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Elendu C, Amaechi DC, Elendu TC, Jingwa KA, Okoye OK, Fiemotonghan BE, Chirinos GA, Agada D, John Okah M, Adebayo OD, Dang K, Egbunu E, Alabi OS, Nasre VS, Yadav CP, Badru MD. Relationship between stress and coronary artery disease: A comprehensive review. Medicine (Baltimore) 2024; 103:e37066. [PMID: 38306543 PMCID: PMC10843306 DOI: 10.1097/md.0000000000037066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/04/2024] [Indexed: 02/04/2024] Open
Abstract
Coronary artery disease (CAD) poses a substantial public health challenge. This review examines the intricate relationship between psychological stress and CAD, drawing from recent research spanning the last 5 to 10 years. The literature review is organized around critical themes. It includes an analysis of genetic loci in CAD susceptibility and underscores the role of green environments in reducing cardiovascular risk. A quantitative analysis presents numerical findings for clarity, while pathophysiological mechanisms are elucidated through informative figures and diagrams. The review engages with controversies and disparities in the literature, offering a balanced perspective. A tabular comparative analysis outlines the strengths and limitations of existing approaches, emphasizing conflicting findings, and environmental factors. The review concludes by distilling key takeaways for healthcare professionals and researchers. Practical implications are explored, and lessons learned from the research process are reflected upon. The conclusion also suggests avenues for further study in understanding stress's impact on CAD.
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Affiliation(s)
| | | | | | | | - Osinachi K. Okoye
- Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria
| | | | | | | | | | | | - Kanishk Dang
- Nicolae Testemițanu State University of Medicine and Pharmacy, Chişinău, Republic of Moldova
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Mesitskaya DF, Fashafsha ZZ, Poltavskaya MG, Andreev DA, Levshina AR, Sultygova EA, Gognieva D, Chomakhidze P, Kuznetsova N, Suvorov A, Marina I. S, Poddubskaya E, Novikova A, Bykova A, Kopylov P. A single-lead ECG based cardiotoxicity detection in patients on polychemotherapy. IJC HEART & VASCULATURE 2024; 50:101336. [PMID: 38304727 PMCID: PMC10831811 DOI: 10.1016/j.ijcha.2024.101336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/04/2023] [Accepted: 01/04/2024] [Indexed: 02/03/2024]
Abstract
Background Anti-cancer treatment can be fraught with cardiovascular complications, which is the most common cause of death among oncological survivors. Without appropriate cardiomonitoring during anti-cancer treatment, it becomes challenging to detect early signs of cardiovascular complications. In order to achieve higher survival rates, it is necessary to monitor oncological patients outpatiently after anti-cancer treatment administration. In this regard, we aim to evaluate the efficacy of single-lead ECG remote monitoring to detect cardiotoxicity in cancer patients with minimal cardiovascular diseases after the first cycle of polychemotherapy. Materials and methods The study included patients 162 patients over 18 years old with first diagnosed different types of solid tumors, planed for adjuvant (within 8 weeks after surgery) or neoadjuvant polychemotherapy. All patients were monitored, outpatiently, during 14-21 days (depending on the regimen of polychemotherapy) after polychemotherapy administration using single-lead ECG. Results QTc > 500 mc prolongation was detected in 8 patients (6.6 %), first-diagnosed arial fibrillation was detected in 11 patients (9 %) in period after chemotherapy administration. Moreover, left ventricular diastolic dysfunction using single-lead ECG after polychemotherapy was detected in 49 (40.1 %) patients with sensitivity 80 %, specificity 95 %, AUC 0.88 (95 % CI, 0.82-0.93). Conclusions The side effects of cancer treatment may cause life-threatening risks. Early identification of cardiotoxicity plays a vital role in the solution of this problem. Using portable devices to detect early cardiotoxicity is a simple, convenient and affordable screening method, that can be used for promptly observation of patients.
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Affiliation(s)
- Dinara F. Mesitskaya
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Zaki Z.A. Fashafsha
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
| | - Maria G. Poltavskaya
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Denis A. Andreev
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anna R. Levshina
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Elizaveta A. Sultygova
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
| | - Daria Gognieva
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Petr Chomakhidze
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Natalia Kuznetsova
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
| | - Alexander Suvorov
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
| | - Sekacheva Marina I.
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Personalized Oncology, Center "Digital Biodesign and Personalized Healthcare" I.M. Sechenov First Moscow State Medical University Moscow, Russia Moscow, Russia
| | - Elena Poddubskaya
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Alena Novikova
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Aleksandra Bykova
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Philipp Kopylov
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Changjie G, Xusheng Z, Hui D, Jianwen L, Ming L. Application of creatinine-based eGFR equations in Chinese septuagenarians and octogenarians. Int Urol Nephrol 2024; 56:719-730. [PMID: 37542000 DOI: 10.1007/s11255-023-03714-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/16/2023] [Indexed: 08/06/2023]
Abstract
PURPOSE The utilization of creatinine-based estimated glomerular filtration rate (eGFR) equations in the adult population is acknowledged. Nevertheless, the appropriateness of creatinine-based eGFR in septuagenarians and octogenarians is debatable. This study evaluates the creatinine-based equations in Chinese septuagenarians and octogenarians cohorts. PATIENTS AND METHODS This study employed a retrospective design, utilizing a review of the hospital medical records system to identify 347 hospitalized participants within the Division of Geriatrics or the Division of Nephrology. These participants underwent renal dynamic imaging with 99 m Tc-DTPA and serum creatinine testing. Comparison of the equations was performed, including the full age-spectrum equation (FAS-Cr equation), European Kidney Function Consortium equation (EKFC equation), Chronic Kidney Disease Epidemiology Collaboration equation for Asian (Asian CKD-EPI equation), Xiangya equation, and Lund-Malmö revised equation (LMR equation). RESULTS Most equations tended to underestimate GFR. The FAS-Cr equation had the smallest interquartile range (IQR), while the Asian CKD-EPI equation (mGFR ≥ 30) and Xiangya equation (mGFR < 30) had the biggest IQRs. The FAS-Cr equation had the highest overall P30 of 63.98%, while the Asian CKD-EPI equation had the highest P30 of 75.64% in mGFR ≥ 60. The Xiangya equation, on the other hand, reported the lowest P30 of 36.36% in mGFR < 30. We discovered similar patterns in root-mean-square error (RMSE) as P30. GFR category misclassification rates in the entire cohort ranged from 46.11 to 49.86% for all equations. The FAS-Cr equation exhibited an advantage in octogenarians over other equations in the GFR category misclassification with mGFR lower than 60 ml/min/1.73 m2. CONCLUSION None of the creatinine-based equations in this study could perform well regarding precision, accuracy, and CKD stages' classification for the Chinese elderly. Nevertheless, the FAS-Cr equation should be suitable for octogenarians with mGFR lower than 60 ml/min/1.73 m2.
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Affiliation(s)
- Guan Changjie
- Department of Nephrology, Guangzhou First People's Hospital, South China University of Technology, No. 1 Panfu Road, Yuexiu District, Guangzhou, 510180, China
| | - Zhu Xusheng
- Department of Nuclear Medicine, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, 510180, China
| | - Dai Hui
- Department of Clinical Laboratory Medicine, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, 510180, China
| | - Li Jianwen
- Department of Nephrology, Guangzhou First People's Hospital, South China University of Technology, No. 1 Panfu Road, Yuexiu District, Guangzhou, 510180, China
| | - Liang Ming
- Department of Nephrology, Guangzhou First People's Hospital, South China University of Technology, No. 1 Panfu Road, Yuexiu District, Guangzhou, 510180, China.
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Zhu X, Xie B, Chen Y, Zeng H, Hu J. Machine learning in the prediction of in-hospital mortality in patients with first acute myocardial infarction. Clin Chim Acta 2024; 554:117776. [PMID: 38216028 DOI: 10.1016/j.cca.2024.117776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 01/14/2024]
Abstract
BACKGROUND Persistent efforts are required to further reduce the in-hospital mortality of patients suffering from acute myocardial infarction (AMI), even in the face of a global trend of declining AMI-related fatalities. We investigated deep machine learning models for in-hospital death prediction in patients on their first AMI. METHOD In this 2-center retrospective analysis, first AMI patients from Hospital I and Hospital II were included; 4783 patients from Hospital 1 were split in a 7:3 ratio between the training and testing sets. Data from 1053 AMI patients in Hospital II was used for further validation. 70 clinical information and laboratory examination parameters as predictive indicators were included. Logistic Regression Classifier (LR), Random Forests Classifier (RF), eXtreme Gradient Boosting (XGB), Support Vector Machine Classifier (SVM), Multilayer Perceptron (MLP), Gradient Boosting Machine (GBM), Bootstrapped Aggregation (Bagging) models with AMI patients were developed. The importance of selected variables was obtained through the Shapley Additive exPlanations (SHAP) method. The performance of each model was shown using the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (Average Precision; AP). RESULT The in-hospital mortality for AMI in the training, testing, and validation sets were 5.7 %, 5.6 %, and 6.0 %, respectively. The top 8 predictors were D-dimer, brain natriuretic peptide, cardiogenic shock, neutrophil, prothrombin time, blood urea nitrogen, cardiac arrest, and phosphorus. In the testing cohort, the models of LR, RF, XGB, SVM, MLP, GBM, and Bagging yielded AUROC values of 0.929, 0.931, 0.907, 0.868, 0.907, 0.923, and 0.932, respectively. Bagging has good predictive value and certain clinical value in external validation with AUROC 0.893. CONCLUSION In order to improve the forecasting accuracy of the risk of AMI patients, guide clinical nursing practice, and lower AMI inpatient mortality, this study looked into significant indicators and the optimal models for predicting AMI inpatient mortality.
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Affiliation(s)
- Xiaoli Zhu
- Department of Laboratory Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, People's Republic of China
| | - Bojian Xie
- Department of Oncological Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, People's Republic of China
| | - Yijun Chen
- Department of Laboratory Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, People's Republic of China
| | - Hanqian Zeng
- Department of Oncological Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, People's Republic of China
| | - Jinxi Hu
- Department of Oncological Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, People's Republic of China.
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Luo Q, Steinberg J, Kahn C, Caruana M, Grogan PB, Page A, Ivers R, Banks E, O'Connell DL, Canfell K. Trends and projections of cause-specific premature mortality in Australia to 2044: a statistical modelling study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 43:100987. [PMID: 38456088 PMCID: PMC10920049 DOI: 10.1016/j.lanwpc.2023.100987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 10/27/2023] [Accepted: 11/28/2023] [Indexed: 03/09/2024]
Abstract
Background Long-term projections of premature mortality (defined as deaths age <75 years) help to inform decisions about public health priorities. This study aimed to project premature mortality rates in Australia to 2044, and to estimate numbers of deaths and potential years of life lost (PYLL) due to premature mortality overall and for 59 causes. Methods We examined the past trends in premature mortality rates using Australian mortality data by sex, 5-year age group and 5-year calendar period up to 2019. Cigarette smoking exposure data (1945-2019) were included to project lung cancer mortality. Age-period-cohort or generalised linear models were developed and validated for each cause to project premature mortality rates to 2044. Findings Over the 25-year period from 1990-1994 to 2015-2019, there was a 44.4% decrease in the overall age-standardised premature mortality rate. This decline is expected to continue, from 162.4 deaths/100,000 population in 2015-2019 to 141.7/100,000 in 2040-2044 (12.7% decrease). Despite declining rates, total numbers of premature deaths are projected to increase by 22.8%, rising from 272,815 deaths in 2015-2019 to 334,894 deaths in 2040-2044. This is expected to result in 1.58 million premature deaths over the 25-year period 2020-2044, accounting for 24.5 million PYLL. Of the high-level cause categories, cancer is projected to remain the most common cause of premature death in Australia by 2044, followed by cardiovascular disease, external causes (including injury, poisoning, and suicide), and respiratory diseases. Interpretation Despite continuously declining overall premature mortality rates, the total number of premature deaths in Australia is projected to remain substantial, and cancer will continue to be the leading cause. These projections can inform the targeting of public health efforts and can serve as benchmarks against which to measure the impact of future interventions. They emphasise the ongoing importance of accelerating the prevention, early detection, and treatment of key health conditions. Funding No funding was provided for this study.
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Affiliation(s)
- Qingwei Luo
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Clare Kahn
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Michael Caruana
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Paul B. Grogan
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Rebecca Ivers
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Dianne L. O'Connell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
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Prendes CF, Rantner B, Hamwi T, Stana J, Feigin VL, Stavroulakis K, Tsilimparis N. Burden of Stroke in Europe: An Analysis of the Global Burden of Disease Study Findings From 2010 to 2019. Stroke 2024; 55:432-442. [PMID: 38252754 DOI: 10.1161/strokeaha.122.042022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 09/21/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND While most European Regions perform well in global comparisons, large discrepancies within stroke epidemiological parameters exist across Europe. The objective of this analysis was to evaluate the stroke burden across European regions and countries in 2019 and its difference to 2010. METHODS The GBD 2019 analytical tools were used to evaluate regional and country-specific estimates of incidence, prevalence, deaths, and disability-adjusted life years of stroke for the European Region as defined by the World Health Organization, with its 53 member countries (EU-53) and for European Union as defined in 2019, with its 28 member countries (EU-28), between 2010 and 2019. Results were analyzed at a regional, subregional, and country level. RESULTS In EU-53, the absolute number of incident and prevalent strokes increased by 2% (uncertainty interval [UI], 0%-4%), from 1 767 280 to 1 802 559 new cases, and by 4% (UI, 3%-5%) between 2010 and 2019, respectively. In EU-28, the absolute number of prevalent strokes and stroke-related deaths increased by 4% (UI, 2%-5%) and by 6% (UI, 1%-10%), respectively. All-stroke age-standardized mortality rates, however, decreased by 18% (UI, -22% to -14%), from 82 to 67 per 100 000 people in the EU-53, and by 15% (UI, -18% to -11%), from 49.3 to 42.0 per 100 000 people in EU-28. Despite most countries presenting reductions in age-adjusted incidence, prevalence, mortality, and disability-adjusted life year rates, these rates remained 1.4×, 1.2×, 1.6×, and 1.7× higher in EU-53 in comparison to the EU-28. CONCLUSIONS EU-53 showed a 2% increase in incident strokes, while they remained stable in EU-28. Age-standardized rates were consistently lower for all-stroke burden parameters in EU-28 in comparison to EU-53, and huge discrepancies in incidence, prevalence, mortality, and disability-adjusted life-year rates were observed between individual countries.
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Affiliation(s)
- Carlota F Prendes
- Department of Vascular Surgery, Ludwig Maximilians University, Munich, Germany (C.F.P., B.R., T.H., J.S., K.S., N.T.)
| | - Barbara Rantner
- Department of Vascular Surgery, Ludwig Maximilians University, Munich, Germany (C.F.P., B.R., T.H., J.S., K.S., N.T.)
| | - Tarek Hamwi
- Department of Vascular Surgery, Ludwig Maximilians University, Munich, Germany (C.F.P., B.R., T.H., J.S., K.S., N.T.)
| | - Jan Stana
- Department of Vascular Surgery, Ludwig Maximilians University, Munich, Germany (C.F.P., B.R., T.H., J.S., K.S., N.T.)
| | - Valery L Feigin
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, New Zealand (V.L.F.)
- Institute for Health Metrics and Evaluation, University of Washington, Seattle (V.L.F.)
- Research Center of Neurology, Moscow, Russia (V.L.F.)
| | - Konstantinos Stavroulakis
- Department of Vascular Surgery, Ludwig Maximilians University, Munich, Germany (C.F.P., B.R., T.H., J.S., K.S., N.T.)
| | - Nikolaos Tsilimparis
- Department of Vascular Surgery, Ludwig Maximilians University, Munich, Germany (C.F.P., B.R., T.H., J.S., K.S., N.T.)
