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Chen CH, Ganesh A. Remote Ischemic Conditioning in Stroke Recovery. Phys Med Rehabil Clin N Am 2024; 35:319-338. [PMID: 38514221 DOI: 10.1016/j.pmr.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Remote ischemic conditioning (RIC) is a therapeutic strategy to protect a vital organ like the brain from ischemic injury through brief and repeat cycles of ischemia and reperfusion in remote body parts such as arm or leg. RIC has been applied in different aspects of the stroke field and has shown promise. This narrative review will provide an overview of how to implement RIC in stroke patients, summarize the clinical evidence of RIC on stroke recovery, and discuss unresolved questions and future study directions.
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Affiliation(s)
- Chih-Hao Chen
- Department of Clinical Neurosciences, University of Calgary, HMRB Room 103, 3280 Hospital Drive, NW Calgary, Alberta, Canada T2N 4Z6; Department of Neurology, National Taiwan University Hospital, No.1, Changde Street, Zhongzheng District, Taipei City 100229, Taiwan (R.O.C.)
| | - Aravind Ganesh
- Department of Clinical Neurosciences, University of Calgary, HMRB Room 103, 3280 Hospital Drive, NW Calgary, Alberta, Canada T2N 4Z6.
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202
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Gill S, Agarwal M. Multiple Sclerosis Part 1: Essentials and the McDonald Criteria. Magn Reson Imaging Clin N Am 2024; 32:207-220. [PMID: 38555137 DOI: 10.1016/j.mric.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS) characterized by relapsing-remitting or progressive neurologic symptoms and focal white matter lesions. The hallmark of the disease is the dissemination of CNS lesions in space and time, which is defined by the McDonald criteria. MRI is an essential diagnostic and prognostic biomarker for MS which can evaluate the entire CNS. MS mimics must be excluded before a diagnosis of MS is made.
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Affiliation(s)
- Sonia Gill
- Section of Neuroradiology, Medical College of Wisconsin, Milwaukee, USA
| | - Mohit Agarwal
- Section of Neuroradiology, Medical College of Wisconsin, Milwaukee, USA.
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203
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Cheng X, Gao Y, Chen X, Lu J, Dai Q, Lai J. Rehabilitative effects of Baduanjin in Chinese stroke patients: A systematic review and meta-analysis. Prev Med Rep 2024; 41:102703. [PMID: 38595729 PMCID: PMC11002574 DOI: 10.1016/j.pmedr.2024.102703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/01/2024] [Accepted: 03/25/2024] [Indexed: 04/11/2024] Open
Abstract
Objective This study aims to systematically assess the rehabilitative effects of Baduanjin in stroke patients. Methods Ten electronic databases were systematically searched using MeSH and free terms for relevant studies written in the English or Chinese language, and published on or before 15 February 2023. Studies in which Baduanjin was the only difference in treatment administered to experimental and control groups were included in the review. The studies' risk of bias was evaluated using the Cochrane criteria. Results Twenty one studies that involved 1,649 participants were included. Compared to the control group, Baduanjin increased the scores for the Fugl-Meyer Assessment (including both upper and lower extremity components), Berg Balance Scale, Trunk Impairment Scale, Functional Ambulation Categories, 6-minute Walking Distance, Modified Barthel Index, Barthel Index, and total effective rate, but reduced the scores for the Pk254 balance function detection system, National Institutes of Health Stroke Scale and neurological deficit scale (P < 0.05, for all). Conclusion The present study findings revealed the potential benefits of Baduanjin in improving movement, balance, trunk, ambulation and neurological functions, and the ability to perform activities of daily living in stroke patients. Larger randomized controlled trials with more standardized intervention protocols are required to obtain more robust evidence.
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Affiliation(s)
- Xi Cheng
- Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350003, China
- Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian 350003, China
| | - Yanling Gao
- Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350003, China
- Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian 350003, China
| | - Xiaofeng Chen
- Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350003, China
- Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian 350003, China
| | - Jinhua Lu
- Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350003, China
- Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian 350003, China
| | - Qingyue Dai
- Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350003, China
- Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian 350003, China
| | - Jinghui Lai
- Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350003, China
- Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian 350003, China
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204
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Bai Y, Cai Y, Chang D, Li D, Huo X, Zhu T. Immunotherapy for depression: Recent insights and future targets. Pharmacol Ther 2024; 257:108624. [PMID: 38442780 DOI: 10.1016/j.pharmthera.2024.108624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/29/2024] [Accepted: 02/20/2024] [Indexed: 03/07/2024]
Abstract
Depression stands as a prominent contributor to global disability, entailing an elevated risk of suicide. Substantial evidence supports the notion that immune dysregulation may play a role in the development of depression and impede responses to antidepressant treatments. Immune dysregulation may cause depression in susceptible individuals through raising inflammatory responses. Differences in immune cell types and the release of pro-inflammatory mediators are observed in the blood and cerebrospinal fluid of patients with major depressive disorder, which is associated with neuroimmune dysfunction. Therefore, the interaction of peripheral and central immune targets in depression needs to be understood. Urgent attention is required for the development of innovative therapeutics directed at modulating immune responses for the treatment of depression. This review delineates the immune mechanisms involved in the pathogenesis of depression, assesses the therapeutic potential of immune system targeting for depression treatment, and deliberates on the merits and constraints of employing immunotherapy in the management of depression.
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Affiliation(s)
- Ying Bai
- Department of Pharmacology, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Medicine, Southeast University, Nanjing 210009, China.
| | - Yang Cai
- Department of Pharmacology, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Medicine, Southeast University, Nanjing 210009, China
| | - Di Chang
- Department of Radiology, Zhongda Hospital, Jiangsu Key Laboratory of Molecular and Functional Imaging, Medical School of Southeast University, Nanjing 210009, China
| | - Daxing Li
- Department of Pharmacology, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Medicine, Southeast University, Nanjing 210009, China
| | - Xinchen Huo
- Department of Pharmacology, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Medicine, Southeast University, Nanjing 210009, China
| | - Tianhao Zhu
- Department of Pharmacology, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Medicine, Southeast University, Nanjing 210009, China
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205
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Liang Y, Lin Y, Jiao B. Health Interventions May Have Divergent Impacts on Health and Economic Equity: A Case Study of the Community-Based Hypertension Improvement Project in Ghana. Appl Health Econ Health Policy 2024; 22:353-362. [PMID: 38267804 DOI: 10.1007/s40258-024-00871-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND AND OBJECTIVE Improving health and economic equity are key objectives in priority setting, particularly in low-income and middle-income countries. This study aims to assess the distributional impacts of the Community-based Hypertension Improvement Project (ComHIP) on health and economic outcomes across wealth quintiles in Ghana. METHODS We developed a decision analytical model to simulate a 30 million cohort of Ghanaians aged 15-49 years. The study specified health outcomes as the prevention of stroke cases and averting deaths among those with hypertension. Furthermore, we explored economic impacts, including savings in out-of-pocket costs for stroke patients and government spending. Financial risk protection against catastrophic and impoverishing health expenditures was also examined. We assessed these outcomes across wealth quintiles, and the corresponding concentration indexes (CIXs) were determined. RESULTS It was estimated that ComHIP could prevent 1450 stroke cases and 564 related deaths annually. Health benefits were observed to be more significant among the wealthier quintiles (CIX 0.217), mainly attributed to a higher occurrence of hypertension within these groups. ComHIP was also projected to result in an annual saving of USD 49,885 in individuals' out-of-pocket costs (CIX 0.262) and USD 37,578 in government spending (CIX 0.146). These savings correspond to the prevention of 335 catastrophic health expenditure cases (CIX - 0.239) and 11 impoverishing health expenditure cases (CIX - 0.600). CONCLUSIONS While ComHIP provides greater health benefits to wealthier groups, it offers substantial financial risk protection for the less wealthy. This study highlights the importance of considering equity in both health and financial risk when making priority-setting decisions.
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Affiliation(s)
- Yizhi Liang
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 90 Smith St, Boston, MA, 02120, USA
| | - Yuqian Lin
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 90 Smith St, Boston, MA, 02120, USA
| | - Boshen Jiao
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 90 Smith St, Boston, MA, 02120, USA.
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Abbasi A, Fryk H, Rudnik J, White R, Vanderkelen M, Scowcroft A, Bonar K. Using an expanded algorithm to estimate prevalence of amyotrophic lateral sclerosis in U.S. and UK. Neurol Sci 2024; 45:2321-2324. [PMID: 38270730 DOI: 10.1007/s10072-024-07336-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/15/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND There is an increasing need to better understand the burden of amyotrophic lateral sclerosis (ALS) using real-world data (RWD). However, identifying ALS cases using RWD presents several challenges due to the rarity of ALS and the differences in database coding systems. METHODS MarketScan claims, and the UK Clinical Practice Research Datalink (CPRD) databases were searched for diagnosis codes of ALS or MND, the only drugs approved for treating ALS (riluzole and edaravone) and clinical visits with 12-month enrolment prior to 1 January 2011. The main algorithm required ≥ 1 ALS diagnosis code together with prescriptions or clinical visits. We expanded the existing algorithm to identify unspecific (possible) ALS group that had codes for motor neuron disease (MND) and the ALS drugs. The study period was from 1 January 2011 until 31 December 2020. RESULTS We identified 16,246 patients with ≥ 1 ALS code in Marketscan (denominator n = 85,279,619), yet only 184 were found in the UK CPRD (denominator n = 21,318,589). Using the main algorithm 9,433 ALS patients were included in MarketScan, with a prevalence ranged between 4.5 per 100,000 in 2019 and 6.2 in 2015. In MarketScan, 3,658 (4.3 per 100,000) had ≥ 1 MND code and the ALS drug codes (possible cases). In CPRD, 47.9% of 2,785 patients with ≥ 1 MND code had a prescription for riluzole (6.3 per 100,000), regarded as possible ALS cases. CONCLUSIONS The expanded algorithm enabled the identification of a large population with ALS, or possible ALS, and the estimation of ALS prevalence in MarketScan and CPRD.
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Affiliation(s)
- Ali Abbasi
- UCB Pharma Ltd., 208 Bath Road, Slough, SL1 3WE, UK.
| | - Henrik Fryk
- UCB Pharma Ltd., 208 Bath Road, Slough, SL1 3WE, UK
| | - Jan Rudnik
- UCB Pharma Ltd., 208 Bath Road, Slough, SL1 3WE, UK
| | | | | | | | - Kerina Bonar
- UCB Pharma Ltd., 208 Bath Road, Slough, SL1 3WE, UK
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207
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Shi D, Zhou Y, He S, Wagner SK, Huang Y, Keane PA, Ting DS, Zhang L, Zheng Y, He M. Cross-modality Labeling Enables Noninvasive Capillary Quantification as a Sensitive Biomarker for Assessing Cardiovascular Risk. Ophthalmol Sci 2024; 4:100441. [PMID: 38420613 PMCID: PMC10899028 DOI: 10.1016/j.xops.2023.100441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 03/02/2024]
Abstract
Purpose We aim to use fundus fluorescein angiography (FFA) to label the capillaries on color fundus (CF) photographs and train a deep learning model to quantify retinal capillaries noninvasively from CF and apply it to cardiovascular disease (CVD) risk assessment. Design Cross-sectional and longitudinal study. Participants A total of 90732 pairs of CF-FFA images from 3893 participants for segmentation model development, and 49229 participants in the UK Biobank for association analysis. Methods We matched the vessels extracted from FFA and CF, and used vessels from FFA as labels to train a deep learning model (RMHAS-FA) to segment retinal capillaries using CF. We tested the model's accuracy on a manually labeled internal test set (FundusCapi). For external validation, we tested the segmentation model on 7 vessel segmentation datasets, and investigated the clinical value of the segmented vessels in predicting CVD events in the UK Biobank. Main Outcome Measures Area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity for segmentation. Hazard ratio (HR; 95% confidence interval [CI]) for Cox regression analysis. Results On the FundusCapi dataset, the segmentation performance was AUC = 0.95, accuracy = 0.94, sensitivity = 0.90, and specificity = 0.93. Smaller vessel skeleton density had a stronger correlation with CVD risk factors and incidence (P < 0.01). Reduced density of small vessel skeletons was strongly associated with an increased risk of CVD incidence and mortality for women (HR [95% CI] = 0.91 [0.84-0.98] and 0.68 [0.54-0.86], respectively). Conclusions Using paired CF-FFA images, we automated the laborious manual labeling process and enabled noninvasive capillary quantification from CF, supporting its potential as a sensitive screening method for identifying individuals at high risk of future CVD events. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Danli Shi
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yukun Zhou
- Centre for Medical Image Computing, University College London, London, UK
| | - Shuang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Siegfried K. Wagner
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Yu Huang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Pearse A. Keane
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Daniel S.W. Ting
- Singapore National Eye Center, Singapore Eye Research Institute, and Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Lei Zhang
- Faculty of Medicine, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Yingfeng Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mingguang He
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
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208
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Li S, Li S, Duan F, Lu B. Depression and NAFLD risk: A meta-analysis and Mendelian randomization study. J Affect Disord 2024; 352:379-385. [PMID: 38387674 DOI: 10.1016/j.jad.2024.02.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Both depression and nonalcoholic fatty liver disease (NAFLD) have a high global prevalence. Growing evidence suggests an association between depression and NAFLD, while the association remains unclear. Thus, in this study, we aimed to explore the effect of depression on the risk of developing NAFLD. METHODS The meta-analysis examined the association between depression and the risk of NAFLD by including observational studies. Relevant studies were searched in PubMed, Embase, the Cochrane Library, and Web of Science. Then a two-sample Mendelian randomization (MR) analysis was performed to explore causal association using genetic instruments identified from a genome-wide association study. RESULTS Six eligible studies were included in the meta-analysis, involving 289,22 depression cases among 167,554 participants. Meta-analysis showed a significant association between depression and a higher risk of developing NAFLD (OR = 1.14, 95 % CI: [1.05, 1.24], P = 0.002). However, we found no convincing evidence supporting a causal role of genetically predicted depression with NAFLD risk (OR = 0.861, 95 % CI: [0.598, 1.238], P = 0.420). LIMITATIONS The insufficient number of included studies, the use of summary-level data, and restrictions on population sources are the major limiting factors. CONCLUSIONS Meta-analysis and MR analysis demonstrated inconsistent results on the relationship between depression and a high risk of developing NAFLD. Specifically, meta-analysis confirmed that depression increases the risk of developing NAFLD, while MR analysis did not support a causal association between genetically determined depression and the risk of NAFLD.
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Affiliation(s)
- Shudi Li
- The Second Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou 450000, China
| | - Suling Li
- The First Affiliated Hospital of Henan University of TCM, Zhengzhou 450000, China
| | - Fei Duan
- The First Affiliated Hospital of Henan University of TCM, Zhengzhou 450000, China
| | - Baoping Lu
- Henan University of Chinese Medicine, Zhengzhou 450046, China.
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209
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Peng Y, Ren Q, Ma H, Lin C, Yu M, Li Y, Chen J, Xu H, Zhao P, Pan S, Tao J, Huang K. Covalent organic framework based cytoprotective therapy after ischemic stroke. Redox Biol 2024; 71:103106. [PMID: 38442647 PMCID: PMC10924141 DOI: 10.1016/j.redox.2024.103106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 03/07/2024] Open
Abstract
Cytoprotection has emerged as an effective therapeutic strategy for mitigating brain injury following acute ischemic stroke (AIS). The sulfonylurea receptor 1-transient receptor potential M4 (SUR1-TRPM4) channel plays a pivotal role in brain edema and neuroinflammation. However, the practical use of the inhibitor glyburide (GLB) is hindered by its low bioavailability. Additionally, the elevated reactive oxygen species (ROS) after AIS exacerbate SUR1-TRPM4 activation, contributing to irreversible brain damage. To overcome these challenges, GLB and superoxide dismutase (SOD) were embedded in a covalent organic framework (COF) with a porous structure and great stability. The resulting S/G@COF demonstrated significant improvements in survival and neurological functions. This was achieved by eliminating ROS, preventing neuronal loss and apoptosis, suppressing neuroinflammation, modulating microglia activation, and ameliorating blood-brain barrier (BBB) disruption. Mechanistic investigations revealed that S/G@COF concurrently activated the Wnt/β-catenin signaling pathway while suppressing the upregulation of SUR1-TRPM4. This study underscores the potential of employing multi-target therapy and drug modification in cytoprotective strategies for ischemic stroke.
