group, randomised, phase 3 trial among Australian adults (≥18 years) with hypertension, who were untreated or receiving monotherapy. Participants were randomly assigned to either treatment, that started with the quadpill (containing irbesartan at 37·5 mg, amlodipine at 1·25 mg, indapamide at 0·625 mg, and bisoprolol at 2·5 mg) or an indistinguishable monotherapy control (irbesartan 150 mg). If blood pressure was not at target, additional medications could be added in both groups, starting with amlodipine at 5 mg. Participants were randomly assigned using an online central randomisation service. There was a 1:1 allocation, stratified by site. Allocation was masked to all participants and study team members (including investigators and those assessing outcomes) except the manufacturer of the investigational product and one unmasked statistician. The primary outcome was difference in unattended office systolic blood pressure at 12 weeks. Secondary outcomes included blood pressure control (standard office blood pressure <140/90 mm Hg), safety, and tolerability. A subgroup continued randomly assigned allocation to 12 months to assess long-term effects. Analyses were per intention to treat. This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry, ACTRN12616001144404, and is now complete. FINDINGS From June 8, 2017, to Aug 31, 2020, 591 participants were recruited, with 743 assessed for eligibility, 152 ineligible or declined, 300 participants randomly assigned to intervention of initial quadpill treatment, and 291 to control of initial standard dose monotherapy treatment. The mean age of the 591 participants was 59 years (SD 12); 356 (60%) were male and 235 (40%) were female; 483 (82%) were White, 70 (12%) were Asian, and 38 (6%) reported as other ethnicity; and baseline mean unattended office blood pressure was 141 mm Hg (SD 13)/85 mm Hg (SD 10). By 12 weeks, 44 (15%) of 300 participants had additional blood pressure medications in the intervention group compared with 115 (40%) of 291 participants in the control group. Systolic blood pressure was lower by 6·9 mm Hg (95% CI 4·9-8·9; p<0·0001) and blood pressure control rates were higher in the intervention group (76%) versus control group (58%; relative risk [RR] 1·30, 95% CI 1·15-1·47; p<0·0001). There was no difference in adverse event-related treatment withdrawals at 12 weeks (intervention 4·0% vs control 2·4%; p=0·27). Among the 417 patients who continued, uptitration occurred more frequently among control participants than intervention participants (p<0·0001). However, at 52 weeks mean unattended systolic blood pressure remained lower by 7·7 mm Hg (95% CI 5·2-10·3) and blood pressure control rates higher in the intervention group (81%) versus control group (62%; RR 1·32, 95% CI 1·16-1·50). In all randomly assigned participants up to 12 weeks, there were seven (3%) serious adverse events in the intervention group and three (1%) serious adverse events in the control group. INTERPRETATION A strategy with early treatment of a fixed-dose quadruple quarter-dose combination achieved and maintained greater blood pressure lowering compared with the common strategy of starting monotherapy. This trial demonstrated the efficacy, tolerability, and simplicity of a quadpill-based strategy. FUNDING National Health and Medical Research Council, Australia.
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Affiliation(s)
- Clara K Chow
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
| | - Emily R Atkins
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; The George Institute for Global Health, UNSW, Sydney, NSW, Australia
| | - Graham S Hillis
- Royal Perth Hospital and Medical School, University of Western Australia, Perth, WA, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Christopher M Reid
- School of Public Health & Preventive Medicine Monash University, Melbourne, VIC, Australia; School of Population Health, Curtin University, Perth, WA, Australia
| | - Markus P Schlaich
- Dobney Hypertension Centre, Royal Perth Hospital Research Foundation, Medical School, University of Western Australia, Perth, WA, Australia
| | - Peter Hay
- Castle Hill Medical Centre, Sydney, NSW, Australia
| | - Kris Rogers
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia; Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Laurent Billot
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia
| | - Michael Burke
- School of Medicine, Western Sydney University, Sydney, Australia
| | - John Chalmers
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia
| | - Bruce Neal
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia; School of Public Health, Imperial College London, London, UK
| | - Anushka Patel
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia
| | - Tim Usherwood
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; The George Institute for Global Health, UNSW, Sydney, NSW, Australia
| | - Ruth Webster
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia; Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
| | - Anthony Rodgers
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia
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11077
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Balidemaj F, Isaxon C, Abera A, Malmqvist E. Indoor Air Pollution Exposure of Women in Adama, Ethiopia, and Assessment of Disease Burden Attributable to Risk Factor. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9859. [PMID: 34574780 PMCID: PMC8472573 DOI: 10.3390/ijerph18189859] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/02/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND AIM Air pollution, a major environmental threat to human health, contributes to the premature deaths of millions of people worldwide. Cooking with solid fuels, such as charcoal and wood, in low- and middle-income countries generates very high emissions of particulate matter within and near the household as a result of their inefficient combustion. Women are especially exposed, as they often perform the cooking. The purpose of this study was to assess the burden of disease attributable to household air pollution exposure from cooking among women in Adama, Ethiopia. METHODS AirQ+ software (WHO Regional Office for Europe, Copenhagen, Denmark) was used to assess the health impact of household air pollution by estimating the burden of disease (BoD) including Acute Lower Respiratory Infections (ALRI), Chronic Obstructive Pulmonary Disease (COPD), Ischemic Heart Disease (IHD), lung cancer, and stroke, among a cohort of women in Adama. Household air pollution exposure estimated by cooking fuel type was assessed through questionnaires. RESULTS Three-quarters (75%) of Adama's population used solid fuel for cooking; with this, the household air pollution attributable mortality was estimated to be 50% (95% CI: 38-58%) due to ALRI, 50% (95% CI: 35-61%) due to COPD, 50% (95% CI: 27-58%) due to lung cancer, (95% CI: 23-48%) due to IHD, and (95% CI: 23-51%) due to stroke. The corresponding disability-adjusted life years (DALYs) per 100,000 women ranged between 6000 and 9000 per disease. CONCLUSIONS This health impact assessment illustrates that household air pollution due to solid fuel use among women in Adama leads to premature death and a substantial quantity of DALYs. Therefore, decreasing or eliminating solid fuel use for cooking purposes could prevent deaths and improve quality of life.
