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Mo H, Wang S. Assessing the spatiotemporal evolution and socioeconomic determinants of PM 2.5-related premature deaths in China from 2000 to 2021. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 946:174323. [PMID: 38955281 DOI: 10.1016/j.scitotenv.2024.174323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/12/2024] [Accepted: 06/25/2024] [Indexed: 07/04/2024]
Abstract
China's swift socioeconomic development has led to extremely severe ambient PM2.5 levels, the associated negative health outcomes of which include premature death. However, a comprehensive explanation of the socioeconomic mechanism contributing to PM2.5-related premature deaths has not yet to be fully elucidated through long-term spatial panel data. Here, we employed a global exposure mortality model (GEMM) and the system generalized method of moments (Sys-GMM) to examine the primary determinants contributing to premature deaths in Chinese provinces from 2000 to 2021. We found that in the research period, premature deaths in China increased by 46 %, reaching 1.87 million, a figure that decreased somewhat after the COVID-19 outbreak. 62 thousand premature deaths were avoided in 2020 and 2021 compared to 2019, primarily due to the decline in PM2.5 concentrations. Premature deaths have increased across all provinces, particularly in North China, and a discernible spatial agglomeration effect was observed, highlighting effects on nearby provinces. The findings also underscored the significance of determinants such as urbanization, import and export trade, and energy consumption in exacerbating premature deaths, while energy intensity exerted a mitigating influence. Importantly, a U-shaped relationship between premature deaths and economic development was unveiled for the first time, implying the need for vigilance regarding potential health impact deterioration and the implementation of countermeasures as the per capita GDP increases in China. Our findings deserve attention from policymakers as they shed fresh insights into atmospheric control and Health China action.
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Affiliation(s)
- Huibin Mo
- Shenzhen Key Laboratory of Ecological Remediation and Carbon Sequestration, Institute of Environment and Ecology, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Shaojian Wang
- School of Geography and Planning, Sun Yat-sen University, Guangzhou 510006, China.
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Li Y, He L, Song H, Bao X, Niu S, Bai J, Ma J, Yuan R, Liu S, Guo J. Cordyceps: Alleviating ischemic cardiovascular and cerebrovascular injury - A comprehensive review. JOURNAL OF ETHNOPHARMACOLOGY 2024; 332:118321. [PMID: 38735418 DOI: 10.1016/j.jep.2024.118321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/28/2024] [Accepted: 05/07/2024] [Indexed: 05/14/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cordyceps has a long medicinal history as a nourishing herb in traditional Chinese medicine (TCM). Ischemic cardio-cerebrovascular diseases (CCVDs), including cerebral ischemic/reperfusion injury (CI/RI) and myocardial ischemic/reperfusion injury (MI/RI), are major contributors to mortality and disability in humans. Numerous studies have indicated that Cordyceps or its artificial substitutes have significant bioactivity on ischemic CCVDs, however, there is a lack of relevant reviews. AIM OF THE STUDY This review was conducted to investigate the chemical elements, pharmacological effects, clinical application and drug safety of Cordycepson ischemic CCVDs. MATERIALS AND METHODS A comprehensive search was conducted on the Web of Science, PubMed, Chinese National Knowledge Infrastructure (CNKI), and Wanfang databases using the keywords "Cordyceps", "Cerebral ischemic/reperfusion injury", and "Myocardial ischemic/reperfusion injury" or their synonyms. The retrieved literature was then categorized and summarized. RESULTS The study findings indicated that Cordyceps and its bioactive components, including adenosine, cordycepin, mannitol, polysaccharide, and protein, have the potential to protect against CI/RI and MI/RI by improving blood perfusion, mitigating damage from reactive oxygen species, suppressing inflammation, preventing cellular apoptosis, and promoting tissue regeneration. Individually, Cordyceps could reduce neuronal excitatory toxicity and blood-brain barrier damage caused by cerebral ischemia. It can also significantly improve cardiac energy metabolism disorders and inhibit calcium overload caused by myocardial ischemia. Additionally, Cordyceps exerts a significant preventive or curative influence on the factors responsible for heart/brain ischemia, including hypertension, thrombosis, atherosclerosis, and arrhythmia. CONCLUSION This study demonstrates Cordyceps' prospective efficacy and safety in the prevention or treatment of CI/RI and MI/RI, providing novel insights for managing ischemic CCVDs.
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Affiliation(s)
- Yong Li
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Liying He
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Haoran Song
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Xiuwen Bao
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Shuqi Niu
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Jing Bai
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Junhao Ma
- College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Run Yuan
- College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Sijing Liu
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Jinlin Guo
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China; College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
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253
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Niu Z, He Q, Chen C. A PM 2.5 pollution-level adaptive air filtration system based on elastic filters for reducing energy consumption. JOURNAL OF HAZARDOUS MATERIALS 2024; 478:135546. [PMID: 39173385 DOI: 10.1016/j.jhazmat.2024.135546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/26/2024] [Accepted: 08/15/2024] [Indexed: 08/24/2024]
Abstract
Exacerbated by human activities and natural events, air pollution poses severe health risks, requiring effective control measures to ensure healthy living environments. Traditional filtration systems that employ high-efficiency particulate air (HEPA) filters are capable of effectively removing particulate matter (PM) in indoor environments. However, these systems often work without considering the fluctuations in air pollution levels, leading to high energy consumption. This study proposed a novel PM2.5 pollution-level adaptive air filtration system that combined elastic thermoplastic polyurethane (TPU) filters and an Internet of Things (IoT) system. The developed system can effectively adjust its filtration performance (i.e., pressure drop and PM2.5 filtration efficiency) in response to real-time air quality conditions by mechanically altering the structures of TPU filters. Furthermore, while operating in varied pollution conditions, the proposed system demonstrated remarkable reductions in pressure drop without notably compromising the pollution control capability. Finally, the energy consumption of the pollution-level adaptive air filtration system was estimated when applied in mechanical ventilation systems in different cities (Hong Kong, Beijing, and Xi'an) with various pollution conditions. The results revealed that, compared to a traditional fixed system, the annual energy consumption could be reduced by up to ∼26.4 % in Hong Kong.
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Affiliation(s)
- Zhuolun Niu
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Shatin, N.T. 999077, Hong Kong SAR, China
| | - Qiguang He
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Shatin, N.T. 999077, Hong Kong SAR, China.
| | - Chun Chen
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Shatin, N.T. 999077, Hong Kong SAR, China; Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Shatin N.T. 999077, Hong Kong SAR, China.
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254
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He G, Jiang M, Tian S, He L, Bai X, Chen S, Li G, Wang C, Zhang Z, Wu Y, Su M, Li X, Guo X, Yang Y, Zhang X, Cui J, Xu W, Song L, Yang H, He W, Zhang Y, Li X, Gao X, Chen L. Clean air policy reduces the atherogenic lipid profile levels: Results from China Health Evaluation And risk Reduction through nationwide Teamwork (ChinaHEART) Study. JOURNAL OF HAZARDOUS MATERIALS 2024; 478:135394. [PMID: 39128148 DOI: 10.1016/j.jhazmat.2024.135394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/16/2024] [Accepted: 07/30/2024] [Indexed: 08/13/2024]
Abstract
Evidence of the associations between long-term exposure to PM2.5 and O3 and human blood lipid concentrations is abundant yet inconclusive. Whether clean air policies could improve lipid profiles remains unclear. In total, 2979312 participants from a Chinese nationwide prospective study were included. For cross-sectional analyses, linear mixed-effects models were utilized to assess the associations of pollutants with lipid profiles (TC, LDL-C, TG, HDL-C). For longitudinal analyses, a quasi-experimental design and difference-in-differences models were employed to investigate the impact of China's Clean Air Act. In the cross-sectional analyses, each IQR increase in PM2.5 was associated with 2.49 % (95 % CI: 2.36 %, 2.62 %), 2.51 % (95 % CI: 2.26 %, 2.75 %), 3.94 % (95 % CI: 3.65 %, 4.23 %), and 1.54 % (95 % CI: 1.38 %, 1.70 %) increases in TC, LDL-C, TG, and HDL-C, respectively. For each IQR increase in O3, TC, LDL-C, TG, and HDL-C changed by 1.06 % (95 % CI: 0.95 %, 1.17 %), 1.21 % (95 % CI: 1.01 %, 1.42 %), 1.78 % (95 % CI: 1.54 %, 2.02 %), and -0.63 % (95 % CI: -0.76 %, -0.49 %), respectively. Longitudinal analyses showed that the intervention group experienced greater TC, LDL-C, and HDL-C reductions (1.77 %, 4.26 %, and 7.70 %, respectively). Our findings suggest that clean air policies could improve lipid metabolism and should be implemented in countries with heavy air pollution burdens.
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Affiliation(s)
- Guangda He
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meijie Jiang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Sifan Tian
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Linkang He
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueke Bai
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shi Chen
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangyu Li
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; 4+4 Medical Doctor Program, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Chunqi Wang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zenglei Zhang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Wu
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mingming Su
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangjie Li
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinxin Guo
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yang Yang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoyan Zhang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianlan Cui
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Xu
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lijuan Song
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Yang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenyan He
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Zhang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xi Li
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xu Gao
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
| | - Liang Chen
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Liu T, Xu H, Huang T, Liu G, Cao H, Lin Y, Li Y, Li Y, Yao X. Fuzheng Touxie Jiedu Huayu Decoction inhibits the MexAB-OprM efflux pump and quorum sensing-mediated biofilm formation in difficult-to-treat multidrug resistance Pseudomonas aeruginosa. JOURNAL OF ETHNOPHARMACOLOGY 2024; 332:118365. [PMID: 38796070 DOI: 10.1016/j.jep.2024.118365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/06/2024] [Accepted: 05/17/2024] [Indexed: 05/28/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Fuzheng Touxie Jiedu Huayu Decoction (FTJHD) is a commonly used clinical formula that has been found effective in resisting multidrug resistance-Pseudomonas aeruginosa in previous in vivo and in vitro studies. AIM OF THE STUDY To investigate the antimicrobial effects of FTJHD and its drug-containing serum alone or in combination with ceftazidime on difficult-to-treat multidrug resistance-P. aeruginosa (DTMDR-P. aeruginosa). MATERIALS AND METHODS The antibacterial effects of FTJHD and its drug-containing alone or in combination with ceftazidime against DTMDR-P. aeruginosa were examined by the tube dilution method and bacterial growth curves. The changes in the bacterial ultrastructure were examined by transmission electron microscopy. The biofilm formation ability of bacteria was examined by crystal violet staining and scanning electron microscopy. The expression of the MexAB-OprM efflux pump and quorum sensing system genes were validated through quantitative polymerase chain reaction. Molecular docking was used to evaluate the interaction between active components and the MexAB-OprM efflux pump. RESULTS FTJHD-containing serums at 1-, 2-, 4-, and 8-fold concentrations reduced the minimal inhibitory concentration (MIC) of ceftazidime against DTMDR-P. aeruginosa from 128 μg/mL to 64 μg/mL. Sub-inhibitory concentrations of ceftazidime in combination with FTJHD and FTJHD-containing serum prolonged the lag period of bacterial growth and reduced bacterial numbers. Additionally, 1/2 MIC of ceftazidime combined with FTJHD-containing serum significantly inhibited the activity of the MexAB-OprM efflux pump and quorum sensing system, thus reducing biofilm formation while causing more severe damage to the bacteria. Molecular docking revealed a strong affinity of quercetin, baicalein, luteolin, kaempferol, and β-sitosterol for the efflux pump regulatory proteins OprM and MexR. CONCLUSION FTJHD can exert synergistic anti-DTMDR-P. aeruginosa effects with ceftazidime by inhibiting biofilm formation mediated by the MexAB-OprM efflux pump and quorum sensing.
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Affiliation(s)
- Tong Liu
- Intensive Care Unit, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine (BUCM), Beijing, China
| | - Hongri Xu
- Emergency Department and Intensive Care Unit, BUCM Third Affiliated Hospital, Beijing, China.
| | - Tingxuan Huang
- Respiratory Department, BUCM Third Affiliated Hospital, Beijing, China
| | - Guoxing Liu
- Liu Zunji Chinese Medicine Clinic, Shannxi, China
| | - Hongyun Cao
- Emergency Department and Intensive Care Unit, BUCM Third Affiliated Hospital, Beijing, China
| | - Ying Lin
- Clinical Laboratory, Dongzhimen Hospital Affiliated to BUCM, Beijing, China
| | - Yali Li
- Emergency Department and Intensive Care Unit, BUCM Third Affiliated Hospital, Beijing, China
| | - Yan Li
- Intensive Care Unit, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine (BUCM), Beijing, China.
| | - Xingwei Yao
- Clinical Laboratory, Dongzhimen Hospital Affiliated to BUCM, Beijing, China.
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256
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Tang L, Wang D, Chang H, Liu Z, Zhang X, Feng X, Han L. Treating ischemic stroke by improving vascular structure and promoting angiogenesis using Taohong Siwu Decoction: An integrative pharmacology strategy. JOURNAL OF ETHNOPHARMACOLOGY 2024; 332:118372. [PMID: 38777084 DOI: 10.1016/j.jep.2024.118372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/17/2024] [Accepted: 05/19/2024] [Indexed: 05/25/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Neovessels represent a crucial therapeutic target and strategy for repairing ischemic tissue. Taohong Siwu Decoction (THSWD) exhibits potential in promoting angiogenesis to address ischemic stroke (IS). However, its impact on neovessel structure and function, alongside the underlying molecular mechanisms, remains elusive. AIM OF THE STUDY Our aim is to investigate the protective effects of THSWD on neovessel structure and function, as well as the associated molecular mechanisms, utilizing an integrative pharmacological approach. MATERIALS AND METHODS We initially employed behavioral tests, 2,3,5-triphenyltetrazolium chloride (TTC) staining, Haematoxylin-eosin (HE) staining, enzyme-linked immunosorbent assay (ELISA), Laser Doppler flowmetry (LDF), Evans blue staining, and immunofluorescence to evaluate the protective effects of THSWD on neovascular structure and function in middle cerebral artery occlusion/reperfusion (MCAO/R) rats. Subsequently, we utilized network pharmacology, metabolomics, and experimental validation to elucidate the underlying molecular mechanisms of THSWD in enhancing neovascular structure and function. RESULT In addition to significantly reducing neurological deficits and cerebral infarct volume, THSWD mitigated pathological damage, blood-brain barrier (BBB) leakage, and cerebral blood flow disruption. Moreover, it preserved neovascular structure and stimulated angiogenesis. THSWD demonstrated potential in ameliorating cerebral microvascular metabolic disturbances including lipoic acid metabolism, fructose and mannose metabolism, purine metabolism, and ether lipid metabolism. Consequently, it exhibited multifaceted therapeutic effects, encompassing anti-inflammatory, antioxidant, energy metabolism modulation, and antiplatelet aggregation properties. CONCLUSION THSWD exhibited protective effects on cerebral vascular structure and function and facilitated angiogenesis by rectifying cerebral microvascular metabolic disturbances in MCAO/R rats. Furthermore, integrated pharmacology offers a promising approach for studying the intricate traditional Chinese medicine (TCM) system in IS treatment.
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Affiliation(s)
- Linfeng Tang
- Department of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China; Anhui Province Key Laboratory of Chinese Medicinal Formula, Hefei, 230012, China
| | - Dandan Wang
- Department of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Hao Chang
- Department of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China; Anhui Province Key Laboratory of Chinese Medicinal Formula, Hefei, 230012, China
| | - Zhuqing Liu
- Department of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China; Anhui Province Key Laboratory of Chinese Medicinal Formula, Hefei, 230012, China
| | - Xueting Zhang
- Department of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China; Anhui Province Key Laboratory of Chinese Medicinal Formula, Hefei, 230012, China
| | - Xuefeng Feng
- Department of Pharmacy, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, China
| | - Lan Han
- Department of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China; Anhui Province Key Laboratory of Chinese Medicinal Formula, Hefei, 230012, China; MOE-Anhui Joint Collaborative Innovation Center for Quality Improvement of Anhui Genuine Chinese Medicinal Materials, Hefei, 230012, China.
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257
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Mascherbauer J, Kammerlander A, Nitsche C, Bax J, Delgado V, Evangelista A, Laroche C, Maggioni AP, Magne J, Vahanian A, Iung B. Sex-related differences in severe native valvular heart disease: the ESC-EORP Valvular Heart Disease II survey. Eur Heart J 2024; 45:3818-3833. [PMID: 39212374 DOI: 10.1093/eurheartj/ehae523] [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: 12/19/2023] [Revised: 04/08/2024] [Accepted: 07/31/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND AND AIMS To assess sex differences in disease characteristics and treatment of patients with severe native valvular heart disease (VHD) included in the VHD II EURObservational Research Programme. METHODS A total of 5219 patients were enrolled in 208 European and North African centres and followed for 6 months [41.2% aortic stenosis (AS), 5.3% aortic regurgitation (AR), 4.5% mitral stenosis (MS), 21.3% mitral regurgitation (MR), 2.7% isolated right-sided VHD, 24.9% multiple left-sided VHD]. Indications for intervention were considered concordant if corresponding to class I recommendations specified in the 2012 ESC or 2014 AHA/ACC VHD guidelines. RESULTS Overall, women were older, more symptomatic, and presented with a higher EuroSCORE II. Bicuspid aortic valve and AR were more prevalent among men while mitral disease, concomitant tricuspid regurgitation (TR), and AS above age 65 were more prevalent among women. On multivariable regression analysis, concordance with recommended treatment was significantly poorer in women with MS and primary MR (both P < .001). Age, patient refusal, and decline of symptoms after conservative treatment were reported significantly more often as reasons to withhold the intervention in females. Concomitant tricuspid intervention was performed at a similar rate in both sexes although prevalence of significant TR was significantly higher in women. In-hospital and 6-month survival did not differ between sexes. CONCLUSIONS (i) Valvular heart disease subtype varied between sexes; (ii) concordance with recommended intervention for MS and primary MR was significantly lower for women; and (iii) survival of men and women was similar at 6 months.
