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Subramanian G, Thomas DC, Bhatnagar D, Quek SYP. Medications Affecting Treatment Outcomes in Dentistry: Part 2. Dent Clin North Am 2024; 68:785-797. [PMID: 39244257 DOI: 10.1016/j.cden.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
Today, it is common for medically complex patients who are receiving multiple medications, to seek routine and emergent dental care. It is essential for the practitioner to recognize and comprehend the impact of such medications on the patient's ability to tolerate the planned dental treatment and on dental treatment outcomes. An active appraisal of current literature is essential to stay abreast of emerging findings and understand their treatment implications. This article outlines the process of such active critical appraisal, illustrating key paradigms of the models that describe the impact of medications on treatment outcomes.
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Affiliation(s)
- Gayathri Subramanian
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, USA.
| | - Davis C Thomas
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, USA
| | - Dipti Bhatnagar
- Department of Oral Medicine and Radiology, Rayat Bahra Dental College and Hospitals, Sahibzada Ajit Singh Nagar, Punjab 140301, India
| | - Samuel Y P Quek
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, USA
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2
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Rietdijk WJR, Dräger S. What every intensivist should know about: The value of limitations in clinical research. J Crit Care 2024; 83:154457. [PMID: 37925244 DOI: 10.1016/j.jcrc.2023.154457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/15/2023] [Accepted: 06/22/2023] [Indexed: 11/06/2023]
Abstract
Not applicable.
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Affiliation(s)
- Wim J R Rietdijk
- Department of Hospital Pharmacy, Erasmus MC, Rotterdam, the Netherlands.
| | - Sarah Dräger
- Department of Hospital Pharmacy, Erasmus MC, Rotterdam, the Netherlands; Division of Internal Medicine, University Hospital Basel, Basel, Switzerland; Rotterdam Clinical Pharmacometrics Group, Rotterdam, the Netherlands
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3
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Bergamaschi V, Baumann F, Warnke I, Corbisiero S, Ludwig F, Riedel A, Gabriel-Felleiter K, Schmidt SJ. Who Benefits from Acute Psychiatric Home Treatment? A Systematic Review. Community Ment Health J 2024; 60:1408-1421. [PMID: 38940978 PMCID: PMC11408559 DOI: 10.1007/s10597-024-01297-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/13/2024] [Indexed: 06/29/2024]
Abstract
Home treatment (HT) treats patients in an acute crisis through an interdisciplinary team with daily appointments for a short treatment period. The effectiveness of HT has already been confirmed. However, only few studies addressed specific patient characteristics associated outcome of treatment. This study aimed to identify patient characteristics associated with successful outcomes of HT. A systematic literature search was conducted according to the PRISMA guidelines. A total of 13 studies were included in the systematic review. Being employed, having a regular income, having an anxiety disorder and family involvement were associated with a successful treatment outcome in HT. High symptom severity and former hospital admissions were associated with unsuccessful treatment outcome in HT in the selected studies. HT seems to be especially beneficial for patients with paid employment or regular income, patients with anxiety disorders, and patients with familial or other social support.
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Affiliation(s)
- Vera Bergamaschi
- Institue of Psychology, University of Bern, Bern, Switzerland.
- Luzerner Psychiatrie, Voltastrasse 42, 6005, Lucerne, Switzerland.
| | - Felix Baumann
- Institue of Psychology, University of Bern, Bern, Switzerland
- Luzerner Psychiatrie, Voltastrasse 42, 6005, Lucerne, Switzerland
| | - Ingeborg Warnke
- Luzerner Psychiatrie, Voltastrasse 42, 6005, Lucerne, Switzerland
| | | | - Fabian Ludwig
- Luzerner Psychiatrie, Voltastrasse 42, 6005, Lucerne, Switzerland
| | - Andreas Riedel
- Luzerner Psychiatrie, Voltastrasse 42, 6005, Lucerne, Switzerland
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4
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Dalrymple KV, Briley AL, Tydeman FAS, Seed PT, Singh CM, Flynn AC, White SL, Poston L. Breastfeeding behaviours in women with obesity; associations with weight retention and the serum metabolome: a secondary analysis of UPBEAT. Int J Obes (Lond) 2024; 48:1472-1480. [PMID: 39048696 PMCID: PMC11420090 DOI: 10.1038/s41366-024-01576-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 06/17/2024] [Accepted: 07/01/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND/OBJECTIVES Maternal obesity is associated with a decreased intention and initiation of breastfeeding as well as a shortened duration of breastfeeding. This analysis was undertaken to identify breastfeeding behaviours, and relationships with maternal anthropometry and the serum metabolome at 6-months postpartum in an ethnically diverse cohort of women with obesity. SUBJECTS/METHODS A cohort analysis of 715 women from the UK Pregnancies Better Eating and Activity Trial (UPBEAT); a multi-centre randomised controlled trial of an antenatal lifestyle intervention in women with obesity. Maternal data were collected in early pregnancy and included body mass index (BMI), socio-demographic characteristics and anthropometry. At 6-months postpartum, breastfeeding behaviours, anthropometry and 158 maternal metabolic measures from blood samples were recorded. Kaplan-Meier curves of breastfeeding duration were constructed and were stratified by obesity class (I: BMI 30.0-34.9 kg/m2, II: 35.0-39.9 kg/m2, III: ≥40.0 kg/m2). Relationships between breastfeeding behaviours, socio-demographic characteristics, the metabolome, and anthropometry were determined using regression analyses. RESULTS Eighty-two percent (591/715) of the cohort-initiated breastfeeding and at the 6-month follow-up 40% (283/715) were breastfeeding exclusively or partially. Duration of exclusive breastfeeding decreased with increasing BMI: Compared to BMI class I (mean 90.4 ± 64 days) the difference in mean for classes II and III were -15.8 days (95% confidence interval: -28.5, -3.1, p < 0.05) and -16.7 (95% CI: -32.0 to -1.35, p < 0.05), respectively. Compared to no breastfeeding, any breastfeeding at 6-months postpartum was associated with improvements in metabolites towards a healthier profile, reduced weight retention by -1.81 kg (95% CI -0.75, -2.88, p < 0.05 ) and reduced anthropometric measures, including mid-upper arm and hip circumferences. The breastfeeding related changes in anthropometry were not evident in women of Black ethnicity. CONCLUSIONS Greater emphasis on enabling breastfeeding for women with obesity could improve duration, women's weight management and metabolic health. The lack of breastfeeding related anthropometric effects in Black women requires further investigation. CLINICAL TRIAL REGISTRY ISRCTN reference 89971375.
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Affiliation(s)
- Kathryn V Dalrymple
- Department of Nutritional Sciences, School of Life Course and Population Sciences, King's College London, London, UK.
| | - Annette L Briley
- Caring Futures Institute, CHNS, Flinders University, Adelaide, SA, Australia
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
| | - Florence A S Tydeman
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
| | - Paul T Seed
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
| | - Claire M Singh
- School of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Angela C Flynn
- Department of Nutritional Sciences, School of Life Course and Population Sciences, King's College London, London, UK
- School of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Sara L White
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Lucilla Poston
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
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5
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Theodoridis X, Chourdakis M, Papaemmanouil A, Chaloulakou S, Papageorgiou N, Georgakou AV, Chatzis G, Triantafyllou A. The Association between Food Groups, Nutraceuticals, and Food Supplements Consumption on Vascular Health Outcomes: A Literature Review. Life (Basel) 2024; 14:1210. [PMID: 39337992 PMCID: PMC11433244 DOI: 10.3390/life14091210] [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: 07/25/2024] [Revised: 08/29/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024] Open
Abstract
Vascular aging, marked by alterations in the structure and function of blood vessels, including heightened arterial stiffness and impaired endothelial function, is linked to a higher likelihood of developing cardiovascular and age-associated pathological conditions. Oxidative stress and inflammation are key stimulation factors in vascular aging. Engaging in healthy dietary habits could enhance the functioning of blood vessels. The aim of this study was to conduct a literature review of the evidence regarding the relationship between food regimens, nutraceuticals, and dietary supplements and vascular health. A search of electronic databases, including PubMed, Scopus, and Web of Science Core Collection, was performed. Experimental and observational studies evaluating the association between food groups, nutraceuticals, supplements, and endothelial function and/or arterial stiffness were deemed eligible for this narrative review. Based on the current body of the included studies, food groups, nutraceuticals, and dietary supplements may not demonstrate superiority over placebos in enhancing markers of vascular health. To obtain more reliable evidence on the effectiveness of interventions in vascular health, additional RCTs with larger sample sizes, extended follow-up periods, and multi-center participation are necessary. Enhancing the credibility of these RCTs requires better control of dietary variables and more precise measurement of vascular health markers.
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Affiliation(s)
- Xenophon Theodoridis
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece; (X.T.); (A.P.); (S.C.); (N.P.); (A.V.G.)
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece
| | - Michail Chourdakis
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece; (X.T.); (A.P.); (S.C.); (N.P.); (A.V.G.)
| | - Androniki Papaemmanouil
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece; (X.T.); (A.P.); (S.C.); (N.P.); (A.V.G.)
| | - Stavroula Chaloulakou
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece; (X.T.); (A.P.); (S.C.); (N.P.); (A.V.G.)
| | - Niki Papageorgiou
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece; (X.T.); (A.P.); (S.C.); (N.P.); (A.V.G.)
| | - Athina Vasiliki Georgakou
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece; (X.T.); (A.P.); (S.C.); (N.P.); (A.V.G.)
| | - Georgios Chatzis
- School of Physical Education and Sports Science, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece;
| | - Areti Triantafyllou
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece
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Almutairi GR, Almegbas NR, Alosaimi RM, Alqahtani MA, Batook SG, Alfageh IA, Alshehri MM, Alanazi SF, Alhowimel AS, Alqahtani BA, Alhwoaimel NA, Alenazi AM. Comorbidities, medications, depression, and physical performance measures associated with severe cognitive impairments in community-dwelling adults. PLoS One 2024; 19:e0309765. [PMID: 39298495 DOI: 10.1371/journal.pone.0309765] [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: 03/14/2024] [Accepted: 08/17/2024] [Indexed: 09/21/2024] Open
Abstract
Cognitive impairment negatively impacts health, psychological, social, and economic domains. Cognitive impairment commonly affects physical functions in older adults, whereas these are deteriorated. However, the prevalence and associated factors of cognitive impairment among community-dwelling adults in Saudi Arabia have not been investigated yet. This study aimed to examine the prevalence of severe cognitive impairment and its associated factors in community-dwelling older adults in Saudi Arabia. This cross-sectional study involved adults aged ≥50 years. Demographic data and clinical data, including number of medications and body mass index (BMI), were collected. Cognitive impairment and depressive symptoms were measured using Arabic versions of the Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire-9 (PHQ-9), respectively. The participants were divided into severe cognitive impairment and mild cognitive impairment or normal cognitive function groups based on a score of <20 or ≥20, respectively, using the MoCA. Physical measures included dynamic gait index (DGI) scores, timed up-and-go (TUG), 5 times sit-to-stand (5XSST), functional reach test, and 6-minute walk test. A total of 206 participants (female: n = 96) were included. The prevalence of severe cognitive impairment in the community-dwelling older adults was 12.6%. The number of chronic conditions (odds ratio [OR]: 2.31, p<0.001), number of medications (OR: 1.36, p = 0.003), and depressive symptoms using PHQ-9 (OR: 1.11, p = 0.009) were significantly associated with severe cognitive impairment after adjustment for other covariates, including age, sex, and BMI. Based on the physical function measures, only the scores for DGI (OR: 0.86, p = 0.003), TUG (OR: 1.16, p = 0.035) and 5XSST (OR: 1.25, p <0.001) were significantly associated with severe cognitive impairment. This study revealed a high prevalence of severe cognitive impairment among community-dwelling adults in Saudi Arabia. Its major risk factors include depressive symptoms, number of chronic conditions and medications, and physical measures, including DGI, TUG, and 5XSST.
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Affiliation(s)
- Gamar R Almutairi
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Noura R Almegbas
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Rawan M Alosaimi
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Maha A Alqahtani
- Department of Research and Innovation, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Saleh G Batook
- East Jeddah General Hospital, Western Region, Jeddah, Saudi Arabia
| | | | - Mohammed M Alshehri
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | | | - Ahmed S Alhowimel
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Bader A Alqahtani
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Norah A Alhwoaimel
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Aqeel M Alenazi
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
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Röben T, van Oostrom S, Benning F, Smit D, Proper K. Preventive health measures in small and medium-sized enterprises: A scoping review on implementation strategies. APPLIED ERGONOMICS 2024; 119:104303. [PMID: 38714103 DOI: 10.1016/j.apergo.2024.104303] [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: 08/24/2023] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/09/2024]
Abstract
OBJECTIVE To describe implementation strategies for preventive health measures in SMEs and the effectiveness of the strategies on implementation outcomes. METHODS A literature search was performed in multiple electronic databases. Studies published between 2000 and 2021 that evaluated the implementation of preventive health measures in SMEs were included. Classification of implementation strategies was based on two complementary classification systems. RESULTS Nineteen studies, of which 5 RCTs were included. Eighteen distinct implementation strategies were reported. All studies applied a combination of implementation strategies, and nearly all reported a positive effect on one or more implementation outcomes: sustainability, acceptability, feasibility, penetration, fidelity, adoption, and appropriateness. CONCLUSIONS Overall, a positive effect of combined implementation strategies on the implementation outcome(s) was found. The 'distribution of educational materials' and 'provide ongoing consultation' combined show positive effects on sustainability.
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Affiliation(s)
- Thomas Röben
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Sandra van Oostrom
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Friederike Benning
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Denise Smit
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Karin Proper
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
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8
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Liu Y, Dai W. To editor: "The role of postoperative blood pressure management in early postoperative hemorrhage in awake craniotomy glioma patients". Neurosurg Rev 2024; 47:510. [PMID: 39212779 DOI: 10.1007/s10143-024-02771-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Revised: 08/24/2024] [Accepted: 08/27/2024] [Indexed: 09/04/2024]
Affiliation(s)
- Yiheng Liu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China, No.74 Linjiang Road, Yuzhong District
| | - Weiran Dai
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China, No.74 Linjiang Road, Yuzhong District.
