29501
|
Bakbak E, Terenzi DC, Trac JZ, Teoh H, Quan A, Glazer SA, Rotstein OD, Al-Omran M, Verma S, Hess DA. Lessons from bariatric surgery: Can increased GLP-1 enhance vascular repair during cardiometabolic-based chronic disease? Rev Endocr Metab Disord 2021; 22:1171-1188. [PMID: 34228302 DOI: 10.1007/s11154-021-09669-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2021] [Indexed: 02/06/2023]
Abstract
Type 2 diabetes (T2D) and obesity represent entangled pandemics that accelerate the development of cardiovascular disease (CVD). Given the immense burden of CVD in society, non-invasive prevention and treatment strategies to promote cardiovascular health are desperately needed. During T2D and obesity, chronic dysglycemia and abnormal adiposity result in systemic oxidative stress and inflammation that deplete the vascular regenerative cell reservoir in the bone marrow that impairs blood vessel repair and exacerbates the penetrance of CVD co-morbidities. This novel translational paradigm, termed 'regenerative cell exhaustion' (RCE), can be detected as the depletion and dysfunction of hematopoietic and endothelial progenitor cell lineages in the peripheral blood of individuals with established T2D and/or obesity. The reversal of vascular RCE has been observed after administration of the sodium-glucose cotransporter-2 inhibitor (SGLT2i), empagliflozin, or after bariatric surgery for severe obesity. In this review, we explore emerging evidence that links improved dysglycemia to a reduction in systemic oxidative stress and recovery of circulating pro-vascular progenitor cell content required for blood vessel repair. Given that bariatric surgery consistently increases systemic glucagon-like-peptide 1 (GLP-1) release, we also focus on evidence that the use of GLP-1 receptor agonists (GLP-1RA) during obesity may act to inhibit the progression of systemic dysglycemia and adiposity, and indirectly reduce inflammation and oxidative stress, thereby limiting the impact of RCE. Therefore, therapeutic intervention with currently-available GLP-1RA may provide a less-invasive modality to reverse RCE, bolster vascular repair mechanisms, and improve cardiometabolic risk in individuals living with T2D and obesity.
Collapse
Affiliation(s)
- Ehab Bakbak
- Division of Cardiac Surgery, St. Michael's Hospital, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Daniella C Terenzi
- Division of Cardiac Surgery, St. Michael's Hospital, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Justin Z Trac
- Division of Cardiac Surgery, St. Michael's Hospital, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Hwee Teoh
- Division of Cardiac Surgery, St. Michael's Hospital, Toronto, ON, Canada
- Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Adrian Quan
- Division of Cardiac Surgery, St. Michael's Hospital, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Stephen A Glazer
- Department of Internal Medicine, Humber River Hospital, Toronto, ON, Canada
- Division of Endocrinology and Metabolism, Queen's University, Kingston, ON, Canada
| | - Ori D Rotstein
- Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Mohammed Al-Omran
- Division of Vascular Surgery, St. Michael's Hospital, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Subodh Verma
- Division of Cardiac Surgery, St. Michael's Hospital, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - David A Hess
- Division of Cardiac Surgery, St. Michael's Hospital, Toronto, ON, Canada.
- Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.
- Molecular Medicine Research Laboratories, Robarts Research Institute, London, ON, Canada.
- Department of Physiology and Pharmacology, Western University, London, ON, Canada.
| |
Collapse
|
29502
|
Guilding C, Li Zhi PK, Mohana Krishnan S, Hubbard PS, McKeegan KS. Insights into Delivering Cross-Cultural Medical Education in the UK and Malaysia. Med Sci Educ 2021; 31:2177-2188. [PMID: 34950534 PMCID: PMC8651923 DOI: 10.1007/s40670-021-01382-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 06/14/2023]
Abstract
Newcastle University UK operates an international campus, NUMed, in Malaysia. NUMed delivers the same medical degree programme as in the UK, within a different cultural context. In this paper, medical education faculty and NUMed graduates with experience working in both the UK and Malaysia provide insights into cross-cultural diversity in approaches to learning. Observations from small and large group teaching and approaches to assessment are discussed in relation to students' cultural backgrounds including previous learning experiences and English language abilities. We provide practice points for educators preparing a diverse range of students to work in global healthcare settings.
Collapse
Affiliation(s)
- Clare Guilding
- School of Medical Education, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH UK
| | - Paul Khoo Li Zhi
- University Hospital of North Durham, County Durham and Darlington NHS Trust, Durham, UK
| | | | - Paul Stephen Hubbard
- School of Medical Education, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH UK
- Newcastle University Medicine Malaysia, Gelang Patah, Johor, Malaysia
| | - Kenneth Scott McKeegan
- School of Medical Education, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH UK
| |
Collapse
|
29503
|
Browne AJ, Chipeta MG, Haines-Woodhouse G, Kumaran EPA, Hamadani BHK, Zaraa S, Henry NJ, Deshpande A, Reiner RC, Day NPJ, Lopez AD, Dunachie S, Moore CE, Stergachis A, Hay SI, Dolecek C. Global antibiotic consumption and usage in humans, 2000-18: a spatial modelling study. Lancet Planet Health 2021; 5:e893-e904. [PMID: 34774223 PMCID: PMC8654683 DOI: 10.1016/s2542-5196(21)00280-1] [Citation(s) in RCA: 211] [Impact Index Per Article: 70.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 05/19/2023]
Abstract
BACKGROUND Antimicrobial resistance (AMR) is a serious threat to global public health. WHO emphasises the need for countries to monitor antibiotic consumption to combat AMR. Many low-income and middle-income countries (LMICs) lack surveillance capacity; we aimed to use multiple data sources and statistical models to estimate global antibiotic consumption. METHODS In this spatial modelling study, we used individual-level data from household surveys to inform a Bayesian geostatistical model of antibiotic usage in children (aged <5 years) with lower respiratory tract infections in LMICs. Antibiotic consumption data were obtained from multiple sources, including IQVIA, WHO, and the European Surveillance of Antimicrobial Consumption Network (ESAC-Net). The estimates of the antibiotic usage model were used alongside sociodemographic and health covariates to inform a model of total antibiotic consumption in LMICs. This was combined with a single model of antibiotic consumption in high-income countries to produce estimates of antibiotic consumption covering 204 countries and 19 years. FINDINGS We analysed 209 surveys done between 2000 and 2018, covering 284 045 children with lower respiratory tract infections. We identified large national and subnational variations of antibiotic usage in LMICs, with the lowest levels estimated in sub-Saharan Africa and the highest in eastern Europe and central Asia. We estimated a global antibiotic consumption rate of 14·3 (95% uncertainty interval 13·2-15·6) defined daily doses (DDD) per 1000 population per day in 2018 (40·2 [37·2-43·7] billion DDD), an increase of 46% from 9·8 (9·2-10·5) DDD per 1000 per day in 2000. We identified large spatial disparities, with antibiotic consumption rates varying from 5·0 (4·8-5·3) DDD per 1000 per day in the Philippines to 45·9 DDD per 1000 per day in Greece in 2018. Additionally, we present trends in consumption of different classes of antibiotics for selected Global Burden of Disease study regions using the IQVIA, WHO, and ESAC-net input data. We identified large increases in the consumption of fluoroquinolones and third-generation cephalosporins in North Africa and Middle East, and south Asia. INTERPRETATION To our knowledge, this is the first study that incorporates antibiotic usage and consumption data and uses geostatistical modelling techniques to estimate antibiotic consumption for 204 countries from 2000 to 2018. Our analysis identifies both high rates of antibiotic consumption and a lack of access to antibiotics, providing a benchmark for future interventions. FUNDING Fleming Fund, UK Department of Health and Social Care; Wellcome Trust; and Bill & Melinda Gates Foundation.
Collapse
Affiliation(s)
- Annie J Browne
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Michael G Chipeta
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Georgina Haines-Woodhouse
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Emmanuelle P A Kumaran
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Bahar H Kashef Hamadani
- Oxford Centre for Global Health Research, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Sabra Zaraa
- School of Pharmacy and School of Public Health, University of Washington, Seattle, WA, USA
| | - Nathaniel J Henry
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Aniruddha Deshpande
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Nicholas P J Day
- Oxford Centre for Global Health Research, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Alan D Lopez
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Susanna Dunachie
- Oxford Centre for Global Health Research, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Catrin E Moore
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Andy Stergachis
- School of Pharmacy and School of Public Health, University of Washington, Seattle, WA, USA; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Christiane Dolecek
- Oxford Centre for Global Health Research, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| |
Collapse
|
29504
|
Kozik A, Pavlova M, Petrov I, Bychkov V, Kim L, Dorozhko E, Cheng C, Rodriguez RD, Sheremet E. A review of surface-enhanced Raman spectroscopy in pathological processes. Anal Chim Acta 2021; 1187:338978. [PMID: 34753586 DOI: 10.1016/j.aca.2021.338978] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 12/17/2022]
Abstract
With the continuous growth of the human population and new challenges in the quality of life, it is more important than ever to diagnose diseases and pathologies with high accuracy, sensitivity and in different scenarios from medical implants to the operation room. Although conventional methods of diagnosis revolutionized healthcare, alternative analytical methods are making their way out of academic labs into clinics. In this regard, surface-enhanced Raman spectroscopy (SERS) developed immensely with its capability to achieve single-molecule sensitivity and high-specificity in the last two decades, and now it is well on its way to join the arsenal of physicians. This review discusses how SERS is becoming an essential tool for the clinical investigation of pathologies including inflammation, infections, necrosis/apoptosis, hypoxia, and tumors. We critically discuss the strategies reported so far in nanoparticle assembly, functionalization, non-metallic substrates, colloidal solutions and how these techniques improve SERS characteristics during pathology diagnoses like sensitivity, selectivity, and detection limit. Moreover, it is crucial to introduce the most recent developments and future perspectives of SERS as a biomedical analytical method. We finally discuss the challenges that remain as bottlenecks for a routine SERS implementation in the medical room from in vitro to in vivo applications. The review showcases the adaptability and versatility of SERS to resolve pathological processes by covering various experimental and analytical methods and the specific spectral features and analysis results achieved by these methods.
Collapse
Affiliation(s)
- Alexey Kozik
- Tomsk Polytechnic University, Lenin Ave, 30, Tomsk, 634050, Russia; Siberian Medical State University, Moskovskiy Trakt, 2, Tomsk, 634050, Russia
| | - Marina Pavlova
- Tomsk Polytechnic University, Lenin Ave, 30, Tomsk, 634050, Russia; Siberian Medical State University, Moskovskiy Trakt, 2, Tomsk, 634050, Russia
| | - Ilia Petrov
- Tomsk Polytechnic University, Lenin Ave, 30, Tomsk, 634050, Russia
| | - Vyacheslav Bychkov
- Tomsk National Research Medical Center of the Russian Academy of Sciences, Cancer Research Institute, 5 Kooperativny Street, Tomsk, 634009, Russia
| | - Larissa Kim
- Tomsk Polytechnic University, Lenin Ave, 30, Tomsk, 634050, Russia
| | - Elena Dorozhko
- Tomsk Polytechnic University, Lenin Ave, 30, Tomsk, 634050, Russia
| | - Chong Cheng
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065, China
| | - Raul D Rodriguez
- Tomsk Polytechnic University, Lenin Ave, 30, Tomsk, 634050, Russia.
| | | |
Collapse
|
29505
|
Lama J, Buhidma Y, Fletcher E, Duty S. Animal models of Parkinson's disease: a guide to selecting the optimal model for your research. Neuronal Signal 2021; 5:NS20210026. [PMID: 34956652 PMCID: PMC8661507 DOI: 10.1042/ns20210026] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 10/10/2021] [Revised: 11/07/2021] [Accepted: 11/09/2021] [Indexed: 12/18/2022] Open
Abstract
Parkinson's disease (PD) is a complex, multisystem disorder characterised by α-synuclein (SNCA) pathology, degeneration of nigrostriatal dopaminergic neurons, multifactorial pathogenetic mechanisms and expression of a plethora of motor and non-motor symptoms. Animal models of PD have already been instructive in helping us unravel some of these aspects. However, much remains to be discovered, requiring continued interrogation by the research community. In contrast with the situation for many neurological disorders, PD benefits from of a wide range of available animal models (pharmacological, toxin, genetic and α-synuclein) but this makes selection of the optimal one for a given study difficult. This is especially so when a study demands a model that displays a specific combination of features. While many excellent reviews of animal models already exist, this review takes a different approach with the intention of more readily informing this decision-making process. We have considered each feature of PD in turn - aetiology, pathology, pathogenesis, motor dysfunctions and non-motor symptoms (NMS) - highlighting those animal models that replicate each. By compiling easily accessible tables and a summary figure, we aim to provide the reader with a simple, go-to resource for selecting the optimal animal model of PD to suit their research needs.
Collapse
Affiliation(s)
- Joana Lama
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Wolfson Centre for Age Related Diseases, Wolfson Wing, Hodgkin Building, Guy’s Campus, London SE1 1UL, U.K
| | - Yazead Buhidma
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Wolfson Centre for Age Related Diseases, Wolfson Wing, Hodgkin Building, Guy’s Campus, London SE1 1UL, U.K
| | - Edward J.R. Fletcher
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Wolfson Centre for Age Related Diseases, Wolfson Wing, Hodgkin Building, Guy’s Campus, London SE1 1UL, U.K
| | - Susan Duty
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Wolfson Centre for Age Related Diseases, Wolfson Wing, Hodgkin Building, Guy’s Campus, London SE1 1UL, U.K
| |
Collapse
|
29506
|
Kilian C, Rovira P, Neufeld M, Ferreira-Borges C, Rumgay H, Soerjomataram I, Rehm J. Modelling the impact of increased alcohol taxation on alcohol-attributable cancers in the WHO European Region. Lancet Reg Health Eur 2021; 11:100225. [PMID: 34918000 PMCID: PMC8642705 DOI: 10.1016/j.lanepe.2021.100225] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Reducing the alcohol-attributable cancer burden in the WHO European Region is a public health priority. This study aims to estimate the number of potentially avoidable cancers in countries of the WHO European Region in 2019 for three scenarios in which current excise duties on alcoholic beverages were increased by 20%, 50%, or 100%. METHODS Mean prices and excise duties for beer, wine, and spirits in the Member States of the WHO European Region in 2020 were used as the baseline scenario. We assumed that increases in excise duties (20%, 50%, and 100%) were fully incorporated into the consumer price. Beverage-specific price elasticities of demand, with lower elasticities for heavy drinkers, were obtained from a meta-analysis. Model estimates were applied to alcohol exposure data for 2009 and cancer incidence and mortality rates for 2019, assuming a 10-year lag time between alcohol intake and cancer development and mortality. FINDINGS Of 180,887 (95% Confidence interval [CI]: 160,595-201,705) new alcohol-attributable cancer cases and 85,130 (95% CI: 74,920-95,523) deaths in the WHO European Region in 2019, 5·9% (95% CI: 5·6-6·4) and 5·7% (95% CI: 5·4-6·1), respectively, could have been avoided by increasing excise duties by 100%. According to our model, alcohol-attributable female breast cancer and colorectal cancer contributed most to the avoidable cases and deaths. INTERPRETATION Doubling current alcohol excise duties could avoid just under 6% (or 10,700 cases and 4,850 deaths) of new alcohol-attributable cancers within the WHO European Region, particularly in Member States of the European Union where excise duties are in many cases very low. FUNDING None.