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Affiliation(s)
- Julia Mascherbauer
- Department of Internal Medicine 3, University Hospital St. Pölten, Dunantplatz 1, 3100 St. Poelten, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Andreas Kammerlander
- Department of Internal Medicine 2, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Christian Nitsche
- Department of Internal Medicine 2, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Jeroen Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Victoria Delgado
- Heart Institute, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Arturo Evangelista
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Cecile Laroche
- EURObservational Research Programme, European Society of Cardiology, Sophia-Antipolis, France
| | | | - Julien Magne
- Department of Cardiology, Dupuytren University Hospital 2, Limoges, France
| | | | - Bernard Iung
- Bichat Hospital, APHP, and INSERM LVTS 1148, Université Paris-Cité, Paris, France
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258
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Jia D, Zhao M, Zhang X, Cheng X, Wei Q, Lou L, Zhao Y, Jin Q, Chen M, Zhang D. Transcriptomic analysis reveals the critical role of chemokine signaling in the anti-atherosclerosis effect of Xuefu Zhuyu decoction. JOURNAL OF ETHNOPHARMACOLOGY 2024; 332:118245. [PMID: 38679399 DOI: 10.1016/j.jep.2024.118245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/18/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The process of atherosclerosis (AS) is complicated. Transcriptomics technology can assist in discovering the underlying mechanisms and exploring the key targets of Traditional Chinese Medicine (TCM) against atherosclerosis. AIM This study aimed to investigate targets and signaling pathways significantly related to AS and the potential intervention targets of Xuefu Zhuyu decoction by transcriptomics. MATERIALS AND METHODS AS models were established by subjecting ApoE-/-mice to an 8-week high-fat diet. Structural changes and plaque formation in the aortic root were observed using hematoxylin-eosin staining (HE staining), while Oil Red O staining was employed to visualize lipid deposition within the aortic root plaque. Movat staining and immunohistochemical staining were conducted to examine the components present in the aortic root plaque. Macrophage content within the plaque was observed through immunofluorescence. Additionally, mRNA sequencing was performed on aortic tissues to identify differentially expressed genes. Enrichment analysis was performed using GO and KEGG analysis. Visualization of the protein-protein interaction (PPI) network was achieved using Cytoscape 3.7.1 and STRING. Western blotting (WB) was employed to assess the protein expression of major differentially expressed genes in the aortic tissue. The drug freeze-dried powder of Xuefu Zhuyu decoction was prepared and the RAW264.7 cells were induced by lipopolysaccharide (LPS) to build an in vitro model. Real-time quantitative PCR was employed to measure the mRNA expression of major differential genes. RESULTS After ApoE-/- mice were fed with an 8-week high-fat diet, observable changes included the thinning of the aortic root wall, the accumulation of foam cells within the plaque, and the formation of cholesterol crystals in the model group. Treatment with Xuefu Zhuyu (XFZY) decoction for 12 weeks significantly reduced the lipid deposition and the number of macrophages (P < 0.05) and significantly increased the collagen content within the plaque (P < 0.01). Enrichment analysis revealed a high enrichment of the Cytokine-cytokine receptor interaction pathway and Chemokine signaling pathway. Noteworthy genes involved in this response included Ccl12, Ccl22, Cx3cr1, Ccr7, Ccr2, Tnfrsf25, and Gdf5. Xuefu Zhuyu decoction significantly downregulated the expression of CX3CL1 and CX3CR1 (P < 0.05) and upregulated the expression of GDF5 (P < 0.01). Compared with control group, in cell models, the mRNA expressions of Ccl12, Ccl22, and Ccr2 were significantly upregulated (P < 0.05 or P < 0.01). Xuefu Zhuyu decoction significantly downregulated the expression of Ccl12, Ccl22, Cx3cr1, Ccr7 and Ccr2 (P < 0.05 or P < 0.01). CONCLUSION Xuefu Zhuyu decoction demonstrates effective regulation of plaque components, retarding plaque progression and preserving plaque stability by modulating lipid metabolism and inflammatory responses. Subsequent transcriptome analysis identified the Cytokine-cytokine receptor interaction and Chemokine signaling pathway as potential key pathways for the therapeutic effects of Xuefu Zhuyu decoction. This insight not only provides crucial avenues for further exploration into the mechanisms underlying Xuefu Zhuyu decoction but also offers valuable perspectives and hypotheses for enhancing disease prevention and treatment strategies.
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Affiliation(s)
- Dongdong Jia
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China; The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, 214151, China.
| | - Mengzhu Zhao
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
| | - Xinyue Zhang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China; Department of Research and Teaching, Beijing Hepingli Hospital, Beijing, 100010, China.
| | - Xu Cheng
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
| | - Qiong Wei
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
| | - Lixia Lou
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
| | - Yizhou Zhao
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
| | - Qiushuo Jin
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
| | - Meng Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.
| | - Dongmei Zhang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
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259
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Sun X, Zhen X, Gu S, Liu K, Yang W, Dong H. Cost-utility analysis of duloxetine in osteoarthritis: from Chinese healthcare perspective. Expert Rev Pharmacoecon Outcomes Res 2024:1-12. [PMID: 39340167 DOI: 10.1080/14737167.2024.2410973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 09/18/2024] [Indexed: 09/30/2024]
Abstract
OBJECTIVES To estimate the cost-utility of duloxetine compared with that of a placebo, common traditional nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase-2 (COX-2) inhibitors for the treatment of osteoarthritis (OA) from a Chinese healthcare perspective. METHODS A Markov model was constructed. The costs and utility inputs were obtained from the database and published literature. Incremental cost-effectiveness ratio (ICER) was the main model outputs. Subgroup analyses were also conducted for patients at high risk of gastrointestinal (GI) or cardiovascular (CV) AEs. Deterministic and probabilistic sensitivity analyses were performed. RESULTS The model estimated an ICER of $3409.21/QALY for duloxetine compared with etoricoxib, with duloxetine dominating other active treatment strategies in patients at a low risk of GI and CV AEs. The ICER for duloxetine over etoricoxib was $322.21/QALY in patients at high risk of GI and CV AEs. These results were consistent with the sensitivity analyses; 53.64% and 53.93% of the patients were willing to use duloxetine comparing with etoricoxib, for which the thresholds were 1.0 and 3.0 per capita gross domestic product (GDP), respectively. CONCLUSIONS Duloxetine is a valuable option for patients with OA; however, uncertainties exist in the model, and these suggestions can be adopted with caution.
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Affiliation(s)
- Xueshan Sun
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xuemei Zhen
- School of Health Care Management, Shandong University, Jinan, Shandong, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, China
| | - Shuyan Gu
- Center for Health Policy and Management Studies, School of Government, Nanjing University, Nanjing, Jiangsu, China
| | - Kaijie Liu
- Taizhou Hospital of Zhejiang, Linhai, Zhejiang, China
| | - Wenqianzi Yang
- Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hengjin Dong
- Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- The fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, Zhejiang, China
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Roy N, Khajanchi M, Alty IG, Hamzah R, Aroke A, Banerjee N, Bhoi S, Chatterjee S, Soni KD, Gadgil A, Gururaj G, Jagnoor J, Joshi A, Joshipura M, Kamble J, Malhotra AK, Mehta S, Mock CN, Mohan R, Nathani P, Rawat R, Sarang B, Sharma MR, Sharma N, Sinha TP, Tewari P, Perez-Iglesias CT, Tripathi I, Leitz PTU, Raykar NP. Consensus recommendations for acute trauma care & outcomes in LMICs from the transdisciplinary research, advocacy & implementation network for trauma in India. Indian J Med Res 2024; 159:274-284. [PMID: 39361792 DOI: 10.25259/ijmr_2417_23] [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: 03/18/2024] [Indexed: 10/05/2024] Open
Abstract
Background & objectives Injuries profoundly impact global health, with substantial deaths and disabilities, especially in low- and middle-income countries (LMICs). This paper presents strategic consensus from the Transdisciplinary Research, Advocacy, and Implementation Network for Trauma in India (TRAIN Trauma India) symposium, advocating for enhanced, system-level trauma care to address this challenge. Methods Five working groups conducted separate literature reviews on pre-hospital trauma care, in-hospital trauma resuscitation and training, trauma systems, trauma registries, and India's Towards Improving Trauma Care Outcomes (TITCO) registry. Using a Delphi approach, the TRAIN Trauma India Symposium generated consensus statements and recommendations for interventions to streamline trauma care and reduce preventable trauma mortality in India and LMICs. Experts prioritized interventions based on cost and difficulty. Results An expert panel agreed on four pre-hospital consensus statements, eight hospital resuscitation consensus statements, six system-level consensus statements, and six trauma registry consensus statements. The expert panel recommended six pre-hospital interventions, four hospital resuscitation interventions, nine system-level interventions, and seven trauma registry interventions applicable to the Indian context. Of these, 14 interventions were ranked as low cost/low difficulty, five high cost/low difficulty, five low cost/high difficulty, and three high cost/high difficulty. Interpretation & conclusions This consensus underscores the urgent need for integrated and efficient trauma systems to reduce preventable mortality, emphasizing the importance of comprehensive care that includes community engagement and robust pre-hospital and acute hospital trauma care pathways. It highlights the critical role of inclusive, system-wide approaches, from enhancing pre-hospital care and in-hospital resuscitation to implementing effective trauma registries to improve outcomes and streamline care across contexts.
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Affiliation(s)
- Nobhojit Roy
- The George Institute for Global Health, JPN Apex Trauma Center, New Delhi, India
| | - Monty Khajanchi
- Department of General Surgery, Seth G S Medical College and KEM Hospital, Mumbai, India
| | - Isaac G Alty
- The George Institute for Global Health, JPN Apex Trauma Center, New Delhi, India
- Department of Critical and Intensive Care, JPN Apex Trauma Center, New Delhi, India
- Department of Surgery, Brigham and Women's Hospital, Boston, United States
| | - Radzi Hamzah
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, United States
| | - Anna Aroke
- Department of Public Health, Tata Institute of Social Science, Mumbai, India
| | - Niladri Banerjee
- Department of General Surgery, All India Institute of Medical Sciences, Jodhpur, India
| | - Sanjeev Bhoi
- Department of Emergency Medicine, JPN Apex Trauma Center, New Delhi, India
| | - Shamita Chatterjee
- Institute of Post-Graduate Medical Education & Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, India
| | - Kapil Dev Soni
- Department of Critical and Intensive Care, JPN Apex Trauma Center, New Delhi, India
| | - Anita Gadgil
- The George Institute for Global Health, JPN Apex Trauma Center, New Delhi, India
| | - Gopalkrishna Gururaj
- Department of Epidemiology and Public Health, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Jagnoor Jagnoor
- Department of Injury in India, The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Anip Joshi
- Department of Surgery, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal
| | - Manjul Joshipura
- Department of Trauma Care Systems, World Health Organization, Geneva, Switzerland
| | - Jyoti Kamble
- Department of Public Health, Tata Institute of Social Science, Mumbai, India
| | - Ajai K Malhotra
- Department of Surgery, University of Vermont Medical Center, Burlington, United States
| | - Sarosh Mehta
- Department of Orthopaedics, Ministry of Health of Saudi Arabia, Mumbai, India
| | - Charles N Mock
- Department of Surgery, University of Washington, Seattle, United States
| | - Rajashekar Mohan
- Deparmtent of General Surgery, All India Institute of Medical Sciences, Mangalagiri, India
| | - Priyansh Nathani
- Department of General Surgery, Dr R N Cooper Municipal General Hospital, Mumbai, India
- WHO Collaborating Centre for Surgical Care Delivery in Low- and Middle-Income Countries, Mumbai, India
| | - Roopa Rawat
- Department of Nursing, All India Institute of Medical Sciences, New Delhi, India
| | - Bhakti Sarang
- WHO Collaborating Centre for Surgical Care Delivery in Low- and Middle-Income Countries, Mumbai, India
- Department of General Surgery, Terna Medical College and Hospital, Mumbai, India
| | - Mohan Raj Sharma
- Department of Neurosurgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Naveen Sharma
- Department of General Surgery, All India Institute of Medical Sciences, Jodhpur, India
| | - Tej Prakash Sinha
- Department of Emergency Medicine, JPN Apex Trauma Center, New Delhi, India
| | | | | | - Isita Tripathi
- Department of Surgery, Brigham and Women's Hospital, Boston, United States
| | | | - Nakul P Raykar
- Department of Surgery, Brigham and Women's Hospital, Boston, United States
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, United States
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Hajdu G, Hughes T, Ouedraogo GL, Flint L, Young M, Parikh V, Lee DY, Peng Y, Gruber WC, Scott DA, Watson W. Safety of a 4-Dose 20-Valent Pneumococcal Conjugate Vaccine Series in Infants: A Randomized Trial. Pediatrics 2024:e2023065218. [PMID: 39363879 DOI: 10.1542/peds.2023-065218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/27/2024] [Accepted: 04/01/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The 20-valent pneumococcal conjugate vaccine (PCV20) was developed to expand protection for pneumococcal disease. It contains all 13-valent pneumococcal conjugate vaccine (PCV13) components plus conjugates for 7 additional serotypes. Our primary objective with this study was to evaluate PCV20 tolerability and safety. METHODS In this phase 3, multi-country, double-blind study, healthy infants born at ≥34 weeks' gestation were randomly assigned 2:1 to receive PCV20 or PCV13 at 2, 4, 6, and 12 to 15 months of age. Safety assessments included local reactions and systemic events within 7 days after each vaccination, adverse events (AEs) from dose 1 to 1 month after dose 3 and from dose 4 to 1 month after dose 4, and serious AEs and newly diagnosed chronic medical conditions from dose 1 through 6 months after the last dose. RESULTS Participants received PCV20 (N = 1000) or PCV13 (N = 504); 91.7% received all 4 doses. The frequencies of local reactions and systemic events were generally similar in PCV20 and PCV13 groups, with most reported as mild or moderate. The most common local reaction was injection site pain (PCV20, 24.7% to 40.5%; PCV13, 26.8% to 42.0%); irritability was the most common systemic event (PCV20, 54.8% to 68.2%; PCV13, 54.7% to 68.5%). AE frequencies were similar in both groups. No serious AEs were related to study vaccines. Few newly diagnosed chronic medical conditions were reported (2.8% in both groups). PCV20 was safe across multiple countries, in late preterm infants, and when administered with other vaccines. CONCLUSIONS A 4-dose series of PCV20 had a tolerability and safety profile similar to that of PCV13.
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Affiliation(s)
| | | | - G Laïssa Ouedraogo
- Vaccine Research and Development, Pfizer Inc, Collegeville, Pennsylvania
| | - Laurence Flint
- Vaccine Research and Development, Pfizer Inc, Pearl River, New York
| | - Mariano Young
- Vaccine Research and Development, Pfizer Inc, Collegeville, Pennsylvania
| | - Vrunda Parikh
- Vaccine Research and Development, Pfizer Inc, Pearl River, New York
| | - Dung-Yang Lee
- Vaccine Research and Development, Pfizer Inc, Collegeville, Pennsylvania
| | - Yahong Peng
- Vaccine Research and Development, Pfizer Inc, Collegeville, Pennsylvania
| | - William C Gruber
- Vaccine Research and Development, Pfizer Inc, Pearl River, New York
| | - Daniel A Scott
- Vaccine Research and Development, Pfizer Inc, Collegeville, Pennsylvania
| | - Wendy Watson
- Vaccine Research and Development, Pfizer Inc, Collegeville, Pennsylvania
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262
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Sun B, Adamis D, McNicholas F. Impact of COVID-19 on referrals to paediatric liaison psychiatry at Children's Health Ireland at Crumlin as the pandemic moved to endemic status. BJPsych Open 2024; 10:e171. [PMID: 39364647 DOI: 10.1192/bjo.2024.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND Rates of acute mental health presentations in youth were increasing pre-pandemic internationally. Longitudinal studies following COVID-19 attest to ongoing deterioration in youth mental health, recognising adverse unintended consequences following public health restrictions. AIMS To examine whether the initial post-COVID-19 increase in mental health presentations persisted following the reclassification of COVID-19 to endemic status, accompanied by the removal of most restrictions. METHOD All referrals to paediatric liaison psychiatry (PLP) between January 2018 and December 2022 in a Dublin tertiary children's hospital were included in the study. An interrupted time series analysis with autoregressive integrated moving average models was conducted, examining referrals with respect to different phases of COVID-19 and application of public health restrictions. RESULTS Some 1385 referrals to PLP were received over the 5-year study. There was a significant decrease in PLP referrals immediately post-COVID-19, followed by a significant and sustained increase as the pandemic progressed and moved to endemic status. Public health restriction phases had a unique effect on those presenting with suicidal ideation, with a significant increase in the number of referrals. There was no effect of restrictions on other clinical profiles. CONCLUSIONS Increased referrals for youth with mental health difficulties, reported during the COVID-19 pandemic, persisted into the early endemic stage, after COVID-19 public health restrictions ceased. Specific impacts of restrictions on suicidal ideation referrals require further study. Investment in child and adolescent mental health services remains a priority, and future pandemic response strategies need to examine unintended consequences of any enforced public health measure.
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Affiliation(s)
- B Sun
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - D Adamis
- Department of Psychiatry, Sligo Mental Health Services, Sligo, Ireland
| | - F McNicholas
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Department of Paediatric Liaison Psychiatry, Children's Health Ireland at Crumlin, Dublin, Ireland
- Lucena Clinic Rathgar, St John of God Hospitaller Services, Dublin, Ireland
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Batard T, Taillé C, Guilleminault L, Bozek A, Floch VBL, Pfaar O, Canonica WG, Akdis C, Shamji MH, Mascarell L. Allergen Immunotherapy for the Prevention and Treatment of Asthma. Clin Exp Allergy 2024. [PMID: 39363801 DOI: 10.1111/cea.14575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 09/09/2024] [Accepted: 09/16/2024] [Indexed: 10/05/2024]
Abstract
Allergic asthma is the predominant phenotype among asthmatics. Although conventional pharmacotherapy is a central component in the management of asthma, it does not enable control of asthma symptoms in all patients. In recent decades, some uncontrolled asthmatic patients, especially those with allergic asthma, have benefited from biological therapies. However, biologics do not address all the unmet needs left by conventional pharmacotherapy. Furthermore, it is noteworthy that neither conventional pharmacotherapy nor biological therapies have disease-modifying properties. In this context, allergen immunotherapy (AIT) represents an indispensable component of the therapeutic arsenal against allergic asthma, due to its disease-modifying immunological effects. In this review article, funded by an AIT manufacturer, we find clinical trials support AIT as the only treatment option able both to improve allergic asthma symptoms and to prevent the onset and worsening of the condition. For patients with severe asthma or other safety concerns, the combination of AIT and biologics offers very promising new treatment modalities for the management of allergic asthma. Trial Registration: clinicaltrials.gov identifier: NCT06027073.