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Affiliation(s)
- Festina Balidemaj
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 222 42 Lund, Sweden;
| | - Christina Isaxon
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, 223 62 Lund, Sweden;
| | - Asmamaw Abera
- Water and Public Health Department, Ethiopia Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia;
| | - Ebba Malmqvist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 222 42 Lund, Sweden;
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11078
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Xiao X, Qin Z, Lv X, Dai Y, Ciren Z, Yangla Y, Zeng P, Ma Y, Li X, Wang L, Hu Y, Yang F, Fan C, Tang D, Dai S, Zhang N, Xie X, Yin J, Zhao X. Dietary patterns and cardiometabolic risks in diverse less-developed ethnic minority regions: results from the China Multi-Ethnic Cohort (CMEC) Study. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 15:100252. [PMID: 34528018 PMCID: PMC8383007 DOI: 10.1016/j.lanwpc.2021.100252] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 01/09/2023]
Abstract
Background In Western developed countries, food-based dietary patterns have been associated with the risk of cardiometabolic diseases, but little is known about such associations in less developed ethnic minority regions (LEMRs), where the cardiometabolic disease burden is growing rapidly and food patterns differ substantially. Methods Between May 2018 and September 2019, we recruited 99556 participants aged 30-79 years from the China Multi-Ethnic Cohort (CMEC) Study. We measured habitual dietary intake with validated food frequency questionnaire (FFQ) and then calculated dietary pattern scores for two of the most studied a priori dietary patterns, i.e., Dietary Approaches to Stop Hypertension (DASH) and alternative Mediterranean (aMED) style diets, and three a posteriori dietary patterns. Four cardiometabolic risks, including hypertension, diabetes, dyslipidaemia and metabolic syndrome (MetS), were newly diagnosed by medical examination and blood tests. We estimated adjusted odds ratios (OR) relating various dietary pattern scores to cardiometabolic risks using marginal structural models under the guidance of directed acyclic graphs. For the above associations, we further calculated the proportion mediated by overweight (PM) using regression-based mediation analysis for better public health implications. Findings The final study sample consisted of 68834 participants. Among them, we newly diagnosed 12803 hypertension, 3527 diabetes, 16342 hyperlipidaemia, and 8198 MetS cases. Overall, all 5 dietary patterns showed considerable associations with risks of hypertension and MetS. Comparing the highest with the lowest quintiles, the DASH score showed the strongest inverse associations with risks of hypertension (OR=0.74, 95% CI:0.70-0.79; PM=10%) and MetS (OR=0.79, 95% CI:0.74-0.85; PM=35%); conversely, scores of the localized a posteriori Yunnan-Guizhou plateau dietary pattern in LEMRs showed the strongest positive associations with risks of hypertension (OR=1.44, 95% CI:1.35-1.52; PM=10%) and MetS (OR=1.35, 95% CI:1.26-1.46; PM=33%), with all P values for trend <0.001. These associations were consistent in various subgroups defined by sex, age, smoking and physical activity, but with magnitudes that differed substantially across different ethnic regions and urbanicity. By investigating the single-component effects of dietary patterns, the dairy intake component contributed a major proportion to the beneficial effects of DASH (41.9% for hypertension and 100.5% for MetS). Interpretation Substantial socioeconomic status and ethnic disparities in diet quality and related cardiometabolic risks were seen in LEMRs, with hypertension being the top diet-related cardiometabolic risk. Our findings support that DASH provides superior dietary guidance compared to aMED for reducing cardiometabolic risks in LEMRs. In particular, the dairy intake encouraged by DASH may produce considerable beneficial effects. Funding This study was funded by the National Key R&D Program of China; full funding sources listed in the acknowledgements.
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Affiliation(s)
- Xiong Xiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zixiu Qin
- the key Laboratory of Environmental Pollution Monitoring and Disease Control, School of Public Health, Guizhou Medical University, Guiyang, China
| | - Xiaoyan Lv
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Yingxue Dai
- Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Zhuoga Ciren
- Tibet Center for Disease Control and Prevention, Lhasa, China
| | | | | | - Yue Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiang Li
- Institute of Surveying and Mapping, Information Engineering University, Zhengzhou, China
| | - Lina Wang
- School of Computer and Communication Engineering, Zhengzhou University of Light Industry, Zhengzhou, China
| | - Yifan Hu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Fan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chaonan Fan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Dan Tang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Suyao Dai
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ning Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaofen Xie
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jianzhong Yin
- School of Public Health, Kunming Medical University; Baoshan College of Traditional Chinese Medicine, Kunming, China
- Prof Jianzhong Yin, School of Public Health, Kunming Medical University; Baoshan College of Traditional Chinese Medicine, Kunming, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Correspondence to: Prof Xing Zhao, Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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11079
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Magel J, Kietrys D, Kruger ES, Fritz JM, Gordon AJ. Physical therapists should play a greater role in managing patients with opioid use and opioid misuse. Subst Abus 2021; 42:255-260. [PMID: 34524070 DOI: 10.1080/08897077.2021.1971818] [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: 10/20/2022]
Abstract
The U.S. opioid crisis necessitates that health care providers of all types work collaboratively to manage patients taking prescription opioid medications and manage those who may be misusing prescription opioids. Musculoskeletal conditions are the most common diagnoses associated with an opioid prescription. Physical therapists commonly manage patients with musculoskeletal conditions and chronic pain. Some patients who attend physical therapy for pain management take prescription opioid medications for pain and some of these patients may be misusing prescription opioids. Physical therapists who manage patients with musculoskeletal conditions are well-positioned to help address the opioid crisis. Historically, physical therapists have not been adequately engaged in efforts to manage persons with co-occurring musculoskeletal pain and opioid misuse or OUD. The American Physical Therapy Association (APTA) has emphasized physical therapy over the use of prescription opioids for the management of painful conditions. The APTA, however, does not highlight the important role that physical therapists could play in monitoring opioid use among patients receiving treatment for pain, nor the role that physical therapists should play in screening for opioid misuse. Such screening could facilitate referral of patients suspected misuse to an appropriate provider for formal assessment and treatment. This commentary presents simulated musculoskeletal patient presentations depicting 2 common opioid use states; chronic opioid use and opioid misuse. The cases highlight and interactions that physical therapists could have with these patients and actions that the physical therapist could take when working inter-disciplinarily. Recommendations are provided that aim to increase physical therapists' knowledge and skills related to managing patients taking prescription opioid medications for pain.
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Affiliation(s)
- John Magel
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - David Kietrys
- Department of Rehabilitation and Movement Sciences, Rutgers School of Health Professions, Newark, NJ, USA
| | - Eric S Kruger
- School of Medicine, Department of Orthopaedics and Rehabiliation, Division of Physical Therapy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Julie M Fritz
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - Adam J Gordon
- Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.,Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA
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11080
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Neal B, Wu Y, Feng X, Zhang R, Zhang Y, Shi J, Zhang J, Tian M, Huang L, Li Z, Yu Y, Zhao Y, Zhou B, Sun J, Liu Y, Yin X, Hao Z, Yu J, Li KC, Zhang X, Duan P, Wang F, Ma B, Shi W, Di Tanna GL, Stepien S, Shan S, Pearson SA, Li N, Yan LL, Labarthe D, Elliott P. Effect of Salt Substitution on Cardiovascular Events and Death. N Engl J Med 2021; 385:1067-1077. [PMID: 34459569 DOI: 10.1056/nejmoa2105675] [Citation(s) in RCA: 328] [Impact Index Per Article: 109.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Salt substitutes with reduced sodium levels and increased potassium levels have been shown to lower blood pressure, but their effects on cardiovascular and safety outcomes are uncertain. METHODS We conducted an open-label, cluster-randomized trial involving persons from 600 villages in rural China. The participants had a history of stroke or were 60 years of age or older and had high blood pressure. The villages were randomly assigned in a 1:1 ratio to the intervention group, in which the participants used a salt substitute (75% sodium chloride and 25% potassium chloride by mass), or to the control group, in which the participants continued to use regular salt (100% sodium chloride). The primary outcome was stroke, the secondary outcomes were major adverse cardiovascular events and death from any cause, and the safety outcome was clinical hyperkalemia. RESULTS A total of 20,995 persons were enrolled in the trial. The mean age of the participants was 65.4 years, and 49.5% were female, 72.6% had a history of stroke, and 88.4% a history of hypertension. The mean duration of follow-up was 4.74 years. The rate of stroke was lower with the salt substitute than with regular salt (29.14 events vs. 33.65 events per 1000 person-years; rate ratio, 0.86; 95% confidence interval [CI], 0.77 to 0.96; P = 0.006), as were the rates of major cardiovascular events (49.09 events vs. 56.29 events per 1000 person-years; rate ratio, 0.87; 95% CI, 0.80 to 0.94; P<0.001) and death (39.28 events vs. 44.61 events per 1000 person-years; rate ratio, 0.88; 95% CI, 0.82 to 0.95; P<0.001). The rate of serious adverse events attributed to hyperkalemia was not significantly higher with the salt substitute than with regular salt (3.35 events vs. 3.30 events per 1000 person-years; rate ratio, 1.04; 95% CI, 0.80 to 1.37; P = 0.76). CONCLUSIONS Among persons who had a history of stroke or were 60 years of age or older and had high blood pressure, the rates of stroke, major cardiovascular events, and death from any cause were lower with the salt substitute than with regular salt. (Funded by the National Health and Medical Research Council of Australia; SSaSS ClinicalTrials.gov number, NCT02092090.).