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Affiliation(s)
- Yuqin Peng
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Qingfan Ren
- School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510640, China
| | - Huanrong Ma
- Department of Medicine Ultrasonics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Chuman Lin
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Mingjia Yu
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yongchuan Li
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Jiancong Chen
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Haihao Xu
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Peng Zhao
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, 510515, China; Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation, Southern Medical University, Guangzhou, 510515, China
| | - Suyue Pan
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Jia Tao
- School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510640, China.
| | - Kaibin Huang
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China; Department of Neurology, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, China.
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210
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Kawi J, Yeh CH, Grant L, Huang X, Wu H, Hua C, Christo P. Retention, adherence, and acceptability testing of a digital health intervention in a 3-group randomized controlled trial for chronic musculoskeletal pain. Complement Ther Med 2024; 81:103030. [PMID: 38437926 DOI: 10.1016/j.ctim.2024.103030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVES Evaluate a digital health intervention using Auricular Point Acupressure (APA) for chronic musculoskeletal pain in terms of participant retention, adherence, acceptability, and satisfaction. Chronic musculoskeletal pain is a global concern and there are persistent challenges in pain management. Despite the value of digital health interventions, these interventions need to be fully evaluated for feasibility. METHODS We conducted a 3-group, longitudinal, randomized controlled trial (RCT). After Institutional Review Board approval, we posted recruitment flyers in a university, healthcare clinics, and community settings. Participants were randomized into an in-person + app group (n = 8), virtual + app group (n = 7), and a wait-list, education-enhanced control group (n = 8), evaluating our outcomes using standard feasibility measures. The 4-week intervention consisted of virtual sessions, telecommunications, and our APA app, followed by a 3-month follow-up. RESULTS Data from 22 participants were subsequently analyzed (95.7%). All app participants adhered to the study protocol and used APA at the minimum recommended frequency and duration. The virtual + app group used APA more during the intervention and follow-up periods. All app participants found the intervention to be acceptable and at least 80% overall were satisfied with APA at the 3-month follow-up. There were no adverse events reported. CONCLUSIONS Our digital health intervention was found to be acceptable and sustainable; participants adhered to and were satisfied with the intervention providing support for a larger RCT. CLINICAL TRIAL #: NCT05020470.
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Affiliation(s)
- Jennifer Kawi
- University of Nevada, Las Vegas, School of Nursing, 4505 S Maryland Parkway, Las Vegas, NV 89154-3018, USA.
| | - Chao Hsing Yeh
- University of Texas Health Science Center at Houston, Cizik School of Nursing, 6901 Bertner Ave, Houston, TX 77030, USA
| | - Lauren Grant
- University of Nevada, Las Vegas, Kirk Kerkorian School of Medicine, 625 Shadow Ln, Las Vegas, NV 89106, USA
| | - Xinran Huang
- University of Texas Health Science Center at Houston, School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Hulin Wu
- University of Texas Health Science Center at Houston, School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Chunyan Hua
- University of Nevada, Las Vegas, William F. Harrah College of Hospitality, 4505 S Maryland Pkwy, Las Vegas, NV 89154, USA
| | - Paul Christo
- Johns Hopkins University, School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA
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211
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Yan LD, Sufra R, St Sauveur R, Jean-Pierre MC, Apollon A, Malebranche R, Théard M, Pierre G, Dévieux J, Lau J, Mourra N, Roberts NL, Rasul R, Nash D, Pirmohamed AM, Devereux RB, Lee MH, Kwan GF, Safford MM, Adrien L, Alfred JP, Deschamps M, Severe P, Fitzgerald DW, Pape JW, Rouzier V, McNairy ML. Spectrum of prevalent cardiovascular diseases in urban Port-au-Prince, Haiti: a population-based cross-sectional study. Lancet Reg Health Am 2024; 33:100729. [PMID: 38590326 PMCID: PMC11000196 DOI: 10.1016/j.lana.2024.100729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 04/10/2024]
Abstract
Background Eighty percent of global cardiovascular disease (CVD) is projected to occur in low- and middle -income countries (LMICs), yet local epidemiological data are scarce. We provide the first population-based, adjudicated CVD prevalence estimates in Port-au-Prince, Haiti to describe the spectrum of heart disease and investigate associated risk factors. Methods Demographic, medical history, clinical, imaging and laboratory data were collected among adults recruited using multistage random sampling from 2019 to 2021. Prevalent CVD (heart failure, stroke, ischemic disease) were adjudicated using epidemiological criteria similar to international cohorts. Multivariable Poisson regressions assessed relationships between risk factors and prevalent CVD. Findings Among 3003 participants, median age was 40 years, 58.1% were female, 70.2% reported income <1 USD/day, and all identified as Black Haitian. CVD age-adjusted prevalence was 14.7% (95% CI 13.3%, 16.5%), including heart failure (11.9% [95% CI 10.5%, 13.5%]), stroke (2.4% [95% CI 1.9%, 3.3%]), angina (2.1% [95% CI 1.6%, 2.9%]), myocardial infarction (1.0% [95% CI 0.6%, 1.8%]), and transient ischemic attack (0.4% [95% CI 0.2%, 1.0%]). Among participants with heart failure, median age was 57 years and 68.5% of cases were among women. The most common subtype was heart failure with preserved ejection fraction (80.4%). Heart failure was associated with hypertension, obesity, chronic kidney disease, depression, and stress. Interpretation Early-onset heart failure prevalence is alarmingly high in urban Haiti and challenge modelling assumptions that ischemic heart disease and stroke dominate CVDs in LMICs. These data underscore the importance of local population-based epidemiologic data within LMICs to expedite the selection and implementation of evidence-based cardiovascular health policies targeting each country's spectrum of heart disease. Funding This study was funded by NIH grants R01HL143788, D43TW011972, and K24HL163393, clinicaltrials.govNCT03892265.
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Affiliation(s)
- Lily D. Yan
- Center for Global Health, Weill Cornell Medicine, NYC, NY, USA
- Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA
| | - Rodney Sufra
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Reichling St Sauveur
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Marie Christine Jean-Pierre
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Alexandra Apollon
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Rodolphe Malebranche
- Collège Haïtien de Cardiologie, Port-au-Prince, Haiti
- Department of Medicine and Pharmacology, Université d'État d'Haïti, Port-au-Prince, Haiti
| | - Michel Théard
- Collège Haïtien de Cardiologie, Port-au-Prince, Haiti
| | - Gerard Pierre
- Collège Haïtien de Cardiologie, Port-au-Prince, Haiti
| | - Jessy Dévieux
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Jennifer Lau
- Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA
| | - Nour Mourra
- Center for Global Health, Weill Cornell Medicine, NYC, NY, USA
- Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA
| | | | - Rehana Rasul
- City University of New York Institute for Implementation Science in Population Health, New York, NY, USA
| | - Denis Nash
- City University of New York Institute for Implementation Science in Population Health, New York, NY, USA
| | | | | | - Myung Hee Lee
- Center for Global Health, Weill Cornell Medicine, NYC, NY, USA
| | - Gene F. Kwan
- Division of Cardiology, Boston University School of Medicine, Boston, MA, USA
| | - Monika M. Safford
- Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA
| | - Lauré Adrien
- Director General, Ministry of Public Health and Population, Haiti
| | - Jean Patrick Alfred
- Director of Studies and Programming, Ministry of Public Health and Population, Haiti
| | - Marie Deschamps
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Patrice Severe
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | | | - Jean W. Pape
- Center for Global Health, Weill Cornell Medicine, NYC, NY, USA
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Vanessa Rouzier
- Center for Global Health, Weill Cornell Medicine, NYC, NY, USA
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Margaret L. McNairy
- Center for Global Health, Weill Cornell Medicine, NYC, NY, USA
- Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA
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212
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Janson A. How and when can we predict the risk of future metabolic disease in children with obesity? Acta Paediatr 2024; 113:850-851. [PMID: 38411354 DOI: 10.1111/apa.17176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 02/19/2024] [Indexed: 02/28/2024]
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213
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Celie KB, Mocharnuk JW, Kanmounye US, Ayala R, Banu T, Lakhoo K. The importance of global bioethics to paediatric health care. Lancet Child Adolesc Health 2024; 8:379-384. [PMID: 38408455 DOI: 10.1016/s2352-4642(23)00317-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/15/2023] [Accepted: 11/21/2023] [Indexed: 02/28/2024]
Abstract
The paradigm of values adopted by the global health community has a palpable, albeit often unseen, impact on patient health care. In this Viewpoint, we investigate an inherent tension in the core values of medical ethics and clinical practice that could explain why paediatric health care faces resource constraints despite compelling economic and societal imperatives to prioritise child health and wellbeing. The dominant narrative in the philosophy of medicine tends to disproportionately underscore values of independence and self-determination, which becomes problematic in the context of paediatric patients, who by their very nature epitomise vulnerability and dependence. A double-jeopardy situation arises when disadvantaged children see their inherent dependence leveraged against them. We illustrate this predicament through specific examples relating to rights and obligations and to autonomy. Alternative value perspectives-communitarianism and relational autonomy-might offer more robust protection for vulnerable children. A shift away from the dominant narrative towards a more explicit and inclusive discussion of values is necessary. Such a shift requires giving a legitimate platform to diverse perspectives, with the presumption that collective moral progress is possible; this endeavour is embodied by global bioethics. Successful implementation of global bioethics, in turn, hinges on close collaboration between practicing clinicians and bioethicists. Taking global bioethics seriously and actively pursuing collaboration could help the global health community achieve more equitable health care.
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Affiliation(s)
- Karel-Bart Celie
- The Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK; Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Operation Smile, Department of Policy and Advocacy, Virginia Beach, VA, USA.
| | | | - Ulrick S Kanmounye
- Operation Smile, Department of Policy and Advocacy, Virginia Beach, VA, USA
| | - Ruben Ayala
- Operation Smile, Department of Policy and Advocacy, Virginia Beach, VA, USA
| | - Tahmina Banu
- Chittagong Research institute for Children Surgery, Chittagong, Bangladesh; Global Initiative for Children's Surgery, Sacramento, CA, USA
| | - Kokila Lakhoo
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Global Initiative for Children's Surgery, Sacramento, CA, USA
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214
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Anita WM, Uttajug A, Seposo XT, Sudo K, Nakata M, Takemura T, Takano H, Fujiwara T, Ueda K. Interplay of Climate Change and Air Pollution- Projection of the under-5 mortality attributable to ambient particulate matter (PM2.5) in South Asia. Environ Res 2024; 248:118292. [PMID: 38266897 DOI: 10.1016/j.envres.2024.118292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/20/2023] [Accepted: 01/20/2024] [Indexed: 01/26/2024]
Abstract
Ambient fine particulate matter (PM2.5) pollution is a leading health risk factor for children under- 5 years, especially in developing countries. South Asia is a PM2.5 hotspot, where climate change, a potential factor affecting PM2.5 pollution, adds a major challenge. However, limited evidence is available on under-5 mortality attributable to PM2.5 under different climate change scenarios. This study aimed to project under-5 mortality attributable to long-term exposure to ambient PM2.5 under seven air pollution and climate change mitigation scenarios in South Asia. We used a concentration-risk function obtained from a previous review to project under-5 mortality attributable to ambient PM2.5. With a theoretical minimum risk exposure level of 2.4 μg/m3, this risk function was linked to gridded annual PM2.5 concentrations from atmospheric modeling to project under-5 mortality from 2010 to 2049 under different climate change mitigation scenarios. The scenarios were developed from the Aim/Endues global model based on end-of-pipe (removing the emission of air pollutants at the source, EoP) and 2 °C target measures. Our results showed that, in 2010-2014, about 306.8 thousand under-5 deaths attributable to PM2.5 occurred in South Asia under the Reference (business as usual) scenario. The number of deaths was projected to increase in 2045-2049 by 36.6% under the same scenario and 7.7% under the scenario where EoP measures would be partially implemented by developing countries (EoPmid), and was projected to decrease under other scenarios, with the most significant decrease (81.2%) under the scenario where EoP measures would be fully enhanced by all countries along with the measures to achieve 2 °C target (EoPmaxCCSBLD) across South Asia. Country-specific projections of under-5 mortality varied by country. The current emission control strategy would not be sufficient to reduce the number of deaths in South Asia. Robust climate change mitigation and air pollution control policy implementation is required.
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Affiliation(s)
| | - Athicha Uttajug
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Japan.
| | | | - Kengo Sudo
- Graduate School of Environmental Studies, Nagoya University, Nagoya, Japan; Japan Agency for Marine-Earth Science and Technology, Yokohama, Japan.
| | - Makiko Nakata
- Faculty of Applied Sociology Kindai University, Osaka, Japan.
| | - Toshihiko Takemura
- Research Institute for Applied Mechanics, Kyushu University, Kyushu, Japan.
| | - Hirohisa Takano
- Graduate School of Global Environmental Studies, Kyoto University, Japan; Graduate School of Engineering, Kyoto University, Japan.
| | - Taku Fujiwara
- Graduate School of Global Environmental Studies, Kyoto University, Japan; Graduate School of Engineering, Kyoto University, Japan.
| | - Kayo Ueda
- Graduate School of Global Environmental Studies, Kyoto University, Japan; Department of Hygiene, Graduate School of Medicine, Hokkaido University, Japan.
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215
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Xu F, Xie L, He J, Huang Q, Shen Y, Chen L, Zeng X. Detection of common pathogenesis of rheumatoid arthritis and atherosclerosis via microarray data analysis. Heliyon 2024; 10:e28029. [PMID: 38628735 PMCID: PMC11019104 DOI: 10.1016/j.heliyon.2024.e28029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/28/2024] [Accepted: 03/11/2024] [Indexed: 04/19/2024] Open
Abstract
Despite extensive research reveal rheumatoid arthritis (RA) is related to atherosclerosis (AS), common pathogenesis between these two diseases still needs to be explored. In current study, we explored the common pathogenesis between rheumatoid arthritis (RA) and atherosclerosis (AS) by identifying 297 Differentially Expressed Genes (DEGs) associated with both diseases. Through KEGG and GO functional analysis, we highlighted the correlation of these DEGs with crucial biological processes such as the vesicle transport, immune system process, signaling receptor binding, chemokine signaling and many others. Employing Protein-Protein Interaction (PPI) network analysis, we elucidated the associations between DEGs, revealing three gene modules enriched in immune system process, vesicle, signaling receptor binding, Pertussis, and among others. Additionally, through CytoHubba analysis, we pinpointed 11 hub genes integral to intergrin-mediated signaling pathway, plasma membrane, phosphotyrosine binding, chemokine signaling pathway and so on. Further investigation via the TRRUST database identified two key Transcription Factors (TFs), SPI1 and RELA, closely linked with these hub genes, shedding light on their regulatory roles. Finally, leveraging the collective insights from hub genes and TFs, we proposed 10 potential drug candidates targeting the molecular mechanisms underlying RA and AS pathogenesis. Further investigation on xCell revealed that 14 types of cells were all different in both AS and RA. This study underscores the shared pathogenic mechanisms, pivotal genes, and potential therapeutic interventions bridging RA and AS, offering valuable insights for future research and clinical management strategies.
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Affiliation(s)
- Fan Xu
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, Fujian Province, China
| | - Linfeng Xie
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Fujian Medical University, Fuzhou, Fujian Province, China
| | - Jian He
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Fujian Medical University, Fuzhou, Fujian Province, China
| | - Qiuyu Huang
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, Fujian Province, China
| | - Yanming Shen
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Fujian Medical University, Fuzhou, Fujian Province, China
| | - Liangwan Chen
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, Fujian Province, China
| | - Xiaohong Zeng
- Department of Rheumatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China
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216
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Jing J, Fang S, Li Y, Liu W, Wang C, Lan Y, Wang Y, Yang C. An enhanced cardio-protective effect of nanoparticles loaded with active components from Polygonum orientale L. against isoproterenol-induced myocardial ischemia in rats. Int J Pharm 2024; 655:124047. [PMID: 38531434 DOI: 10.1016/j.ijpharm.2024.124047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/12/2024] [Accepted: 03/23/2024] [Indexed: 03/28/2024]
Abstract
In this study, nanoparticles loaded with active components from Polygonum orientale L. (PO), a traditional Chinese herb known for its anti-myocardial ischemic properties, were investigated for cardio-protective properties. Specifically, OVQ-Nanoparticles (OVQ-NPs) with Orientin (Ori), Vitexin (Vit), and Quercetin (Que) was obtained by double emulsion-solvent evaporation method. The OVQ-NPs exhibited a spherical shape, with a uniform size distribution of 136.77 ± 3.88 nm and a stable ζ-potential of -13.40 ± 2.24 mV. Notably, these nanoparticles exhibited a favorable sustained-release characteristic, resulting in an extended circulation time within the living organism. Consequently, the administration of these nanoparticles resulted in significant improvements in electrocardiograms and heart mass index of myocardial ischemic rats induced by isoproterenol, as well as decreased serum levels of CK, LDH, and AST. Furthermore, the results of histopathological examination, such as H&E staining and TUNEL staining, confirmed a reduced level of cardiac tissue pathology and apoptosis. Moreover, the quantification of biochemical indicators (SOD, MDA, GSH, NO, TNF-α, and IL-6) demonstrated that OVQ-NPs effectively mitigated myocardial ischemia by regulating oxidative stress and inflammatory pathways. In conclusion, OVQ-NPs demonstrate promising therapeutic potential as an intervention for myocardial ischemia, providing a new perspective on traditional Chinese medicine treatment in this area.