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9
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Huang M, Liu Y. To editor: "T2-FLAIR mismatch sign, an imaging biomarker for CDKN2A-intact in non-enhancing astrocytoma, IDH-mutant". Neurosurg Rev 2024; 47:486. [PMID: 39187707 DOI: 10.1007/s10143-024-02744-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2024] [Revised: 08/10/2024] [Accepted: 08/23/2024] [Indexed: 08/28/2024]
Affiliation(s)
- Mingsheng Huang
- Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Yiheng Liu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Peinemann F, Oberle D, Drechsel-Bäuerle U, Keller-Stanislawski B. Adverse Menstrual Events Reported After and Before (or Without) COVID-19 Vaccination: A Systematic Review and Meta-Analysis of Comparative Observational Studies. Pharmacoepidemiol Drug Saf 2024; 33:e5877. [PMID: 39090813 DOI: 10.1002/pds.5877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 06/21/2024] [Accepted: 07/03/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Reports of adverse menstrual events emerged during the COVID-19 vaccination campaign in multiple countries. This raised the question whether these reports were caused by the vaccines. The aim of this systematic review was to evaluate comparative studies on this topic (registered at PROSPERO [CRD42022324973]). METHODS We included observational studies such as cohort studies and surveys comparing the response to self-reported questionnaires between post- versus pre-vaccination data. PubMed and Cochrane Library searches were conducted on 1 September 2023. The primary outcome was the incidence of any prespecified adverse menstrual event, and the outcome measure was the risk ratio. The meta-analysis was conducted by using the Mantel-Haenszel method and the random effects model. We summarized the results on risk factors as well as key findings of the studies included. RESULTS We retrieved 161 references from electronic databases and additional sources such as references lists. Of those, we considered 21 comparative observational studies. The meta-analysis of any adverse menstrual adverse event reported in 12 studies resulted in a pooled estimate (risk ratio 1.13; 95% CI, 0.96-1.31) that did not favor any group. The analysis was constrained by considerable clinical and statistical heterogeneity. Risk factors for self-reported menstrual changes included a history of COVID-19 infection, the concern about COVID-19 vaccines, smoking, previous cycle irregularities, depression, and stress, and other issues. CONCLUSIONS The risk ratio did not favor any group and heterogeneity was prevalent among the studies. Most studies suggested that the reported changes were temporary, minor, and nonserious.
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Affiliation(s)
- Frank Peinemann
- Safety of Biomedicines and Diagnostics, Pharmacovigilance, Paul-Ehrlich-Institut, Langen, Germany
- Children's Hospital, University Hospital of Cologne, Cologne, Germany
| | - Doris Oberle
- Safety of Biomedicines and Diagnostics, Pharmacovigilance, Paul-Ehrlich-Institut, Langen, Germany
| | - Ursula Drechsel-Bäuerle
- Safety of Biomedicines and Diagnostics, Pharmacovigilance, Paul-Ehrlich-Institut, Langen, Germany
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11
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Bianconi A, Fiore M, Zauli E, Acuti Martellucci C, Rosso A, Dallolio L, Flacco ME, Manzoli L. How strong is the evidence supporting the WHO guidelines on physical activity, sedentary behaviour and sleep in early childhood? Eur J Clin Invest 2024:e14294. [PMID: 39086022 DOI: 10.1111/eci.14294] [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: 06/03/2024] [Accepted: 07/20/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND The WHO issued recommendations about the ideal amount of physical activity, sedentary behaviour and sleep in infants, toddlers and preschool children. To facilitate their interpretation and translation into public health policies, we analysed the quantity and quality of the evidence that supported the development of each WHO recommendation. METHODS All data for each exposure-outcome pair analysed in the studies informing WHO guidelines were extracted, and predefined criteria, based upon GRADE methodology, were used to classify each outcome and study result. RESULTS Among the 237 studies that could be included, 37 were experimental and 200 were observational, yielding 920 analyses of exposure-outcome associations. Sixty-two analyses used a relevant outcome, with or without significant results. Five of the 10 WHO recommendations were based upon zero analyses with significant results on relevant health outcomes. The remaining recommendations were mostly based upon analyses evaluating obesity-related outcomes. Eight of the 10 GLs thresholds were not supported by any significant analysis on clinically relevant outcomes. CONCLUSION While these findings should not be interpreted as an attempt to disprove the benefits of healthy lifestyle habits in early childhood, neither to minimize the work of the experts in this complex research field, very limited evidence currently supports the adoption of recommended thresholds as behavioural surveillance and public health interventions targets. Therefore, until further data are available, public health interventions should be developed balancing whether to focus on the achievement of specific targets that are still not supported by high-quality evidence or on the general promotion of healthy behaviours.
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Affiliation(s)
- Alessandro Bianconi
- Section of Hygiene and Preventive Medicine, University of Bologna, Bologna, Italy
| | - Matteo Fiore
- Section of Hygiene and Preventive Medicine, University of Bologna, Bologna, Italy
| | - Enrico Zauli
- Department of Medical Translation, University of Ferrara, Ferrara, Italy
| | | | - Annalisa Rosso
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Laura Dallolio
- Section of Hygiene and Preventive Medicine, University of Bologna, Bologna, Italy
| | - Maria Elena Flacco
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Lamberto Manzoli
- Section of Hygiene and Preventive Medicine, University of Bologna, Bologna, Italy
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12
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Yang L, Liang M, Huang Y. Concerns about methodology and findings in coffee and tea consumption and dementia research. J Formos Med Assoc 2024:S0929-6646(24)00348-6. [PMID: 39084947 DOI: 10.1016/j.jfma.2024.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Accepted: 07/26/2024] [Indexed: 08/02/2024] Open
Affiliation(s)
- Lihua Yang
- Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi, 530021, China
| | - Mei Liang
- Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi, 530021, China
| | - Yuan Huang
- Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi, 530021, China.
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13
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Tian H, Xie C, Teng B, Zeng Q, Zhao Y, Li F, Jiang C, Chen Z. The genetic effects of hormones modulated by the Pituitary-Thyroid/Adrenal/Gonadal axis on the risk of developing venous thromboembolism: a mendelian randomization study. BMC Cardiovasc Disord 2024; 24:383. [PMID: 39054435 PMCID: PMC11270940 DOI: 10.1186/s12872-024-04039-y] [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: 03/21/2024] [Accepted: 07/10/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND The aim of this study was to explore the genetic effects of hormones modulated through the pituitary-thyroid/adrenal/gonadal axis on the risk of developing venous thromboembolism (VTE) and to investigate the potentially causal relationships between them. METHODS A two-sample Mendelian randomization (MR) design was used. The single-nucleotide polymorphisms (SNPs) used as instrumental variables for various hormones and hormone-mediated diseases were derived from published genome-wide association studies (GWASs). Summary statistics for the risk of developing VTE (including deep venous thrombosis [DVT] and pulmonary embolism [PE]) were obtained from the UK Biobank and the FinnGen consortium. Inverse-variance weighting (IVW) was applied as the primary method to analyse causal associations. Other MR methods were used for supplementary estimates and sensitivity analysis. RESULTS A genetic predisposition to greater free thyroxine (FT4) concentrations was associated with a greater risk of developing DVT (OR = 1.0007, 95%CI [1.0001-1.0013], p = 0.0174) and VTE (OR = 1.0008, 95%CI [1.0002-1.0013], p = 0.0123). Genetically predicted hyperthyroidism was significantly associated with an increased risk of developing DVT (OR = 1.0685, 95%CI [1.0139-1.1261], p = 0.0134) and VTE (OR = 1.0740, 95%CI [1.0165-1.1348], p = 0.0110). According to the initial MR analysis, testosterone concentrations were positively associated with the risk of developing VTE (OR = 1.0038, 95%CI [1.004-1.0072], p = 0.0285). After sex stratification, estradiol concentrations were positively associated with the risk of developing DVT (OR = 1.0143, 95%CI [1.0020-1.0267], p = 0.0226) and VTE (OR = 1.0156, 95%CI [1.0029-1.0285], p = 0.0158) in females, while the significant relationship between testosterone and VTE did not persist. SHBG rs858518 was identified as the only SNP that was associated with an increased risk of developing VTE, mediated by estradiol, in females. CONCLUSIONS Genetically predicted hyperthyroidism and increased FT4 concentrations were positively associated with the risk of developing VTE. The effects of genetically predicted sex hormones on the risk of developing VTE differed between males and females. Greater genetically predicted estradiol concentrations were associated with an increased risk of developing VTE in females, while the SHBG rs858518 variant may become a potential prevention and treatment target for female VTE.
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Affiliation(s)
- Hao Tian
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, 1 N. Youyi Street, Chongqing, 400016, China
| | - Chaozheng Xie
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Biyun Teng
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, 1 N. Youyi Street, Chongqing, 400016, China
| | - Qiu Zeng
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, 1 N. Youyi Street, Chongqing, 400016, China
| | - Yu Zhao
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, 1 N. Youyi Street, Chongqing, 400016, China
| | - Fenghe Li
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, 1 N. Youyi Street, Chongqing, 400016, China
| | - Chuli Jiang
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, 1 N. Youyi Street, Chongqing, 400016, China
| | - Zheng Chen
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, 1 N. Youyi Street, Chongqing, 400016, China.
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Bekelcho T, Birgoda GT, Leul H, Maile M, Alemayehu M, Olani AB. Near miss road traffic accidents and associated factors among truck drivers in Gamo zone, southern Ethiopia by using a contributory factors interaction model. Front Public Health 2024; 12:1386521. [PMID: 39114508 PMCID: PMC11303317 DOI: 10.3389/fpubh.2024.1386521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Background Road traffic accidents (RTAs) are among the leading causes of injuries, fatalities, and the resulting increase in financial burdens worldwide. Every year, RTAs cause numerous serious injuries and fatalities in Ethiopia. it is important to understand how prevalent near-miss crash accidents are, and which by definition could have injured the victim but did not result in an actual accident. The determinants of these near-misses are essential in road crash accident reduction strategies. In spite of the fact that near-miss accidents are much more common than actual losses or injuries, very little research has been conducted on them. Thus, this study was intended to assess the near-miss accidents and associated factors among truckers in Gamo zone, southern Ethiopia. Methodology The community-based cross-sectional study was employed from May 12 to July 10,2022, using a structured interviewer-administered questionnaire. A simple random sampling technique was used to select participants. The data were analyzed using the statistical package for social sciences. A binary and multivariate logistic regression model was used to identify the determinants of near-miss accidents. A statistical significance level was set at p < 0.05. Results About 72.5% of truckers had experienced near-miss road traffic accidents. The majority of the near-miss accidents were caused by speeding, followed by driving on the wrong side of the road and skidding, 65 (22.6%), 39 (13.5%), and 38 (13.2%), respectively. Driving frequency per week, location of accidents, condition of the road, sleeping status, and weather conditions were significantly associated with near-miss accidents. Conclusion The prevalence of near-miss accidents is high in the Gamo zone. Being a younger and less educated driver, high driving frequency per week, driving on major roads and junctions, foggy weather, and inadequate sleep all contribute to the occurrence of accidents. Road safety measures that could address these identified factors are required to mitigate potential RTAs.
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Affiliation(s)
- Tariku Bekelcho
- Department of Emergency Medicine and Critical Care, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | | | - Hawi Leul
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Maechel Maile
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Micheal Alemayehu
- Department of Emergency and Critical Care, Tirunesh Beijing General Hospital, Addis Ababa, Ethiopia
| | - Ararso Baru Olani
- Department of Emergency Medicine and Critical Care, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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15
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Sonnenberg A. Cost-benefit considerations of the biased diagnostician. Diagnosis (Berl) 2024; 0:dx-2024-0031. [PMID: 39026445 DOI: 10.1515/dx-2024-0031] [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: 02/12/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVES In the cognitive process of establishing a diagnosis, the performance of a diagnostician can be characterized in terms of sensitivity and specificity. The aims of the present study are to analyze in quantitative terms how cognitive bias affects the performance of a diagnostician, and how a diagnostician's biased decision making is further influenced by personal cost-benefit considerations. METHODS The test matrices of two sequential diagnostic tests are manipulated according to the rules of linear algebra, using multiplication of the second with the first test matrix to calculate their joint test characteristics. The decision tree and receiver operating characteristic (ROC) of a biased and unbiased diagnostician are used to calculate which combination of test characteristics maximizes the expected utility value. RESULTS Biased diagnosticians cannot establish a diagnosis beyond their own limited or distorted level of understanding. An unbiased and a biased diagnostician alike adjust their choice of test characteristics according to their different cost-benefit estimation of the various test outcomes. From the perspective of an unbiased diagnostician, the choices made by a biased diagnostician appear to invert reality. However, the same appearance of inverted reality is perceived by the biased diagnostician, judging the choices made by the unbiased diagnostician. CONCLUSIONS As a general principle, human testers cannot test beyond their own level of understanding. They only see what they know. As they base their judgment on preconceived notions about the utilities associated with different test outcomes, human testers also tend to only know what they want to know.