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Affiliation(s)
- Thierry Batard
- Innovation & Science Department, Stallergenes Greer, Antony, France
| | - Camille Taillé
- Service de Pneumologie et Centre de référence pour les maladies respiratoires rares, Hôpital Bichat, AP-HP Nord-Université Paris Cité, Paris, France
- CRISALIS F-CRIN Network, Paris, France
| | - Laurent Guilleminault
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), INSERM UMR1291, CNRS UMR5051, University Toulouse III, Toulouse, France
- Department of Respiratory Medicine, Toulouse University Hospital, Faculty of Medicine, Toulouse, France
- CRISALIS/FCRIN, Toulouse, France
| | - Andrzej Bozek
- Clinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, Katowice, Poland
| | | | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Walter G Canonica
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Cezmi Akdis
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - Mohamed H Shamji
- National Heart and Lung Institute, Imperial College London, London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
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264
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Hussien M. Value for solidarity: a proxy for community understanding and acceptance of the basic principles of community-based health insurance in rural Ethiopia. HEALTH ECONOMICS REVIEW 2024; 14:82. [PMID: 39365415 DOI: 10.1186/s13561-024-00565-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 10/01/2024] [Indexed: 10/05/2024]
Abstract
BACKGROUND Solidarity is an aspect of human association that gives emphasis to the cohesive social bond that holds a group together and is valued and understood by all members of the group. A lack of understanding of the solidarity principle is one of the main reasons for low population coverage in microhealth insurance schemes. This study aimed to examine the extent to which people value solidarity and the factors that explain the differences. METHODS A community-based cross-sectional study was carried out in two districts of northeast Ethiopia among 1232 randomly selected households which have ever been registered in a community-based health insurance scheme. Face-to-face interviews were conducted with household heads using a standardized questionnaire deployed to an electronic data collection platform. Solidarity was measured using three dimensions: income solidarity, risk solidarity, and cost coverage. Principal component analysis was used to construct composite variables, and the reliability of the tools was checked using Cronbach's alpha. A multivariable analysis was performed using the partial proportional odds model to determine the associations between variables. The degree of association was assessed using the odds ratio, and statistical significance was determined at 95% confidence interval. RESULTS Three-quarters (75%) of the respondents rated risk solidarity as high, while 70% and 63% rated income solidarity and cost coverage as high, respectively. Place of residence (AOR = 2.23; 95% CI: 1.68, 2.94), wealth index (AOR = 1.51; 95% CI: 1.07, 2.12), self-rated health status (AOR = 1.64; 95% CI: 1.12, 2.40), trust in insurance schemes (AOR = 1.68; 95% CI: 1.22, 2.30), perceived quality of care (AOR = 1.75; 95% CI: 1.33, 2.31) and frequency of outpatient visits (AOR = 2.05; 95% CI: 1.30, 3.24) were significant predictors of value for solidarity. CONCLUSIONS The community placed greater value for solidarity, indicating community understanding and acceptance of the core principles of microhealth insurance. Administrators of the insurance scheme, health authorities, and other actors should strive to create a transparent management system and improve access to high-quality health care, which will facilitate community acceptance of the insurance scheme and its guiding principles.
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Affiliation(s)
- Mohammed Hussien
- Department of Health Systems Management and Health Economics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box: 79, Bahir Dar, Ethiopia.
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265
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Yang C, Zhang Y, Li H, Ji X, Wang H, Lv X. Sensory impairments associated with cognitive impairment among older adults in China: A community-based, 10-year prospective cohort study. J Glob Health 2024; 14:04175. [PMID: 39363845 DOI: 10.7189/jogh.14.04175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024] Open
Abstract
Background To address an existing gap in knowledge due to limited and inconclusive evidence, we aimed to investigate the association between sensory impairments and cognitive decline among older Chinese individuals. Methods We retrieved data on 6862 adults aged ≥65 years that were collected through the Chinese Longitudinal Healthy Longevity Study (CLHLS), a nationwide, prospective, community-based elderly cohort study. Visual or hearing impairment in the CLHLS were identified through self-reported questionnaire. Sensory impairments were categorised as no sensory impairment, hearing impairment only, visual impairment only, and dual sensory impairment according to hearing and vision function. Cognitive impairment was defined as having a score <18 on the Chinese version of the Mini Mental State Examination. We used a Cox proportional hazard model to evaluate the relationship between sensory and cognitive impairments. Results Among 6862 participants, 5.7% had dual sensory impairment, 7.4% had hearing impairment only, and had 17.2% visual impairment only. Compared with participants with no sensory impairment, those with hearing impairment only (adjusted hazard ratio (aHR) = 1.65; 95% confidence interval (CI) = 1.41, 1.92), visual impairment only (aHR = 1.25; 95% CI = 1.11, 1.41), and dual sensory impairment (aHR = 1.47; 95% CI = 1.25, 1.74) were significantly associated with higher risk of cognitive impairment in the fully adjusted model. Conclusions Our results show that having hearing impairment only, visual impairment only, and dual sensory impairment was significantly associated with a higher risk of cognitive impairment among Chinese older adults aged ≥65 years. This suggest a need for the timely identification and management of sensory impairments for the elderly to reduce dementia risk.
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Affiliation(s)
- Chao Yang
- Department of Psychiatry, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Ying Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Huan Li
- Department of Psychiatry, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Xiao Ji
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Huali Wang
- Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University), Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Xiaozhen Lv
- Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University), Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
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van de Graaf SFJ, Paulusma CC, In Het Panhuis W. Getting in the zone: Metabolite transport across liver zones. Acta Physiol (Oxf) 2024:e14239. [PMID: 39364668 DOI: 10.1111/apha.14239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 09/16/2024] [Accepted: 09/24/2024] [Indexed: 10/05/2024]
Abstract
The liver has many functions including the regulation of nutrient and metabolite levels in the systemic circulation through efficient transport into and out of hepatocytes. To sustain these functions, hepatocytes display large functional heterogeneity. This heterogeneity is reflected by zonation of metabolic processes that take place in different zones of the liver lobule, where nutrient-rich blood enters the liver in the periportal zone and flows through the mid-zone prior to drainage by a central vein in the pericentral zone. Metabolite transport plays a pivotal role in the division of labor across liver zones, being either transport into the hepatocyte or transport between hepatocytes through the blood. Signaling pathways that regulate zonation, such as Wnt/β-catenin, have been shown to play a causal role in the development of metabolic dysfunction-associated steatohepatitis (MASH) progression, but the (patho)physiological regulation of metabolite transport remains enigmatic. Despite the practical challenges to separately study individual liver zones, technological advancements in the recent years have greatly improved insight in spatially divided metabolite transport. This review summarizes the theories behind the regulation of zonation, diurnal rhythms and their effect on metabolic zonation, contemporary techniques used to study zonation and current technological challenges, and discusses the current view on spatial and temporal metabolite transport.
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Affiliation(s)
- Stan F J van de Graaf
- Tytgat Institute for Liver and Intestinal Research, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology, Endocrinology and Metabolism (AGEM), Amsterdam University Medical Center, Amsterdam, The Netherlands
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Coen C Paulusma
- Tytgat Institute for Liver and Intestinal Research, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology, Endocrinology and Metabolism (AGEM), Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Wietse In Het Panhuis
- Tytgat Institute for Liver and Intestinal Research, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology, Endocrinology and Metabolism (AGEM), Amsterdam University Medical Center, Amsterdam, The Netherlands
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267
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Chien WT, Ma DCF, Bressington D, Mou H. Family-based interventions versus standard care for people with schizophrenia. Cochrane Database Syst Rev 2024; 10:CD013541. [PMID: 39364773 DOI: 10.1002/14651858.cd013541.pub2] [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] [Indexed: 10/05/2024]
Abstract
BACKGROUND People with schizophrenia often experience long-term psychosocial disabilities and frequent relapse. Family plays a key role in caring for ill relatives, which in turn probably contributes to high levels of distress and burdens for the family. Family-based interventions have been developed and applied to family members and their relatives with schizophrenia to improve their outcomes. This is an update of a Cochrane review that was last updated in 2011, which has been split into this review, one on group- versus individual-based family interventions and one on family-based cognitive versus behavioural management interventions. OBJECTIVES To assess the effects of family-based interventions for people with schizophrenia or schizophrenia-like disorders and their families compared with standard care. SEARCH METHODS We searched the following electronic databases from inception until April 2023: CENTRAL, Medline, Embase, PsycInfo, CINAHL, WHO International Clinical Trials Registry Platform (ICTRP), Clinicaltrials.gov, SinoMed, China Network Knowledge Infrastructure (CNKI), Wanfang, and Chinese Scientific Journals Database (VIP). We also searched the reference lists of included studies and accessible reviews for additional references. SELECTION CRITERIA We included randomised controlled trials (RCTs) that compared the effects of family-based interventions for people with schizophrenia or schizophrenia-like disorders and their families and reported at least one patient's and one family member's outcomes. In this update, we only investigated standard care as the comparator. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. The review authors independently screened studies, extracted data, and assessed risk of bias for each study using the Cochrane risk of bias tool for RCTs. We pooled data and estimated effects with the mean difference (MD), standardised mean difference (SMD), or risk ratio (RR) with 95% confidence interval (CI). We judged the certainty of evidence using GRADEpro GDT. We divided the outcomes into short-term (≤ 1 month postintervention), medium-term (> 1 to 6 months postintervention), and long-term follow-up (> 6 months postintervention), if available. MAIN RESULTS We identified 26 RCTs in this review, with 1985 people with schizophrenia or schizophrenia-like disorders, and 2056 family members. Most family-based interventions were conducted on a weekly or biweekly basis, with duration ranging from five weeks to two years. We had substantial concerns regarding the methodological quality of the included studies given that we judged all studies at high risk of performance bias and several studies at high risk of detection, attrition or reporting bias. Low-certainty evidence indicated that family-based interventions may reduce patients' relapse at one month or less postintervention (RR 0.66, 95% CI 0.49 to 0.89; 4 RCTs, 229 participants). We downgraded the evidence by two levels due to imprecision (small number of participants) and high risk of performance, detection and attrition bias. Compared to standard care, family-based interventions probably reduce caregiver burden at one month or less postintervention (MD -5.84, 95% CI -6.77 to -4.92; 8 RCTs, 563 participants; moderate-certainty evidence) and may result in more family members shifting from high to low expressed emotion (RR 3.90, 95% CI 1.11 to 13.71; 2 RCTs, 72 participants; low-certainty evidence). Family interventions may result in little to no difference in patients' death (RR 0.48, 95% CI 0.18 to 1.32; 6 RCTs, 304 participants; low-certainty evidence) and hospital admission (≤ 1 month postintervention; RR 0.81, 95% CI 0.51 to 1.29; 2 RCTs, 153 participants; low-certainty evidence) in comparison with standard care. Due to the heterogeneous measures and various follow-up periods, we were unable to provide pooled effect estimates for patients' compliance with medication and quality of life. We were very uncertain whether family interventions resulted in enhanced compliance with medication and improved quality of life for patients. We downgraded the evidence to very low certainty due to high risk of bias across studies, inconsistency (different directions of effects across studies), and imprecision (small number of participants or CIs of most studies including the possibility of no effect). AUTHORS' CONCLUSIONS This review synthesised the latest evidence on family interventions versus standard care for people with schizophrenia or schizophrenia-like disorders and their families. This review suggests that family interventions might improve patients' outcomes (e.g. relapse) and families' outcomes (e.g. caregiver burden and expressed emotion), with little to no difference in patients' hospital admission and adverse effects in terms of death. However, evidence on patients' compliance with medication and quality of life was very uncertain. Overall, the evidence was of moderate to very low certainty. Future large and well-designed RCTs are needed to provide more reliable evaluation of effects of family interventions in people with schizophrenia or schizophrenia-like disorders and their families.
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Affiliation(s)
- Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Dennis Chak Fai Ma
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | | | - Huanyu Mou
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China
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Aramruang T, Malhotra A, Numthavaj P, Looareesuwan P, Anothaisintawee T, Dejthevaporn C, Sirirutbunkajorn N, Attia J, Thakkinstian A. Prediction models for identifying medication overuse or medication overuse headache in migraine patients: a systematic review. J Headache Pain 2024; 25:165. [PMID: 39363297 DOI: 10.1186/s10194-024-01874-4] [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: 06/25/2024] [Accepted: 09/22/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND Migraine is a debilitating neurological disorder that presents significant management challenges, resulting in underdiagnosis and inappropriate treatments, leaving patients at risk of medication overuse (MO). MO contributes to disease progression and the development of medication overuse headache (MOH). Predicting which migraine patients are at risk of MO/MOH is crucial for effective management. Thus, this systematic review aims to review and critique available prediction models for MO/MOH in migraine patients. METHODS A systematic search was conducted using Embase, Scopus, Medline/PubMed, ACM Digital Library, and IEEE databases from inception to April 22, 2024. The risk of bias was assessed using the prediction model risk of bias assessment tool. RESULTS Out of 1,579 articles, six studies with nine models met the inclusion criteria. Three studies developed new prediction models, while the remaining validated existing scores. Most studies utilized cross-sectional and prospective data collection in specific headache settings and migraine types. The models included up to 53 predictors, with sample sizes from 17 to 1,419 participants. Traditional statistical models (logistic regression and least absolute shrinkage and selection operator regression) were used in two studies, while one utilized a machine learning (ML) technique (support vector machines). Receiver operating characteristic analysis was employed to validate existing scores. The area under the receiver operating characteristic (AUROC) for the ML model (0.83) outperformed the traditional statistical model (0.62) in internal validation. The AUROCs ranged from 0.84 to 0.85 for the validation of existing scores. Common predictors included age and gender; genetic data and questionnaire evaluations were also included. All studies demonstrated a high risk of bias in model construction and high concerns regarding applicability to participants. CONCLUSION This review identified promising results for MO/MOH prediction models in migraine patients, although the field remains limited. Future research should incorporate important risk factors, assess discrimination and calibration, and perform external validation. Further studies with robust designs, appropriate settings, high-quality and quantity data, and rigorous methodologies are necessary to advance this field.
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Affiliation(s)
- Teerapong Aramruang
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | | | - Pawin Numthavaj
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Panu Looareesuwan
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Thunyarat Anothaisintawee
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Charungthai Dejthevaporn
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nat Sirirutbunkajorn
- Department of Diagnostic and Therapeutic Radiology, Division of Radiation Oncology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - John Attia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Ammarin Thakkinstian
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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269
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Zhang M, Sun Y, Zhang L, Xu Y, Liu Y, Li K. The application of mass defect percentage in the evaluation of acute coronary syndrome. Nucl Med Commun 2024:00006231-990000000-00348. [PMID: 39363632 DOI: 10.1097/mnm.0000000000001907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
OBJECTIVES White blood cells, neutrophils, lymphocytes, and neutrophil-to-lymphocyte ratio (NLR) distribution patterns in patients with anatomic coronary disease have previously been associated with cardiac events such as myocardial infarct size, complications, and prognosis. However, it remains unknown whether myocardial perfusion mass defect percentage (MDP) obtained from gated myocardial perfusion imaging (G-MPI) correlates with these hematological parameters. Therefore, our research aimed to investigate the application of MDP in the evaluation of acute coronary syndrome (ACS). METHODS Thirty-six patients with ACS underwent single-photon emission computed tomography/computed tomography using retrospective electrocardiography gating during the resting state. The primary outcome was the percentage of left ventricular mass with abnormal myocardial perfusion (i.e. MDP) in G-MPI. Furthermore, the correlation between myocardial perfusion MDP and lymphocyte count, neutrophil count, white blood cell count, and NLR was calculated. In addition, we explored the relationship of myocardial perfusion MDP with other cardiac function parameters obtained from G-MPI, such as summed rest score, left ventricular ejection fraction, end-systolic volume, and end-diastolic volume. RESULTS Myocardial perfusion MDP significantly correlated with white blood cell count, neutrophil count, and NLR (P < 0.01). Furthermore, these hematological parameters were significantly different between low and high MDP groups. Additionally, myocardial perfusion MDP negatively correlated with end-systolic volume (r = -0.615) and left ventricular ejection fraction (r = -0.657). CONCLUSION Myocardial perfusion MDP has a high correlation with inflammatory cell counts and cardiac function parameters obtained from G-MPI in ACS; this may be of help in the evaluation and treatment of these patients.
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Affiliation(s)
- Man Zhang
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, 250014, China
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270
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Sang H, Lee H, Park J, Kim S, Woo HG, Koyanagi A, Smith L, Lee S, Hwang YC, Park TS, Lim H, Yon DK, Rhee SY. Machine Learning-Based Prediction of Neurodegenerative Disease in Patients With Type 2 Diabetes by Derivation and Validation in 2 Independent Korean Cohorts: Model Development and Validation Study. J Med Internet Res 2024; 26:e56922. [PMID: 39361401 DOI: 10.2196/56922] [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: 01/31/2024] [Revised: 06/03/2024] [Accepted: 07/26/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND Several machine learning (ML) prediction models for neurodegenerative diseases (NDs) in type 2 diabetes mellitus (T2DM) have recently been developed. However, the predictive power of these models is limited by the lack of multiple risk factors. OBJECTIVE This study aimed to assess the validity and use of an ML model for predicting the 3-year incidence of ND in patients with T2DM. METHODS We used data from 2 independent cohorts-the discovery cohort (1 hospital; n=22,311) and the validation cohort (2 hospitals; n=2915)-to predict ND. The outcome of interest was the presence or absence of ND at 3 years. We selected different ML-based models with hyperparameter tuning in the discovery cohort and conducted an area under the receiver operating characteristic curve (AUROC) analysis in the validation cohort. RESULTS The study dataset included 22,311 (discovery) and 2915 (validation) patients with T2DM recruited between 2008 and 2022. ND was observed in 133 (0.6%) and 15 patients (0.5%) in the discovery and validation cohorts, respectively. The AdaBoost model had a mean AUROC of 0.82 (95% CI 0.79-0.85) in the discovery dataset. When this result was applied to the validation dataset, the AdaBoost model exhibited the best performance among the models, with an AUROC of 0.83 (accuracy of 78.6%, sensitivity of 78.6%, specificity of 78.6%, and balanced accuracy of 78.6%). The most influential factors in the AdaBoost model were age and cardiovascular disease. CONCLUSIONS This study shows the use and feasibility of ML for assessing the incidence of ND in patients with T2DM and suggests its potential for use in screening patients. Further international studies are required to validate these findings.