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Affiliation(s)
- Jincheng Jing
- State Key Laboratory of Functions and Applications of Medicinal Plants/Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang 550004, Guizhou, China; School of Pharmacy, Guizhou Medical University, Guiyang 550004, Guizhou, China
| | - Shumei Fang
- State Key Laboratory of Functions and Applications of Medicinal Plants/Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang 550004, Guizhou, China; School of Pharmacy, Guizhou Medical University, Guiyang 550004, Guizhou, China
| | - Yueting Li
- State Key Laboratory of Functions and Applications of Medicinal Plants/Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang 550004, Guizhou, China; Engineering Research Center for the Development and Application of Ethnic Medicine and TCM (Ministry of Education), Guizhou Medical University, Guiyang 550004, Guizhou, China
| | - Wenting Liu
- State Key Laboratory of Functions and Applications of Medicinal Plants/Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang 550004, Guizhou, China; School of Pharmacy, Guizhou Medical University, Guiyang 550004, Guizhou, China
| | - Cong Wang
- State Key Laboratory of Functions and Applications of Medicinal Plants/Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang 550004, Guizhou, China; School of Pharmacy, Guizhou Medical University, Guiyang 550004, Guizhou, China
| | - Yanyu Lan
- State Key Laboratory of Functions and Applications of Medicinal Plants/Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang 550004, Guizhou, China; Engineering Research Center for the Development and Application of Ethnic Medicine and TCM (Ministry of Education), Guizhou Medical University, Guiyang 550004, Guizhou, China
| | - Yonglin Wang
- State Key Laboratory of Functions and Applications of Medicinal Plants/Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang 550004, Guizhou, China; Engineering Research Center for the Development and Application of Ethnic Medicine and TCM (Ministry of Education), Guizhou Medical University, Guiyang 550004, Guizhou, China.
| | - Chang Yang
- State Key Laboratory of Functions and Applications of Medicinal Plants/Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang 550004, Guizhou, China; Engineering Research Center for the Development and Application of Ethnic Medicine and TCM (Ministry of Education), Guizhou Medical University, Guiyang 550004, Guizhou, China.
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217
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Chowdhury S, Hänninen R, Sofiev M, Aunan K. Fires as a source of annual ambient PM 2.5 exposure and chronic health impacts in Europe. Sci Total Environ 2024; 922:171314. [PMID: 38423313 DOI: 10.1016/j.scitotenv.2024.171314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/29/2024] [Accepted: 02/25/2024] [Indexed: 03/02/2024]
Abstract
Chronic exposure to ambient PM2.5 is the largest environmental health risk in Europe. We used a chemical transport model and recent exposure response functions to simulate ambient PM2.5, contribution from fires and related health impacts over Europe from 1990 to 2019. Our estimation indicates that the excess death burden from exposure to ambient PM2.5 declined across Europe at a rate of 10,000 deaths per year, from 0.57 million (95 % confidence intervals: 0.44-0.75 million) in 1990 to 0.28 million (0.19-0.42 million) in the specified period. Among these excess deaths, approximately 99 % were among adults, while only around 1 % occurred among children. Our findings reveal a steady increase in fire mortality fractions (excess deaths from fires per 1000 deaths from ambient PM2.5) from 2 in 1990 to 13 in 2019. Notably, countries in Eastern Europe exhibited significantly higher fire mortality fractions and experienced more pronounced increases compared to those in Western and Central Europe. We performed sensitivity analyses by considering fire PM2.5 to be more toxic as compared to other sources, as indicated by recent studies. By considering fire PM2.5 to be more toxic than other PM2.5 sources results in an increased relative contribution of fires to excess deaths, reaching 2.5-13 % in 2019. Our results indicate the requirement of larger mitigation and adaptation efforts and more sustainable forest management policies to avert the rising health burden from fires.
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Affiliation(s)
| | | | | | - Kristin Aunan
- CICERO Center for International Climate Research, Oslo, Norway
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218
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Shi Y, Li N, Li Z, Chen M, Chen Z, Wan X. Impact of comprehensive air pollution control policies on six criteria air pollutants and acute myocardial infarction morbidity, Weifang, China: A quasi-experimental study. Sci Total Environ 2024; 922:171206. [PMID: 38408668 DOI: 10.1016/j.scitotenv.2024.171206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/06/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
Comprehensive air pollution control policies may reduce pollutant emissions. However, the impact on disease morbidity of the change for the concentration of air pollutants following the policies has been insufficiently studied. We aim to assess the impact of comprehensive air pollution control policies on the levels of six criteria air pollutants and acute myocardial infarction (AMI) morbidity in Weifang, China. This study performed an interrupted time series analysis. The linear model with spline terms and generalized additive quasi-Poisson model were used to estimate the immediate change from 2016 to 2019 in the daily concentration of six air pollutants (PM2.5, PM10, SO2, NO2, O3, and, CO) and AMI incident cases (Age ≥35) associated with the implementation of air pollution control policies in Weifang, respectively. After the implementation of air pollution control policies, air quality in Weifang had been improved. Specifically, the daily concentrations of PM2.5, PM10, SO2, and, CO immediately decreased by 27.9 % (95 % CI: 6.6 % to 44.3 %), 32.9 % (95 % CI: 17.5 % to 45.5 %), 14.6 % (95 % CI: 0.4 % to 26.8 %), and 33.9 % (95 % CI: 22.0 % to 44.0 %), respectively. In addition, the policies implementation was also associate with the immediate decline in the AMI morbidity (-6.5 %, 95 % CI: -10.4 % to -2.3 %). And subgroup analyses indicate that the health effects of the policy intervention were only observed in female (-9.4 %, 95 % CI: -14.4 % to -4.2 %) and those aged ≥65 years (-10.5 %, 95 % CI: -14.6 % to -6.2 %). During the final 20 months of the study period, the policy intervention was estimated to prevent 1603 (95 % CI: 574 to 2587) cases of incident AMI in Weifang. Our results provide strong rationale that the policy intervention significantly reduced ambient pollutant concentrations and AMI morbidity, which highlighted the importance for a comprehensive and rigorous air pollution control policy in regions with severe air pollution.
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Affiliation(s)
- Yulin Shi
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine Peking Union Medical College, Beijing 100005, China
| | - Ning Li
- Weifang Center for Disease Control and Prevention, Weifang 261061, Shandong, China
| | - Zhongyan Li
- Weifang People's Hospital, Weifang 261044, Shandong, China
| | - Min Chen
- Weifang Center for Disease Control and Prevention, Weifang 261061, Shandong, China
| | - Zuosen Chen
- Weifang Center for Disease Control and Prevention, Weifang 261061, Shandong, China
| | - Xia Wan
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
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219
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Wen Y, Sun F, Xie Z, Zhang M, An Z, Liu B, Sun Y, Wang F, Mao Y. Machine learning-assisted novel recyclable flexible triboelectric nanogenerators for intelligent motion. iScience 2024; 27:109615. [PMID: 38632997 PMCID: PMC11022051 DOI: 10.1016/j.isci.2024.109615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/14/2024] [Accepted: 03/26/2024] [Indexed: 04/19/2024] Open
Abstract
In the smart era, big data analysis based on sensor units is important in intelligent motion. In this study, a dance sports and injury monitoring system (DIMS) based on a recyclable flexible triboelectric nanogenerator (RF-TENG) sensor module, a data processing hardware module, and an upper computer intelligent analysis module are developed to promote intelligent motion. The resultant RF-TENG exhibits an ultra-fast response time of 17 ms, coupled with robust stability demonstrated over 4200 operational cycles, with 6% variation in output voltage. The DIMS enables immersive training by providing visual feedback on sports status and interacting with virtual games. Combined with machine learning (K-nearest neighbor), good classification results are achieved for ground-jumping techniques. In addition, it shows some potential in sports injury prediction (i.e., ankle sprains, knee hyperextension). Overall, the sensing system designed in this study has broad prospects for future applications in intelligent motion and healthcare.
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Affiliation(s)
- Yuzhang Wen
- Physical Education Department, Northeastern University, Shenyang 110819, China
| | - Fengxin Sun
- Physical Education Department, Northeastern University, Shenyang 110819, China
| | - Zhenning Xie
- Physical Education Department, Northeastern University, Shenyang 110819, China
| | - Mengqi Zhang
- Physical Education Department, Northeastern University, Shenyang 110819, China
| | - Zida An
- Faculty of Robot Science and Engineering, Northeastern University, Shenyang 110819, China
| | - Bing Liu
- Criminal Investigation Police University of China, Shenyang 110035, China
| | - Yuning Sun
- Physical Education Department, Northeastern University, Shenyang 110819, China
| | - Fei Wang
- Faculty of Robot Science and Engineering, Northeastern University, Shenyang 110819, China
| | - Yupeng Mao
- Physical Education Department, Northeastern University, Shenyang 110819, China
- School of Strength and Conditioning Training, Beijing Sport University, Beijing 100084, China
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220
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Weyant C, Hooda Y, Munira SJ, Lo NC, Ryckman T, Tanmoy AM, Kanon N, Seidman JC, Garrett D, Saha SK, Goldhaber-Fiebert JD, Saha S, Andrews JR. Cost-effectiveness and public health impact of typhoid conjugate vaccine introduction strategies in Bangladesh. Vaccine 2024; 42:2867-2876. [PMID: 38531727 DOI: 10.1016/j.vaccine.2024.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE Typhoid fever causes substantial morbidity and mortality in Bangladesh. The government of Bangladesh plans to introduce typhoid conjugate vaccines (TCV) in its expanded program on immunization (EPI) schedule. However, the optimal introduction strategy in addition to the costs and benefits of such a program are unclear. METHODS We extended an existing mathematical model of typhoid transmission to integrate cost data, clinical incidence data, and recently conducted serosurveys in urban, semi-urban, and rural areas. In our primary analysis, we evaluated the status quo (i.e., no vaccination) and eight vaccine introduction strategies including routine and 1-time campaign strategies, which differed by age groups targeted and geographic focus. Model outcomes included clinical incidence, seroincidence, deaths, costs, disability-adjusted life years (DALYs), and incremental cost-effectiveness ratios (ICERs) for each strategy. We adopted a societal perspective, 10-year model time horizon, and 3 % annual discount rate. We performed probabilistic, one-way, and scenario sensitivity analyses including adopting a healthcare perspective and alternate model time horizons. RESULTS We projected that all TCV strategies would be cost saving compared to the status quo. The preferred strategy was a nationwide introduction of TCV at 9-12 months of age with a single catch-up campaign for children ages 1-15, which was cost saving compared to all other strategies and the status quo. In the 10 years following implementation, we projected this strategy would avert 3.77 million cases (95 % CrI: 2.60 - 5.18), 11.31 thousand deaths (95 % CrI: 3.77 - 23.60), and save $172.35 million (95 % CrI: -14.29 - 460.59) compared to the status quo. Our findings were broadly robust to changes in parameter values and willingness-to-pay thresholds. CONCLUSIONS We projected that nationwide TCV introduction with a catch-up campaign would substantially reduce typhoid incidence and very likely be cost saving in Bangladesh.
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Affiliation(s)
- Christopher Weyant
- Department of Health Policy and Center for Health Policy, Stanford School of Medicine and Freeman Spogli Institute, Stanford University, Stanford, CA, United States.
| | - Yogesh Hooda
- Child Health Research Foundation, Dhaka, Bangladesh
| | | | - Nathan C Lo
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA, United States
| | - Theresa Ryckman
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | | | - Naito Kanon
- Child Health Research Foundation, Dhaka, Bangladesh
| | | | | | - Samir K Saha
- Child Health Research Foundation, Dhaka, Bangladesh; Department of Microbiology, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh
| | - Jeremy D Goldhaber-Fiebert
- Department of Health Policy and Center for Health Policy, Stanford School of Medicine and Freeman Spogli Institute, Stanford University, Stanford, CA, United States
| | - Senjuti Saha
- Child Health Research Foundation, Dhaka, Bangladesh
| | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA, United States
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Fang Z, Jia S, Mou X, Li Z, Hu T, Tu Y, Zhao J, Zhang T, Lin W, Lu Y, Feng C, Xia S. Shared genetic architecture and causal relationship between liver and heart disease. iScience 2024; 27:109431. [PMID: 38523778 PMCID: PMC10959668 DOI: 10.1016/j.isci.2024.109431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/08/2024] [Accepted: 03/04/2024] [Indexed: 03/26/2024] Open
Abstract
This study investigates the relationship and genetic mechanisms of liver and heart diseases, focusing on the liver-heart axis (LHA) as a fundamental biological basis. Through genome-wide association study analysis, we explore shared genes and pathways related to LHA. Shared genetic factors are found in 8 out of 20 pairs, indicating genetic correlations. The analysis reveals 53 loci with pleiotropic effects, including 8 loci exhibiting shared causality across multiple traits. Based on SNP-p level tissue-specific multi-marker analysis of genomic annotation (MAGMA) analysis demonstrates significant enrichment of pleiotropy in liver and heart diseases within different cardiovascular tissues and female reproductive appendages. Gene-specific MAGMA analysis identifies 343 pleiotropic genes associated with various traits; these genes show tissue-specific enrichment primarily in the liver, cardiovascular system, and other tissues. Shared risk loci between immune cells and both liver and cardiovascular diseases are also discovered. Mendelian randomization analyses provide support for causal relationships among the investigated trait pairs.
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Affiliation(s)
- Ziyi Fang
- Department of Gastroenterology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, China
| | - Sixiang Jia
- Department of Cardiology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, China
| | - Xuanting Mou
- Department of Cardiology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, China
| | - Zhe Li
- Department of Cardiology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, China
| | - Tianli Hu
- Department of Cardiology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, China
| | - Yiting Tu
- Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jianqiang Zhao
- Department of Cardiology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, China
| | - Tianlong Zhang
- Department of Critical Care Medicine, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, China
| | - Wenting Lin
- Department of Cardiology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, China
| | - Yile Lu
- Department of Cardiology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, China
| | - Chao Feng
- Department of Cardiology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, China
| | - Shudong Xia
- Department of Cardiology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu 322000, China
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Zhao J, Yang T, Yi J, Hu H, Lai Q, Nie L, Liu M, Chu C, Yang J. AP39 through AMPK-ULK1-FUNDC1 pathway regulates mitophagy, inhibits pyroptosis, and improves doxorubicin-induced myocardial fibrosis. iScience 2024; 27:109321. [PMID: 38558936 PMCID: PMC10981016 DOI: 10.1016/j.isci.2024.109321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 01/10/2024] [Accepted: 02/20/2024] [Indexed: 04/04/2024] Open
Abstract
Doxorubicin induces myocardial injury and fibrosis. Still, no effective interventions are available. AP39 is an H2S donor that explicitly targets mitochondria. This study investigated whether AP39 could improve doxorubicin-induced myocardial fibrosis. Doxorubicin induced significant myocardial fibrosis while suppressing mitophagy-related proteins and elevating pyroptosis-related proteins. Conversely, AP39 reverses these effects, enhancing mitophagy and inhibiting pyroptosis. In vitro experiments revealed that AP39 inhibited H9c2 cardiomyocyte pyroptosis, improved doxorubicin-induced impairment of mitophagy, reduced ROS levels, ameliorated the mitochondrial membrane potential, and upregulated AMPK-ULK1-FUNDC1 expression. In contrast, AMPK inhibitor (dorsomorphin) and ULK1 inhibitor (SBI-0206965) reversed AP39 antagonism of doxorubicin-induced FUNDC1-mediated impairment of mitophagy and secondary cardiomyocyte pyroptosis. These results suggest that mitochondria-targeted H2S can antagonize doxorubicin-induced pyroptosis and impaired mitophagy in cardiomyocytes via AMPK-ULK1-FUNDC1 and ameliorated myocardial fibrosis and remodeling.