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Qu X, Song X, Da L, Zhang C, Zhang Y, Sun Y, Qiao Z, Ha L, Li L, Hu R. Predictors of Outcome After Traumatic Brain Injury: Experience at a Tertiary Healthcare Facility in Inner Mongolia, China. World Neurosurg 2024; 182:e478-e485. [PMID: 38048962 DOI: 10.1016/j.wneu.2023.11.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/24/2023] [Accepted: 11/25/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Traumatic brain injury (TBI) is 1 of the leading causes of death in all age groups globally. Understanding TBI causative factors and early interventions that may result in poor outcomes plays an important role in decreasing the mortality and disability associated with TBI. METHODS In this retrospective case-control study, we collected electronic case data from patients with TBI who visited our hospital between 2018 and 2022. We collected patient information from accident to discharge, and by using linear regression predicted factors influencing death from TBI. RESULTS A total of 957 patients with a mean age of 56.4 ± 17.0 years and a Glasgow Coma Scale score of 12 ± 3.7 on admission were included in the study. Of the total, 54 patients died in the hospital. Multifactorial logistic regression showed that the Glasgow Coma Scale scores, degree of injury on admission, surgical treatment, and brainstem hemorrhage all had a significant effect on the survival status of the patients at discharge. CONCLUSIONS Understanding the causes, patterns, and distribution of people with TBI in this study will benefit our country and others to develop policies, research, health management, and rehabilitation tools at the national level.
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Affiliation(s)
- XingBo Qu
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - XiaoMing Song
- Department of Mathematics, School of Mathematical Sciences, Inner Mongolia University, Hohhot, China
| | - Lin Da
- Department of Mathematics, School of Mathematical Sciences, Inner Mongolia University, Hohhot, China
| | - ChunYu Zhang
- Department of Neurology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Yan Zhang
- Department of Rehabilitation Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - YanDong Sun
- Department of Rehabilitation Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - ZhuoJun Qiao
- Department of Rehabilitation Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - LiYa Ha
- Department of Rehabilitation Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - LanJun Li
- Department of Rehabilitation Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Riletemuer Hu
- Department of Rehabilitation Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
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Wang C, Chen H, Su H, Sheng Q, Lang Y, Yu Q, Lv Z, Wang R. The role and mechanism of RIPK1 in vascular endothelial dysfunction in chronic kidney disease. FASEB J 2024; 38:e23446. [PMID: 38275125 DOI: 10.1096/fj.202301916rr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/28/2023] [Accepted: 01/10/2024] [Indexed: 01/27/2024]
Abstract
Endothelial dysfunction is common in patients with chronic kidney disease (CKD) and cardiovascular events, but the mechanism is unclear. In our study, we found elevated levels of RIPK1 in patients with CKD and cardiovascular events through bioinformation analysis. Elevated RIPK1 levels were found in serum samples of CKD patients and were associated with vascular endothelial dysfunction and renal function. We constructed the five of six nephrectomy of CKD mice model, finding that RIPK1 expressions were elevated in abdominal aorta endothelial cells. After RIPK1 inhibition and overexpression, it was found that RIPK1 could regulate the expression of endothelial nitric oxide synthase (eNOS) and cell adhesion molecule 1 (ICAM-1), and activation of inflammatory responses and endoplasmic reticulum (ER) stress. In addition, uremic toxin induced abnormal expression of RIPK1 in vitro. We observed RIPK1-mediating endothelial dysfunction and inflammation responses by ER stress pathways through gain and loss of function. In order to explore the specific mechanism, we conducted co-immunoprecipitation and expression regulation of RIPK1 and IKK, finding that RIPK1 formed complex with IKK and regulated IKK expression. In conclusion, we demonstrated that RIPK1 levels were closely associated with vascular endothelial dysfunction in patients with CKD. With uremic toxins, RIPK1 expression was elevated, which led to the activation of inflammation through the ER stress pathway, resulting in vascular endothelial injury. Besides, activation of RIPK1-IKK-NF-κB axis was a key driver of endothelial dysfunction in CKD. Our study provides a new perspective for the study of cardiovascular events in CKD.
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Affiliation(s)
- Cheng Wang
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Huimin Chen
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Hong Su
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Nephrology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Qinghao Sheng
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yating Lang
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Qun Yu
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Zhimei Lv
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Nephrology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Rong Wang
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Nephrology, Shandong Provincial Hospital, Shandong University, Jinan, China
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Niazi E, Dumanski SM. Change of HeART: Cardiovascular Implications of Assisted Reproductive Technology. CJC Open 2024; 6:142-152. [PMID: 38487072 PMCID: PMC10935705 DOI: 10.1016/j.cjco.2023.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/10/2023] [Indexed: 03/17/2024] Open
Abstract
Cardiovascular (CV) disease is the leading cause of death in women, and it may manifest differently than in men, in part related to sex-specific CV risk factors. In females, assisted reproductive technologies (ARTs) are commonly used to treat infertility, and they utilize controlled ovarian stimulation involving the administration of exogenous sex hormones. ARTs, and especially controlled ovarian stimulation, have been associated with an increased pregnancy and short-term CV risk, although the long-term CV implications of these treatments in individuals treated with ARTs and their offspring remain unclear. This review endeavors to provide a comprehensive examination of what is known about the relationship between ART and CV outcomes for females treated with ARTs, as well as their offspring, and recommendations for future research. Novel insights into female-specific CV risk factors are critical to reduce the disproportionate burden of CV disease in Canadian women. ART has revolutionized reproductive medicine, offering hope to millions of individuals with infertility worldwide, and a further understanding of the CV implications of this important sex-specific CV risk factor is warranted urgently.
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Affiliation(s)
- Elaha Niazi
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute, Calgary, Alberta, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Sandra M. Dumanski
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute, Calgary, Alberta, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
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Dai Q, Guo Y, Dong X, Gao Y, Li S, Zhao J, Xu Y, Liu K. The role of leptin in ischemic stroke and its subtypes: A Mendelian randomization study. Nutr Metab Cardiovasc Dis 2024; 34:360-368. [PMID: 37949710 DOI: 10.1016/j.numecd.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/18/2023] [Accepted: 09/01/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND AND AIMS Observational studies have suggested a relationship between leptin and risk of stroke. However, evidence for the association remains inconsistent, and whether the association reflects a causal relationship remains to be established. To clarify this relationship, we adopted a two-sample Mendelian randomization (MR) analysis to investigate whether leptin plays a causal role in the risk of stroke and its subtypes. METHODS AND RESULTS Five independent single-nucleotide polymorphisms (SNPs) associated with the leptin level from genome-wide association studies (GWASs) of European individuals were selected. We performed an MR analysis using the inverse-variance-weighted (IVW) as primary method to examine the causal effects of leptin on ischemic stroke (IS). Moreover, MR-Egger intercept and Cochran's Q statistic were also performed to detect the pleiotropy or heterogeneity of our MR results. Genetically predicted circulating leptin level was not associated with ischemic stroke [odds ratio (OR): 1.48, 95% confidence interval (CI): 0.78-2.8, P = 0.22], large artery stroke (OR: 1.44, 95% CI: 0.39-5.25, P = 0.57), cardioembolic stroke (OR:1.33, 95% CI: 0.55-3.22, P = 0.52), and small vessel stroke (OR: 1.48, 95% CI: 0.39-5.63, P = 0.56) using the IVW method. Likewise, there is no convincing evidence for the associations between leptin levels and cardiovascular diseases (CVD) risk factors. CONCLUSIONS This study did not provide evidence that leptin levels are associated with increased risk of stroke and its subtypes.
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Affiliation(s)
- Qinqin Dai
- Nursing School of Zhengzhou University, Zhengzhou, Henan Province, China; The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yuanli Guo
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China; Nursing School of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xiaofang Dong
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China; Nursing School of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yuan Gao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China; Nursing School of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Shen Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Jiawei Zhao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yuming Xu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
| | - Kai Liu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China; Nursing School of Zhengzhou University, Zhengzhou, Henan Province, China.
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261
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Rostami A, Elyassirad D, Vatanparast M, Abouei Mehrizi MA, Hasanpour M, Rezaee H, Haghir A, Keykhosravi E. Functional Outcome and Mortality Predictors in Patients with Cerebral Ischemic Infarction After Decompressive Craniectomy: Cross-Sectional Study. World Neurosurg 2024; 182:e847-e853. [PMID: 38101538 DOI: 10.1016/j.wneu.2023.12.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 12/09/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE Surgeons commonly perform Decompressive craniectomy (DC) to manage patients with cerebral ischemic infarction. However, there are conflicting data on the long-term functional outcomes following DC. Therefore, this study aims to determine the functional outcome of patients with cerebral ischemic infarction after DC. METHODS This prospective and retrospective cross-sectional study included 148 patients with cerebral ischemic infarction who underwent DC at Ghaem Hospital, Mashhad, Iran, from March 2011 to March 2021. The Modified Rankin Scale (mRS) assesses disability in these patients and determines the recovery and degree of long-term functional outcomes. Demographic and clinical data were extracted and recorded in a researcher-made questionnaire. RESULTS In summary, the follow-up revealed a survival rate of 39.2% among patients with ischemic stroke. The comparison of the mean infarct volume in patients with various mRS scores showed that the mean infarct volume was significantly higher in patients with unfavorable functional outcomes, based on mRS scores at discharge (P = 0.05), 3 months mRS (P < 0.01), and mRS score at final follow-up (P = 0.01). Final mortality was higher in patients with higher mRS scores at discharge, after 3 months, and final follow-up (P < 0.01). Older age and infarction volume can predict mRS and mortality in patients with ischemic stroke (P < 0.01). CONCLUSIONS The present study showed that mortality and mRS scores at various times are associated with infarction volume and older age in patients with ischemic stroke.
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Affiliation(s)
- Amin Rostami
- Department of Neurosurgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Daniel Elyassirad
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahsa Vatanparast
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohammad Hasanpour
- Department of Neurosurgery, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Rezaee
- Department of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhosein Haghir
- Department of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Keykhosravi
- Department of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, Iran.
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262
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Li Y, Dai C, Hua Z, Xia L, Ding Y, Wang Q, Gié MLM, Bouvet M, Cai H. A human serum albumin-indocyanine green complex offers improved tumor identification in fluorescence-guided surgery. Transl Cancer Res 2024; 13:437-452. [PMID: 38410209 PMCID: PMC10894326 DOI: 10.21037/tcr-23-2338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/18/2024] [Indexed: 02/28/2024]
Abstract
Background Complete tumor removal is critical for achieving a good prognosis in patients but remains challenging for surgeons. Near-infrared fluorescence-guided surgery (NIRFGS) enables surgeons to accurately localize tumors in real time and facilitates accurate resection. Indocyanine green (ICG) has been approved by the U.S. Food and Drug Administration and the National Medical Products Administration for many years. Although the application of ICG has progressed for a variety of surgeries, there are inherent limitations to ICG, including poor water solubility and photostability, short blood half-life, and aggregation in blood, resulting in poor imaging performance. We found that mixing ICG with human serum albumin (HSA) preoperatively and then injecting it can improve the imaging performance. Methods We prepared fluorescent probes by combining ICG with HSA and identified their optimal ratio via in vitro absorption measurement and emission spectrum characterization of ICG-HSA complex with different mixing ratios and concentration gradients. Subsequently, under the optimal ratio and clinical simulated concentration, we conducted dynamic change analysis of the fluorescence spectral properties after mixing. We then compared the uptake of ICG-HSA in vitro for two different cell types and the imaging performance of different molar ratios of ICG and HSA in mouse models. Results Through in vitro absorption and emission spectrum characterization of ICG-HSA mixtures with different mixing ratios and concentration gradients, the optimal ratio of the mixture was obtained (ICG:HSA =4:5). Using this ratio, clinical simulated concentration, and mixing, we completed the dynamic change analysis of the fluorescence spectrum properties. The results verified that HSA can improve the dispersion and stability of ICG in aqueous solution, reduce the proportion of free-state ICG, and thus improve the biodistribution. Moreover, the fluorescence performance of ICG was improved. ICG-HSA and ICG uptake in MDA-MB-231 cells and imaging in vivo showed that HSA increased the enrichment of ICG in tumor compared to ICG alone (ICG-HSAfluorescence intensity =237.3±10.7 vs. ICGfluorescence intensity =127.1±10.7). Compared with ICG alone, ICG-HSA provided a clearer tumor boundary and higher tumor-to-background ratio (TBR) (ICG-HSATBRmax 3.49±0.56 vs. ICGTBRmax 1.94±0.23). Conclusions This study suggests that ICG-HSA can achieve higher tumor-to-background contrast with shorter time and can provide an overall superior imaging performance compared to ICG alone, thus exhibiting considerable potential for clinical application.
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Affiliation(s)
- Yunlong Li
- Department of Biomedical Engineering, College of Engineering and Applied Sciences, Nanjing University, Nanjing, China
| | - Chun Dai
- Department of General Surgery, The People’s Hospital of Yangzhong City, Yangzhong, China
| | - Zhaolai Hua
- Department of General Surgery, The People’s Hospital of Yangzhong City, Yangzhong, China
| | - Lin Xia
- Department of General Surgery, The People’s Hospital of Yangzhong City, Yangzhong, China
| | - Yongbin Ding
- Department of General Surgery, Pukou Branch of Jiangsu People’s Hospital, Nanjing, China
| | - Qiang Wang
- School of Life Sciences, Jiangsu University, Zhenjiang, China
| | - Marie-Laure Matthey Gié
- Department of Thoracic and Endocrine Surgery, University Hospital of Geneva (HUG), Geneva, Switzerland
- Department of Surgery, Clinica Moncucco, Lugano, Switzerland
| | - Michael Bouvet
- Department of Surgery, University of California, San Diego, CA, USA
| | - Huiming Cai
- Nanjing Nuoyuan Medical Devices Co., Ltd., Nanjing, China
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Ma YN, Jiang X, Liu H, Song P, Tang W. Conversion therapy for initially unresectable hepatocellular carcinoma: Current status and prospects. Biosci Trends 2024; 17:415-426. [PMID: 38143080 DOI: 10.5582/bst.2023.01322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
Research has shown that locoregional and/or systemic treatments can reduce the tumor stage, enabling radical surgical resection in patients with initially unresectable hepatocellular carcinoma. This is referred to as conversion therapy. Patients who undergo conversion therapy followed by curative surgery experience a significant survival benefit compared to those who receive chemotherapy alone, those who are successfully downstaged with conversion therapy but not treated with surgery, or those who are treated with upfront surgery. Several treatments have been studied as conversion therapy. However, the success rate of conversion varies greatly, ranging from 0.8% to 60%. Combined locoregional plus systemic conversion therapy has demonstrated significant clinical advantages, with a conversion rate of up to 60%, an objective remission rate of 96% for patients, and a disease control rate of up to 100%. However, patients who underwent conversion therapy experienced significantly more complications than those who underwent direct LR without conversion therapy. Conversion therapy can cause hepatotoxicity, bone marrow suppression, local adhesions, increased fragility of blood vessels and liver tissues, and hepatic edema, which can increase the difficulty of surgery. In addition, criteria need to be established to evaluate the efficacy of conversion therapy and subsequent treatment. Further clinical evidence in this area is urgently needed.
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Affiliation(s)
- Ya-Nan Ma
- Department of Gastroenterology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Xuemei Jiang
- Department of Gastroenterology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Hui Liu
- Department of Interventional Radiology, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou, China
| | - Peipei Song
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Wei Tang
- International Health Care Center, National Center for Global Health and Medicine, Tokyo, Japan
- Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou, China
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264
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Kong X, Tao X, Li L, Zhao X, Ren J, Yang S, Chen X, Xiang H, Wu G, Li Y, Dong D. Global trends and partial forecast of adverse effects of medical treatment from 1990 to 2019: an epidemiological analysis based on the global burden of disease study 2019. BMC Public Health 2024; 24:295. [PMID: 38273270 PMCID: PMC10809510 DOI: 10.1186/s12889-023-17560-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 12/21/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The possibility of adverse effects of medical treatment (AEMT) is increasing worldwide, but little is known about AEMT in China. This study analyzed the health burden of AEMT in China in recent years through the Global Burden of Disease Study (GBD) 2019 and compared it with the worldwide average level and those in different sociodemographic index (SDI) regions. METHODS We calculated the age-standardized rate (ASR) of deaths, disability-adjusted life years (DALYs), years of life lost (YLLs), years lived with disability (YLDs), incidence and prevalence attributed to AEMT in China, worldwide and countries with different sociodemographic indices during 1990-2019 using the latest data and methods from the GBD 2019. RESULTS From 1990 to 2019, the global age-standardized death rate (ASDR), DALYs, and YLLs for AEMT showed a significant downward trend and were negatively associated with the SDI. By 2040, the ASDR is expected to reach approximately 1.58 (95% UI: 1.33-1.80). From 1990 to 2019, there was no significant change in the global incidence of AEMT. The occurrence of AEMT was related to sex, and the incidence of AEMT was greater among females. In addition, the incidence of AEMT-related injuries and burdens, such as ASR of DALYs, ASR of YLLs and ASR of YLDs, was greater among women than among men. Very old and very young people were more likely to be exposed to AEMT. CONCLUSIONS From 1990 to 2019, progress was made worldwide in reducing the harm caused by AEMT. However, the incidence and prevalence of AEMT did not change significantly overall during this period. Therefore, the health sector should pay more attention to AEMT and take effective measures to reduce AEMT.