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Affiliation(s)
- Amnon Sonnenberg
- 20088 The Portland VA Medical Center and the Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, OR, USA
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16
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Wang K, Chen Z, Wei Z, He L, Gong L. Association between body fat distribution and asthma in adults: results from the cross-sectional and bidirectional Mendelian randomization study. Front Nutr 2024; 11:1432973. [PMID: 39104756 PMCID: PMC11299241 DOI: 10.3389/fnut.2024.1432973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 07/12/2024] [Indexed: 08/07/2024] Open
Abstract
Background Many studies define obesity based on body mass index (BMI) and explore its relationship with adult asthma. However, BMI only considers height and weight, ignoring other factors such as body fat, which may have a greater impact on health. We investigated the relationship between body fat distribution and adult asthma using both a cross-sectional study and bidirectional Mendelian randomization (MR) analysis. Methods Weighted logistic regression models were used to examine the relationship between body fat distribution measurements and adult asthma in the cross-sectional study from National Health and Nutrition Examination Survey (NHANES) 2011-2018. Restricted cubic spline (RCS) curves were employed to explore the dose-response relationship between them. The inverse-variance weighted (IVW) method was used as the main method of MR analysis to explore the causal effect of exposure on outcome. Results After adjusting for all covariates, weighted logistic regression analysis indicated that fat mass in the left arm, left leg, right arm, right leg, trunk, and total body is associated with an increased risk of developing adult asthma (p < 0.05). RCS curves showed that all six fat mass indicators exhibit a J-shaped relationship with adult asthma. Forward MR analysis found a causal effect of six fat mass indicators on the increased risk of adult asthma (p < 0.05). However, reverse MR did not reveal any causal effect of adult asthma on these six fat mass indicators (p > 0.05). Conclusion Our study supports a positive correlation and a unidirectional causality between body fat distribution measurements and the risk of adult asthma. Further studies are needed to validate our findings.
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Affiliation(s)
- Kang Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Zhujun Chen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Zhengxiao Wei
- Department of Clinical Laboratory, Public Health Clinical Center of Chengdu, Chengdu, China
| | - Lijun He
- Department of Ultrasound, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Liang Gong
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Army Medical University, Chongqing, China
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17
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Giraldo-Cadavid LF, Insignares D, Velasco V, Londoño N, Galvis AM, Rengifo ML, Bastidas-Goyes AR. Fiberoptic Endoscopy Evaluation of Swallowing (FEES) Findings Associated with High Pneumonia Risk in a Cohort of Patients at Risk of Dysphagia. Dysphagia 2024:10.1007/s00455-024-10727-w. [PMID: 38958706 DOI: 10.1007/s00455-024-10727-w] [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: 08/07/2023] [Accepted: 05/23/2024] [Indexed: 07/04/2024]
Abstract
Aspiration detected in the fiberoptic endoscopy evaluation of swallowing (FEES) has been inconsistently associated with pneumonia, with no evidence of the risk of pneumonia from other alterations in swallowing safety detected in FEES. We conducted a dynamic, ambidirectional cohort study involving 148 subjects at risk of dysphagia in a tertiary university hospital. Our aim was to determine the risk of pneumonia attributed to alterations in swallowing safety detected during FEES. We used multivariate negative binomial regression models to adjust for potential confounders. The incidence density rate (IR) of pneumonia in patients with tracheal aspiration of any consistency was 26.6/100 people-years (RR 7.25; 95% CI: 3.50-14.98; P < 0.001). The IR was 19.7/100 people-years (RR 7.85; 95% CI: 3.34-18.47; P < 0.001) in those with laryngeal penetration of any consistency and 18.1/100 people-years (RR 6.24; 95% CI: 2.58-15.09; P < 0.001) in those with pharyngeal residue of any consistency. When adjusted for aspiration, the association of residue and penetration with pneumonia disappeared, suggesting that their risk of pneumonia is dependent on the presence of aspiration and that only aspiration is independently associated with pneumonia. This increased risk of pneumonia was significant in uni- and multivariate negative binomial regression models. We found an independently increased risk of pneumonia among patients with dysphagia and aspiration detected during FEES. Alterations in the oral and pharyngeal phases of swallowing, without aspiration, did not increase the risk of pneumonia.
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Affiliation(s)
- Luis F Giraldo-Cadavid
- Department of Epidemiology and Biostatistics, Facultad de Medicina de la Universidad de La Sabana, Chia, Cundinamarca, Colombia.
- Interventional Pulmonology Division, Fundación Neumológica Colombiana, Bogotá DC, Colombia.
- Departments of Internal Medicine and Pulmonary Medicine, Facultad de Medicina de la Universidad de La Sabana, Campus Puente del Común, Autopista norte de Bogotá Km 7, Chía, Cundinamarca, Colombia.
| | - Diego Insignares
- Interventional Pulmonology Division, Fundación Neumológica Colombiana, Bogotá DC, Colombia
- Departments of Internal Medicine and Pulmonary Medicine, Facultad de Medicina de la Universidad de La Sabana, Campus Puente del Común, Autopista norte de Bogotá Km 7, Chía, Cundinamarca, Colombia
| | - Valentina Velasco
- Department of Rehabilitation Medicine, Facultad de Medicina de la Universidad de La Sabana and Clínica Universidad de La Sabana, Chía, Colombia
| | - Natalia Londoño
- Department of Epidemiology and Biostatistics, Facultad de Medicina de la Universidad de La Sabana, Chia, Cundinamarca, Colombia
| | - Ana María Galvis
- Department of Rehabilitation Medicine, Clínica Universidad de La Sabana, Chía, Colombia
| | - María Leonor Rengifo
- Department of Rehabilitation Medicine, Facultad de Medicina de la Universidad de La Sabana and Clínica Universidad de La Sabana, Chía, Colombia
| | - Alirio R Bastidas-Goyes
- Department of Epidemiology and Biostatistics, Facultad de Medicina de la Universidad de La Sabana, Chia, Cundinamarca, Colombia
- Departments of Internal Medicine and Pulmonary Medicine, Facultad de Medicina de la Universidad de La Sabana, Campus Puente del Común, Autopista norte de Bogotá Km 7, Chía, Cundinamarca, Colombia
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18
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Glass D, Yuill N. Social motor synchrony in autism spectrum conditions: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1638-1653. [PMID: 38014541 PMCID: PMC11193327 DOI: 10.1177/13623613231213295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
LAY ABSTRACT When two people interact, they often fall into sync with one another by moving their bodies at the same time. Some say autistic people are not as good as non-autistic people at moving at the same time as a partner. This has led some researchers to ask whether measuring synchrony might help diagnose autism. We reviewed the research so far to look at differences in Social Motor Synchrony (SMS) (the way we move together) between autistic people and people they interact with. The research suggests that interactions involving an autistic partner (either two autistic partners, or an autistic and non-autistic partner) show lower synchrony than a non-autistic pair. However, we recognised elements in the research so far that may have affected SMS in interactions involving an autistic person. One way SMS may have been affected in research so far might be the way interactions have been set up in the research studies. Few papers studied interactions between two autistic people or looked at synchrony in comfortable environments with autistic-preferred tasks. The studies also do not explain why synchrony might be different, or weaker, in pairs involving autistic partners. We use these limitations to suggest improvements for future research.
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19
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Goulas S, Karamitros G. The Perceived Impact of COVID-19 on Graduate Medical Education and Recommendations for Bridging the Educational Gap. J Surg Res 2024; 299:237-248. [PMID: 38781733 DOI: 10.1016/j.jss.2024.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 03/18/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION COVID-19 generated a system-wide shock causing an unbalanced equilibrium between producing adequately trained physicians and meeting extraordinary operational needs. Previous studies report the experience of surgical residents during COVID-19 at a regional level. This study measures the learning losses related with the redeployment of highly specialized medical professionals to the care of COVID-19 patients, while we systematically investigate proposed remedial strategies. METHODS We administered an online cross-sectional survey in 67 countries capturing training inputs (i.e., surgeries and seminars residents participated in) before and during the pandemic and retrieved residents' expected learning outputs, career prospects and recommended remedial measures for learning losses. We compared responses of residents working in (treatment group) and out (control group) of hospitals with COVID-19 patients. RESULTS The analysis included 432 plastic surgery residents who were in training during the pandemic. Most of the learning losses were found in COVID-19 hospitals with 37% and 16% loss of surgeries and seminars, respectively, per week. Moreover, 74%, 44%, and 55% of residents expected their surgical skill, scientific knowledge, and overall competence, respectively, to be lower than those of residents who graduated before COVID. Residents in COVID-19 hospitals reported participating in significantly (P < 0.001) fewer surgeries and having significantly (P < 0.001) lower surgical skill relative to those not in COVID-19 hospitals. CONCLUSIONS The perceived lower competence and the fall-off in surgical skill and scientific knowledge among future surgeons suggest that health-care systems globally may have limited capacity to perform specialized and costly procedures in the future.
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Affiliation(s)
- Sofoklis Goulas
- Economic Studies Program, Brookings Institution, Washington, District of Columbia; World Bank, Washington, District of Columbia; Aletheia Research Institution, Palo Alto, California; Hoover Institution, Stanford University, Stanford, California
| | - Georgios Karamitros
- Medical School, University of Ioannina, Ioannina, Greece; Department of Plastic Surgery, University Hospital of Ioannina, Ioannina, Greece.
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Vosters TG, Kingma FM, Stel VS, van den Born BJH, Huisman BJMV, van Ittersum FJ, Jager KJ, Vogt L, van Valkengoed IGM. Sex differences in CKD risk factors across ethnic groups. Nephrol Dial Transplant 2024; 39:1194-1197. [PMID: 38331417 PMCID: PMC11250226 DOI: 10.1093/ndt/gfae038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Indexed: 02/10/2024] Open
Affiliation(s)
- Taryn G Vosters
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Frouke M Kingma
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Vianda S Stel
- Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Bert-Jan H van den Born
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Internal & Vascular Medicine, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Brechje J M V Huisman
- Amsterdam UMC, University of Amsterdam, Dept Internal Medicine, Section Nephrology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Frans J van Ittersum
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Nephrology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Kitty J Jager
- Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Liffert Vogt
- Amsterdam UMC, University of Amsterdam, Dept Internal Medicine, Section Nephrology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Irene G M van Valkengoed
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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21
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Mancini L, Strauss FJ, Lim HC, Tavelli L, Jung RE, Naenni N, Thoma DS. Impact of keratinized mucosa on implant-health related parameters: A 10-year prospective re-analysis study. Clin Implant Dent Relat Res 2024; 26:554-563. [PMID: 38419210 DOI: 10.1111/cid.13314] [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: 10/28/2023] [Revised: 01/30/2024] [Accepted: 02/07/2024] [Indexed: 03/02/2024]
Abstract
AIM To investigate whether the lack of keratinized mucosa (KM) affects peri-implant health after 10 years of loading. MATERIALS AND METHODS Data from 74 patients with 148 implants from two randomized controlled studies comparing different implant systems were included and analyzed. Clinical parameters including bleeding on probing (BOP), probing depth (PD), plaque index, marginal bone loss (MBL), and KM width (KMW) at buccal sites were collected at baseline (time of the final prosthesis insertion), 5-year and 10 years postloading. Multivariable logistic and linear regression models by means of a generalized estimated equation (GEE) were used to evaluate the influence of buccal KM on peri-implant clinical parameters; BOP, MBL, PD, and adjusted for implant type (one-piece or two-piece) and compliance. RESULTS A total of 35 (24.8%) implants were healthy, 67 (47.5%) had mucositis and 39 (27.6%) were affected by peri-implantitis. In absence of buccal KM (KM = 0 mm), 75% of the implants exhibited mucositis, while in the presence of KM (KMW >0 mm) 41.2% exhibited mucositis. Regarding peri-implantitis, the corresponding percentages were 20% (KM = 0 mm) and 26.7% (KM >0 mm). Unadjusted logistic regression showed that the presence of buccal KM tended to reduce the odds of showing BOP at buccal sites (OR: 0.28 [95% CI, 0.07 to 1.09], p = 0.06). The adjusted logistic regression model revealed that having buccal KM (OR: 0.21 [95% CI, 0.05 to 0.85], p = 0.02) and using two-piece implants (OR: 0.34 [95% CI, 0.15 to 0.75], p = 0.008) significantly reduced the odds of showing BOP. Adjusted linear regression by means of GEE showed that KM and two-piece implants were associated with reduced MBL and MBL changes (p < 0.05). CONCLUSION The lack of buccal KM appears to be linked with peri-implant parameters such as BOP and MBL, but the association is weak. The design of one-piece implants may account for their increased odds of exhibiting BOP.
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Affiliation(s)
- Leonardo Mancini
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
| | - Franz J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Faculty of Dentistry, Universidad Finis Terrae, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Hyun-Chang Lim
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Lorenzo Tavelli
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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Jordan A, Näslund-Koch C, Vedel-Krogh S, Egil Bojesen S, Skov L. Alcohol consumption and risk of psoriasis: Results from observational and genetic analyses in more than 100,000 individuals from the Danish general population. JAAD Int 2024; 15:197-205. [PMID: 38707928 PMCID: PMC11066682 DOI: 10.1016/j.jdin.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2024] [Indexed: 05/07/2024] Open
Abstract
Background Psoriasis is associated with high alcohol consumption, but the causality of this relationship is unclear. Objective We aimed to use a Mendelian randomization approach to investigate the causal effects of alcohol on incident psoriasis. Methods We included 102,655 adults from the prospective Copenhagen studies. All participants filled out a questionnaire on alcohol consumption, were physically examined, and had blood drawn for biochemical and genetic analyses. We created a genetic instrument based on the number of fast-metabolizing alleles in alcohol dehydrogenase 1B and alcohol dehydrogenase 1C, known to be associated with alcohol consumption, to test whether alcohol consumption was causally associated with psoriasis. Results Observationally, we found an increased risk of incident psoriasis among individuals with high alcohol consumption compared to those with low alcohol consumption with a hazard ratio of 1.30 (95% confidence interval 1.05-1.60) in the fully adjusted model. Using genetic data to predict alcohol consumption to avoid confounding and reverse causation, we found no association between number of fast-metabolizing alleles and risk of psoriasis. Limitations Alcohol consumption was self-reported and psoriasis was defined using the International Classification of Diseases 10th revision and 8th revision codes. Conclusion Alcohol consumption is observationally but not causally associated with incident psoriasis.
