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Matsuki Y, Takashima M, Ueki M, Iwamoto M, Oiki S. Probing membrane deformation energy by KcsA potassium channel gating under varied membrane thickness and tension. FEBS Lett 2024. [PMID: 38880762 DOI: 10.1002/1873-3468.14956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/18/2024]
Abstract
This study investigated how membrane thickness and tension modify the gating of KcsA potassium channels when simultaneously varied. The KcsA channel undergoes global conformational changes upon gating: expansion of the cross-sectional area and longitudinal shortening upon opening. Thus, membranes impose differential effects on the open and closed conformations, such as hydrophobic mismatches. Here, the single-channel open probability was recorded in the contact bubble bilayer, by which variable thickness membranes under a defined tension were applied. A fully open channel in thin membranes turned to sporadic openings in thick membranes, where the channel responded moderately to tension increase. Quantitative gating analysis prompted the hypothesis that tension augmented the membrane deformation energy when hydrophobic mismatch was enhanced in thick membranes.
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Affiliation(s)
- Yuka Matsuki
- Department of Anesthesiology and Reanimatology, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Japan
- Life Science Innovation Center, University of Fukui, Yoshida-gun, Japan
| | - Masako Takashima
- Department of Molecular Neuroscience, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Japan
| | - Misuzu Ueki
- Life Science Innovation Center, University of Fukui, Yoshida-gun, Japan
- Department of Molecular Neuroscience, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Japan
| | - Masayuki Iwamoto
- Life Science Innovation Center, University of Fukui, Yoshida-gun, Japan
- Department of Molecular Neuroscience, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Japan
| | - Shigetoshi Oiki
- Biomedical Imaging Research Center, University of Fukui, Yoshida-gun, Japan
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Zhang J, Liu H, Yu H, Xu WX. Development of a novel staging classification for Siewert II adenocarcinoma of the esophagogastric junction after neoadjuvant chemotherapy. World J Gastrointest Oncol 2024; 16:2529-2542. [DOI: 10.4251/wjgo.v16.i6.2529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 03/09/2024] [Accepted: 04/15/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Stage classification for Siewert II adenocarcinoma of the esophagogastric junction (AEG) treated with neoadjuvant chemotherapy (NAC) has not been established.
AIM To investigate the optimal stage classification for Siewert II AEG with NAC.
METHODS A nomogram was established based on Cox regression model that analyzed variables associated with overall survival (OS) and disease-specific survival (DSS). The nomogram performance in terms of discrimination and calibration ability was evaluated using the likelihood-ratio test, Akaike information criterion, Harrell concordance index, time-receiver operating characteristic curve, and decision curve analysis.
RESULTS Data from 725 patients with Siewert type II AEG who underwent neoadjuvant therapy and gastrectomy were obtained from the Surveillance, Epidemiology, and End Results database. Univariate and multivariate analyses revealed that sex, marital status, race, ypT stage, and ypN stage were independent prognostic factors of OS, whereas sex, race, ypT stage, and ypN stage were independent prognostic factors for DSS. These factors were incorporated into the OS and DSS nomograms. Our novel nomogram model performed better in terms of OS and DSS prediction compared to the 8th American Joint Committee of Cancer pathological staging system for esophageal and gastric cancer. Finally, a user-friendly web application was developed for clinical use.
CONCLUSION The nomogram established specifically for patients with Siewert type II AEG receiving NAC demonstrated good prognostic performance. Validation using external data is warranted before its widespread clinical application.
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Affiliation(s)
- Jian Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Hao Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Hang Yu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Wei-Xiang Xu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
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Zhang J, Liu H, Yu H, Xu WX. Development of a novel staging classification for Siewert II adenocarcinoma of the esophagogastric junction after neoadjuvant chemotherapy. World J Gastrointest Oncol 2024; 16:2541-2554. [DOI: 10.4251/wjgo.v16.i6.2541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 03/09/2024] [Accepted: 04/15/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Stage classification for Siewert II adenocarcinoma of the esophagogastric junction (AEG) treated with neoadjuvant chemotherapy (NAC) has not been established.
AIM To investigate the optimal stage classification for Siewert II AEG with NAC.