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Affiliation(s)
- Xin Kong
- Department of Pharmacy, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
- School of pharmacy, Dalian Medical University, Dalian, 116044, China
| | - Xufeng Tao
- Department of Pharmacy, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Lu Li
- Department of Pharmacy, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Xinya Zhao
- Department of Pharmacy, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
- School of pharmacy, Dalian Medical University, Dalian, 116044, China
| | - Jiaqi Ren
- Department of Pharmacy, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
- School of pharmacy, Dalian Medical University, Dalian, 116044, China
| | - Shilei Yang
- Department of Pharmacy, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Xuyang Chen
- Department of Pharmacy, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Hong Xiang
- Laboratory of Integrative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Guoyu Wu
- Department of Pharmacy, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
| | - Yunming Li
- Department of Pharmacy, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
| | - Deshi Dong
- Department of Pharmacy, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
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Liu L, Peng J, Wang N, Wu Z, Zhang Y, Cui H, Zang D, Lu F, Ma X, Yang J. Comparison of seven surrogate insulin resistance indexes for prediction of incident coronary heart disease risk: a 10-year prospective cohort study. Front Endocrinol (Lausanne) 2024; 15:1290226. [PMID: 38323107 PMCID: PMC10844492 DOI: 10.3389/fendo.2024.1290226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/08/2024] [Indexed: 02/08/2024] Open
Abstract
Background There were seven novel and easily accessed insulin resistance (IR) surrogates established, including the Chinese visceral adiposity index (CVAI), the visceral adiposity index (VAI), lipid accumulation product (LAP), triglyceride glucose (TyG) index, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC) and TyG-waist to height ratio (TyG-WHtR). We aimed to explore the association between the seven IR surrogates and incident coronary heart disease (CHD), and to compare their predictive powers among Chinese population. Methods This is a 10-year prospective cohort study conducted in China including 6393 participants without cardiovascular disease (CVD) at baseline. We developed Cox regression analyses to examine the association of IR surrogates with CHD (hazard ratio [HR], 95% confidence intervals [CI]). Moreover, the receiver operating characteristic (ROC) curve was performed to compare the predictive values of these indexes for incident CHD by the areas under the ROC curve (AUC). Results During a median follow-up period of 10.25 years, 246 individuals newly developed CHD. Significant associations of the IR surrogates (excepted for VAI) with incident CHD were found in our study after fully adjustment, and the fifth quintile HRs (95% CIs) for incident CHD were respectively 2.055(1.216-3.473), 1.446(0.948-2.205), 1.753(1.099-2.795), 2.013(1.214-3.339), 3.169(1.926-5.214), 2.275(1.391-3.719) and 2.309(1.419-3.759) for CVAI, VAI, LAP, TyG, TyG-BMI, TyG-WC and TyG-WHtR, compared with quintile 1. Furthermore, CVAI showed maximum predictive capacity for CHD among these seven IR surrogates with the largest AUC: 0.632(0.597,0.667). Conclusion The seven IR surrogates (excepted for VAI) were independently associated with higher prevalence of CHD, among which CVAI is the most powerful predictor for CHD incidence in Chinese populations.
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Affiliation(s)
- Li Liu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Jie Peng
- Department of Geriatric Medicine, Qilu Hospital of Shandong University, Key Laboratory of Cardiovascular Proteomics of Shandong Province, Jinan, China
| | - Ning Wang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Zhenguo Wu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Yerui Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Huiliang Cui
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Dejin Zang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Fanghong Lu
- Cardio-Cerebrovascular Control and Research Center, Shandong Academy of Medical Sciences, Jinan, China
| | - Xiaoping Ma
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
- Department of Obstetrics and Gynecology, LiaoCheng People’s Hospital, Liaocheng, China
| | - Jianmin Yang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
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Cheng CJ, Yu HB. Global trends and development of acupuncture for stroke: A review and bibliometric analysis. Medicine (Baltimore) 2024; 103:e36984. [PMID: 38241541 PMCID: PMC10798747 DOI: 10.1097/md.0000000000036984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/22/2023] [Indexed: 01/21/2024] Open
Abstract
The objective of this review is to elaborate on the status, hotspots, and trends of researches on acupuncture for stroke over the past 26 years. Publications about acupuncture for stroke were downloaded from the Web of Science Core Collection, and these papers were published up to December 31, 2022. A bibliometric analysis of acupuncture for stroke was conducted by CiteSpace (6.2.R4) and VOSviewer (1.6.17). In this study, VOSviewer was used for visual analysis of countries, institutions, authors, journals, keywords, and co-cited references. CiteSpace was used to draw a keyword burst map and a co-cited reference burst map. A total of 534 papers were obtained from the Web of Science Core Collection. The number of papers per year showed a rapid upward trend. The most productive country and institution in this field were China (452) and the Fujian University of Traditional Chinese Medicine (43), respectively. Tao Jing had the highest number of articles (34), and EZ Longa was the most popular author (129 co-citations). Neural Regeneration Research (51) was the most productive journal, and Stroke (1346) was the most co-cited journal. An paper written by EZ Longa was the most influential reference, with the highest citation count. The hotspots and frontiers of this area of research were focused on the mechanisms of acupuncture, especially its neural regenerative or neuroprotective effects. This study used CiteSpace and VOSviewer for bibliometric analysis to provide researchers with information on the research status, hotspots, and trends in acupuncture for stroke research over the past 26 years.
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Affiliation(s)
- Chang-Jiang Cheng
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Hai-Bo Yu
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
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267
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Jiang Y, Xiong Y, Chi Y, Lin F, Zhao Q, Li Y. Healthcare-Seeking Delays in Acute Ischemic Stroke Patients: The Influence of Gender, Immigrant Status, and Educational Background. Risk Manag Healthc Policy 2024; 17:191-204. [PMID: 38264584 PMCID: PMC10803282 DOI: 10.2147/rmhp.s445001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/16/2024] [Indexed: 01/25/2024] Open
Abstract
Purpose Timely medical attention is crucial for patients with Acute Ischemic Stroke (AIS), as delays can significantly impact therapeutic outcomes. These delays are influenced by a combination of socio-cultural, educational, and clinical factors. Patients and Methods An in-depth analysis was conducted to assess the prevalence and median duration of healthcare-seeking delays in AIS patients. The study specifically investigated the independent impacts of sociocultural and clinical determinants on these delays, with a focus on immigrant status, gender disparities, and educational levels. Multivariate regression analysis was employed to identify these independent effects while controlling for potential confounding factors. Results Among 1419 AIS patients, 82.52% (n = 1171) experienced delays exceeding 2 hours from symptom onset of symptoms to hospital arrival. The median delay was 12.3 hours. Immigrant populations encountering longer delays compared to native groups. Younger males (<45 years) and elderly females were more prone to delay in healthcare-seeking. Identified independent risk factors for delay included male gender (OR = 1.65 [95% CI:1.14-2.48]), self-acknowledged diabetes (OR = 2.50 [95% CI:1.21-5.17]), small vessel (OR = 2.07 [95% CI:1.27-3.36]), and wake stroke (OR = 7.04 [95% CI:3.69-13.44]). Educational background (high school and above), GCS score with 3-8 points (OR = 0.52 [95% CI:0.09-0.69]), understanding stroke-related knowledge (OR = 0.26 [95% CI:0.09-0.44]), conscious disturbance (OR = 0.25 [95% CI:0.10-0.62]) and limb weakness (OR=0.21[95% CI:0.21-0.49]) are protective factors for timely treatment. Conclusion Immigrant populations experienced longer delays from symptom onset to hospital arrival. The crucial roles of education and knowledge about stroke underscore the need for enhanced health literacy campaigns and public awareness, with a targeted focus on younger males and elderly females.
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Affiliation(s)
- Youli Jiang
- Department of Neurology, People’s Hospital of Longhua, Shenzhen, 518109, People’s Republic of China
| | - Yao Xiong
- Department of Neurology, People’s Hospital of Longhua, Shenzhen, 518109, People’s Republic of China
| | - Yue Chi
- Department of Neurology, People’s Hospital of Longhua, Shenzhen, 518109, People’s Republic of China
| | - Fu Lin
- Department of Neurology, People’s Hospital of Longhua, Shenzhen, 518109, People’s Republic of China
| | - Qingshi Zhao
- Department of Neurology, People’s Hospital of Longhua, Shenzhen, 518109, People’s Republic of China
| | - Yanfeng Li
- Department of Neurology, People’s Hospital of Longhua, Shenzhen, 518109, People’s Republic of China
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Aminorroaya A, Saeedi Moghaddam S, Tavolinejad H, Aryan Z, Heidari B, Ebrahimi H, Naderian M, Shobeiri P, Ghanbari A, Rezaei N, Malekpour MR, Haghshenas R, Rezaei N, Larijani B, Farzadfar F. Burden of Ischemic Heart Disease and Its Attributable Risk Factors in North Africa and the Middle East, 1990 to 2019: Results From the GBD Study 2019. J Am Heart Assoc 2024; 13:e030165. [PMID: 37956220 PMCID: PMC10926818 DOI: 10.1161/jaha.123.030165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND The North Africa and Middle East (NAME) region has one of the highest burdens of ischemic heart disease (IHD) worldwide. This study reports the contemporary epidemiology of IHD in NAME. METHODS AND RESULTS We estimated the incidence, prevalence, deaths, years of life lost, years lived with disability, disability-adjusted life years (DALYs), and premature mortality of IHD, and its attributable risk factors in NAME from 1990 to 2019 using the results of the GBD (Global Burden of Disease study 2019). In 2019, 0.8 million lives and 18.0 million DALYs were lost due to IHD in NAME. From 1990 to 2019, the age-standardized DALY rate of IHD significantly decreased by 33.3%, mostly due to the reduction of years of life lost rather than years lived with disability. In 2019, the proportion of premature death attributable to IHD was higher in NAME compared with global measures: 26.8% versus 16.9% for women and 18.4% versus 14.8% for men, respectively. The age-standardized DALY rate of IHD attributed to metabolic risks, behavioral risks, and environmental/occupational risks significantly decreased by 28.7%, 37.8%, and 36.4%, respectively. Dietary risk factors, high systolic blood pressure, and high low-density lipoprotein cholesterol were the top 3 risks contributing to the IHD burden in most countries of NAME in 2019. CONCLUSIONS In 2019, IHD was the leading cause of death and lost DALYs in NAME, where premature death due to IHD was greater than the global average. Despite the great reduction in the age-standardized DALYs of IHD in NAME from 1990 to 2019, this region still had the second-highest burden of IHD in 2019 globally.
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Affiliation(s)
- Arya Aminorroaya
- Section of Cardiovascular Medicine, Department of Internal Medicine Yale School of Medicine New Haven CT USA
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
- Tehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
- Kiel Institute for the World Economy Kiel Germany
| | - Hamed Tavolinejad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
- Tehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran
| | - Zahra Aryan
- Department of Medicine Rutgers New Jersey Medical School Newark NJ USA
| | - Behnam Heidari
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Hedyeh Ebrahimi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
| | - Mohammadreza Naderian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
- Tehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran
- Department of Cardiovascular Medicine Mayo Clinic Rochester MN USA
| | - Parnian Shobeiri
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
| | - Ali Ghanbari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
| | - Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
| | - Rosa Haghshenas
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute Tehran University of Medical Sciences Tehran Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute Tehran University of Medical Sciences Tehran Iran
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269
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Rubio JMB, Moyà-Alcover G, Jaume-I-Capó A, Petrović N. Crowdsourced human-based computational approach for tagging peripheral blood smear sample images from Sickle Cell Disease patients using non-expert users. Sci Rep 2024; 14:1201. [PMID: 38216623 PMCID: PMC10786843 DOI: 10.1038/s41598-024-51591-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/07/2024] [Indexed: 01/14/2024] Open
Abstract
In this paper, we present a human-based computation approach for the analysis of peripheral blood smear (PBS) images images in patients with Sickle Cell Disease (SCD). We used the Mechanical Turk microtask market to crowdsource the labeling of PBS images. We then use the expert-tagged erythrocytesIDB dataset to assess the accuracy and reliability of our proposal. Our results showed that when a robust consensus is achieved among the Mechanical Turk workers, probability of error is very low, based on comparison with expert analysis. This suggests that our proposed approach can be used to annotate datasets of PBS images, which can then be used to train automated methods for the diagnosis of SCD. In future work, we plan to explore the potential integration of our findings with outcomes obtained through automated methodologies. This could lead to the development of more accurate and reliable methods for the diagnosis of SCD.
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Affiliation(s)
- José María Buades Rubio
- UGiVIA Research Group, Department of Mathematics and Computer Science, University of the Balearic Islands, 07122, Palma, Spain
| | - Gabriel Moyà-Alcover
- UGiVIA Research Group, Department of Mathematics and Computer Science, University of the Balearic Islands, 07122, Palma, Spain
- Laboratory for Artificial Intelligence Applications (LAIA@UIB), University of the Balearic Islands, 07122, Palma, Spain
| | - Antoni Jaume-I-Capó
- UGiVIA Research Group, Department of Mathematics and Computer Science, University of the Balearic Islands, 07122, Palma, Spain.
- Laboratory for Artificial Intelligence Applications (LAIA@UIB), University of the Balearic Islands, 07122, Palma, Spain.
| | - Nataša Petrović
- UGiVIA Research Group, Department of Mathematics and Computer Science, University of the Balearic Islands, 07122, Palma, Spain
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270
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Hughes O, Bentley AR, Breeze CE, Aguet F, Xu X, Nadkarni G, Sun Q, Lin BM, Gilliland T, Meyer MC, Du J, Raffield LM, Kramer H, Morton RW, Gouveia MH, Atkinson EG, Valladares-Salgado A, Wacher-Rodarte N, Dueker ND, Guo X, Hai Y, Adeyemo A, Best LG, Cai J, Chen G, Chong M, Doumatey A, Eales J, Goodarzi MO, Ipp E, Irvin MR, Jiang M, Jones AC, Kooperberg C, Krieger JE, Lange EM, Lanktree MB, Lash JP, Lotufo PA, Loos RJF, Ha My VT, Peralta-Romero J, Qi L, Raffel LJ, Rich SS, Rodriquez EJ, Tarazona-Santos E, Taylor KD, Umans JG, Wen J, Young BA, Yu Z, Zhang Y, Ida Chen YD, Rundek T, Rotter JI, Cruz M, Fornage M, Lima-Costa MF, Pereira AC, Paré G, Natarajan P, Cole SA, Carson AP, Lange LA, Li Y, Perez-Stable EJ, Do R, Charchar FJ, Tomaszewski M, Mychaleckyj JC, Rotimi C, Morris AP, Franceschini N. Genome-wide study investigating effector genes and polygenic prediction for kidney function in persons with ancestry from Africa and the Americas. CELL GENOMICS 2024; 4:100468. [PMID: 38190104 PMCID: PMC10794846 DOI: 10.1016/j.xgen.2023.100468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/31/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024]
Abstract
Chronic kidney disease is a leading cause of death and disability globally and impacts individuals of African ancestry (AFR) or with ancestry in the Americas (AMS) who are under-represented in genome-wide association studies (GWASs) of kidney function. To address this bias, we conducted a large meta-analysis of GWASs of estimated glomerular filtration rate (eGFR) in 145,732 AFR and AMS individuals. We identified 41 loci at genome-wide significance (p < 5 × 10-8), of which two have not been previously reported in any ancestry group. We integrated fine-mapped loci with epigenomic and transcriptomic resources to highlight potential effector genes relevant to kidney physiology and disease, and reveal key regulatory elements and pathways involved in renal function and development. We demonstrate the varying but increased predictive power offered by a multi-ancestry polygenic score for eGFR and highlight the importance of population diversity in GWASs and multi-omics resources to enhance opportunities for clinical translation for all.