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Affiliation(s)
- Alexander Jordan
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Charlotte Näslund-Koch
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Signe Vedel-Krogh
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Stig Egil Bojesen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Copenhagen City Heart Study, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Feingold D, Neria Y, Bitan DT. PTSD, distress and substance use in the aftermath of October 7th, 2023, terror attacks in Southern Israel. J Psychiatr Res 2024; 174:153-158. [PMID: 38631140 DOI: 10.1016/j.jpsychires.2024.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/10/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024]
Abstract
The October 7th, 2023, terror attacks in Israel were characterized by a scope and magnitude not previously known to Israeli citizens. The aim of this study was to examine the prevalence and correlates of posttraumatic stress disorder (PTSD), emotional distress and use of addictive substances among Israeli adults, approximately one month following the attacks. PTSD was assessed with the Posttraumatic Stress Disorder Checklist (PCL-5) and emotional distress was assessed with a brief version of the Hopkins Symptom Checklist (HSCL-25). Participants also ranked the degree of change in their frequency of use of six addictive substances. The final sample consisted of 415 Jewish and Arab Israeli adults. Results indicate that one month following the attacks, 31.4% of the total sample qualified for positive screening of PTSD. An increase in the use of tobacco, alcohol, tranquilizers and sleep medications was reported by 16.5%, 10.1%, 11.1% and 10.6% of the sample, respectively. Being at a younger age, of female sex and with increased exposure to the attacks was associated with increased levels of PTSD (β = -0.24, p < 0.001; β = 0.19, p < 0.001 and β = 0.29, p < 0.001, respectively) and increased distress (β = -0.22, p < 0.001, β = 0.26, p < 0.001 and β = 0.19, p < 0.001, respectively). Being male was significantly associated with increased use of cannabis (Adjusted Odds Ratio (AOR) = 4.73, 95% Confidence Interval (CI) = 1.70-13.13, p = 0.003), and level of exposure to traumatic events was significantly associated with increased use of tranquilizers (AOR = 1.58, 95% CI = 1.17-2.13, p = 0.003). The high magnitude of symptomatic response should alert other countries as they prepare for national disasters.
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Affiliation(s)
- Daniel Feingold
- Psychology Department, Achva Academic College, Achva, Israel.
| | - Yuval Neria
- Columbia University, Irving Medical Center, New York, USA
| | - Dana Tzur Bitan
- Department of Community Mental Health, University of Haifa, Haifa, Israel; Shalvata Mental Health Center, Hod Hasharon, Israel
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Barrett-Jolley R, German AJ. Variables associated with owner perceptions of the health of their dog: Further analysis of data from a large international survey. PLoS One 2024; 19:e0280173. [PMID: 38748734 PMCID: PMC11095744 DOI: 10.1371/journal.pone.0280173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/30/2024] [Indexed: 05/19/2024] Open
Abstract
In a recent study (doi: 10.1371/journal.pone.0265662), associations were identified between owner-reported dog health status and diet, whereby those fed a vegan diet were perceived to be healthier. However, the study was limited because it did not consider possible confounding from variables not included in the analysis. The aim of the current study was to extend these earlier findings, using different modelling techniques and including multiple variables, to identify the most important predictors of owner perceptions of dog health. From the original dataset, two binary outcome variables were created: the 'any health problem' distinguished dogs that owners perceived to be healthy ("no") from those perceived to have illness of any severity; the 'significant illness' variable distinguished dogs that owners perceived to be either healthy or having mild illness ("no") from those perceived to have significant or serious illness ("yes"). Associations between these health outcomes and both owner-animal metadata and healthcare variables were assessed using logistic regression and machine learning predictive modelling using XGBoost. For the any health problem outcome, best-fit models for both logistic regression (area under curve [AUC] 0.842) and XGBoost (AUC 0.836) contained the variables dog age, veterinary visits and received medication, whilst owner age and breed size category also featured. For the significant illness outcome, received medication, veterinary visits, dog age and were again the most important predictors for both logistic regression (AUC 0.903) and XGBoost (AUC 0.887), whilst breed size category, education and owner age also featured in the latter. Any contribution from the dog vegan diet variable was negligible. The results of the current study extend the previous research using the same dataset and suggest that diet has limited impact on owner-perceived dog health status; instead, dog age, frequency of veterinary visits and receiving medication are most important.
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Affiliation(s)
- Richard Barrett-Jolley
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Alexander J. German
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
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Kaufmann JE, Gensicke H, Schaedelin S, Luft AR, Goeggel-Simonetti B, Fischer U, Michel P, Strambo D, Kägi G, Vehoff J, Nedeltchev K, Kahles T, Kellert L, Rosenbaum S, von Rennenberg R, Riegler C, Seiffge D, Sarikaya H, Zietz A, Wischmann J, Polymeris AA, Hänsel M, Globas C, Bonati LH, Brehm A, De Marchis GM, Peters N, Nolte CH, Christensen H, Wegener S, Psychogios MN, Arnold M, Lyrer P, Traenka C, Engelter ST. Toward Individual Treatment in Cervical Artery Dissection: Subgroup Analysis of the TREAT-CAD Randomized Trial. Ann Neurol 2024; 95:886-897. [PMID: 38362818 DOI: 10.1002/ana.26886] [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: 08/02/2023] [Revised: 12/28/2023] [Accepted: 01/23/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE Uncertainty remains regarding antithrombotic treatment in cervical artery dissection. This analysis aimed to explore whether certain patient profiles influence the effects of different types of antithrombotic treatment. METHODS This was a post hoc exploratory analysis based on the per-protocol dataset from TREAT-CAD (NCT02046460), a randomized controlled trial comparing aspirin to anticoagulation in patients with cervical artery dissection. We explored the potential effects of distinct patient profiles on outcomes in participants treated with either aspirin or anticoagulation. Profiles included (1) presenting with ischemia (no/yes), (2) occlusion of the dissected artery (no/yes), (3) early versus delayed treatment start (>median), and (4) intracranial extension of the dissection (no/yes). Outcomes included clinical (stroke, major hemorrhage, death) and magnetic resonance imaging outcomes (new ischemic or hemorrhagic brain lesions) and were assessed for each subgroup in separate logistic models without adjustment for multiple testing. RESULTS All 173 (100%) per-protocol participants were eligible for the analyses. Participants without occlusion had decreased odds of events when treated with anticoagulation (odds ratio [OR] = 0.28, 95% confidence interval [CI] = 0.07-0.86). This effect was more pronounced in participants presenting with cerebral ischemia (n = 118; OR = 0.16, 95% CI = 0.04-0.55). In the latter, those with early treatment (OR = 0.26, 95% CI = 0.07-0.85) or without intracranial extension of the dissection (OR = 0.34, 95% CI = 0.11-0.97) had decreased odds of events when treated with anticoagulation. INTERPRETATION Anticoagulation might be preferable in patients with cervical artery dissection presenting with ischemia and no occlusion or no intracranial extension of the dissection. These findings need confirmation. ANN NEUROL 2024;95:886-897.
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Affiliation(s)
- Josefin E Kaufmann
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
| | - Henrik Gensicke
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
| | - Sabine Schaedelin
- Department of Clinical Research, Clinical Trial Unit, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Andreas R Luft
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland
- Center for Neurology and Rehabilitation, Cereneo, Vitznau, Switzerland
| | - Barbara Goeggel-Simonetti
- Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
- Department of Neuropediatrics, Institute of Pediatrics of Southern Switzerland, San Giovanni Hospital, Bellinzona, Switzerland
| | - Urs Fischer
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Patrik Michel
- Stroke Center and Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Davide Strambo
- Stroke Center and Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Georg Kägi
- Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
- Department of Neurology and Stroke Center, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Jochen Vehoff
- Department of Neurology and Stroke Center, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Krassen Nedeltchev
- Department of Neurology and Stroke Center, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Timo Kahles
- Department of Neurology and Stroke Center, Cantonal Hospital Aarau, Aarau, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Lars Kellert
- Department of Neurology, Ludwig Maximilian University, Munich, Germany
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Sverre Rosenbaum
- Department of Neurology, Bispebjerg Hospital and University of Copenhagen, Copenhagen, Denmark
| | - Regina von Rennenberg
- Department of Neurology with Experimental Neurology, Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph Riegler
- Department of Neurology with Experimental Neurology, Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - David Seiffge
- Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Hakan Sarikaya
- Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Annaelle Zietz
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
| | | | - Alexandros A Polymeris
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Martin Hänsel
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland
| | - Christoph Globas
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland
| | - Leo H Bonati
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland
| | - Alex Brehm
- Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Gian Marco De Marchis
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Neurology and Stroke Center, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Nils Peters
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
| | - Christian H Nolte
- Department of Neurology with Experimental Neurology, Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Healths at Charité, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Hanne Christensen
- Department of Neurology, Bispebjerg Hospital and University of Copenhagen, Copenhagen, Denmark
| | - Susanne Wegener
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland
| | - Marios-Nikos Psychogios
- Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Marcel Arnold
- Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Philippe Lyrer
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Christopher Traenka
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
| | - Stefan T Engelter
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
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Birungi N, Berge KG, Åstrøm AN, Brattabø IV. Association of child abuse and neglect training with filing reports of concern to child welfare services: a cross-sectional study. BMC Oral Health 2024; 24:427. [PMID: 38582849 PMCID: PMC10999089 DOI: 10.1186/s12903-024-04222-9] [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: 10/10/2023] [Accepted: 04/02/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND The aptitude, knowledge, and competence of dental health personnel on child abuse and neglect (CAN) is not optimal for deciding when to file a report of concern to child welfare services (CWS). OBJECTIVES The aim of this study was, firstly, to assess the association of the public dental health personnel 's (PDHP) training on CAN received in the last three work years, i.e., in 2016 through 2018 with filing reports to the CWS in the same period and secondly to assess the association of expressed need of training on CAN with filing reports to the CWS. METHODS This cross-sectional study uses data from an electronic survey census of PDHP from Norway (n = 1791) conducted in 2019. The Pearson chi-square test, non-parametric tests, logistic, and negative binomial regression were used for unadjusted and adjusted analysis. Data was reported with proportions, odds ratios (OR), incidence rate ratios and 95% confidence intervals (CIs). RESULTS From 2016 to 2018, the prevalence estimate of filing reports to CWS was 50%, with a mean (standard deviation) of 1.39 (2.11) reports sent. The logistic regression analysis showed an association between filing reports of concern and CAN training in the last three years. Compared to those that had not received CAN training during the three previous years, the ORs (95% CI) for filing reports to the CWS during the same period was 2.5 (1.6-4.0) for one day CAN work training, 3.2 (2.0-5.1) for 2-4 days CAN training and 4.9 (2.6-9.4) for five or more days CAN training. Compared to workers who did not need training in reporting (routines of CAN), those who expressed the need for a little more and more training were less likely to file a report. The corresponding OR were 0.6 (0.4-0.9) and 0.6 (0.3-0.9), respectively. CONCLUSION CAN training during the last three years is associated with filing reports of concern to CWS in the same period among PDHP in Norway. The likelihood of filing CAN reports increased with the number of days of CAN training received. Secondly, the PDHP with an expressed need for training on CAN routines were less likely to report suspicions to CWS.
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Affiliation(s)
- Nancy Birungi
- Oral Health Centre of Expertise in Vestland County, Bergen, Norway.
| | | | - Anne Nordrehaug Åstrøm
- Oral Health Centre of Expertise in Vestland County, Bergen, Norway
- Institute of Clinical Dentistry, University of Bergen, Bergen, Norway
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Olaiya OR, Abraha B, Ogbeide OJ, Huynh MNQ, Amin A, McRae MH, Coroneos CJ, Mbuagbaw L. Reporting bias in breast reconstruction clinical trials: Which and when clinical trials get published. J Plast Reconstr Aesthet Surg 2024; 91:399-406. [PMID: 38461624 DOI: 10.1016/j.bjps.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/17/2024] [Accepted: 02/04/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Reporting bias refers to the phenomenon in which the reporting of research findings is influenced by the nature of the results. Without the totality of evidence, clinical practice may be misguided. The objective of this work was to examine the extent of reporting bias in clinical trials of breast reconstruction surgery. METHODS We searched and extracted data from all completed breast reconstruction clinical trials published in ClinicalTrials.gov from database inception to August 2020. Investigators sought to identify published full manuscripts of the registered trials. The primary outcome was classified as positive or nonpositive and trials were classified as industry or nonindustry funded. Time to publication in a peer-reviewed journal was computed and compared using time-to-event analysis. Trial characteristics associated with publication were evaluated using logistic regression. RESULTS A total of 156 clinical trials were identified, of which, 53 trials were published. The median time to publication was 22 months (IQR, 13-35 months). Industry-funded studies were associated with a longer time to publication (HR = 2.4, p = 0.023) and publication in lower-impact journals (OR = 3.7, p = 0.048). Randomized clinical trials were associated with faster times to publication than nonrandomized studies (aHR = 3.2, p = 0.030). Statistical significance and the effect size were not associated with time to publication. CONCLUSIONS We found no evidence that industry-funded trials were more likely to report a positive primary outcome. However, industry-funded trials were associated with a longer time to publication and publication in lower-impact journals.
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Affiliation(s)
- Oluwatobi R Olaiya
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.
| | - Beraki Abraha
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | | | - Minh N Q Huynh
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Asmarah Amin
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Mark H McRae
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Christopher J Coroneos
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada
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28
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Kong Q, Gao Q, Li W, Chen Z. The Impact of Imaging-Diagnosed Sarcopenia on Long-term Prognosis After Curative Resection for Hepatocellular Carcinoma: A Systematic Review and Meta-analysis. Acad Radiol 2024; 31:1272-1283. [PMID: 38071101 DOI: 10.1016/j.acra.2023.11.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/15/2023] [Accepted: 11/29/2023] [Indexed: 04/14/2024]
Abstract
BACKGROUND Recent research suggests that sarcopenia potentially influences the long-term postoperative prognosis of malignant tumors. Thus, the primary objective of this study was to investigate the impact of imaging-diagnosed sarcopenia on the long-term prognosis of hepatocellular carcinoma (HCC) patients after curative resection. METHODS In our approach, all studies incorporated in this study employed Cox proportional hazards models with multivariable adjusted hazard ratios. The meta-analysis was performed using R statistical software. The primary outcomes were quantified using hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS This study analyzed 30 studies, involving 7352 HCC patients after curative resection (2695 in the sarcopenia group and 4657 in the non-sarcopenia group). The meta-analysis of 28 studies indicated that patients in the sarcopenia group demonstrated notably inferior overall survival (OS) compared with the non-sarcopenia group (HR=2.20; 95% CI, 1.88-2.58; p < 0.01). Similarly, sarcopenia exhibits a significant association with poor recurrence-free survival (RFS) and disease-free survival (DFS) based on 16 and 6 studies (HR=1.50; 95% CI, 1.39-1.63; p < 0.01 and HR=1.96; 95% CI, 1.83-2.10; p < 0.01, respectively). CONCLUSION In conclusion, imaging-diagnosed sarcopenia adversely affects the long-term prognosis, including OS, RFS, and DFS, in HCC patients after curative resection. The findings hold considerable importance in guiding comprehensive healthcare procedures for HCC patients after surgery.