METHODS A nomogram was established based on Cox regression model that analyzed variables associated with overall survival (OS) and disease-specific survival (DSS). The nomogram performance in terms of discrimination and calibration ability was evaluated using the likelihood-ratio test, Akaike information criterion, Harrell concordance index, time-receiver operating characteristic curve, and decision curve analysis.
RESULTS Data from 725 patients with Siewert type II AEG who underwent neoadjuvant therapy and gastrectomy were obtained from the Surveillance, Epidemiology, and End Results database. Univariate and multivariate analyses revealed that sex, marital status, race, ypT stage, and ypN stage were independent prognostic factors of OS, whereas sex, race, ypT stage, and ypN stage were independent prognostic factors for DSS. These factors were incorporated into the OS and DSS nomograms. Our novel nomogram model performed better in terms of OS and DSS prediction compared to the 8th American Joint Committee of Cancer pathological staging system for esophageal and gastric cancer. Finally, a user-friendly web application was developed for clinical use.
CONCLUSION The nomogram established specifically for patients with Siewert type II AEG receiving NAC demonstrated good prognostic performance. Validation using external data is warranted before its widespread clinical application.
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Affiliation(s)
- Jian Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Hao Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Hang Yu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Wei-Xiang Xu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
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Niu Y, Wen L, Yang Y, Zhang Y, Fu Y, Lu Q, Wang Y, Yu X, Yu X. Diagnostic performance of Node Reporting and Data System (Node-RADS) for assessing mesorectal lymph node in rectal cancer by CT. BMC Cancer 2024; 24:716. [PMID: 38862951 PMCID: PMC11165899 DOI: 10.1186/s12885-024-12487-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 06/07/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND To compare the diagnostic performance of the Node-RADS scoring system and lymph node (LN) size in preoperative LN assessment for rectal cancer (RC), and to investigate whether the selection of size as the primary criterion whereas morphology as the secondary criterion for LNs can be considered the preferred method for clinical assessment. METHODS Preoperative CT data of 146 RC patients treated with radical resection surgery were retrospectively analyzed. The Node-RADS score and short-axis diameter of size-prioritized LNs and the morphology-prioritized LNs were obtained. The correlations of Node-RADS score to the pN stage, LNM number and lymph node ratio (LNR) were investigated. The performances on assessing pathological lymph node metastasis were compared between Node-RADS score and short-axis diameter. A nomogram combined the Node-RADS score and clinical features was also evaluated. RESULTS Node-RADS score showed significant correlation with pN stage, LNM number and LNR (Node-RADS of size-prioritized LN: r = 0.600, 0.592, and 0.606; Node-RADS of morphology-prioritized LN: r = 0.547, 0.538, and 0.527; Node-RADSmax: r = 0.612, 0.604, and 0.610; all p < 0.001). For size-prioritized LN, Node-RADS achieved an AUC of 0.826, significantly superior to short-axis diameter (0.826 vs. 0.743, p = 0.009). For morphology-prioritized LN, Node-RADS exhibited an AUC of 0.758, slightly better than short-axis diameter (0.758 vs. 0.718, p = 0.098). The Node-RADS score of size-prioritized LN was significantly better than that of morphology-prioritized LN (0.826 vs. 0.758, p = 0.038). The nomogram achieved the best diagnostic performance (AUC = 0.861) than all the other assessment methods (p < 0.05). CONCLUSIONS The Node-RADS scoring system outperforms the short-axis diameter in predicting lymph node metastasis in RC. Size-prioritized LN demonstrates superior predictive efficacy compared to morphology-prioritized LN. The nomogram combined the Node-RADS score of size-prioritized LN with clinical features exhibits the best diagnostic performance. Moreover, a clear relationship was demonstrated between the Node-RADS score and the quantity-dependent pathological characteristics of LNM.