Collapse
Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Pol Rovira
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
| | - Maria Neufeld
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Carina Ferreira-Borges
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Harriet Rumgay
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
- Centre for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Department of Psychiatry, Hamburg, Germany
| |
Collapse
|
29507
|
Ma Q, Li R, Wang L, Yin P, Wang Y, Yan C, Ren Y, Qian Z, Vaughn MG, McMillin SE, Hay SI, Naghavi M, Cai M, Wang C, Zhang Z, Zhou M, Lin H, Yang Y. Temporal trend and attributable risk factors of stroke burden in China, 1990–2019: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health 2021; 6:e897-e906. [PMID: 34838196 PMCID: PMC9047702 DOI: 10.1016/s2468-2667(21)00228-0] [Citation(s) in RCA: 224] [Impact Index Per Article: 74.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/11/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022]
Abstract
Background Understanding the temporal trend of the disease burden of stroke and its attributable risk factors in China, especially at provincial levels, is important for effective prevention strategies and improvement. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) is to investigate the disease burden of stroke and its risk factors at national and provincial levels in China from 1990 to 2019. Methods Following the methodology in the GBD 2019, the incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of stroke cases in the Chinese population were estimated by sex, age, year, stroke subtypes (ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage), and across 33 provincial administrative units in China from 1990 to 2019. Attributable mortality and DALYs of underlying risk factors were calculated by a comparative risk assessment. Findings In 2019, there were 3·94 million (95% uncertainty interval 3·43–4·58) new stroke cases in China. The incidence rate of stroke increased by 86·0% (73·2–99·0) from 1990, reaching 276·7 (241·3–322·0) per 100 000 population in 2019. The age-standardised incidence rate declined by 9·3% (3·3–15·5) from 1990 to 2019. Among 28·76 million (25·60–32·21) prevalent cases of stroke in 2019, 24·18 million (20·80–27·87) were ischaemic stroke, 4·36 million (3·69–5·05) were intracerebral haemorrhage, and 1·58 million (1·32–1·91) were subarachnoid haemorrhage. The prevalence rate increased by 106·0% (93·7–118·8) and age-standardised prevalence rate increased by 13·2% (7·7–19·1) from 1990 to 2019. In 2019, there were 2·19 million (1·89–2·51) deaths and 45·9 million (39·8–52·3) DALYs due to stroke. The mortality rate increased by 32·3% (8·6–59·0) from 1990 to 2019. Over the same period, the age-standardised mortality rate decreased by 39·8% (28·6–50·7) and the DALY rate decreased by 41·6% (30·7–50·9). High systolic blood pressure, ambient particulate matter pollution exposure, smoking, and diet high in sodium were four major risk factors for stroke burden in 2019. Moreover, we found marked differences of stroke burden and attributable risk factors across provinces in China from 1990 to 2019. Interpretation The disease burden of stroke is still severe in China, although the age-standardised incidence and mortality rates have decreased since 1990. The stroke burden in China might be reduced through blood pressure management, lifestyle interventions, and air pollution control. Moreover, because substantial heterogeneity of stroke burden existed in different provinces, improved health care is needed in provinces with heavy stroke burden. Funding National Key Research and Development Program of China and Taikang Yicai Public Health and Epidemic Control Fund.
Collapse
|
29508
|
Boesch SM, Indelicato E. Body Mass Index and Height in Friedreich Ataxia: What Do We Know? Neurol Genet 2021; 7:e637. [PMID: 34786479 PMCID: PMC8589261 DOI: 10.1212/nxg.0000000000000637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/28/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Sylvia M. Boesch
- From the Department of Neurology, Center for Rare Movement Disorders Innsbruck, Medical University Innsbruck, Austria
| | - Elisabetta Indelicato
- From the Department of Neurology, Center for Rare Movement Disorders Innsbruck, Medical University Innsbruck, Austria
| |
Collapse
|
29509
|
Hawkins EJ, Malte CA, Gordon AJ, Williams EC, Hagedorn HJ, Drexler K, Blanchard BE, Burden JL, Knoeppel J, Danner AN, Lott A, Liberto JG, Saxon AJ. Accessibility to Medication for Opioid Use Disorder After Interventions to Improve Prescribing Among Nonaddiction Clinics in the US Veterans Health Care System. JAMA Netw Open 2021; 4:e2137238. [PMID: 34870679 PMCID: PMC8649831 DOI: 10.1001/jamanetworkopen.2021.37238] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
IMPORTANCE With increasing rates of opioid use disorder (OUD) and overdose deaths in the US, increased access to medications for OUD (MOUD) is paramount. Rigorous effectiveness evaluations of large-scale implementation initiatives using quasi-experimental designs are needed to inform expansion efforts. OBJECTIVE To evaluate a US Department of Veterans Affairs (VA) initiative to increase MOUD use in nonaddiction clinics. DESIGN, SETTING, AND PARTICIPANTS This quality improvement initiative used interrupted time series design to compare trends in MOUD receipt. Primary care, pain, and mental health clinics in the VA health care system (n = 35) located at 18 intervention facilities and nonintervention comparison clinics (n = 35) were matched on preimplementation MOUD prescribing trends, clinic size, and facility complexity. The cohort of patients with OUD who received care in intervention or comparison clinics in the year after September 1, 2018, were evaluated. The preimplementation period extended from September 1, 2017, through August 31, 2018, and the postimplementation period from September 1, 2018, through August 31, 2019. EXPOSURES The multifaceted implementation intervention included education, external facilitation, and quarterly reports. MAIN OUTCOMES AND MEASURES The main outcomes were the proportion of patients receiving MOUD and the number of patients per clinician prescribing MOUD. Segmented logistic regression evaluated monthly proportions of MOUD receipt 1 year before and after initiative launch, adjusting for demographic and clinical covariates. Poisson regression models examined yearly changes in clinician prescribing over the same time frame. RESULTS Overall, 7488 patients were seen in intervention clinics (mean [SD] age, 53.3 [14.2] years; 6858 [91.6%] male; 1476 [19.7%] Black, 417 [5.6%] Hispanic; 5162 [68.9%] White; 239 [3.2%] other race [including American Indian or Alaska Native, Asian, Native Hawaiian or other Pacific Islander, and multiple races]; and 194 [2.6%] unknown) and 7558 in comparison clinics (mean [SD] age, 53.4 [14.0] years; 6943 [91.9%] male; 1463 [19.4%] Black; 405 [5.4%] Hispanic; 5196 [68.9%] White; 244 [3.2%] other race; 250 [3.3%] unknown). During the preimplementation year, the proportion of patients receiving MOUD in intervention clinics increased monthly by 5.0% (adjusted odds ratio [AOR], 1.05; 95% CI, 1.03-1.07). Accounting for this preimplementation trend, the proportion of patients receiving MOUD increased monthly by an additional 2.3% (AOR, 1.02; 95% CI, 1.00-1.04) during the implementation year. Comparison clinics increased by 2.6% monthly before implementation (AOR, 1.03; 95% CI, 1.01-1.04), with no changes detected after implementation. Although preimplementation-year trends in monthly MOUD receipt were similar in intervention and comparison clinics, greater increases were seen in intervention clinics after implementation (AOR, 1.04; 95% CI, 1.01-1.08). Patients treated with MOUD per clinician in intervention clinics saw greater increases from before to after implementation compared with comparison clinics (incidence rate ratio, 1.50; 95% CI, 1.28-1.77). CONCLUSIONS AND RELEVANCE A multifaceted implementation initiative in nonaddiction clinics was associated with increased MOUD prescribing. Findings suggest that engagement of clinicians in general clinical settings may increase MOUD access.
Collapse
Affiliation(s)
- Eric J. Hawkins
- Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington
- Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, Seattle, Washington
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
| | - Carol A. Malte
- Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington
- Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, Seattle, Washington
| | - Adam J. Gordon
- Informatics, Decision-Enhancement, and Analytic Sciences Center, Health Services Research & Development, VA Salt Lake City Health Care System, Salt Lake City, Utah
- Program for Addiction Research, Clinical Care, Knowledge, and Advocacy, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City
| | - Emily C. Williams
- Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington
- Department of Health Systems and Population Health, University of Washington, Seattle
| | - Hildi J. Hagedorn
- Center for Care Delivery & Outcomes Research, Health Services Research & Development, Minneapolis VA Health Care System, Minneapolis, Minnesota
- Department of Psychiatry, University of Minnesota, Minneapolis
| | - Karen Drexler
- Office of Mental Health and Suicide Prevention, Veterans Health Administration, Washington, DC
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, Georgia
| | - Brittany E. Blanchard
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
| | - Jennifer L. Burden
- Office of Mental Health and Suicide Prevention, Veterans Health Administration, Washington, DC
| | - Jennifer Knoeppel
- Office of Mental Health and Suicide Prevention, Veterans Health Administration, Washington, DC
| | - Anissa N. Danner
- Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington
- Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, Seattle, Washington
| | - Aline Lott
- Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington
- Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, Seattle, Washington
| | - Joseph G. Liberto
- Office of Mental Health and Suicide Prevention, Veterans Health Administration, Washington, DC
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Andrew J. Saxon
- Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington
- Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, Seattle, Washington
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
| |
Collapse
|
29510
|
Renaud-Charest O, Lui LMW, Eskander S, Ceban F, Ho R, Di Vincenzo JD, Rosenblat JD, Lee Y, Subramaniapillai M, McIntyre RS. Onset and frequency of depression in post-COVID-19 syndrome: A systematic review. J Psychiatr Res 2021; 144:129-37. [PMID: 34619491 DOI: 10.1016/j.jpsychires.2021.09.054] [Citation(s) in RCA: 170] [Impact Index Per Article: 56.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/18/2021] [Accepted: 09/29/2021] [Indexed: 01/04/2023]
Abstract
Following recovery from COVID-19, an increasing proportion of individuals have reported the persistence and/or new onset of symptoms which collectively have been identified as post-COVID-19 syndrome by the National Institute for Health and Care Excellence. Although depressive symptoms in the acute phase of COVID-19 have been well characterized, the frequency of depression following recovery of the acute phase remains unknown. Herein, we sought to determine the frequency of depressive symptoms and clinically-significant depression more than 12 weeks following SARS-CoV-2 infection. A systematic search of PubMed, Ovid Medline and Google Scholar for studies published between January 1, 2020 and June 5, 2021 was conducted. Frequency and factors associated with depression in post-COVID-19 syndrome were recorded and qualitatively assessed through narrative synthesis. Methodological quality and risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale (NOS) for prospective cohort studies. Of 316 articles identified through our systematic search, eight studies were included. The frequency of depressive symptoms +12 weeks following SARS-CoV-2 infection ranged from 11 to 28%. The frequency of clinically-significant depression and/or severe depressive symptoms ranged from 3 to 12%. The severity of acute COVID-19 was not associated with the frequency of depressive symptoms. However, the component studies were highly heterogeneous with respect to mode of ascertainment, time of assessment, and location and age of patients. The majority of studies did not include an unexposed control group. Future research should endeavour to produce a standardized classification of post-COVID-19 syndrome, and as well as include unexposed control groups.
Collapse
|
29511
|
Lovatt S, Wong CW, Holroyd E, Butler R, Phan T, Patwala A, Loke YK, Mallen CD, Kwok CS. Smoking cessation after acute coronary syndrome: A systematic review and meta-analysis. Int J Clin Pract 2021; 75:e14894. [PMID: 34541754 DOI: 10.1111/ijcp.14894] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/02/2021] [Accepted: 09/17/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Smoking cessation is an effective secondary prevention measure after acute coronary syndrome (ACS). We conducted a systematic review with the aim to better understand which patients have a greater propensity to quit smoking and the risk factors for continued smoking after ACS. METHODS We searched MEDLINE and EMBASE for studies that evaluated smoking cessation after ACS. The pooled rate of smoking cessation across included studies was performed. Random effects meta-analysis for different variables and their association with smoking cessation was conducted. RESULTS A total of 39 studies with 11 228 patients were included in this review. The pooled rate of smoking cessation following ACS across 38 studies was 45.0%. Factors associated with greater likelihood of smoking cessation were attendance at cardiac rehabilitation (OR 1.90 95% CI 1.44-2.51), married/not alone (OR 1.68 95% CI 1.32-2.13), intention/attempt to quit smoking (OR 1.27 95% CI 1.11-1.46), diabetes mellitus (OR 1.24 95% CI 1.03-1.51) and hospitalised duration (OR 1.09 95% CI 1.02-1.15). Variables associated with a lower likelihood of smoking cessation were depression (OR 0.57 95% CI 0.43-0.75), chronic obstructive pulmonary disease/lung disease (OR 0.73 95% CI 0.57-0.93), previous admission with acute myocardial infarction/cardiac admission (OR 0.61 95% CI 0.47-0.80), cerebrovascular disease/transient ischaemic attack (OR 0.42 95% CI 0.30-0.58) and unemployment (OR 0.37 95% CI 0.17-0.80). CONCLUSIONS The majority of smokers with an ACS continue to smoke after admission. Patients attending cardiac rehabilitation show increased odds of quitting while people who are depressed and those with chronic lung disease were less likely to quit smoking and should be targeted for intensive smoking cessation interventions.
Collapse
Affiliation(s)
- Saul Lovatt
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Chun Wai Wong
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Eric Holroyd
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Rob Butler
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Thanh Phan
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Ashish Patwala
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Yoon K Loke
- Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Chun Shing Kwok
- Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
- School of Medicine, Keele University, Stoke-on-Trent, UK
| |
Collapse
|
29512
|
Li J, Wang P, Zhou Y, Liang H, Lu Y, Luan K. A novel classification method of lymph node metastasis in colorectal cancer. Bioengineered 2021; 12:2007-2021. [PMID: 34024255 PMCID: PMC8806456 DOI: 10.1080/21655979.2021.1930333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/07/2021] [Accepted: 05/08/2021] [Indexed: 11/21/2022] Open
Abstract
Colorectal cancer lymph node metastasis, which is highly associated with the patient's cancer recurrence and survival rate, has been the focus of many therapeutic strategies that are highly associated with the patient's cancer recurrence and survival rate. The popular methods for classification of lymph node metastasis by neural networks, however, show limitations as the available low-level features are inadequate for classification, and the radiologists are unable to quickly review the images. Identifying lymph node metastasis in colorectal cancer is a key factor in the treatment of patients with colorectal cancer. In the present work, an automatic classification method based on deep transfer learning was proposed. Specifically, the method resolved the problem of repetition of low-level features and combined these features with high-level features into a new feature map for classification; and a merged layer which merges all transmitted features from previous layers into a map of the first full connection layer. With a dataset collected from Harbin Medical University Cancer Hospital, the experiment involved a sample of 3,364 patients. Among these samples, 1,646 were positive, and 1,718 were negative. The experiment results showed the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 0.8732, 0.8746, 0.8746 and 0.8728, respectively, and the accuracy and AUC were 0.8358 and 0.8569, respectively. These demonstrated that our method significantly outperformed the previous classification methods for colorectal cancer lymph node metastasis without increasing the depth and width of the model.