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Affiliation(s)
- Qingyan Kong
- Division of Hepatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, 37 Guo Xue Rd, Chengdu 610041, Sichuan Province, China
| | - Qianqian Gao
- Division of Hepatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, 37 Guo Xue Rd, Chengdu 610041, Sichuan Province, China
| | - Wenjie Li
- Division of Hepatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, 37 Guo Xue Rd, Chengdu 610041, Sichuan Province, China
| | - Zheyu Chen
- Division of Hepatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, 37 Guo Xue Rd, Chengdu 610041, Sichuan Province, China.
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Fafard St-Germain AA, Hutchinson J, Tarasuk V. The relationship between household food insecurity and overweight or obesity among children and adults in Canada: a population-based, propensity score weighting analysis. Appl Physiol Nutr Metab 2024; 49:473-486. [PMID: 38224041 DOI: 10.1139/apnm-2023-0302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Household food insecurity is independently associated with adverse health outcomes among Canadians, but its association with overweight and obesity is poorly understood partly because of limited attention to confounding. This study assessed the relationship between food insecurity status and overweight/obesity in Canada. Cross-sectional data for individuals aged 2-64 years were drawn from the 2004 and 2015 Canadian Community Health Survey-Nutrition. Overweight/obesity was defined using body mass index calculated with measured height and weight. Food insecurity status was assessed with the 18-item Household Food Security Survey Module. The relationship was examined among preschool children (n = 2007), girls (n = 5512), boys (n = 5507), women (n = 8317), and men (n = 7279) using propensity score weighted logistic regressions to control for confounding. Relative to their food-secure counterparts, girls in moderately food-insecure households (39.7% vs. 28.5%), boys in severely food-insecure households (54.4% vs. 35.0%), and women in moderately and severely food-insecure households (58.9% and 73.1% vs. 50.7%) had higher overweight/obesity prevalence; men in moderately food-insecure households had a lower prevalence (48.9% vs. 66.3%). With propensity score weighting, no association existed between food insecurity and overweight/obesity among preschool children, girls, boys, or men. For women, moderate (adjusted odds ratio (AOR): 1.61; 95% confidence interval (95%CI): 1.06-2.47) and severe (AOR: 2.33; 95%CI: 1.22-4.44) food insecurity was positively associated with overweight/obesity; the association was strongest for severe food insecurity and obesity (AOR: 3.38; 95%CI: 1.60-7.16). Additional research is needed to better understand the nature of the relationship among women. Problems of food insecurity and overweight/obesity among Canadian children and men should not be conflated in public health interventions.
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Affiliation(s)
| | - Joy Hutchinson
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Valerie Tarasuk
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
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Lau WC, Huang L, Zheng X, Ming WK, Leong NC, Tak Wong Y, Yin Z, Yu H, Lyu J, Deng L. Prognostic nomograms for predicting long-term overall survival in spindle cell melanoma: a population-based study. Front Endocrinol (Lausanne) 2024; 15:1260966. [PMID: 38572477 PMCID: PMC10988970 DOI: 10.3389/fendo.2024.1260966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 03/06/2024] [Indexed: 04/05/2024] Open
Abstract
Background There are few research findings on the survival prognosis of spindle cell melanoma (SCM), which is an unusual kind of melanoma. The purpose of this study was to develop a thorough nomogram for predicting the overall survival (OS) of patients with SCM and to assess its validity by comparing it with the conventional American Joint Committee on Cancer (AJCC) staging system. Methods The Surveillance, Epidemiology, and End Results database was searched, and 2,015 patients with SCM were selected for the analysis. The patients were randomly divided into training (n = 1,410) and validation (n = 605) cohorts by using R software. Multivariate Cox regression was performed to identify predictive factors. A nomogram was established based on these characteristics to predict OS in SCM. The calibration curve, concordance index (C-index), area under the receiver operating characteristic curve, and decision-curve analysis were utilized to assess the accuracy and reliability of the model. The net reclassification improvement and integrated discrimination improvement were also applied in this model to evaluate its differences with the AJCC model. Results The developed nomogram suggests that race, AJCC stage, chemotherapy status, regional node examination status, marital status, and sex have the greatest effects on OS in SCM. The nomogram had a higher C-index than the AJCC staging system (0.751 versus 0.633 in the training cohort and 0.747 versus 0.650 in the validation cohort). Calibration plots illustrated that the model was capable of being calibrated. These criteria demonstrated that the nomogram outperforms the AJCC staging system alone. Conclusion The nomogram developed in this study is sufficiently reliable for forecasting the risk and prognosis of SCM, which may facilitate personalized treatment recommendations in upcoming clinical trials.
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Affiliation(s)
- Wai Chi Lau
- Department of Dermatology, The First Affiliated Hospital of Jinan University & Jinan University Institute of Dermatology, Guangzhou, China
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Liying Huang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xinkai Zheng
- Department of Dermatology, The First Affiliated Hospital of Jinan University & Jinan University Institute of Dermatology, Guangzhou, China
| | - Wai-kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Nga Cheng Leong
- Department of Dermatology, The First Affiliated Hospital of Jinan University & Jinan University Institute of Dermatology, Guangzhou, China
- Department of Dermatology, Kiang Wu Hospital, Macau, China
| | - Yu Tak Wong
- Department of Dermatology, The First Affiliated Hospital of Jinan University & Jinan University Institute of Dermatology, Guangzhou, China
- SHENZHEN BeauCare Clinic, Shenzhen, China
| | - Zhinan Yin
- Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai Institute of Translational Medicine Zhuhai People’s Hospital Affiliated with Jinan University, Zhuhai, China
- The Biomedical Translational Research Institute, Health Science Center (School of Medicine), Jinan University, Guangzhou, China
| | - Hai Yu
- Department of Dermatology, The First Affiliated Hospital of Jinan University & Jinan University Institute of Dermatology, Guangzhou, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, China
| | - Liehua Deng
- Department of Dermatology, The First Affiliated Hospital of Jinan University & Jinan University Institute of Dermatology, Guangzhou, China
- Department of Dermatology, The Fifth Affiliated Hospital of Jinan University, Heyuan, China
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Kim HS. Dark Data in Real-World Evidence: Challenges, Implications, and the Imperative of Data Literacy in Medical Research. J Korean Med Sci 2024; 39:e92. [PMID: 38469965 PMCID: PMC10927386 DOI: 10.3346/jkms.2024.39.e92] [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: 09/04/2023] [Accepted: 02/01/2024] [Indexed: 03/13/2024] Open
Abstract
Randomized controlled trials (RCTs) and real-world evidence (RWE) studies are crucial and complementary in generating clinical evidence. RCTs provide controlled settings to validate the clinical effect of specific drugs or medical devices, while RWE integrates extrinsic factors, encompassing external influences affecting real-world scenarios, thus challenging RCT results in practical applications. In this study, we explore the impact of extrinsic factors on RWE outcomes, focusing on "dark data," which refers to data collected but not used or excluded from the analyses. Dark data can arise in many ways during research process, from selecting study samples to data collection and analysis. However, even unused or unanalyzed dark data hold potential insights, providing a comprehensive view of clinical contexts. Extrinsic factors lead to divergent RWE outcomes that could differ from RCTs beyond statistical correction's scope. Two main types of dark data exist: "known-unknown" and "unknown-unknown." The distinction between these dark data types highlights RWE's complexity. The transformation of unknown into known depends on data literacy-powerful utilization capabilities that can be interpreted based on medical expertise. Shifting the focus to excluded subjects or unused data in real-world contexts reveals unexplored potential. Understanding the significance of dark data is vital in reflecting the complexity of clinical settings. Connecting RCTs and RWEs requires medical data literacy, enabling clinicians to decipher meaningful insights. In the big data and artificial intelligence era, medical staff must navigate data complexities while promoting the core role of medicine. Prepared clinicians will lead this transformative journey, ensuring data value shapes the medical landscape.
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Affiliation(s)
- Hun-Sung Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Gao Y, Zhou M, Xu X, Ma JY, Qin MF. Body composition and risk of gestational diabetes mellitus: A univariable and multivariable Mendelian randomization study. J Diabetes Investig 2024; 15:346-354. [PMID: 38013660 PMCID: PMC10906022 DOI: 10.1111/jdi.14115] [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: 08/16/2023] [Revised: 11/05/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023] Open
Abstract
OBJECTIVE In this study, we employed a Mendelian randomization (MR) approach to investigate the independent causal associations of six body composition traits with gestational diabetes mellitus (GDM). METHODS Genome-wide significant levels (P < 10 × 5-8 ) of single nucleotide polymorphisms associated with body water mass, total protein, whole body fat-free mass, weight, whole body fat mass, and body fat percentage were used as instrumental variables. Data on GDM were obtained from the FinnGen Consortium, and both univariable and multivariable Mendelian randomization were performed. We utilized five different analytical methods including inverse-variance weighted (IVW), MR Egger, weighted median, simple mode, and weighted mode to assess the robustness of the results. RESULTS With univariable Mendelian randomization, the risk of GDM increased per 1-standard deviation (SD) increase in weight (ORweight = 1.297, P = 3.06 × 10-5 ), whole body fat mass (ORwhole body fat mass = 1.408, P = 1.32 × 10-6 ), and the risk of GDM increased per percent increase in body fat percentage (ORbody fat percentage = 1.661, P = 1.01 × 10-8 ). Total protein had a protective effect on the risk of GDM (ORtotal protein = 0.880, P = 0.048). However, there was no significant causal association between increases in body water mass and whole body fat-free mass per SD and the risk of GDM. Causal associations between weight, whole body fat mass, body fat percentage, and total protein with GDM were reduced to null in multivariable Mendelian randomization. CONCLUSION The present study furnishes genetic evidence to elucidate the causal relationship between body composition traits and GDM. Additionally, further studies are imperative to establish a causal connection between body composition traits and gestational diabetes mellitus.
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Affiliation(s)
- Yuan Gao
- The Second Affiliated Hospital of Nanchang UniversityNanchangChina
- Nursing School of Nanchang UniversityNanchangChina
| | - Min Zhou
- The Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Xuan Xu
- The Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Jun Yang Ma
- School of Clinical MedicineJining Medical UniversityJiningChina
- Department of General SurgeryThe First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qianfoshan Hospital)JinanChina
| | - Man Fen Qin
- The Second Affiliated Hospital of Nanchang UniversityNanchangChina
- Nursing School of Nanchang UniversityNanchangChina
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de Boo LW, Jóźwiak K, Ter Hoeve ND, van Diest PJ, Opdam M, Wang Y, Schmidt MK, de Jong V, Kleiterp S, Cornelissen S, Baars D, Koornstra RHT, Kerver ED, van Dalen T, Bins AD, Beeker A, van den Heiligenberg SM, de Jong PC, Bakker SD, Rietbroek RC, Konings IR, Blankenburgh R, Bijlsma RM, Imholz ALT, Stathonikos N, Vreuls W, Sanders J, Rosenberg EH, Koop EA, Varga Z, van Deurzen CHM, Mooyaart AL, Córdoba A, Groen E, Bart J, Willems SM, Zolota V, Wesseling J, Sapino A, Chmielik E, Ryska A, Broeks A, Voogd AC, van der Wall E, Siesling S, Salgado R, Dackus GMHE, Hauptmann M, Kok M, Linn SC. Prognostic value of histopathologic traits independent of stromal tumor-infiltrating lymphocyte levels in chemotherapy-naïve patients with triple-negative breast cancer. ESMO Open 2024; 9:102923. [PMID: 38452438 PMCID: PMC10937239 DOI: 10.1016/j.esmoop.2024.102923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/09/2024] [Accepted: 02/04/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND In the absence of prognostic biomarkers, most patients with early-stage triple-negative breast cancer (eTNBC) are treated with combination chemotherapy. The identification of biomarkers to select patients for whom treatment de-escalation or escalation could be considered remains an unmet need. We evaluated the prognostic value of histopathologic traits in a unique cohort of young, (neo)adjuvant chemotherapy-naïve patients with early-stage (stage I or II), node-negative TNBC and long-term follow-up, in relation to stromal tumor-infiltrating lymphocytes (sTILs) for which the prognostic value was recently reported. MATERIALS AND METHODS We studied all 485 patients with node-negative eTNBC from the population-based PARADIGM cohort which selected women aged <40 years diagnosed between 1989 and 2000. None of the patients had received (neo)adjuvant chemotherapy according to standard practice at the time. Associations between histopathologic traits and breast cancer-specific survival (BCSS) were analyzed with Cox proportional hazard models. RESULTS With a median follow-up of 20.0 years, an independent prognostic value for BCSS was observed for lymphovascular invasion (LVI) [adjusted (adj.) hazard ratio (HR) 2.35, 95% confidence interval (CI) 1.49-3.69], fibrotic focus (adj. HR 1.61, 95% CI 1.09-2.37) and sTILs (per 10% increment adj. HR 0.75, 95% CI 0.69-0.82). In the sTILs <30% subgroup, the presence of LVI resulted in a higher cumulative incidence of breast cancer death (at 20 years, 58%; 95% CI 41% to 72%) compared with when LVI was absent (at 20 years, 32%; 95% CI 26% to 39%). In the ≥75% sTILs subgroup, the presence of LVI might be associated with poor survival (HR 11.45, 95% CI 0.71-182.36, two deaths). We confirm the lack of prognostic value of androgen receptor expression and human epidermal growth factor receptor 2 -low status. CONCLUSIONS sTILs, LVI and fibrotic focus provide independent prognostic information in young women with node-negative eTNBC. Our results are of importance for the selection of patients for de-escalation and escalation trials.