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Affiliation(s)
- Hyunji Sang
- Department of Endocrinology and Metabolism, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Hojae Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Republic of Korea
| | - Jaeyu Park
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Republic of Korea
| | - Sunyoung Kim
- Department of Family Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Ho Geol Woo
- Department of Neurology, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
| | - Sihoon Lee
- Department of Internal Medicine, Gachon University College of Medicine, Incheon, Republic of Korea
| | - You-Cheol Hwang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong and Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Tae Sun Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine, Jeonbuk National University, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Republic of Korea
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Republic of Korea
- Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Republic of Korea
- Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea
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271
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Quan J, Uchitomi H, Shigeyama R, Gao C, Ogata T, Inaba A, Orimo S, Miyake Y. High-sensitivity acceleration sensor detecting micro-mechanomyogram and deep learning approach for parkinson's disease classification. Sci Rep 2024; 14:22941. [PMID: 39358456 DOI: 10.1038/s41598-024-74526-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: 03/05/2024] [Accepted: 09/26/2024] [Indexed: 10/04/2024] Open
Abstract
High-sensitivity acceleration sensors have been independently developed by our research group to detect vibrations that are > 10 dB smaller than those detected by conventional commercial sensors. This study is the first to measure high-frequency micro-vibrations in muscle fibers, termed micro-mechanomyogram (MMG) in patients with Parkinson's disease (PwPD) using a high-sensitivity acceleration sensor. We specifically measured the extensor pollicis brevis muscle at the base of the thumb in PwPD and healthy controls (HC) and detected not only low-frequency MMG (< 15 Hz) but also micro-MMG (≥ 15 Hz), which was preciously undetectable using commercial acceleration sensors. Analysis revealed remarkable differences in the frequency characteristics of micro-MMG between PwPD and HC. Specifically, during muscle power output, the low-frequency MMG energy was greater in PwPD than in HC, while the micro-MMG energy was smaller in PwPD compared to HC. These results suggest that micro-MMG detected by the high-sensitivity acceleration sensor provides crucial information for distinguishing between PwPD and HC. Moreover, a deep learning model trained on both low-frequency MMG and micro-MMG achieved a high accuracy (92.19%) in classifying PwPD and HC, demonstrating the potential for a diagnostic system for PwPD using micro-MMG.
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Affiliation(s)
- Jingyu Quan
- Department of Computer Science, Tokyo Institute of Technology, Tokyo, 226-8502, Japan
| | - Hirotaka Uchitomi
- Department of Computer Science, Tokyo Institute of Technology, Tokyo, 226-8502, Japan.
| | - Ryo Shigeyama
- Department of Computer Science, Tokyo Institute of Technology, Tokyo, 226-8502, Japan
| | - Chenguang Gao
- Department of Computer Science, Tokyo Institute of Technology, Tokyo, 226-8502, Japan
| | - Taiki Ogata
- Department of Computer Science, Tokyo Institute of Technology, Tokyo, 226-8502, Japan
| | - Akira Inaba
- Department of Neurology, Kanto Central Hospital, Tokyo, 158-8531, Japan
| | - Satoshi Orimo
- Department of Neurology, Kanto Central Hospital, Tokyo, 158-8531, Japan
- Kamiyoga Setagaya Street Clinic, Tokyo, 158-0098, Japan
| | - Yoshihiro Miyake
- Department of Computer Science, Tokyo Institute of Technology, Tokyo, 226-8502, Japan
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272
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Tomlinson MM, Kerstiens S, Smith C, Agbonlahor O, Clarke J, Vincent K, Walker KL, McLeish AC, Keith RJ, Smith T, Yeager RA, Wood LA, Bhatnagar A, Hart JL. The association between perceived neighborhood safety and cardiovascular disease risk factors. PSYCHOL HEALTH MED 2024:1-12. [PMID: 39360605 DOI: 10.1080/13548506.2024.2410418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 09/09/2024] [Indexed: 10/04/2024]
Abstract
Cardiovascular disease (CVD) remains the leading cause of mortality in the U.S. accounting for 1 in 4 deaths each year. Environmental factors, such as neighborhood safety, may increase the risk of CVD. Therefore, the current study assessed perceived neighborhood safety and its association with CVD risk factors (i.e. dyslipidemia, hypertension, type II diabetes) among 663 adults (mean age: 49.97 years, 61.24% female, 78.28% White). Participants completed self-report measures as part of a larger study of environmental influences on cardiac health. Results indicated that individuals reporting low perceived neighborhood safety had greater odds of having at least one CVD risk factor (OR = 2.76, 95% CI: 1.46, 5.22) compared to those with high perceived safety. There was a significant interaction between gender and the presence of at least one CVD risk factor in relation to perceived neighborhood safety. Low perceived neighborhood safety was associated with greater odds of having at least one CVD risk factor among males (OR = 5.48, 95% C.I: 1.82, 16.52) but not females. These findings suggest that low perceived safety is associated with CVD risk factors, especially among males. Future work should seek to better understand the interaction by gender in the relationship between perceived safety and CVD risk factors.
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Affiliation(s)
- Madeline M Tomlinson
- College of Health Professions, Bellarmine University, Louisville, KY, USA
- Department of Epidemiology and Population Health, School of Public Health and Information Health Sciences, University of Louisville, Louisville, KY, USA
| | - Savanna Kerstiens
- Department of Communication Studies, Northwestern University, Evanston, IL, USA
| | - Courteney Smith
- Brian Lamb School of Communication, Purdue University, West Lafayette, IN, USA
| | - Osayande Agbonlahor
- Department of Epidemiology and Population Health, School of Public Health and Information Health Sciences, University of Louisville, Louisville, KY, USA
| | - Julianna Clarke
- Department of Epidemiology and Population Health, School of Public Health and Information Health Sciences, University of Louisville, Louisville, KY, USA
| | - Kolbie Vincent
- Department of Communication, University of Louisville, Louisville, KY, USA
| | - Kandi L Walker
- Department of Communication, University of Louisville, Louisville, KY, USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA
- Superfund Research Center, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Alison C McLeish
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Rachel J Keith
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA
- Superfund Research Center, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Ted Smith
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA
- Superfund Research Center, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Ray A Yeager
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA
- Superfund Research Center, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Lindsey A Wood
- Department of Epidemiology and Population Health, School of Public Health and Information Health Sciences, University of Louisville, Louisville, KY, USA
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA
- Superfund Research Center, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Joy L Hart
- Department of Communication, University of Louisville, Louisville, KY, USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA
- Superfund Research Center, School of Medicine, University of Louisville, Louisville, KY, USA
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273
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Karlsson H, Mcntyre S, Gustavson S, Andersson D, Szczot I, Heilig M, Perini I. Choice of alcohol over a natural reward: an experimental study in light and heavy social drinkers. Psychopharmacology (Berl) 2024:10.1007/s00213-024-06679-6. [PMID: 39358610 DOI: 10.1007/s00213-024-06679-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/22/2024] [Indexed: 10/04/2024]
Abstract
RATIONALE & OBJECTIVES A core symptom of alcohol use disorder (AUD) is a progressively increased choice of alcohol over alternative rewards despite negative consequences. Here, we investigated choice between personalized alcohol vs. natural rewards in a laboratory setting, and compared this behavior between non-treatment-seeking heavy drinkers and light social drinkers. METHODS 30 light social drinkers (15 men drinking < 15 drinks/week and 15 women drinking < 10 drinks/week) and 30 heavy, non-treatment-seeking drinkers (drinking more than these levels; 15 women). In the Concurrent Choice Alcohol Food (CCAF) task, participants chose between individually tailored images of alcohol and snack rewards and collected points towards the respective reward. To assess cost sensitivity, points associated to the images varied so that they favored alcohol or snack, or were equal, creating three relative point levels. RESULTS Choice preference for alcohol was strongly correlated with Alcohol Use Disorder Identification Test (AUDIT) scores, supporting the external validity of the choice procedure. Compared to light drinkers, heavy drinkers showed increased choice preference for alcohol, as indicated by a between-group difference in points of subjective equality, a metric that quantifies the relative point level at which alcohol and snacks were equally likely to be chosen. In both groups, choice preference strongly depended on the relative point level of alcohol compared to snacks, suggesting that responding for alcohol in heavy drinkers was sensitive to costs. CONCLUSIONS Our results replicate previous findings of a relationship between self-reported alcohol use and choice preference for alcohol. We also found that choice behavior was strongly dependent on relative cost of alcohol in both groups, although price sensitivity was lower in heavy compared to light drinkers. An increased choice preference for alcohol in heavy drinkers suggests that they attribute a higher relative reinforcing value to alcohol compared to natural rewards.
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Affiliation(s)
- Hanna Karlsson
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Psychiatry Building, 58183, Linköping, Sweden
| | - Sarah Mcntyre
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Psychiatry Building, 58183, Linköping, Sweden
| | - Sarah Gustavson
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Psychiatry Building, 58183, Linköping, Sweden
| | - David Andersson
- Department of Management and Engineering, Division of Economics, Linköping University, 58183, Linköping, Sweden
| | - Ilona Szczot
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Psychiatry Building, 58183, Linköping, Sweden
| | - Markus Heilig
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Psychiatry Building, 58183, Linköping, Sweden
| | - Irene Perini
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Psychiatry Building, 58183, Linköping, Sweden.
- Center for Medical Image Science and Visualization (CMIV), Linköping University, 58183, Linköping, Sweden.
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274
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Oh S, Cho KH, Kim MC, Sim DS, Hong YJ, Kim JH, Ahn Y, Lee SY, Shin MH, Kim W, Jeong MH. Ten-year trends in lipid management among patients after myocardial infarction in South Korea. PLoS One 2024; 19:e0304710. [PMID: 39361921 DOI: 10.1371/journal.pone.0304710] [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: 02/12/2024] [Accepted: 05/17/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND Dyslipidemia is an important risk factor for acute myocardial infarction. However, real-world data on its prevalence and lipid management trends for Korean patients with acute myocardial infarction are limited. This study aimed to determine the 10-year temporal trends in dyslipidemia prevalence and lipid management in this patient population. METHODS AND FINDINGS The study used a merged database of two nationwide observational cohorts (2011-2020) that included 26,751 participants. The primary endpoints were the achievement rates of the (1) absolute low-density lipoprotein cholesterol (LDL-C) target of <70 mg/dL (<1.8 mmol/L), (2) relative LDL-C target reduction of >50% from the baseline, (3) absolute or relative LDL-C target (American target), and (4) both absolute and relative LDL-C targets (European target). The dyslipidemia prevalence increased from 11.1% to 17.1%, whereas the statin prescription rate increased from 92.9% to 97.0% from 2011 to 2020. The rate of high-intensity statin use increased from 12.80% in 2012 to 69.30% in 2020. The rate of ezetimibe use increased from 4.50% in 2016 to 22.50% in 2020. The high-intensity statin and ezetimibe prescription rates (0.20% to 9.30% from 2016 to 2020) increased gradually. The absolute and relative LDL-C target achievement rates increased from 41.4% and 20.8% in 2012 to 62.5% and 39.5% in 2019, respectively. The American (45.7% in 2012 to 68.6% in 2019) and European (16.5% in 2012 to 33.8% in 2019) target achievement rates also increased. CONCLUSIONS The adoption of lipid management guidelines in clinical practice has improved. However, continued efforts are needed to reduce the risk of recurrent ischemic events.
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Affiliation(s)
- Seok Oh
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Kyung Hoon Cho
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Min Chul Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Doo Sun Sim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju Han Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sang Yeub Lee
- Chung-Ang University Gwangmyeong Hospital and Department of Internal Medicine, Division of Cardiology, Chung-Ang University College of Medicine, Gwangmyeong, Republic of Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Republic of Korea
| | - Weon Kim
- Department of Internal Medicine, Division of Cardiology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Republic of Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
- Department of Cardiology, Gwangju Veterans Hospital, Gwangju, Republic of Korea
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Sivakumaran D, Jenum S, Markussen DL, Serigstad S, Srivastava A, Saghaug CS, Ulvestad E, Knoop ST, Grewal HMS. Protein and transcriptional biomarker profiling may inform treatment strategies in lower respiratory tract infections by indicating bacterial-viral differentiation. Microbiol Spectr 2024; 12:e0283123. [PMID: 39269158 PMCID: PMC11448388 DOI: 10.1128/spectrum.02831-23] [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: 07/12/2023] [Accepted: 08/16/2024] [Indexed: 09/15/2024] Open
Abstract
Lower respiratory tract infections (LRTIs) remain a significant global cause of infectious disease-related mortality. Accurate discrimination between acute bacterial and viral LRTIs is crucial for optimal patient care, prevention of unnecessary antibiotic prescriptions, and resource allocation. Plasma samples from LRTI patients with bacterial (n = 36), viral (n = 27; excluding SARS-CoV-2), SARS-CoV-2 (n = 22), and mixed bacterial-viral (n = 38) etiology were analyzed for protein profiling. Whole-blood RNA samples from a subset of patients (bacterial, n = 8; viral, n = 8; and SARS-CoV-2, n = 8) were analyzed for transcriptional profiling. Lasso regression modeling identified a seven-protein signature (CRP, IL4, IL9, IP10, MIP1α, MIP1β, and TNFα) that discriminated between patients with bacterial (n = 36) vs viral (n = 27) infections with an area under the curve (AUC) of 0.98. When comparing patients with bacterial and mixed bacterial-viral infections (antibiotics clinically justified; n = 74) vs patients with viral and SARS-CoV-2 infections (antibiotics clinically not justified; n = 49), a 10-protein signature (CRP, bFGF, eotaxin, IFNγ, IL1β, IL7, IP10, MIP1α, MIP1β, and TNFα) with an AUC of 0.94 was identified. The transcriptional profiling analysis identified 232 differentially expressed genes distinguishing bacterial (n = 8) from viral and SARS-CoV-2 (n = 16) etiology. Protein-protein interaction enrichment analysis identified 20 genes that could be useful in the differentiation between bacterial and viral infections. Finally, we examined the performance of selected published gene signatures for bacterial-viral differentiation in our gene set, yielding promising results. Further validation of both protein and gene signatures in diverse clinical settings is warranted to establish their potential to guide the treatment of acute LRTIs. IMPORTANCE Accurate differentiation between bacterial and viral lower respiratory tract infections (LRTIs) is vital for effective patient care and resource allocation. This study investigated specific protein signatures and gene expression patterns in plasma and blood samples from LRTI patients that distinguished bacterial and viral infections. The identified signatures can inform the design of point-of-care tests that can aid healthcare providers in making informed decisions about antibiotic prescriptions in order to reduce unnecessary use, thereby contributing to reduced side effects and antibiotic resistance. Furthermore, the potential for faster and more accurate diagnoses for improved patient management in acute LRTIs is compelling.
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Affiliation(s)
- Dhanasekaran Sivakumaran
- Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, Bergen, Norway
| | - Synne Jenum
- Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, Bergen, Norway
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Dagfinn Lunde Markussen
- Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, Bergen, Norway
- Emergency Care Clinic, Haukeland University Hospital, Bergen, Norway
- Department of Microbiology, Haukeland University Hospital, Bergen, Norway
| | - Sondre Serigstad
- Emergency Care Clinic, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Aashish Srivastava
- Genome Core-Facility, Clinical Laboratory (K2), Haukeland University Hospital, University of Bergen, Bergen, Norway
| | - Christina Skår Saghaug
- Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, Bergen, Norway
- Department of Microbiology, Haukeland University Hospital, Bergen, Norway
| | - Elling Ulvestad
- Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, Bergen, Norway
- Department of Microbiology, Haukeland University Hospital, Bergen, Norway
| | - Siri Tandberg Knoop
- Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, Bergen, Norway
- Department of Microbiology, Haukeland University Hospital, Bergen, Norway
| | - Harleen M S Grewal
- Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, Bergen, Norway
- Department of Microbiology, Haukeland University Hospital, Bergen, Norway
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276
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Hasselbalch RB, Schytz PA, Schultz M, Sindet-Pedersen C, Kristensen JH, Strandkjær N, Knudsen SS, Pries-Heje M, Pareek M, Kragholm KH, Carlson N, Schou M, Andersen MP, Bundgaard H, Torp-Pedersen C, Iversen KK. Implications of Age for the Diagnostic and Prognostic Value of Cardiac Troponin T and I. Clin Chem 2024; 70:1231-1240. [PMID: 39119905 DOI: 10.1093/clinchem/hvae107] [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: 03/07/2024] [Accepted: 06/24/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND The influence of age on cardiac troponin is unclear and may vary between cardiac troponin T (cTnT) and I (cTnI). We aimed to compare the impact of age on the diagnostic and prognostic utility of cTnT and cTnI. METHODS This Danish nationwide, register-based cohort study included patients with at least one cardiac troponin (cTn) measurement from 2009 through June 2022, stratified into decades of age. We used peak cTn concentration during admission, dichotomized as positive/negative and normalized to the 99th percentile. Receiver operating characteristics for myocardial infarction (MI) and logistic regression were used to estimate the odds ratio (OR) for mortality at 1 year. RESULTS We included 541 817 patients; median age 66 years (interquartile range [IQR] 51-77) and 256 545 (47%) female. A total of 40 359 (7.4%) had an MI, and 59 800 (14.1%) patients died within 1 year of admission. The predictive ability of both cTns for MI were highest for patients 30 to 50 years. This was most pronounced for cTnT, the specificity of which fell from 83% among patients 40 to 49 years to 4% for patients ≥90 years. The prognostic ability of both cTns for 1-year mortality declined with age. cTnT had stronger prognostic ability for all age-groups; OR for a positive cTnT 28.4 (95% CI, 20.1-41.0) compared with 9.4 (95% CI, 5.0-16.7) for cTnI among patients <30 years. CONCLUSIONS The predictive and prognostic ability of cTnT and cTnI declined with age. cTnT had a low specificity for MI in elderly patients. However, cTnT was the strongest prognostic marker among all age groups.