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Affiliation(s)
- Yue Niu
- Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, 410013, China
- Department of Diagnostic Radiology, Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Lu Wen
- Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, 410013, China
| | - Yanhui Yang
- Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, 410013, China
- Department of Diagnostic Radiology, Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Yi Zhang
- Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, 410013, China
- Department of Diagnostic Radiology, Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Yi Fu
- Medical department, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, 410013, China
| | - Qiang Lu
- Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, 410013, China
| | - Yu Wang
- Clinical and Technical Support, Philips Healthcare, Shanghai, 200072, China
| | - Xiao Yu
- Clinical and Technical Support, Philips Healthcare, Shanghai, 200072, China
| | - Xiaoping Yu
- Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, 410013, China.
- Department of Diagnostic Radiology, Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
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Hanson JL, Kahhalé I, Sen S. Integrating data science and neuroscience in developmental psychopathology: Formative examples and future directions. Dev Psychopathol 2024:1-8. [PMID: 38769837 DOI: 10.1017/s0954579424001056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
This commentary discusses opportunities for advancing the field of developmental psychopathology through the integration of data science and neuroscience approaches. We first review elements of our research program investigating how early life adversity shapes neurodevelopment and may convey risk for psychopathology. We then illustrate three ways that data science techniques (e.g., machine learning) can support developmental psychopathology research, such as by distinguishing between common and diverse developmental outcomes after stress exposure. Finally, we discuss logistical and conceptual refinements that may aid the field moving forward. Throughout the piece, we underscore the profound impact of Dr Dante Cicchetti, reflecting on how his work influenced our own, and gave rise to the field of developmental psychopathology.
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Affiliation(s)
- Jamie L Hanson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Learning Research & Development Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Isabella Kahhalé
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Learning Research & Development Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sriparna Sen
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Learning Research & Development Center, University of Pittsburgh, Pittsburgh, PA, USA
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Frowijn I, Masthoff E, Vermunt JK, Bogaerts S. Transgressive incidents targeted on staff in forensic psychiatric healthcare: a latent class analysis. Front Psychiatry 2024; 15:1394535. [PMID: 38832326 PMCID: PMC11145633 DOI: 10.3389/fpsyt.2024.1394535] [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: 03/04/2024] [Accepted: 04/22/2024] [Indexed: 06/05/2024] Open
Abstract
Transgressive incidents directed at staff by forensic patients occur frequently, leading to detrimental psychological and physical harm, underscoring urgency of preventive measures. These incidents, emerging within therapeutic relationships, involve complex interactions between patient and staff behavior. This study aims to identify clusters of transgressive incidents based on incident characteristics such as impact, severity, (presumed) cause, type of aggression, and consequences, using latent class analysis (LCA). Additionally, variations in incident clusters based on staff, patient, and context characteristics were investigated. A total of 1,184 transgressive incidents, reported by staff and targeted at staff by patients between 2018-2022, were extracted from a digital incident reporting system at Fivoor, a Dutch forensic psychiatric healthcare organisation. Latent Class Analysis revealed six incident classes: 1) verbal aggression with low impact; 2) verbal aggression with medium impact; 3) physical aggression with medium impact; 4) verbal menacing/aggression with medium impact; 5) physical aggression with high impact; and 6) verbal and physical menacing/aggression with high impact. Significant differences in age and gender of both staff and patients, staff function, and patient diagnoses were observed among these classes. Incidents with higher impact were more prevalent in high security clinics, while lower-impact incidents were more common in clinics for patients with intellectual disabilities. Despite limitations like missing information, tailored prevention approaches are needed due to varying types of transgressive incidents across patients, staff, and units.