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Affiliation(s)
- Bruce Neal
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Yangfeng Wu
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Xiangxian Feng
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Ruijuan Zhang
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Yuhong Zhang
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Jingpu Shi
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Jianxin Zhang
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Maoyi Tian
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Liping Huang
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Zhifang Li
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Yan Yu
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Yi Zhao
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Bo Zhou
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Jixin Sun
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Yishu Liu
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Xuejun Yin
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Zhixin Hao
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Jie Yu
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Ka-Chun Li
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Xinyi Zhang
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Peifen Duan
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Faxuan Wang
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Bing Ma
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Weiwei Shi
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Gian Luca Di Tanna
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Sandrine Stepien
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Sana Shan
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Sallie-Anne Pearson
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Nicole Li
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Lijing L Yan
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Darwin Labarthe
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
| | - Paul Elliott
- From the George Institute for Global Health (B.N., M.T., L.H., Y.L., X.Y., J.Y., K.-C.L., G.L.D.T., S. Stepien, S. Shan) and the Centre for Big Data Research in Health (S.-A.P.), University of New South Wales, and George Clinical (N.L.) - all in Sydney; the School of Public Health (B.N., K.-C.L., P.E.), the U.K. Dementia Research Institute (P.E.), the British Heart Foundation Centre for Research Excellence (P.E.), and the NIHR Imperial Biomedical Research Centre (P.E.), Imperial College London, Health Data Research (P.E.), the NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards (P.E.), and the Medical Research Council Centre for Environment and Health (P.E.) - all in London; Peking University Clinical Research Center, Peking University (Y.W.), the George Institute for Global Health at Peking University Health Science Center (Y.W., M.T., Z.H., X.Z., L.L.Y.), and the Department of Cardiology, Peking University Third Hospital (J.Y.), Beijing, the School of Public Health, Changzhi Medical College, Changzhi (X.F., Z.L., P.D.), the School of Public Health, Xi'an Jiaotong University, Xi'an (R.Z., Y.Y.), the School of Public Health and Management, Ningxia Medical University, Yinchuan (Y. Zhang, Y. Zhao, F.W.), the Department of Evidence-Based Medicine, First Hospital of China Medical University, Shenyang (J. Shi, B.Z., B.M.), the Department of Noncommunicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang (J.Z., J. Sun, W.S.), the School of Public Health, Harbin Medical University, Harbin (M.T.), the Global Health Research Center, Duke Kunshan University, Kunshan (L.L.Y.), and the School of Health Sciences, Wuhan University, Wuhan (L.L.Y.) - all in China; and the Feinberg School of Medicine, Northwestern University, Chicago (D.L.)
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11081
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Shah DR, Leslie A, Destigter K, van de Broek-Altenburg E, Horton S, Dahn B. Medical Imaging: The Missing Element of National Health Plans. JOURNAL OF GLOBAL RADIOLOGY 2021. [DOI: 10.7191/jgr.2021.1158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Purpose: Radiology global outreach programs have increased in recent years but progressed more slowly than other specialties. Establishing radiology services is increasingly recognized as a priority in resource-limited settings. Myanmar has a tremendous disease burden that is treatable with interventional radiology (IR) techniques, and aims to grow and effectively integrate this service into its public healthcare sector. Through collaborations between Asia Pacific Society of Cardiovascular and Interventional Radiology (APSCVIR) and Myanmar Radiological Society (MRS), the field of IR has grown exponentially over recent years. This study aims to provide a Myanmar national IR report on the current trends and future challenges.
Methods and materials: Descriptive variables across five domains (facility and equipment, workforce, supplies, infrastructure, and casemix) from the four public sector hospitals with IR capability were obtained between 2016-2019. The four hospitals were Yangon General Hospital (YGH), Yangon Specialty Hospital (YSH), Mandalay General Hospital (MGH), and Defense Services General Hospital (DSGH). Data were analyzed to demonstrate progress in IR and the differing casemix.
Results: There are currently four IR-capable hospitals and nine interventional radiologists across Myanmar’s public healthcare sector. IR case volumes tripled from 514 cases in 2016 to more than 1,500 cases in 2019. The three most common procedures performed were trans-arterial chemoembolization (TACE, 63%), bronchial arterial embolization (BAE, 7.7%), and drainages (7.7%). Significant challenges to the growth and adoption of IR services span the domains of infrastructure, equipment and supplies, workforce, and IR awareness, among other clinical specialties.
Conclusion: Myanmar’s healthcare priorities, coupled with international radiological outreach programs, have led to rapid growth of IR. The exponential growth in case volumes is promising for Myanmar and other developing countries. But to widen the scope of practice and integrate the service within local clinical workflows, a holistic effort that addresses multiple domains is needed in the future.
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11082
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Ruggeri M, Signorini A, Caravaggio S, Santori C, Rosiello F, Coluzzi F. Cost-Effectiveness Analysis of Tapentadol Versus Oxycodone/Naloxone in both Branded and Generic Formulations in Patients with Musculoskeletal Pain. Clin Drug Investig 2021; 41:875-883. [PMID: 34524651 DOI: 10.1007/s40261-021-01074-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Current evidence shows that tapentadol hydrochloride prolonged-release is more cost effective than other opioids. However, the introduction into the market of generic formulations of traditional comparators, leading to potential savings due to their lower price, creates space for further research. The objective of this study is to evaluate and compare the efficacy of tapentadol versus oxycodone/naloxone and the economic impact of the two alternatives in both branded and generic formulations. METHODS A cost-effectiveness analysis was performed using the third-payer perspective (TPP), with specific reference to the Italian National Health Service. A Markov model was implemented to simulate transitions between states, comparing two arms: The first arm simulated the administration of tapentadol, while the second simulated the administration of oxycodone/naloxone, both branded and generic. The results were reported in terms of net monetary benefit (NMB). The willingness to pay (WPT) was estimated at €35,000/quality-adjusted life year. RESULTS Tapentadol was dominant in all scenarios, assuming a population of 1000 individuals over a 1-year time horizon. In all cases, although the prices of oxycodone/naloxone generic formulations were lower, the costs associated with treatment discontinuation were always higher than those associated with tapentadol. The comparison with the branded formulation of oxycodone/naloxone was associated with the highest savings of €431.77 per patient, and with the highest NMB of €1943.77 per patient. CONCLUSION The results of this pharmacoeconomic evaluation promote the use of tapentadol in comparison with oxycodone/naloxone, confirming the results obtained in previous studies with reference to the generic formulations.