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Affiliation(s)
- Rasmus Bo Hasselbalch
- Department of Cardiology, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
- Department of Emergency Medicine, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
| | - Philip Andreas Schytz
- Department of Cardiology, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
| | - Martin Schultz
- Department of Cardiology, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
- Department of Emergency Medicine, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
| | - Caroline Sindet-Pedersen
- Department of Cardiology, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
| | - Jonas Henrik Kristensen
- Department of Cardiology, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
- Department of Emergency Medicine, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
| | - Nina Strandkjær
- Department of Cardiology, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
- Department of Emergency Medicine, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
| | - Sophie Sander Knudsen
- Department of Cardiology, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
- Department of Emergency Medicine, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
| | - Mia Pries-Heje
- Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Manan Pareek
- Department of Cardiology, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
| | | | - Nicholas Carlson
- Department of Nephrology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Morten Schou
- Department of Emergency Medicine, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mikkel Porsborg Andersen
- Department of Cardiology, Copenhagen University Hospital-Nordsjaellands Hospital, Hilleroed, Denmark
| | - Henning Bundgaard
- Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, Copenhagen University Hospital-Nordsjaellands Hospital, Hilleroed, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Karmark Iversen
- Department of Cardiology, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
- Department of Emergency Medicine, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Internal Medicine, Copenhagen University Hospital-Herlev-Gentofte Hospital, Copenhagen, Denmark
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277
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Berlowitz I, García Torres E, Ruiz Macedo JC, Wolf U, Maake C, Martin-Soelch C. Traditional Indigenous-Amazonian Therapy Involving Ceremonial Tobacco Drinking as Medicine: A Transdisciplinary Multi-Epistemic Observational Study. HEALTH EDUCATION & BEHAVIOR 2024:10901981231213348. [PMID: 39360499 DOI: 10.1177/10901981231213348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Abstract
Although the tobacco plant has been employed as a medicinal and sacred herb by Indigenous cultures across the Americas, its usage drastically changed after the 15th-century colonial arrival; its large-scale commodification and global marketing once brought to Europe lead to hedonic and addictive uses harmful to health. As a consequence, tobacco smoking is now one of the largest public health problems worldwide. However, in the Peruvian Amazon, a region of origin of tobacco species, Indigenous healers still know how to use the plant for therapeutic purposes. Due to a general disregard of Indigenous knowledge and stigma, these uses have however not so far been clinically investigated. We hence conducted for the first time a clinical field study assessing a sample of patients treated by a traditional healer specialized in tobacco in the Peruvian Amazon (observational design, pilot study, N = 27). The study was conducted within a transdisciplinary and multi-epistemic medical frame, in close partnership with an Amazonian healer. We used validated self-report scales to quantitatively assess mental health variables before and after the weeklong treatment, and mixed-methods to report experienced effects. Paired-samples t-tests comparing pre- and post-treatment scores revealed significant reductions in anxiety, depression, perceived stress, and general symptom indicators. Experienced effects included initial physical discomfort, followed by psychologically or existentially/spiritually significant insights. Our findings point to a sophisticated therapeutic approach based on Indigenous knowledge of tobacco applications, which should be further investigated. The study also contributes to the burgeoning scientific field on therapeutic uses of contentious psychoactive plants.
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Affiliation(s)
- Ilana Berlowitz
- University of Zurich, Zurich, Switzerland
- University of Fribourg, Fribourg, Switzerland
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278
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Wu CH, Lee PL, Wang YF, Lirng JF, Chen ST, Lin CJ, Wang SJ, Chou KH, Chen SP. Phasic perfusion dynamics among migraine subtypes: a multimodel arterial spin labeling investigation. J Headache Pain 2024; 25:167. [PMID: 39363159 DOI: 10.1186/s10194-024-01880-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Accepted: 09/27/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND Migraine-related perfusion changes are documented but inconsistent across studies due to limited sample size and insufficient phenotyping. The phasic and spatial dynamics across migraine subtypes remains poorly characterized. This study aimed to determine spatiotemporal dynamics of gray matter (GM) perfusion in migraine. METHODS We prospectively recruited episodic (EM) and chronic migraine (CM) patients, diagnosed with the International Headache Society criteria and healthy controls (HCs) between 2021 and 2023 from the headache center in a tertiary medical center, and adjacent communities. Magnetic resonance (3-tesla) arterial spin labeling (ASL) was conducted for whole brain cerebral blood flow (CBF) in all participants. The voxel-wise and whole brain gray matter (GM) CBF were compared between subgroups. Spatial pattern analysis of CBF and its correlations with headache frequency were investigated regarding different migraine phases and subtypes. Sex- and age-adjusted voxel-wise and whole brain GM comparisons were performed between HCs and different EM and CM phases. Spatial pattern analysis was conducted by CBF clusters with phasic differences and spin permutation test. Correlations between headache frequency and CBF were investigated regarding different EM and CM phases. RESULTS Totally 344 subjects (172 EM, 120 CM, and 52 HCs) were enrolled. Higher CBF in different anatomical locations was identified in ictal EM and CM. The combined panels of the specific locations with altered CBF in ictal EM on receiver operating characteristic curve analysis demonstrated areas under curve of 0.780 (vs. HCs) and 0.811 (vs. preictal EM). The spatial distribution of ictal-interictal CBF alteration of EM and CM were not correlated with each other (p = 0.665; r = - 0.018). Positive correlations between headache frequency and CBF were noted in ictal EM and CM regarding whole GM and specific anatomical locations. CONCLUSIONS Patients with migraine exhibited unique spatiotemporal CBF dynamics across different phases and distinct between subtypes. The findings provide neurobiological insights into how selected anatomical structures engage in a migraine attack and adapt to plastic change of repeated attacks along with chronicity.
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Grants
- V113C-120, V113E004-1, V112C-113 & V112E-004-1 (to SJW); V112D67-001-MY3-2 & V113C-058 (to SPC); V112B-007 (to CHW) Taipei Veterans General Hospital
- V113C-120, V113E004-1, V112C-113 & V112E-004-1 (to SJW); V112D67-001-MY3-2 & V113C-058 (to SPC); V112B-007 (to CHW) Taipei Veterans General Hospital
- V113C-120, V113E004-1, V112C-113 & V112E-004-1 (to SJW); V112D67-001-MY3-2 & V113C-058 (to SPC); V112B-007 (to CHW) Taipei Veterans General Hospital
- CI-112-2 (to CHW) Yen Tjing Ling Medical Foundation
- N/A Professor Tsuen CHANG's Scholarship Program from Medical Scholarship Foundation In Memory Of Professor Albert Ly-Young Shen
- N/A Vivian W. Yen Neurological Foundation
- No.112-V-B-039; No. 113-V-B-020 (to CHW) Yin Shu-Tien Foundation Taipei Veterans General Hospital-National Yang Ming Chiao Tung University Excellent Physician Scientists Cultivation Program
- NSTC 108-2314-B-010-022 -MY3, 110-2326-B-A49A-501-MY3 & 112-2314-B-A49-037-MY3 (to SPC); 110-2321-B-010-005-, 111-2321-B-A49-004, 111-2321-B-A49-011, 111-2314-B-A49-069-MY3, 111-2314-B-075-086-MY3, 111-2314-B-A49-090-MY3 & 112-2321-B-075-007 (to SJW); 113-2314-B-A49-070- & 112-2314-B-A49-056- (to KHC); 111-2314-B-075-025 -MY3 & 110-2314-B-075-005 (to CHW) National Science and Technology Council
- NSTC 108-2314-B-010-022 -MY3, 110-2326-B-A49A-501-MY3 & 112-2314-B-A49-037-MY3 (to SPC); 110-2321-B-010-005-, 111-2321-B-A49-004, 111-2321-B-A49-011, 111-2314-B-A49-069-MY3, 111-2314-B-075-086-MY3, 111-2314-B-A49-090-MY3 & 112-2321-B-075-007 (to SJW); 113-2314-B-A49-070- & 112-2314-B-A49-056- (to KHC); 111-2314-B-075-025 -MY3 & 110-2314-B-075-005 (to CHW) National Science and Technology Council
- NSTC 108-2314-B-010-022 -MY3, 110-2326-B-A49A-501-MY3 & 112-2314-B-A49-037-MY3 (to SPC); 110-2321-B-010-005-, 111-2321-B-A49-004, 111-2321-B-A49-011, 111-2314-B-A49-069-MY3, 111-2314-B-075-086-MY3, 111-2314-B-A49-090-MY3 & 112-2321-B-075-007 (to SJW); 113-2314-B-A49-070- & 112-2314-B-A49-056- (to KHC); 111-2314-B-075-025 -MY3 & 110-2314-B-075-005 (to CHW) National Science and Technology Council
- NSTC 108-2314-B-010-022 -MY3, 110-2326-B-A49A-501-MY3 & 112-2314-B-A49-037-MY3 (to SPC); 110-2321-B-010-005-, 111-2321-B-A49-004, 111-2321-B-A49-011, 111-2314-B-A49-069-MY3, 111-2314-B-075-086-MY3, 111-2314-B-A49-090-MY3 & 112-2321-B-075-007 (to SJW); 113-2314-B-A49-070- & 112-2314-B-A49-056- (to KHC); 111-2314-B-075-025 -MY3 & 110-2314-B-075-005 (to CHW) National Science and Technology Council
- N/A Brain Research Center, National Yang Ming Chiao Tung University from The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan
- N/A Brain Research Center, National Yang Ming Chiao Tung University from The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan
- MOHW107-TDU-B-211-123001, MOHW 108-TDU-B-211-133001 and MOHW112-TDU-B-211-144001 Ministry of Health and Welfare
- VGHUST-112-G1-2-1 (to SJW) Veterans General Hospitals and University System of Taiwan Joint Research Program
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Affiliation(s)
- Chia-Hung Wu
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pei-Lin Lee
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen-Feng Wang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St. Beitou Dist., Taipei, 112304, Taiwan
| | - Jiing-Feng Lirng
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shu-Ting Chen
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chung-Jung Lin
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan.
- Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St. Beitou Dist., Taipei, 112304, Taiwan.
| | - Kun-Hsien Chou
- Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St. Beitou Dist., Taipei, 112304, Taiwan.
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Shih-Pin Chen
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan.
- Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St. Beitou Dist., Taipei, 112304, Taiwan.
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.
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279
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Doedens A, Skarp S, Holmström L, Pakanen L, Saarimäki S, Kerkelä R, Pylkäs K, Huikuri HV, Junttila J. Genetic variants associated with cardiac hypertrophy-related sudden cardiac death and cardiovascular outcomes in a Finnish population. Heart 2024:heartjnl-2024-324623. [PMID: 39362746 DOI: 10.1136/heartjnl-2024-324623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 09/14/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND Hypertrophic cardiomyopathy is a common cause of non-ischaemic sudden cardiac death (SCD). Left ventricular hypertrophy (LVH) without cardiomyopathy-related myocardial disarray is a common autopsy finding and is often associated with prior hypertension in SCD subjects. Our aim was to investigate novel rare gene variants among SCD subjects with presumably hypertension-related LVH and myocardial fibrosis at autopsy. METHODS Whole exome sequencing was used to study rare variants (minor allele frequency<0.005) estimated to be deleterious in 96 non-ischaemic SCD subjects with presumably hypertension-related LVH and myocardial fibrosis. Associations of the identified variants with cardiac disease endpoints were replicated in the Finnish national genetic study (FinnGen) dataset. RESULTS 18 variants were estimated likely to affect protein function and 14 of these were associated with cardiomyopathies, heart failure, conduction abnormalities, hypertension and/or cardiac arrest in Finnish population (FinnGen). Three of the variants were classified as pathogenic or likely pathogenic. These include the splice site variant NM_000449.3:c.234-1G>A in regulatory factor X5 and frameshift variants NM_000449.3:c.234-1G>A in dehydrogenase/reductase 7C and NM_015873.3:c.1164del in villin like. CONCLUSIONS We identified rare deleterious variants associated with LVH in SCD subjects. Several of the identified rare variants associated with cardiovascular endpoints including heart failure, cardiomyopathies, cardiac arrest and hypertension in general population.
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Affiliation(s)
- Anne Doedens
- Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Sini Skarp
- Faculty of Medicine, University of Oulu, Oulu, Finland
| | | | - Lasse Pakanen
- Department of Forensic Medicine, Oulu University Hospital, Oulu, Finland
| | | | - Risto Kerkelä
- Research Unit of Biomedicine, University of Oulu, Oulu, Finland
| | - Katri Pylkäs
- Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit and Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Heikki V Huikuri
- Department of Internal Medicine, University of Oulu, Oulu, Finland
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280
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Maiga Y, Moskatel LS, Diallo SH, Sangho O, Dolo H, Konipo F, Diallo S, Coulibaly A, Daou M, Sangaré M, Coulibaly T, Sissoko A, Landouré G, Albakaye M, Traoré Z, Dao AK, Togo M, Mahamadou S, Coulibaly SDP, Kissani N, Nimaga K, Sanogo R, Berna F, Ouologem M, Kuaté C, Cowan R, Nizard J. Assessing traditional medicine in the treatment of neurological disorders in Mali: prelude to efficient collaboration. BMC Complement Med Ther 2024; 24:352. [PMID: 39363271 DOI: 10.1186/s12906-024-04645-5] [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: 10/23/2023] [Accepted: 09/16/2024] [Indexed: 10/05/2024] Open
Abstract
INTRODUCTION Neurological disorders (ND) have a high incidence in sub-Saharan Africa (SSA). In this region, systemic challenges of conventional medicine (CM) and cultural beliefs have contributed to a large utilization of traditional medicine (TM). Yet, data on TM and those who use it in the treatment of ND in SSA are scarce. Here, we systematically analyze its role as a therapy modality for ND in Mali, the socio-demographic characteristics of its users, and propose next steps to optimize the dual usages of TM and CM for patients with ND. METHODS We conducted a questionnaire study in two phases. In phase one, patients with ND answered questions on their usage of and attitudes towards TM. In phase two, the TM therapists who provided care to the patients in phase one answered questions regarding their own practices for treating ND. Patients were recruited from the country's two university neurology departments. RESULTS 3,534 of the 4,532 patients seen in the Departments of Neurology in 2019 met the inclusion criteria. Among these 3,534 patients, 2,430 (68.8%) had previously consulted TM for their present ND. Patients over 60 years of age most often used TM (83.1%). By education, illiterate patients utilized TM the most (85.5%) while those with more than a secondary education used TM the least (48.6%). An income greater than the minimum guaranteed salary was associated with decreased use of traditional medicine (OR 0.29, CI 0.25-0.35, p < 0.001). Among those using TM, it was overwhelmingly thought to be more effective than CM (84.6%). Linking illness to supernatural causes and believing TM therapists had a better understanding of illnesses were the most common reasons patients used traditional medicine (82.3% and 80.5%, respectively). We then interviewed 171 TM therapists who had provided care to the patients in phase one. These providers most commonly "sometimes" (62.6%) referred patients to CM and 4.1% never had. A majority of TM providers (62.6%) believed collaboration with CM could be improved by having doctor "take into account" our existence. CONCLUSION Our work shows that TM plays a central role in the provision of care for patients with ND in SSA with certain cohorts using it at higher rates. Future development of treatment of ND in SSA will require optimizing TM with CM and needs buy-in from all stakeholders including conventional medicine clinicians, traditional medicine therapists, researchers, politicians, and most importantly, patients.
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Affiliation(s)
- Youssoufa Maiga
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali.
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali.
- Laboratory of Therapeutics (EA3826), Faculty of Medicine (EA3826), Nantes, France.
| | | | - Seybou H Diallo
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Oumar Sangho
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Housseini Dolo
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Fatoumata Konipo
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Salimata Diallo
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | - Awa Coulibaly
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | - Mariam Daou
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | - Modibo Sangaré
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Thomas Coulibaly
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Adama Sissoko
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Guida Landouré
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Mohamed Albakaye
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | | | - Abdoul Karim Dao
- Department of Internal Medicine and Specialties, Gabriel Touré Teaching Hospital, Bamako, Mali
| | - Mamadou Togo
- Department of Internal Medicine and Specialties, Gabriel Touré Teaching Hospital, Bamako, Mali
| | - Saliou Mahamadou
- Department of Internal Medicine and Specialties, Gabriel Touré Teaching Hospital, Bamako, Mali
| | | | - Najib Kissani
- Neurology Department, University Teaching Hospital Mohammed VI, Marrakesh, Morocco
| | | | - Rokia Sanogo
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Fabrice Berna
- Hôpitaux Universitaires de Strasbourg, 1 Place de L'Hôpital, Clinique Psychiatrique, 67091, Strasbourg Cedex, France
| | - Madani Ouologem
- Service de Neurologie, Département de Médecine, Hôpital de Kati, Kati, Mali
| | - Callixte Kuaté
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | - Robert Cowan
- Department of Neurology, Stanford University, Palo Alto, CA, USA
| | - Julien Nizard
- Laboratory of Therapeutics (EA3826), Faculty of Medicine (EA3826), Nantes, France
- Faculty of Medicine, University of Nantes, Nantes, France
- Federal Center of Palliative Care and Support, Laboratory of Therapeutics, UHCof, Nantes, France
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281
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He J, Cabrera-Mendoza B, De Angelis F, Pathak GA, Koller D, Curhan SG, Curhan GC, Mecca AP, van Dyck CH, Polimanti R. Sex differences in the pleiotropy of hearing difficulty with imaging-derived phenotypes: a brain-wide investigation. Brain 2024; 147:3395-3408. [PMID: 38454550 PMCID: PMC11449129 DOI: 10.1093/brain/awae077] [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: 08/25/2023] [Revised: 01/22/2024] [Accepted: 02/21/2024] [Indexed: 03/09/2024] Open
Abstract
Hearing difficulty (HD) is a major health burden in older adults. While ageing-related changes in the peripheral auditory system play an important role, genetic variation associated with brain structure and function could also be involved in HD predisposition. We analysed a large-scale HD genome-wide association study (GWAS; ntotal = 501 825, 56% females) and GWAS data related to 3935 brain imaging-derived phenotypes (IDPs) assessed in up to 33 224 individuals (52% females) using multiple MRI modalities. To investigate HD pleiotropy with brain structure and function, we conducted genetic correlation, latent causal variable, Mendelian randomization and multivariable generalized linear regression analyses. Additionally, we performed local genetic correlation and multi-trait co-localization analyses to identify genomic regions and loci implicated in the pleiotropic mechanisms shared between HD and brain IDPs. We observed a widespread genetic correlation of HD with 120 IDPs in females, 89 in males and 171 in the sex-combined analysis. The latent causal variable analysis showed that some of these genetic correlations could be due to cause-effect relationships. For seven of them, the causal effects were also confirmed by the Mendelian randomization approach: vessel volume→HD in the sex-combined analysis; hippocampus volume→HD, cerebellum grey matter volume→HD, primary visual cortex volume→HD and HD→fluctuation amplitudes of node 46 in resting-state functional MRI dimensionality 100 in females; global mean thickness→HD and HD→mean orientation dispersion index in superior corona radiata in males. The local genetic correlation analysis identified 13 pleiotropic regions between HD and these seven IDPs. We also observed a co-localization signal for the rs13026575 variant between HD, primary visual cortex volume and SPTBN1 transcriptomic regulation in females. Brain structure and function may have a role in the sex differences in HD predisposition via possible cause-effect relationships and shared regulatory mechanisms.