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Affiliation(s)
- Iris Frowijn
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
- Fivoor Science and Treatment Innovation (FARID), Rotterdam, Netherlands
| | - Erik Masthoff
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
- Fivoor Science and Treatment Innovation (FARID), Rotterdam, Netherlands
| | - Jeroen K. Vermunt
- Department of Methodology and Statistics, Tilburg University, Tilburg, Netherlands
| | - Stefan Bogaerts
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
- Fivoor Science and Treatment Innovation (FARID), Rotterdam, Netherlands
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Yoseph A, Teklesilasie W, Guillen-Grima F, Astatkie A. Community-Based Health Education Led by Women's Groups Significantly Improved Maternal Health Service Utilization in Southern Ethiopia: A Cluster Randomized Controlled Trial. Healthcare (Basel) 2024; 12:1045. [PMID: 38786455 PMCID: PMC11121210 DOI: 10.3390/healthcare12101045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/09/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE This study aimed to evaluate the effect of health education intervention (HEI) on maternal health service utilization (MHSU) in southern Ethiopia. METHODS From 10 January to 1 August 2023, a community-based, two-arm, parallel-group cluster randomized controlled trial (cRCT) was conducted among pregnant mothers in the Northern Zone of Sidama National Regional State, Ethiopia. We utilized multilevel mixed-effects modified Poisson regression with robust variance to control for the effects of clustering and potential confounders. The level of significance was adjusted for multiple comparisons. RESULTS The overall utilization of at least one antenatal care (ANC) visit was 90.2% in the treatment group and 59.5% in the comparator group (χ2 = 89.22, p < 0.001). Health facility delivery (HFD) utilization was considerably different between the treatment group (74.3%) and the comparator group (50.8%) (χ2 = 70.50, p < 0.001). HEI significantly increased ANC utilization (adjusted risk ratio [ARR]: 1.32; 99% CI: 1.12-1.56) and HFD utilization (ARR: 1.24; 99% CI: 1.06-1.46). The utilization of at least one postnatal care (PNC) service was 65.4% in the treatment group and 52.1% in the comparator group (χ2 = 19.51, p = 0.01). However, after controlling for the effects of confounders and clustering, the impact of HEI on PNC utilization was insignificant between the two groups (ARR: 1.15; 99% CI: 0.89-1.48). CONCLUSION A community-based HEI significantly increased ANC and HFD utilization but did not increase PNC utilization. Expanding the HEI with certain modifications will have a superior effect on improving MHSU. TRIAL REGISTRATION NUMBER NCT05865873.
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Affiliation(s)
- Amanuel Yoseph
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa P.O. Box 1560, Ethiopia; (W.T.); (A.A.)
| | - Wondwosen Teklesilasie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa P.O. Box 1560, Ethiopia; (W.T.); (A.A.)
| | - Francisco Guillen-Grima
- Department of Health Sciences, Public University of Navarra, 31008 Pamplona, Spain
- Healthcare Research Institute of Navarra (IdiSNA), 31008 Pamplona, Spain
- Department of Preventive Medicine, Clinica Universidad de Navarra, 31008 Pamplona, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, 46980 Madrid, Spain
| | - Ayalew Astatkie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa P.O. Box 1560, Ethiopia; (W.T.); (A.A.)
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Cai Y, Liu J, Yang H, Zheng L, Wu D, Xiao E, Dai Y. Utilizing multicompartmental restriction spectrum magnetic resonance imaging for liver fibrosis characterization in a mouse model. Med Phys 2024. [PMID: 38753987 DOI: 10.1002/mp.17126] [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: 10/07/2023] [Revised: 04/01/2024] [Accepted: 04/05/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Currently, an advanced imaging method may be necessary for magnetic resonance imaging (MRI) to diagnosis and quantify liver fibrosis (LF). PURPOSE To evaluate the feasibility of the multicompartmental restriction spectrum imaging (RSI) model to characterize LF in a mouse model. METHODS Thirty mice with carbon tetrachloride (CCl4)-induced LF and eight control mice were investigated using multi-b-value (ranging from 0 to 2000 s/mm2) diffusion-weighted imaging (DWI) on a 3T scanner. DWI data were processed using RSI model (2-5 compartments) with the Bayesian Information Criterion (BIC) determining the optimal model. Conventional ADC value and signal fraction of each compartment in the optimal RSI model were compared across groups. Receiver operating characteristics (ROC) curve analysis was performed to determine the diagnosis performances of different parameters, while Spearman correlation analysis was employed to investigate the correlation between different tissue compartments and the stage of LF. RESULTS According to BIC results, a 4-compartment RSI model (RSI4) with optimal ADCs of 0.471 × 10-3, 1.653 × 10-3, 9.487 × 10-3, and > 30 × 10-3, was the optimal model to characterize LF. Significant differences in signal contribution fraction of the C1 and C3 compartments were observed between LF and control groups (P = 0.018 and 0.003, respectively). ROC analysis showed that RSI4-C3 was the most effective single diffusion parameter for characterizing LF (AUC = 0.876, P = 0.003). Furthermore, the combination of ADC values and RSI4-C3 value increased the diagnosis performance significantly (AUC = 0.894, P = 0.002). CONCLUSION The 4-compartment RSI model has the potential to distinguish LF from the control group based on diffusion parameters. RSI4-C3 showed the highest diagnostic performance among all the parameters. The combination of ADC and RSI4-C3 values further improved the discrimination performance.