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Affiliation(s)
- Matteo Ruggeri
- Istituto Superiore di Sanità, Rome, Italy. .,St. Camillus International University of Health Sciences, Rome, Italy.
| | - Alessandro Signorini
- St. Camillus International University of Health Sciences, Rome, Italy.,John Cabot University, Rome, Italy
| | - Silvia Caravaggio
- St. Camillus International University of Health Sciences, Rome, Italy
| | - Costanza Santori
- St. Camillus International University of Health Sciences, Rome, Italy
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11083
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Kongsted A, Jensen TS, Doktor K, Hestbæk L. Effects of weekly pain monitoring on back pain outcomes: a non-randomised controlled study. Chiropr Man Therap 2021; 29:37. [PMID: 34530882 PMCID: PMC8444569 DOI: 10.1186/s12998-021-00393-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 09/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Disease monitoring is an important element of self-management of several chronic diseases. Pain monitoring has become very easily available, but the role in musculoskeletal pain conditions is not clear. Awareness of pain might be helpful for people to understand pain, but focusing on pain may on the contrary negatively affect pain experience and behaviours. The objective of this study was to investigate the potential impact of pain monitoring on low back pain (LBP), specifically to determine if pain intensity, activity limitation and pain control, differed between patients with weekly pain monitoring over 12 months and patients with follow-ups at 2 weeks, 3 months and 12 months. METHODS This was a non-randomised controlled study embedded in a cohort study with data collection November 1st 2016 to December 21st 2018. Adults seeking care for LBP were enrolled at the first visit to a chiropractor and followed with surveys after 2 weeks, 3 months and 12 months. Those enrolled first, n = 1,623, furthermore received weekly SMS-questions about pain frequency and pain intensity, whereas those enrolled next was the control group, n = 1,269 followed only by surveys. Outcomes at 12-months were compared, adjusting for group differences on baseline parameters. RESULTS LBP intensity (0-10) was slightly lower at 12-months follow-up in the SMS group than the control group (adjusted beta - 0.40 (95% CI: - 0.62; - 0.19)). No relevant between-group differences were observed for activity limitation (0-100) (1.51 (95% CI: - 0.83; 3.85)) or ability to control pain (0-10) (- 0.08 (95% CI - 0.31; 0.15)). CONCLUSIONS Frequent pain monitoring did not demonstrate any negative effects of weekly pain monitoring, and it was perhaps even helpful. The role of self-monitoring as part of self-managing LBP should be explored further including optimal frequencies, formats, and methods for feedback. TRIAL REGISTRATION The study was not registered as a clinical trial.
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Affiliation(s)
- Alice Kongsted
- Chiropractic Knowledge Hub, Campusvej 55, 5230, Odense M, Denmark. .,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Tue Secher Jensen
- Chiropractic Knowledge Hub, Campusvej 55, 5230, Odense M, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,Diagnostic Center, Silkeborg Regional Hospital, Falkevej 1, 8600, Silkeborg, Denmark
| | - Klaus Doktor
- Chiropractic Knowledge Hub, Campusvej 55, 5230, Odense M, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Lise Hestbæk
- Chiropractic Knowledge Hub, Campusvej 55, 5230, Odense M, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,Diagnostic Center, Silkeborg Regional Hospital, Falkevej 1, 8600, Silkeborg, Denmark
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11084
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Song J, Pan R, Yi W, Wei Q, Qin W, Song S, Tang C, He Y, Liu X, Cheng J, Su H. Ambient high temperature exposure and global disease burden during 1990-2019: An analysis of the Global Burden of Disease Study 2019. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 787:147540. [PMID: 33992940 DOI: 10.1016/j.scitotenv.2021.147540] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/27/2021] [Accepted: 04/30/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND A warming climate throughout the 21st century makes ambient high temperature exposure a major threat to population health worldwide. Mitigating the health impact of high temperature requires a timely, comprehensive and reliable assessment of disease burden globally, regionally and temporally. AIM Based on Global Burden of Disease (GBD) Study 2019, this study aimed to evaluate the disease burden attributable to high temperature from various epidemiology perspectives. METHODS A three-stage analysis was undertaken to investigate the number and age-standardized rates of death and disability-adjusted life years (DALY) attributable to high temperature from GBD Study 2019. First, we reported the high temperature-related disease burden for the whole world and for different groups by gender, age, region, country and disease. Second, we examined the temporal trend of the disease burden attributable to high temperature from 1990 to 2019. Finally, we explored if and how the high temperature-related disease burden was modified by a number of country-level indicators. RESULTS Globally, high temperature accounted for 0.54% of death and 0.46% of DALY in 2019, equating to the age-standardized rates of death and DALY (per 100,000 population) of 3.99 (95% uncertainty interval (UI): 2.88, 5.93) and 156.81 (95% UI: 107.98, 261.98), respectively. In 2019, the high temperature-related DALY and death rates were the highest for lower respiratory infections, although they showed a downward trend. In contrast, during 1990-2019, high temperature-related non-communicable diseases burden exhibited an upward trend. Meanwhile, the disease burden attributable to high temperature varied spatially, with the heaviest burden in regions with low sociodemographic index (SDI) and the lightest burden in regions with high SDI. In addition, high temperature-related disease burden appeared to be higher in a country with a higher population density and PM2.5 concentration background but lower in a country with a higher density of greenness. CONCLUSION This study for the first time provided a comprehensive understanding of the global disease burden attributable to high temperature, underscoring the policy priority to protect human health worldwide in the context of global warming with particular attention to vulnerable countries or regions as well as susceptible population and diseases.
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Affiliation(s)
- Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Wei Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Shasha Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Chao Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Xiangguo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
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11085
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Xiong W, Liu W, Nishida S, Komiyama D, Liu W, Hirakawa J, Kawashima H. Therapeutic Effects of an Anti-sialyl Lewis X Antibody in a Murine Model of Allergic Asthma. Int J Mol Sci 2021; 22:9961. [PMID: 34576124 PMCID: PMC8471066 DOI: 10.3390/ijms22189961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/02/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022] Open
Abstract
Asthma is an allergic disease that causes severe infiltration of leukocytes into the lungs. Leukocyte infiltration is mediated by the binding of sialyl Lewis X (sLex) glycans present on the leukocytes to E-and P-selectins present on the endothelial cells at the sites of inflammation. Here, we found that mouse eosinophils express sLex glycans, and their infiltration into the lungs and proliferation in the bone marrow were significantly suppressed by an anti-sLex monoclonal antibody (mAb) F2 in a murine model of ovalbumin-induced asthma. The percentage of eosinophils in the bronchoalveolar lavage fluid and bone marrow and serum IgE levels decreased significantly in the F2-administered mice. Levels of T helper type 2 (Th2) cytokines and chemokines, involved in IgE class switching and eosinophil proliferation and recruitment, were also decreased in the F2-administered mice. An ex vivo cell rolling assay revealed that sLex glycans mediate the rolling of mouse eosinophils on P-selectin-expressing cells. These results indicate that the mAb F2 exerts therapeutic effects in a murine model of allergen-induced asthma, suggesting that sLex carbohydrate antigen could serve as a novel therapeutic target for allergic asthma.
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Affiliation(s)
| | | | | | | | | | | | - Hiroto Kawashima
- Laboratory of Microbiology and Immunology, Graduate School of Pharmaceutical Sciences, Chiba University, Chiba 260-8675, Japan; (W.X.); (W.L.); (S.N.); (D.K.); (W.L.); (J.H.)