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Affiliation(s)
- Junxiong Zhao
- Department of Cardiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421000, China
| | - Ting Yang
- School of Pharmaceutical Science of University of South China, Hengyang 421000, China
- Department of Pharmacy, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421000, China
| | - Jiali Yi
- Department of Cardiology, Hunan University of Medicine General Hospital, Huaihua 418000, China
| | - Hongmin Hu
- Department of Cardiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421000, China
| | - Qi Lai
- School of Pharmaceutical Science of University of South China, Hengyang 421000, China
- Department of Pharmacy, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421000, China
| | - Liangui Nie
- Department of Cardiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421000, China
| | - Maojun Liu
- Department of Cardiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421000, China
| | - Chun Chu
- Department of Pharmacy, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421000, China
| | - Jun Yang
- Department of Cardiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421000, China
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Temtem M, Mendonça MI, Gomes Serrão M, Santos M, Sá D, Sousa F, Soares C, Rodrigues R, Henriques E, Freitas S, Borges S, Rodrigues M, Guerra G, Drumond Freitas A, Sousa AC, Palma Dos Reis R. Predictive improvement of adding coronary calcium score and a genetic risk score to a traditional risk model for cardiovascular event prediction. Eur J Prev Cardiol 2024; 31:709-715. [PMID: 38175668 DOI: 10.1093/eurjpc/zwae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024]
Abstract
AIMS Coronary artery calcium score (CACS) and polygenic risk score have been used as novel markers to predict cardiovascular (CV) events of asymptomatic individuals compared with traditional scores. No previous studies have directly compared the additive capacity of these two markers relative to conventional scores. The aim of the study was to evaluate the change in CV risk prediction ability when CACS, genetic risk score (GRS), or both are added to Systematic Coronary Risk Evaluation 2 (SCORE2). METHODS AND RESULTS In a prospective, observational population-based study, 1002 asymptomatic subjects (mean age 53.1 ± 6.8 years, 73.8% male), free of clinical coronary disease and diabetes, were selected from GENEMACOR-study controls. SCORE2, CACS, and GRS were estimated to evaluate CV events' predictive and discriminative ability through Harrell's C-statistics. Net reclassification improvement (NRI) and integrated discrimination index were used to reclassify the population. Multivariable Cox proportional hazard ratio (HR) analysis assessed the variables independently associated with CV events. C-statistic demonstrated that the discriminative value for CV event occurrence was 0.608 for SCORE2, increasing to 0.749 (P = 0.001) when CACS was added, and improved to 0.802 (P = 0.0008) with GRS, showing a better discriminative capacity for CV events. Continuous NRI reclassified >70% of the population. Cox proportional analysis showed that the highest categories of SCORE2, CACS, and GRS remained in the equation with an HR of 2.9 (P = 0.003), 5.0 (P < 0.0001), and 3.2 (P = 0.003), respectively, when compared with the lowest categories. CONCLUSION In our population, CACS added to SCORE2 had better ability than GRS in CV event risk prediction, discrimination, and reclassification. However, adding the three scores can become clinically relevant, especially in intermediate-risk persons.
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Affiliation(s)
- Margarida Temtem
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Maria Isabel Mendonça
- Centro de Investigação Dra. Maria Isabel Mendonça, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Marco Gomes Serrão
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Marina Santos
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Débora Sá
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Francisco Sousa
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Carolina Soares
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Ricardo Rodrigues
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Eva Henriques
- Centro de Investigação Dra. Maria Isabel Mendonça, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Sónia Freitas
- Centro de Investigação Dra. Maria Isabel Mendonça, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Sofia Borges
- Centro de Investigação Dra. Maria Isabel Mendonça, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Mariana Rodrigues
- Centro de Investigação Dra. Maria Isabel Mendonça, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Graça Guerra
- Centro de Investigação Dra. Maria Isabel Mendonça, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - António Drumond Freitas
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Ana Célia Sousa
- Centro de Investigação Dra. Maria Isabel Mendonça, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
- Faculdade de Medicina, Universidade da Madeira, Campus da Penteada, Funchal 9020-105, Portugal
| | - Roberto Palma Dos Reis
- Faculdade de Ciências Médicas, NOVA Medical School, Campo dos Mártires da Pátria 130, Lisboa 1169-056, Portugal
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Köhne S, Hillemacher T, Glahn A, Bach P. Emerging drugs in phase II and III clinical development for the treatment of alcohol use disorder. Expert Opin Emerg Drugs 2024:1-14. [PMID: 38606899 DOI: 10.1080/14728214.2024.2342951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/10/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Alcohol Use Disorder (AUD) poses an ongoing significant global health burden. AUD is highly prevalent and affects not only the individuals with AUD, but also their communities and society at large. Even though pharmacotherapy is an integral part of AUD treatment, the few available substances show limited efficacy and limited clinical impact. Thus, there is a need for new innovative pharmacotherapeutic approaches. AREAS COVERED This paper provides a comprehensive review of drugs approved for the treatment of AUD as well as those currently in phase II and III development. Data from recent clinical trials has been reviewed and supplemented by additional literature based on a systematic search of the PubMed database and clinical trials registries. Compounds discussed include disulfiram, naltrexone, nalmefene, acamprosat, baclofen, sodium oxybate, doxazosin, varenicline, zonisamide, gabapentin, apremilast, ibudilast, ivermectin, tolcapone, mifepristone, suvorexant, ketamine, psilocybin, semaglutide, oxytocin and cannabidiol. EXPERT OPINION Even though the majority of the discussed compounds lack sufficient evidence to support their efficacy, multiple promising new treatment options are currently under investigation. Future research has to consider specific phenotypes and subgroups of AUD as well as a possible enhancement of the effects of psychotherapy through combination with pharmacotherapy. Practitioners should be encouraged to use available compounds to support existing therapeutic regimens.
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Affiliation(s)
- Sophie Köhne
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany
| | - Thomas Hillemacher
- Department of Psychiatry and Psychotherapy, Paracelsus Medical University Nuremberg, Nürnberg, Germany
| | - Alexander Glahn
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany
| | - Patrick Bach
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim. Heidelberg University, Heidelberg, Germany
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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225
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Lammers EMJ, Zijlstra JM, Retèl VP, Aleman BMP, van Leeuwen FE, Nijdam A. Effectiveness and Cost-Effectiveness of Survivorship Care for Survivors of Hodgkin Lymphoma (INSIGHT Study): Protocol for a Multicenter Retrospective Cohort Study With a Quasi-Experimental Design. JMIR Res Protoc 2024; 13:e55601. [PMID: 38635308 DOI: 10.2196/55601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Hodgkin lymphoma (HL) occurs at young ages, with the highest incidence between 20 and 40 years. While cure rates have improved to 80%-90% over the past decades, survivors of HL are at substantial risk of late treatment-related complications, such as cardiovascular diseases, breast cancer, severe infections, and hypothyroidism. To reduce morbidity and mortality from late treatment effects, the Dutch Better care after lymphoma, Evaluation of long-term Treatment Effects and screening Recommendations (BETER) consortium developed a survivorship care program for 5-year survivors of HL that includes risk-based screening for and treatment of (risk factors for) late adverse events. Even though several cancer survivorship care programs have been established worldwide, there is a lack of knowledge about their effectiveness in clinical practice. OBJECTIVE The Improving Nationwide Survivorship care Infrastructure and Guidelines after Hodgkin lymphoma Treatment (INSIGHT) study evaluates whether Dutch BETER survivorship care for survivors of HL decreases survivors' burden of disease from late adverse events after HL treatment and associated health care costs and improves their quality of life. METHODS The INSIGHT study is a multicenter retrospective cohort study with a quasi-experimental design and prospective follow-up, embedded in the national BETER survivorship care infrastructure. The first BETER clinics started in 2013-2016 and several other centers started or will start BETER clinics in 2019-2024. This allows us to compare survivors who did and those who did not receive BETER survivorship care in the last decade. Survivors in the intervention group are matched to controls (n=450 per group) based on sex, age at diagnosis (±5 years), age in 2013 (±5 years), and treatment characteristics. The primary outcome is the burden of disease in disability-adjusted life years from cardiovascular disease, breast cancer, severe infections, and hypothyroidism. In a cost-effectiveness analysis, we will assess the cost of BETER survivorship care per averted or gained disability-adjusted life year and quality-adjusted life year. Secondary outcomes are BETER clinic attendance, adherence to screening guidelines, and knowledge and distress about late effects among survivors of HL. Study data are collected from a survivor survey, a general practitioner survey, medical records, and through linkages with national disease registries. RESULTS The study was funded in November 2020 and approved by the institutional review board of the Netherlands Cancer Institute in July 2021. We expect to finalize recruitment by October 2024, data collection by early 2025, and data analysis by May 2025. CONCLUSIONS INSIGHT is the first evaluation of a comprehensive survivorship program using real-world data; it will result in new information on the (cost-)effectiveness of survivorship care in survivors of HL in clinical practice. The results of this study will be used to improve the BETER program where necessary and contribute to more effective evidence-based long-term survivorship care for lymphoma survivors. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/55601.
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Affiliation(s)
- Eline M J Lammers
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Josée M Zijlstra
- Department of Hematology, Amsterdam UMC, location Vrije Universiteit, Cancer Center, Amsterdam, Netherlands
| | - Valesca P Retèl
- Department of Health Technology Assessment, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Berthe M P Aleman
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Flora E van Leeuwen
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Annelies Nijdam
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
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Sliwa K, Viljoen CA, Stewart S, Miller MR, Prabhakaran D, Kumar RK, Thienemann F, Piniero D, Prabhakaran P, Narula J, Pinto F. Cardiovascular disease in low- and middle-income countries associated with environmental factors. Eur J Prev Cardiol 2024; 31:688-697. [PMID: 38175939 DOI: 10.1093/eurjpc/zwad388] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 01/06/2024]
Abstract
There is a growing recognition that the profound environmental changes that have occurred over the past century pose threats to human health. Many of these environmental factors, including air pollution, noise pollution, as well as exposure to metals such as arsenic, cadmium, lead, and other metals, are particularly detrimental to the cardiovascular health of people living in low-to-middle income countries (LMICs). Low-to-middle income countries are likely to be disproportionally burdened by cardiovascular diseases provoked by environmental factors. Moreover, they have the least capacity to address the core drivers and consequences of this phenomenon. This review summarizes the impact of environmental factors such as climate change, air pollution, and metal exposure on the cardiovascular system, and how these specifically affect people living in LMICs. It also outlines how behaviour changes and interventions that reduce environmental pollution would have significant effects on the cardiovascular health of those from LMICs, and globally.
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Affiliation(s)
- Karen Sliwa
- Cape Heart Institute, Chris Barnard Building, University of Cape Town, Faculty of Health Sciences, Cnr Anzio Road and Falmouth Road, 7925, Observatory, Cape Town, South Africa
- Division of Cardiology, Department of Medicine, Groote Schuur Hospital, Main Road, 7925, Observatory, Cape Town, South Africa
| | - Charle André Viljoen
- Cape Heart Institute, Chris Barnard Building, University of Cape Town, Faculty of Health Sciences, Cnr Anzio Road and Falmouth Road, 7925, Observatory, Cape Town, South Africa
- Division of Cardiology, Department of Medicine, Groote Schuur Hospital, Main Road, 7925, Observatory, Cape Town, South Africa
| | - Simon Stewart
- Institute for Health Research, University of Notre Dame Australia, 32 Mouat St, Fremantle, Western Australia, 6160, Australia
- Eduardo Mondlane University, 3435 Avenida Julius Nyerere, Maputo, Mozambique
| | - Mark R Miller
- Centre for Cardiovascular Science, University of Edinburgh, Queens Medical Research Institute, 47 Little France Crescent, Edinburgh, EH4 3RL, UK
| | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, C1/52, Safdarjung Development Area, New Delhi, 110016, India
| | - Raman Krishna Kumar
- Department of Pediatric Cardiology, Amrita Institute of Medical Sciences and Research Centre, Ponekkara PO, Cochin 682041, Kerala, India
| | - Friedrich Thienemann
- Cape Heart Institute, Chris Barnard Building, University of Cape Town, Faculty of Health Sciences, Cnr Anzio Road and Falmouth Road, 7925, Observatory, Cape Town, South Africa
- Department of Internal Medicine, University Hospital Zurich, University of Zurich, 100 Rämistrasse, 8091 Zurich, Switzerland
| | - Daniel Piniero
- Facultad de Medicina, Universidad de Buenos Aires, Arenales 2463, Buenos Aires, C1124AAN, Argentina
| | - Poornima Prabhakaran
- Centre for Chronic Disease Control, C1/52, Safdarjung Development Area, New Delhi, 110016, India
| | - Jagat Narula
- Department of Cardiology, McGovern Medical School, University of Texas Health, 7000 Fannin St, Houston, TX 77030, USA
| | - Fausto Pinto
- Department of Cardiology, Faculty of Medicine, University of Lisbon, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
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Jiang Z, Zhang S, Gao T, Chen K, Liu Y, Liu Y, Wang T, Zeng P. Co-exposure to multiple air pollutants, genetic susceptibility, and the risk of myocardial infarction onset: a cohort analysis of the UK Biobank participants. Eur J Prev Cardiol 2024; 31:698-706. [PMID: 38085043 DOI: 10.1093/eurjpc/zwad384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/18/2023] [Accepted: 12/06/2023] [Indexed: 04/19/2024]
Abstract
AIMS The relationship between the long-term joint exposure to ambient air pollution and incidence of myocardial infarction (MI) and modification by genetic susceptibility remain inconclusive. METHODS AND RESULTS We analysed 329 189 UK Biobank participants without MI at baseline. Exposure concentrations to particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOx) were obtained. Air pollution score assessing the joint exposure was calculated, and its association with MI was evaluated via Cox model under the P value aggregation framework. Genetic susceptibility to MI was evaluated by incorporating polygenic risk score (PRS) into models. Risk prediction models were also established. During a median follow-up of 13.4 years, 9993 participants developed MI. Per interquartile range increase of PM2.5, PM10, NO2, and NOx resulted in 74% [95% confidence intervals (CIs) 69%-79%], 67% (63%-72%), 46% (42%-49%), and 38% (35%-41%) higher risk of MI. Compared with the lowest quartile (Q1) of air pollution score, the multivariable adjusted hazard ratio (HR) (95%CIs) of Q4 (the highest cumulative air pollution) was 3.50 (3.29-3.72) for MI. Participants with the highest PRS and air pollution score possessed the highest risk of incident MI (HR = 4.88, 95%CIs 4.35-5.47). Integrating PRS, air pollution exposure, and traditional factors substantially improved risk prediction of MI. CONCLUSION Long-term joint exposure to air pollutants including PM2.5, PM10, NO2, and NOx is substantially associated with increased risk of MI. Genetic susceptibility to MI strengthens such adverse joint association. Air pollutions together with genetic and traditional factors enhance the accuracy of MI risk prediction.
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Affiliation(s)
- Zhou Jiang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Shuo Zhang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Tongyu Gao
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Keying Chen
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Yuxin Liu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Ying Liu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Ting Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Ping Zeng
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Key Laboratory of Environment and Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Xuzhou Engineering Research Innovation Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Jiangsu Engineering Research Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
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Øvretveit K, Ingeström EML, Spitieris M, Tragante V, Wade KH, Thomas LF, Wolford BN, Wisløff U, Gudbjartsson DF, Holm H, Stefansson K, Brumpton BM, Hveem K. Polygenic risk scores associate with blood pressure traits across the lifespan. Eur J Prev Cardiol 2024; 31:644-654. [PMID: 38007706 DOI: 10.1093/eurjpc/zwad365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 10/18/2023] [Accepted: 11/02/2023] [Indexed: 11/28/2023]
Abstract
AIMS Hypertension is a major modifiable cause of morbidity and mortality that affects over 1 billion people worldwide. Blood pressure (BP) traits have a strong genetic component that can be quantified with polygenic risk scores (PRSs). To date, the performance of BP PRSs has mainly been assessed in adults, and less is known about polygenic hypertension risk in childhood. METHODS AND RESULTS Multiple PRSs for systolic BP (SBP), diastolic BP (DBP), and pulse pressure were developed using either genome-wide significant weights, pruning and thresholding, or Bayesian regression. Among 87 total PRSs, the top performer for each trait was applied in independent cohorts of children and adult to assess genotype-phenotype associations and disease risk across the lifespan. Differences between those with low (1st decile), average (2nd-9th decile), and high (10th decile) PRS emerge in the first years of life and are maintained throughout adulthood. These diverging BP trajectories also seem to affect cardiovascular and renal disease risk, with increased risk observed among those in the top decile and reduced risk among those in the bottom decile of the polygenic risk distribution compared with the rest of the population. CONCLUSION Genetic risk factors are associated with BP traits across the lifespan, beginning in the first years of life. Given the importance of exposure time in disease pathogenesis and the early rise in BP levels among those genetically susceptible, PRSs may help identify high-risk individuals prior to hypertension onset, facilitate primordial prevention, and reduce the burden of this public health challenge.