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Affiliation(s)
- Yeyu Cai
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Jiayi Liu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - HaiTao Yang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Liyun Zheng
- Shanghai Institute of Medical Imaging, Shanghai, China
| | - Dongmei Wu
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronics Science, East China Normal University, Shanghai, China
| | - Enhua Xiao
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yongming Dai
- School of Biomedical Engineering & State Key Laboratory of Advanced Medical Materials and Devices, ShanghaiTech University, Shanghai, China
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De Salazar PM, Kamau A, Cavelan A, Akech S, Mpimbaza A, Snow RW, Penny MA. Severe outcomes of malaria in children under time-varying exposure. Nat Commun 2024; 15:4069. [PMID: 38744878 PMCID: PMC11094066 DOI: 10.1038/s41467-024-48191-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 04/22/2024] [Indexed: 05/16/2024] Open
Abstract
In malaria epidemiology, interpolation frameworks based on available observations are critical for policy decisions and interpreting disease burden. Updating our understanding of the empirical evidence across different populations, settings, and timeframes is crucial to improving inference for supporting public health. Here, via individual-based modeling, we evaluate a large, multicountry, contemporary Plasmodium falciparum severe malaria dataset to better understand the relationship between prevalence and incidence of malaria pediatric hospitalizations - a proxy of malaria severe outcomes- in East-Africa. We find that life-long exposure dynamics, and subsequent protection patterns in children, substantially determine the likelihood of malaria hospitalizations relative to ongoing prevalence at the population level. Unsteady transmission patterns over a lifetime in children -increasing or decreasing- lead to an exponential relationship of hospitalization rates versus prevalence rather than the asymptotic pattern observed under steady transmission. Addressing this increase in the complexity of malaria epidemiology is crucial to update burden assessments via inference models that guide current and future policy decisions.
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Affiliation(s)
- Pablo M De Salazar
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Alice Kamau
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Aurelien Cavelan
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Samuel Akech
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Arthur Mpimbaza
- Child Health and Development Centre, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Robert W Snow
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Melissa A Penny
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
- Telethon Kids Institute, Nedlands, WA, Australia.
- Centre for Child Health Research, University of Western Australia, Crawley, WA, Australia.
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Fox KR, Rausch JR, Grant VR, Ferketich AK, Groner JA, Garg V, Cua CL, Jackson JL. Associations of Impulsivity and Risky Decision-Making with E-Cigarette-Related Outcomes Among Adolescents with Congenital Heart Disease: Variable- and Person-Oriented Approaches. Behav Med 2024:1-12. [PMID: 38706412 DOI: 10.1080/08964289.2024.2347226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 04/01/2024] [Indexed: 05/07/2024]
Abstract
Adolescents with congenital heart disease (CHD) have elevated risk for acquired cardiovascular complications, increasing their vulnerability to e-cigarette-related health harms. Impulsivity and risky decision-making have been associated with adolescent substance use, but the relationships between these factors and e-cigarette-related outcomes among cardiovascular at-risk adolescents with CHD are unknown. This cross-sectional study aimed to (a) determine the associations of impulsivity and risky decision-making with e-cigarette-related outcomes (i.e. susceptibility, ever use, perceptions of harm and addictiveness) via variable-oriented analysis (logistic regression), (b) identify groups of adolescents with similar profiles of impulsivity and risky decision-making via exploratory person-oriented analysis (latent profile analysis; LPA), and (c) examine differences on e-cigarette-related outcomes between profile groups. Adolescents aged 12 to 18 years with CHD (N = 98) completed a survey assessing impulsivity facets (Short UPPS-P) and e-cigarette-related outcomes and were administered a risky decision-making task (Iowa Gambling Task, Version 2; IGT2). In variable-oriented analyses, impulsivity facets (negative urgency, positive urgency, lack of premeditation) but not risky decision-making were associated with e-cigarette susceptibility and ever use. The exploratory LPA identified two groups with similar patterns of responding on the Short UPPS-P and IGT2 labeled "Low Impulsivity" and "High Impulsivity," which were primarily characterized by significant differences in negative and positive urgency. Adolescents in the High Impulsivity group had increased odds of e-cigarette susceptibility but not ever use compared to the Low Impulsivity group. This work indicates that strategies to prevent e-cigarette use among adolescents with CHD may be enhanced by addressing impulsivity, particularly negative and positive urgency.