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11086
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Assessment of the required performance and the development of corresponding program decision rules for neglected tropical diseases diagnostic tests: Monitoring and evaluation of soil-transmitted helminthiasis control programs as a case study. PLoS Negl Trop Dis 2021; 15:e0009740. [PMID: 34520474 PMCID: PMC8480900 DOI: 10.1371/journal.pntd.0009740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 09/29/2021] [Accepted: 08/17/2021] [Indexed: 12/02/2022] Open
Abstract
Recently, the World Health Organization established the Diagnostic Technical Advisory Group to identify and prioritize diagnostic needs for neglected tropical diseases, and to ultimately describe the minimal and ideal characteristics for new diagnostic tests (the so-called target product profiles (TPPs)). We developed two generic frameworks: one to explore and determine the required sensitivity (probability to correctly detect diseased persons) and specificity (probability to correctly detect persons free of disease), and another one to determine the corresponding samples sizes and the decision rules based on a multi-category lot quality assurance sampling (MC-LQAS) approach that accounts for imperfect tests. We applied both frameworks for monitoring and evaluation of soil-transmitted helminthiasis control programs. Our study indicates that specificity rather than sensitivity will become more important when the program approaches the endgame of elimination and that the requirements for both parameters are inversely correlated, resulting in multiple combinations of sensitivity and specificity that allow for reliable decision making. The MC-LQAS framework highlighted that improving diagnostic performance results in a smaller sample size for the same level of program decision making. In other words, the additional costs per diagnostic tests with improved diagnostic performance may be compensated by lower operational costs in the field. Based on our results we proposed the required minimal and ideal diagnostic sensitivity and specificity for diagnostic tests applied in monitoring and evaluating of soil-transmitted helminthiasis control programs. The World Health Organization established an advisory group to identify and prioritize diagnostic needs for neglected tropical diseases, and to ultimately describe the minimal and ideal characteristics for new diagnostic tests. To support this advisory group, we developed two generic frameworks, which we applied to soil-transmitted helminthiases: one to explore and determine the required sensitivity (probability to correctly detect a diseased person) and specificity (probability to correctly detect a person free of disease), and another one to determine the corresponding samples size and decision rules during surveys. We showed that specificity rather than sensitivity will become more important when the program approaches the endgame of elimination and that the requirements for both parameters are inversely correlated, resulting in multiple combinations of sensitivity and specificity that allow for reliable decision making. We also highlighted that improving diagnostic performance results in smaller sample sizes for the same level of program decision making. In other words, the additional costs per diagnostic tests with improved diagnostic performance can be compensated by the lower operational costs in the field. Based on our results we proposed to the advisory group the required performance characteristics of diagnostic tests for soil-transmitted helminthiasis control programs.
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11087
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Mattos ÂZ, Debes JD, Boonstra A, Vogel A, Mattos AA. Immune aspects of hepatocellular carcinoma: From immune markers for early detection to immunotherapy. World J Gastrointest Oncol 2021; 13:1132-1143. [PMID: 34616518 PMCID: PMC8465446 DOI: 10.4251/wjgo.v13.i9.1132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/02/2021] [Accepted: 07/05/2021] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is one of the most prevalent cancers and one of the main causes of cancer-related deaths worldwide. Most HCCs develop in an inflammatory microenvironment, and mounting evidence emphasizes the importance of immune aspects in hepatocarcinogenesis. In normal physiology, both innate and adaptive immune responses are responsible for eliminating malignantly transformed cells, thus preventing the development of liver cancer. However, in the setting of impaired natural killer cells and exhaustion of T cells, HCC can develop. The immunogenic features of HCC have relevant clinical implications. There is a large number of immune markers currently being studied for the early detection of liver cancer, which would be critical in order to improve surveillance programs. Moreover, novel immunotherapies have recently been proven to be effective, and the combination of atezolizumab and bevacizumab is currently the most effective treatment for advanced HCC. It is expected that in the near future different subgroups of patients will benefit from specific immunotherapy. The better we understand the immune aspects of HCC, the greater the benefit to patients through surveillance aiming for early detection of liver cancer, which allows for curative treatments, and, in cases of advanced disease, through the selection of the best possible therapy for each individual.
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Affiliation(s)
- Ângelo Z Mattos
- Graduate Program in Medicine: Hepatology, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
- Gastroenterology and Hepatology Unit, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 90020-090, Brazil
| | - Jose D Debes
- Department of Medicine, Division of Gastroenterology and Infectious Diseases, University of Minnesota, Minneapolis, MN 55812, United States
- Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam NL-3015, The Netherlands
| | - Andre Boonstra
- Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam NL-3015, The Netherlands
| | - Arndt Vogel
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover 30625, Germany
| | - Angelo A Mattos
- Graduate Program in Medicine: Hepatology, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
- Gastroenterology and Hepatology Unit, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 90020-090, Brazil
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11088
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Rofaiel DP, Hession P, Flaherty GT. Analysis of web-based travel health advice provided to international travellers with chronic medical and psychiatric illnesses. Int J Med Inform 2021; 154:104566. [PMID: 34520934 DOI: 10.1016/j.ijmedinf.2021.104566] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/30/2021] [Accepted: 08/30/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The internet is an important source of travel health information. Individuals living with chronic illnesses consult patient organisation websites for illness-related information. We analysed the scope of online travel health information available to patients with pre-existing medical conditions. STUDY DESIGN A descriptive content analysis of patient organisation websites was conducted. METHODS The Google® search engine was interrogated using search terms related to the principal chronic diseases from the Global Burden of Disease Study. Data relating to 41 travel health variables were extracted from each eligible website. An aggregate quality score was derived for each organisation based on the presence of specific website information. Visitor usage and search analytics for each organisation's website were also described. RESULTS We examined 145 official organisation websites relating to 10 major chronic illnesses. The largest number of websites was retrieved for patients with cancer (n = 36). Only 21 (16.5%) websites provided information on fitness-to-travel considerations. COPD websites had the highest average quality score (17.68%), followed by diabetes (14.91%) and dementia (13.28%). Mental health illness websites had the lowest score of 1.33%. There was a trend towards increased emphasis on pre-travel preparation and medications. Insect bite avoidance, malaria, animal bites, jet lag, and repatriation were addressed to the least extent. CONCLUSIONS Our analysis exposes significant deficits in the coverage of travel health topics. Patient organisations should provide accessible pre-travel health advice to website users. Future research should elucidate the influence of web-based pre-travel health information on the behaviour of travellers with chronic disease.
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Affiliation(s)
- David P Rofaiel
- School of Medicine, National University of Ireland Galway, Galway, Ireland; National Institute for Prevention and Cardiovascular Health, Galway, Ireland
| | - Paul Hession
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Gerard T Flaherty
- School of Medicine, National University of Ireland Galway, Galway, Ireland; National Institute for Prevention and Cardiovascular Health, Galway, Ireland; School of Medicine, International Medical University, Kuala Lumpur, Malaysia.
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11089
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Sustainability analysis of Finnish pre-schoolers' diet based on targets of the EAT-Lancet reference diet. Eur J Nutr 2021; 61:717-728. [PMID: 34524506 PMCID: PMC8854143 DOI: 10.1007/s00394-021-02672-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 08/31/2021] [Indexed: 12/02/2022]
Abstract
Purpose The EAT-Lancet reference diet is a healthy plant-based diet produced within planetary boundaries. To inform the food system transformation, we compared Finnish pre-schoolers’ food consumption with the reference diet’s food group targets. Methods Food record data for 3- to 6-year-old pre-schoolers were collected in the cross-sectional DAGIS survey. Ingredients of composite dishes were available in the data. In addition, we manually decomposed industrial products such as sausages and biscuits by estimating the shares of ingredients. We also estimated the consumption of added sugars and converted the consumption of dairy products into milk equivalents. We used usual intake modelling to estimate the mean consumption and the proportion of children who met the reference diet’s targets. We set the target amounts separately for 3- to 4-year-olds and 5- to 6-year-olds in grams by proportioning the published target amounts (assuming a 2500 kcal diet) to the children’s mean reported energy intake. Results For both age groups (3- to 4-year-olds, n = 460; 5- to 6-year-olds, n = 402), the daily mean consumption of whole grains, vegetables, legumes, nuts, and unsaturated oils was below targets, whereas the consumption of red meat, dairy foods, tubers, and added sugars was above targets. The consumption of fruit and fish was in line with targets. Conclusion To comply with the reference diet’s targets, major changes in the diets of Finnish children are needed. The key food groups targeted for higher consumption are whole grains and legumes and targeted for lower consumption red meat and dairy products. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02672-3.