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Affiliation(s)
- Karsten Øvretveit
- K.G. Jebsen Centre for Genetic Epidemiology, Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, N-7491 Trondheim, Norway
| | - Emma M L Ingeström
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Michail Spitieris
- K.G. Jebsen Centre for Genetic Epidemiology, Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, N-7491 Trondheim, Norway
- Department of Mathematical Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | | | - Kaitlin H Wade
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 1TH, UK
- Population Health Science, Bristol Medical School, Bristol BS8 1TH, UK
- Avon Longitudinal Study of Parents and Children, Bristol BS8 1TH, UK
| | - Laurent F Thomas
- K.G. Jebsen Centre for Genetic Epidemiology, Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, N-7491 Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Brooke N Wolford
- K.G. Jebsen Centre for Genetic Epidemiology, Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, N-7491 Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Daniel F Gudbjartsson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Hilma Holm
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Ben M Brumpton
- K.G. Jebsen Centre for Genetic Epidemiology, Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, N-7491 Trondheim, Norway
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Levanger, Norway
| | - Kristian Hveem
- K.G. Jebsen Centre for Genetic Epidemiology, Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, N-7491 Trondheim, Norway
- Department of Innovation and Research, St. Olavs Hospital, Trondheim, Norway
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Room SA, Chiu YC, Pan SY, Chen YC, Hsiao TC, Chou CCK, Hussain M, Chi KH. A comprehensive examination of temporal-seasonal variations of PM 1.0 and PM 2.5 in taiwan before and during the COVID-19 lockdown. Environ Sci Pollut Res Int 2024:10.1007/s11356-024-33174-4. [PMID: 38632201 DOI: 10.1007/s11356-024-33174-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
COVID-19 has been a significant global concern due to its contagious nature. In May 2021, Taiwan experienced a severe outbreak, leading the government to enforce strict Pandemic Alert Level 3 restrictions in order to curtail its spread. Although previous studies in Taiwan have examined the effects of these measures on air quality, further research is required to compare different time periods and assess the health implications of reducing particulate matter during the Level 3 lockdown. Herein, we analyzed the mass concentrations, chemical compositions, seasonal variations, sources, and potential health risks of PM1.0 and PM2.5 in Central Taiwan before and during the Level 3 lockdown. As a result, coal-fired boilers (47%) and traffic emissions (53%) were identified as the predominant sources of polycyclic aromatic hydrocarbons (PAHs) in PM1.0, while in PM2.5, the dominant sources of PAHs were coal-fired boilers (28%), traffic emissions (50%), and iron and steel sinter plants (22.1%). Before the pandemic, a greater value of 20.9 ± 6.92 μg/m3 was observed for PM2.5, which decreased to 15.3 ± 2.51 μg/m3 during the pandemic due to a reduction in industrial and anthropogenic emissions. Additionally, prior to the pandemic, PM1.0 had a contribution rate of 79% to PM2.5, which changed to 89% during the pandemic. Similarly, BaPeq values in PM2.5 exhibited a comparable trend, with PM1.0 contributing 86% and 65% respectively. In both periods, the OC/EC ratios for PM1.0 and PM2.5 were above 2, due to secondary organic compounds. The incremental lifetime cancer risk (ILCR) of PAHs in PM2.5 decreased by 4.03 × 10-5 during the pandemic, with PM1.0 contributing 73% due to reduced anthropogenic activities.
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Affiliation(s)
- Shahzada Amani Room
- Institute of Environmental and Occupational Health Sciences, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Yi Chen Chiu
- Institute of Environmental and Occupational Health Sciences, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Shih Yu Pan
- Institute of Environmental and Occupational Health Sciences, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Yu-Cheng Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli, Taiwan
| | - Ta-Chih Hsiao
- Graduate Institute of Environmental Engineering, National Taiwan University, Taipei, Taiwan
| | - Charles C-K Chou
- Research Center for Environmental Changes, Academia Sinica, Taipei, 115, Taiwan
| | - Majid Hussain
- Department of Forestry and Wildlife Management, University of Haripur, 22620, Hattar Road, Haripur City, KP, Pakistan
| | - Kai Hsien Chi
- Institute of Environmental and Occupational Health Sciences, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan.
- National Institute of Environmental Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli, Taiwan.
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Pryde SJ, Williams O, O'Hare MP, Murdock C, Pedlow K. Exploring access to community neurorehabilitation for people with progressive neurological conditions: a qualitative study. Disabil Rehabil 2024:1-14. [PMID: 38632940 DOI: 10.1080/09638288.2024.2338198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Community neurorehabilitation enables people with progressive neurological conditions (PNCs) to manage their symptoms to live an active, fulfilling life; however, it is not accessible to all. This study explored the factors influencing access to community neurorehabilitation in Northern Ireland from the perspective of people with PNCs and their carers. METHODS Eleven people living with a PNC and three carers took part in virtual focus groups. Data was thematically analysed using the framework method. RESULTS Access to neurorehabilitation was described as a staged journey, driven by people with PNCs, and impacted by interactions with others. Four themes were identified: the person in the driving seat, describing the value of person-centred care and the need for proactivity; the traffic lights, depicting the role and influence of health care professionals (HCPs); the need for direction; and roadworks and roadblocks, identifying additional barriers to access. In addition, six fundamentals of good access were identified. CONCLUSIONS This study adds depth to our understanding of the complexity, and the roles and needs of people with PNCs and HCPs, in accessing community neurorehabilitation. Further research is needed to determine how best to empower people to access rehabilitation.
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Affiliation(s)
- Shona J Pryde
- School of Health Sciences, Ulster University, Londonderry, UK
- Physiotherapy Department, Belfast Health and Social Care Trust, Belfast, UK
| | | | | | - Carolyn Murdock
- School of Health Sciences, Ulster University, Londonderry, UK
| | - Katy Pedlow
- School of Health Sciences, Ulster University, Londonderry, UK
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231
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de Montalembert M, Anderson A, Costa FF, Inusa BPD, Jastaniah W, Kunz JB, Tinga B, Ingoli E, James J, Hartfield R, Beaubrun A, Lartey B, Odame I. Sickle Cell Health Awareness, Perspectives, and Experiences (SHAPE) survey: Perspectives of adolescent and adult patients, caregivers, and healthcare professionals on the burden of sickle cell disease. Eur J Haematol 2024. [PMID: 38634725 DOI: 10.1111/ejh.14211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/20/2024] [Accepted: 03/26/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES Sickle cell disease (SCD) is an inherited disorder that causes lifelong complications, substantially impacting the physical and emotional well-being of patients and their caregivers. Studies investigating the effects of SCD on quality of life (QOL) are often limited to individual countries, lack SCD-specific QOL questionnaires, and exclude the caregiver experience. The SHAPE survey aimed to broaden the understanding of the global burden of SCD on patients and their caregivers and to capture the viewpoint of healthcare providers (HCPs). METHODS A total of 919 patients, 207 caregivers, and 219 HCPs from 10, 9, and 8 countries, respectively, answered a series of closed-ended questions about their experiences with SCD. RESULTS The symptoms most frequently reported by patients were fatigue/tiredness (84%) and pain/vaso-occlusive crises (71%). Patients' fatigue/tiredness had one of the greatest impacts on both patients' and caregivers' QOL. On average, patients and caregivers reported missing 7.5 days and 5.0 days per month, respectively, of school or work. HCPs reported a need for effective tools to treat fatigue/tiredness and a desire for more support to educate patients on long-term SCD-related health risks. CONCLUSIONS The multifaceted challenges identified using the SHAPE survey highlight the global need to improve both patient and caregiver QOL.
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Affiliation(s)
- Mariane de Montalembert
- Department of General Pediatrics and Pediatric Infectious Diseases, Sickle Cell Center, Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Cité, Paris, France
| | - Alan Anderson
- Department of Pediatric Hematology-Oncology, PRISMA Health Comprehensive SCD Program, University of South Carolina School of Medicine, Greenville, South Carolina, USA
| | - Fernando F Costa
- Haematology and Haemotherapy Centre, School of Medicine, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Baba P D Inusa
- Department of Paediatric Haematology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Wasil Jastaniah
- Department of Pediatric Oncology Hematology Bone Marrow Transplant, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Joachim B Kunz
- Department of Pediatric Oncology, Hematology and Immunology, Hopp Children's Cancer Center Heidelberg (KiTZ), University of Heidelberg, Heidelberg, Germany
| | - Biba Tinga
- Sickle Cell Disease Association of Canada, Toronto, Canada
| | - Elvie Ingoli
- IST e.V., German Sickle Cell Disease and Thalassaemia Association, Eschweiler, Germany
| | | | - Regina Hartfield
- Sickle Cell Disease Association of America, Inc., Hanover, Maryland, USA
| | | | | | - Isaac Odame
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Birhanu MM, Zengin A, Evans RG, Joshi R, Kalyanram K, Kartik K, Danaei G, Barr E, Riddell MA, Suresh O, Srikanth VK, Arabshahi S, Thomas N, Thrift AG. Comparison of the performance of cardiovascular risk prediction tools in rural India: the Rishi Valley Prospective Cohort Study. Eur J Prev Cardiol 2024; 31:723-731. [PMID: 38149975 DOI: 10.1093/eurjpc/zwad404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/07/2023] [Accepted: 12/20/2023] [Indexed: 12/28/2023]
Abstract
AIMS We compared the performance of cardiovascular risk prediction tools in rural India. METHODS AND RESULTS We applied the World Health Organization Risk Score (WHO-RS) tools, Australian Risk Score (ARS), and Global risk (Globorisk) prediction tools to participants aged 40-74 years, without prior cardiovascular disease, in the Rishi Valley Prospective Cohort Study, Andhra Pradesh, India. Cardiovascular events during the 5-year follow-up period were identified by verbal autopsy (fatal events) or self-report (non-fatal events). The predictive performance of each tool was assessed by discrimination and calibration. Sensitivity and specificity of each tool for identifying high-risk individuals were assessed using a risk score cut-off of 10% alone or this 10% cut-off plus clinical risk criteria of diabetes in those aged >60 years, high blood pressure, or high cholesterol. Among 2333 participants (10 731 person-years of follow-up), 102 participants developed a cardiovascular event. The 5-year observed risk was 4.4% (95% confidence interval: 3.6-5.3). The WHO-RS tools underestimated cardiovascular risk but the ARS overestimated risk, particularly in men. Both the laboratory-based (C-statistic: 0.68 and χ2: 26.5, P = 0.003) and non-laboratory-based (C-statistic: 0.69 and χ2: 20.29, P = 0.003) Globorisk tools showed relatively good discrimination and agreement. Addition of clinical criteria to a 10% risk score cut-off improved the diagnostic accuracy of all tools. CONCLUSION Cardiovascular risk prediction tools performed disparately in a setting of disadvantage in rural India, with the Globorisk performing best. Addition of clinical criteria to a 10% risk score cut-off aids assessment of risk of a cardiovascular event in rural India. LAY SUMMARY In a cohort of people without prior cardiovascular disease, tools used to predict the risk of cardiovascular events varied widely in their ability to accurately predict who would develop a cardiovascular event.The Globorisk, and to a lesser extent the ARS, tools could be appropriate for this setting in rural India.Adding clinical criteria, such as sustained high blood pressure, to a cut-off of 10% risk of a cardiovascular event within 5 years could improve identification of individuals who should be monitored closely and provided with appropriate preventive medications.
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Affiliation(s)
- Mulugeta Molla Birhanu
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Level 5, Block E, Monash Medical Centre, 246 Clayton Road, Melbourne, Victoria 3168, Australia
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Level 5, Block E, Monash Medical Centre, 246 Clayton Road, Melbourne, Victoria 3168, Australia
| | - Roger G Evans
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Victoria, Australia
- Pre-clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Rohina Joshi
- Faculty of Medicine, School of Population Health, University of New South Wales, Sydney, Australia
- George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- George Institute for Global Health, New Delhi, India
| | - Kartik Kalyanram
- Rishi Valley Rural Health Centre, Madanapalle, Chittoor District, Andhra Pradesh, India
| | - Kamakshi Kartik
- Rishi Valley Rural Health Centre, Madanapalle, Chittoor District, Andhra Pradesh, India
| | - Goodarz Danaei
- Department of Global Health and Population and Epidemiology, Harvard University T H Chan School of Public Health, Boston, MA, USA
| | - Elizabeth Barr
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Michaela A Riddell
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Level 5, Block E, Monash Medical Centre, 246 Clayton Road, Melbourne, Victoria 3168, Australia
| | - Oduru Suresh
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Level 5, Block E, Monash Medical Centre, 246 Clayton Road, Melbourne, Victoria 3168, Australia
- Rishi Valley Rural Health Centre, Madanapalle, Chittoor District, Andhra Pradesh, India
| | - Velandai K Srikanth
- Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Victoria, Australia
- National Centre for Healthy Ageing, Monash University and Peninsual Health, Melbourne, Victoria, Australia
| | - Simin Arabshahi
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Level 5, Block E, Monash Medical Centre, 246 Clayton Road, Melbourne, Victoria 3168, Australia
| | - Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
| | - Amanda G Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Level 5, Block E, Monash Medical Centre, 246 Clayton Road, Melbourne, Victoria 3168, Australia
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Johnsen AM, Wagman P, Broström A, Fransson EI. Work-, lifestyle-, and health-related factors among women and men working in the emergency medical services. Int J Occup Saf Ergon 2024:1-11. [PMID: 38632949 DOI: 10.1080/10803548.2024.2332115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Objectives. This study aimed to describe work-, lifestyle-, and health-related factors among ambulance personnel, and to analyse differences between women and men. Methods. The cross-sectional study (N = 106) included self-reported and objective measures of work, lifestyle, and health in 10 Swedish ambulance stations. The data collection comprised clinical health examination, blood samples, tests of physical capacity, and questionnaires. Results. A high proportion of the ambulance personnel reported heavy lifting, risk of accidents, threats and violence at work. A low level of smoking and alcohol use, and a high level of leisure-time physical activity were reported. The ambulance personnel had, on average, good self-rated health, high work ability and high physical capacity. However, the results also showed high proportions with risk factors for cardiovascular disease (CVD), e.g., high blood pressure, and high levels of blood lipids. More women than men reported high work demands. Furthermore, women performed better in tests of physical capacity and had a lower level of CVD risk factors. Conclusions. Exposure to work-related factors that might affect health was common among ambulance personnel. Lifestyle- and health-related factors were somewhat contradictory, with a low proportion reporting lifestyle-related risk factors, but a high proportion having risk factors for CVD.