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Affiliation(s)
- Jun He
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Brenda Cabrera-Mendoza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), Veteran Affairs Connecticut Healthcare System, West Haven, CT 06516, USA
| | - Flavio De Angelis
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Gita A Pathak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), Veteran Affairs Connecticut Healthcare System, West Haven, CT 06516, USA
| | - Dora Koller
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona 08028, Spain
| | - Sharon G Curhan
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Gary C Curhan
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Adam P Mecca
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Christopher H van Dyck
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, New Haven, CT 06510, USA
- Departments of Neuroscience and Neurology, Yale University School of Medicine, New Haven, CT 06511, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), Veteran Affairs Connecticut Healthcare System, West Haven, CT 06516, USA
- Wu Tsai Institute, Yale University, New Haven, CT 06511, USA
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282
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Gerard T, Naye F, Decary S, Langevin P, Cook C, Hutting N, Martel M, Tousignant-Laflamme Y. Prognostic factors of pain, disability, and poor outcomes in persons with neck pain - an umbrella review. Clin Rehabil 2024:2692155241268373. [PMID: 39363645 DOI: 10.1177/02692155241268373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
OBJECTIVE The aim of this study was to identify prognostic factors pertaining to neck pain from systematic reviews. DATA SOURCES A search on PubMed, Scopus, and CINAHL was performed on June 27, 2024. Additional grey literature searches were performed. REVIEW METHODS We conducted an umbrella review and included systematic reviews reporting the prognostic factors associated with non-specific or trauma-related neck pain and cervical radiculopathy. Prognostic factors were sorted according to the outcome predicted, the direction of the predicted outcome (worse, better, inconsistent), and the grade of evidence (Oxford Center of Evidence). The predicted outcomes were regrouped into five categories: pain, disability, work-related outcomes, quality of life, and poor outcomes (as "recovery"). Risk of bias analysis was performed with the ROBIS tool. RESULTS We retrieved 884 citations from three databases, read 39 full texts, and included 16 studies that met all selection criteria. From these studies, we extracted 44 prognostic factors restricted to non-specific neck pain, 47 for trauma-related neck pain, and one for cervical radiculopathy. We observed that among the prognostic factors, most were associated with characteristics of the condition, cognitive-emotional factors, or socio-environmental and lifestyle factors. CONCLUSION This study identified over 40 prognostic factors associated mainly with non-specific neck pain or trauma-related neck pain. We found that a majority were associated with worse outcomes and pertained to domains mainly involving cognitive-emotional factors, socio-environmental and lifestyle factors, and the characteristics of the condition to predict outcomes and potentially guide clinicians to tailor their interventions for people living with neck pain.
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Affiliation(s)
- Thomas Gerard
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Quebec, Canada
| | - Florian Naye
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Quebec, Canada
| | - Simon Decary
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Quebec, Canada
| | - Pierre Langevin
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Cirris), Université Laval, Quebec City, Quebec, Canada
- PhysioInteractive/Cortex, Quebec, Quebec, Canada
- Département de réadaptation, Université Laval, Quebec, Quebec, Canada
| | - Chad Cook
- Department of Orthopaedics, Division of Physical Therapy, Duke University, Durham, NC, USA
- Department of Population Health Sciences, Duke University, Durham, NC, USA
- Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Nathan Hutting
- Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Marylie Martel
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Yannick Tousignant-Laflamme
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Quebec, Canada
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283
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De Lay NR, Verma N, Sinha D, Garrett A, Osterberg MK, Porter D, Reiling S, Giedroc DP, Winkler ME. The five homologous CiaR-controlled Ccn sRNAs of Streptococcus pneumoniae modulate Zn-resistance. PLoS Pathog 2024; 20:e1012165. [PMID: 39361718 DOI: 10.1371/journal.ppat.1012165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 09/22/2024] [Indexed: 10/05/2024] Open
Abstract
Zinc is a vital transition metal for all bacteria; however, elevated intracellular free Zn levels can result in mis-metalation of Mn-dependent enzymes. For Mn-centric bacteria such as Streptococcus pneumoniae that primarily use Mn instead of Fe as an enzyme cofactor, Zn is particularly toxic at high concentrations. Here, we report our identification and characterization of the function of the five homologous, CiaRH-regulated Ccn sRNAs in controlling S. pneumoniae virulence and metal homeostasis. We show that deletion of all five ccn genes (ccnA, ccnB, ccnC, ccnD, and ccnE) from S. pneumoniae strains D39 (serotype 2) and TIGR4 (serotype 4) causes Zn hypersensitivity and an attenuation of virulence in a murine invasive pneumonia model. We provide evidence that bioavailable Zn disproportionately increases in S. pneumoniae strains lacking the five ccn genes. Consistent with a response to Zn intoxication or relatively high intracellular free Zn levels, expression of genes encoding the CzcD Zn exporter and the Mn-independent ribonucleotide reductase, NrdD-NrdG, were increased in the ΔccnABCDE mutant relative to its isogenic ccn+ parent strain. The growth inhibition by Zn that occurs as the result of loss of the ccn genes is rescued by supplementation with Mn or Oxyrase, a reagent that removes dissolved oxygen. Lastly, we found that the Zn-dependent growth inhibition of the ΔccnABCDE strain was not altered by deletion of sodA, whereas the ccn+ ΔsodA strain phenocopied the ΔccnABCDE strain. Overall, our results indicate that the Ccn sRNAs have a crucial role in preventing Zn intoxication in S. pneumoniae.
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Affiliation(s)
- Nicholas R De Lay
- Department of Microbiology and Molecular Genetics, McGovern Medical School, University of Texas Health Science Center, Houston, Texas, United States of America
- MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, University of Texas Health Science Center, Houston, Texas, United States of America
| | - Nidhi Verma
- Department of Microbiology and Molecular Genetics, McGovern Medical School, University of Texas Health Science Center, Houston, Texas, United States of America
| | - Dhriti Sinha
- Department of Microbiology and Molecular Genetics, McGovern Medical School, University of Texas Health Science Center, Houston, Texas, United States of America
| | - Abigail Garrett
- Department of Biology, Indiana University Bloomington, Bloomington, Indiana, United States of America
| | - Maximillian K Osterberg
- Department of Chemistry, Indiana University, Bloomington, Bloomington, Indiana, United States of America
| | - Daisy Porter
- Department of Microbiology and Molecular Genetics, McGovern Medical School, University of Texas Health Science Center, Houston, Texas, United States of America
| | - Spencer Reiling
- Department of Microbiology and Molecular Genetics, McGovern Medical School, University of Texas Health Science Center, Houston, Texas, United States of America
| | - David P Giedroc
- Department of Chemistry, Indiana University, Bloomington, Bloomington, Indiana, United States of America
| | - Malcolm E Winkler
- Department of Biology, Indiana University Bloomington, Bloomington, Indiana, United States of America
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284
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Yan L, Ge H, Wang Z, Shen A, Xu Q, Jiang D, Cao Y. Roles of low muscle strength and sarcopenic obesity on incident symptomatic knee osteoarthritis: A longitudinal cohort study. PLoS One 2024; 19:e0311423. [PMID: 39361683 DOI: 10.1371/journal.pone.0311423] [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: 06/12/2024] [Accepted: 09/18/2024] [Indexed: 10/05/2024] Open
Abstract
OBJECTIVES Sarcopenia is prevalent in middle to old age. We aimed to investigate the association between muscle strength and the incident knee osteoarthritis (OA). METHODS 12,043 participants were collected from the China Health and Retirement Longitudinal Study. The effects of sarcopenic obesity (defined by obesity in combination with possible sarcopenia) on knee OA onset were calculated using Poisson regression models. Mediation analysis was fit to estimate mediating proportion of muscle strength on the association between obesity and incident knee OA. RESULTS The study all enrolled 12,043 participants with 2,008 progressed to knee OA. Poisson analyses demonstrated causal association of general obesity (RR:1.23, 95% CI: 1.08 to 1.39) and abdominal obesity (RR:1.23, 95% CI: 1.11 to 1.35) with knee OA onset. For the risk of incident knee OA, participants with the highest level of normalized grip strength had a decreased risk of incident knee OA by 0.33 (RR:0.67, 95% CI: 0.60 to 0.75) times compared to the control group, and chair-rising time was associated with increased risk of incident knee OA by 0.65 (RR:1.65, 95% CI: 1.17 to 2.33) times. Sensitivity analysis identified similar results. Participants with sarcopenic obesity were about 2 times risk of incident knee OA than reference group. Normalized grip strength and chair-rising time mediated the association between obesity and incidence of knee OA. CONCLUSIONS Sarcopenic obesity is correlated with an increased risk of knee OA. Muscle strength recovery may alleviate the risk of incident knee OA in middle to old age with obesity.
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Affiliation(s)
- Laijun Yan
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Haiya Ge
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhengming Wang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Anping Shen
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qinguang Xu
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ding Jiang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuelong Cao
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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285
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Liuzzo D, Fell N, Heath G, Raghavan P, Levine D. Behavioral Risk Profiles of Stroke Survivors Among US Adults: Geographic Differences Between Stroke Belt and Non-Stroke Belt States. Prev Chronic Dis 2024; 21:E77. [PMID: 39361936 DOI: 10.5888/pcd21.240113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024] Open
Abstract
Introduction Stroke, a leading cause of illness, death, and long-term disability in the US, presents with significant disparities across the country, most notably in southeastern states comprising the "Stroke Belt." This study intended to identify differences between Stroke Belt states (SBS) and non-Stroke Belt states (NSBS) in terms of prevalence of stroke, sociodemographic and behavioral risk factors, and health-related quality of life (HRQOL). Methods We analyzed data from the 2019 Behavioral Risk Factor Surveillance System to compare demographic characteristics, risk factors, physical activity adherence, functional independence, and HRQOL among stroke survivors in SBS and NSBS. Results Of 18,745 stroke survivors, 4,272 were from SBS and 14,473 were from NSBS. Stroke was more prevalent in SBS (odds ratio [OR] = 1.39; 95% CI, 1.35-1.44; P < .001), with significant differences by age, sex, and race and ethnicity, except for Hispanic ethnicity. Selected stroke risk factors were more common in every category in SBS. Stroke survivors in SBS were less likely to meet physical activity guidelines for aerobic (OR = 0.77; 95% CI, 0.69-0.86; P < .001) and aerobic and strengthening combined (OR = 0.77; 95% CI, 0.70-0.86; P < .001) activities. Stroke survivors in SBS were more likely to not meet either physical activity guideline (OR = 1.31; 95% CI, 1.22-1.41; P < .001). Conclusions Living in SBS significantly increased the odds of stroke occurrence. Stroke survivors from SBS reported lower HRQOL and insufficient physical activity as well as lower functional independence. Specific strategies are needed for residents of SBS, with a focus on policies and primary and secondary prevention practices across healthcare professions.
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Affiliation(s)
- Derek Liuzzo
- Department of Physical Therapy, College of Health, Education, and Professional Studies, University of Tennessee at Chattanooga
| | - Nancy Fell
- Department of Physical Therapy, College of Health, Education, and Professional Studies, University of Tennessee at Chattanooga
| | - Gregory Heath
- Department of Health and Human Performance, College of Health, Education, and Professional Studies, University of Tennessee at Chattanooga
- Department of Internal Medicine, University of Tennessee Health Science Center College of Medicine, Chattanooga
| | - Preeti Raghavan
- Department of Physical Medicine and Neurology, Johns Hopkins Medicine, Baltimore, Maryland
| | - David Levine
- Department of Physical Therapy, College of Health, Education, and Professional Studies, University of Tennessee at Chattanooga
- University of Tennessee at Chattanooga, 615 McCallie Ave, Mapp 203G, Chattanooga, TN 37403
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286
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Zhou J, Wang FD, Li LQ, Li YJ, Wang SY, Chen EQ. Nucleos(t)ide analogs to treat patients with positive hepatitis B virus deoxyribonucleic acid and normal alanine transaminase: protocol for an open-label single-center randomized parallel controlled trial. Trials 2024; 25:652. [PMID: 39363218 DOI: 10.1186/s13063-024-08433-x] [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: 10/30/2023] [Accepted: 08/27/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND Direct high-quality evidence remains absent on the benefits of HBeAg-negative chronic hepatitis B patients (CHB) with normal alanine transaminase (ALT) and positive HBV DNA after nucleos(t)ide analogs (NAs) treatment. METHODS This is a single-center, open-label, randomized parallel controlled trial with a follow-up duration of 96 weeks. An estimated 300 patients will be recruited at West China Hospital of Sichuan University, China. After stratified by serum HBV DNA (< 2000 vs. ≥ 2000 IU/ml), eligible patients will be randomized (allocation ratio 1:1) to receive either antiviral therapy (the treatment group) or regular examination alone (the control group). The primary outcomes are rates of virological response and changes in the levels of serum HBV pregenomic RNA (pgRNA) and scores of health-related qualities of life. DISCUSSION This randomized controlled trial focuses on HBeAg-negative patients with normal ALT, including those of the inactive carrier phase and the grey zone, whose antiviral treatment remains controversial. Additionally, a health-related quality of life scale is introduced to comprehensively estimate the benefit of antiviral treatment apart from virological response and adverse liver events. Meaningfully, the study findings will provide high-quality and direct evidence for optimal clinical management in such populations. TRIAL REGISTRATION This trial was registered with the Chinese Clinical Trial Registry (ChiCTR2300069391) on 15 March 2023.
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Affiliation(s)
- Jing Zhou
- Center of Infectious Diseases, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Wuhou District, Chengdu, 610041, China
| | - Fa-Da Wang
- Center of Infectious Diseases, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Wuhou District, Chengdu, 610041, China
| | - Lan-Qing Li
- Center of Infectious Diseases, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Wuhou District, Chengdu, 610041, China
| | - Yu-Jin Li
- Center of Infectious Diseases, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Wuhou District, Chengdu, 610041, China
| | - Shi-Yan Wang
- Department of Pharmacy, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Wuhou District, Chengdu, 610041, China
| | - En-Qiang Chen
- Center of Infectious Diseases, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Wuhou District, Chengdu, 610041, China.
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287
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Liew JW, Petrow E, Tilley S, LaValley MP, Roemer FW, Guermazi A, Lewis CE, Torner J, Nevitt MC, Lynch JA, Felson D. Comparison of definitions of early knee osteoarthritis for likelihood of progression at 2-year and 5-year follow-up: the Multicenter Osteoarthritis Study. Ann Rheum Dis 2024:ard-2024-226060. [PMID: 39362696 DOI: 10.1136/ard-2024-226060] [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: 05/02/2024] [Accepted: 09/11/2024] [Indexed: 10/05/2024]
Abstract
BACKGROUND Preventing worsening osteoarthritis (OA) in persons with early OA is a major treatment goal. We evaluated if different early OA definitions yielded enough cases of worsening OA within 2-5 years to make trial testing treatments feasible. METHODS We assessed different definitions of early OA using data from Multicenter Osteoarthritis (MOST) Study participants who were followed up longitudinally. We defined early OA as having at least minimal knee pain (WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) pain ≥3/20) with different levels of pre-radiographic OA. For MRI, we required knee pain and used MRI definitions with combinations of cartilage damage, osteophytes, bone marrow lesions and meniscus damage.The primary outcome, worsening OA at 2 or 5 years, combined structural (Kellgren and Lawrence grade ≥2 with joint space narrowing ≥1) and symptom (WOMAC pain ≥6 with increase ≥2 from baseline) outcomes. We also examined structural and symptom outcomes separately. RESULTS For worsening OA at 2 years, we included 750 participants (mean age 65 years, 60% female, 90% white, mean body mass index 29.2 kg/m2). Fewer than 10% of early OA knees had the combined outcome at 2 or 5 years. At 2 years, for several early OA definitions, roughly 20% of knees had either structural or symptom worsening outcomes. Two-year trials of either, but not both, outcomes would need to recruit over 1200 patients. CONCLUSION Most knees with early OA are stable and do not progress. Some painful knees experience worse pain but not structural progression and vice versa. Trial testing treatments to prevent OA illness or disease will be challenging.