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Affiliation(s)
- Odessica Hughes
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Charles E Breeze
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department Health and Human Services, Bethesda, MD, USA; UCL Cancer Institute, University College London, London, UK
| | - Francois Aguet
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Xiaoguang Xu
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, UK
| | - Girish Nadkarni
- The Charles Bronfman Institute of Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Quan Sun
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bridget M Lin
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thomas Gilliland
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute, Cambridge, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Mariah C Meyer
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jiawen Du
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura M Raffield
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Holly Kramer
- Division of Nephrology and Hypertension, Loyola University Chicago, Maywood, IL, USA
| | - Robert W Morton
- Population Health Research Institute, Hamilton, ON, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Mateus H Gouveia
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Elizabeth G Atkinson
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Adan Valladares-Salgado
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Niels Wacher-Rodarte
- Unidad de Investigación Médica en Epidemiologia Clinica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Nicole D Dueker
- John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA USA
| | - Yang Hai
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA USA
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Lyle G Best
- Missouri Breaks Industries Research Inc., Eagle Butte, SD, USA
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Guanjie Chen
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Michael Chong
- Population Health Research Institute, Hamilton, ON, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Ayo Doumatey
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - James Eales
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, UK
| | - Mark O Goodarzi
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Eli Ipp
- Division of Endocrinology and Metabolism, Department of Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Marguerite Ryan Irvin
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Minzhi Jiang
- Department of Applied Physical Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alana C Jones
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Jose E Krieger
- Laboratório de Genética e Cardiologia Molecular do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ethan M Lange
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew B Lanktree
- Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - James P Lash
- Division of Nephrology, Department of Medicine, University of Illinois, Chicago, IL, USA
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Ruth J F Loos
- The Charles Bronfman Institute of Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vy Thi Ha My
- The Charles Bronfman Institute of Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jesús Peralta-Romero
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Lihong Qi
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
| | - Leslie J Raffel
- Department of Pediatrics, Genetic and Genomic Medicine, University of California, Irvine, Irvine, CA, USA
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Erik J Rodriquez
- Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Eduardo Tarazona-Santos
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Kent D Taylor
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA USA
| | - Jason G Umans
- MedStar Health Research Institute, Hyattsville MD and Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
| | - Jia Wen
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bessie A Young
- University of Washington School of Medicine, Seattle, WA, USA; Office of Healthcare Equity, UW Justice, Equity, Diversity, and Inclusion Center for Transformational Research (UW JEDI-CTR), University of Washington, Seattle, WA, USA; Division of Nephrology, Department of Medicine, University of Washington, Seattle, WA, USA; Kidney Research Institute, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Zhi Yu
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute, Cambridge, MA, USA
| | - Ying Zhang
- Center for American Indian Health Research, Department of Biostatistics and Epidemiology, Hudson College of Public Health, The University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - Yii-Der Ida Chen
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA USA
| | - Tanja Rundek
- Department of Neurology, Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA USA
| | - Miguel Cruz
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, Houston, TX, USA
| | | | - Alexandre C Pereira
- Laboratório de Genética e Cardiologia Molecular do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Aging Division, Brigham Women's Hospital, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Guillaume Paré
- Population Health Research Institute, Hamilton, ON, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Pradeep Natarajan
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute, Cambridge, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Shelley A Cole
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - April P Carson
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Leslie A Lange
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Yun Li
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eliseo J Perez-Stable
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Ron Do
- The Charles Bronfman Institute of Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Fadi J Charchar
- School of Science, Psychology and Sport, Federation University, Ballarat, VIC, Australia; Department of Cardiovascular Sciences, University of Leicester, Leicester, UK; Department of Physiology, University of Melbourne, Melbourne, VIC, Australia
| | - Maciej Tomaszewski
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, UK; Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Josyf C Mychaleckyj
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
| | - Charles Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Andrew P Morris
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK.
| | - Nora Franceschini
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Kuwornu JP, Maldonado F, Groot G, Penz E, Cooper EJ, Reid A, Marciniuk DD. Real-World Cost-Consequence Analysis of an Integrated Chronic Disease Management Program in Saskatchewan, Canada. Health Serv Insights 2024; 17:11786329231224621. [PMID: 38223214 PMCID: PMC10785729 DOI: 10.1177/11786329231224621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/28/2023] [Indexed: 01/16/2024] Open
Abstract
An integrated disease management program otherwise called a clinical pathway was recently implemented in Saskatchewan, Canada for patients living with chronic obstructive pulmonary disease (COPD). This study compared the real-world costs and consequences of the COPD clinical pathway program with 2 control treatment programs. The study comprised adult COPD patients in Regina (clinical pathway group, N = 759) matched on propensity scores to 2 independent control groups of similar adults in (1) Regina (historical controls, N = 759) and (2) Saskatoon (contemporaneous controls, N = 759). The study measures included patient-level healthcare costs and acute COPD exacerbation outcomes, both tracked in population-based administrative health data over a one-year follow-up period. Analyses included Cox proportional hazards models and differences in means between groups. The bias-corrected and accelerated bootstrap method was used to calculate 95% confidence intervals (CI). The COPD pathway patients had lower risks of moderate (hazard ratio [HR] =0.57, 95% CI [0.40-0.83]) and severe (HR = 0.43, 95% CI [0.28-0.66]) exacerbations compared to the historical control group, but similar risks compared with the contemporaneous control group. The COPD pathway patients experienced fewer episodes of exacerbations compared with the historical control group (mean difference = -0.30, 95% CI [-0.40, -0.20]) and the contemporaneous control group (mean difference = -0.12, 95% CI [-0.20, -0.03]). Average annual healthcare costs in Canadian dollars were marginally higher among patients in the COPD clinical pathway (mean = $10 549, standard deviation [SD] =$18 149) than those in the contemporaneous control group ($8841, SD = $17 120), but comparable to the historical control group ($10 677, SD = $21 201). The COPD pathway provides better outcomes at about the same costs when compared to the historical controls, but only slightly better outcomes and at a marginally higher cost when compared to the contemporaneous controls.
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Affiliation(s)
- John Paul Kuwornu
- Research Department, Saskatchewan Health Authority, Regina, SK, Canada
| | | | - Gary Groot
- Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Erika Penz
- Respirology, Critical Care & Sleep Medicine, The Respiratory Research Centre, University of Saskatchewan, Saskatoon, SK, Canada
| | - Elizabeth J Cooper
- Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Amy Reid
- Clinical Integration Unit, Saskatchewan Health Authority, Regina, SK, Canada
| | - Darcy D Marciniuk
- Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
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272
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Cheru A, Edessa D, Regassa LD, Gobena T. Incidence and predictors of chronic kidney disease among patients with diabetes treated at governmental hospitals of Harari Region, eastern Ethiopia, 2022. Front Public Health 2024; 11:1290554. [PMID: 38249421 PMCID: PMC10797702 DOI: 10.3389/fpubh.2023.1290554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/04/2023] [Indexed: 01/23/2024] Open
Abstract
Background Chronic kidney disease (CKD) is the leading cause of morbidity and mortality in diabetic patients. However, limited evidence is available about its incidence and predictors in Ethiopia, specifically in the Harari region. Methods A retrospective follow-up study was conducted among 520 diabetes patients who followed their treatment at governmental hospitals in the Harari region between 1 September 2012, and 30 May 2022. The risk of developing CKD was calculated with a 95% CI, and the risk was stratified by type of diabetes mellitus. Predictors of CKD were determined using the Gompertz regression model with the baseline Cox model. Results Data from 494 patients were included in the final analysis with 26 (5%) excluded. A total of 51 patients (10.32%) developed CKD over the 10-year follow-up period with an incidence rate of 2.16 cases (95% CI 1.64-2.84) per 100 person-years of observation. The risk of CKD was increased by three times (AHR: 3.09, 45 95% CI: 1.56, 6.14) among patients older than 60 years and by more than three times (AHR: 3.53, 95% CI: 1.43, 8.71) among patients with diabetes mellitus for longer than 5 years of stay with the diabetes mellitus. Moreover, the risk of CKD was increased four-fold among patients with high-density lipoprotein cholesterol (HDL-C) levels <40 mg/dL (AHR: 3.84, 95% CI, 1.80-8.18) and those with positive baseline proteinuria (AHR: 3.77, 95% CI: 1.43-8.71). Conclusion We found that one in ten diabetic patients had developed CKD within 10 years of the diabetes mellitus diagnosis. Advanced age, longer duration of diabetes, lower baseline HDL-C level, and proteinuria had increased the hazards of developing CKD. We recommend a more focused follow-up of older adult patients with advanced disease status at baseline for optimal control of diabetes mellitus that prevents its furthering to CKD.
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Affiliation(s)
- Abera Cheru
- School of Environmental Health Science, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Dumessa Edessa
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemma Demissie Regassa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tesfaye Gobena
- School of Environmental Health Science, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
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273
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Gao Q, Li L, Bai J, Fan L, Tan J, Wu S, Cai J. Association of stage 1 hypertension defined by the 2017 ACC/AHA guideline with cardiovascular events and mortality in Chinese adults. Chin Med J (Engl) 2024; 137:63-72. [PMID: 37319412 PMCID: PMC10766249 DOI: 10.1097/cm9.0000000000002669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND The 2017 American College of Cardiology/American Heart Association (ACC/AHA) blood pressure (BP) guideline lowered the threshold defining hypertension to 130/80 mmHg. However, how stage 1 hypertension defined using this guideline is associated with cardiovascular events in Chinese adults remains unclear. This study assessed the association between stage 1 hypertension defined by the 2017 ACC/AHA guideline and clinical outcomes in the Chinese population. METHODS Participants with stage 1 hypertension ( n = 69,509) or normal BP ( n = 34,142) were followed in this study from 2006/2007 to 2020. Stage 1 hypertension was defined as a systolic blood pressure of 130-139 mmHg or a diastolic blood pressure of 80-89 mmHg. None were taking antihypertensive medication or had a history of myocardial infarction (MI), stroke, or cancer at baseline. The primary outcome was a composite of MI, stroke, and all-cause mortality. The secondary outcomes were individual components of the primary outcome. Cox proportional hazards models were used for the analysis. RESULTS During a median follow-up of 11.09 years, we observed 10,479 events (MI, n = 995; stroke, n = 3408; all-cause mortality, n = 7094). After multivariable adjustment, the hazard ratios for stage 1 hypertension vs. normal BP were 1.20 (95% confidence interval [CI], 1.13-1.25) for primary outcome, 1.24 (95% CI, 1.05-1.46) for MI, 1.45 (95% CI, 1.33-1.59) for stroke, and 1.11 (95% CI, 1.04-1.17) for all-cause mortality. The hazard ratios for participants with stage 1 hypertension who were prescribed antihypertensive medications compared with those without antihypertensive treatment during the follow-up was 0.90 (95% CI, 0.85-0.96). CONCLUSIONS Using the new definition, Chinese adults with untreated stage 1 hypertension are at higher risk for MI, stroke, and all-cause mortality. This finding may help to validate the new BP classification system in China.
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Affiliation(s)
- Qiannan Gao
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Liuxin Li
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, Hebei 063000, China
| | - Jingjing Bai
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Luyun Fan
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Jiangshan Tan
- Emergency Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, Hebei 063000, China
| | - Jun Cai
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
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Raddaoui Y, Ben Amara A, Noamen A, Antit S, Hajri Y, Habli J, Ibn Hadj Amor H, Ben Youssef Y, Zakhama L, Fehri W. Rôle de la dépression dans l’équilibre tensionnel : Etude transversale
multicentrique. LA TUNISIE MEDICALE 2024; 102:7-12. [PMID: 38545723 PMCID: PMC11261507 DOI: 10.62438/tunismed.v102i1.4723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 07/25/2024]
Abstract
RESEARCH PROBLEM Hypertension is a multifactorial disease that affects approximately one third of the Tunisian adult population. It is a major risk factor for stroke and cardiovascular disease. Environmental and psychosocial factors play an important role in hypertension onset and control. The prevalence of depression among hypertensive patients is 26, 8% and its presence is associated with increased risk of cardiovascular related morbi-mortality. Our study aims to evaluate the role of depression in blood pressure control among ambulatory hypertensive patients. Investigative process: This study is a cross-sectional, multicentric and descriptive study. We intend to include three hundred and two patients. A 24-hour ambulatory blood pressure monitor will be used to evaluate blood pressure control. Depression will be assessed by the 9-item Patient Health Questionnaire (PHQ-9) in Tunisian dialect. Clinical, socio-environmental, psychosocial and therapeutic and prognosis data will be collected from medical records. Patients will be classified into two groups: Controlled versus non-controlled hypertension. PHQ-9 scores will be then compared between the two cohorts. RESEARCH PLAN Ethical considerations will be undertaken and respected. All patients should express an informed oral consent before enrollment. This trial will run for three months from the 15th August 2022. TRIAL REGISTRATION NCT05516173.
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Affiliation(s)
- Yosra Raddaoui
- Hospital of Main Military Training of Tunis
- University of Tunis El Manar, Faculty of medicine of Tunis, Tunisia
| | - Ahmed Ben Amara
- Regional hospital of Ben Arous
- University of Tunis El Manar, Faculty of medicine of Tunis, Tunisia
| | - Aymen Noamen
- Hospital of Main Military Training of Tunis
- University of Tunis El Manar, Faculty of medicine of Tunis, Tunisia
| | - Saoussen Antit
- Security Forces Hospital, La Marsa
- University of Tunis El Manar, Faculty of medicine of Tunis, Tunisia
| | - Youssef Hajri
- Security Forces Hospital, La Marsa
- University of Tunis El Manar, Faculty of medicine of Tunis, Tunisia
| | | | | | | | - Lilia Zakhama
- Security Forces Hospital, La Marsa
- University of Tunis El Manar, Faculty of medicine of Tunis, Tunisia
| | - Wafa Fehri
- Hospital of Main Military Training of Tunis
- University of Tunis El Manar, Faculty of medicine of Tunis, Tunisia
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Kong J, Zhang D. Current status and quality of radiomics studies for predicting outcome in acute ischemic stroke patients: a systematic review and meta-analysis. Front Neurol 2024; 14:1335851. [PMID: 38229595 PMCID: PMC10789857 DOI: 10.3389/fneur.2023.1335851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/15/2023] [Indexed: 01/18/2024] Open
Abstract
Background Pre-treatment prediction of reperfusion and long-term prognosis in acute ischemic stroke (AIS) patients is crucial for effective treatment and decision-making. Recent studies have demonstrated that the inclusion of radiomics data can improve the performance of predictive models. This paper reviews published studies focused on radiomics-based prediction of reperfusion and long-term prognosis in AIS patients. Methods We systematically searched PubMed, Web of Science, and Cochrane databases up to September 9, 2023, for studies on radiomics-based prediction of AIS patient outcomes. The methodological quality of the included studies was evaluated using the phase classification criteria, the radiomics quality scoring (RQS) tool, and the Prediction model Risk Of Bias Assessment Tool (PROBAST). Two separate meta-analyses were performed of these studies that predict long-term prognosis and reperfusion in AIS patients. Results Sixteen studies with sample sizes ranging from 67 to 3,001 were identified. Ten studies were classified as phase II, and the remaining were categorized as phase 0 (n = 2), phase I (n = 1), and phase III (n = 3). The mean RQS score of all studies was 39.41%, ranging from 5.56 to 75%. Most studies (87.5%, 14/16) were at high risk of bias due to their retrospective design. The remaining two studies were categorized as low risk and unclear risk, respectively. The pooled area under the curve (AUC) was 0.88 [95% confidence interval (CI) 0.84-0.92] for predicting the long-term prognosis and 0.80 (95% CI 0.74-0.86) for predicting reperfusion in AIS. Conclusion Radiomics has the potential to predict immediate reperfusion and long-term outcomes in AIS patients. Further external validation and evaluation within the clinical workflow can facilitate personalized treatment for AIS patients. This systematic review provides valuable insights for optimizing radiomics prediction systems for both reperfusion and long-term outcomes in AIS patients. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023461671, identifier CRD42023461671.