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Affiliation(s)
- Anna M Johnsen
- School of Health and Welfare, Jönköping University, Sweden
| | - Petra Wagman
- School of Health and Welfare, Jönköping University, Sweden
| | - Anders Broström
- School of Health and Welfare, Jönköping University, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Sweden
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Choe RH, Kuzemchak BC, Kotsanos GJ, Mirdamadi E, Sherry M, Devoy E, Lowe T, Packer JD, Fisher JP. Designing Biomimetic 3D-Printed Osteochondral Scaffolds for Enhanced Load-Bearing Capacity. Tissue Eng Part A 2024. [PMID: 38481121 DOI: 10.1089/ten.tea.2023.0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Osteoarthritis is a debilitating chronic joint disorder that affects millions of people worldwide. Since palliative and surgical treatments cannot completely regenerate hyaline cartilage within the articulating joint, osteochondral (OC) tissue engineering has been explored to heal OC defects. Utilizing computational simulations and three-dimensional (3D) printing, we aimed to build rationale around fabricating OC scaffolds with enhanced biomechanics. First, computational simulations revealed that interfacial fibrils within a bilayer alter OC scaffold deformation patterns by redirecting load-induced stresses toward the top of the cartilage layer. Principal component analysis revealed that scaffolds with 800 μm long fibrils (scaffolds 8A-8H) possessed optimal biomechanical properties to withstand compression and shear forces. While compression testing indicated that OC scaffolds with 800 μm fibrils did not have greater compressive moduli than other scaffolds, interfacial shear tests indicated that scaffold 8H possessed the greatest shear strength. Lastly, failure analysis demonstrated that yielding or buckling models describe interfacial fibril failure depending on fibril slenderness S. Specifically for scaffolds with packing density n = 6 and n = 8, the yielding failure model fits experimental loads with S < 10, while the buckling model fitted scaffolds with S < 10 slenderness. The research presented provides critical insights into designing 3D printed interfacial scaffolds with refined biomechanics toward improving OC tissue engineering outcomes.
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Affiliation(s)
- Robert H Choe
- Fischell Department of Bioengineering, University of Maryland, College Park, College Park, Maryland, USA
- Fischell Department of Bioengineering, Center for Engineering Complex Tissues, University of Maryland, College Park, College Park, Maryland, USA
| | - Blake C Kuzemchak
- Fischell Department of Bioengineering, University of Maryland, College Park, College Park, Maryland, USA
- Fischell Department of Bioengineering, Center for Engineering Complex Tissues, University of Maryland, College Park, College Park, Maryland, USA
| | - George J Kotsanos
- Fischell Department of Bioengineering, University of Maryland, College Park, College Park, Maryland, USA
- Fischell Department of Bioengineering, Center for Engineering Complex Tissues, University of Maryland, College Park, College Park, Maryland, USA
| | - Eman Mirdamadi
- Fischell Department of Bioengineering, University of Maryland, College Park, College Park, Maryland, USA
- Department of Oral and Maxillofacial Surgery, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Mary Sherry
- Fischell Department of Bioengineering, University of Maryland, College Park, College Park, Maryland, USA
- Fischell Department of Bioengineering, Center for Engineering Complex Tissues, University of Maryland, College Park, College Park, Maryland, USA
| | - Eoin Devoy
- Fischell Department of Bioengineering, University of Maryland, College Park, College Park, Maryland, USA
- Fischell Department of Bioengineering, Center for Engineering Complex Tissues, University of Maryland, College Park, College Park, Maryland, USA
| | - Tao Lowe
- Fischell Department of Bioengineering, University of Maryland, College Park, College Park, Maryland, USA
- Department of Oral and Maxillofacial Surgery, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Jonathan D Packer
- Department of Orthopedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - John P Fisher
- Fischell Department of Bioengineering, University of Maryland, College Park, College Park, Maryland, USA
- Fischell Department of Bioengineering, Center for Engineering Complex Tissues, University of Maryland, College Park, College Park, Maryland, USA
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Liu PPS, Chang HR, Hsu JY, Huang HK, Loh CH, Yeh JI. Association between holiday and weekend admissions and mortality outcomes among patients with acute myocardial infarction receiving percutaneous coronary intervention in Taiwan. Sci Rep 2024; 14:8892. [PMID: 38632335 DOI: 10.1038/s41598-024-59571-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 04/12/2024] [Indexed: 04/19/2024] Open
Abstract
There is a lack of studies that concurrently differentiate the effect of the holiday season from the weekend effect on mortality risk in patients with acute myocardial infarction (AMI). We evaluated the mortality risk among patients admitted with AMI who underwent percutaneous coronary intervention, using data from the Taiwan National Health Insurance Research Database. Adult AMI patients admitted during January and February between 2013 and 2020 were enrolled and classified into the holiday season (using the Chinese New Year holiday seasons as an indicator) (n = 1729), weekend (n = 4725), and weekday (n = 14,583) groups according to the first day of admission. A multivariable logistic regression model was used to assess the risk. With the weekday group or the weekend group as the reference, the holiday season group did not have increased risks of in-hospital mortality (adjusted odds ratio [aOR] 1.15; 95% confidence intervals [CI] 0.93-1.42 or aOR 1.23; 95% CI 0.96-1.56) and 7-day mortality (aOR 1.20; 95% CI 0.90-1.58 or aOR 1.24; 95% CI 0.90-1.70). Stratified and subgroup analyses showed similar trends. We conclude that holiday season-initiated admissions were not associated with higher mortality risks in AMI admission cases than weekday or weekend admissions.
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Affiliation(s)
- Peter Pin-Sung Liu
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
- Center for Healthy Longevity, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Huai-Ren Chang
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Division of Cardiology, Department of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Jin-Yi Hsu
- Center for Aging and Health, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Huei-Kai Huang
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien, 97002, Taiwan
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Ching-Hui Loh
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
- Center for Aging and Health, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Jih-I Yeh
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
- School of Medicine, Tzu Chi University, Hualien, Taiwan.
- Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien, 97002, Taiwan.
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Adoboi F, Mohammed A, Duodu PA, Aboagye RG, Seidu AA, Wongnaah FG, Ahinkorah BO. Sex-related inequalities in crude and age-standardized suicide rates: trends in Ghana from 2000 to 2019. BMC Public Health 2024; 24:1070. [PMID: 38632578 DOI: 10.1186/s12889-024-18516-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Suicide represents a major public health concern, affecting a significant portion of individuals. However, there remains a gap in understanding the age and sex disparities in the occurrence of suicide. Therefore, this study aimed to investigate the sex-related inequalities in suicide rates in Ghana from 2000 to 2019. METHODS We utilized data from the WHO Health Equity Assessment Toolkit (HEAT) online software. We analysed sex differences in both crude and age-standardized suicide rates in Ghana spanning from 2000 to 2019. Crude and age-adjusted suicide rates were calculated based on the International Classification of Diseases (ICD) definition and coding of suicide mortality. We measured inequality in terms of sex. Two inequality indicators were used to examine the suicide rates: the difference (D) and the ratio (R). RESULTS Age-standardized and crude suicide rates in Ghana were higher among men from 2000 to 2019. Between 2000 and 2007, the age-standardized suicide rate for women rose steadily and declined slightly between 2008 and 2019. Age-standardized suicide rates for men increased consistently from 2000 to 2010, then declined steadily from 2011 to 2019. The crude suicide rates among men and women followed similar patterns. The widest absolute inequality in crude suicide rates (D) was recorded in 2013 (D=-11.91), while the smallest difference was observed in 2000 (D=-7.16). We also found the greatest disparity in age-standardized rates in 2011 (D=-21.46) and the least in 2000 (D=-14.32). The crude suicide rates increased with age for both men and women aged 15-54 years and 55-85+ years respectively. However, the increased rate was higher in men than in women across all age groups surveyed. A similar pattern was observed for relative inequality in both crude and age-standardized rates of suicide. CONCLUSION The suicide rate in Ghana has declined over time. Suicide is more common among older men. Inequalities in suicide rates, in both absolute and relative terms, are similar. There is a need to monitor suicide trends in Ghana, especially among older men. Moreover, the findings could serve as a basis for future studies on suicide in Ghana.
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Affiliation(s)
- Faustina Adoboi
- Cape Coast Nursing and Midwifery Training College, Cape Coast, Ghana
| | - Aliu Mohammed
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Precious Adade Duodu
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, England, UK
| | - Richard Gyan Aboagye
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, 2052, Sydney, NSW, Australia.
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
| | - Abdul-Aziz Seidu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, 4811, Queensland, QLD, Australia
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, P.O. Box 256, Ghana
- REMS Consultancy Services Limited, Sekondi-Takoradi, Western Region, Ghana
| | | | - Bright Opoku Ahinkorah
- REMS Consultancy Services Limited, Sekondi-Takoradi, Western Region, Ghana
- School of Clinical Medicine, University of New South Wales Sydney, Sydney, Australia
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Hansford HJ, Jones MD, Cashin AG, Ostelo RW, Chiarotto A, Williams SA, Sharma S, Rose JM, Devonshire JJ, Ferraro MC, Wewege MA, McAuley JH. The smallest worthwhile effect on pain intensity of exercise therapy for people with chronic low back pain: a discrete choice experiment study. J Orthop Sports Phys Ther 2024:1-26. [PMID: 38630543 DOI: 10.2519/jospt.2024.12279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
OBJECTIVE: To identify the smallest worthwhile effect (SWE) of exercise therapy for people with non-specific chronic low back pain (CLBP). DESIGN: Discrete choice experiment. METHODS: The SWE was estimated as the lowest reduction in pain that participants would consider exercising worthwhile, compared to not exercising i.e., effects due to natural history and other components (e.g., regression to the mean). We recruited English-speaking adults in Australia with non-specific CLBP to our online survey via email obtained from a registry of previous participants and advertisements on social media. We used discrete choice experiment to estimate the SWE of exercise compared to no exercise for pain intensity. We analysed the discrete choice experiment using a mixed logit model, and mitigated hypothetical bias through certainty calibration, with sensitivity analyses performed with different certainty calibration thresholds. RESULTS: Two-hundred and thirteen participants completed the survey. The mean age (±SD) was 50.7±16.5, median (IQR) pain duration 10 years (5-20), and mean pain intensity (±SD) was 5.8±2.3 on a 0-10 numerical rating scale. For people with CLBP the SWE of exercise was a between-group reduction in pain of 20%, compared to no exercise. In the sensitivity analyses, the SWE varied with different levels of certainty calibration; from 0% without certainty calibration to 60% with more extreme certainty calibration. CONCLUSION: This patient-informed threshold of clinical importance could guide the interpretation of findings from randomised trials and meta-analyses of exercise therapy compared to no exercise.
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Affiliation(s)
- Harrison J Hansford
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Matthew D Jones
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Aidan G Cashin
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Raymond Wjg Ostelo
- Department of Health Sciences, Faculty of Science and Amsterdam Movement Science Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, Amsterdam University Medical Centre, location Vrije Universiteit, Amsterdam Movement Sciences, The Netherlands
| | - Alessandro Chiarotto
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Sam A Williams
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Saurab Sharma
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - John M Rose
- Neil Smith Research Chair in Sustainable Transport Futures, Institute of Transport and Logistics Studies, The University of Sydney Business School, Sydney, New South Wales, 2006, Australia
| | - Jack J Devonshire
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Michael C Ferraro
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Michael A Wewege
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - James H McAuley
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
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Shen H, Zheng R, Du M, Christiani DC. Environmental pollutants exposure-derived extracellular vesicles: crucial players in respiratory disorders. Thorax 2024:thorax-2023-221302. [PMID: 38631896 DOI: 10.1136/thorax-2023-221302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Individual exposure to environmental pollutants, as one of the most influential drivers of respiratory disorders, has received considerable attention due to its preventability and controllability. Considering that the extracellular vesicle (EV) was an emerging intercellular communication medium, recent studies have highlighted the crucial role of environmental pollutants derived EVs (EPE-EVs) in respiratory disorders. METHODS PubMed and Web of Science were searched from January 2018 to December 2023 for publications with key words of environmental pollutants, respiratory disorders and EVs. RESULTS Environmental pollutants could disrupt airway intercellular communication by indirectly stimulating airway barrier cells to secrete endogenous EVs, or directly transmitting exogenous EVs, mainly by biological pollutants. Mechanistically, EPE-EVs transferred specific contents to modulate biological functions of recipient cells, to induce respiratory inflammation and impair tissue and immune function, which consequently contributed to the development of respiratory diseases, such as asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, pulmonary hypertension, lung cancer and infectious lung diseases. Clinically, EVs could emerged as promising biomarkers and biological agents for respiratory diseases attributed by their specificity, convenience, sensibility and stability. CONCLUSIONS Further studies of EPE-EVs are helpful to understand the aetiology and pathology of respiratory diseases, and facilitate the precision respiratory medicine in risk screening, early diagnosis, clinical management and biotherapy.
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Affiliation(s)
- Haoran Shen
- School of Pediatrics, Nanjing Medical University, Nanjing, China
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Rui Zheng
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Genetic Toxicology, The Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Mulong Du
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Departments of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - David C Christiani
- Departments of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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López-Cerdá S, Molinaro G, Tello RP, Correia A, Künig S, Steinberger P, Jeltsch M, Hirvonen JT, Barreto G, Stöckl J, Santos HA. Study of the Synergistic Immunomodulatory and Antifibrotic Effects of Dual-Loaded Budesonide and Serpine1 siRNA Lipid-Polymer Nanoparticles Targeting Macrophage Dysregulation in Tendinopathy. ACS Appl Mater Interfaces 2024; 16:18643-18657. [PMID: 38564504 DOI: 10.1021/acsami.4c02363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Musculoskeletal diseases involving tissue injury comprise tendon, ligament, and muscle injury. Recently, macrophages have been identified as key players in the tendon repair process, but no therapeutic strategy involving dual drug delivery and gene delivery to macrophages has been developed for targeting the two main dysregulated aspects of macrophages in tendinopathy, i.e., inflammation and fibrosis. Herein, the anti-inflammatory and antifibrotic effects of dual-loaded budesonide and serpine1 siRNA lipid-polymer hybrid nanoparticles (LPNs) are evaluated in murine and human macrophage cells. The modulation of the gene and protein expression of factors associated with inflammation and fibrosis in tendinopathy is demonstrated by real time polymerase chain reaction and Western blot. Macrophage polarization to the M2 phenotype and a decrease in the production of pro-inflammatory cytokines are confirmed in macrophage cell lines and primary cells. The increase in the activity of a matrix metalloproteinase involved in tissue remodelling is proven, and studies evaluating the interactions of LPNs with T cells proved that dual-loaded LPNs act specifically on macrophages and do not induce any collateral effects on T cells. Overall, these dual-loaded LPNs are a promising combinatorial therapeutic strategy with immunomodulatory and antifibrotic effects in dysregulated macrophages in the context of tendinopathy.
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Affiliation(s)
- Sandra López-Cerdá
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, University of Helsinki, Helsinki FI-00014, Finland
| | - Giuseppina Molinaro
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, University of Helsinki, Helsinki FI-00014, Finland
| | - Rubén Pareja Tello
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, University of Helsinki, Helsinki FI-00014, Finland
| | - Alexandra Correia
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, University of Helsinki, Helsinki FI-00014, Finland
| | - Sarojinidevi Künig
- Centre for Pathophysiology, Infectiology and Immunology, Institute of Immunology, Medical University of Vienna, 1090 Vienna, Austria
| | - Peter Steinberger
- Centre for Pathophysiology, Infectiology and Immunology, Institute of Immunology, Medical University of Vienna, 1090 Vienna, Austria
| | - Michael Jeltsch
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, University of Helsinki, Helsinki FI-00014, Finland
- Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki FI-00014, Finland
- Wihuri Research Institute, Helsinki FI-00014, Finland
- Helsinki One Health, University of Helsinki, Helsinki FI-00014, Finland
| | - Jouni T Hirvonen
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, University of Helsinki, Helsinki FI-00014, Finland
| | - Goncalo Barreto
- Translational Immunology Research Program, Faculty of Medicine, University of Helsinki, Helsinki FI-00014, Finland
- Orton Orthopedic Hospital, Tenholantie 10, Helsinki 00280, Finland
- Medical Ultrasonics Laboratory (MEDUSA), Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo 02150, Finland
| | - Johannes Stöckl
- Centre for Pathophysiology, Infectiology and Immunology, Institute of Immunology, Medical University of Vienna, 1090 Vienna, Austria
| | - Hélder A Santos
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, University of Helsinki, Helsinki FI-00014, Finland
- Department of Biomaterials and Biomedical Technology, University Medical Center Groningen, University of Groningen, Ant. Deusinglaan 1, 9713 AV Groningen, The Netherlands
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Chandwe K, Bwakura-Dangarembizi M, Amadi B, Tawodzera G, Ngosa D, Dzikiti A, Chulu N, Makuyana R, Zyambo K, Mutasa K, Mulenga C, Besa E, Sturgeon JP, Mudzingwa S, Simunyola B, Kazhila L, Zyambo M, Sonkwe H, Mutasa B, Chipunza M, Sauramba V, Langhaug L, Mudenda V, Murch SH, Hill S, Playford RJ, VanBuskirk K, Prendergast AJ, Kelly P. Malnutrition enteropathy in Zambian and Zimbabwean children with severe acute malnutrition: A multi-arm randomized phase II trial. Nat Commun 2024; 15:2910. [PMID: 38632262 DOI: 10.1038/s41467-024-45528-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 01/26/2024] [Indexed: 04/19/2024] Open
Abstract
Malnutrition underlies almost half of all child deaths globally. Severe Acute Malnutrition (SAM) carries unacceptable mortality, particularly if accompanied by infection or medical complications, including enteropathy. We evaluated four interventions for malnutrition enteropathy in a multi-centre phase II multi-arm trial in Zambia and Zimbabwe and completed in 2021. The purpose of this trial was to identify therapies which could be taken forward into phase III trials. Children of either sex were eligible for inclusion if aged 6-59 months and hospitalised with SAM (using WHO definitions: WLZ <-3, and/or MUAC <11.5 cm, and/or bilateral pedal oedema), with written, informed consent from the primary caregiver. We randomised 125 children hospitalised with complicated SAM to 14 days treatment with (i) bovine colostrum (n = 25), (ii) N-acetyl glucosamine (n = 24), (iii) subcutaneous teduglutide (n = 26), (iv) budesonide (n = 25) or (v) standard care only (n = 25). The primary endpoint was a composite of faecal biomarkers (myeloperoxidase, neopterin, α1-antitrypsin). Laboratory assessments, but not treatments, were blinded. Per-protocol analysis used ANCOVA, adjusted for baseline biomarker value, sex, oedema, HIV status, diarrhoea, weight-for-length Z-score, and study site, with pre-specified significance of P < 0.10. Of 143 children screened, 125 were randomised. Teduglutide reduced the primary endpoint of biomarkers of mucosal damage (effect size -0.89 (90% CI: -1.69,-0.10) P = 0.07), while colostrum (-0.58 (-1.4, 0.23) P = 0.24), N-acetyl glucosamine (-0.20 (-1.01, 0.60) P = 0.67), and budesonide (-0.50 (-1.33, 0.33) P = 0.32) had no significant effect. All interventions proved safe. This work suggests that treatment of enteropathy may be beneficial in children with complicated malnutrition. The trial was registered at ClinicalTrials.gov with the identifier NCT03716115.