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Affiliation(s)
- L W de Boo
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - K Jóźwiak
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - N D Ter Hoeve
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P J van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Opdam
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Y Wang
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M K Schmidt
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - V de Jong
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S Kleiterp
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S Cornelissen
- Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - D Baars
- Department of Biometrics, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - R H T Koornstra
- Department of Medical Oncology, Rijnstate Medical center, Arnhem, The Netherlands
| | - E D Kerver
- Department of Medical Oncology, OLVG, Amsterdam, The Netherlands
| | - T van Dalen
- Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands
| | - A D Bins
- Department of Medical Oncology, Amsterdam UMC, Amsterdam, The Netherlands
| | - A Beeker
- Department of Medical Oncology, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | | | - P C de Jong
- Department of Medical Oncology, Sint Antonius Hospital, Utrecht, The Netherlands
| | - S D Bakker
- Department of Internal Medicine, Zaans Medical Centre, Zaandam, The Netherlands
| | - R C Rietbroek
- Department of Medical Oncology, Rode Kruis Hospital, Beverwijk, The Netherlands
| | - I R Konings
- Department of Medical Oncology, Amsterdam UMC, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - R Blankenburgh
- Department of Medical Oncology, Saxenburgh Medical Center, Hardenberg, The Netherlands
| | - R M Bijlsma
- Department of Medical Oncology, UMC Utrecht Cancer Center, Utrecht, The Netherlands
| | - A L T Imholz
- Department of Internal Medicine, Deventer Hospital, Deventer, The Netherlands
| | - N Stathonikos
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - W Vreuls
- Department of Pathology, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
| | - J Sanders
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - E H Rosenberg
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - E A Koop
- Department of Pathology, Gelre Ziekenhuizen, Apeldoorn, The Netherlands
| | - Z Varga
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - C H M van Deurzen
- Department of Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - A L Mooyaart
- Department of Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - A Córdoba
- Department of Pathology, Complejo Hospitalaria de Navarra, Pamplona, Spain
| | - E Groen
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J Bart
- Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands
| | - S M Willems
- Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands
| | - V Zolota
- Department of Pathology, Rion University Hospital, Patras, Greece
| | - J Wesseling
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - A Sapino
- Department of Medical Sciences, University of Torino, Torino, Italy; Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - E Chmielik
- Tumor Pathology Department, Maria Sklodowska-Curie Memorial National Research Institute of Oncology, Gliwice, Poland
| | - A Ryska
- Charles University Medical Faculty and University Hospital, Hradec Kralove, Czech Republic
| | - A Broeks
- Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A C Voogd
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | - E van der Wall
- Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S Siesling
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands; Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - R Salgado
- Division of Clinical Medicine and Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Pathology, GZA-ZNA Hospitals, Antwerp, Belgium
| | - G M H E Dackus
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - M Kok
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Tumorbiology & Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S C Linn
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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Wang P, Fang E, Zhao X, Feng J. Nomogram for soiling prediction in postsurgery hirschsprung children: a retrospective study. Int J Surg 2024; 110:1627-1636. [PMID: 38116670 PMCID: PMC10942236 DOI: 10.1097/js9.0000000000000993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE The aim of this study was to develop a nomogram for predicting the probability of postoperative soiling in patients aged greater than 1 year operated for Hirschsprung disease (HSCR). MATERIALS AND METHODS The authors retrospectively analyzed HSCR patients with surgical therapy over 1 year of age from January 2000 and December 2019 at our department. Eligible patients were randomly categorized into the training and validation set at a ratio of 7:3. By integrating the least absolute shrinkage and selection operator [LASSO] and multivariable logistic regression analysis, crucial variables were determined for establishment of the nomogram. And, the performance of nomogram was evaluated by C-index, area under the receiver operating characteristic curve, calibration curves, and decision curve analysis. Meanwhile, a validation set was used to further assess the model. RESULTS This study enrolled 601 cases, and 97 patients suffered from soiling. Three risk factors, including surgical history, length of removed bowel, and surgical procedures were identified as predictive factors for soiling occurrence. The C-index was 0.871 (95% CI: 0.821-0.921) in the training set and 0.878 (95% CI: 0.811-0.945) in the validation set, respectively. And, the AUC was found to be 0.896 (95% CI: 0.855-0.929) in the training set and 0.866 (95% CI: 0.767-0.920) in the validation set. Additionally, the calibration curves displayed a favorable agreement between the nomogram model and actual observations. The decision curve analysis revealed that employing the nomogram to predict the risk of soiling occurrence would be advantageous if the threshold was between 1 and 73% in the training set and 3-69% in the validation set. CONCLUSION This study represents the first efforts to develop and validate a model capable of predicting the postoperative risk of soiling in patients aged greater than 1 year operated for HSCR. This model may assist clinicians in determining the individual risk of soiling subsequent to HSCR surgery, aiding in personalized patient care and management.
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Affiliation(s)
| | | | | | - Jiexiong Feng
- Department of Pediatric Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, People’s Republic of China
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Yao P, Liao X, Huang J, Dang Y, Jiang H. Identifying causal relationships between gastroesophageal reflux and extraesophageal diseases: A Mendelian randomization study. Medicine (Baltimore) 2024; 103:e37054. [PMID: 38363933 PMCID: PMC10869099 DOI: 10.1097/md.0000000000037054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/03/2024] [Indexed: 02/18/2024] Open
Abstract
Traditional observational and in vivo studies have suggested an etiological link between gastroesophageal reflux disease (GERD) and the development of extraesophageal diseases (EEDs), such as noncardiac chest pain. However, evidence demonstrating potential causal relationships is lacking. This study evaluated the potential causal relationship between GERD and EEDs, including throat and chest pain, asthma, bronchitis, chronic rhinitis, nasopharyngitis and pharyngitis, gingivitis and periodontal disease, cough, using multiple Mendelian randomization (MR) methods, and sensitivity analysis was performed. The Mendelian randomization Pleiotropy RESidual Sum and Outlier and PhenoScanner tools were used to further check for heterogeneous results and remove outliers. MR with inverse-variance weighted (IVW) showed a significant causal relationship between GERD and EEDs after Bonferroni correction. IVW results indicated that GERD increased the risk of chronic rhinitis, nasopharyngitis and pharyngitis (odds ratio [OR] = 1.482, 95% confidence interval [CI] = 1.267-1.734, P < .001], gingivitis and periodontal disease (OR = 1.166, 95% CI = 1.046-1.190, P = .001), throat and chest pain (OR = 1.585, 95% CI = 1.455-1.726, P < .001), asthma (OR = 1.539, 95% CI = 1.379-1.717, P < .001), and bronchitis (OR = 1.249, 95% CI = 1.168-1.335, P < .001). Sensitivity analysis did not detect pleiotropy. Leave-one-out analysis shows that MR results were not affected by individual single nucleotide polymorphisms. The funnel plot considers the genetic instrumental variables to be almost symmetrically distributed. This MR supports a causal relationship among GERD and EEDs. Precise moderation based on causality and active promotion of collaboration among multidisciplinary physicians ensure high-quality diagnostic and treatment recommendations and maximize patient benefit.
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Affiliation(s)
- Peishan Yao
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaomin Liao
- Guangxi Medical University, Nanning, Guangxi, China
| | - Junming Huang
- The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Yi Dang
- Department of Gastroenterology, Yulin Red Cross Hospital, Yulin, Guangxi, China
| | - Haixing Jiang
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Burns C, Michelogiannakis D, Ahmed ZU, Rossouw PE, Javed F. Influence of psychostimulants on bone mineral density and content among children with attention deficit hyperactivity disorder. A systematic review. Bone 2024; 179:116982. [PMID: 38006907 DOI: 10.1016/j.bone.2023.116982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/08/2023] [Accepted: 11/21/2023] [Indexed: 11/27/2023]
Abstract
There is a controversy over the influence of psychostimulant medications on bone mineral density (BMD) and bone mineral content (BMC) among children with attention-deficit-hyperactivity-disorder (ADHD). The aim of the present systematic review was to assess the influence of psychostimulant medications on BMD and BMC among children with ADHD. A comprehensive search of electronic databases, including PubMed, Scopus, Embase, and Cochrane Library, was conducted to identify relevant studies published up until July 2023. Clinical studies that addressed the focused question "Do psychostimulant medications affect bone mineral density and content in children with ADHD?" were included. Letters to the Editor, studies on animal-models, ex-vivo and in-vitro studies, commentaries and reviews were excluded. The primary outcome measures were changes in BMD and BMC. Study quality was assessed using the risk of bias for non-randomized studies-exposure tool. Five non-randomized clinical studies were included. The number of participants ranged from 18 to 6489 with mean ages ranging from 7.3 to 13.75 years. The study durations ranged between five and seven years. In all studies osseous evaluation was done using dual-energy X-ray absorptiometry. The bone locations examined included total body, lumbar-spine, femur, femoral-neck, femoral body, and pelvis. Two studies reported that psychostimulant medications reduce BMC and BMD. In one study, bone turnover, serum leptin and fat levels were reduced in children using psychostimulant medications but no unusual reduction recorded among controls. In general, 80 % of the studies concluded that psychostimulant medications compromise BMC and BMD. Power analysis was done in one study. One study had a low RoB and the remaining demonstrated some concerns. Given the methodological concerns observed in the included studies, arriving at a definitive conclusion regarding the effects of psychostimulant medications on BMC, BMD, and bone turnover in children with ADHD is challenging. However, it is important to acknowledge that an association between psychostimulant medications and these bone-related parameters cannot be disregarded.
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Affiliation(s)
- Christopher Burns
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY, United States
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY, United States
| | - Zain Uddin Ahmed
- Department of Community Dentistry & Oral Disease Prevention, Eastman Institute for Oral Health, University of Rochester, NY, United States
| | - P Emile Rossouw
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY, United States
| | - Fawad Javed
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY, United States.
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Joosten SA, Genta PR. Staring us in the face: resumption of CPAP therapy. Eur Respir J 2024; 63:2302213. [PMID: 38302178 DOI: 10.1183/13993003.02213-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 12/12/2023] [Indexed: 02/03/2024]
Affiliation(s)
- Simon A Joosten
- School of Clinical Sciences, Monash University, Clayton, Australia
- Monash Lung Sleep Allergy Immunology, Monash Health, Clayton, Australia
- Epworth Partners, Epworth Health, Melbourne, Australia
| | - Pedro R Genta
- Laboratório do sono, LIM 63, Divisão de Pneumologia, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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Soare IA, Ansari W, Nguyen JL, Mendes D, Ahmed W, Atkinson J, Scott A, Atwell JE, Longworth L, Becker F. Health-related quality of life in mild-to-moderate COVID-19 in the UK: a cross-sectional study from pre- to post-infection. Health Qual Life Outcomes 2024; 22:12. [PMID: 38287294 PMCID: PMC10826014 DOI: 10.1186/s12955-024-02230-5] [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: 06/20/2023] [Accepted: 01/09/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND The aim of this study was to estimate the impact of mild-to-moderate COVID-19 on health-related quality of life (HRQoL) over time among individuals in the United Kingdom, adding to the evidence base that had focussed on severe COVID-19. METHODS A bespoke online survey was administered to individuals who self-reported a positive COVID-19 test. An amended version of a validated generic HRQoL instrument (EQ-5D-5L) was used to measure HRQoL retrospectively at different timepoints over the course of an infection: pre-COVID-19, acute COVID-19, and long COVID. In addition, HRQoL post-COVID-19 was captured by the original EQ-5D-5L questionnaire. A mixed-effects model was used to estimate changes in HRQoL over time, adjusted for a range of variables correlated with HRQoL. RESULTS The study recruited 406 participants: (i) 300 adults and 53 adolescents with mild-to-moderate COVID-19 who had not been hospitalised for COVID-19 during acute COVID-19, and (ii) 53 adults who had been hospitalised for COVID-19 in the acute phase and who had been recruited for validation purposes. Data were collected between January and April 2022. Among participants included in the base-case analysis, EQ-5D-5L utility scores were lower during both acute COVID-19 (β=-0.080, p = 0.001) and long COVID (β=-0.072, p < 0.001) compared to pre COVID-19. In addition, EQ-5D-5L utility scores post-COVID-19 were found to be similar to the EQ-5D-5L utility scores before COVID-19, including for patients who had been hospitalised for COVID-19 during the acute phase or for those who had experienced long COVID. Moreover, being hospitalised in the acute phase was associated with additional utility decrements during both acute COVID-19 (β=-0.147, p = 0.026) and long (β=-0.186, p < 0.001) COVID. CONCLUSION Patients perceived their HRQoL to have varied significantly over the course of a mild-to-moderate COVID-19 infection. However, HRQoL was found to return to pre-COVID-19 levels, even for patients who had been hospitalised for COVID-19 during the acute phase or for those who had experienced long COVID.