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Affiliation(s)
- Jinfen Kong
- Department of Radiology, Yuhuan Second People's Hospital, Yuhuan, Taizhou, Zhejiang, China
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Ong SK, Haruyama R, Yip CH, Ngan TT, Li J, Lai D, Zhang Y, Yi S, Shankar A, Suzanna E, Jung SY, Ho PJ, Yusuf A, Nessa A, Jung KW, Fernando E, Baral S, Bagherian M, Pradhan P, Jugder U, Vongdala C, Yusof SN, Thiri K, Sripan P, Cairo C, Matsuda T, Sangrajran S, Kiak-Mien Tan V, Mehrotra R, Anderson BO. Feasibility of monitoring Global Breast Cancer Initiative Framework key performance indicators in 21 Asian National Cancer Centers Alliance member countries. EClinicalMedicine 2024; 67:102365. [PMID: 38125964 PMCID: PMC10731600 DOI: 10.1016/j.eclinm.2023.102365] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
Background The Global Breast Cancer Initiative (GBCI) Framework, launched by the World Health Organisation (WHO) in 2023, emphasises assessing, strengthening, and scaling up services for the early detection and management of breast cancer. This study aims to determine the feasibility of monitoring the status of breast cancer control in the 21 Asian National Cancer Centers Alliance (ANCCA) countries based on the three GBCI Framework key performance indicators (KPIs): stage at diagnosis, time to diagnosis, and treatment completion. Methods We reviewed published literature on breast cancer control among 21 ANCCA countries from May to July 2023 to establish data availability and compiled the latest descriptive statistics and sources of the indicators using a standardised data collection form. We performed bivariate Pearson's correlation analysis to measure the strength of correlation between stage at diagnosis, mortality and survival rates, and universal health coverage. Findings Only 12 (57%) ANCCA member countries published national cancer registry reports on breast cancer age-standardised incidence rate (ASIR) and age-standardised mortality rate (ASMR). Indonesia, Myanmar, and Nepal had provincial data and others relied on WHO's Global Cancer Observatory (GLOBOCAN) estimates. GLOBOCAN data differed from the reported national statistics by 5-10% in Bhutan, Indonesia, Iran, the Republic of Korea, Singapore, and Thailand and >10% in China, India, Malaysia, Mongolia, and Sri Lanka. The proportion of patients diagnosed in stages I and II strongly correlated with the five-year survival rate and with the universal health coverage (UHC) index. Three countries (14%) reported national data with >60% of invasive breast cancer patients diagnosed at stages I and II, and a five-year survival rate of >80%. Over 60% of the ANCCA countries had no published national data on breast cancer staging, the time interval from presentation to diagnosis, and diagnosis to treatment. Five (24%) countries reported data on treatment completion. The definition of delayed diagnosis and treatment completion varied across countries. Interpretation GBCI's Pillar 1 KPI correlates strongly with five-year survival rate and with the UHC index. Most ANCCA countries lacked national data on cancer staging, timely diagnosis, and treatment completion KPIs. While institutional-level data were available in some countries, they may not represent the nationwide status. Strengthening cancer surveillance is crucial for effective breast cancer control. The GBCI Framework indicators warrant more detailed definitions for standardised data collection. Surrogate indicators which are measurable and manageable in country-specific settings, could be considered for monitoring GBCI indicators. Ensuring UHC and addressing health inequalities are essential to early diagnosis and treatment of breast cancer. Funding Funding for this research article's processing fee (APC) will be provided by the affiliated institution to support the open-access publication of this work. The funding body is not involved in the study design; collection, management, analysis and interpretation of data; or the decision to submit for publication. The funding body will be informed of any planned publications, and documentation provided.
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Affiliation(s)
- Sok King Ong
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam
| | - Rei Haruyama
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Japan
| | | | - Tran Thu Ngan
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
- Centre for Public Health, Queen's University Belfast, United Kingdom
| | - Jingmei Li
- Women's Health and Genetics, Genome Institute of Singapore, A∗Star, Singapore
| | - Daphne Lai
- School of Digital Science, Universiti Brunei Darussalam, Brunei Darussalam
| | - Yawei Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Siyan Yi
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Abhishek Shankar
- Department of Radiation Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Evlina Suzanna
- National Cancer Center Indonesia, Dharmais Cancer Hospital, Jakarta, Indonesia
| | - So-Youn Jung
- Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Peh Joo Ho
- Women's Health and Genetics, Genome Institute of Singapore, A∗Star, Singapore
| | - Aasim Yusuf
- Shaukat Khanum Memorial Cancer Hospital and Research Centres, Lahore and Peshawar, Pakistan
| | - Ashrafun Nessa
- Department of Gynaecological Oncology, Bangabandhu Sheikh Mujib Medical University, Bangladesh
| | - Kyu-Won Jung
- National Cancer Centre Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Eshani Fernando
- National Cancer Control Programme, Ministry of Health, Sri Lanka
| | | | - Maryam Bagherian
- Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | | | - Uranbolor Jugder
- Cancer Registry-surveillance and Early Detection Division, National Cancer Center of Mongolia, Ulaanbaatar, Mongolia
| | | | | | - Khin Thiri
- Pink Rose Breast Cancer Patients Support Group, Yangon, Myanmar
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Thailand
| | - Clarito Cairo
- Department of Health, Disease Prevention and Control Bureau, Manila, Philippines
| | - Tomohiro Matsuda
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | | | | | - Ravi Mehrotra
- Indian Cancer Genome Atlas, India & Centre for Health, Innovation and Policy Foundation, India
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277
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Lin M, Hong Y, Hong S, Zhang S. Discrete Wavelet Transform based ECG classification using gcForest: A deep ensemble method. Technol Health Care 2024; 32:95-105. [PMID: 38759040 PMCID: PMC11191494 DOI: 10.3233/thc-248008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are the leading global cause of mortality, necessitating advanced diagnostic tools for early detection. The electrocardiogram (ECG) is pivotal in diagnosing cardiac abnormalities due to its non-invasive nature. OBJECTIVE This study aims to propose a novel approach for ECG signal classification, addressing the challenges posed by the complexity of ECG signals associated with various diseases. METHODS Our method integrates Discrete Wavelet Transform (DWT) for feature extraction, capturing salient features of cardiovascular diseases. Subsequently, the gcForest model is employed for efficient classification. The approach is tested on the MIT-BIH Arrhythmia Database. RESULTS The proposed method demonstrates promising results on the MIT-BIH Arrhythmia Database, achieving a test accuracy of 98.55%, recall of 98.48%, precision of 98.44%, and an F1 score of 98.46%. Additionally, the model exhibits robustness and low sensitivity to hyper-parameters. CONCLUSION The combined use of DWT and the gcForest model proves effective in ECG signal classification, showcasing high accuracy and reliability. This approach holds potential for improving early detection of cardiovascular diseases, contributing to enhanced cardiac healthcare.
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Affiliation(s)
- Mingfeng Lin
- Department of General Surgery, Zhongshan Hospital of Xiamen University, Xiamen, Fujian, China
- School of Informatics, Xiamen University, Xiamen, Fujian, China
| | - Yuanzhen Hong
- Department of General Surgery, Zhongshan Hospital of Xiamen University, Xiamen, Fujian, China
- Hepatology Department’s Three Wards, Xiamen Hospital, Beijing University of Chinese Medicine, Xiamen, Fujian, China
| | - Shichai Hong
- Department of Vascular Surgery, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, China
| | - Suzhen Zhang
- Department of General Surgery, Zhongshan Hospital of Xiamen University, Xiamen, Fujian, China
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Abedi J, Ghafari ME, Kheirkhah J, Moladoust H, Aghajankhah MR. Evaluation of the prevalence and predictors of right ventricular diastolic dysfunction in patients undergoing coronary artery bypass surgery. ARYA ATHEROSCLEROSIS 2024; 20:21-27. [PMID: 39697852 PMCID: PMC11651314 DOI: 10.48305/arya.2024.41897.2907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 04/21/2024] [Indexed: 12/20/2024]
Abstract
BACKGROUND With the increase in the number of coronary artery bypass grafting (CABG) surgeries, the concern about complications after it has also increased. RV diastolic dysfunction (RVDD) is one of the post-CABG complications, and in this study, we intend to investigate its frequency and predictors. METHODS In this cross-sectional study, eighty CABG candidate adult patients were included. A history of previous heart surgery or arrhythmia were the main exclusion criteria. After recording demographic and clinical information, echocardiography of the right ventricle (RV) was performed the day before the surgery and seven days later. The functional parameters were obtained according to the Guidelines for the Echocardiographic Assessment of the Right Heart in Adults. RESULTS Eighty patients with an average age of 60.25 ± 8.93 years participated in the study. Most patients were male (72.5%). Thirteen patients had RVDD before CABG (30.8% grade I and 69.2% grade II). All these 13 patients had RVDD grade II after surgery (P=0.046). Among 67 patients with normal RV function before CABG, RV function was normal in only 20 patients (29.9%) after CABG. The incidence of grade I and grade II post-CABG RVDD (post-coronary artery bypass grafting right ventricle diastolic dysfunction) was 11.9% and 58.2%, respectively (P<0.001). Univariate logistic regression analysis showed that there was no association between pre-CABG variables, neither demographic nor echocardiographic, and the occurrence of RVDD after CABG. CONCLUSION CABG surgery is associated with a high incidence of RVDD, which cannot be predicted before surgery. The short-term and long-term consequences of this complication are still unknown.
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Affiliation(s)
- Jamshid Abedi
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Ebrahim Ghafari
- Department of Epidemiology and Biostatistics, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - Jalal Kheirkhah
- Department of Cardiology, Healthy Heart Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Hassan Moladoust
- Department of Biochemistry and Medical Physics, Healthy Heart Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Reza Aghajankhah
- Department of Cardiology, Healthy Heart Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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279
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Chen X, He F, Jiang Y, Chen X, Yan Y. Application of standardized management and effect evaluation of chronic obstructive pulmonary disease patients using the big data center of the Internet of Things. Digit Health 2024; 10:20552076241237706. [PMID: 38495860 PMCID: PMC10943746 DOI: 10.1177/20552076241237706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/20/2024] [Indexed: 03/19/2024] Open
Abstract
Objective Early detection, diagnosis, treatment and management of chronic obstructive pulmonary disease can lower morbidity and perhaps mortality. This study aimed to evaluate the effect of the application of standardized management against the background of the rapid development of the big data center of modern internet of things technology. Methods Participants ≥40 years of age with chronic obstructive pulmonary disease presenting at Xiamen Medical College Affiliated Haicang Hospital from October 2019 to October 2020 were selected as the observation patients based on the Internet of Things big data center for chronic obstructive pulmonary disease standardized management, and control patients from the community were selected for without down to the chronic obstructive pulmonary disease standardized management. Follow-up after 2 years of patient health records and acute episodes using the World Health Organization Quality of Life Questionnaire-Brief version to evaluate the quality of life of the two groups revealed differences. Results The results of comparative analysis of the number of acute attacks before and after follow-up in the observation and control groups after propensity score matching showed that the decrease in acute episodes before and after in the observation group was significant compared with that in the control group (t = -3.664, P < 0.001). The quality of life of chronic obstructive pulmonary disease patients indicated that the effect in the observation group was greater than that in the control group according to the World Health Organization Quality of Life Questionnaire-Brief version. Conclusion In this study, we analyzed the application of modern internet of things technology in the management of chronic obstructive pulmonary disease patients, discussed the effect of standardized management, and promoted the self-management of chronic obstructive pulmonary disease patients. The effectiveness and continuity of the standardized management model for chronic obstructive pulmonary disease implemented in Xiamen city based on the internet of things big data center were considered true and effective.
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Affiliation(s)
- Xiaoping Chen
- Department of Medical Affairs, Xiamen Haicang Hospital, Xiamen, China
| | - Fei He
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yan Jiang
- Department of Medical Affairs, Xiamen Haicang Hospital, Xiamen, China
| | - Xuezhen Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yubing Yan
- Medical Records Room, Zhongshan Hospital, Xiamen University, Xiamen, China
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Rao AS, Nair A, Nivetha K, Ayesha B, Hardi K, Divya V, Veena SM, Anantharaju KS, More SS. Impacts of Omega-3 Fatty Acids, Natural Elixirs for Neuronal Health, on Brain Development and Functions. Methods Mol Biol 2024; 2761:209-229. [PMID: 38427239 DOI: 10.1007/978-1-0716-3662-6_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Omega-3 fatty acids play a seminal role in maintaining the structural and functional integrity of the nervous system. These specialized molecules function as precursors for many lipid-based biological messengers. Also, studies suggest the role of these fatty acids in regulating healthy sleep cycles, cognitive ability, brain development, etc. Dietary intake of essential poly unsaturated fatty acids (PUFA) such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are foundational to the optimal working of the nervous system. Besides regulating health, these biomolecules have great therapeutic value in treating several diseases, particularly nervous system diseases and disorders. Many recent studies conclusively demonstrated the beneficial effects of Omega-3 fatty acids in treating depression, neuropsychiatric disorders, neurodegenerative disorders, neurochemical disorders, and many other illnesses associated with the nervous system. This chapter summates the multifaceted role of poly unsaturated fatty acids, especially Omega-3 fatty acids (EPA and DHA), in the neuronal health and functioning. The importance of dietary intake of these essential fatty acids, their recommended dosages, bioavailability, the mechanism of their action, and therapeutic values are extensively discussed.
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Affiliation(s)
- Archana S Rao
- School of Basic and Applied Sciences, Dayananda Sagar University, Bangalore, India
| | - Ajay Nair
- School of Basic and Applied Sciences, Dayananda Sagar University, Bangalore, India
| | - K Nivetha
- School of Basic and Applied Sciences, Dayananda Sagar University, Bangalore, India
| | - Bibi Ayesha
- School of Basic and Applied Sciences, Dayananda Sagar University, Bangalore, India
| | - Kapadia Hardi
- School of Basic and Applied Sciences, Dayananda Sagar University, Bangalore, India
| | - Vora Divya
- School of Basic and Applied Sciences, Dayananda Sagar University, Bangalore, India
| | - S M Veena
- Department of Biotechnology, Sapthagiri College of Engineering, Bangalore, India
| | - K S Anantharaju
- Department of Chemistry, Dayananda Sagar College of Engineering, Bangalore, India
| | - Sunil S More
- School of Basic and Applied Sciences, Dayananda Sagar University, Bangalore, India
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Ferrero-Hernández P, Farías-Valenzuela C, Castillo-Paredes A, Rezende LFM, Cristi-Montero C, Sadarangani KP, Christofaro DGD, Ferrari G. Preventable incidence cases from non-communicable diseases attributable to insufficient physical activity in Chile. Public Health 2024; 226:53-57. [PMID: 38006742 DOI: 10.1016/j.puhe.2023.10.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/04/2023] [Accepted: 10/30/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVES Lack of sufficient physical activity (PA) has been associated with an increased risk of several non-communicable diseases (NCDs) and all-cause mortality. This study aimed to estimate the number of preventable incidence cases of NCDs attributable to insufficient PA in the Chilean population. STUDY DESIGN Comparative risk assessment modelling study. METHODS This study examined data from 5834 participants aged ≥20 years from the Chilean National Survey (2016-2017). PA was assessed by the Global Physical Activity Questionnaire (GPAQ), and metabolic equivalent of tasks (METs) were assigned according to PA intensity. Estimated incidence cases of NCDs in Chile in 2019 were obtained from the Global Burden of Disease study. Relative risks for breast cancer, colon cancer, ischaemic heart disease, diabetes and stroke were obtained from a published meta-analysis and applied to the prevalence of insufficient PA estimates through the potential impact fraction equation. RESULTS High levels of PA (≥8000 MET-min/week) could potentially avoid more than 22,000 (64.6 %) incidence NCD cases, ranging from 498 (10.1 %) preventable cases of breast cancer to 5629 (14.7 %) cases of diabetes. Other modelled scenarios also showed to reduce the incidence cases of all five NCDs but to a lesser extent; where at least PA recommendation was achieved, preventable NCDs were reduced by 6522 cases (18.7 %), and where a 10 % relative reduction in insufficient PA level in the population was achieved, preventable NCDs were reduced by 651 (1.8 %) cases. CONCLUSIONS The study results provide estimates for the incidence cases of preventable NCDs attributable to insufficient PA, highlighting the important role of PA in NCD prevention in Chile.