Collapse
Affiliation(s)
- Jin Li
- College of Intelligent Systems Science and Engineering, Harbin Engineering University, Harbin, Heilongjiang Province, China
| | - Peng Wang
- College of Intelligent Systems Science and Engineering, Harbin Engineering University, Harbin, Heilongjiang Province, China
| | - Yang Zhou
- College of Intelligent Systems Science and Engineering, Harbin Engineering University, Harbin, Heilongjiang Province, China
- Department of Radiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China
| | - Hong Liang
- College of Intelligent Systems Science and Engineering, Harbin Engineering University, Harbin, Heilongjiang Province, China
| | - Yang Lu
- College of Information and Electrical Engineering, Heilongjiang Bayi Agricultural University, Daqing, Heilongjiang Province, China
| | - Kuan Luan
- College of Intelligent Systems Science and Engineering, Harbin Engineering University, Harbin, Heilongjiang Province, China
| |
Collapse
|
29513
|
Debenham J, Grummitt L, Newton NC, Teesson M, Slade T, Conrod P, Kelly EV. Personality-targeted prevention for adolescent tobacco use: Three-year outcomes for a randomised trial in Australia. Prev Med 2021; 153:106794. [PMID: 34508734 DOI: 10.1016/j.ypmed.2021.106794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 08/29/2021] [Accepted: 09/05/2021] [Indexed: 11/21/2022]
Abstract
This is the first study to investigate the effectiveness of Preventure, a selective personality-targeted prevention program, in reducing the uptake of tobacco smoking over a three-year period in adolescence. A cluster randomised controlled trial was conducted to assess the effectiveness of Preventure. Schools were block randomised to either the Preventure group (n = 7 schools) or the Control group (n = 7 schools) and students were assessed at five time points (baseline, 6-, 12-, 24- and 36-months post-baseline) on measures of tobacco use, intentions to use and self-efficacy to resist peer pressure to smoke tobacco. Intervention effects were estimated using mixed models to account for the hierarchical data structure. Exploratory analyses assessed intervention effects among internalising and externalising personality traits. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12612000026820; www.anzctr.org.au). A total of 1005 adolescents (mean age: 13.4 years, SD = 0.47) attending 14 Australian schools in February 2012 were recruited to the study. Relative to students in Control schools, students in Preventure schools were less likely to report recent tobacco use (OR = 0.66 95% CI = 0.50, 0.87) and intentions to use tobacco in the future (OR = 0.77 95% CI = 0.60, 0.97) over the three-year follow-up. Students in Preventure schools with internalising personality traits had a greater increase in their likelihood to report high self-efficacy to resist peer pressure to smoke sustained three-years post program delivery (OR = 1.85 95% CI = 1.0, 3.4). Findings from this study support the use of selective personality-targeted preventive interventions in reducing tobacco smoking during adolescence.
Collapse
|
29514
|
Shi Y, Han Y, Wang Y, Qi L, Chen X, Chen W, Li W, Zhang H, Zhu T, Gong J. Serum branched-chain amino acids modifies the associations between air pollutants and insulin resistance. Ecotoxicol Environ Saf 2021; 225:112780. [PMID: 34537587 DOI: 10.1016/j.ecoenv.2021.112780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/02/2021] [Accepted: 09/11/2021] [Indexed: 06/13/2023]
Abstract
Growing evidence supports that air pollution exposure has become a risk factor of type II diabetes mellitus through the induction of insulin resistance (IR), but the presented findings did not provide a consistent relationship between air pollution exposure and IR in the temporal scale and the magnitude. Reported associated with IR and air pollution exposure, branched-chain amino acids (BCAAs) in blood might modify the association between air pollution exposure and IR. We took advantage of an existing panel study on elderly people who were healthy or with pre-diabetes. Amino acids were analyzed from the serum samples using a UPLC-QQQ-MS, and the homeostasis model assessment of insulin resistance (HOMA-IR) values were calculated to represent the levels of IR in each visit. Exposures to PM2.5, NO2, SO2, CO, O3, and black carbon (BC) were estimated using data from a monitoring station. Linear mixed-effects models were applied to estimate the associations between the air pollution and HOMA-IR, as well as the modifying effects of BCAAs. We found significantly higher concentrations of BCAAs in the pre-diabetic subjects than healthy ones. The concentrations of BCAAs were all significantly associated with HOMA-IR. For subjects with high-level BCAAs, HOMA-IR was positively associated with an IQR increase in PM2.5, NO2, BC, and CO at lag day 2 and in PM2.5, SO2, NO2, BC, and CO at lag day 7. While for subjects with low-level BCAAs, there was no significant association observed at any lag day except for CO at lag day 5. The study provided evidence that circulating BCAAs may modify the relationship between air pollution exposure and the level of insulin resistance in humans.
Collapse
Affiliation(s)
- Yunxiu Shi
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, International Joint Laboratory for Regional Pollution Control (IJRC), Ministry of Education, College of Environmental Sciences and Engineering, Beijing 100871, China
| | - Yiqun Han
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, International Joint Laboratory for Regional Pollution Control (IJRC), Ministry of Education, College of Environmental Sciences and Engineering, Beijing 100871, China; Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Yanwen Wang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, International Joint Laboratory for Regional Pollution Control (IJRC), Ministry of Education, College of Environmental Sciences and Engineering, Beijing 100871, China; National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liang Qi
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, International Joint Laboratory for Regional Pollution Control (IJRC), Ministry of Education, College of Environmental Sciences and Engineering, Beijing 100871, China; School of Food and Biological Engineering, Shaanxi University of Science & Technology, Xi'an 710021, China
| | - Xi Chen
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, International Joint Laboratory for Regional Pollution Control (IJRC), Ministry of Education, College of Environmental Sciences and Engineering, Beijing 100871, China; Hebei Xiongan Green-Research Inspection and Certification Co., Ltd., Shenzhen Institute of Building Research Co., Ltd., Shenzhen, China
| | - Wu Chen
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, International Joint Laboratory for Regional Pollution Control (IJRC), Ministry of Education, College of Environmental Sciences and Engineering, Beijing 100871, China
| | - Weiju Li
- Peking University Hospital, Peking University, Beijing 100871, China
| | - Hongyin Zhang
- Peking University Hospital, Peking University, Beijing 100871, China
| | - Tong Zhu
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, International Joint Laboratory for Regional Pollution Control (IJRC), Ministry of Education, College of Environmental Sciences and Engineering, Beijing 100871, China
| | - Jicheng Gong
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, International Joint Laboratory for Regional Pollution Control (IJRC), Ministry of Education, College of Environmental Sciences and Engineering, Beijing 100871, China.
| |
Collapse
|
29515
|
Nasri O, Pouragha H, Baigi V, Shalyari N, Yunesian M. Quality of life and sleep disorders in Tehran Employees Cohort (TEC); Association with secondhand smoking and wealth index. J Environ Health Sci Eng 2021; 19:1473-1481. [PMID: 34900281 PMCID: PMC8617127 DOI: 10.1007/s40201-021-00702-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 07/05/2021] [Indexed: 05/11/2023]
Abstract
PURPOSE Second-hand smoke is recognized as a major indoor pollutant. Evidences indicated that Second-hand smoke exposure can influence on not only physical health, but also mental well-being. As the correlation of secondhand smoke exposure with sleep quality and quality of life has not yet been clarified sufficiently, the purpose of this study was to evaluate the association between Second-hand smoke exposure, with sleep quality and quality of life after adjusting for active smoking and other relevant confounders. METHODS The participants of this study were 1790 staff in Tehran University of Medical Sciences with different jobs employed in various academic departments (clinical, research, services, educational and technical ones). They participated voluntarily in this research project and completed the informed consent form between 2018 and 2019. A translated questionnaire of Global Adult Tobacco Survey was used to gather information about smoke exposure. When to evaluate the quality of life, the WHOQOL-BREF tool was applied. All statistical analyses were executed using STATA V14 software. RESULTS High rate of smoking and also exposure to second-hand smoke significantly increased sleep disorder and reduced the quality of life. In other words, smokers or those who are exposed to second-hand smoke suffer from sleep disturbances and had a poorer physical, psychological, and environmental quality of life. Additionally, the results of multivariate regression analysis demonstrated that the secondhand-smoke group had 1.38 times higher rate of sleep disorder in comparison with non-smokers, that was statistically significant. The women had 2.68 times higher odds of having sleep disorder compared to men. (95 % CI: 2.20 to 3.27). On the other hand, mean score of psychological domain of quality of life in secondhand-smoke group was lower with the size of difference as 0.66 than that in non-smokers, and the difference was statistically significant (p = 0.001). CONCLUSIONS Both active smoking and exposure to second hand smoke have a negative impact on sleep quality and quality of life.
Collapse
Affiliation(s)
- Omid Nasri
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Vali Baigi
- Sina Trauma and Surgery Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Naseh Shalyari
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
29516
|
Åsberg K, Lundgren O, Henriksson H, Henriksson P, Bendtsen P, Löf M, Bendtsen M. Multiple lifestyle behaviour mHealth intervention targeting Swedish college and university students: protocol for the Buddy randomised factorial trial. BMJ Open 2021. [PMCID: PMC8719203 DOI: 10.1136/bmjopen-2021-051044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Introduction The time during which many attend college or university is an important period for developing health behaviours, with potentially major implications for future health. Therefore, it is concerning that many Swedish students excessively consume alcohol, have unhealthy diets, are not physical active and smoke. The potential of digital interventions which integrate support for change of all of these behaviours is largely unexplored, as are the dismantled effects of the individual components that make up digital lifestyle behaviour interventions. Methods and analysis A factorial randomised trial (six factors with two levels each) will be employed to estimate the effects of the components of a novel mHealth multiple lifestyle intervention on alcohol consumption, diet, physical activity and smoking among Swedish college and university students. A Bayesian group sequential design will be employed to periodically make decisions to continue or stop recruitment, with simulations suggesting that between 1500 and 2500 participants will be required. Multilevel regression models will be used to analyse behavioural outcomes collected at 2 and 4 months postrandomisation. Ethics and dissemination The study was approved by the Swedish Ethical Review Authority on 2020-12-15 (Dnr 2020-05496). The main concern is the opportunity cost if the intervention is found to only have small effects. However, considering the lack of a generally available evidence-based multiple lifestyle behaviour support to university and college students, this risk was deemed acceptable given the potential benefits from the study. Recruitment will begin in March 2021, and it is expected that recruitment will last no more than 24 months. A final data set will, therefore, be available in July 2023, and findings will be reported no later than December 2023. Trial registration number ISRCTN23310640; Pre-results.
Collapse
Affiliation(s)
- Katarina Åsberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Oskar Lundgren
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Hanna Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Preben Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Medical Specialist, Motala Hospital, Motala, Sweden
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
29517
|
Costa-Urrutia P, Colistro V, Franco-Trecu V, Granados J, Álvarez Fariña R, Rodríguez-Arellano ME. Dyslipidemia, Obesity, and Ethnicity in Mexican Children. Int J Environ Res Public Health 2021; 18:ijerph182312659. [PMID: 34886385 PMCID: PMC8656470 DOI: 10.3390/ijerph182312659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/23/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022]
Abstract
The aim of this study was to assess lipid disorders in children from five ethnic groups, both urban and indigenous, from northern and central Mexico. We measured the lipid profile to determine the ability of the body mass index (BMI) to discriminate an abnormally high lipid level using receiving operating characteristics (ROC). We analyzed the association and interaction of obesity and ethnicity with lipid disorders using generalized linear models in 977 children. The highest prevalence of lipid disorders (high TG, high TC, high LDL, high APOB, and dyslipidemia) was found in central Mexico-Mexico City and urban northern Mexico. The BMI performed better at predicting low HDL in Seris, a northern indigenous group (0.95, CI: 0.69–0.85), and Mexico City (0.75, CI: 0.69–0.82), and high LDL in Puebla (central Mexico, 0.80, CI: 0.69–0.85). Obesity significantly (p < 0.05) increases lipid disorders by around two times (OR~2) for almost all lipid markers. Obesity and ethnic interaction increase the lipid disorders by more than five times for different lipid markers and ethnic groups (high total cholesterol OR = 5.31; low HDL OR = 5.11, and dyslipidemia OR = 5.68). Lipid disorders are not restricted to children with high BMIs, but obesity exacerbates these. The emerging lipid disorder risk depends on the ethnic group.
Collapse
Affiliation(s)
- Paula Costa-Urrutia
- Laboratorio de Medicina Genómica del Hospital Regional Lic. Adolfo López Mateos, ISSSTE, Ciudad de México 01030, Mexico
- Correspondence: (P.C.-U.); (M.E.R.-A.)
| | - Valentina Colistro
- Departamento de Métodos Cuantitativos, Facultad de Medicina, Universidad de la República, Avda, General Flores 2125, Montevideo 11800, Uruguay;
| | - Valentina Franco-Trecu
- Departamento de Ecología y Evolución, Facultad de Ciencias, Universidad de la República, Iguá 4225, Montevideo 11400, Uruguay;
| | - Julio Granados
- Departamento de Trasplantes, División de Inmunogenética, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avda, Vasco de Quiroga, Ciudad de México 14080, Mexico;
| | - Rafael Álvarez Fariña
- Ciencias del Deporte, Universidad Anáhuac, Av. Universidad Anáhuac 46, Col. Lomas Anáhuac, Huixquilucan, Naucalpan de Juárez 52786, Mexico;
| | - Martha Eunice Rodríguez-Arellano
- Laboratorio de Medicina Genómica del Hospital Regional Lic. Adolfo López Mateos, ISSSTE, Ciudad de México 01030, Mexico
- Correspondence: (P.C.-U.); (M.E.R.-A.)
| |
Collapse
|
29518
|
Abstract
Diagnosis, prevention, management and treatment of acute and chronic medical conditions have improved with technological advancements in terms of scalability, efficacy, access, and personalized approach. Digital therapeutic applications (DTx) (Blue Star, Diabeo System, Livongo Diabetes Program, Tidepool etc.,) use web-based applications/cloud platforms to provide evidence-based, personalized, rapid point of care management of chronic, behavior-modifiable conditions, including diabetes mellitus (DM). DTx has improved patient compliance, therapeutic success and economic outcomes in DM management by enabling active patient engagement, lifestyle change, comprehensive medical care, and periodic monitoring of glycemic status. Addressing concerns along DTx data vulnerability, comparative efficacy with conventional treatments, ability to accommodate diverse population needs, and resolving ambiguous regulatory policies and reimbursement guidelines are critical for increasing access to DTx, and overcoming availability, accessibility, and affordability issues in the existing resource limited healthcare environment. In this commentary the authors explore the potential, prospects, and challenges of DTx in the management of Diabetes Mellitus.