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Affiliation(s)
- Jean W Liew
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Eva Petrow
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Sarah Tilley
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | | | - Frank W Roemer
- Radiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Department of Radiology, Friedrich Alexander University Erlangen Nuremberg Faculty of Medicine, Erlangen, Bayern, Germany
| | - Ali Guermazi
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Radiology, VA Boston Healthcare System, West Roxbury, Massachusetts, USA
| | - Cora E Lewis
- The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - James Torner
- Epidemiology, University of Iowa, Iowa, Iowa, USA
| | - Michael C Nevitt
- University of California San Francisco, San Francisco, California, USA
| | - John A Lynch
- University of California San Francisco, San Francisco, California, USA
| | - David Felson
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
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288
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Malevolti MC, Baccini M, Caldarella A, Garofalo G, Gorini G, Levi M, Manneschi G, Masala G, Monasta L, Profili F, Carreras G. Lung cancer and smoking: years lived with disability in Tuscany (Italy). An analysis from the ACAB study. BMC Public Health 2024; 24:2696. [PMID: 39363189 DOI: 10.1186/s12889-024-20109-4] [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: 03/28/2024] [Accepted: 09/17/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND Lung cancer (LC) is among the most common neoplasms, mostly caused by smoking. This study, carried out within the ACAB project, aims to provide local, updated and systematic estimates of years lived with disability (YLD) from LC due to smoking in the Tuscany region, Italy. METHODS We estimated YLD for the year 2022 for the whole region and at subregional level by local health unit (LHU) using data from the Tuscany Cancer Registry and local surveys. YLD were calculated by applying the severity-specific LC prevalence, estimated with an incidence-based disease model, to the corresponding disability weight. The burden from smoking was computed by: modelling the prevalence of smokers with a Bayesian Dirichlet-Multinomial regression model; estimating the distribution of smokers by pack-years simulating individual smoking histories; collecting relative risks from the literature. RESULTS In 2022 in Tuscany, LC caused 7.79 (95% uncertainty interval [UI] = 2.26, 17.27) and 25.50 (95% UI = 7.30, 52.68) YLDs per 100,000 females and males, respectively, with slight variations by LHU, and 53% and 66% of the YLDs were caused by smoking. CONCLUSION The updated estimates of the burden of LC attributable to smoking for the Tuscany region as a whole and for each LHU provide indications to inform strategic prevention plans and set public health priorities. The impact of smoking on YLDs from LC is not negligible and heterogeneous by LHU, thus requiring local interventions.
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Affiliation(s)
- Maria Chiara Malevolti
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, 50139, Italy
| | - Michela Baccini
- Department of Statistics, Computer Science, Applications "Giuseppe Parenti" (DiSIA), University of Florence, Florence, Italy
| | - Adele Caldarella
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, 50139, Italy
| | - Giorgio Garofalo
- Public Hygiene and Nutrition Unit, Department of Prevention, Local Health Authority Tuscany Centre, Florence, Italy
| | - Giuseppe Gorini
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, 50139, Italy
| | - Miriam Levi
- Epidemiology Unit, Department of Prevention, Local Health Authority Tuscany Centre, Florence, Italy
| | - Gianfranco Manneschi
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, 50139, Italy
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, 50139, Italy
| | - Lorenzo Monasta
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Giulia Carreras
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, 50139, Italy.
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Jones OA, Mohamed S, Hinz R, Paterson A, Sobowale OA, Dickie BR, Parkes LM, Parry-Jones AR. Neuroinflammation and blood-brain barrier breakdown in acute, clinical intracerebral hemorrhage. J Cereb Blood Flow Metab 2024:271678X241274685. [PMID: 39360420 DOI: 10.1177/0271678x241274685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Abstract
Neuroinflammation is a promising therapeutic target in intracerebral hemorrhage (ICH), characterized in the brain by microglial activation and blood-brain barrier (BBB) breakdown. In this study, 36 acute, spontaneous, supratentorial ICH patients underwent dynamic contrast-enhanced MRI to measure BBB permeability (Ktrans) 1-3 days post-onset and 16 returned for [11C](R)-PK11195 PET to quantify microglial activation (BPND), 2-7 days post-onset. We first tested if these markers were increased and co-localized in the perihematomal brain and found that perihematomal Ktrans and BPND were increased vs. the contralateral brain, but regions of high Ktrans and BPND only overlapped by a mean of 4.9%. We then tested for associations of perihematomal Ktrans and BPND with clinical characteristics (age, ICH volume & location, blood pressure), other markers of inflammation (edema, IL-6, and CRP), and long-term functional outcome (90-day mRS). Lower perihematomal BPND was associated with increasing age. Lobar hemorrhage was associated with greater Ktrans than deep, but Ktrans and BPND were not associated with ICH volume, or other inflammatory markers. While perihematomal Ktrans and BPNDwere not associated with outcome, contralateral Ktrans was significantly associated with greater 90-day mRS. Exploratory analyses demonstrated that blood pressure variability over 72 h was also associated with contralateral Ktrans.
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Affiliation(s)
- Olivia A Jones
- Division of Psychology, Communication and Human Neuroscience, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Saffwan Mohamed
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Rainer Hinz
- Geoffrey Jefferson Brain Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Division of Imaging, Informatics and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Alastair Paterson
- Division of Psychology, Communication and Human Neuroscience, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Oluwaseun A Sobowale
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Ben R Dickie
- Geoffrey Jefferson Brain Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Division of Imaging, Informatics and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Laura M Parkes
- Division of Psychology, Communication and Human Neuroscience, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Adrian R Parry-Jones
- Geoffrey Jefferson Brain Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Salford, UK
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290
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Zeng Y, Yu S, Lu L, Zhang J, Xu C. Ginger-derived nanovesicles attenuate osteoarthritis progression by inhibiting oxidative stress via the Nrf2 pathway. Nanomedicine (Lond) 2024:1-17. [PMID: 39360651 DOI: 10.1080/17435889.2024.2403324] [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: 05/09/2024] [Accepted: 09/09/2024] [Indexed: 10/04/2024] Open
Abstract
Aim: Osteoarthritis (OA) is a common degenerative joint disease. Previous studies demonstrated ginger-derived exosome-like nanovesicles (GDN) showed therapeutic effects in degenerative diseases. However, it remains unknown whether GDN could alleviate OA progression.Materials & methods: In this study, GDN were obtained and characterized. Then we evaluated the effects of GDN in tert-butyl hydroperoxide (TBHP)-induced chondrocytes, posttraumatic OA rat model and ex vivo cultured human OA cartilage explants.Results: We demonstrated GDN promoted cartilage anabolism and alleviated oxidative stress in TBHP-induced chondrocytes and OA rat. Our results also showed GDN exhibited protective effects in cultured cartilage explants. Furthermore, we verified the Nrf2 pathway was associated with protective effects of GDN.Conclusion: Altogether, our findings demonstrated GDN hold great potential for OA treatment.
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Affiliation(s)
- Yiming Zeng
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Shun Yu
- Department of Burns & Plastic Surgery, The Affiliated Hospital of Jiangnan University, Wuxi, 214041, China
| | - Lin Lu
- Department of Plastic & Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Jun Zhang
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Chen Xu
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
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291
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Foster K, Wong CYJ. Advances in inhaler therapy for asthma and chronic obstructive pulmonary disease: a comprehensive review of Fostair™ and Trimbow™. J Pharm Pharmacol 2024; 76:1301-1309. [PMID: 38954755 DOI: 10.1093/jpp/rgae090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 06/14/2024] [Indexed: 07/04/2024]
Abstract
The management of asthma and chronic obstructive pulmonary disease (COPD) poses considerable challenges due to the intricate nature of these respiratory conditions. Fostair™ and Trimbow™, two pressurized metered dose inhalers, have emerged as noteworthy therapeutic options for treating both asthma and COPD. Fostair combines an inhaled corticosteroid, specifically beclometasone dipropionate, with a long-acting beta2-agonist, formoterol fumarate dihydrate, offering a dual-action approach to mitigate airway inflammation and bronchoconstriction. Conversely, Trimbow integrates a tri-particulate formulation consisting of beclometasone dipropionate, formoterol fumarate dihydrate, and glycopyrronium bromide, providing a comprehensive strategy to target the pathophysiology of COPD and asthma. Recent clinical trials have underscored Trimbow's superior efficacy compared with Fostair, particularly in terms of reducing exacerbation rates and enhancing lung function. However, despite their therapeutic promise, both inhalers encounter challenges, including limited generalizability of study findings and a disparity between in vitro and human trial results. This literature review offers an in-depth analysis of Fostair and Trimbow, delving into their mechanisms of action, clinical applications, and outcomes in human studies for asthma and COPD. Additionally, the review discusses the role of combination therapy in managing respiratory diseases and underscores the necessity for further research to address existing knowledge gaps and optimize therapeutic outcomes.
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Affiliation(s)
- Katie Foster
- Department of Life Sciences, University of Bath, Bath, BA2 7AY, United Kingdom
| | - Chun Yuen Jerry Wong
- Respiratory Technology, Woolcock Institute of Medical Research, Sydney, NSW 2037, Australia
- Faculty of Medicine and Health Sciences, Macquarie Medical School, Macquarie University, Sydney, NSW 2109, Australia
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292
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Rust R, Nih LR, Liberale L, Yin H, El Amki M, Ong LK, Zlokovic BV. Brain repair mechanisms after cell therapy for stroke. Brain 2024; 147:3286-3305. [PMID: 38916992 PMCID: PMC11449145 DOI: 10.1093/brain/awae204] [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: 03/11/2024] [Revised: 06/04/2024] [Accepted: 06/08/2024] [Indexed: 06/27/2024] Open
Abstract
Cell-based therapies hold great promise for brain repair after stroke. While accumulating evidence confirms the preclinical and clinical benefits of cell therapies, the underlying mechanisms by which they promote brain repair remain unclear. Here, we briefly review endogenous mechanisms of brain repair after ischaemic stroke and then focus on how different stem and progenitor cell sources can promote brain repair. Specifically, we examine how transplanted cell grafts contribute to improved functional recovery either through direct cell replacement or by stimulating endogenous repair pathways. Additionally, we discuss recently implemented preclinical refinement methods, such as preconditioning, microcarriers, genetic safety switches and universal (immune evasive) cell transplants, as well as the therapeutic potential of these pharmacologic and genetic manipulations to further enhance the efficacy and safety of cell therapies. By gaining a deeper understanding of post-ischaemic repair mechanisms, prospective clinical trials may be further refined to advance post-stroke cell therapy to the clinic.
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Affiliation(s)
- Ruslan Rust
- Department of Physiology and Neuroscience, University of Southern California, Los Angeles, CA 90033, USA
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- Institute for Regenerative Medicine, University of Zurich, 8952 Schlieren, Switzerland
| | - Lina R Nih
- Department of Brain Health, University of Nevada, Las Vegas, NV 89154, USA
| | - Luca Liberale
- Department of Internal Medicine, University of Genoa, 16132 Genova, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Hao Yin
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada
| | - Mohamad El Amki
- Department of Neurology, University Hospital and University of Zurich, 8091 Zurich, Switzerland
| | - Lin Kooi Ong
- School of Health and Medical Sciences & Centre for Health Research, University of Southern Queensland, Toowoomba, QLD 4350, Australia
| | - Berislav V Zlokovic
- Department of Physiology and Neuroscience, University of Southern California, Los Angeles, CA 90033, USA
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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293
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Iqbal I, Shahid S, Kanwar S, Kabir F, Umrani F, Ahmed S, Khan W, Qazi MF, Aziz F, Muneer S, Kalam A, Hotwani A, Mehmood J, Qureshi AK, Hasan Z, Shakoor S, Mirza S, McGee L, Lo SW, Kumar N, Azam I, Bentley SD, Jehan F, Nisar MI. Pneumococcal carriage and changes in serotype distribution post- PCV13 introduction in children in Matiari, Pakistan. Vaccine 2024; 42:126238. [PMID: 39168078 PMCID: PMC11413484 DOI: 10.1016/j.vaccine.2024.126238] [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: 06/13/2024] [Revised: 07/30/2024] [Accepted: 08/14/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND In early 2021, the 10-valent Pneumococcal conjugate vaccine (PCV10) was replaced with 13-valent (PCV13) by the federal directorate of immunization (FDI), Pakistan. We assessed the impact of a higher valent vaccine, PCV13, on the serotype distribution of nasopharyngeal carriage in rural Pakistan. METHODS Children <2 years were randomly selected from two rural union councils of Matiari, Sindh in Pakistan between September-October,2022. Clinical, sociodemographic and vaccination histories were recorded. Nasopharyngeal swabs were collected and processed at Infectious Disease Research Laboratory, Aga Khan University, Karachi. Whole genome sequencing was performed on the culture positive isolates. RESULTS Of the 200 children enrolled, pneumococcus was detected in 140(70 %) isolates. Majority of age-eligible children (60.1 %,110/183) received 3 PCV13 doses. PCV10 carriage declined from 13.2 %(78/590) in 2017/18 to 7.2 % (10/140) in 2022, additional PCV13 serotypes (3, 6A/6C and 19A) decreased from 18.5 %(109/590) to 11.4 %(16/140) while non-PCV13 serotypes increased from 68.3 %(403/590) to 81.4 %(114/140). There were 88.5 %(n = 124), 80.7 %(n = 113), 55.0 %(n = 77), and 46.0 %(n = 65) isolates predicted to be resistant to cotrimoxazole, penicillin(meningitis cut-off), tetracycline, and erythromycin respectively. CONCLUSION Replacing PCV10 with PCV13 rapidly decreased prevalence of PCV13 carriage among vaccinated children in Matiari, Pakistan. Vaccine-driven selection pressure may have been responsible for the increase of non-PCV13 serotypes.
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Affiliation(s)
- Izn Iqbal
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Shahira Shahid
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Samiah Kanwar
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Furqan Kabir
- Infectious Diseases Research Laboratory (IDRL), Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Fayaz Umrani
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Sheraz Ahmed
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Waqasuddin Khan
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Fatima Aziz
- Infectious Diseases Research Laboratory (IDRL), Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sahrish Muneer
- Infectious Diseases Research Laboratory (IDRL), Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Adil Kalam
- Infectious Diseases Research Laboratory (IDRL), Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Aneeta Hotwani
- Infectious Diseases Research Laboratory (IDRL), Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Junaid Mehmood
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Zahra Hasan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Sadia Shakoor
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Shaper Mirza
- Syed Babar Ali School of Science and Engineering, Lahore University of Management Sciences, Lahore, Pakistan
| | - Lesley McGee
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stephanie W Lo
- Parasites and Microbes, Wellcome Sanger Institute, Hinxton, UK
| | - Narender Kumar
- Parasites and Microbes, Wellcome Sanger Institute, Hinxton, UK
| | - Iqbal Azam
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Fyezah Jehan
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Muhammad Imran Nisar
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
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294
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Shi Y, Peng T, Liang Y, Li Y, Ren R, Zhang Y, Yan X, Chen X, Chen D, Shen G. Extending Dynamic Blind Interaction: Microgap Discharge-Induced Flexible Virtual Electrotactile Braille. ACS APPLIED MATERIALS & INTERFACES 2024. [PMID: 39360713 DOI: 10.1021/acsami.4c13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Abstract
Braille is an essential implement for the blind to communicate with outside, but traditional Braille is limited to a paper-based format that cannot directly provide real-time word information. In this work, a flexible virtual electrotactile Braille is proposed that can benefit the blind from blocked interaction. The Braille interface, S-shaped wires and a sphere electrode with a textile fingerstall integrated by silicone, offers flexibility and simultaneously generates the microgap through textile cracks, which achieves virtual electrotactile sensation by electrostatic discharge. Powered by a high-voltage triboelectric generator of 10.2 kV designed through the charge accumulation and induction strategy, the electrotactile stimulation is realized with a microgap discharge of only 40 μA current induced on the finger. A dynamic electrotactile Braille is finally assembled, controlled by a programmable relay array. The strategies of short circuit and voice reminder are employed, so that the recognition of dynamic Braille letters is realized with spatiotemporal electrotactile stimulation and high recognition accuracy. This virtual electrotactile Braille brings convenience for the blind to access the information world and illustrates its applications to promote virtual electrotactility in this special community.
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Affiliation(s)
- Yuxiang Shi
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing 100081, China
- Institute of Flexible Electronics, Beijing Institute of Technology, Beijing 102488, China
| | - Tianrui Peng
- School of Information and Electronics, Beijing Institute of Technology, Beijing 100081, China
| | - Yuning Liang
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing 100081, China
| | - Yuhan Li
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing 100081, China
| | - Rui Ren
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing 100081, China
| | - Youyi Zhang
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing 100081, China
| | - Xiao Yan
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing 100081, China
| | - Xiangyu Chen
- Beijing Key Laboratory of Micro-Nano Energy and Sensor, Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing 100083, China
- School of Nanoscience and Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Di Chen
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing 100081, China
- Institute of Flexible Electronics, Beijing Institute of Technology, Beijing 102488, China
| | - Guozhen Shen
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing 100081, China
- Institute of Flexible Electronics, Beijing Institute of Technology, Beijing 102488, China
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295
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Gafari O, Agyapong-Badu S, Alwan NA, Tully MA, McDonough S, Stokes M, Barker M. Misaligned or misheard? Physical activity and healthy eating messaging to ethnic minority communities during the COVID-19 pandemic: A qualitative study and scoping review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003345. [PMID: 39361630 DOI: 10.1371/journal.pgph.0003345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 08/26/2024] [Indexed: 10/05/2024]
Abstract
This mixed-methods study identified physical activity (PA) and healthy eating messages produced during the COVID-19 pandemic and explored how they were received by UK ethnic minority communities. A scoping review of research and grey literature identified categories of PA and healthy eating messaging targeted at ethnic minorities. Individual and group interviews were conducted, audio-recorded, transcribed and analysed using inductive thematic analysis. There was active community engagement in all study phases to ensure relevance and co-production of findings. Interviews were held with 41 study participants aged 18-86 years (20 men) residing in England and Wales using digital conferencing and in person. The scoping review identified 24 records containing messages grouped into three categories: 1) PA messages; 2) healthy eating messages; 3) risk messages. Five themes described participants' views of these messages: 1) lack of awareness of messaging; 2) responses to PA messaging; 3) responses to healthy eating messaging; 4) perceptions of risk messaging and 5) perceptions of conflict in messages. The review revealed that physical activity and healthy eating messaging specifically targeting ethnic minority communities is limited. This limited messaging was almost entirely missed by these communities. When received, the messaging was not interpreted as intended, perceived to be conflicting and risk messaging was perceived as blaming. More work with ethnic minority communities needs to be done to co-produce meaningful and appropriate PA and healthy eating messaging in a timely manner.