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Affiliation(s)
- P Ferrero-Hernández
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Chile
| | - C Farías-Valenzuela
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Lota 2465, Providencia 7510157, Chile
| | - A Castillo-Paredes
- Grupo AFySE, Investigación en Actividad Física y Salud Escolar, Escuela de Pedagogía en Educación Física, Facultad de Educación, Universidad de Las Américas, Santiago 8370040, Chile
| | - L F M Rezende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - C Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - K P Sadarangani
- Universidad Autónoma de Chile, Providencia, Chile; Escuela de Kinesiología, Facultad de Salud y Odontología, Universidad Diego Portales, Santiago, Chile
| | - D G D Christofaro
- Graduate Program in Movement Sciences, Physical Education Department, School of Technology and Sciences, São Paulo State University (Unesp), Sao Paulo, Brazil
| | - G Ferrari
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Chile.
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Tian X, Zeng J, Li X, Li S, Zhang T, Deng Y, Yin F, Ma Y. Assessing the short-term effects of PM 2.5 and O 3 on cardiovascular mortality using high-resolution exposure: a time-stratified case cross-over study in Southwestern China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:3775-3785. [PMID: 38087153 DOI: 10.1007/s11356-023-31276-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/24/2023] [Indexed: 01/19/2024]
Abstract
Air pollution is a major risk factor of cardiovascular disease (CVD). To date, limited studies have estimated the effects of ambient air pollution on CVD mortality using high-resolution exposure assessment, which might fail to capture the spatial variation in exposure and introduce bias in results. Besides, the three-year action plan (TYAP, 2018-2020) was released; thus, the constitution and health effect of air pollutants may have changed. In this study, we estimated the short-term effect exposed to particulate matters with parameter less than 2.5 µm (PM2.5) and ozone (O3) with 0.05° × 0.05° resolution on CVD mortality and measured the influence of TYAP in the associations. We used random forest models with spatial weight matrices to attain high-resolution pollutant concentrations and conditional Poisson regression to assess the relationship between air pollution and cardiovascular mortality. With an increase of 10 µg/m3 in PM2.5 and O3 during 2018-2021 in the Sichuan Basin (SCB), CVD mortality increased 1.0134 (95% CI 1.0102, 1.0166) and 1.0083 (95% CI 1.0060, 1.0107), respectively, using high-resolution air pollutant concentration, comparing to 1.0070 (95% CI 1.0052, 1.0087) and 1.0057 (95% CI 1.0037, 1.0078) using data from air quality monitoring stations (AQMs). After TYAP, the relative risk (RR) due to PM2.5 rose up to 1.0149 (95% CI 1.0054, 1.0243), and the RR due to O3 rose up to 1.0089 (95% CI 1.0030, 1.0148) in Sichuan Province. We found significantly positive association of cardiovascular mortality and air pollution in Sichuan Province. And using high-resolution exposure would be more accurate to estimate the effect of air pollution on CVD. After TYAP, the cardiovascular mortality risk estimation due to PM2.5 decreased in elderly in SCB, and the risk due to O3 increased in Sichuan Province.
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Affiliation(s)
- Xinyue Tian
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jing Zeng
- Department of Chronic Disease Surveillance, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Xuelin Li
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Sheng Li
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tao Zhang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ying Deng
- Department of Chronic Disease Surveillance, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Fei Yin
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yue Ma
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
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Xiao Y, Fang H, Zhu Y, Zhou J, Dai Z, Wang H, Xia Z, Tu Z, Leong KW. Multifunctional Cationic Hyperbranched Polyaminoglycosides that Target Multiple Mediators for Severe Abdominal Trauma Management. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2305273. [PMID: 37997512 PMCID: PMC10767409 DOI: 10.1002/advs.202305273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/12/2023] [Indexed: 11/25/2023]
Abstract
Trauma and its associated complications, including dysregulated inflammatory responses, severe infection, and disseminated intravascular coagulation (DIC), continue to pose lethal threats worldwide. Following injury, cell-free nucleic acids (cfNAs), categorized as damage-associated molecular patterns (DAMPs), are released from dying or dead cells, triggering local and systemic inflammatory responses and coagulation abnormalities that worsen disease progression. Harnessing cfNA scavenging strategies with biomaterials has emerged as a promising approach for treating posttrauma systemic inflammation. In this study, the effectiveness of cationic hyperbranched polyaminoglycosides derived from tobramycin (HPT) and disulfide-included HPT (ss-HPT) in scavenging cfNAs to mitigate posttrauma inflammation and hypercoagulation is investigated. Both cationic polymers demonstrate the ability to suppress DAMP-induced toll-like receptor (TLR) activation, inflammatory cytokine secretion, and hypercoagulation by efficiently scavenging cfNAs. Additionally, HPT and ss-HPT exhibit potent antibacterial efficacy attributed to the presence of tobramycin in their chemical composition. Furthermore, HPT and ss-HPT exhibit favorable modulatory effects on inflammation and therapeutic outcomes in a cecal ligation puncture (CLP) mouse abdominal trauma model. Notably, in vivo studies reveal that ss-HPT displayed high accumulation and retention in injured organs of traumatized mice while maintaining a higher biodegradation rate in healthy mice, contrasting with findings for HPT. Thus, functionalized ss-HPT, a bioreducible polyaminoglycoside, holds promise as an effective option to enhance therapeutic outcomes for trauma patients by alleviating posttrauma inflammation and coagulation complications.
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Affiliation(s)
- Yongqiang Xiao
- Department of Burn Surgerythe First Affiliated HospitalNaval Medical UniversityShanghai200433P. R. China
- Department of Biomedical EngineeringColumbia UniversityNew YorkNY10027USA
- ENT InstituteDepartment of Facial Plastic and Reconstructive SurgeryEye & ENT HospitalFudan UniversityShanghai200031P. R. China
| | - He Fang
- Department of Burn Surgerythe First Affiliated HospitalNaval Medical UniversityShanghai200433P. R. China
| | - Yuefei Zhu
- Department of Biomedical EngineeringColumbia UniversityNew YorkNY10027USA
| | - Jie Zhou
- Department of Breast SurgeryAffiliated Cancer Hospital and InstituteGuangzhou Medical UniversityGuangzhou510095P. R. China
| | - Zhanzhan Dai
- Department of Burn Surgerythe First Affiliated HospitalNaval Medical UniversityShanghai200433P. R. China
| | - Hongxia Wang
- Department of Biomedical EngineeringColumbia UniversityNew YorkNY10027USA
| | - Zhaofan Xia
- Department of Burn Surgerythe First Affiliated HospitalNaval Medical UniversityShanghai200433P. R. China
| | - Zhaoxu Tu
- Department of Biomedical EngineeringColumbia UniversityNew YorkNY10027USA
- The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdong510655P. R. China
| | - Kam W. Leong
- Department of Biomedical EngineeringColumbia UniversityNew YorkNY10027USA
- Department of Systems BiologyColumbia University Medical CenterNew YorkNY10032USA
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Hamid AK, Tayem AA, Al-Aish ST, Al Sakini AS, Hadi DD, Al-Aish RT. Empagliflozin and other SGLT2 inhibitors in patients with heart failure and preserved ejection fraction: a systematic review and meta-analysis. Ther Adv Cardiovasc Dis 2024; 18:17539447241289067. [PMID: 39400108 PMCID: PMC11483696 DOI: 10.1177/17539447241289067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 09/11/2024] [Indexed: 10/15/2024] Open
Abstract
BACKGROUND Heart failure (HF) is a highly prevalent disease, among the primary factors contributing to morbidity and death. One of its types is heart failure with preserved ejection fraction (HFpEF) comprising 40%-50% of newly diagnosed HF cases. Despite the high prevalence of HFpEF, there is still a lack of knowledge regarding the best drugs and treatment approaches to be used. However, the sodium-glucose co-transporter 2 (SGLT2) inhibitors could be a promising treatment. OBJECTIVES To examine SGLT2 inhibitors' effect on hospitalization, cardiovascular death, and estimated glomerular filtration rate (eGFR) in HFpEF patients. SEARCH METHODS We conducted searches for randomized controlled trials (RCTs) in PubMed, Embase, Scopus, and Web of Science up to July 2024. SELECTION CRITERIA We chose RCTs that examined the effects of SGLT2 inhibitors and placebo in individuals with higher than 40% ejection fraction (HFpEF). DATA COLLECTION AND ANALYSIS The methodology for the systematic review and meta-analysis was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. MAIN RESULTS We included 8 studies with 16,509 participants. Drugs examined in our paper included empagliflozin, dapagliflozin, sotogliflozin, and ertugliflozin. Various outcomes were analyzed in different papers. However, different SGLT2 inhibitors lead to a decreased risk of cardiovascular hospitalization and kidney injury. Our meta-analysis showed a decreased risk of cardiovascular hospitalization but not death due to cardiovascular causes or other causes. These results were regardless of baseline status of eGFR, systolic blood pressure, atrial fibrillation or flutter, diabetes mellitus, sex, body mass index, and nt-proBNP. The included studies were of moderate to high quality. CONCLUSION For individuals with HFpEF, SGLT2 inhibitors have been proven to be a safe and effective medication. However, more studies are needed for longer durations, reporting adverse events, effects on exercise tolerance, and other secondary outcomes.
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Affiliation(s)
- Abdulrahman Khaldoon Hamid
- College of Medicine, University of Alexandria, Champollion Street, Al Mesallah Sharq, Al Attarin, Alexandria Governorate 21648, Egypt
| | | | | | | | - Dalia Dhia Hadi
- Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
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Irfan A, Riggs DW, Koromia G, DeFilippis AP, Soliman EZ, Bhatnagar A, Carll AP. Smoking-associated Electrocardiographic Abnormalities Predict Cardiovascular Mortality: Insights from NHANES. RESEARCH SQUARE 2024:rs.3.rs-3615687. [PMID: 38260619 PMCID: PMC10802705 DOI: 10.21203/rs.3.rs-3615687/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Background— Smoking is associated with arrhythmia and sudden cardiac death, but the biological mechanisms remain unclear. Abnormal electrocardiogram (ECG) durations of ventricular repolarization (QT interval), atrial depolarization (P wave), and atrioventricular depolarization (PR interval and segment), predict cardiac arrhythmia and mortality. Objectives— To elucidate how smoking affects cardiac excitation, we assessed in a nationally representative sample (NHANES III) associations between cotinine, abnormalities in P duration, PR interval, PR segment, rate-corrected QT (QTc), QRS duration, and JT interval, and long-term mortality. Methods— We analyzed data from 5,633 adults using survey-weighted multinomial logistic regression to estimate associations between tobacco use (>15 ng/ml serum cotinine) and short (<5th percentile) or long (>95th percentile) ECG intervals, relative to reference (5 - 95th percentile). Results— After adjustment for demographics, risk factors, and conduction-altering medications, smoking was associated with a higher odds of short PR interval, PR segment, and QRS, and long JT. Broader ECG effects of smoking were also assessed by survey-weighted linear regression of continuous cotinine and ECG intervals, which revealed cotinine inversely associated with PR segment and QTc. Over a 22-year follow-up, many ECG abnormalities predicted cardiovascular mortality in smokers, including long JT, QRS, and QTc, and short QRS. Conclusions— Smoking increases likelihood for rapid atrioventricular conduction, rapid ventricular depolarization, and slow ventricular repolarization. The ventricular electrophysiologic abnormalities associated with smoking also predict cardiovascular mortality in smokers; however, traditional ECG measures of cardiac risk like QTc can overlook these ventricular defects and their independent predictive value in smokers.
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286
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Gallagher L, Breslin G, Leavey G, Curran E, Rosato M. Determinants of unintentional injuries in preschool age children in high-income countries: A systematic review. Child Care Health Dev 2024; 50:e13161. [PMID: 37555597 DOI: 10.1111/cch.13161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 06/09/2023] [Accepted: 07/11/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Injuries are the leading cause of death and disability in preschool children who are subject to specific risk factors. We sought to clarify the determinants of unintentional injuries in children aged 5 years and under in high-income countries and report on the methodological quality of the selected studies. METHODS A systematic review was conducted of observational studies investigating determinants of unintentional injury in children aged 0-5. Searches were conducted in Web of Science, Medline, Embase, PsycInfo and CINAHL. All methods of data analysis and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2021) guidelines. Determinants are reported at the child, parental, household and area level. RESULTS An initial search revealed 6179 records. Nineteen studies met the inclusion criteria: 17 cohort studies and 2 case control studies. While studies included longitudinal surveys and administrative healthcare data analysis, the highest quality studies examined were case-control designs. Child factors associated with unintentional injury include male gender, age of the child at the time of injury, advanced gross motor score, sleeping problems, birth order, attention deficit hyperactivity disorder (ADHD) diagnosis and below average score on the standard strengths and difficulties scale. Parental factors associated with unintentional injuries included younger parenthood, poor maternal mental health, hazardous or harmful drinking by an adult within the home, substance misuse, low maternal education, low paternal involvement in childcare and routine and manual socioeconomic classification. Household factors associated with injury were social rented accommodation, single-parent household, White ethnicity in the United Kingdom, number of children in the home and parental perception of a disorganised home environment. Area-level factors associated with injury were area-level deprivation and geographic remoteness. CONCLUSION Child factors were the strongest risk factors for injury, whereas parental factors were the most consistent. Further research is needed to examine the role of supervision in the relationships between these risk factors and injury. Injury intent should be considered in studies using administrative healthcare data. Prospective research may consider utilising linked survey and administrative data to counter the inherent weaknesses of these research approaches.
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Affiliation(s)
- Laura Gallagher
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
| | - Gavin Breslin
- School Of Psychology, Queen's University Belfast, Belfast, UK
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
| | - Emma Curran
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
| | - Michael Rosato
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
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287
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Tardalkar K, Bhamare N, Kshersagar J, Chaudhari L, Deshpande N, Patil J, Sharma RK, Joshi MG. Recellularization of Acellular Xeno Kidney Scaffold: An In Vivo Method to Generate Bioartificial Kidney. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1450:77-92. [PMID: 37610657 DOI: 10.1007/5584_2023_785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
A significant hurdle for kidney tissue engineering is reproducing the complex three-dimensional structure of the kidney. In our study, a stepwise approach of generating a reproducible Xeno kidney scaffold from a goat kidney is described, which can be implanted and recellularized by host cells. We have proposed a combination of sodium dodecyl sulfate and Triton-X-100-based protocol to generate a reproducible Xeno kidney scaffold, which was then analyzed by histology, DNA quantification, SEM, and renal angiography. Further, a small portion from the cortico-medullar region of the acellular scaffold was implanted in the rat's kidney subcapsular pocket for a period of 1 month, to check the recruitment of host cells into the scaffold. Post implantation, the extracellular matrix of the scaffold was well preserved and it did not induce any damage or inflammation in the native kidney. Implantation of the Xeno scaffold resulted in apparent early vascularization which helped in the recruitment of the host cells, which was characterized by histology, immunohistochemistry, and scanning electron microscopy. Implanted Xeno scaffold showed AQP-1, Nephrin, α-SMA, and VEGF expression in proximal tubules and renal glomerulus. Importantly, Ki-67 and WTAP-expressing cells were also observed near proximal tubules suggesting a high level of proliferation in the scaffold. Thus, showing the potential of Xeno kidney development that can be recellularized by the host cell to engineer into a functional kidney.