Collapse
Affiliation(s)
| | - Kevin Yan
- Pharmalytics Group, Vancouver, Canada
| | | | | |
Collapse
|
29519
|
Abstract
Brewed tea (Camellia sinensis) is a major dietary source of flavonoids, in particular flavan-3-ols. Tea consumption has been suggested to be inversely associated with a decreased risk of cardiovascular disease (CVD). Several biological mechanisms support the inverse relationship between tea flavonoid intake and CVD risk. Given the recent accumulating evidence from various systematic reviews regarding the role of tea as a beverage in reducing CVD risk and severity, we conducted an umbrella review to describe and critically evaluate the totality of evidence to date. We searched the PubMed, Web of Science, Cochrane Database of Systematic Reviews, and BIOSIS databases for systematic reviews published between January 1, 2010 and February 22, 2020 reporting relationships between tea (C. sinensis) consumption and CVD mortality, CVD diagnosis or incidence, CVD events, stroke events, blood pressure, endothelial function, blood lipids and triglycerides, and inflammatory markers. Herein, we describe results from 23 included systematic reviews. Consistently consuming 2 cups of unsweet tea per day offers the right levels of flavonoids to potentially decrease CVD risk and its progression. This is supported by the consistency between a recent high-quality systematic review and dose-response meta-analyses of population-based studies demonstrating beneficial effects of consumption on CVD mortality, CVD events and stroke events and medium- to high-quality systematic reviews of intervention studies that further elucidate potential benefits on both validated (i.e., SBP, DBP, total cholesterol, and LDL-cholesterol) and emerging risk biomarkers of CVD (TNF-ɑ and IL-6). On the basis of this umbrella review, the consumption of tea as a beverage did not seem to be harmful to health; therefore, the benefits of moderate consumption likely outweigh risk. Future large, clinical intervention studies will provide better mechanistic insight with the ability to confirm the outcome effects shown across observational studies. The review protocol was registered on PROSPERO (https://www.crd.york.ac.uk/PROSPERO/) as CRD42020218159.KEY MESSAGESIt is reasonable to judge that 2 cups of unsweet tea per day has the potential to decrease CVD risk and progression due to its flavonoid content.The primary side effects of tea documented in human studies are hepatotoxicity and gastrointestinal disturbances (i.e., vomiting and diarrhea) after high-dose supplemental intake.Additional clinical research is needed to fully elucidate the effects of tea flavonoids on markers of CVD, as many studies were under-powered to detect changes.[Figure: see text].
Collapse
Affiliation(s)
- Abby Keller
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, USA
| | | |
Collapse
|
29520
|
Abstract
Acid-sensing ion channel 3 (ASIC3) belongs to the epithelial sodium channel/degenerin (ENaC/DEG) superfamily. There are 7 different ASIC subunits encoded by 5 different genes. Most ASIC subunits form trimeric ion channels that upon activation by extracellular protons mediate a transient inward current inducing cellular excitability. ASIC subunits exhibit differential tissue expression and biophysical properties, and the ability of subunits to form homo- and heteromeric trimers further increases the complexity of currents measured and their pharmacological properties. ASIC3 is of particular interest, not only because it exhibits high expression in sensory neurones, but also because upon activation it does not fully inactivate: a transient current is followed by a sustained current that persists during a period of extracellular acidity, i.e. ASIC3 can encode prolonged acidosis as a nociceptive signal. Furthermore, certain mediators sensitize ASIC3 enabling smaller proton concentrations to activate it and other mediators can directly activate the channel at neutral pH. Moreover, there is a plethora of evidence using transgenic mouse models and pharmacology, which supports ASIC3 as being a potential target for development of analgesics. This review will focus on current understanding of ASIC3 function to provide an overview of how ASIC3 contributes to physiology and pathophysiology, examining the mechanisms by which it can be modulated, and highlighting gaps in current understanding and future research directions.
Collapse
Affiliation(s)
| | | | - Taufiq Rahman
- Department of Pharmacology, University of Cambridge, Cambridge, UK
| |
Collapse
|
29521
|
Abstract
This review outlines the important oral implications of tobacco use. The lining of the mouth (oral mucosa), if exposed to tobacco and its products in a susceptible individual, can develop benign, potentially malignant, and malignant tumours. Treatment and prognosis depend on tumour type, how early it is detected, its size and site in the oral cavity and whether it has spread. Advanced oral squamous cell carcinoma (OSCC) has a 20% 5-year survival rate. Tobacco use also increases the risk of periodontitis, peri-implantitis, caries, alveolar osteitis and halitosis. Although less life threatening than OSCC, these tobacco related conditions create a substantial financial and health burden for individuals and society. Dental practitioners routinely examine the oral cavity for signs of mucosal and tooth changes, are experienced in recognising variations from normal and have established management and referral pathways. They are also ideally positioned to provide brief interventions to assist their patients to quit smoking.
Collapse
Affiliation(s)
- Pauline J Ford
- School of Dentistry, The University of Queensland, Brisbane, Australia
| | - Alison M Rich
- Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| |
Collapse
|
29522
|
Duan P, Wang Y, Lin R, Zeng Y, Chen C, Yang L, Yue M, Zhong S, Wang Y, Zhang Q. Impact of early life exposures on COPD in adulthood: A systematic review and meta-analysis. Respirology 2021; 26:1131-1151. [PMID: 34541740 DOI: 10.1111/resp.14144] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/16/2021] [Accepted: 08/29/2021] [Indexed: 02/06/2023]
Abstract
Early life represents a critical period for the development and growth of the lungs. Adverse exposures in this stage may drive the development of chronic obstructive pulmonary disease (COPD). Thus, we quantitatively evaluated the impact of different early life exposures on COPD in adulthood. The PubMed, Embase and Cochrane Library electronic databases were searched for articles published from January 2001 to October 2020. A total of 30 studies (795,935 participants) met the criteria and were included in the review. We found a significant association of COPD with childhood serious respiratory infections, pneumonia or bronchitis (pooled adjusted OR [aOR], 2.23 [95% CI, 1.63-3.07]). The probability of COPD was increased 3.45-fold for children with than without asthma (pooled aOR, 3.45 [95% CI, 2.37-5.02]). In addition, the probability of COPD was associated with maternal smoking (pooled aOR, 1.42 [95% CI, 1.17-1.72]), any child maltreatment (pooled aOR, 1.30 [95% CI, 1.18-1.42]) and low birth weight (pooled aOR, 1.58 [95% CI, 1.08-2.32]) but not childhood environmental tobacco smoke exposure (pooled aOR, 1.15 [0.83-1.61]) or premature birth (pooled aOR, 1.17 [95% CI, 0.87-1.58]). Furthermore, subgroup analyses revealed that probability was increased for only women with childhood physical abuse, sexual abuse and exposure to intimate partner violence. Factors resulting in COPD in adults could trace back to early life. Childhood respiratory disease, maltreatment, maternal smoking and low birth weight increase the risk of COPD. Promising advances in prevention strategies for early life exposures could markedly decrease the risk of COPD.
Collapse
Affiliation(s)
- Pengfei Duan
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
- Department of Infectious Disease Prevention and Control, The Zhongshan Second People's Hospital, Zhongshan, China
| | - Yao Wang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Rongqing Lin
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Yiming Zeng
- Department of Pulmonary and Critical Care Medicine, Respiratory Medicine Center of Fujian Province, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Chengshui Chen
- Respiratory Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Li Yang
- Respiratory Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Minghui Yue
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Shan Zhong
- Center for Research and Technology of Precision Medicine, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, China
| | - Yun Wang
- Center for Research and Technology of Precision Medicine, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, China
| | - Qingying Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
- Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, China
| |
Collapse
|
29523
|
Turesky TK, Shama T, Kakon SH, Haque R, Islam N, Someshwar A, Gagoski B, Petri WA, Nelson CA, Gaab N. Brain morphometry and diminished physical growth in Bangladeshi children growing up in extreme poverty: A longitudinal study. Dev Cogn Neurosci 2021; 52:101029. [PMID: 34801857 PMCID: PMC8605388 DOI: 10.1016/j.dcn.2021.101029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/14/2021] [Accepted: 10/24/2021] [Indexed: 11/25/2022] Open
Abstract
Diminished physical growth is a common marker of malnutrition and it affects approximately 200 million children worldwide. Despite its importance and prevalence, it is not clear whether diminished growth relates to brain development and general cognitive ability. Further, diminished growth is more common in areas of extreme poverty, raising the possibility that it may mediate previously shown links between socioeconomic status (SES) and brain structure. To address these gaps, 79 children growing up in an extremely poor, urban area of Bangladesh underwent MRI at age six years. Structural brain images were submitted to Mindboggle software, a Docker-compliant and high-reproducibility tool for tissue segmentation and regional estimations of volume, surface area, cortical thickness, sulcal depth, and mean curvature. Diminished growth predicted brain morphometry and mediated the link between SES and brain morphometry most consistently for subcortical and white matter subcortical volumes. Meanwhile, brain volume in left pallidum and right ventral diencephalon mediated the relationship between diminished growth and full-scale IQ. These findings offer malnutrition as one possible pathway through which SES affects brain development and general cognitive ability in areas of extreme poverty.
Collapse
Affiliation(s)
- Ted K Turesky
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States; Harvard Graduate School of Education, Cambridge, MA, United States; Harvard Medical School, Boston, MA, United States.
| | - Talat Shama
- The International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Rashidul Haque
- The International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Nazrul Islam
- National Institute of Neuroscience and Hospital, Dhaka, Bangladesh
| | - Amala Someshwar
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Borjan Gagoski
- Harvard Graduate School of Education, Cambridge, MA, United States; Fetal-Neonatal Neuroimaging and Development Science Center, Boston Children's Hospital, Boston, MA, United States
| | - William A Petri
- Division of Infectious Diseases and International Health, Department of Medicine, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Charles A Nelson
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States; Harvard Graduate School of Education, Cambridge, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Nadine Gaab
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States; Harvard Graduate School of Education, Cambridge, MA, United States; Harvard Medical School, Boston, MA, United States
| |
Collapse
|
29524
|
Kerr CJ, Waterworth SP, Brodie D, Sandercock GRH, Ingle L. The associations between physical activity intensity, cardiorespiratory fitness, and non-alcoholic fatty liver disease. J Gastroenterol Hepatol 2021; 36:3508-3514. [PMID: 34427948 DOI: 10.1111/jgh.15672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 07/28/2021] [Accepted: 08/20/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIM High levels of physical activity and cardiorespiratory fitness may protect against non-alcoholic fatty liver disease. We investigated whether different physical activity intensities and cardiorespiratory fitness were independent predictors of non-alcoholic fatty liver disease. METHODS We included healthy adults with no prior diagnosis of liver dysfunction. Non-alcoholic fatty liver disease prevalence was estimated based on fatty liver index scores. We created tertiles of self-reported low, moderate, and vigorous physical activity. Participants completed an incremental treadmill test to estimate cardiorespiratory fitness, and data were subsequently separated into quintile groups (Q1 [least fit] through Q5 [most fit]). RESULTS Non-alcoholic fatty liver disease prevalence in our sample of 7111 adults was 28.3% in male adults and 6.5% in female adults. Logistic regression showed the relative odds of non-alcoholic fatty liver disease were 42% lower if > 60 min/week of vigorous physical activity was maintained (odds ratio [OR] = 0.58, confidence interval [CI]: 0.49-0.68). There was a negative dose-response association between cardiorespiratory fitness and non-alcoholic fatty liver disease between Q1 and Q4. Compared with Q1, odds were 39% (OR = 0.61, CI: 0.51-0.73) lower in Q2, through to 51% lower in Q5 (OR = 0.49, CI: 0.41-0.60). Moderate physical activity did not reduce the odds of non-alcoholic liver disease. CONCLUSIONS We found the lowest prevalence of non-alcoholic fatty liver disease in adults achieving > 60 min/week of vigorous physical activity. However, a stronger dose-response relationship existed between cardiorespiratory fitness and non-alcoholic fatty liver disease. Improving cardiorespiratory fitness as a potential therapeutic target for treatment and prevention of non-alcoholic fatty liver disease warrants further investigation.
Collapse
Affiliation(s)
- Catherine J Kerr
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Essex, UK
| | - Sally P Waterworth
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Essex, UK
| | - David Brodie
- Department of Health, Buckinghamshire New University, Bucks, UK
| | - Gavin R H Sandercock
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Essex, UK
| | - Lee Ingle
- Department of Sport, Health & Exercise Sciences, University of Hull, Hull, UK
| |
Collapse
|
29525
|
Shen X, MacSweeney N, Chan SW, Barbu MC, Adams MJ, Lawrie SM, Romaniuk L, McIntosh AM, Whalley HC. Brain structural associations with depression in a large early adolescent sample (the ABCD study®). EClinicalMedicine 2021; 42:101204. [PMID: 34849476 PMCID: PMC8608869 DOI: 10.1016/j.eclinm.2021.101204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Depression is the leading cause of disability worldwide with > 50% of cases emerging before the age of 25 years. Large-scale neuroimaging studies in depression implicate robust structural brain differences in the disorder. However, most studies have been conducted in adults and therefore, the temporal origins of depression-related imaging features remain largely unknown. This has important implications for understanding aetiology and informing timings of potential intervention. METHODS Here, we examine associations between brain structure (cortical metrics and white matter microstructural integrity) and depression ratings (from caregiver and child), in a large sample (N = 8634) of early adolescents (9 to 11 years old) from the US-based, Adolescent Brain and Cognitive Development (ABCD) Study®. Data was collected from 2016 to 2018. FINDINGS We report significantly decreased global cortical and white matter metrics, and regionally in frontal, limbic and temporal areas in adolescent depression (Cohen's d = -0⋅018 to -0⋅041, β = -0·019 to -0⋅057). Further, we report consistently stronger imaging associations for caregiver-reported compared to child-reported depression ratings. Divergences between reports (caregiver vs child) were found to significantly relate to negative socio-environmental factors (e.g., family conflict, absolute β = 0⋅048 to 0⋅169). INTERPRETATION Depression ratings in early adolescence were associated with similar imaging findings to those seen in adult depression samples, suggesting neuroanatomical abnormalities may be present early in the disease course, arguing for the importance of early intervention. Associations between socio-environmental factors and reporter discrepancy warrant further consideration, both in the wider context of the assessment of adolescent psychopathology, and in relation to their role in aetiology. FUNDING Wellcome Trust (References: 104036/Z/14/Z and 220857/Z/20/Z) and the Medical Research Council (MRC, Reference: MC_PC_17209).