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11090
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Oakman J, Kinsman N, Briggs AM. Staying at work with musculoskeletal pain: What supporting resources do people need? Musculoskeletal Care 2021; 20:330-340. [PMID: 34520116 DOI: 10.1002/msc.1591] [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: 08/26/2021] [Revised: 09/05/2021] [Accepted: 09/08/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Maintaining productive employment can be challenging for people with ongoing low back pain (LBP) or neck pain (NP) due to pain, function and participation sequelae. Resources and information to support them staying at work may be beneficial, although preferences for the nature and accessibility of resources remain uncertain. The current study aimed to explore the work experiences and information-seeking behaviours of employed individuals with ongoing LBP or NP, to support them in staying at work. METHOD Semi-structured interviews were undertaken with 40 participants currently employed with ongoing LBP or NP. The interview schedule covered participants' experience of managing their LBP or NP at work, resources sought to assist with finding or maintaining employment, and where they accessed these resources. Interviews were recorded and analysed using thematic analysis. RESULTS Participants were employed in a wide range of job types and most reported a decrease in productivity. Five key themes were identified: (1) the meaning of work, (2) to disclose or not, (3) information seeking, (4) gaps in resources, (5) trusted sources. Work was highly valued by participants, despite the challenges in maintaining employment with ongoing LBP or NP. To support staying at work a range of information was sought by participants, but challenges in accessing reputable resources and trusting the sources were identified as key issues. CONCLUSION Opportunities exist for easily accessible, multi-level information from trustworthy sources targeted at the employer organisations, individuals and clinicians to support people in staying at work with ongoing LBP or NP.
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Affiliation(s)
- Jodi Oakman
- Department of Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Natasha Kinsman
- Department of Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Andrew M Briggs
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
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11091
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Canedo-García A, García-Sánchez JN, Díaz-Prieto C, Pacheco-Sanz DI. Evaluation of the Benefits, Satisfaction, and Limitations of Intergenerational Face-to-Face Activities: A General Population Survey in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9683. [PMID: 34574603 PMCID: PMC8468254 DOI: 10.3390/ijerph18189683] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 11/16/2022]
Abstract
Over the last decades, social isolation and loneliness among older adults have given rise to an increased interest in the study of intergenerational relationships. Intergenerational programs provide a great opportunity for older adults to connect with people of other generations. Many studies have reported the beneficial effects of these programs, improving the mental and physical health of the elderly and contributing to better academic formation and social skills in children. The aim of this study was to examine the benefits, satisfaction, and limitations of the intergenerational interactions derived from the performance of face-to-face activities, such as daily and healthcare activities, educational, cultural and leisure activities, and physical or sport activities. Participants were subjects living in Spain of any age (grouped into three age groups: <22, 22-40, and >40 years old) and from different social groups who completed an electronic 88-item questionnaire. The analysis of sociodemographic variables of the survey respondents revealed that people aged 40 or more, with personal autonomy, single or married, and living with a partner and/or other relative, and not retired, performed face-to-face activities with people of other generations with a significantly higher frequency than the rest of the groups for each variable. Most participants who participated in intergenerational face-to-face activities reported benefits to their physical and mental health, mood, relationships, self-determination, social participation, and academic education. Most participants were quite or very satisfied with the person with whom they performed this type of activities, especially if this person was a friend or a close relative. Except for grandparents, people who participated in intergenerational face-to-face activities and who had no limitations or disabilities were more frequently reported by the participants. In conclusion, intergenerational interactions derived from the performance of face-to-face activities can contribute to improve both the physical and mental health, social skills, and relationships of all people involved.
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Affiliation(s)
- Alejandro Canedo-García
- Department of Psychology, Sociology and Philosophy, Universidad de León, 24071 León, Spain; (A.C.-G.); (C.D.-P.)
| | - Jesús-Nicasio García-Sánchez
- Department of Psychology, Sociology and Philosophy, Universidad de León, 24071 León, Spain; (A.C.-G.); (C.D.-P.)
| | - Cristina Díaz-Prieto
- Department of Psychology, Sociology and Philosophy, Universidad de León, 24071 León, Spain; (A.C.-G.); (C.D.-P.)
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11092
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Short-term effect of fine particulate matter and ozone on non-accidental mortality and respiratory mortality in Lishui district, China. BMC Public Health 2021; 21:1661. [PMID: 34517854 PMCID: PMC8439017 DOI: 10.1186/s12889-021-11713-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/29/2021] [Indexed: 11/29/2022] Open
Abstract
Background In recent years, air pollution has become an imminent problem in China. Few studies have investigated the impact of air pollution on the mortality of the middle-aged and elderly people. Therefore, this study aims to evaluate the impact of PM2.5 (fine particulate matter) and O3 (ozone) on non-accidental mortality and respiratory mortality of the middle-aged and elderly people in Lishui District of Nanjing and provide the evidence for potential prevention and control measures of air pollution. Method Using daily mortality and atmospheric monitoring data from 2015 to 2019, we applied a generalized additive model with time-series analysis to evaluate the association of PM2.5 and O3 exposure with daily non-accidental mortality and respiratory mortality in Lishui District. Using the population attributable fractions to estimate the death burden caused by short-term exposure to O3 and PM2.5。. Result For every 10 μg/m3 increase in PM2.5, non-accidental mortality increased 0.94% with 95% confidence interval (CI) between 0.05 and 1.83%, and PM2.5 had a more profound impact on females than males. For every 10 μg/m3 increase in O3, respiratory mortality increased 1.35% (95% CI: 0.05, 2.66%) and O3 had a more profound impact on males than females. Compared with the single pollutant model, impact of the two-pollutant model on non-accidental mortality and respiratory mortality slightly decreased. In summer and winter as opposed to the other seasons, O3 had a more obvious impact on non-accidental mortality. The population attributable fractions of non-accidental mortality were 0.84% (95% CI:0.00, 1.63%) for PM2.5 and respiratory mortality were 0.14% (95% CI:0.01, 0.26%) for O3. For every 10 μg/m3 decrease in PM2.5, 122 (95% CI: 6, 237) non-accidental deaths could be avoided. For every 10 μg/m3 decrease in O3, 10 (95% CI: 1, 38) respiratory deaths could be avoided. Conclusion PM2.5 and O3 could significantly increase the risk of non-accidental and respiratory mortality in the middle-aged and elderly people in Lishui District of Nanjing. Exposed to air pollutants, men were more susceptible to O3 damage, and women were more susceptible to PM2.5 damage. Reduction of PM2.5 and O3 concentration in the air may have the potential to avoid considerable loss of lives.
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11093
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Wang Z, Guo E, Yang B, Xiao R, Lu F, You L, Chen G. Trends and age-period-cohort effects on mortality of the three major gynecologic cancers in China from 1990 to 2019: Cervical, ovarian and uterine cancer. Gynecol Oncol 2021; 163:358-363. [PMID: 34507827 DOI: 10.1016/j.ygyno.2021.08.029] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/18/2021] [Accepted: 08/30/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Gynecologic cancers seriously threaten women's life and health. This study aims to assess the long-term trends of mortality from the three major gynecologic cancers in China and to examine the age-, period-, and cohort-specific effects behind them during the period 1990 to 2019. METHODS The mortality data of cervical, ovarian, and uterine cancer in China were obtained from the Global Burden of Disease Study 2019 and were analyzed with the age-period-cohort framework. RESULTS It was found that the net drift for cervical cancer mortality was -0.19% (95% CI, -0.46% to 0.08%) per year, for ovarian cancer was 0.76% (95% CI, 0.57% to 0.95%) per year, and for uterine cancer was -3.09% (95% CI, -3.44% to -2.76%) per year from 1990 to 2019. During this period, while cervical cancer remained the most common cause of death among gynecologic cancers among Chinese women, ovarian cancer replaced uterine cancer as the second leading cause of death in gynecologic cancers after about 2005. Significant age, cohort, and period effects were found for the mortality trends of all three major gynecologic cancers. CONCLUSIONS The secular trends of mortality from the three major gynecologic cancers in China and their underlying age, period, and cohort effects are likely to reflect the progress of diagnosis and treatment, rapid socio-economic transitions, and the accompanying lifestyle and behavior changes. More priorities of further epidemiology studies and efforts on the prevention and control should be given to three major gynecologic cancers.