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Affiliation(s)
- Olatundun Gafari
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Sandra Agyapong-Badu
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Nisreen A Alwan
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- School of Primary Care and Population Sciences, University of Southampton, Southampton, United Kingdom
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, Northern Ireland
| | - Suzanne McDonough
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
- School of Physiotherapy, Royal College of Surgeons Ireland, Dublin, Ireland
| | - Maria Stokes
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Mary Barker
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
- MRC Lifecourse Epidemiology Research Centre, University of Southampton, Southampton, United Kingdom
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296
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Jiang Y, Zhang S, Chen Y, Wang H, He X, Bin C, Fu R, Wang H, Zhu H, Pan M, Zhang Q, Lu Y. Physical activity and risk of Parkinson's disease: an updated systematic review and meta-analysis. J Neurol 2024:10.1007/s00415-024-12672-y. [PMID: 39363041 DOI: 10.1007/s00415-024-12672-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Revised: 08/26/2024] [Accepted: 08/27/2024] [Indexed: 10/05/2024]
Abstract
BACKGROUND AND OBJECTIVES Although recent meta-analyses have shown that the association between physical activity (PA) and the risk of developing Parkinson's disease (PD) is influenced by gender differences, a growing number of studies are revealing the general applicability of this association across genders. This study aimed to reassess the association and dose-response relationship between PA and PD risk in populations. METHODS A systematic search of PubMed, Embase, Cochrane Library, and Web of Science databases was conducted in this study from inception to February 1, 2024, without language restrictions. Stratified analyses were conducted to explore the association between PA and PD risk, combining multivariate-adjusted effect estimates via random-effects models, and to validate the dose-response relationship between the two. RESULTS This study included 21 observational studies, comprising 13 cohort studies and 8 case-control studies. The pooled analysis revealed that PA significantly reduced the risk of developing PD [relative risk (RR) = 0.77, 95% CI 0.70-0.85]. In addition, the dose-response analysis revealed both linear and nonlinear associations, with linear results indicating a 9% reduction in PD risk for every 10 MET-h/wk increase in PA. The study also demonstrated that the protective effect of PA against PD was significant for both sexes. Moreover, no statistically significant effects of PA on preventing PD were observed in individuals with a BMI > 26 (RR = 0.35, 95% CI 0.12-1.02) or in Asian populations (RR = 0.78, 95% CI 0.60-1.01); however, the trends suggest potential protective effects, warranting further investigation. Sensitivity analyses confirmed the robustness of these findings. CONCLUSION This meta-analysis produced substantial evidence to reaffirm the protective effect of high PA on PD across various population groups and the inverse dose-response relationship with PD risk, and to validate the protective effect of PA among different demographic groups.
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Affiliation(s)
- Yanjie Jiang
- Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, No.157 Daming Road, Nanjing, 210022, People's Republic of China
| | - Shipeng Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, People's Republic of China
| | - Yuecan Chen
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Hanyu Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, People's Republic of China
| | - Xingyi He
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, People's Republic of China
| | - Chengli Bin
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, People's Republic of China
| | - Rui Fu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, People's Republic of China
| | - Huan Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, People's Republic of China
| | - Hanqi Zhu
- Jinzhong University, Shanxi, People's Republic of China
| | - Moshen Pan
- Shanghai University of Finance and Economics, Shanghai, People's Republic of China
| | - Qinxiu Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, People's Republic of China.
| | - Yan Lu
- Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, No.157 Daming Road, Nanjing, 210022, People's Republic of China.
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297
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Hyeon Cho S, Kim DK, Song MC, Lee E, Park S, Chung D, Ha J. Deciphering changes in the incidence of hemorrhagic stroke and cerebral venous sinus thrombosis during the coronavirus disease 2019 pandemic: A nationwide time-series correlation study. PLoS One 2024; 19:e0301313. [PMID: 39361618 DOI: 10.1371/journal.pone.0301313] [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: 03/20/2024] [Accepted: 06/17/2024] [Indexed: 10/05/2024] Open
Abstract
INTRODUCTION Hemorrhagic stroke and cerebral venous sinus thrombosis (CVST) are associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination. We aimed to investigate changes in the incidence of hemorrhagic stroke and CVST in South Korea before and during the coronavirus disease 2019 pandemic and the factors associated with these changes. MATERIALS AND METHODS We conducted a nationwide time-series study using population-based databases between 2007 and 2022. The real-world and forecasted incidences of acute non-traumatic subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and CVST during the pandemic period (2020-2022) were estimated and compared with the pre-pandemic period (2007-2019). The prevalence of conventional risk factors was measured using time-series data. Finally, a time-series correlation analysis was performed to examine the temporal association between conventional risk factors, SARS-CoV-2 infection, and SARS-CoV-2 vaccination. RESULTS The incidence of hemorrhagic stroke (SAH and ICH) was lower during the pandemic than during the pre-pandemic period. This observed decrease was associated with a reduction in the prevalence of conventional risk factors but not with SARS-CoV-2 infection or vaccination. The incidence of CVST was higher during the pandemic than during the pre-pandemic period, which may be temporally related to SARS-CoV-2 vaccination (Pearson correlation coefficient [r] = 0.349, P = 0.031). CONCLUSION We report reassuring evidence of hemorrhagic stroke associated with SARS-CoV-2 infection and vaccination. However, awareness of CVST may be required for future vaccine rollouts and SARS-CoV-2 outbreaks.
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Affiliation(s)
- Soo Hyeon Cho
- Department of Nursing, Graduate School of Yonsei University, Seoul, Korea
| | - Dong Kyu Kim
- Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea
| | - Min Cheol Song
- Health Policy Division, Public Health Center, Yangpyeong County Office, Yangpyeong, Korea
| | - Euiho Lee
- Department of Integrative Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Yongin Severance Hospital, Yongin, Korea
| | - Seoncheol Park
- Department of Mathematics, Hanyang University, Seoul, Korea
- Research Institute for Natural Sciences, Hanyang University, Seoul, Korea
| | - Darda Chung
- Department of Neurology, Korea University Anam Hospital, Seoul, Korea
| | - Jongmok Ha
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
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298
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Chen B, Gao P, Yang Y, Ma Z, Sun Y, Lu J, Qi L, Li M. Discordant definitions of small airway dysfunction between spirometry and parametric response mapping: the HRCT-based study. Insights Imaging 2024; 15:233. [PMID: 39356413 DOI: 10.1186/s13244-024-01819-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 09/06/2024] [Indexed: 10/03/2024] Open
Abstract
OBJECTIVES To analyze the lung structure of small airway dysfunction (SAD) defined by spirometry and parametric response mapping (PRM) using high-resolution computed tomography (HRCT), and to analyze the predictive factors for SAD. METHODS A prospective study was conducted with 388 participants undergoing pulmonary function test (PFT) and inspiratory-expiratory chest CT scans. The clinical data and HRCT assessments of SAD patients defined by both methods were compared. A prediction model for SAD was constructed based on logistic regression. RESULTS SAD was defined in 122 individuals by spirometry and 158 by PRM. In HRCT visual assessment, emphysema, tree-in-bud sign, and bronchial wall thickening have higher incidence in SAD defined by each method. (p < 0.001). Quantitative CT showed that spirometry-SAD had thicker airway walls (p < 0.001), smaller lumens (p = 0.011), fewer bronchi (p < 0.001), while PRM-SAD had slender blood vessels. Predictive factors for spirometry-SAD were age, male gender, the volume percentage of emphysema in PRM (PRMEmph), tree-in-bud sign, bronchial wall thickening, bronchial count; for PRM-SAD were age, male gender, BMI, tree-in-bud sign, emphysema, the percentage of blood vessel volume with a cross-sectional area less than 1 mm2 (BV1/TBV). The area under curve (AUC) values for the fitted predictive models were 0.855 and 0.808 respectively. CONCLUSIONS Compared with PRM, SAD defined by spirometry is more closely related to airway morphology, while PRM is sensitive to early pulmonary dysfunction but may be interfered by pulmonary vessels. Models combining patient information and HRCT assessment have good predictive value for SAD. CRITICAL RELEVANCE STATEMENT HRCT reveals lung structural differences in small airway dysfunction defined by spirometry and parametric response mapping. This insight aids in understanding methodological differences and developing radiological tools for small airways that align with pathophysiology. KEY POINTS Spirometry-SAD shows thickened airway walls, narrowed lumen, and reduced branch count, which are closely related to airway morphology. PRM shows good sensitivity to early pulmonary dysfunction, although its assessment of SAD based on gas trapping may be affected by the density of pulmonary vessels and other lung structures. Combining patient information and HRCT features, the fitted model has good predictive performance for SAD defined by both spirometry and PRM (AUC values are 0.855 and 0.808, respectively).
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Affiliation(s)
- Bin Chen
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
- Zhang Guozhen Small pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China
| | - Pan Gao
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
- Zhang Guozhen Small pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China
| | - Yuling Yang
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
- Zhang Guozhen Small pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China
| | - Zongjing Ma
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
- Zhang Guozhen Small pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China
| | - Yingli Sun
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
- Zhang Guozhen Small pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China
| | - Jinjuan Lu
- Department of Radiology, Shanghai Geriatric Medical Center, Shanghai, China
| | - Lin Qi
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
- Zhang Guozhen Small pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China.
| | - Ming Li
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
- Zhang Guozhen Small pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China.
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Fonseca-Gomes J, Costa-Coelho T, Ferreira-Manso M, Inteiro-Oliveira S, Vaz SH, Alemãn-Serrano N, Atalaia-Barbacena H, Ribeiro-Rodrigues L, Ramalho RM, Pinto R, Vicente Miranda H, Tanqueiro SR, de Almeida-Borlido C, Ramalho MJ, Miranda-Lourenço C, Belo RF, Ferreira CB, Neves V, Rombo DM, Viais R, Martins IC, Jerónimo-Santos A, Caetano A, Manso N, Mäkinen P, Marttinen M, Takalo M, Bremang M, Pike I, Haapasalo A, Loureiro JA, Pereira MC, Santos NC, Outeiro TF, Castanho MARB, Fernandes A, Hiltunen M, Duarte CB, Castrén E, de Mendonça A, Sebastião AM, Rodrigues TM, Diógenes MJ. A small TAT-TrkB peptide prevents BDNF receptor cleavage and restores synaptic physiology in Alzheimer's disease. Mol Ther 2024; 32:3372-3401. [PMID: 39205389 DOI: 10.1016/j.ymthe.2024.08.022] [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: 01/20/2024] [Revised: 08/01/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024] Open
Abstract
In Alzheimer's disease (AD), amyloid β (Aβ)-triggered cleavage of TrkB-FL impairs brain-derived neurotrophic factor (BDNF) signaling, thereby compromising neuronal survival, differentiation, and synaptic transmission and plasticity. Using cerebrospinal fluid and postmortem human brain samples, we show that TrkB-FL cleavage occurs from the early stages of the disease and increases as a function of pathology severity. To explore the therapeutic potential of this disease mechanism, we designed small TAT-fused peptides and screened their ability to prevent TrkB-FL receptor cleavage. Among these, a TAT-TrkB peptide with a lysine-lysine linker prevented TrkB-FL cleavage both in vitro and in vivo and rescued synaptic deficits induced by oligomeric Aβ in hippocampal slices. Furthermore, this TAT-TrkB peptide improved the cognitive performance, ameliorated synaptic plasticity deficits and prevented Tau pathology progression in vivo in the 5XFAD mouse model of AD. No evidence of liver or kidney toxicity was found. We provide proof-of-concept evidence for the efficacy and safety of this therapeutic strategy and anticipate that this TAT-TrkB peptide has the potential to be a disease-modifying drug that can prevent and/or reverse cognitive deficits in patients with AD.
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Affiliation(s)
- João Fonseca-Gomes
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Tiago Costa-Coelho
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Research Institute for Medicines (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, 1649-003 Lisbon, Portugal
| | - Mafalda Ferreira-Manso
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Research Institute for Medicines (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, 1649-003 Lisbon, Portugal; Department of Pharmaceutical Sciences and Medicines, Faculdade de Farmácia, Universidade de Lisboa, 1649-003 Lisbon, Portugal
| | - Sara Inteiro-Oliveira
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Sandra H Vaz
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Nuno Alemãn-Serrano
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Henrique Atalaia-Barbacena
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Leonor Ribeiro-Rodrigues
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Rita M Ramalho
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Rui Pinto
- Laboratory of Systems Integration Pharmacology, Clinical, and Regulatory Science, Research Institute for Medicines (iMED.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, 1649-003 Lisbon, Portugal; Dr. Joaquim Chaves Laboratório de Análises Clínicas, 2790-224 Carnaxide, Portugal
| | - Hugo Vicente Miranda
- iNOVA4Health, NOVA Medical School, NMS, Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal
| | - Sara R Tanqueiro
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Carolina de Almeida-Borlido
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Maria João Ramalho
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology, and Energy, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal; ALiCE-Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
| | - Catarina Miranda-Lourenço
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Rita F Belo
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Catarina B Ferreira
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Vera Neves
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Diogo M Rombo
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Ricardo Viais
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Ivo C Martins
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - André Jerónimo-Santos
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - António Caetano
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Nuno Manso
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Petra Mäkinen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Mikael Marttinen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland; Structural and Computational Biology, European Molecular Biology Laboratory, 69117 Heidelberg, Germany
| | - Mari Takalo
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Michael Bremang
- Proteome Sciences, Coveham House, Downside Bridge Road, KT11 3EP Cobham, UK
| | - Ian Pike
- Proteome Sciences, Coveham House, Downside Bridge Road, KT11 3EP Cobham, UK
| | - Annakaisa Haapasalo
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70211 Kuopio, Finland
| | - Joana A Loureiro
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology, and Energy, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal; ALiCE-Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
| | - Maria Carmo Pereira
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology, and Energy, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal; ALiCE-Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
| | - Nuno C Santos
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Tiago F Outeiro
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Göttingen, 37073 Göttingen, Germany; Max Planck Institute for Experimental Medicine, 37075 Göttingen, Germany; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; German Center for Neurodegenerative Diseases (DZNE), 37075 Göttingen, Germany
| | - Miguel A R B Castanho
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Adelaide Fernandes
- Research Institute for Medicines (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, 1649-003 Lisbon, Portugal; Department of Pharmaceutical Sciences and Medicines, Faculdade de Farmácia, Universidade de Lisboa, 1649-003 Lisbon, Portugal
| | - Mikko Hiltunen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Carlos B Duarte
- CNC - Center for Neuroscience and Cell Biology and Department of Life Sciences, University of Coimbra, 3004-504 Coimbra, Portugal
| | - Eero Castrén
- Neuroscience Center, University of Helsinki, 00014 Helsinki, Finland
| | - Alexandre de Mendonça
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Ana M Sebastião
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Tiago M Rodrigues
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal.
| | - Maria José Diógenes
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal.
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300
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Noble RMN, Soni S, Liu SN, Rachid JJ, Mast HE, Wiedemeyer A, Holody CD, Mah R, Woodman AG, Ferdaoussi M, Lemieux H, Dyck JRB, Bourque SL. Maternal ketone supplementation throughout gestation improves neonatal cardiac dysfunction caused by perinatal iron deficiency. Clin Sci (Lond) 2024; 138:1249-1264. [PMID: 39288030 DOI: 10.1042/cs20241386] [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: 07/14/2024] [Revised: 09/02/2024] [Accepted: 09/17/2024] [Indexed: 09/19/2024]
Abstract
Iron deficiency (ID) is common during gestation and in early infancy and has been shown to adversely affect cardiac development and function, which could lead to lasting cardiovascular consequences. Ketone supplementation has been shown to confer cardioprotective effects in numerous disease models. Here, we tested the hypothesis that maternal ketone supplementation during gestation would mitigate cardiac dysfunction in ID neonates. Female Sprague-Dawley rats were fed an iron-restricted or iron-replete diet before and throughout pregnancy. Throughout gestation, iron-restricted dams were given either a daily subcutaneous injection of ketone solution (containing β-hydroxybutyrate [βOHB]) or saline (vehicle). Neonatal offspring cardiac function was assessed by echocardiography at postnatal days (PD)3 and 13. Hearts and livers were collected post-mortem for assessments of mitochondrial function and gene expression profiles of markers oxidative stress and inflammation. Maternal iron restriction caused neonatal anemia and asymmetric growth restriction at all time points assessed, and maternal βOHB treatment had no effect on these outcomes. Echocardiography revealed reduced ejection fraction despite enlarged hearts (relative to body weight) in ID offspring, resulting in impaired oxygen delivery, which was attenuated by maternal βOHB supplementation. Further, maternal ketone supplementation affected biochemical markers of mitochondrial function, oxidative stress and inflammation in hearts of neonates, implicating these pathways in the protective effects conferred by βOHB. In summary, βOHB supplementation confers protection against cardiac dysfunction in ID neonates and could have implications for the treatment of anemic babies.
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Affiliation(s)
- Ronan M N Noble
- Department of Pediatrics, University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
- Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Shubham Soni
- Department of Pediatrics, University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
- Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Si Ning Liu
- Department of Pediatrics, University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
- Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Jad-Julian Rachid
- Department of Pediatrics, University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
- Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Heather E Mast
- Faculty Saint-Jean, University of Alberta, Edmonton, AB, Canada
| | - Alyssa Wiedemeyer
- Department of Pediatrics, University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
- Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Claudia D Holody
- Department of Pediatrics, University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
- Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Richard Mah
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
- Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Andrew G Woodman
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
- Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada
- Department of Anesthesiology, University of Alberta, Edmonton, Canada
| | - Mourad Ferdaoussi
- Department of Pediatrics, University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
- Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Helene Lemieux
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
- Faculty Saint-Jean, University of Alberta, Edmonton, AB, Canada
| | - Jason R B Dyck
- Department of Pediatrics, University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
- Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Stephane L Bourque
- Department of Pediatrics, University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
- Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada
- Department of Anesthesiology, University of Alberta, Edmonton, Canada
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