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Affiliation(s)
- Kishor Tardalkar
- Department of Stem Cells & Regenerative Medicine, D Y Patil Education Society (Deemed to be University), Kolhapur, Maharashtra, India
| | - Nilesh Bhamare
- Department of Stem Cells & Regenerative Medicine, D Y Patil Education Society (Deemed to be University), Kolhapur, Maharashtra, India
| | - Jeevitaa Kshersagar
- Department of Stem Cells & Regenerative Medicine, D Y Patil Education Society (Deemed to be University), Kolhapur, Maharashtra, India
| | - Leena Chaudhari
- Department of Stem Cells & Regenerative Medicine, D Y Patil Education Society (Deemed to be University), Kolhapur, Maharashtra, India
| | - Nimish Deshpande
- Department of Stem Cells & Regenerative Medicine, D Y Patil Education Society (Deemed to be University), Kolhapur, Maharashtra, India
| | - Jitendra Patil
- Department of Radiology, D Y Patil Medical College, D Y Patil Education Society (Deemed to be University), Kolhapur, Maharashtra, India
| | - Rakesh Kumar Sharma
- Department of Obstetrics and Gynaecology, D Y Patil Medical College, D Y Patil Education Society (Deemed to be University), Kolhapur, Maharashtra, India
| | - Meghnad G Joshi
- Department of Stem Cells & Regenerative Medicine, D Y Patil Education Society (Deemed to be University), Kolhapur, Maharashtra, India
- Stem Plus Biotech, SMK Commercial Complex, Sangli, Maharashtra, India
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288
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Xie Q, Gu J. Therapeutic and Safety Promise of Mesenchymal Stem Cells for Liver Failure: From Preclinical Experiment to Clinical Application. Curr Stem Cell Res Ther 2024; 19:1351-1368. [PMID: 37807649 DOI: 10.2174/011574888x260690230921174343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 10/10/2023]
Abstract
Liver failure (LF) is serious liver damage caused by multiple factors, resulting in severe impairment or decompensation of liver synthesis, detoxification, metabolism, and biotransformation. The general prognosis of LF is poor with high mortality in non-transplant patients. The clinical treatments for LF are mainly internal medicine comprehensive care, artificial liver support system, and liver transplantation. However, none of the above treatment strategies can solve the problems of all liver failure patients and has its own limitations. Mesenchymal stem cells (MSCs) are a kind of stem cells with multidirectional differentiation potential and paracrine function, which play an important role in immune regulation and tissue regeneration. In recent years, MSCs have shown multiple advantages in the treatment of LF in pre-clinical experiments and clinical trials. In this work, we reviewed the biological characteristics of MSCs, the possible molecular mechanisms of MSCs in the treatment of liver failure, animal experiments, and clinical application, and also discussed the existing problems of MSCs in the treatment of liver failure.
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Affiliation(s)
- Qiong Xie
- National Engineering Research Center of Cell Products, AmCellGene Engineering Co., Ltd, Tianjin, 300457, China
| | - Jundong Gu
- National Engineering Research Center of Cell Products, AmCellGene Engineering Co., Ltd, Tianjin, 300457, China
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289
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Zanuzzi MG, Garzon ME, Cornavaca MT, Bernabeu F, Albertini RA, Ellena G, Romero CA. Social determinants of blood pressure control in a middle-income country in Latin America. J Biosoc Sci 2024; 56:50-62. [PMID: 36794341 DOI: 10.1017/s0021932023000044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Blood pressure (BP) control is a key intervention to decrease cardiovascular diseases (CVD), the main cause of death in low and middle-income countries (MIC). Scarce data on the determinants of BP control in Latin America are available. Our objective is to explore the role of gender, age, education, and income as social determinants of BP control in Argentina, a MIC with a universal health care system. We evaluated 1184 persons in two hospitals. Blood pressure was measured using automatic oscillometric devices. We selected those patients treated for hypertension. The average BP of less than 140/90 mmHg was considered a controlled BP. We found 638 hypertensive individuals, of whom 477 (75%) were receiving antihypertensive drugs, and of those, 248 (52%) had controlled BP. The prevalence of low education was more frequent in uncontrolled patients (25.3% vs. 16.1%; P < .01). We did not find association between household income, gender, and BP control. Older patients had less BP control (44% of those older than 75 years vs. 60.9% of those younger than 40; test for trend P < .05). Multivariate regression indicates low education (OR 1.71 95% CI [1.05, 2.79]; P = .03) and older age (OR 1.01; 95% IC [1.00, 1.03]) as independent predictors of the lack of BP control. We conclude that rates of BP control are low in Argentina. In a MIC with a universal health care system low education and old age but not household income are independent predictors of the lack of BP control.
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Affiliation(s)
- Matias G Zanuzzi
- Servicio de Clinica Medica, Hospital Privado Universitario de Córdoba, Argentina
- Instituto Universitario de Ciencias Biomedicas de Córdoba (IUCBC), Argentina
| | - Maria E Garzon
- Servicio de Clinica Medica, Hospital Privado Universitario de Córdoba, Argentina
- Instituto Universitario de Ciencias Biomedicas de Córdoba (IUCBC), Argentina
| | - Maria Teresita Cornavaca
- Servicio de Clinica Medica, Hospital Privado Universitario de Córdoba, Argentina
- Instituto Universitario de Ciencias Biomedicas de Córdoba (IUCBC), Argentina
| | - Francisco Bernabeu
- Servicio de Clinica Medica, Hospital Privado Universitario de Córdoba, Argentina
- Instituto Universitario de Ciencias Biomedicas de Córdoba (IUCBC), Argentina
| | - Ricardo A Albertini
- Servicio de Clinica Medica, Hospital Privado Universitario de Córdoba, Argentina
- Instituto Universitario de Ciencias Biomedicas de Córdoba (IUCBC), Argentina
| | - Gustavo Ellena
- Servicio de Clinica Medica, Hospital Privado Universitario de Córdoba, Argentina
- Instituto Universitario de Ciencias Biomedicas de Córdoba (IUCBC), Argentina
| | - Cesar A Romero
- Servicio de Clinica Medica, Hospital Privado Universitario de Córdoba, Argentina
- Global Health Initiative, Henry Ford Hospital, Detroit, MI, USA
- Hypertension and Vascular Research Division, Internal Medicine Department, Henry Ford Hospital, Detroit, MI, USA
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290
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Chilcot J, Hackett RA. Association Between Optimism and Incident Stroke Among Stroke Survivors: Findings From the English Longitudinal Study of Ageing. Ann Behav Med 2024; 58:48-55. [PMID: 37706520 PMCID: PMC10729789 DOI: 10.1093/abm/kaad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Personality has been implicated in stroke death. However, the role of personality in stroke incidence is unclear. PURPOSE Our primary aim was to investigate associations between optimism, determination, control, and the "Big Five" personality traits on incident stroke. A secondary aim was to assess the potential mediating role of health behaviors in the personality-stroke relationship. METHODS A total of 3,703 stroke-free participants from the English Longitudinal Study of Ageing provided data on personality using the Midlife Development Inventory at Wave 5 (2010/11). Self-reported incident stroke was assessed from Waves 6 to 8 (2012-2017). Associations were modeled using discrete-time survival proportional odds logistic models. Analyses were adjusted for sociodemographic factors, history of other cardiometabolic diseases, and health behaviors. RESULTS Over 6 years follow-up there were 125 incident strokes. Higher optimism (hazard ratio [HR] = 0.66; 95% confidence interval [CI] 0.53, 0.82), openness (HR = 0.72; 95% CI 0.53, 0.98), and conscientiousness (HR = 0.59; 95% CI 0.42, 0.84) were associated with reduced incident stroke risk in unadjusted models. After adjustment for sociodemographic factors and history of cardiometabolic disease, only the association between optimism and incident stroke remained significant (HR = 0.72; 95% CI 0.57, 0.92). The effect of optimism remained significant in a final model adjusting for health behaviors (HR = 0.75; 95% CI 0.60, 0.96). There was evidence of a small but significant mediating effect of physical activity. CONCLUSIONS Higher trait optimism was associated with reduced stroke risk. This association was partially mediated by physical activity albeit the effect was small, and caution warranted inferring causality. The interplay of personality, behavior, and clinical risk factors in stroke incidence and survivorship needs further investigation.
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Affiliation(s)
- Joseph Chilcot
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King’s College London, London, UK
| | - Ruth A Hackett
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King’s College London, London, UK
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291
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Rethemiotaki I. Global prevalence of cardiovascular diseases by gender and age during 2010-2019. Arch Med Sci Atheroscler Dis 2023; 8:e196-e205. [PMID: 38283927 PMCID: PMC10811545 DOI: 10.5114/amsad/176654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/08/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction The aim of this study was to evaluate the global, gender, and age-related cardiovascular disease (CVD) burden during 2010-2019. Not only the global trend in the prevalence of CVDs was studied but also whether there was a statistically significant difference between genders and ages during 2010-2019. Material and methods Detailed information from 2010 to 2019, including global rates of prevalence of 11 categories of CVD, was collected from the Global Burden of Disease Study 2019. The statistical methods used to analyze the results of this study are the independent samples t-test and one-way analysis of variance (ANOVA) test. Results The global prevalence rate of CVDs increased from 0.061% in 2010 to 0.070% in 2019. There was a statistically significant difference in prevalence rates between genders in all cardiovascular diseases except atrial fibrillation and flutter. Females have higher prevalence rates of CVDs worldwide. Moreover, females have statistically significantly higher prevalence rates of stroke, hypertensive heart disease, rheumatic heart disease, non-rheumatic valvular heart disease, endocarditis, peripheral artery disease and other cardiovascular and circulatory diseases globally. On the other hand, males have statistically significantly higher prevalence rates of cardiomyopathy and myocarditis, and ischemic heart disease globally. Rheumatic heart disease has a statistically significantly higher prevalence rate in the age group of 25-49 years than the other age groups. Conclusions The significance of this study is not only that it has succeeded in evaluating the global, gender, and age-related cardiovascular disease (CVD) burden, finding statistically significant associations, but it is also the only study to achieve this goal in the last decade.
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Affiliation(s)
- Irene Rethemiotaki
- School of Electrical and Computer Engineering, Technical University of Crete, Crete, Greece
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292
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Sinclair J, Dillon S, Lowe NM, Melia A. Effects of a Nutrition Education Programme in Stage IV Cardiac Rehabilitation Patients: A 3-Arm Randomised Controlled Trial. Life (Basel) 2023; 14:63. [PMID: 38255678 PMCID: PMC10817625 DOI: 10.3390/life14010063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/23/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
This trial examined the influence of two nutrition intervention programmes on health-related and nutritional intake indices pertinent to cardiovascular disease compared to usual care in stage IV cardiac rehabilitation patients. Sixty-six patients were recruited from the Heartbeat North-West cardiac rehabilitation centre in Preston (United Kingdom). Patients were randomly assigned to Usual care, Biggest loser or Nutrition education arms. Usual care undertook their usual two exercise classes per week without nutritional support, Biggest loser underwent weekly education sessions focussing on weight loss using the themes within the British Heart Foundation 'So You Want to Lose Weight for Good' guidelines, and Nutrition education followed the same themes as Biggest loser but in a more focussed manner informed by patient focus groups. In total, this was a 12-week trial in which patients spent 6 weeks engaged in their allocated intervention arm, after which all participants switched to Usual care. The primary outcome was systolic blood pressure, and secondary measures of anthropometric, blood biomarker, nutritional knowledge (via the Mediterranean Diet Assessment Tool) and nutritional intake indices were measured at baseline, 6 weeks, and 12 weeks (follow-up). Intention-to-treat analyses revealed no significant alterations in the primary outcome (Usual care: baseline = 130.45 mmHg, 6 weeks = 127.83 mmHg, and follow-up = 126.35 mmHg, Biggest loser: baseline = 133.50 mmHg, 6 weeks = 123.06 mmHg, and follow-up = 135.22 mmHg, or Nutrition education: baseline = 135.23 mmHg, 6 weeks = 129.20 mmHg, and follow-up = 126.26 mmHg) between arms. However, at 6 weeks, improvements in triglycerides were significantly greater in Usual care (baseline = 1.61 mmol/L and 6 weeks = 1.43 mmol/L) group compared to Nutrition education (baseline = 1.70 mmol/L and 6 weeks = 2.21 mmol/L). Improvements in nutrition knowledge were significantly greater in Nutrition education (baseline = 8.48, 6 weeks = 9.77, and follow-up = 10.07) compared to Usual care (baseline = 7.71, 6 weeks = 8.00, and follow-up = 8.00) and Biggest loser (baseline = 7.71, 6 weeks = 8.73, and follow-up = 8.36). At 6 weeks, the Biggest loser group (baseline = 4.75 g and 6 weeks = 3.83 g) exhibited significantly greater improvements in salt intake compared to Usual care (baseline = 4.87 g and 6 weeks = 4.28 g) and Nutrition education (baseline = 19.25 g and 6 weeks = 16.78 g) in saturated fatty acids compared to Usual care (baseline = 20.26 g and 6 weeks = 21.34 g). This trial shows the effectiveness of nutritional interventions for improving nutritional knowledge and dietary practices in stage IV cardiac rehabilitation, but the mechanisms and longer-term effects of increased triglyceride levels in the Nutrition education group requires further exploration.
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Affiliation(s)
- Jonathan Sinclair
- Centre for Global Development, School of Health, Social Work & Sport, University of Central Lancashire, Preston PR1 2HE, Lancashire, UK
- Research Centre for Applied Sport, Physical Activity and Performance, School of Health, Social Work & Sport, University of Central Lancashire, Preston PR1 2HE, Lancashire, UK
| | - Stephanie Dillon
- Research Centre for Applied Sport, Physical Activity and Performance, School of Health, Social Work & Sport, University of Central Lancashire, Preston PR1 2HE, Lancashire, UK
| | - Nicola M. Lowe
- Research Centre for Applied Sport, Physical Activity and Performance, School of Health, Social Work & Sport, University of Central Lancashire, Preston PR1 2HE, Lancashire, UK
| | - April Melia
- Centre for Global Development, School of Health, Social Work & Sport, University of Central Lancashire, Preston PR1 2HE, Lancashire, UK
- Research Centre for Applied Sport, Physical Activity and Performance, School of Health, Social Work & Sport, University of Central Lancashire, Preston PR1 2HE, Lancashire, UK
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Yu W, Yang B, Xu S, Gao Y, Huang Y, Wang Z. Diabetic Retinopathy and Cardiovascular Disease: A Literature Review. Diabetes Metab Syndr Obes 2023; 16:4247-4261. [PMID: 38164419 PMCID: PMC10758178 DOI: 10.2147/dmso.s438111] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024] Open
Abstract
Diabetic complications can be divided into macrovascular complications such as cardiovascular disease and cerebrovascular disease and microvascular complications such as diabetic retinopathy, diabetic nephropathy and diabetic neuropathy. Among them, cardiovascular disease (CVD) is an important cause of death in diabetic patients. Diabetes retinopathy (DR) is one of the main reasons for the increasing disability rate of diabetes. In recent years, some studies have found that because DR and CVD have a common pathophysiological basis, the occurrence of DR and CVD are inseparable, and to a certain extent, DR can predict the occurrence of CVD. With the development of technology, the fundus parameters of DR can be quantitatively analyzed as an independent risk factor of CVD. In addition, the cytokines related to DR can also be used for early screening of DR. Although many advances have been made in the treatment of CVD, its situation of prevention and treatment is still not optimistic. This review hopes to discuss the feasibility of DR in predicting CVD from the common pathophysiological mechanism of DR and CVD, the new progress of diagnostic techniques for DR, and the biomarkers for early screening of DR.
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Affiliation(s)
- Wenhua Yu
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Bo Yang
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Siting Xu
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Yun Gao
- Department of Pathology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Yan Huang
- Department of Ophthalmology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Zhongqun Wang
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
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294
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Zhang X, Lv H, Chen X, Li M, Zhou X, Jia X. Analysis of ischemic stroke burden in Asia from 1990 to 2019: based on the global burden of disease 2019 data. Front Neurol 2023; 14:1309931. [PMID: 38187147 PMCID: PMC10770854 DOI: 10.3389/fneur.2023.1309931] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024] Open
Abstract
Background Ischemic stroke has the characteristics of high morbidity, mortality, and recurrence rate. This study aimed to describe and assess the burden of ischemic stroke in Asia based on the global burden of disease (GBD) 2019 data and provide a crucial scientific foundation for the prevention and control of this life-threatening disease. Method This study used the GBD 2019 data to assess the burden of ischemic stroke. The indicators used in this study were derived from the following methods: (i) the incidence of ischemic stroke was estimated using the disability model for the global burden of disease study-mixed effects regression (DisMod-MR), a Bayesian meta-regression disease modeling tool; (ii) the non-specific codes of all available data on mortality were corrected and used to estimate mortality rates for ischemic stroke and the cause of death ensemble model was used to estimate mortality rates; and (iii) the disability-adjusted life years (DALYs) is the sum of years lived with disability (YLD) and the years of life lost (YLL), which quantifies the health loss due to specific diseases and injuries. In addition, the joinpoint regression model was adopted to analyze the temporal trend of ischemic stroke from 1990 to 2019 in Asia. Result This study found an increase in the burden of ischemic stroke in 2019 compared to 1990. Moreover, the age-standardized incidence rate (ASIR) of ischemic stroke showed a gradual upward trend over the specific period. The age-standardized mortality rate (ASMR) showed a downward trend in Asia from 1990 to 2019. The burden of ischemic stroke was more concentrated on older age groups, particularly those older than 65 years. East Asia had the highest burden of ischemic stroke compared to other regions in Asia. Particularly, China, India, Indonesia, and Japan had the highest burdens of ischemic stroke among the Asian countries and regions. However, the population with the highest burden of ischemic stroke was still the elderly group. Conclusion Based on our study, it is evident that the burden of ischemic stroke exists substantially and exhibits variations in the aspects of age, gender, and geographical region in Asia. Without targeted implementation of population-wide primary strategies for prevention and control, the burden of ischemic stroke is likely to worsen significantly in the future.