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Affiliation(s)
- Kanta Chandwe
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Mutsa Bwakura-Dangarembizi
- Zvitambo Institute for Maternal and Child Health Research, McLaughlin Avenue, Meyrick Park, Harare, Zimbabwe
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Parirenyatwa Hospital, Harare, Zimbabwe
| | - Beatrice Amadi
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Gertrude Tawodzera
- Zvitambo Institute for Maternal and Child Health Research, McLaughlin Avenue, Meyrick Park, Harare, Zimbabwe
| | - Deophine Ngosa
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Anesu Dzikiti
- Zvitambo Institute for Maternal and Child Health Research, McLaughlin Avenue, Meyrick Park, Harare, Zimbabwe
| | - Nivea Chulu
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Robert Makuyana
- Zvitambo Institute for Maternal and Child Health Research, McLaughlin Avenue, Meyrick Park, Harare, Zimbabwe
| | - Kanekwa Zyambo
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Kuda Mutasa
- Zvitambo Institute for Maternal and Child Health Research, McLaughlin Avenue, Meyrick Park, Harare, Zimbabwe
| | - Chola Mulenga
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Ellen Besa
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Jonathan P Sturgeon
- Zvitambo Institute for Maternal and Child Health Research, McLaughlin Avenue, Meyrick Park, Harare, Zimbabwe
- Blizard Institute, Queen Mary University of London, Newark Street, London, UK
| | - Shepherd Mudzingwa
- Zvitambo Institute for Maternal and Child Health Research, McLaughlin Avenue, Meyrick Park, Harare, Zimbabwe
| | - Bwalya Simunyola
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Lydia Kazhila
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Masuzyo Zyambo
- Department of Anaesthesia, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Hazel Sonkwe
- Department of Anaesthesia, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Batsirai Mutasa
- Zvitambo Institute for Maternal and Child Health Research, McLaughlin Avenue, Meyrick Park, Harare, Zimbabwe
| | - Miyoba Chipunza
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Virginia Sauramba
- Zvitambo Institute for Maternal and Child Health Research, McLaughlin Avenue, Meyrick Park, Harare, Zimbabwe
| | - Lisa Langhaug
- Zvitambo Institute for Maternal and Child Health Research, McLaughlin Avenue, Meyrick Park, Harare, Zimbabwe
| | - Victor Mudenda
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | | | - Susan Hill
- Great Ormond Street Hospital, London, UK
| | - Raymond J Playford
- University of West London, Ealing, London, UK
- University College Cork, College Road, Cork, Ireland
| | - Kelley VanBuskirk
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Andrew J Prendergast
- Zvitambo Institute for Maternal and Child Health Research, McLaughlin Avenue, Meyrick Park, Harare, Zimbabwe
- Blizard Institute, Queen Mary University of London, Newark Street, London, UK
| | - Paul Kelly
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia.
- Blizard Institute, Queen Mary University of London, Newark Street, London, UK.
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241
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Shen G, Liu Z, Wang L, Li J. Inter-leg systolic blood pressure difference has been associated with all-cause and cardiovascular mortality: analysis of NHANES 1999-2004. BMC Public Health 2024; 24:1071. [PMID: 38632605 DOI: 10.1186/s12889-024-18508-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 04/02/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Inter-leg systolic blood pressure difference (ILSBPD) has emerged as a novel cardiovascular risk factor. This study aims to investigate the predictive value of ILSBPD on all-cause and cardiovascular mortality in general population. METHODS We combined three cycles (1999-2004) of the National Health and Nutrition Examination Survey (NHANES) data. Levels of ILSBPD were calculated and divided into four groups based on three cut-off values of 5, 10 and 15mmHg. Time-to-event curves were estimated with the use of the Kaplan-Meier method, and two multivariable Cox proportional hazards regression models were conducted to assess the hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause and cardiovascular mortality associated with ILSBPD. RESULTS A total of 6 842 subjects were included, with the mean (SD) age of 59.5 (12.8) years. By December 31, 2019, 2 544 and 648 participants were identified all-cause and cardiovascular mortality respectively during a median follow-up of 16.6 years. Time-to-event analyses suggested that higher ILSBPD was associated with increased all-cause and cardiovascular mortality (logrank, p < 0.001). Every 5mmHg increment of ILSBPD brings about 5% and 7% increased risk of all-cause and cardiovascular mortality, and individuals with an ILSBPD ≥ 15mmHg were significantly associated with higher incidence of all-cause mortality (HR 1.43, 95%CI 1.18-1.52, p < 0.001) and cardiovascular mortality (HR 1.73, 95%CI 1.36-2.20, p < 0.001) when multiple confounding factors were adjusted. Subgroup and sensitivity analysis confirmed the relationship. CONCLUSIONS Our findings suggest that the increment of ILSBPD was significantly associated with higher risk of all-cause and cardiovascular mortality in general population.
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Affiliation(s)
- Geng Shen
- Division of Cardiology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, 100034, Beijing, China
| | - Zhihao Liu
- Division of Cardiology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, 100034, Beijing, China
| | - Leyi Wang
- Division of Cardiology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, 100034, Beijing, China
| | - Jianping Li
- Division of Cardiology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, 100034, Beijing, China.
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242
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Lin L, Dacal E, Díez N, Carmona C, Martin Ramirez A, Barón Argos L, Bermejo-Peláez D, Caballero C, Cuadrado D, Darias-Plasencia O, García-Villena J, Bakarjiev A, Postigo M, Recalde-Jaramillo E, Flores-Chavez M, Santos A, Ledesma-Carbayo MJ, Rubio JM, Luengo-Oroz M. Edge Artificial Intelligence (AI) for real-time automatic quantification of filariasis in mobile microscopy. PLoS Negl Trop Dis 2024; 18:e0012117. [PMID: 38630833 DOI: 10.1371/journal.pntd.0012117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 03/29/2024] [Indexed: 04/19/2024] Open
Abstract
Filariasis, a neglected tropical disease caused by roundworms, is a significant public health concern in many tropical countries. Microscopic examination of blood samples can detect and differentiate parasite species, but it is time consuming and requires expert microscopists, a resource that is not always available. In this context, artificial intelligence (AI) can assist in the diagnosis of this disease by automatically detecting and differentiating microfilariae. In line with the target product profile for lymphatic filariasis as defined by the World Health Organization, we developed an edge AI system running on a smartphone whose camera is aligned with the ocular of an optical microscope that detects and differentiates filarias species in real time without the internet connection. Our object detection algorithm that uses the Single-Shot Detection (SSD) MobileNet V2 detection model was developed with 115 cases, 85 cases with 1903 fields of view and 3342 labels for model training, and 30 cases with 484 fields of view and 873 labels for model validation before clinical validation, is able to detect microfilarias at 10x magnification and distinguishes four species of them at 40x magnification: Loa loa, Mansonella perstans, Wuchereria bancrofti, and Brugia malayi. We validated our augmented microscopy system in the clinical environment by replicating the diagnostic workflow encompassed examinations at 10x and 40x with the assistance of the AI models analyzing 18 samples with the AI running on a middle range smartphone. It achieved an overall precision of 94.14%, recall of 91.90% and F1 score of 93.01% for the screening algorithm and 95.46%, 97.81% and 96.62% for the species differentiation algorithm respectively. This innovative solution has the potential to support filariasis diagnosis and monitoring, particularly in resource-limited settings where access to expert technicians and laboratory equipment is scarce.
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Affiliation(s)
- Lin Lin
- Spotlab, Madrid, Spain
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Claudia Carmona
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III-Madrid, Madrid, Spain
| | - Alexandra Martin Ramirez
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III-Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC) Instituto de Salud Carlos III-Madrid, Madrid, Spain
| | - Lourdes Barón Argos
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III-Madrid, Madrid, Spain
| | | | | | | | | | | | | | | | - Ethan Recalde-Jaramillo
- Spotlab, Madrid, Spain
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Flores-Chavez
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III-Madrid, Madrid, Spain
- Fundación Mundo Sano, Madrid, Spain
| | - Andrés Santos
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | - María Jesús Ledesma-Carbayo
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | - José M Rubio
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III-Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC) Instituto de Salud Carlos III-Madrid, Madrid, Spain
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Tian F, Zhong X, Ye Y, Liu X, He G, Wu C, Chen Z, Zhu Q, Yu S, Fan J, Yao H, Ma W, Dong X, Liu T. Mutual Associations of Exposure to Ambient Air Pollutants in the First 1000 Days of Life With Asthma/Wheezing in Children: Prospective Cohort Study in Guangzhou, China. JMIR Public Health Surveill 2024; 10:e52456. [PMID: 38631029 DOI: 10.2196/52456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/21/2023] [Accepted: 03/05/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The first 1000 days of life, encompassing pregnancy and the first 2 years after birth, represent a critical period for human health development. Despite this significance, there has been limited research into the associations between mixed exposure to air pollutants during this period and the development of asthma/wheezing in children. Furthermore, the finer sensitivity window of exposure during this crucial developmental phase remains unclear. OBJECTIVE This study aims to assess the relationships between prenatal and postnatal exposures to various ambient air pollutants (particulate matter 2.5 [PM2.5], carbon monoxide [CO], sulfur dioxide [SO2], nitrogen dioxide [NO2], and ozone [O3]) and the incidence of childhood asthma/wheezing. In addition, we aimed to pinpoint the potential sensitivity window during which air pollution exerts its effects. METHODS We conducted a prospective birth cohort study wherein pregnant women were recruited during early pregnancy and followed up along with their children. Information regarding maternal and child characteristics was collected through questionnaires during each round of investigation. Diagnosis of asthma/wheezing was obtained from children's medical records. In addition, maternal and child exposures to air pollutants (PM2.5 CO, SO2, NO2, and O3) were evaluated using a spatiotemporal land use regression model. To estimate the mutual associations of exposure to mixed air pollutants with the risk of asthma/wheezing in children, we used the quantile g-computation model. RESULTS In our study cohort of 3725 children, 392 (10.52%) were diagnosed with asthma/wheezing. After the follow-up period, the mean age of the children was 3.2 (SD 0.8) years, and a total of 14,982 person-years were successfully followed up for all study participants. We found that each quartile increase in exposure to mixed air pollutants (PM2.5, CO, SO2, NO2, and O3) during the second trimester of pregnancy was associated with an adjusted hazard ratio (HR) of 1.24 (95% CI 1.04-1.47). Notably, CO made the largest positive contribution (64.28%) to the mutual effect. After categorizing the exposure according to the embryonic respiratory development stages, we observed that each additional quartile of mixed exposure to air pollutants during the pseudoglandular and canalicular stages was associated with HRs of 1.24 (95% CI 1.03-1.51) and 1.23 (95% CI 1.01-1.51), respectively. Moreover, for the first year and first 2 years after birth, each quartile increment of exposure to mixed air pollutants was associated with HRs of 1.65 (95% CI 1.30-2.10) and 2.53 (95% CI 2.16-2.97), respectively. Notably, SO2 made the largest positive contribution in both phases, accounting for 50.30% and 74.70% of the association, respectively. CONCLUSIONS Exposure to elevated levels of mixed air pollutants during the first 1000 days of life appears to elevate the risk of childhood asthma/wheezing. Specifically, the second trimester, especially during the pseudoglandular and canalicular stages, and the initial 2 years after birth emerge as crucial susceptibility windows. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR-ROC-17013496; https://tinyurl.com/2ctufw8n.
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Affiliation(s)
- Fenglin Tian
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Xinqi Zhong
- Department of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yufeng Ye
- Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Xiaohan Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Cuiling Wu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Zhiqing Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Qijiong Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Siwen Yu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Jingjie Fan
- Department of Prevention and Health Care, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Huan Yao
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Xiaomei Dong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
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Li T, Guo Y, Zhao Z, Chen M, Lin Q, Hu X, Yao Z, Hu B. Automated Diagnosis of Major Depressive Disorder With Multi-Modal MRIs Based on Contrastive Learning: A Few-Shot Study. IEEE Trans Neural Syst Rehabil Eng 2024; 32:1566-1576. [PMID: 38512734 DOI: 10.1109/tnsre.2024.3380357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Depression ranks among the most prevalent mood-related psychiatric disorders. Existing clinical diagnostic approaches relying on scale interviews are susceptible to individual and environmental variations. In contrast, the integration of neuroimaging techniques and computer science has provided compelling evidence for the quantitative assessment of major depressive disorder (MDD). However, one of the major challenges in computer-aided diagnosis of MDD is to automatically and effectively mine the complementary cross-modal information from limited datasets. In this study, we proposed a few-shot learning framework that integrates multi-modal MRI data based on contrastive learning. In the upstream task, it is designed to extract knowledge from heterogeneous data. Subsequently, the downstream task is dedicated to transferring the acquired knowledge to the target dataset, where a hierarchical fusion paradigm is also designed to integrate features across inter- and intra-modalities. Lastly, the proposed model was evaluated on a set of multi-modal clinical data, achieving average scores of 73.52% and 73.09% for accuracy and AUC, respectively. Our findings also reveal that the brain regions within the default mode network and cerebellum play a crucial role in the diagnosis, which provides further direction in exploring reproducible biomarkers for MDD diagnosis.
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Moreno KGT, Marques AAM, da Silva GP, Bertoncelo LA, Pessoal LB, Gonçalves LD, Dos Santos AC, Souza RIC, Silva DB, Gasparotto Junior A. Cardioprotective Effects of Aloysia polystachya Essential Oil on a Rat Model with Multiple Cardiovascular Risk Factors. Planta Med 2024. [PMID: 38631368 DOI: 10.1055/a-2294-6922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Traditional medicine is a frequently utilized method to treat cardiovascular disease and its primary risk factors, including hypertension and dyslipidemia. Aloysia polystachya is a species that is commonly employed to treat various pathological conditions, and it has already been identified as having some cardioprotective effects. This study aimed to investigate the protective effects of the essential oil extracted from the leaves of A. polystachya in a rat model that simulates multiple cardiovascular risk factors. We evaluate the acute toxicity, as well as the cardioprotective effects, by giving different doses of A. polystachya essential oil (1.47 mg/kg, 4.40 mg/kg, and 13.20 mg/kg) over a period of 42 days. The control group was treated with rosuvastatin (5 mg/kg). At the end of the treatments, the renal function, electrocardiography, blood pressure, vascular reactivity, serum biochemical profile, and organ histopathology were evaluated. The main compounds identified in the essential oil of A. polystachya using gas chromatography coupled with mass spectrometry were beta-myrcene (1.08%), limonene (40.13%), and carvone (56.47%). The essential oil of A. polystachya not only lacks acute toxicity but also mitigates the reduction in the excretion of sodium, chloride, and creatinine in urine. Furthermore, it reduces electrocardiographic abnormalities and decreases blood pressure levels. Moreover, this treatment prevents an elevation in markers of inflammation and oxidative stress in the bloodstream. Our findings indicate significant cardioprotective effects of the essential oil of A. polystachya against multiple risk factors for cardiovascular diseases in hypertensive rats.