Collapse
Affiliation(s)
- Xueyi Shen
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
- Corresponding author.
| | - Niamh MacSweeney
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - Stella W.Y. Chan
- Department of Clinical Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Miruna C. Barbu
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - Mark J. Adams
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - Stephen M. Lawrie
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - Liana Romaniuk
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - Andrew M. McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - Heather C. Whalley
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| |
Collapse
|
29526
|
Wu YZ, Huang HT, Ho CJ, Shih CL, Chen CH, Cheng TL, Wang YC, Lin SY. Molecular Weight of Hyaluronic Acid Has Major Influence on Its Efficacy and Safety for Viscosupplementation in Hip Osteoarthritis: A Systematic Review and Meta-Analysis. Cartilage 2021; 13:169S-184S. [PMID: 34109828 PMCID: PMC8808882 DOI: 10.1177/19476035211021903] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND This study aimed to compare the efficacy and safety of intra-articular hyaluronic acid (HA) injection with different molecular weights (MWs) for treating hip osteoarthritis (OA). METHODS A systematic literature search for relevant studies was conducted in 3 electronic databases, including PubMed, BMJ Journals, and Cochrane Library, from inception to April 2020. Extracted outcomes included visual analogue scale (VAS) (1, 3, and 6 months), Lequesne index (3 and 6 months), and adverse effects. HAs were classified into low-molecular-weight (LMW), moderate-molecular-weight (MMW), high-molecular-weight (HMW), and ultra-high-molecular-weight (UHMW) groups. Meta-analysis was performed using Review Manager 5.3. RESULTS A total of 15 studies with 614 patients were included. Our meta-analysis showed that the HMW HA group had the best improvement in VAS and Lequesne index compared with other HA groups for all the follow-up visits. Moreover, the HMW group demonstrated significantly better improvement than the other groups in VAS at 6-month follow-up and in Lequesne index at 3- and 6-month follow-ups. Analysis for adverse effects revealed low rates of systemic adverse effects (≤0.6%) in all groups and similar rate of local adverse effects (around 10%) among the groups except for UHMW HA group (37.5%). CONCLUSION Among different MWs of HA for treating hip OA, HMW HA injection demonstrated the best efficacy for up to 6 months after treatment without increased risk of adverse effects. Further studies with more comprehensive data and a higher level of evidence are required to prove our results.
Collapse
Affiliation(s)
- Yen-Zung Wu
- Department of Orthopedics, Kaohsiung
Medical University Hospital, Kaohsiung Medical University, Kaohsiung
| | - Hsuan-Ti Huang
- Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung,Department of Orthopedics, Kaohsiung
Municipal Ta-Tung Hospital, Kaohsiung
| | - Cheng-Jung Ho
- Department of Orthopedics, Kaohsiung
Medical University Hospital, Kaohsiung Medical University, Kaohsiung,Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung
| | - Chia-Lung Shih
- Clinical Medicine Research Center,
Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City
| | - Chung-Hwan Chen
- Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung,Department of Orthopedics, Kaohsiung
Municipal Ta-Tung Hospital, Kaohsiung,Institute of Medical Science and
Technology, National Sun Yat-Sen University, Kaohsiung
| | - Tsung-Lin Cheng
- Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung,Department of Physiology, College of
Medicine, Kaohsiung Medical University, Kaohsiung
| | - Ying-Chun Wang
- Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Department of Orthopedics, Kaohsiung
Municipal Ta-Tung Hospital, Kaohsiung
| | - Sung-Yen Lin
- Department of Orthopedics, Kaohsiung
Medical University Hospital, Kaohsiung Medical University, Kaohsiung,Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung,Sung-Yen Lin, Department of Orthopedics,
Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100,
Tzyou 1st Road, Sanmin District, Kaohsiung City, Kaohsiung, 80756.
| |
Collapse
|
29527
|
Abstract
As survival of infants born extremely preterm increases, more are now reaching adulthood. It is well documented that survivors born extremely preterm experience more developmental delay and disability in multiple domains compared with term-born controls in early childhood and school age. However, with increasing age, health problems involving physical and mental health become more evident. Despite these challenges, it is reassuring that self-reported quality of life remains good. Future directions of research include development of age-appropriate interventions to optimise health and development of individuals born extremely preterm beyond school age.
Collapse
|
29528
|
Kirmizi M, Yalcinkaya G, Sengul YS, Kalemci O, Angin S. Investigation of balance performance under different sensory and dual-task conditions in patients with chronic neck pain. Musculoskelet Sci Pract 2021; 56:102449. [PMID: 34419890 DOI: 10.1016/j.msksp.2021.102449] [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: 03/08/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Most studies suggest that people with chronic neck pain (CNP) have decreased balance abilities. However, balance performance during performing concurrent tasks is not clarified. OBJECTIVES To investigate balance performance under different sensory and dual-task conditions in people with and without CNP. METHOD Twenty-two women with CNP and twenty-two asymptomatic women were tested using the Biodex Stability System. Overall stability index (OSI), anterior/posterior stability index (APSI), medial/lateral stability index (MLSI) were obtained in two sessions: eyes-open and eyes-closed. Both sessions consisted of four conditions: quiet standing, rotating head, counting backward, standing on foam. Higher index scores mean poorer balance. DESIGN Case-Control study. RESULTS A mixed factorial ANOVA (2 × 8 design) showed that there was a main effect of CNP on OSI, APSI, and MLSI (p < 0.001), which indicates that CNP causes poor balance. Further, there was an interaction between CNP and test conditions for only OSI (p < 0.05). Simple effects tests showed that patients with CNP had higher OSI in all conditions except standing on foam with eyes-open, and quiet standing and counting backward with eyes-closed (p < 0.05). The largest effect size was obtained during rotating head with eyes-open (η2:0.301), followed by counting backward with eyes-open and quiet standing with eyes-open (η2:0.267 and 0.245). Performing a concurrent task, closing eyes, or standing on foam mostly increased OSI in both groups (p < 0.05). CONCLUSIONS Patients with CNP have poorer balance under different sensory and dual-task conditions. Addressing balance assessment while performing concurrent tasks, especially head rotations, may offer new insights into the management of CNP.
Collapse
Affiliation(s)
- Muge Kirmizi
- Faculty of Health Sciences, Izmir Katip Celebi University, Department of Physiotherapy and Rehabilitation, Izmir, Turkey; Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey.
| | - Gamze Yalcinkaya
- Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Yesim Salik Sengul
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Orhan Kalemci
- Department of Neurosurgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Salih Angin
- Faculty of Health Sciences, Cyprus International University, Nicosia, Cyprus
| |
Collapse
|
29529
|
Song L, Pan K, Du X, Jiang S, Zeng X, Zhang J, Lei L, Zhang M, Zhang Y, Fan D, Liu Z, Zhou J, Zhao J. Ambient PM 2.5-induced brain injury is associated with the activation of PI3K/AKT/FoxO1 pathway. Environ Sci Pollut Res Int 2021; 28:68276-68287. [PMID: 34268684 DOI: 10.1007/s11356-021-15405-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
PM2.5-related neurological and mental diseases, such as cognitive impairment and stroke, tend to cause disability. Six-week-old male C57BL/6 mice were divided into 6 groups and exposed to concentrated PM2.5 or filtered air for 2, 4, and 6 months, respectively. The neurobehavioral changes of mice were tested. The weight of the whole brain and olfactory bulbs were recorded at the end of exposure, and the brain structure was observed by hematoxylin and eosin (HE) staining. Serum indicators, mRNA, and protein expressions were detected. The spatial learning memory ability was impaired, and the mice were more anxious after PM2.5 exposure. Relative brain weight decreased with age, and PM2.5 exposure exceeded the decrease of relative brain weight. Interestingly, superoxide dismutase (SOD) and albumin decreased in the PM2.5-exposed groups although neuronal morphology and other serum indicators did not show significant difference between PM and FA groups. Moreover, PM2.5 induced the increase of plasminogen at 2 months but recovered at 4 months and then increased at 6 months again. The results from protein expression and transcriptomic test demonstrated that PI3K/AKT/FoxO1 pathway might be activated after 6-month PM2.5 exposure in mice. Indicators albumin, the percentage of albumin over IgG (A/G value), and plasminogen were the main serous changes in mice after early-stage (2 months) and long-term (6 months) PM2.5 exposure. In addition, early-stage injury induced by PM2.5 might recover at later time point and display significant injury again with the exposure time. PM2.5 exposure-induced brain injury might be associated with the activation of PI3K/AKT/FoxO1 pathway.
Collapse
Affiliation(s)
- Liying Song
- Department of Environmental Health, School of Public Health and the Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Box 249, 130 Dong'an Road, Shanghai, 200032, China
| | - Kun Pan
- Department of Environmental Health, School of Public Health and the Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Box 249, 130 Dong'an Road, Shanghai, 200032, China
| | - Xihao Du
- Department of Environmental Health, School of Public Health and the Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Box 249, 130 Dong'an Road, Shanghai, 200032, China
| | - Shuo Jiang
- Department of Environmental Health, School of Public Health and the Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Box 249, 130 Dong'an Road, Shanghai, 200032, China
| | - Xuejiao Zeng
- Department of Environmental Health, School of Public Health and the Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Box 249, 130 Dong'an Road, Shanghai, 200032, China
| | - Jia Zhang
- Department of Environmental Health, School of Public Health and the Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Box 249, 130 Dong'an Road, Shanghai, 200032, China
| | - Lei Lei
- Department of Environmental Health, School of Public Health and the Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Box 249, 130 Dong'an Road, Shanghai, 200032, China
| | - Mengdi Zhang
- Department of Environmental Health, School of Public Health and the Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Box 249, 130 Dong'an Road, Shanghai, 200032, China
| | - Yuwen Zhang
- Department of Environmental Health, School of Public Health and the Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Box 249, 130 Dong'an Road, Shanghai, 200032, China
| | - Dongxia Fan
- Department of Environmental Health, School of Public Health and the Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Box 249, 130 Dong'an Road, Shanghai, 200032, China
| | - Zhixiu Liu
- Department of Environmental Health, School of Public Health and the Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Box 249, 130 Dong'an Road, Shanghai, 200032, China
| | - Ji Zhou
- Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China
| | - Jinzhuo Zhao
- Department of Environmental Health, School of Public Health and the Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Box 249, 130 Dong'an Road, Shanghai, 200032, China.
- Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China.
- IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China.
| |
Collapse
|
29530
|
Buss VH, Varnfield M, Harris M, Barr M. Validation of a lifestyle-based risk score for type 2 diabetes mellitus in Australian adults. Prev Med Rep 2021; 24:101647. [PMID: 34976696 PMCID: PMC8684002 DOI: 10.1016/j.pmedr.2021.101647] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/19/2021] [Accepted: 11/17/2021] [Indexed: 11/30/2022] Open
Abstract
A lifestyle-based score can satisfactorily predict 5-year risk of type 2 diabetes. The model’s performance was similar to the standard tool in an Australian cohort. Lifestyle predictors might be easier for laypersons to know and interpret.
The study aimed to assess the performance of a lifestyle-based prognostic risk model (Diabetes Lifestyle Score) for the prediction of 5-year risk of type 2 diabetes mellitus. The model comprises nine self-reported predictors (sex, age, antihypertensive drugs, body mass index, family history of diabetes, physical activity, fruits, vegetables, and wholemeal/brown bread). We conducted an external validation and update of the model in an Australian cohort including 97,615 residents of New South Wales aged 45 years and older who were free of type 1 and 2 diabetes mellitus at baseline. Of all participants, 4,741 developed type 2 diabetes mellitus over 5 years. We conducted the statistical analyses in RStudio using the programming language R. The area under the receiver operating characteristic curve (AUC) of the original model was 0.726 (95% confidence interval: 0.719, 0.733). After adjusting the calibration intercept and slope, the original model performed reasonably well in the external cohort. The best performance was measured by using the numerical predictors as continuous variables and refitting all coefficients (AUC: 0.741, 95% confidence interval: 0.734, 0.748). The results of the original model after calibration were comparable to those received from the AUSDRISK score which is routinely used in Australian clinical practice. Hence, the lifestyle-based model might be a reasonable alternative for laypersons since the required information is most likely known by these. Further, the risk score may communicate the message about the importance of a healthy diet to reduce the risk of diabetes.
Collapse
Affiliation(s)
- Vera Helen Buss
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Surgical Treatment and Rehabilitation Service – STARS, Level 7, 296 Herston Road, Herston, Queensland 4029, Australia
- Centre for Primary Health and Equity, University of New South Wales, Level 3, AGSM Building, UNSW Sydney, New South Wales 2052, Australia
- Corresponding author at: Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Surgical Treatment and Rehabilitation Service – STARS, Level 7, 296 Herston Road, Herston, Queensland 4029, Australia.
| | - Marlien Varnfield
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Surgical Treatment and Rehabilitation Service – STARS, Level 7, 296 Herston Road, Herston, Queensland 4029, Australia
| | - Mark Harris
- Centre for Primary Health and Equity, University of New South Wales, Level 3, AGSM Building, UNSW Sydney, New South Wales 2052, Australia
| | - Margo Barr
- Centre for Primary Health and Equity, University of New South Wales, Level 3, AGSM Building, UNSW Sydney, New South Wales 2052, Australia
| |
Collapse
|
29531
|
Mekonen T, Chan GCK, Connor JP, Hides L, Leung J. Estimating the global treatment rates for depression: A systematic review and meta-analysis. J Affect Disord 2021; 295:1234-42. [PMID: 34665135 DOI: 10.1016/j.jad.2021.09.038] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/02/2021] [Accepted: 09/12/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Depression is considered a global crisis due to its high prevalence and associated disabilities. The burden posed by depression could be reduced by increasing access to timely treatment. Limited information is available on treatment rates of depression, particularly in low- and middle-income countries. This study aimed to estimate the treatment rates for depression in the general adult population by World Bank income classification. METHODS We searched PubMed, EMBASE, PsycINFO, and CINAHL, supplemented with hand-search of reference lists to identify community-based studies. The overall treatment rate for depression was estimated from studies that reported any treatment (behavioral or pharmacological treatments) in healthcare or informal non-healthcare settings. Data were pooled using a random-effects meta-analysis model. Subgroup analyses by income classification were completed. Meta-regression was conducted by study characteristics. The protocol was pre-registered at PROSPERO (CRD42020161683). RESULTS We included 65 studies comprising 1.1 million participants from 79 countries and territories. The global 12-month/lifetime pooled treatment rate was 34.8% (95% confidence interval: 29.9, 39.9%). The treatment rates were 48.3% (43.0, 53.6%) in high-income countries, 21.4% (15.1, 27.7%) in middle-income countries, and 16.8% (11.3, 23.0%) in low-income countries. Among the treated samples, 12-month minimally adequate treatment was estimated to be 40%. LIMITATION We reported a substantial level of between-study heterogeneity, which was partially explained by study characteristics in the meta-regression. CONCLUSION Globally, approximately one-third of people with depression receive treatment. Three in five treated people with depression did not receive minimally adequate treatment. Depression treatment rates are considerably lower in low-and middle-income countries.
Collapse
|
29532
|
Callison K, Schiman C, Schiman JC. Smoking cessation and weight gain: Evidence from China. Econ Hum Biol 2021; 43:101045. [PMID: 34330065 DOI: 10.1016/j.ehb.2021.101045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 06/28/2021] [Accepted: 07/11/2021] [Indexed: 06/13/2023]
Abstract
Cigarette smoking has long been viewed as a means to control body weight. However, studies on the association between smoking cessation and weight gain have reported mixed findings and, notably, there is limited evidence among the Chinese population - the world's largest smoker population. The extent to which smoking cessation is positively associated with body weight is of interest as excessive weight gain contributes to heart disease, diabetes, hypertension, musculoskeletal disorders, and some cancers. Additionally, concerns over weight gain may dissuade current smokers from quitting. Using data from the China Health and Nutrition Survey (CHNS), we examine the association between smoking cessation and body weight in China. To account for the nonrandom nature of smoking cessation, our research design relies on within-individual variation in smoking status to remove the influence of time-invariant unobserved differences across individuals that are correlated with both cessation and body weight. We find that smoking cessation is associated with a modest increase in weight (0.329 kg, 0.51 % off the mean) and no significant changes in the prevalence of overweight or obesity.