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Affiliation(s)
- Zhenkun Wang
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Department of Scientific Research, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ensong Guo
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Bin Yang
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Rourou Xiao
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Funian Lu
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Lixin You
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Gang Chen
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Department of Scientific Research, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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11094
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Deng Y, Wei B, Zhai Z, Zheng Y, Yao J, Wang S, Xiang D, Hu J, Ye X, Yang S, Wu Y, Li N, Xu P, Lyu J, Dai Z. Dietary Risk-Related Colorectal Cancer Burden: Estimates From 1990 to 2019. Front Nutr 2021; 8:690663. [PMID: 34504859 PMCID: PMC8421520 DOI: 10.3389/fnut.2021.690663] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 07/28/2021] [Indexed: 01/17/2023] Open
Abstract
Background: Colorectal cancer remains a public health problem worldwide. Dietary risk factors play a key role in the carcinogenesis and progression of colorectal cancer. This study aimed to explore the geographical and temporal trends in various dietary factor-related colorectal cancers. Methods: Data were extracted from the Global Burden of Disease (GBD) 2019 study, including the deaths, disability-adjusted life-years (DALYs), age-standardized rate (ASR), and summary exposure value (SEV) among 4 world regions, 11 age groups, 21 regions, and 204 countries and territories between 1990 and 2019. The estimated annual percentage changes (EAPCs) were calculated to evaluate the variation trend of ASR. Results: Dietary factors were the leading cause of colorectal cancer death and DALY rate, regardless of age. Dietary factor-related deaths and DALYs accounted for 32 and 34% of global colorectal cancer, respectively. Further analysis showed that low whole grain intake remained the leading cause of cancer death and DALY rate, followed by milk and calcium. Diets that were low in whole grains, milk, and calcium accounted for 81.61% of deaths and 81.64% of DALYs. Deaths and DALYs of dietary factors related to colorectal cancer grew by half from 1990 to 2019. All ASRs remained higher for men than women. Asia carried the highest colorectal cancer burden attributed to dietary risks, especially for East Asia [age-standardized death rate (ASDR): EAPC = 1.15, 95% CI:0.88–1.42; DALY: EAPC = 1.08, 95% CI:0.82–1.34]. The heavy burden also existed in high-middle and middle socio-demographic index (SDI) quintiles. China has always had the highest deaths and DALYs of colorectal cancer attributable to dietary risks, followed by the USA, India, and Japan. Conclusions: Large variations existed in the dietary risk-related colorectal cancer burdens among sexes, regions, and countries. More targeted interventions to address modifiable dietary risk factors would save 32% of deaths and 34% of DALYs for colorectal cancer.
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Affiliation(s)
- Yujiao Deng
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Bajin Wei
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Zhen Zhai
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yi Zheng
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jia Yao
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Shuqian Wang
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Dong Xiang
- Celilo Cancer Center, Oregon Health Science Center Affiliated Mid-Columbia Medical Center, The Dalles, OR, United States
| | - Jingjing Hu
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States
| | - Xianghua Ye
- Department of Radiotherapy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Si Yang
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ying Wu
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Na Li
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Peng Xu
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhijun Dai
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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11095
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Pinho J, Küppers C, Nikoubashman O, Wiesmann M, Schulz JB, Reich A, Werner CJ. Frailty is an outcome predictor in patients with acute ischemic stroke receiving endovascular treatment. Age Ageing 2021; 50:1785-1791. [PMID: 34087930 DOI: 10.1093/ageing/afab092] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/14/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Frailty is a disorder of multiple physiological systems impairing the capacity of the organism to cope with insult or stress. It is associated with poor outcomes after acute illness. Our aim was to study the impact of frailty on the functional outcome of patients with acute ischemic stroke (AIS) submitted to endovascular stroke treatment (EST). METHODS We performed a retrospective study of patients with AIS of the anterior circulation submitted to EST between 2012 and 2017, based on a prospectively collected local registry of consecutive patients. The Hospital Frailty Risk Score (HFRS) at discharge was calculated for each patient. We compared groups of patients with and without favourable 3-month outcome after index AIS (modified Rankin Scale 0-2 and 3-6, respectively). A multivariable logistic regression model was used to identify variables independently associated with favourable 3-month outcome. Diagnostic test statistics were used to compare HFRS with other prognostic scores for AIS. RESULTS We included 489 patients with median age 75.6 years (interquartile range [IQR] = 65.3-82.3) and median NIHSS 15 (IQR = 11-19). About 29.7% presented a high frailty risk (HFRS >15 points). Patients with favourable 3-month outcome presented lower HFRS and lower prevalence of high frailty risk. High frailty risk was independently associated with decreased likelihood of favourable 3-month outcome (adjusted odds ratio = 0.48, 95% confidence interval = 0.26-0.89). Diagnostic performances of HFRS and other prognostic scores (THRIVE and PRE scores, SPAN-100 index) for outcome at 3-months were similar. DISCUSSION Frailty is an independent predictor of outcome in AIS patients submitted to EST.
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Affiliation(s)
- João Pinho
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen D-52074, Germany
| | - Charlotte Küppers
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen D-52074, Germany
| | - Omid Nikoubashman
- Department of Neuroradiology, Medical Faculty, RWTH Aachen University, Aachen D-52074, Germany
| | - Martin Wiesmann
- Department of Neuroradiology, Medical Faculty, RWTH Aachen University, Aachen D-52074, Germany
| | - Jörg B Schulz
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen D-52074, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen D-52074, Germany
| | - Arno Reich
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen D-52074, Germany
| | - Cornelius J Werner
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen D-52074, Germany
- Department of Neurology, Medical Faculty, Section Interdisciplinary Geriatrics, RWTH Aachen University, Aachen D-52074, Germany
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11096
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Jeemon P, Séverin T, Amodeo C, Balabanova D, Campbell NRC, Gaita D, Kario K, Khan T, Melifonwu R, Moran A, Ogola E, Ordunez P, Perel P, Piñeiro D, Pinto FJ, Schutte AE, Wyss FS, Yan LL, Poulter NR, Prabhakaran D. World Heart Federation Roadmap for Hypertension - A 2021 Update. Glob Heart 2021; 16:63. [PMID: 34692387 PMCID: PMC8447967 DOI: 10.5334/gh.1066] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 12/20/2022] Open
Abstract
The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for local adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential Medicines' list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the 'Roadmap for raised BP' as 'Roadmap for hypertension' by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidence-based, inexpensive BP-lowering agents.