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Affiliation(s)
- Kristen R Fox
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Joseph R Rausch
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Victoria R Grant
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Amy K Ferketich
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Judith A Groner
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Vidu Garg
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
- Center for Cardiovascular Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Clifford L Cua
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jamie L Jackson
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
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11
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Kumar S, Davidson CA, Jain R, Saini R. Factor structure and measurement invariance of Schizotypal Personality Questionnaire-Brief Revised (Updated) in India. Early Interv Psychiatry 2024; 18:312-319. [PMID: 37650484 DOI: 10.1111/eip.13463] [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: 03/02/2023] [Revised: 05/23/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
AIM Schizotypal Personality Questionnaire-Brief Revised-Updated (SPQ-BRU) is an easy-to-conduct, theoretically consistent, and psychometrically better measure of schizotypal personality. However, its study is limited to developed countries. Thus, in the present study, we tested the factor structure and measurement invariance of SPQ-BRU in India. METHODS A sample of 734 college students was selected from two sites (n = 614 from Muzaffarnagar in western Uttar Pradesh and n = 120 from Guhana in Haryana). Confirmatory factor analysis was used to test the good fitness of the different models of SPQ-BRU and the measurement invariance across sex and region. RESULTS The first-order nine-factor model was a better-fit model (among a set of first-order and second-order models), whereas the second-order three-factor model was a more parsimonious good-fit model of SPQ-BRU. The nine-factor model was strongly invariant across sex and region. Women had higher social anxiety, ideas of reference, and lower constricted affect than men. Moreover, the Gohana sample was higher on several schizotypal personality facades than the Muzaffarnagar sample. CONCLUSIONS The present study supported the cross-cultural validity of schizotypal personality and partially established a reliable and valid SPQ-BRU-Hindi language version.
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Affiliation(s)
- Sanjay Kumar
- Department of Psychology, D.A.V. College, Muzaffarnagar, India
| | - Charlie A Davidson
- Department of Psychology, Emory University, Atlanta, Georgia, USA
- Clinical Development Lead, Akin Mental Health, San Francisco, California, USA
| | - Ranjeeta Jain
- Department of Psychology, D.A.V. College, Muzaffarnagar, India
| | - Reena Saini
- Department of Psychology, D.A.V. College, Muzaffarnagar, India
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12
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Meyer MR, Kirmess KM, Eastwood S, Wente‐Roth TL, Irvin F, Holubasch MS, Venkatesh V, Fogelman I, Monane M, Hanna L, Rabinovici GD, Siegel BA, Whitmer RA, Apgar C, Bateman RJ, Holtzman DM, Irizarry M, Verbel D, Sachdev P, Ito S, Contois J, Yarasheski KE, Braunstein JB, Verghese PB, West T. Clinical validation of the PrecivityAD2 blood test: A mass spectrometry-based test with algorithm combining %p-tau217 and Aβ42/40 ratio to identify presence of brain amyloid. Alzheimers Dement 2024; 20:3179-3192. [PMID: 38491912 PMCID: PMC11095426 DOI: 10.1002/alz.13764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/25/2024] [Accepted: 01/31/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND With the availability of disease-modifying therapies for Alzheimer's disease (AD), it is important for clinicians to have tests to aid in AD diagnosis, especially when the presence of amyloid pathology is a criterion for receiving treatment. METHODS High-throughput, mass spectrometry-based assays were used to measure %p-tau217 and amyloid beta (Aβ)42/40 ratio in blood samples from 583 individuals with suspected AD (53% positron emission tomography [PET] positive by Centiloid > 25). An algorithm (PrecivityAD2 test) was developed using these plasma biomarkers to identify brain amyloidosis by PET. RESULTS The area under the receiver operating characteristic curve (AUC-ROC) for %p-tau217 (0.94) was statistically significantly higher than that for p-tau217 concentration (0.91). The AUC-ROC for the PrecivityAD2 test output, the Amyloid Probability Score 2, was 0.94, yielding 88% agreement with amyloid PET. Diagnostic performance of the APS2 was similar by ethnicity, sex, age, and apoE4 status. DISCUSSION The PrecivityAD2 blood test showed strong clinical validity, with excellent agreement with brain amyloidosis by PET.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Lucy Hanna