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Affiliation(s)
| | | | | | | | - Waqas Ahmed
- PHMR Limited, Ashby Business Park, Nottingham Road, LE651NG, Ashby-De-La-Zouch, UK
| | | | | | | | - Louise Longworth
- PHMR Limited, Ashby Business Park, Nottingham Road, LE651NG, Ashby-De-La-Zouch, UK
| | - Frauke Becker
- PHMR Limited, Ashby Business Park, Nottingham Road, LE651NG, Ashby-De-La-Zouch, UK
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Kangkhetkron T, Juntarawijit C. Pesticide exposure and lung cancer risk: A case-control study in Nakhon Sawan, Thailand. F1000Res 2024; 9:492. [PMID: 38435081 PMCID: PMC10904940 DOI: 10.12688/f1000research.24114.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2024] [Indexed: 03/05/2024] Open
Abstract
Background Pesticide exposure might increase risk of lung cancer. The purpose of this study was to investigate the association between the historical use of pesticides and lung cancer using a case-control design. Methods This case-control study compared a lifetime pesticide exposure of 233 lung cancer cases, and 447 healthy neighbours matched for gender, and age (±5 years). Data on demographic, pesticide exposure and other related factors were collected using a face-to-face interview questionnaire. Associations between lung cancer and types of pesticides as well as individual pesticides were analysed using logistic regression adjusted for gender, age, cigarette smoking, occupation, cooking fumes exposure, and exposure to air pollution. Results It was found that lung cancer was positively associated with the lifetime use of herbicides and insecticides. Compared to people in the non-exposed groups, those in Q3-Q4 days of using herbicides and insecticides had an elevated risk of lung cancer, with odds ratio (OR) between 2.20 (95% confidence interval (CI) 1.24-3.89), and 3.99 (95% CI 1.62-7.11) (p < 0.001). For individual pesticides, those presenting a significant association with lung cancer were dieldrin (OR = 2.56; 95% CI 1.36-4.81), chlorpyrifos (OR = 3.29; 95 % CI 1.93-5.61), and carbofuran (OR = 2.10; 95% CI 1.28-3.42). It was also found, for the first time, carbofuran, glyphosate, and paraquat to be significantly associated with lung cancer. Conclusions The study confirmed dieldrin, and chlorpyrifos as risk factors and suggested carbofuran, glyphosate, and paraquat as potential risk factors for the disease. The paper stands as a noteworthy contribution to literature, particularly because the majority of publications on the topic originate from developed Western countries. However, further studies are imperative to validate the results and pinpoint additional individual pesticides that may be associated with lung cancer.
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Affiliation(s)
- Teera Kangkhetkron
- Department of Natural Resources and Environment, Faculty of Agriculture, Natural Resources and Environment, Naresuan University, Phitsanulok, 65000, Thailand
- Nakhon Sawan Provincial Public Health Office, Minstry of Public Health, Muang District, Nakhon Sawan, 60000, Thailand
| | - Chudchawal Juntarawijit
- Department of Natural Resources and Environment, Faculty of Agriculture, Natural Resources and Environment, Naresuan University, Muang District, Phitsanulok, 65000, Thailand
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Ahmed A, Smith M, Mandal S, Bushnik T. Who enrolls and why? Examining center-specific underlying patterns behind enrollment: a New York City-based traumatic brain injury model systems study. Brain Inj 2024; 38:19-25. [PMID: 38219046 DOI: 10.1080/02699052.2024.2304863] [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: 06/17/2022] [Accepted: 01/09/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND To elucidate the sociodemographic and study factors involved in enrollment in the Traumatic Brain Injury Model System (TBIMS) database, this study examined the effect of a variety of variables on enrollment at a local TBIMS center. METHODS A sample of 654 individuals from the local TBIMS center was studied examining enrollment by age, gender, race, ethnicity, homelessness status at date of injury, history of homelessness, health insurance status, presence of social support, primary language, consenting in hospital or after discharge, and the need for an interpreter. Binary logistic regression was conducted to identify variables that predict center-based enrollment into TBIMS. RESULTS Results demonstrated that older age was associated with decreasing enrollment (OR = 0.99, p = 0.01), needing an interpreter made enrollment less likely (OR = 0.33, p < 0.01), being primarily Spanish speaking predicted enrollment (OR = 3.20, p = 0.02), Hispanic ethnicity predicted enrollment (OR = 7.31, p = 0.03), and approaching individuals in the hospital predicted enrollment (OR = 6.94, p < 0.01). Here, OR denotes the odds ratio estimate from a logistic regression model and P denotes the corresponding p-value. CONCLUSIONS These results can be useful in driving enrollment strategies at this center for other similar TBI research, and to contribute a representative TBI sample to the national database.
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Affiliation(s)
- Asim Ahmed
- Rusk Rehabilitation at NYU Langone Health, Department of Rehabilitation, New York, NY, United States
- New York Medical College, School of Medicine, Valhalla, NY, United States
| | - Michelle Smith
- Rusk Rehabilitation at NYU Langone Health, Department of Rehabilitation, New York, NY, United States
| | - Soutrik Mandal
- NYU Grossman School of Medicine Department of Population Health, New York, NY, United States
| | - Tamara Bushnik
- Rusk Rehabilitation at NYU Langone Health, Department of Rehabilitation, New York, NY, United States
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Kong Q, Yi M, Teng F, Chen Z. Enhanced prognosis of HCC patients undergoing radical treatments with tenofovir versus entecavir: A meta-analysis based on propensity score matching studies. Asian J Surg 2024; 47:55-62. [PMID: 37739894 DOI: 10.1016/j.asjsur.2023.09.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/14/2023] [Accepted: 09/06/2023] [Indexed: 09/24/2023] Open
Abstract
The selection of postoperative antiviral therapy for hepatocellular carcinoma (HCC) patients with HBV infection undergoing radical treatments (HPHR) is a topic of ongoing debate and controversy. The primary aim of this study was to compare the prognostic impact of selecting entecavir (ETV) or tenofovir disoproxil fumarate (TDF) as antiviral therapy options in HPHR. All the studies included in this analysis were implemented propensity score matching (PSM) methodology. Meta-analysis was performed using R statistical software (version 4.3.0). The primary outcome measures, overall survival (OS) and recurrence-free survival (RFS), were quantified using hazard ratios (HR) and 95% confidence intervals (CI). This study analyzed 13 studies involving 6961 patients (2394 in the TDF group and 4567 in the ETV group). We conducted a meta-analysis of 8 studies that included a total of 5289 patients using the PSM analysis method. In comparison to the ETV group, the TDF group demonstrated significantly better RFS (HR = 0.81; 95% CI, 0.70-0.93; p = 0.0034) and OS (HR = 0.61; 95% CI, 0.42-0.88; p = 0.0085). Furthermore, the disparity between the two drugs was particularly evident in the prognosis of patients undergoing hepatectomy. Regional disparities were observed, with mainland China studies favoring RFS benefits and Taiwan or Korea studies favoring OS benefits. In conclusion, TDF has demonstrated significant superiority over ETV in terms of RFS and OS outcomes for HPHR. The findings hold significant implications for informing clinical decision-making and guiding the selection of postoperative antiviral therapy drugs in HCC patients.
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Affiliation(s)
- Qingyan Kong
- Division of Hepatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, China
| | - Mengshi Yi
- Division of Hepatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, China
| | - Fei Teng
- Division of Hepatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, China
| | - Zheyu Chen
- Division of Hepatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, China.
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Stamoulis T, Dragioti E, Gouva M, Mantzoukas S, Κourakos M. Unveiling the Nexus: Depressive Symptoms and Medication Adherence in Hypertensive Patients' Self-care: A Systematic Review. Mater Sociomed 2024; 36:65-72. [PMID: 38590593 PMCID: PMC10999142 DOI: 10.5455/msm.2024.36.65-72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/25/2024] [Indexed: 04/10/2024] Open
Abstract
Background Hypertension, a significant public health concern, is frequently linked to emotional disorders like depression. Research shows a reciprocal link between depression and hypertension, potentially influencing patients' adherence to self-care routines. Objective This systematic review aimed to examine the association between depressive symptoms and aspects of self-care, with a focus on medication adherence in individuals diagnosed with hypertension. Methods Following PRISMA guidelines, a systematic review was conducted by searching PubMed, PsycINFO and Scopus until March 17, 2023. The included studies involved quantitative primary research conducted in English, focusing on adults (≥18 years) diagnosed with hypertension and experiencing depressive symptoms. Observational studies were assessed using the Newcastle-Ottawa Scale, and randomized controlled trials were evaluated using the revised Cochrane Risk of Bias Tool (RoB 2.0). Due to the great diversity of these studies, a narrative synthesis of the results was undertaken. Results: A total of 18 studies involving 6,131 people with hypertension, that met our eligibility criteria were ultimately included. The reported rates of depressive symptoms ranged from 4% to 43%. Of these studies, nine reported a statistically significant association, showcasing an adverse impact of depressive symptoms on medication adherence. The remaining nine did not confirm the above. Conclusion This systematic review highlights the diverse body of research exploring depressive symptoms and medication adherence among individuals with hypertension. The review suggests a need for increased attention to self-care practices, particularly in relation to adherence to antihypertensive medication. However, it recommends the conduction of more robust longitudinal studies to comprehensively explore this relationship.
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Affiliation(s)
- Theofilos Stamoulis
- Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
| | - Elena Dragioti
- Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
| | - Mary Gouva
- Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
| | - Stefanos Mantzoukas
- Research Laboratory of Integrated Health, Care and Well-being, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
| | - Michael Κourakos
- Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
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Li W, Chai JL, Li Z, Guo CC, Wei R, Sun TF, Liang XZ. No evidence of genetic causality between diabetes and osteonecrosis: a bidirectional two-sample Mendelian randomization analysis. J Orthop Surg Res 2023; 18:970. [PMID: 38104164 PMCID: PMC10725608 DOI: 10.1186/s13018-023-04428-7] [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: 08/22/2023] [Accepted: 11/29/2023] [Indexed: 12/19/2023] Open
Abstract
OBJECTIVE This study aimed to examine whether diabetes mellitus is causally associated with osteonecrosis. METHOD Using publicly accessible genome-wide association study statistics, a bidirectional two-sample Mendelian randomization analysis was carried out. In order to determine whether diabetes has a causal effect on osteonecrosis and whether osteonecrosis has a causal effect on diabetes, we extracted six date on diabetes in Europeans from IEU OpenGWAS and GWAS Catalogue and osteonecrosis in Europeans from FinnGen. We then evaluated the data using inverse variance weighting, MR-Egger regression, weighted median, weighted mode, and simple mode. The results' stability and dependability were then evaluated using sensitivity analysis and heterogeneity analysis. Finally, meta-analysis is used to further confirm if there is a relationship between diabetes and osteonecrosis. RESULTS When diabetes was used as an exposure factor, MR-Egger regression showed that directional fold product was unlikely to bias the results. Cochran's Q test showed only minor heterogeneity in a few data sets. Multidirectional tests Egger-intercept, MR-PRESSO and funnel plots for most data did not show multidirectional and asymmetry at the gene level. Most of the IVW results showed no causal relationship between diabetes mellitus and osteonecrosis. The results of meta-analysis of IVW methods further confirmed the absence of a causal relationship. Inverse MR analysis also showed no causal relationship between osteonecrosis and diabetes. CONCLUSION Results of bidirectional MR analysis show no evidence of causal relationship between diabetes and osteonecrosis.
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Affiliation(s)
- Wei Li
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250355, Shandong, China
| | - Jin-Lian Chai
- College of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, 250355, Shandong, China
| | - Zhe Li
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, 250000, Shandong, China
| | - Cong-Cong Guo
- Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, 250000, Shandong, China
| | - Ran Wei
- Science and Technology Department, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250011, Shandong, China
| | - Tie-Feng Sun
- Shandong Provincial Research Institute of Traditional Chinese Medicine, Jinan, 250014, Shandong, China
| | - Xue-Zhen Liang
- Orthopaedic Microsurgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, 16369 Jingshi Road, Jinan, 250014, Shandong, China.
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250355, Shandong, China.
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Costache AD, Ignat BE, Grosu C, Mastaleru A, Abdulan I, Oancea A, Roca M, Leon MM, Badescu MC, Luca S, Jigoranu AR, Chetran A, Mitu O, Costache II, Mitu F. Inflammatory Pathways in Overweight and Obese Persons as a Potential Mechanism for Cognitive Impairment and Earlier Onset Alzeihmer's Dementia in the General Population: A Narrative Review. Biomedicines 2023; 11:3233. [PMID: 38137454 PMCID: PMC10741501 DOI: 10.3390/biomedicines11123233] [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: 10/23/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
The overweight status or obesity can be confirmed through classical methods such as the body mass index (BMI) and the waist-to-hip ratio (WHR). Apart from metabolic issues such as atherosclerosis, liver steatosis, or diabetes mellitus, long-term obesity or overweight status can pose a risk for cardiovascular and neurovascular complications. While some acute adverse events like coronary syndromes of strokes are well-documented to be linked to an increased body mass, there are also chronic processes that, due to their silent onset and evolution, are underdiagnosed and not as thoroughly studied. Through this review, we aimed to collect all relevant data with regard to the long-term impact of obesity on cognitive function in all ages and its correlation with an earlier onset of dementia such as Alzheimer's disease (AD). The exact mechanisms through which a decline in cognitive functions occurs in overweight or obese persons are still being discussed. A combination of factors has been acknowledged as potential triggers, such as a sedentary lifestyle and stress, as well as a genetic predisposition, for example, the apolipoprotein E (ApoE) alleles in AD. Most research highlights the impact of vascular dysfunction and systemic inflammation on the nervous system in patients with obesity and the subsequent neurological changes. Obesity during the early to mid-ages leads to an earlier onset of cognitive dysfunction in various forms. Also, lifestyle intervention can reverse cognitive dysfunction, especially dieting, to encourage weight loss.
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Affiliation(s)
- Alexandru Dan Costache
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Bogdan Emilian Ignat
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Cristina Grosu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Alexandra Mastaleru
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Irina Abdulan
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Andra Oancea
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Mihai Roca
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Maria Magdalena Leon
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Minerva Codruta Badescu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Stefana Luca
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Alexandru Raul Jigoranu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Adriana Chetran
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Ovidiu Mitu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Irina Iuliana Costache
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Florin Mitu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.D.C.); (A.M.); (I.A.); (A.O.); (M.R.); (M.M.L.); (M.C.B.); (S.L.); (A.R.J.); (A.C.); (O.M.); (I.I.C.); (F.M.)