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Affiliation(s)
- Xueli Zhang
- School of Health Management, Changchun University of Chinese Medicine, Changchun, China
- Jilin Provincial People’s Hospital, Changchun, China
| | - Hengliang Lv
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Xin Chen
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Maoxuan Li
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xiaojing Zhou
- Department of Biochemistry, Clinical Medical College, Changchun University of Chinese Medicine, Changchun, China
| | - Xiaoying Jia
- School of Health Management, Changchun University of Chinese Medicine, Changchun, China
- Jilin Provincial People’s Hospital, Changchun, China
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295
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Engda T, Tessema B, Mesifin N, Nuru A, Belachew T, Moges F. Shiga toxin-producing Escherichia coli O157:H7 among diarrheic patients and their cattle in Amhara National Regional State, Ethiopia. PLoS One 2023; 18:e0295266. [PMID: 38127993 PMCID: PMC10734908 DOI: 10.1371/journal.pone.0295266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Shiga toxin-producing Escherichia coli O157:H7 (STEC O157:H7) is a zoonotic pathogen that causes diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome worldwide. This study aimed to determine the prevalence, antibiotic susceptibility, and associated risk factors of STEC O157:H7 among diarrheic patients and their cattle. METHODS A cross-sectional study was conducted among diarrheic patients and their cattle in Amhara National Regional State, Ethiopia from December- 2020 to June- 2022. A total of 1,149 diarrheic patients and 229 cattle were included in the study. STEC O157:H7 detection was done using culture, latex agglutination test, and polymerase chain reaction on diarrheic stool samples and recto-anal mucosal swabs of cattle. Antibiotic susceptibility tests were performed using disk diffusion techniques. Risk factors association were identified using binary and multivariable logistic regression analysis. RESULTS The overall prevalence of STEC O157:H7 in diarrheic patients and their cattle was 11.1% (128/1149) and 14.4% (33/229) respectively. High percentage of the study subjects were found in under-five children (34.5%). Age less than 5 (AOR: 4.02, 95%CI:1.608-10.058,P = 0.003), and greater than 64 years old (AOR:3.36, 95% CI:1.254-8.986, P = 0.016), presence of diarrheic patient in the house (AOR:2.11, 95%CI:1.309-3.390, P = 0.002), availability of cattle in the house (AOR:2.52, 95%CI:1.261-5.049, P = 0.009), and habit of consuming raw foods (AOR:4.35, 95%CI:2.645-7.148, P = 0.000) were risk factors. Antibiotic resistance was shown in 109(85.2%), and 31(93.9%) isolates from diarrheic patients and their cattle respectively. The highest levels of antibiotic resistance were found to tetracycline (54.7%, 69.7%) in diarrheic patients and their cattle respectively. Multiple drug resistance was also observed among 56(43.8%) and 11(33.3%) isolates in diarrheic patients and their cattle respectively. CONCLUSION Our study showed high prevalence of STEC O157:H7 in diarrheic patients and their cattle. Therefore, health education should be given to the community on how to care for animals, proper sanitation, and the impact of raw food consumption.
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Affiliation(s)
- Tigist Engda
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belay Tessema
- Faculty of Medicine, Institute of Medical Microbiology and Virology, University of Leipzig, Leipzig, Germany
| | - Nebiyu Mesifin
- Department of Internal Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anwar Nuru
- College of Veterinary Medicine and Animal Sciences, University of Gondar, Gondar, Ethiopia
| | - Teshome Belachew
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Feleke Moges
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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296
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Ripon RK, Rimti FH, Kercy M, Hossain S, Motahara U, Hossain MS, Sikder MT. A trend analysis of Black American women with cardiovascular disease and chronic medical conditions, sociodemographic factors from NHANES From 2011 to 2020. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002521. [PMID: 38109309 PMCID: PMC10727433 DOI: 10.1371/journal.pgph.0002521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 09/19/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Significant racial and gender differences exist in the prevalence of CVD in the United States. The goal of this study is to evaluate the prevalence of CVD among Black American women, the relationship between CVD and some medical conditions, and significant sociodemographic factors. METHODS The researchers in this study used data from four cycles of the NHANES, carried out by the NCHS. 2011 to 2012, 2013 to 2014, 2015 to 2016, and 2017 to 2020 were the cycles that were chosen. The researchers used the survey package in the R programming language to examine the data. RESULTS People with CVD problems 20 years of age and older were included in the analyses. Black American women experienced a considerable prevalence of CVD from 2011 to 2020. These women were more likely to report having completed no more schooling than the ninth grade, being widowed/divorced/separated, and having undergone a hysterectomy, as well as having a history of diabetes, asthma, obesity, arthritis, and depression. Black American women with CVD had a 3.8-fold increased risk of diabetes and a 5.6-fold increased risk of arthritis. CONCLUSION This study shows that Black American women with CVD are more likely to have chronic illnesses such as hysterectomy, diabetes, asthma, obesity, arthritis, and depression. Black American women's cardiovascular risk profiles can be updated using the data from this study.
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Affiliation(s)
- Rezaul Karim Ripon
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
- McHigher Center for Health Research, Boston, Massachusetts, United States of America
| | | | - Mickelder Kercy
- The City University of New York, New York, New York, United States of America
| | - Shahriar Hossain
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
- McHigher Center for Health Research, Boston, Massachusetts, United States of America
| | - Umma Motahara
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Md. Sharif Hossain
- McHigher Center for Health Research, Boston, Massachusetts, United States of America
- Division of Epidemiology, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Md. Tajuddin Sikder
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
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297
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Ramezankhani A, Azizi F, Hadaegh F. Sex differences in risk factors for coronary heart disease events: a prospective cohort study in Iran. Sci Rep 2023; 13:22398. [PMID: 38104178 PMCID: PMC10725458 DOI: 10.1038/s41598-023-50028-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 12/14/2023] [Indexed: 12/19/2023] Open
Abstract
We investigated sex-specific associations and their differences between major cardiovascular risk factors and the risk of incident coronary heart disease (CHD) and hard CHD (defined as nonfatal myocardial infarction and CHD death). A total of 7518 (3377 men) participants from the Tehran Lipid and Glucose Study were included. Cox models were used to estimate the hazard ratios (HRs) and women-to-men ratios of HRs for CHD events associated with each risk factor. During 20 years of follow-up (1999-2018), 1068 (631 men) and 345 (238 men) new cases of CHD and hard CHD, respectively, were documented. In total population, the incidence rates per 1000 person-years were 9.5 (9.0-10.1) and 2.9 (2.6-3.2) for CHD and hard CHD, respectively. Hypertension, diabetes, pre-diabetes, and a high waist-to-hip ratio (WHR) were associated with a greater HR of hard CHD in women than men; the women-to-men HRs were 2.85 [1.36-5.98], 1.92 [1.11-3.31], 2.04 [1.09-3.80] and 1.42 [1.10-1.82], respectively. Diabetes was associated with a higher HR of CHD in women than men (ratio of HRs 1.49 (1.10-2.01). In conclusion, we found that hypertension, diabetes, pre-diabetes, and high WHR conferred a greater excess risk of CHD events in women than in men, suggesting that Iranian women may require greater attention for the prevention of CHD events.
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Affiliation(s)
- Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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298
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Walker NF, Schutz C, Ward A, Barr D, Opondo C, Shey M, Elkington PT, Wilkinson KA, Wilkinson RJ, Meintjes G. Elevated plasma matrix metalloproteinases associate with Mycobacterium tuberculosis blood stream infection and mortality in HIV-associated tuberculosis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.12.23299845. [PMID: 38168355 PMCID: PMC10760259 DOI: 10.1101/2023.12.12.23299845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Mortality from HIV-associated tuberculosis (HIV-TB) is high, particularly among hospitalised patients. In 433 people living with HIV admitted to hospital with symptoms of TB, we investigated plasma matrix metalloproteinases (MMP) and matrix-derived biomarkers in relation to TB diagnosis, mortality and Mycobacterium tuberculosis (Mtb) blood stream infection (BSI). Compared to other diagnoses, MMP-8 was elevated in confirmed TB and in Mtb-BSI, positively correlating with extracellular matrix breakdown products. Baseline MMP-3, -7, -8, -10 and procollagen III N-terminal propeptide (PIIINP) associated with Mtb-BSI and 12-week mortality. These findings implicate MMP dysregulation in pathophysiology of advanced HIV-TB and support MMP inhibition as a host-directed therapeutic strategy for HIV-TB.
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Affiliation(s)
- N F Walker
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, United Kingdom
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
- TB Centre and Department of Clinical Research, London School of Hygiene and Tropical Medicine, WC1E 7HT, United Kingdom
| | - C Schutz
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
- Department of Medicine, University of Cape Town, Observatory 7925, South Africa
| | - A Ward
- Department of Medicine, University of Cape Town, Observatory 7925, South Africa
| | - D Barr
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
- Wellcome Liverpool Glasgow Centre for Global Health Research, University of Liverpool, Liverpool, L69 3BX, United Kingdom
- Department of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, G51 4TF
| | - C Opondo
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, WC1E 7HT, United Kingdom
| | - M Shey
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
- Department of Medicine, University of Cape Town, Observatory 7925, South Africa
| | - P T Elkington
- NIHR Biomedical Research Centre, School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, SO16 6YD, United Kingdom
| | - K A Wilkinson
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
- Department of Medicine, University of Cape Town, Observatory 7925, South Africa
- The Francis Crick Institute, London, NW1 1AT, United Kingdom
| | - R J Wilkinson
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
- Department of Medicine, University of Cape Town, Observatory 7925, South Africa
- The Francis Crick Institute, London, NW1 1AT, United Kingdom
- Department of Infectious Diseases, Imperial College London, W12 0NN, United Kingdom
| | - G Meintjes
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
- Department of Medicine, University of Cape Town, Observatory 7925, South Africa
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299
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Liu Y, Xu Y, Xu X, Chen X, Chen H, Zhang J, Ma J, Zhang W, Zhang R, Chen J. Metagenomic identification of pathogens and antimicrobial-resistant genes in bacterial positive blood cultures by nanopore sequencing. Front Cell Infect Microbiol 2023; 13:1283094. [PMID: 38192400 PMCID: PMC10773726 DOI: 10.3389/fcimb.2023.1283094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/30/2023] [Indexed: 01/10/2024] Open
Abstract
Nanopore sequencing workflows have attracted increasing attention owing to their fast, real-time, and convenient portability. Positive blood culture samples were collected from patients with bacterial bloodstream infection and tested by nanopore sequencing. This study compared the sequencing results for pathogen taxonomic profiling and antimicrobial resistance genes to those of species identification and phenotypic drug susceptibility using traditional microbiology testing. A total of 37 bacterial positive blood culture results of strain genotyping by nanopore sequencing were consistent with those of mass spectrometry. Among them, one mixed infection of bacteria and fungi was identified using nanopore sequencing and confirmatory quantitative polymerase chain reaction. The amount of sequencing data was 21.89 ± 8.46 MB for species identification, and 1.0 MB microbial strain data enabled accurate determination. Data volumes greater than or equal to 94.6 MB nearly covered all the antimicrobial resistance genes of the bacteria in our study. In addition, the results of the antimicrobial resistance genes were compared with those of phenotypic drug susceptibility testing for Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. Therefore, the nanopore sequencing platform for rapid identification of causing pathogens and relevant antimicrobial resistance genes complementary to conventional blood culture outcomes may optimize antimicrobial stewardship management for patients with bacterial bloodstream infection.
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Affiliation(s)
- Yahui Liu
- Department of Laboratory Medicine, Shanghai Xuhui District Central Hospital & Fudan University Affiliated Xuhui Hospital, Shanghai, China
- Department of Laboratory Medicine, Shanghai Post and Telecommunication Hospital, Shanghai, China
| | - Yumei Xu
- Department of Laboratory Medicine, Shanghai Xuhui District Central Hospital & Fudan University Affiliated Xuhui Hospital, Shanghai, China
| | - Xinyu Xu
- Department of Laboratory Medicine, Shanghai Post and Telecommunication Hospital, Shanghai, China
| | - Xianghui Chen
- Shanghai Diabetes Institute, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongli Chen
- Shanghai Diabetes Institute, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingjing Zhang
- Precision Medicine Center, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiayu Ma
- Precision Medicine Center, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenrui Zhang
- Precision Medicine Center, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Zhang
- Shanghai Diabetes Institute, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Chen
- Department of Laboratory Medicine, Shanghai Post and Telecommunication Hospital, Shanghai, China
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300
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Marye DM, Debalkie Atnafu D, Belayneh M, Takele Alemu A. User Fee Exemption Policy Significantly Improved Adherence to Maternal Health Service Utilization in Bahir Dar City, Northwest Ethiopia: A Comparative Cross-Sectional Study. CLINICOECONOMICS AND OUTCOMES RESEARCH 2023; 15:775-785. [PMID: 38106643 PMCID: PMC10722901 DOI: 10.2147/ceor.s431488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/06/2023] [Indexed: 12/19/2023] Open
Abstract
Background Increasing free and skilled delivery is a top priority in the global effort to reduce maternal and newborn mortality. Reducing user-fees through exemption policy has contributed to universal health coverage. However, there is scant evidence regarding the effect of exempted maternal services on adherence to utilization in Ethiopia. Thus, this study aimed to assess the effect of fee exemption policy on adherence to maternal health service utilization and its predictors. Methods A community-based comparative cross-sectional study was conducted in Bahir Dar City. A two-stage multistage sampling was employed; 497 women participated. Data were collected by face-to-face interview; entered and cleaned using Epi-Data 3.1. SPSS version 25 was used for further analysis. Bivariable and multivariable logistic regression models were computed to assess the association between explanatory and outcome variables. An adjusted odds ratio with a 95% confidence interval was used to interpret the degree of association. The effect of fee exemption policy on adherence to maternal health service utilization was measured by propensity score matching. Results The overall adherence to maternal service utilization was 54.2%. Factors associated with adherence to maternal health service utilization were pregnancy complications [AOR: 4.1, 95% CI (2.32, 7.28)], secondary and above education [AOR: 4.6, 95% CI (1.38, 15.08)], early ANC1 booking [AOR: 3.1, 95% CI (1.83, 5.16)], autonomous women [AOR: 2.1, 95% CI (1.02, 4.39)], user fee exemption [AOR: 2.3, 95% CI (1.20, 4.47)] and high parity [AOR: 0.39, 95% CI (0.2, 0.75)]. User fee exemption induced a 22.7% increment in adherence to maternal service utilization (ATET=0.227, t=2.13). Conclusion User fee exemption policy significantly improved adherence to maternal health service utilization. Promoting a fee exemption policy through third-party financing can enhance maternal health service utilization adherence in hard-to-reach settings of Ethiopia by targeting mothers with higher pregnancies, no complications, no autonomy, and less education.
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Affiliation(s)
- Demlie Mekonnen Marye
- Department of Health System Management and Health Economics, School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia
| | - Desta Debalkie Atnafu
- Department of Health System Management and Health Economics, School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
| | - Melesse Belayneh
- Department of Health System Management and Health Economics, School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ayenew Takele Alemu
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
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