Collapse
Affiliation(s)
- Kevin Callison
- Department of Health Policy and Management, Tulane University School of Public Health and Tropical Medicine, United States
| | - Cuiping Schiman
- Department of Economics, Georgia Southern University, United States
| | - Jeffrey C Schiman
- Department of Economics, Georgia Southern University, United States.
| |
Collapse
|
29533
|
Fagerberg B, Barregard L. Review of cadmium exposure and smoking-independent effects on atherosclerotic cardiovascular disease in the general population. J Intern Med 2021; 290:1153-1179. [PMID: 34157165 DOI: 10.1111/joim.13350] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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: 11/29/2022]
Abstract
BACKGROUND Exposure to cadmium (Cd) via food and smoking is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD). Blood and urine levels of Cd are established biomarkers of exposure. OBJECTIVES To review (1) the smoking-independent associations between Cd exposure and ASCVD, including the possible presence of a nonlinear dose-response relationship with Cd exposure and (2) the causal effects of Cd exposure on different stages of atherosclerosis. METHODS Narrative review. RESULTS Cd confers increased risk of ASCVD and asymptomatic atherosclerosis in the carotid and coronary arteries above B-Cd >0.5 μg/L or U-Cd >0.5 μg/g creatinine, but it has not been shown below a threshold of these exposure levels. Adjustment for smoking does not exclude the possibility of residual confounding, but several studies in never-smoking cohorts have shown associations between Cd and ASCVD, and experimental studies have demonstrated pro-atherosclerotic effects of Cd. Cd accumulates in arterial walls and atherosclerotic plaques, reaching levels shown to have proatherosclerotic effects. Suggested early effects are increased subendothelial retention of atherogenic lipoproteins, which become oxidized, and endothelial dysfunction and damage with increased permeability for monocytes, which in the intima turn to macrophages and then to foam cells. Later, Cd may contribute to plaque rupture and erosion by endothelial apoptosis and degradation of the fibrous cap. Finally, by having prothrombotic and antifibrinolytic effects, the CVD risk may be further increased. CONCLUSIONS There is strong evidence that Cd causes ASCVD above a suggested exposure level via mechanisms in early as well as the late stages of atherosclerotic disease.
Collapse
Affiliation(s)
- Björn Fagerberg
- Wallenberg Laboratory for Cardiovascular and Metabolic Research, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Barregard
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
29534
|
Brown E, Wilding JPH, Alam U, Barber TM, Karalliedde J, Cuthbertson DJ. The expanding role of SGLT2 inhibitors beyond glucose-lowering to cardiorenal protection. Ann Med 2021; 53:2072-2089. [PMID: 33107349 PMCID: PMC8592607 DOI: 10.1080/07853890.2020.1841281] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/12/2020] [Indexed: 12/17/2022] Open
Abstract
The kidney plays a major physiological role in glucose homeostasis but also contributes to the pathophysiology of type 2 diabetes (T2D), mediated by renal sodium glucose cotransporters (SGLTs). This recognition led to the development of SGLT2 inhibitors that inhibit proximal renal tubular renal glucose and sodium reabsorption. The glucoretic and natriuretic effect of SGLT2 inhibitors is associated with reductions in HbA1c levels, body weight, systolic blood pressure and triglycerides. Major vascular complications of T2D include cardiovascular disease and chronic kidney disease (CKD). Results from several cardiovascular outcome trials (CVOTs) with these drugs have highlighted benefits in reducing major adverse cardiovascular events by 11%, reducing the risk of cardiovascular death or hospitalization for heart failure (HF) by 23% and reducing the risk of progression of renal disease by 45%. Their cardiorenal benefits are apparent across a range of eGFRs (within CKD1-3 groups) and the presence or absence of ischaemic heart disease, HF or T2D. In patients with HF with reduced ejection fraction (HFrEF), similar risk reductions in cardiovascular death and HF events are also seen; results from studies in patients with HF with preserved ejection fraction (HFpEF) are awaited. Cardiorenal benefits have been recently reported in patients with CKD, regardless of the presence or absence of T2D. Indications for use of SGLT2 inhibitors have extended beyond glucose-lowering to a central role in cardiorenal protection. This review will first explore the mechanisms by which glycaemic control, weight loss and cardiovascular risk factors are modulated therapeutically with SGLT2 inhibitors. Subsequently, we outline putative mechanisms underpinning the cardiorenal benefits seen, including in HF and CKD, in the context of completed and ongoing clinical studies. Treatment strategies with SGLT2 inhibitors in individuals with CKD or HF, with and/or without T2D are increasingly appealing. Combination therapy with complementary therapeutic agents is also explored.
Collapse
Affiliation(s)
- Emily Brown
- Department of Metabolic and Cardiovascular Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - John P. H. Wilding
- Department of Metabolic and Cardiovascular Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Uazman Alam
- Department of Metabolic and Cardiovascular Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
- Division of Diabetes, Endocrinology and Gastroenterology, Institute of Human Development, University of Manchester, Manchester, UK
| | - Thomas M. Barber
- Human Metabolism Research Unit, University of Warwick, Coventry, UK
- University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Janaka Karalliedde
- School of Cardiovascular Medicine & Sciences, King’s College London, London, UK
| | - Daniel J. Cuthbertson
- Department of Metabolic and Cardiovascular Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| |
Collapse
|
29535
|
Klimis H, Thiagalingam A, McIntyre D, Marschner S, Von Huben A, Chow CK. Text messages for primary prevention of cardiovascular disease: The TextMe2 randomized clinical trial. Am Heart J 2021; 242:33-44. [PMID: 34428440 DOI: 10.1016/j.ahj.2021.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/10/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Primary prevention guidelines emphasize the importance of lifestyle modification, but many at high-risk have suboptimal cardiovascular risk factor (CVRF) control. Text message support may improve control, but the evidence is sparse. Our objective was to determine the impact of text messages on multiple CVRFs in a moderate-high risk primary prevention cohort. METHODS This study was a single-blind randomized clinical trial comparing semi-personalized text message-based support to standard care. A random sample of adults with 10-year absolute cardiovascular risk score ≥10% and without coronary heart disease, referred from February 2019 to January 2020, were recruited from an outpatient cardiology clinic in a large tertiary hospital in Sydney, Australia. Patients were randomized 1:1 to intervention or control. Intervention participants received 4 texts per week over 6 months, and standard care, with content covering: diet, physical activity, smoking, general cardiovascular health, and medication adherence. Controls received standard care only. Content was semipersonalized (smoking status, vegetarian or not-vegetarian, physical ability, taking medications or not) and delivered randomly using automated software. The primary outcome was the difference in the proportion of patients who have ≥3 uncontrolled CVRFs (out of: low-density lipoprotein cholesterol >2.0 mmol/L, blood pressure >140/90 mm Hg, body mass index ≥25 kg/m2, physical inactivity, current smoker) at 6 months adjusted for baseline. Secondary outcomes included differences in biomedical and behavioral CVRFs. RESULTS Among 295 eligible participants, 246 (mean age, 58.6 ± 10.7 years; 39.4% female) were randomized to intervention (n = 124) or control (n = 122). At 6 months, there was no significant difference in the proportion of patients with ≥3 uncontrolled CVRFs (adjusted relative risk [RR] 0.98; 95% confidence interval [CI] 0.75-1.29; P = .88). Intervention participants were less likely to be physically inactive (adjusted RR 0.72; 95% CI 0.57-0.92; P = .01), but there were no significant changes in other single CVRFs. More intervention participants reduced the number of uncontrolled CVRFs at 6-months from baseline than controls (86% vs 75%; RR 1.15; 95% CI 1.00-1.32; P = .04). CONCLUSIONS In moderate-high cardiovascular risk primary prevention, text message-based support did not significantly reduce the proportion of patients with ≥3 uncontrolled CVRFs. However, the program did motivate behavior change and significantly improved cardiovascular risk factor control overall. Larger multicenter studies are needed.
Collapse
Affiliation(s)
- Harry Klimis
- Westmead Applied Research Centre and Faculty of Medicine and Health, University of Sydney, Westmead, NSW, Australia; Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia.
| | - Aravinda Thiagalingam
- Westmead Applied Research Centre and Faculty of Medicine and Health, University of Sydney, Westmead, NSW, Australia; Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia
| | - Daniel McIntyre
- Westmead Applied Research Centre and Faculty of Medicine and Health, University of Sydney, Westmead, NSW, Australia
| | - Simone Marschner
- Westmead Applied Research Centre and Faculty of Medicine and Health, University of Sydney, Westmead, NSW, Australia
| | - Amy Von Huben
- Westmead Applied Research Centre and Faculty of Medicine and Health, University of Sydney, Westmead, NSW, Australia
| | - Clara K Chow
- Westmead Applied Research Centre and Faculty of Medicine and Health, University of Sydney, Westmead, NSW, Australia; Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia
| |
Collapse
|
29536
|
Petersen KS, Davis KM, Rogers CJ, Proctor DN, West SG, Kris-Etherton PM. Herbs and spices at a relatively high culinary dosage improves 24-hour ambulatory blood pressure in adults at risk of cardiometabolic diseases: a randomized, crossover, controlled-feeding study. Am J Clin Nutr 2021; 114:1936-1948. [PMID: 34510174 PMCID: PMC8634565 DOI: 10.1093/ajcn/nqab291] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 08/12/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Intake of a single meal containing herbs and spices attenuates postprandial lipemia, hyperglycemia, and oxidative stress, and improves endothelial function. There has been limited investigation of the effect of longer-term intake of mixed herbs and spices on risk factors for cardiometabolic diseases. OBJECTIVES The objective was to assess the effect of an average American diet containing herbs and spices at 0.5 (low-spice diet; LSD), 3.3 (moderate-spice diet; MSD), and 6.6 (high-spice diet; HSD) g · d-1 · 2100 kcal-1 on lipids and lipoproteins as well as other risk factors for cardiometabolic diseases in at-risk adults. METHODS A 3-period, randomized, crossover, controlled-feeding study with 71 participants was conducted at the Pennsylvania State University. Each diet was consumed for 4 wk with a minimum 2-wk washout period. Outcomes were assessed at baseline and the end of each diet period. RESULTS No between-diet effects were observed for LDL cholesterol, the primary outcome. Between-diet differences were observed for mean 24-h systolic (P = 0.02) and diastolic (P = 0.005) ambulatory blood pressure. The HSD lowered mean 24-h systolic blood pressure compared with the MSD (-1.9 mm Hg; 95% CI: -3.6, -0.2 mm Hg; P = 0.02); the difference between the HSD and LSD was not statistically significant (-1.6 mm Hg; 95% CI: -3.3, 0.04 mm Hg; P = 0.058). The HSD lowered mean 24-h diastolic blood pressure compared with the LSD (-1.5 mm Hg; 95% CI: -2.5, -0.4 mm Hg; P = 0.003). No differences were detected between the LSD and MSD. No between-diet effects were observed for clinic-measured blood pressure, markers of glycemia, or vascular function. CONCLUSIONS In the context of a suboptimal US-style diet, addition of a relatively high culinary dosage of mixed herbs and spices (6.6 g · d-1 · 2100 kcal-1) tended to improve 24-h blood pressure after 4 wk, compared with lower dosages (0.5 and 3.3 g · d-1 · 2100 kcal-1), in adults at elevated risk of cardiometabolic diseases.This trial was registered at clinicaltrials.gov as NCT03064932.
Collapse
Affiliation(s)
- Kristina S Petersen
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
| | - Kristin M Davis
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | - Connie J Rogers
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
| | - David N Proctor
- Department of Kinesiology, Pennsylvania State University, University Park, PA, USA
| | - Sheila G West
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | - Penny M Kris-Etherton
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
| |
Collapse
|
29537
|
Jin H, Ge X, Huan Z, Yao H, Xu C, Cai J. Stress-induced phosphoprotein 1 restrains spinal cord ischaemia-reperfusion injury by modulating NF-κB signalling. J Cell Mol Med 2021; 25:11075-11084. [PMID: 34734476 PMCID: PMC8650032 DOI: 10.1111/jcmm.17030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 10/01/2021] [Accepted: 10/19/2021] [Indexed: 12/15/2022] Open
Abstract
Spinal cord injury (SCI), a major cause of disability, causes high global disease and economic burdens. Stress-induced phosphoprotein 1 (STIP1) has been identified to be involved in spinal cord ischaemia-reperfusion injury (SCII); however, the effect of STIP1 on SCII remains unclear until now. This study aimed to examine the role of STIP1 in SCII and unravel the possible mechanisms. Western blotting and immunohistochemical staining showed that STIP1 expression rapidly increased and then decreased in rat spinal cord following SCII treatment. Neurological function scoring, HE staining, immunohistochemical staining and Western blotting revealed that STIP1 overexpression alleviated SCII-induced motor dysfunction of hind limbs, neuronal loss and inflammation in spinal cord, and inhibited activity of nuclear factor kappa B (NF-κB) signalling in rats. Immunoprecipitation identified that STIP1 was co-located with Iba-1. In addition, STIP1 was found to ameliorate oxygen and glucose deprivation (OGD)-induced inflammation and activation of NF-κB signalling in mouse microglia BV2 cells, and STIP1 resulted in decrease of heat shock protein family A member 8 (HSPA8), increase of IκBβ expression and reduced binding of IκBβ to HSPA8 in BV2 cells. The results of the present study demonstrate that STIP1 alleviates ischaemia/reperfusion-induced neuronal injury and inflammation in rat spinal cord and mouse microglial cells by deactivating NF-κB signalling. These findings may provide novel insights for the clinical diagnosis and treatment of SCI.