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Affiliation(s)
- Panniyammakal Jeemon
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandum, IN
| | | | - Celso Amodeo
- Universidade Federal de São Paulo (UNIFESP), São Paulo, BR
| | | | | | - Dan Gaita
- Universitatea de Medicina si Farmacie Victor Babes, Timisoara, RO
| | - Kazuomi Kario
- Jichi Medical University School of Medicine, Shimotsuke, Tochigi, JP
| | | | | | - Andrew Moran
- Columbia University and Resolve to Save Lives, New York, US
| | | | - Pedro Ordunez
- Pan American Health Organization, Washington, DC, US
| | - Pablo Perel
- London School of Hygiene & Tropical Medicine and World Heart Federation, Geneva, GB
| | | | - Fausto J. Pinto
- Santa Maria University Hospital (CHULN), CAML, CCUL, Lisboa, PT
| | - Aletta E. Schutte
- University of New South Wales; The George Institute for Global Health, Sydney, AU
| | - Fernando Stuardo Wyss
- Cardiovascular Technology and Services of Guatemala – CARDIOSOLUTIONS, Guatemala, GT
| | | | | | - Dorairaj Prabhakaran
- London School of Hygiene & Tropical Medicine, London, GB
- Public Health Foundation of India, Gurugram, IN
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11097
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Li Y, Fan T, Qi Q, Wang J, Qiu H, Zhang L, Wu X, Ye J, Chen G, Long J, Wang Y, Huang G, Li J. Efficacy of a Novel Exoskeletal Robot for Locomotor Rehabilitation in Stroke Patients: A Multi-center, Non-inferiority, Randomized Controlled Trial. Front Aging Neurosci 2021; 13:706569. [PMID: 34497506 PMCID: PMC8419710 DOI: 10.3389/fnagi.2021.706569] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/14/2021] [Indexed: 01/29/2023] Open
Abstract
Objective: To investigate the efficacy and safety of a novel lower-limb exoskeletal robot, BEAR-H1 (Shenzhen Milebot Robot Technology), in the locomotor function of subacute stroke patients. Methods: The present study was approved by the ethical committee of the First Affiliated Hospital of Nanjing Medical University (No. 2019-MD-43), and registration was recorded on the Chinese Clinical Trial Registry with a unique identifier: ChiCTR2100044475. A total of 130 patients within 6 months of stroke were randomly divided into two groups: the robot group and the control group. The control group received routine training for walking, while in the robot group, BEAR-H1 lower-limb exoskeletal robot was used for locomotor training. Both groups received two sessions daily, 5 days a week for 4 weeks consecutively. Each session lasted 30 min. Before treatment, after treatment for 2 weeks, and 4 weeks, the patients were assessed based on the 6-minute walking test (6MWT), functional ambulation scale (FAC), Fugl-Meyer assessment lower-limb subscale (FMA-LE), and Vicon gait analysis. Results: After a 4-week intervention, the results of 6MWT, FMA-LE, FAC, cadence, and gait cycle in the two groups significantly improved (P < 0.05), but there was no significant difference between the two groups (P > 0.05). The ratio of stance phase to that of swing phase, swing phase symmetry ratio (SPSR), and step length symmetry ratio (SLSR) was not significantly improved after 4 weeks of training in both the groups. Further analyses revealed that the robot group exhibited potential benefits, as the point estimates of 6MWT and Δ6MWT (post-pre) at 4 weeks were higher than those in the control group. Additionally, within-group comparison showed that patients in the robot group had a significant improvement in 6MWT earlier than their counterparts in the control group. Conclusions: The rehabilitation robot in this study could improve the locomotor function of stroke patients; however, its effect was no better than conventional locomotor training.
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Affiliation(s)
- Yongqiang Li
- Center of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tao Fan
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Qi Qi
- Shanghai YangZhi Rehabilitation Hospital, (Shanghai Sunshine Rehabilitation Center), Shanghai, China
| | - Jun Wang
- Guangdong Work Injury Rehabilitation Hospital (Guangdong Work Injury Rehabilitation Center), Guangzhou, China
| | - Huaide Qiu
- Center of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lingye Zhang
- Center of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xixi Wu
- Jiangsu Zhongshan Geriatric Rehabilitation Hospital, Nanjing, China
| | - Jing Ye
- Shenzhen MileBot Robotics Co., Ltd., Shenzhen, China
| | - Gong Chen
- Shenzhen MileBot Robotics Co., Ltd., Shenzhen, China
| | - Jianjun Long
- Department of Rehabilitation Medicine, The Second People's Hospital of Shenzhen, Shenzhen, China
| | - Yulong Wang
- Department of Rehabilitation Medicine, The Second People's Hospital of Shenzhen, Shenzhen, China
| | - Guozhi Huang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jianan Li
- Center of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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11098
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Reconstruction of the dynamic in a fatal traffic accident with prolonged dragging of the victim. Leg Med (Tokyo) 2021; 53:101963. [PMID: 34500311 DOI: 10.1016/j.legalmed.2021.101963] [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: 04/06/2021] [Accepted: 08/25/2021] [Indexed: 11/21/2022]
Abstract
The post-mortem examination of victims of fatal road crashes and the reconstruction of the dynamic of traffic accidents are fundamental in vehicular homicides, where the degree of negligence/careless of the driver has to be established. Here we present a case in which a pedestrian was dragged along an SUV for 3.5 km, until the vehicle was parked at the house of the driver, arising the suspect of vehicular manslaughter and failure to provide assistance. On the basis of death scene investigation, analysis of video recording from a surveillance camera, post-mortem computerized tomography (PMCT) and complete post-mortem examination, including gross and microscopical findings, the accident was reconstructed as a frontal collision between the right portion of the bumper and the right side of the body of a standing pedestrian, with deformation of the bumper and production of a metal sheet hook; secondary run-over the right feet, cranio-facial trauma against the bodywork of the vehicle and hooking of the right hand of the victim to the metal sheet; prolonged dragging of the pedestrian over the road surface and severe bleeding. A multidisciplinary-multimodal methodology, including PMCT, allowed to assess the cause of death as hemorrhagic shock, suggested that the victim would have likely survived if the vehicle had stopped, and is increasingly recommendable in fatal road accidents.
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11099
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Frailty should now be measured in all randomized controlled trials including older people. J Hypertens 2021; 39:419-420. [PMID: 33543884 DOI: 10.1097/hjh.0000000000002724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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11100
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Sohi I, Franklin A, Chrystoja B, Wettlaufer A, Rehm J, Shield K. The Global Impact of Alcohol Consumption on Premature Mortality and Health in 2016. Nutrients 2021; 13:nu13093145. [PMID: 34579021 PMCID: PMC8470338 DOI: 10.3390/nu13093145] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/01/2021] [Accepted: 09/01/2021] [Indexed: 12/14/2022] Open
Abstract
This study aimed to estimate the impact of alcohol use on mortality and health among people 69 years of age and younger in 2016. A comparative risk assessment approach was utilized, with population-attributable fractions being estimated by combining alcohol use data from the Global Information System on Alcohol and Health with corresponding relative risk estimates from meta-analyses. The mortality and health data were obtained from the Global Health Observatory. Among people 69 years of age and younger in 2016, 2.0 million deaths and 117.2 million Disability Adjusted Life Years (DALYs) lost were attributable to alcohol consumption, representing 7.1% and 5.5% of all deaths and DALYs lost in that year, respectively. The leading causes of the burden of alcohol-attributable deaths were cirrhosis of the liver (457,000 deaths), road injuries (338,000 deaths), and tuberculosis (190,000 deaths). The numbers of premature deaths per 100,000 people were highest in Eastern Europe (155.8 deaths per 100,000), Central Europe (52.3 deaths per 100,000 people), and Western sub-Saharan Africa (48.7 deaths per 100,000). A large portion of the burden of disease caused by alcohol among people 69 years of age and younger is preventable through the implementation of cost-effective alcohol policies such as increases in taxation.
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Affiliation(s)
- Ivneet Sohi
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (A.F.); (B.C.); (A.W.); (J.R.); (K.S.)
- Correspondence:
| | - Ari Franklin
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (A.F.); (B.C.); (A.W.); (J.R.); (K.S.)
| | - Bethany Chrystoja
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (A.F.); (B.C.); (A.W.); (J.R.); (K.S.)
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
- Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
| | - Ashley Wettlaufer
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (A.F.); (B.C.); (A.W.); (J.R.); (K.S.)
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (A.F.); (B.C.); (A.W.); (J.R.); (K.S.)
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
- Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, 33 Russell Street, Toronto, ON M5S 2S1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada
- Institute of Medical Science, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Street 46, D-01187 Dresden, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya Street, 8, b. 2, 119992 Moscow, Russia
| | - Kevin Shield
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (A.F.); (B.C.); (A.W.); (J.R.); (K.S.)
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, 33 Russell Street, Toronto, ON M5S 2S1, Canada
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