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
- Romanian Academy of Medical Sciences, 927180 Bucharest, Romania
- Romanian Academy of Scientists, 050044 Bucharest, Romania
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Cavaleri D, Capogrosso CA, Guzzi P, Bernasconi G, Re M, Misiak B, Crocamo C, Bartoli F, Carrà G. Blood concentrations of anterior pituitary hormones in drug-naïve people with first-episode psychosis: A systematic review and meta-analysis. Psychoneuroendocrinology 2023; 158:106392. [PMID: 37778198 DOI: 10.1016/j.psyneuen.2023.106392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION The role of anterior pituitary hormones - i.e., adrenocorticotropic hormone (ACTH), luteinizing and follicle stimulating hormones (LH and FSH), growth hormone (GH), prolactin (PRL), and thyroid-stimulating hormone (TSH) - in early schizophrenia and psychoses unclear. We thus performed a systematic review and meta-analysis on the blood concentrations of ACTH, LH and FSH, GH, PRL, and TSH in drug-naïve people with first-episode psychosis (FEP) as compared with healthy controls. METHODS We searched Embase, MEDLINE, and PsycInfo for articles indexed until September 2022. Data quality was appraised. Random-effects meta-analyses were carried out, generating pooled standardized mean differences (SMDs). Between-study heterogeneity was estimated using the I2 statistic. Sensitivity and meta-regression analyses were performed. RESULTS Twenty-six studies were included. Drug-naïve people with FEP, compared to healthy subjects, had higher blood concentrations of ACTH (k = 7; N = 548; SMD = 0.62; 95%CI: 0.29 to 0.94; p < 0.001; I2 = 60.9%) and PRL (k = 17; N = 1757; SMD = 0.85; 95%CI: 0.56 to 1.14; p < 0.001; I2 = 85.5%) as well as lower levels of TSH (k = 6; N = 677; SMD = -0.34; 95%CI: -0.54 to -0.14; p = 0.001; I2 = 29.1%). Meta-regressions did not show any moderating effect of age (p = 0.78), sex (p = 0.21), or symptom severity (p = 0.87) on PRL concentrations in drug-naïve FEP. Available data were not sufficient to perform meta-analyses on FSH, LH, and GH. CONCLUSIONS Drug-naïve people with FEP have altered ACTH, PRL, and TSH blood concentrations, supporting the hypothesis that an abnormal anterior pituitary hormone secretion may be involved in the onset of schizophrenia and psychoses. Further research is needed to elucidate the role of pituitary hormones in FEP.
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Affiliation(s)
- Daniele Cavaleri
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy.
| | | | - Pierluca Guzzi
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Gianna Bernasconi
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Martina Re
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Francesco Bartoli
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy; Division of Psychiatry, University College London, Maple House 149, London W1T 7BN, United Kingdom
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Hopstaken JS, Daamen LA, Patijn GA, de Vos-Geelen J, Festen S, Bonsing BA, Verheij M, Hermans JJ, Bruno MJ, de Wilde RF, de Hingh IHJT, Besselink MG, Laarhoven KJHMV, Stommel MWJ. Nationwide evaluation of pancreatic cancer networks ten years after the centralization of pancreatic surgery. HPB (Oxford) 2023; 25:1513-1522. [PMID: 37580180 DOI: 10.1016/j.hpb.2023.07.904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/26/2023] [Accepted: 07/24/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Due to centralization of pancreatic surgery, patients with pancreatic cancer are treated in pancreatic cancer networks, composed of referring hospitals (Spokes) and an expert center (Hub). This study aimed to investigate I) how pancreatic cancer networks are organized and II) evaluated by involved clinicians. METHODS Two online surveys were sent out between January-May 2022. Part I was sent out to the surgical network directors of all hospitals of the Dutch Pancreatic Cancer Group (DPCG). Part II was sent out to all involved clinicians in the Hubs-and-Spokes networks. RESULTS There was a large variety between the 15 networks concerning number of affiliated Spokes (1-7), annual pancreatoduodenectomies (20-129), and use of a service level agreement (SLA) (40%). More Spoke clinicians considered the Spoke the best location for diagnostic workup (74% vs 36%, P < 0.001). Only 30% of Spoke clinicians attended the Hubs multidisciplinary team meeting frequently. More Hub clinicians thought that exchange of patient information should be improved (37% vs 51%, P = 0.005). CONCLUSION A large variety in Dutch pancreatic cancer networks was observed concerning number of affiliated Spokes, use of SLAs, and logistic aspects of network care. Improvement of network care concern agreements on diagnostic workup, use of SLA, Spoke participation in the MDT, and patient information exchange.
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Affiliation(s)
| | - Lois A Daamen
- Department of Surgery, UMC Utrecht Cancer Center, Utrecht, the Netherlands; Dept. of Radiation Oncology, UMC Utrecht Cancer Center, Utrecht, the Netherlands
| | - Gijs A Patijn
- Department of Surgery, Isala Oncology Center, Zwolle, the Netherlands
| | - Judith de Vos-Geelen
- Department of Internal Medicine, Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, the Netherlands
| | | | | | - Marcel Verheij
- Department of Radiation Oncology, Radboudumc, Nijmegen, the Netherlands
| | - John J Hermans
- Department of Medical Imaging, Radboudumc, Nijmegen, the Netherlands
| | - Marco J Bruno
- Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Roeland F de Wilde
- Department of Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Marc G Besselink
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
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Liu G, Liu W, Zheng X, Li J. The higher the household income, the lower the possibility of depression and anxiety disorder: evidence from a bidirectional Mendelian randomization study. Front Psychiatry 2023; 14:1264174. [PMID: 38053539 PMCID: PMC10694246 DOI: 10.3389/fpsyt.2023.1264174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/14/2023] [Indexed: 12/07/2023] Open
Abstract
Objectives Observational studies have demonstrated that household income is associated with morbidity of mental disorders. However, a causal relationship between the two factors remains unclear. Therefore, we investigated the causal relationship between household income status and genetic liability of mental disorders using a bidirectional Mendelian randomization (MR) study. Methods This MR study included a large cohort of the European population from publicly available genome-wide association study datasets. A random-effects inverse-variance weighting model was used as the main standard, with MR-Egger regression, weighted median, and maximum likelihood estimations performed concurrently as supplements. Sensitivity analysis, consisting of heterogeneity and horizontal pleiotropy tests, was performed using Cochran's Q test, MR-Egger intercept, and MR-PRESSO tests to ensure the reliability of the conclusions. Results A higher household income tended to be associated with a lower risk of genetic liability for depression (odds ratio [OR]: 0.655, 95% confidence interval [CI] = 0.522-0.822, p < 0.001) and anxiety disorder (OR: 0.666, 95% CI = 0.526-0.843, p < 0.001). No associations were observed for schizophrenia (OR: 0.678, 95% CI = 0.460-1.000, p = 0.05), panic disorder (OR: 0.837, 95% CI = 0.445-1.577, p = 0.583), insomnia (OR: 1.051, 95% CI = 0.556-1.986, p = 0.877), obsessive-compulsive disorder (OR: 1.421, 95% CI = 0.778-2.596, p = 0.252), and bipolar disorder (OR: 1.126, 95% CI = 0.757-1.677, p = 0.556). A reverse MR study showed no reverse causal relationship between psychiatric disorders and household income. Sensitivity analysis verified the reliability of the results. Conclusion Our results revealed that the population with a higher household income tended to have a minor risk of genetic liability in depression and anxiety disorders.
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Affiliation(s)
- Guangyan Liu
- Department of Geriatrics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Wenlin Liu
- Department of Traditional Chinese Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xifeng Zheng
- Department of Cardiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Junyan Li
- Department of Geriatrics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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Dasgupta S, Dasgupta J, Goswami B, Mondal J. Randomized controlled trial comparing efficacy of a combination regime containing two cervical sensitizers (mifepristone + Foley's catheter) versus single agent mifepristone or Foley's catheter for labor induction in women attempting TOLAC at late third trimester with a dead fetus in utero. J Obstet Gynaecol Res 2023; 49:2671-2679. [PMID: 37678840 DOI: 10.1111/jog.15772] [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: 04/12/2023] [Accepted: 08/08/2023] [Indexed: 09/09/2023]
Abstract
Randomized controlled trial comparing efficacy of a combination regime containing two cervical sensitizers (mifepristone + Foley's catheter) versus single agent mifepristone or Foley's catheter for labor induction in women attempting TOLAC at late third trimester with a dead fetus in utero. AIM To compare efficacy and safety of a new combination regime comprising of two cervical sensitizers used simultaneously with single agents, for labor induction in women attempting TOLAC at ≥34 weeks' gestation with a dead fetus. METHOD This was a multiarm randomized controlled trial (RCT) where participants received one of the three regimes-single agent oral Mifepristone 200 mg, intracervical Foley's catheter (16 Fr size, filled with 40 mL normal saline after intracervical instillation), and combination regime consisting of both used simultaneously. Number of women undergoing vaginal birth within 48 h of induction (VB48 ) was the primary outcome compared between groups. RESULTS VB48 was higher in participants on combination regime in comparison to participants on Foley's catheter (54 vs. 42). Total vaginal births were higher in participants on combination regime compared to both single agents (58 vs. 48 and 44). Duration and dose of oxytocin augmentation was lower in participants on combination regime compared to both single agents. Induction birth interval was short in participants on combination regime compared to those on Foley's catheter. Maternal complications between groups were similar. CONCLUSION Combination of cervical sensitizers for labor induction in late third trimester among women with dead fetus attempting TOLAC resulted in higher proportion of vaginal births and might reduce risk of scar dehiscence due to requirement of a lower dose of oxytocin for augmentation.
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Affiliation(s)
- Subhankar Dasgupta
- Department of Obstetrics and Gynecology, Rampurhat Government Medical College &Hospital, Birbhum, West Bengal, India
| | - Jija Dasgupta
- AILABS, Adani Enterprises LTD, Kolkata, West Bengal, India
| | - Barnali Goswami
- Department of Obstetrics and Gynecology, College of Obstetrics Gynecology and Child Health, CRSS, Kolkata, West Bengal, India
| | - Joyeeta Mondal
- Department of obstetrics and gynecology, Diamond harbor government medical college and hospital, Diamond Harbor, West Bengal, India
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Silveira KSRD, Serra-Negra JM, Prado IM, Abreu LG, Reis TVD, Auad SM. Sleep disturbances are associated with feeding practices and age in preterm infants. Sleep Med 2023; 111:2-8. [PMID: 37696121 DOI: 10.1016/j.sleep.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Preterm infants are under risk of several shortcomings including sleep disturbances (SD). This cross-sectional study evaluated factors associated with SD in preterm and low birth weight infants in a reference center for preterm children at a University Hospital, southeastern Brazil. METHODS A hundred-four dyads of mothers-infants 0-3 years participated. Mothers answered an online questionnaire (Google Forms®) evaluating childbirth characteristics, gestational age, breastfeeding, bottle feeding, non-nutritive sucking habits and sociodemographic information. The Brazilian version of the Brief Infant Sleep Questionnaire (BISQ) evaluated SD. Bivariate and Logistic Regression analyses were performed (p < 0.05). RESULTS SD was present in 45.2% of the sample. Multivariate Logistic Regression Model showed that infants breastfed ≥3 times at night had 5.006 more chances to have SD (CI 95% = 1.229-20.400) compared to those who did not breastfeed at night. Infants who were bottle-fed 3 ≥ times at night had 6.952 more chances to have SD (CI = 95% = 1.364-35.427) compared to those who were bottle fed less frequently. The chance of SD decreased 6.6% (CI 95% = 0.889-0.982) for each increase of a month in infant's age, and infants from families with higher income had 3.535 more chances to have SD (CI 95% = 1.006-12.416). CONCLUSION The younger the child, a higher frequency of night feeding and belonging to higher income families were associated with SD. Recognizing the associated factors with SD in newborns and infants can aid families to better deal with this issue, promote better sleep quality and individualized counseling.
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Affiliation(s)
| | - Junia Maria Serra-Negra
- Department of Pediatric Dentistry - School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ivana Meyer Prado
- Department of Pediatric Dentistry - School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry - School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thaliny Vitória Diniz Reis
- Department of Pediatric Dentistry - School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Sheyla Marcia Auad
- Department of Pediatric Dentistry - School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Nishida T, Mahmoudinezhad G, Weinreb RN, Baxter SL, Eslani M, Liebmann JM, Girkin CA, Fazio MA, M Zangwill L, Moghimi S. Smoking and progressive retinal nerve fibre layer thinning in glaucoma. Br J Ophthalmol 2023; 107:1658-1664. [PMID: 36100361 DOI: 10.1136/bjo-2022-321237] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 09/01/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS To investigate the relationship between smoking and smoking intensity, and the rate of retinal nerve fibre layer (RNFL) thinning in patients with primary open angle glaucoma (POAG). METHODS In this longitudinal study, patients with POAG who had at least 3 years of follow-up with a minimum of 5 visits of optical coherence tomography (OCT) were enrolled. The smoking intensity was calculated as the pack-year at the baseline OCT. Univariable and multivariable linear mixed models were used to determine the effect of each parameter on the rates of RNFL thinning over time. Non-linear least-squares estimation with piecewise regression model was used to investigate the cut-off point for the relationship between circumpapillary RNFL thinning and smoking intensity. RESULTS A total of 466 eyes of 314 patients were included over the mean (95% CI) follow-up of 6.6 (6.4 to 6.7) years. Of the 314 patients, 121 (39%) had reported any history of smoking. Greater smoking intensity was associated with faster RNFL thinning (-0.06 (95% CI -0.11 to 0.00) µm/year per 10 pack-year higher; p=0.031) after adjusted for confounding factors. RNFL thinning became significantly faster when smoking intensity was >8 pack-year. CONCLUSIONS Smoking intensity is associated with faster rates of RNFL thinning. Evaluation of smoking intensity might add information to the assessment of risk of glaucoma progression. Future studies are required to explore if withdrawing smoking as a modifiable risk factor can decrease progression in patients with glaucoma.
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Affiliation(s)
- Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Golnoush Mahmoudinezhad
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Sally L Baxter
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
- Department of Biomedical Informatics, University of California San Diego, La Jolla, California, USA
| | - Medi Eslani
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York, USA
| | - Christopher A Girkin
- Bernard School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Massimo A Fazio
- Bernard School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
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