Collapse
Affiliation(s)
- Hongdou Jin
- Department of General SurgeryWuxi 9th Hospital Affiliated to Soochow UniversityWuxi CityJiangsu ProvinceChina
| | - Xin Ge
- Department of ICUWuxi 9th Hospital Affiliated to Soochow UniversityWuxi CityJiangsu ProvinceChina
| | - Zhirong Huan
- Department of ICUWuxi 9th Hospital Affiliated to Soochow UniversityWuxi CityJiangsu ProvinceChina
| | - Hao Yao
- Department of ICUWuxi 9th Hospital Affiliated to Soochow UniversityWuxi CityJiangsu ProvinceChina
| | - Ce Xu
- Department of ICUWuxi 9th Hospital Affiliated to Soochow UniversityWuxi CityJiangsu ProvinceChina
| | - Jimin Cai
- Department of ICUWuxi 9th Hospital Affiliated to Soochow UniversityWuxi CityJiangsu ProvinceChina
| |
Collapse
|
29538
|
Basnet B, Yadav JK, Gajurel BP, Shing YK, Kandel B, Nepal G. Role of female community health volunteers in ischemic stroke prevention, identification, referral and rehabilitation in Nepal. Ann Med Surg (Lond) 2021; 72:102893. [PMID: 34992775 PMCID: PMC8712991 DOI: 10.1016/j.amsu.2021.102893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/26/2021] [Indexed: 01/01/2023] Open
Abstract
For the past three decades, female community health volunteers (FCHVs) have been at the forefront of Nepal's health map and have contributed significantly to its improving health indicators such as maternal mortality rate and infant mortality rate. Given the changing epidemiology of Nepal and the shift of burden from communicable to non-communicable diseases (NCDs), it is important to revitalize their role with the changing times. The prevalence of ischemic stroke in Nepal is on the rise. However, very few people make it to the hospital within the time frame for thrombolysis and the patient's knowledge about ischemic stroke seems to play a major part. FCHVs can play a significant role in improving ischemic stroke care by raising awareness about the condition, its risk factors, and informing the public about the need for timely treatment. They can help screen for common risk factors such as obesity, hypertension and diabetes as well as monitor for treatment in previously diagnosed individuals. Randomized controlled trials have shown to yield favorable results in NCDs with engagement of FCHVs. With proper training and support, they can play an important role in improving ischemic stroke care in low- and middle-income countries like Nepal.
Collapse
Affiliation(s)
- Babin Basnet
- Department of Internal Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Jayant Kumar Yadav
- Department of Internal Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | | | - Yow Ka Shing
- Department of Internal Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Bipin Kandel
- Department of Internal Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Gaurav Nepal
- Rani Primary Health Care Center, Biratnagar 56613, Morang, Nepal
| |
Collapse
|
29539
|
Meghji J, Mortimer K, Mpangama S. TB and COPD in low-income settings: a collision of old foes. Thorax 2021; 77:1057-1058. [PMID: 34853155 DOI: 10.1136/thoraxjnl-2021-218220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Jamilah Meghji
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK .,Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Kevin Mortimer
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.,Department of Respiratory Medicine, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK
| | | |
Collapse
|
29540
|
Wang J, Zhou Y, Ding J, Xiao J. Functional gradient alteration in individuals with cognitive vulnerability to depression. J Psychiatr Res 2021; 144:338-344. [PMID: 34735837 DOI: 10.1016/j.jpsychires.2021.10.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Establishing a better understanding of the structure of the hierarchy is a primary goal of neuroscience. Recent research has highlighted a connectome gradient dysfunction in patients with major depressive disorder (MDD). However, it remains unclear whether these changes exist prior to the onset of the disease. METHODS We used a newly developed resting-state functional connectivity (FC)-based gradient approach to evaluate the principal functional gradient in individuals with cognitive vulnerability to depression (CVD) and healthy controls (HC). We further examined the associations between CVD-related alterations in the principal connectome gradient with multiple cognitive behavioral variables. RESULTS Individuals with CVD showed significantly lower functional gradient scores in the left ventral insular gyrus than HC. The left ventral insular gyrus gradient score was positively correlated with the total attentional control scale as well as the dimension of attentional control. The left ventral insular gyrus gradient score was negatively correlated with the total BHS scale, the dimension of expectations, the total RRS scale, and the depression-related dimension. CONCLUSIONS The preliminary results indicate that alterations in the principal functional gradient in individuals with CVD might be a biomarker of cognitive vulnerability to MDD, and the alterations may exist prior to the onset of depression.
Collapse
Affiliation(s)
- Junyi Wang
- Beijing Key Laboratory of Learning and Cognition and Department of Psychology, Capital Normal University, Beijing, China
| | - Yinglu Zhou
- Department of Biostatistics & Bioinformatics, School of Medicine, Duke University, Durham, NC, 27705, USA
| | - Jinhong Ding
- Beijing Key Laboratory of Learning and Cognition and Department of Psychology, Capital Normal University, Beijing, China.
| | - Jing Xiao
- Beijing Key Laboratory of Learning and Cognition and Department of Psychology, Capital Normal University, Beijing, China.
| |
Collapse
|
29541
|
Du L, Ma J, Zhang X. Association between lncRNA genetic variants and susceptibility to large artery atherosclerotic stroke. Metab Brain Dis 2021; 36:2589-2595. [PMID: 34468915 DOI: 10.1007/s11011-021-00833-1] [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: 05/26/2021] [Accepted: 08/23/2021] [Indexed: 11/26/2022]
Abstract
Studies have already illustrated the role of long non-coding RNAs (lncRNAs) in the progression of atherosclerosis, while the potential role of lncRNA gene variation in susceptibility to large artery atherosclerotic stroke (LAAS) remains controversial. We therefore conducted this study to explore and verify the gene expression modules of LAAS. Differentially expressed genes (DEGs) in atherosclerosis were screened in 3 patients with LAAS, and 3 healthy control patients. A further 31 individuals were used to screen DEGs, and MALAT1, MEG3, or SENCR were identified. Real-time PCR and western blotting were used to assess the difference in DEGs between the atherosclerotic and the non-atherosclerotic artery models. A total of 454 DEGs were detected from the initial screening step, and MALAT1, MEG3, or SENCR were applied to predict the risk of LAAS. The AUC of MALAT1, MEG3, and SENCR in predicting the risk of LAAS was 0.746 (95% CI: 0.398-0.753; P = 0.005), 0.575 (95% CI: 0.398-0.753; P = 0.389), and 0.629 (95% CI: 0.449- .808; P = 0.141), respectively. Moreover, there were significant differences between the atherosclerotic and non-atherosclerotic artery models for the expression of MALAT1, GCNT1, VEGFA, and VCAM-1. This study found that the MALAT1 contributes to LAAS susceptibility, and might play an important role in the progression of LAAS.
Collapse
Affiliation(s)
- Lei Du
- Department of Neurology, The First Affiliated Hospital of Xinjiang Medical University, No.137 South Liyushan Road, Urmuqi, 830099, China
| | - Jianhua Ma
- Department of Neurology, The First Affiliated Hospital of Xinjiang Medical University, No.137 South Liyushan Road, Urmuqi, 830099, China
| | - Xiaoning Zhang
- Department of Neurology, The First Affiliated Hospital of Xinjiang Medical University, No.137 South Liyushan Road, Urmuqi, 830099, China.
| |
Collapse
|
29542
|
Fidanzi C, Manzo Margiotta F, Spinelli C, Janowska A, Dini V, Oranges T, Romanelli M, Morganti R, Viacava P, D'Erme AM, Bagnoni G. Risk factors in pediatric melanoma: a retrospective study of 39 cases. Melanoma Res 2021; 31:555-560. [PMID: 34570022 DOI: 10.1097/cmr.0000000000000778] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Pediatric melanoma is a rare form of the tumor whose epidemiology is widely increasing thanks to the improvement of dermoscopic and anatomopathologic diagnostic techniques. Although it is a tumor of considerable interest in adults, little has been described about the pediatric field. The objective of our study was then to identify the possible risk factors for the development of melanoma in the pediatric population. We performed a retrospective study conducted in the Melanoma and Skin Cancer Unit and Unit of Dermatology (Livorno, Italy). We analyzed a population of 38 children under 21 years with a diagnosis of melanoma. This population was compared with a control population of 114 children followed up in our dermatologic clinic. From our combined univariate-multivariate statistics analysis, the number of nevi [regression coefficient (RC) of 1.04 and odds ratio (OR) of 2.8 confidence interval (Cl, 1.2-6.6)], and family history of melanoma [RC of 1.99 and OR of 7.3 (Cl, 2.3-22.7)] emerged as possible risk factors for the development of melanoma. The identification of these elements would allow the physician to carry out a more targeted preliminary assessment of the patient, potentially decisive in cases of diagnostic doubt of the lesion. Our study also lays the foundations for identifying those children who, despite not having received a diagnosis of melanoma on histologic examination, should be considered as patients susceptible to a focused follow-up, because of the presence of the risk factors that emerged from our research.
Collapse
Affiliation(s)
- Cristian Fidanzi
- Unit of Dermatology, Department of Medical and Oncological Area, University of Pisa
| | - Flavia Manzo Margiotta
- Unit of Dermatology, Department of Medical and Oncological Area, University of Pisa
- Institute of Life Sciences, Scuola Superiore Sant'Anna
| | - Claudio Spinelli
- Pediatric, Adolescent and Young Adults Surgery Division, Department of Surgical, Medical, Pathological, Molecular and Critical Area, University of Pisa, Pisa
| | - Agata Janowska
- Unit of Dermatology, Department of Medical and Oncological Area, University of Pisa
| | - Valentina Dini
- Unit of Dermatology, Department of Medical and Oncological Area, University of Pisa
| | - Teresa Oranges
- Unit of Dermatology, Department of Medical and Oncological Area, University of Pisa
- Department of Health Sciences, Anna Meyer Children's University Hospital, University of Florence, Florence
| | - Marco Romanelli
- Unit of Dermatology, Department of Medical and Oncological Area, University of Pisa
| | - Riccardo Morganti
- Statistical Support to Clinical Trials Department, University of Pisa, Pisa
| | - Paolo Viacava
- Clinical Pathology Departmental Area, Services Department, Operative Union Of Pathological Anatomy, Livorno Hospital
| | - Angelo M D'Erme
- Melanoma and Skin Cancer Unit AVNO (Area Vasta Nord Ovest) and Unit of Dermatology, Specialist Surgery Area, Department Of General Surgery, Livorno Hospital, Livorno, Italy
| | - Giovanni Bagnoni
- Melanoma and Skin Cancer Unit AVNO (Area Vasta Nord Ovest) and Unit of Dermatology, Specialist Surgery Area, Department Of General Surgery, Livorno Hospital, Livorno, Italy
| |
Collapse
|
29543
|
Xu SX, Deng WF, Qu YY, Lai WT, Huang TY, Rong H, Xie XH. The integrated understanding of structural and functional connectomes in depression: A multimodal meta-analysis of graph metrics. J Affect Disord 2021; 295:759-770. [PMID: 34517250 DOI: 10.1016/j.jad.2021.08.120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/26/2021] [Accepted: 08/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND From the perspective of information processing, an integrated understanding of the structural and functional connectomes in depression patients is important, a multimodal meta-analysis is required to detect the robust alterations in graph metrics across studies. METHODS Following a systematic search, 952 depression patients and 1447 controls in nine diffusion magnetic resonance imaging (dMRI) and twelve rest state functional MRI (rs-fMRI) studies with high methodological quality met the inclusion criteria and were included in the meta-analysis. RESULTS Regarding the dMRI results, no significant differences of meta-analytic metrics were found; regarding the rs-fMRI results, the modularity and local efficiency were found to be significantly lower in the depression group than in the controls (Hedge's g = -0.330 and -0.349, respectively). CONCLUSION Our findings suggested a lower modularity and network efficiency in the rs-fMRI network in depression patients, indicating that the pathological imbalances in brain connectomes needs further exploration. LIMITATIONS Included number of trials was low and heterogeneity should be noted.
Collapse
Affiliation(s)
- Shu-Xian Xu
- Brain Function and Psychosomatic Medicine Institute, Second People's Hospital of Huizhou, Huizhou, Guangdong, China; Department of Psychiatry, Shenzhen Kangning Hospital and Shenzhen Mental Health Center, Shenzhen, Guangdong, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wen-Feng Deng
- Huizhou Center for Disease Control and Prevention, Huizhou, Guangdong, China
| | - Ying-Ying Qu
- Center of Acute Psychiatry Service, Second People's Hospital of Huizhou, Huizhou, Guangdong, China
| | - Wen-Tao Lai
- Department of Radiology, Shenzhen Kangning Hospital and Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Tan-Yu Huang
- Department of Radiology, Second People's Hospital of Huizhou, Huizhou, Guangdong, China
| | - Han Rong
- Department of Psychiatry, Shenzhen Kangning Hospital and Shenzhen Mental Health Center, Shenzhen, Guangdong, China; Affiliated Shenzhen Clinical College of Psychiatry, Jining Medical University, Jining, Shandong, China
| | - Xin-Hui Xie
- Brain Function and Psychosomatic Medicine Institute, Second People's Hospital of Huizhou, Huizhou, Guangdong, China; Department of Psychiatry, Shenzhen Kangning Hospital and Shenzhen Mental Health Center, Shenzhen, Guangdong, China; Center of Acute Psychiatry Service, Second People's Hospital of Huizhou, Huizhou, Guangdong, China.
| |
Collapse
|
29544
|
Kim AH, Armah G, Dennis F, Wang L, Rodgers R, Droit L, Baldridge MT, Handley SA, Harris VC. Enteric virome negatively affects seroconversion following oral rotavirus vaccination in a longitudinally sampled cohort of Ghanaian infants. Cell Host Microbe 2021; 30:110-123.e5. [PMID: 34932985 PMCID: PMC8763403 DOI: 10.1016/j.chom.2021.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/22/2021] [Accepted: 11/29/2021] [Indexed: 01/04/2023]
Abstract
Rotavirus vaccines (RVVs) have substantially diminished mortality from severe rotavirus (RV) gastroenteritis but are significantly less effective in low- and middle-income countries (LMICs), limiting their life-saving potential. The etiology of RVV’s diminished effectiveness remains incompletely understood, but the enteric microbiota has been implicated in modulating immunity to RVVs. Here, we analyze the enteric microbiota in a longitudinal cohort of 122 Ghanaian infants, evaluated over the course of 3 Rotarix vaccinations between 6 and 15 weeks of age, to assess whether bacterial and viral populations are distinct between non-seroconverted and seroconverted infants. We identify bacterial taxa including Streptococcus and a poorly classified taxon in Enterobacteriaceae as positively correlating with seroconversion. In contrast, both bacteriophage diversity and detection of Enterovirus B and multiple novel cosaviruses are negatively associated with RVV seroconversion. These findings suggest that virome-RVV interference is an underappreciated cause of poor vaccine performance in LMICs. Longitudinal analysis of microbiota of Ghanaian infants receiving rotavirus vaccine Streptococcus and Enterobacteriaceae taxa positively associate with RVV seroconversion Enterovirus B, Cosavirus A, and phage richness negatively associate with RVV serostatus
Collapse
|
29545
|
Cirillo W, Freitas LRC, Kitaka EL, Matos-Souza JR, Silva MR, Coelho OR, Coelho-Filho OR, Sposito AC, Nadruz W. Impact of emergency short-stay unit opening on in-hospital global and cardiology indicators. J Eval Clin Pract 2021; 27:1262-1270. [PMID: 33421284 DOI: 10.1111/jep.13534] [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: 10/27/2020] [Revised: 12/20/2020] [Accepted: 12/23/2020] [Indexed: 11/26/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Emergency short-stay unit (SSU) alleviates emergency department (ED) overcrowding, but may affect in-hospital indicators. Cardiology patients comprise a substantial part of patients admitted at SSU. This study evaluated whether SSU opening differentially modified in-hospital indicators at a whole general hospital and at its cardiology division (CARD). METHODS We retrospectively analysed indicators based on 859 686 ED visits, and 171 547 hospital admissions, including 12 110 CARD admissions, from 2007 to 2018 at a general tertiary hospital, and compared global ED indicators and in-hospital indicators at the hospital and CARD before (2007-2011) and after (2011-2018) SSU opening. RESULTS After SSU opening, monthly ED bed occupancy rate decreased (mean ± SD 200 ± 18% vs 187 ± 22%; P < .001) and in-hospital admissions from ED increased at the hospital (median [interquartile range] 460 [81] vs 524 [41], P < .001) and CARD (50 [12] vs 54 [12], P = .004). In parallel, monthly in-hospital elective admissions decreased at CARD (34 [18] vs 28 [17], P = .019), but not at the hospital (712 [73] vs 700 [104], P = .54). Average length of stay (LOS) increased at both hospital (8.5 ± 0.3 vs 8.7 ± 0.4 days, P < .001) and CARD (9.2 ± 1.5 vs 10.3 ± 2.3 days, P = .002) after SSU opening, but percent admissions at SSU showed a direct relationship with LOS solely at CARD. Furthermore, cardiology patients admitted at SSU had greater LOS, prevalence of coronary heart disease and age than those admitted at the conventional cardiology ward. CONCLUSIONS SSU opening improved ED crowding, but was associated with changes in in-hospital indicators, particularly at CARD, and in the characteristics of hospitalized cardiology patients. These findings suggest that in-hospital cardiology services may need re-evaluation following SSU opening at a general hospital.