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Affiliation(s)
- Karyne Garcia Tafarelo Moreno
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Aline Aparecida Macedo Marques
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Gabriela Pereira da Silva
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Luana Ale Bertoncelo
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Luciane Barbosa Pessoal
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Larissa Dantas Gonçalves
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Ariany Carvalho Dos Santos
- Laboratory of Histopathology, Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | | | - Denise Brentan Silva
- Laboratory of Natural Products and Mass Spectrometry (LAPNEM), Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Arquimedes Gasparotto Junior
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
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van den Berg H, Bashar K, Chowdhury R, Bhatt RM, Gupta HP, Kumar A, Sabesan S, Shriram AN, Konuganti HKR, Sinha ATS, Sedaghat MM, Enayati A, Hassan HM, Najmee AS, Saleem S, Uranw S, Kusumawathie PHD, Perera D, Esmail MA, Carrington LB, Al-Eryani SM, Kumari R, Nagpal BN, Sultana S, Velayudhan R, Yadav RS. Perceived needs of disease vector control programs: A review and synthesis of (sub)national assessments from South Asia and the Middle East. PLoS Negl Trop Dis 2024; 18:e0011451. [PMID: 38630832 DOI: 10.1371/journal.pntd.0011451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 03/26/2024] [Indexed: 04/19/2024] Open
Abstract
Systems for disease vector control should be effective, efficient, and flexible to be able to tackle contemporary challenges and threats in the control and elimination of vector-borne diseases. As a priority activity towards the strengthening of vector control systems, it has been advocated that countries conduct a vector-control needs assessment. A review was carried out of the perceived needs for disease vector control programs among eleven countries and subnational states in South Asia and the Middle East. In each country or state, independent teams conducted vector control needs assessment with engagement of stakeholders. Important weaknesses were described for malaria, dengue and leishmaniases regarding vector surveillance, insecticide susceptibility testing, monitoring and evaluation of operations, entomological capacity and laboratory infrastructure. In addition, community mobilization and intersectoral collaboration showed important gaps. Countries and states expressed concern about insecticide resistance that could reduce the continued effectiveness of interventions, which demands improved monitoring. Moreover, attainment of disease elimination necessitates enhanced vector surveillance. Vector control needs assessment provided a useful planning tool for systematic strengthening of vector control systems. A limitation in conducting the vector control needs assessment was that it is time- and resource-intensive. To increase the feasibility and utility of national assessments, an abridged version of the guidance should focus on operationally relevant topics of the assessment. Similar reviews are needed in other regions with different contextual conditions.
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Affiliation(s)
- Henk van den Berg
- Laboratory of Entomology, Wageningen University, Wageningen, the Netherlands
| | - Kabirul Bashar
- Department of Zoology, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Rajib Chowdhury
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, and Department of Public Health, Independent University Bangladesh, Dhaka, Bangladesh
- World Health Organization Country Office for Bangladesh, Dhaka, Bangladesh
| | | | | | - Ashwani Kumar
- ICMR-Vector Control Research Centre, Puducherry, India
- Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | | | | | | | | | | | - Ahmadali Enayati
- School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | | | | | | | - Surendra Uranw
- B. P. Koirala Institute of Health Sciences, Dharan, Nepal
| | | | | | - Mohammed A Esmail
- National Malaria Control Program, Ministry of Public Health & Population, Sana'a, Yemen
| | | | - Samira M Al-Eryani
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt
| | - Roop Kumari
- World Health Organization Country Office for India, New Delhi, India
| | - Bhupender N Nagpal
- Regional Office for South-East Asia, World Health Organization, New Delhi, India
| | - Sabera Sultana
- World Health Organization Country Office for Bangladesh, Dhaka, Bangladesh
| | - Raman Velayudhan
- Veterinary Public Health, Vector Control and Environment Unit, Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Rajpal S Yadav
- Veterinary Public Health, Vector Control and Environment Unit, Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
- Academy of Public Health Entomology, Udaipur, India
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Li SW, Zhang LH, Cai Y, Zhou XB, Fu XY, Song YQ, Xu SW, Tang SP, Luo RQ, Huang Q, Yan LL, He SQ, Zhang Y, Wang J, Ge SQ, Gu BB, Peng JB, Wang Y, Fang LN, Wu WD, Ye WG, Zhu M, Luo DH, Jin XX, Yang HD, Zhou JJ, Wang ZZ, Wu JF, Qin QQ, Lu YD, Wang F, Chen YH, Chen X, Xu SJ, Tung TH, Luo CW, Ye LP, Yu HG, Mao XL. Deep learning assists detection of esophageal cancer and precursor lesions in a prospective, randomized controlled study. Sci Transl Med 2024; 16:eadk5395. [PMID: 38630847 DOI: 10.1126/scitranslmed.adk5395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 03/27/2024] [Indexed: 04/19/2024]
Abstract
Endoscopy is the primary modality for detecting asymptomatic esophageal squamous cell carcinoma (ESCC) and precancerous lesions. Improving detection rate remains challenging. We developed a system based on deep convolutional neural networks (CNNs) for detecting esophageal cancer and precancerous lesions [high-risk esophageal lesions (HrELs)] and validated its efficacy in improving HrEL detection rate in clinical practice (trial registration ChiCTR2100044126 at www.chictr.org.cn). Between April 2021 and March 2022, 3117 patients ≥50 years old were consecutively recruited from Taizhou Hospital, Zhejiang Province, and randomly assigned 1:1 to an experimental group (CNN-assisted endoscopy) or a control group (unassisted endoscopy) based on block randomization. The primary endpoint was the HrEL detection rate. In the intention-to-treat population, the HrEL detection rate [28 of 1556 (1.8%)] was significantly higher in the experimental group than in the control group [14 of 1561 (0.9%), P = 0.029], and the experimental group detection rate was twice that of the control group. Similar findings were observed between the experimental and control groups [28 of 1524 (1.9%) versus 13 of 1534 (0.9%), respectively; P = 0.021]. The system's sensitivity, specificity, and accuracy for detecting HrELs were 89.7, 98.5, and 98.2%, respectively. No adverse events occurred. The proposed system thus improved HrEL detection rate during endoscopy and was safe. Deep learning assistance may enhance early diagnosis and treatment of esophageal cancer and may become a useful tool for esophageal cancer screening.
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Affiliation(s)
- Shao-Wei Li
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
- Institute of Digestive Disease, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
- Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Li-Hui Zhang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430000, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan 430000, China
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510000, China
| | - Yue Cai
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Xian-Bin Zhou
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Xin-Yu Fu
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Ya-Qi Song
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Shi-Wen Xu
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Shen-Ping Tang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Ren-Quan Luo
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430000, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan 430000, China
| | - Qin Huang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Ling-Ling Yan
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Sai-Qin He
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Yu Zhang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Jun Wang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Shu-Qiong Ge
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Bin-Bin Gu
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Jin-Bang Peng
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Yi Wang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Li-Na Fang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Wei-Dan Wu
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Wen-Guang Ye
- Department of Gastroenterology, Zhejiang University School Medicine Affiliated Hangzhou Cancer Hospital, Hangzhou 310000, China
| | - Min Zhu
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Ding-Hai Luo
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Xiu-Xiu Jin
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Hai-Deng Yang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Jing-Jing Zhou
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Zhen-Zhen Wang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Jian-Fen Wu
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Qiao-Qiao Qin
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Yan-di Lu
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Fei Wang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Ya-Hong Chen
- Health Management Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Xia Chen
- Department of Gastroenterology, Wenling First People's Hospital, Taizhou, Zhejiang 317500, China
| | - Shan-Jing Xu
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Chen-Wen Luo
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Li-Ping Ye
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
- Institute of Digestive Disease, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
- Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
| | - Hong-Gang Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430000, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan 430000, China
| | - Xin-Li Mao
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
- Institute of Digestive Disease, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
- Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
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Espin A, Irazusta J, Aiestaran M, Latorre Erezuma U, García-García J, Arrinda I, Acedo K, Rodriguez-Larrad A. Videoconference-Supervised Group Exercise Reduces Low Back Pain in Eldercare Workers: Results from the ReViEEW Randomised Controlled Trial. J Occup Rehabil 2024:10.1007/s10926-024-10182-2. [PMID: 38632115 DOI: 10.1007/s10926-024-10182-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE To assess the effects of a group exercise intervention conducted by real-time videoconference on the low back pain of eldercare workers. METHODS We randomly assigned 130 eldercare workers to an experimental group (EG: n = 65) or control group (CG: n = 65). Participants from both groups took part in routine prevention programs carried out in their workplace, and participants from the EG received an additional 12-week resistance-exercise intervention supervised by real-time videoconference. Assessments were conducted before and after the intervention, and the primary outcome was average low back pain intensity during the last 7 days, measured by the 0-10 numerical rating scale. Secondary outcomes included additional measures of low back, neck, shoulder and hand/wrist pain, as well as psycho-affective parameters, medication consumption and muscle performance. Both intention-to-treat and per-protocol analyses were applied with a group-by-time ANCOVA including baseline measurements as covariates. RESULTS 125 participants completed post-intervention assessments (EG: n = 63, CG: n = 62). The intention-to-treat analysis showed an effect favouring the EG on average low back pain intensity (p = 0.034). Improvements in additional low back and hand/wrist pain outcomes were also observed, as well as on upper limb muscle performance (p < 0.05). The per-protocol analysis demonstrated additional benefits in depression, quality of life, hypnotic/anxiolytic medication consumption and lower limb and trunk muscle performance in participants with ≥ 50% adherence (p < 0.05). CONCLUSIONS The intervention was effective for reducing the low back and hand/wrist pain of eldercare workers and increasing upper limb muscle performance. The per-protocol analysis showed additional benefits in psycho-affective parameters, medication consumption and muscle performance. TRIAL REGISTRATION ClinicalTrials.gov, NCT05050526. Registered 20 September 2021-Prospectively registered, https://www. CLINICALTRIALS gov/study/NCT05050526.
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Affiliation(s)
- Ander Espin
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain.
- Biobizkaia Health Research Institute, Barakaldo, Spain.
| | - Jon Irazusta
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
| | - Maialen Aiestaran
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Unai Latorre Erezuma
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
| | - Julia García-García
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
| | | | | | - Ana Rodriguez-Larrad
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
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Reguant-Closa A, Pedolin D, Herrmann M, Nemecek T. Review of Diet Quality Indices that can be Applied to the Environmental Assessment of Foods and Diets. Curr Nutr Rep 2024:10.1007/s13668-024-00540-0. [PMID: 38625631 DOI: 10.1007/s13668-024-00540-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE OF REVIEW The aim was to identify indices of diet quality and health that could be applied to the environmental assessment of foods in order to provide metrics that collectively assess nutritional, health and environmental dimensions. RECENT FINDINGS The review identified five major groups of indices: nutrient-food quantity-based; guideline-based; diversity-based; nutrient quality-based; health-based. Nutrient-food quantity-based and guideline type indices were the most frequently used to evaluate diet quality. Scaled assessment using a nutritional functional unit is the most common integration of diet quality with the environmental analysis of foods. There are fewer indices that measure the heath impacts of foods, but epidemiological dietary risk factors seem a promising approach to integrate diet and health impacts into the environmental assessment of foods. Five groups of nutritional and health indices were identified that can be applied when performing an environmental assessment of foods. This review proposes different methodological insights when doing such assessments to ensure transparency and comparability of the results.
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Affiliation(s)
- Alba Reguant-Closa
- Life Cycle Assessment Research Group, 191, CH-8046, Reckenholzstrasse, Zurich, Switzerland.
| | - Dario Pedolin
- Life Cycle Assessment Research Group, 191, CH-8046, Reckenholzstrasse, Zurich, Switzerland
| | - Moritz Herrmann
- Life Cycle Assessment Research Group, 191, CH-8046, Reckenholzstrasse, Zurich, Switzerland
| | - Thomas Nemecek
- Life Cycle Assessment Research Group, 191, CH-8046, Reckenholzstrasse, Zurich, Switzerland
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Chang WL, Chen YF, Lee YH, Shiu MN, Chang PY, Guo CY, Huang CJ, Chiang CE, Chen CH, Chuang SY, Cheng HM. Cardiovascular Risk in Patients With Treated Isolated Diastolic Hypertension and Isolated Low Diastolic Blood Pressure. J Am Heart Assoc 2024; 13:e032771. [PMID: 38606761 DOI: 10.1161/jaha.123.032771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 03/08/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND The prognosis of high or markedly low diastolic blood pressure (DBP) with normalized on-treatment systolic blood pressure on major adverse cardiovascular events (MACEs) is uncertain. This study examined whether treated isolated diastolic hypertension (IDH) and treated isolated low DBP (ILDBP) were associated with MACEs in patients with hypertension. METHODS AND RESULTS A total of 7582 patients with on-treatment systolic blood pressure <130 mm Hg from SPRINT (Systolic Blood Pressure Intervention Trial) were categorized on the basis of average DBP: <60 mm Hg (n=1031; treated ILDBP), 60 to 79 mm Hg (n=5432), ≥80 mm Hg (n=1119; treated IDH). MACE risk was estimated using Cox proportional-hazards models. Among the SPRINT participants, median age was 67.0 years and 64.9% were men. Over a median follow-up of 3.4 years, 512 patients developed a MACE. The incidence of MACEs was 3.9 cases per 100 person-years for treated ILDBP, 1.9 cases for DBP 60 to 79 mm Hg, and 1.8 cases for treated IDH. Comparing with DBP 60 to 79 mm Hg, treated ILDBP was associated with an 1.32-fold MACE risk (hazard ratio [HR], 1.32, 95% CI, 1.05-1.66), whereas treated IDH was not (HR, 1.18 [95% CI, 0.87-1.59]). There was no effect modification by age, sex, atherosclerotic cardiovascular disease risk, or cardiovascular disease history (all P values for interaction >0.05). CONCLUSIONS In this secondary analysis of SPRINT, among treated patients with normalized systolic blood pressure, excessively low DBP was associated with an increased MACE risk, while treated IDH was not. Further research is required for treated ILDBP management.
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Affiliation(s)
- Wei-Lun Chang
- Division of Faculty Development Taipei Veterans General Hospital Taipei Taiwan
| | - Ying-Fan Chen
- Department of Internal Medicine Taipei Veterans General Hospital Taipei Taiwan
| | - Yu-Hsuan Lee
- Division of Faculty Development Taipei Veterans General Hospital Taipei Taiwan
| | - Ming-Neng Shiu
- Department of Pharmacy, College of Pharmaceutical Sciences National Yang Ming Chiao Tung University Taipei Taiwan
| | - Po-Yin Chang
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration Silver Spring MD USA
| | - Chao-Yu Guo
- Division of Biostatistics and Data science Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University Taipei Taiwan
| | - Chi-Jung Huang
- Center for Evidence-based Medicine Taipei Veterans General Hospital Taipei Taiwan
| | - Chern-En Chiang
- School of Medicine, College of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
- Division of Cardiology, Department of Medicine Taipei Veterans General Hospital Taipei Taiwan
| | - Chen-Huan Chen
- School of Medicine, College of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
- Division of Cardiology, Department of Medicine Taipei Veterans General Hospital Taipei Taiwan
- ReShining Clinic Taipei Taiwan
| | - Shao-Yuan Chuang
- Institute of Population Health Science, National Health Research Institutes Miaoli County Taiwan
| | - Hao-Min Cheng
- Division of Faculty Development Taipei Veterans General Hospital Taipei Taiwan
- Center for Evidence-based Medicine Taipei Veterans General Hospital Taipei Taiwan
- Ph.D. Program of Interdisciplinary Medicine (PIM) National Yang Ming Chiao Tung University College of Medicine Taipei Taiwan
- Institute of Public Health National Yang Ming Chiao Tung University College of Medicine Taipei Taiwan
- Institute of Health and Welfare Policy National Yang Ming Chiao Tung University College of Medicine Taipei Taiwan
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