Collapse
Affiliation(s)
- Willian Cirillo
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Lidia R C Freitas
- Division of Informatics, Clinics Hospital, State University of Campinas, Campinas, Brazil
| | - Edson L Kitaka
- Division of Informatics, Clinics Hospital, State University of Campinas, Campinas, Brazil
| | - José R Matos-Souza
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Marcos R Silva
- Emergency Division, Clinics Hospital, State University of Campinas, Campinas, Brazil
| | - Otávio R Coelho
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Otávio R Coelho-Filho
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Andrei C Sposito
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Wilson Nadruz
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| |
Collapse
|
29546
|
Frank P, Jokela M, Batty GD, Cadar D, Steptoe A, Kivimäki M. Association Between Systemic Inflammation and Individual Symptoms of Depression: A Pooled Analysis of 15 Population-Based Cohort Studies. Am J Psychiatry 2021; 178:1107-1118. [PMID: 34645276 DOI: 10.1176/appi.ajp.2021.20121776] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [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: 11/30/2022]
Abstract
OBJECTIVE Evidence from anti-inflammatory drug trials for the treatment of depression has been inconsistent. This may be ascribed to the differing symptom-specific effects of inflammation. Accordingly, the authors explored the associations between systemic inflammation and an array of individual symptoms of depression across multiple studies. METHODS This random-effects pooled analysis included 15 population-based cohorts and 56,351 individuals age 18 years and older. Serum or plasma concentrations of C-reactive protein (CRP) and interleukin-6 (IL-6) were measured at baseline. Using validated self-report measures, 24 depressive symptoms were ascertained in 15 cross-sectional studies, and, in seven cohorts, were also assessed at follow-up (mean follow-up period, 3.2 years). RESULTS The prevalence of depressive symptoms ranged from 1.1% (suicidal ideation) to 21.5% (sleep problems). In cross-sectional analyses, higher concentrations of CRP were robustly associated with an increased risk of experiencing four physical symptoms (changes in appetite, felt everything was an effort, loss of energy, sleep problems) and one cognitive symptom (little interest in doing things). These associations remained after adjustment for sociodemographic variables, behavioral factors, and chronic conditions; in sex- and age-stratified analyses; in longitudinal analyses; when using IL-6 as the inflammatory marker of interest; in depressed individuals; and after excluding chronically ill individuals. For four exclusively emotional symptoms (bothered by things, hopelessness about the future, felt fearful, life had been a failure), the overall evidence was strongly against an association with inflammation. CONCLUSIONS These findings suggest symptom-specific rather than generalized effects of systemic inflammation on depression. Future trials exploring anti-inflammatory treatment regimens for depression may benefit from targeting individuals presenting with symptom profiles characterized by distinct inflammation-related physical and cognitive symptoms.
Collapse
Affiliation(s)
- Philipp Frank
- Research Department of Epidemiology and Public Health (Frank, Batty, Kivimäki) and Research Department of Behavioural Science and Health (Frank, Cadar, Steptoe), University College London; Department of Psychology and Logopedics (Jokela) and Clinicum Unit (Kivimäki), Faculty of Medicine, University of Helsinki, Helsinki
| | - Markus Jokela
- Research Department of Epidemiology and Public Health (Frank, Batty, Kivimäki) and Research Department of Behavioural Science and Health (Frank, Cadar, Steptoe), University College London; Department of Psychology and Logopedics (Jokela) and Clinicum Unit (Kivimäki), Faculty of Medicine, University of Helsinki, Helsinki
| | - G David Batty
- Research Department of Epidemiology and Public Health (Frank, Batty, Kivimäki) and Research Department of Behavioural Science and Health (Frank, Cadar, Steptoe), University College London; Department of Psychology and Logopedics (Jokela) and Clinicum Unit (Kivimäki), Faculty of Medicine, University of Helsinki, Helsinki
| | - Dorina Cadar
- Research Department of Epidemiology and Public Health (Frank, Batty, Kivimäki) and Research Department of Behavioural Science and Health (Frank, Cadar, Steptoe), University College London; Department of Psychology and Logopedics (Jokela) and Clinicum Unit (Kivimäki), Faculty of Medicine, University of Helsinki, Helsinki
| | - Andrew Steptoe
- Research Department of Epidemiology and Public Health (Frank, Batty, Kivimäki) and Research Department of Behavioural Science and Health (Frank, Cadar, Steptoe), University College London; Department of Psychology and Logopedics (Jokela) and Clinicum Unit (Kivimäki), Faculty of Medicine, University of Helsinki, Helsinki
| | - Mika Kivimäki
- Research Department of Epidemiology and Public Health (Frank, Batty, Kivimäki) and Research Department of Behavioural Science and Health (Frank, Cadar, Steptoe), University College London; Department of Psychology and Logopedics (Jokela) and Clinicum Unit (Kivimäki), Faculty of Medicine, University of Helsinki, Helsinki
| |
Collapse
|
29547
|
Zhuang Z, Gao M, Lv J, Yu C, Guo Y, Bian Z, Yang L, Du H, Chen Y, Ning F, Liu H, Chen J, Chen Z, Huang T, Li L. Associations of toothbrushing behaviour with risks of vascular and nonvascular diseases in Chinese adults. Eur J Clin Invest 2021; 51:e13634. [PMID: 34152010 DOI: 10.1111/eci.13634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/28/2022]
Abstract
Accumulating evidence has shown that poor oral hygiene is associated with increased risk of cardiometabolic diseases in Western populations. However, its relevance about the relationships in Chinese adults remains unclear. The China Kadoorie Biobank enrolled 512 715 adults aged 30-79 years in China during 2004-2008. Cox regression was used to estimate adjusted hazard ratios (HRs) for each disease associated with measures of oral hygiene. Overall 9.3% of the participants reported rarely or never brushing teeth at baseline. Participants who rarely or never brushed teeth had adjusted HR of 1.12 (95% CI: 1.09, 1.15) for MVE, with similar HRs for stroke (1.08, 1.05-1.12), intracerebral haemorrhage (1.18, 1.11-1.26) and pulmonary heart disease (1.22, 1.13-1.32) compared with those who brushed teeth regularly. Those who did not brush teeth also had increased risk of cancer (1.09, 1.04-1.14), chronic obstructive pulmonary disease (COPD) (1.12, 1.05-1.20), liver cirrhosis (1.25, 1.09-1.44) and all-cause death (1.25, 1.21-1.28) but not type 2 diabetes (0.94, 0.86-1.03) and chronic kidney disease (0.98, 0.81-1.18). Among Chinese adults, we found that poor oral hygiene is associated with higher risks of major vascular disease, cancer, COPD, liver cirrhosis and all-cause deaths, but not type 2 diabetes and chronic kidney disease.
Collapse
Affiliation(s)
- Zhenhuang Zhuang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Meng Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
- Peking University Institute of Environmental Medicine, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Nuffield Department of Population Health, Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Nuffield Department of Population Health, Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Nuffield Department of Population Health, Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Feng Ning
- NCDs Prevention and Control Department, Qingdao CDC, Qingdao, China
| | - Huilin Liu
- NCDs Prevention and Control Department, Hunan CDC, Hunan, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Nuffield Department of Population Health, Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Tao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| |
Collapse
|
29548
|
Heine M, Lategan F, Erasmus M, Lombaard CM, Mc Carthy N, Olivier J, van Niekerk M, Hanekom S. Health education interventions to promote health literacy in adults with selected non-communicable diseases living in low-to-middle income countries: A systematic review and meta-analysis. J Eval Clin Pract 2021; 27:1417-1428. [PMID: 33749092 DOI: 10.1111/jep.13554] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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: 12/24/2020] [Revised: 02/15/2021] [Accepted: 02/21/2021] [Indexed: 12/17/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Health illiteracy is an important contributor to the burden of non-communicable diseases (NCDs); in particular in settings where health illiteracy is part of a perpetuating system of risk factors. Interventions that promote health literacy may provide an important tool in the primary and secondary prevention of NCDs. The objective of this systematic review was to evaluate the effectiveness of health literacy interventions on health literacy in the management of patients with selected NCDs living in low-to-middle income countries (LMIC). METHODS Seven electronic databases were searched (October 29, 2020) for RCTs aimed at improving health literacy in adults with NCDs in LMICs. Eligible NCDs included those pertaining to cancer, cardiovascular disease (CVD), chronic respiratory disease (CRD) or Diabetes. Studies were included that explicitly focussed on improving health literacy, and reported comprehensive measures of health literacy, or components thereof (ie, knowledge, attitude or behaviour). Random-effect meta-analyses were conducted for continuous outcome measures (Hedges-g). RESULTS The completed search yielded 2573 unique results of which 53 unique studies met the inclusion criteria. Studies included patients with cancer (n = 1, 2%), CRD (n = 8, 15%), CVD (n = 11, 21%) or Diabetes (n = 33, 62%). A significant (P < .01) summary effect was found for disease knowledge (SES = 1.27 [n = 23, 95%CI = 1.05-1.49]), attitude (SES = 1.17 [n = 20, 95%CI = 0.88-1.47]), and behaviour (SES = 1.20 [n = 31, 95%CI = 0.94-1.46]). CONCLUSIONS These results support the conclusion that there is compelling evidence, in particular, for patients with Diabetes, that health-literacy interventions are effective in promoting disease knowledge, attitude and behaviour across four chronic conditions that drive the burden of NCDs.
Collapse
Affiliation(s)
- Martin Heine
- Institute of Sport and Exercise Medicine, Division of Orthopaedics, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Frandene Lategan
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Misha Erasmus
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Chris-Mari Lombaard
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nina Mc Carthy
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jeandri Olivier
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Marnus van Niekerk
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Susan Hanekom
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| |
Collapse
|
29549
|
McGarrigle CA, Ward M, Kenny RA. Negative aging perceptions and cognitive and functional decline: Are you as old as you feel? J Am Geriatr Soc 2021; 70:777-788. [PMID: 34850967 DOI: 10.1111/jgs.17561] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Research has shown the associations between negative aging perceptions and cognitive and physical decline may be mediated through behavioral and psychological pathways, but they are rarely examined simultaneously. We aimed at assessing the difference in the probability of following a high-, mid-, or low-performing cognitive trajectory, and a high- or low-performing physical function trajectory by negative aging perceptions. We sought to test two competing pathway mechanisms for the associations. METHODS This longitudinal study used data from the Irish Longitudinal Study on Ageing (TILDA), a nationally representative study of community-dwelling adults in Ireland. Adults aged ≥50 years who participated in two or more waves of TILDA (n = 6121) were included. An analysis of the population aged 65 years and above was also conducted (n = 2359). We identified latent class trajectories of Mini-Mental State Examination (MMSE), Instrumental Activities of Daily Living (IADL), ADL, and Timed-Up-and-Go (TUG) performance using Latent Growth Class Analysis (LGCA) on data collected every 2 years over 5 waves. Multinomial logistic regression was used to estimate the likelihood of membership to each trajectory class by negative aging perceptions (APQ). Finally, we tested possible behavioral, psychological, and social mechanisms. RESULTS LCGA identified three trajectory classes in cognitive and two in each physical function measure. People with the highest tertile of negative APQ were more likely to be in the declining MMSE class and the increasing IADL, ADL, and TUG classes. These associations for cognitive function were partially mediated by psychosocial pathways and for physical function were fully mediated by both psychosocial and health behavior pathways. CONCLUSIONS Negative aging perceptions were associated with cognitive and physical function declines. Poor self-rated health, depressive symptoms, loneliness, and low exercise seem to explain the relationships; however, the possibility of reverse causation remains.
Collapse
Affiliation(s)
| | - Mark Ward
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland.,Mercer's Institute for Successful Ageing, St James' Hospital, Dublin, Ireland
| |
Collapse
|
29550
|
Teoh SP, Bustamam RS, Mustapha FI, Yip CH, Saad M, Somasundaram S, Megat Ramli PN, Nik Farid ND, Bhoo-Pathy N. Proposal for development of a guideline in maintaining quality cancer care during and post-covid-19 in an upper middle-income country with universal health coverage. J Cancer Policy 2021; 30:100300. [PMID: 35559796 PMCID: PMC8378062 DOI: 10.1016/j.jcpo.2021.100300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/27/2021] [Accepted: 08/16/2021] [Indexed: 11/26/2022]
Abstract
Background During periods of high community transmission of COVID-19, the public hospitals in Malaysia, an upper middle-income country, have been forced to scale down elective surgeries, prioritize cancer treatments based on treatment benefits, and postpone non-emergency imaging procedures. These inevitably led to disruptions in cancer care delivery within the public health care system. This study aims to explore the facilitators and barriers faced by healthcare providers and cancer survivors in cancer care, and to co-design a guideline to maintain the delivery of cancer care amid the disaster situations. Method In-depth interviews (IDIs) will be conducted with Malaysian healthcare providers and cancer survivors and findings will be analysed thematically. The insights will be used in a subsequent phase to co-design a guideline to maintain the delivery of quality cancer care in Malaysia via a three-round modified Delphi survey with a broad range of cancer stakeholders. Expected results Findings derived from IDIs and existing literature will be included for rating across three rounds by the expert panel. Feedback provided will be refined until consensus on the best practises for cancer care continuity during crises is achieved. Conclusion The output of the present study is not only expected to ensure the continuity of delivery of high-quality cancer care in Malaysia during the ongoing pandemic but also to be adapted during unforeseen crises in the near future. Policy summary statement Collaborative work between policy makers, public health physicians, members of the multidisciplinary oncology team as well as cancer survivors is vital in developing an evidenced- based contingency plan for maintaining access to cancer care.
Collapse
|