- Center for Statistical SciencesBrown University School of Public HealthProvidenceRhode IslandUSA
| | | | | | | | - Charles Apgar
- American College of RadiologyPhiladelphiaPennsylvaniaUSA
| | | | | | | | | | | | | | | | | | | | | | - Tim West
- C2N DiagnosticsSt. LouisMissouriUSA
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13
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Lopez Naranjo C, Razzaq FA, Li M, Wang Y, Bosch‐Bayard JF, Lindquist MA, Gonzalez Mitjans A, Garcia R, Rabinowitz AG, Anderson SG, Chiarenza GA, Calzada‐Reyes A, Virues‐Alba T, Galler JR, Minati L, Bringas Vega ML, Valdes‐Sosa PA. EEG functional connectivity as a Riemannian mediator: An application to malnutrition and cognition. Hum Brain Mapp 2024; 45:e26698. [PMID: 38726908 PMCID: PMC11082925 DOI: 10.1002/hbm.26698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 04/05/2024] [Accepted: 04/12/2024] [Indexed: 05/13/2024] Open
Abstract
Mediation analysis assesses whether an exposure directly produces changes in cognitive behavior or is influenced by intermediate "mediators". Electroencephalographic (EEG) spectral measurements have been previously used as effective mediators representing diverse aspects of brain function. However, it has been necessary to collapse EEG measures onto a single scalar using standard mediation methods. In this article, we overcome this limitation and examine EEG frequency-resolved functional connectivity measures as a mediator using the full EEG cross-spectral tensor (CST). Since CST samples do not exist in Euclidean space but in the Riemannian manifold of positive-definite tensors, we transform the problem, allowing for the use of classic multivariate statistics. Toward this end, we map the data from the original manifold space to the Euclidean tangent space, eliminating redundant information to conform to a "compressed CST." The resulting object is a matrix with rows corresponding to frequencies and columns to cross spectra between channels. We have developed a novel matrix mediation approach that leverages a nuclear norm regularization to determine the matrix-valued regression parameters. Furthermore, we introduced a global test for the overall CST mediation and a test to determine specific channels and frequencies driving the mediation. We validated the method through simulations and applied it to our well-studied 50+-year Barbados Nutrition Study dataset by comparing EEGs collected in school-age children (5-11 years) who were malnourished in the first year of life with those of healthy classmate controls. We hypothesized that the CST mediates the effect of malnutrition on cognitive performance. We can now explicitly pinpoint the frequencies (delta, theta, alpha, and beta bands) and regions (frontal, central, and occipital) in which functional connectivity was altered in previously malnourished children, an improvement to prior studies. Understanding the specific networks impacted by a history of postnatal malnutrition could pave the way for developing more targeted and personalized therapeutic interventions. Our methods offer a versatile framework applicable to mediation studies encompassing matrix and Hermitian 3D tensor mediators alongside scalar exposures and outcomes, facilitating comprehensive analyses across diverse research domains.
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Affiliation(s)
- Carlos Lopez Naranjo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Fuleah Abdul Razzaq
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Min Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
- Hangzhou Dianzi UniversityZhejiangHangzhouChina
| | - Ying Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
| | | | | | - Anisleidy Gonzalez Mitjans
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
- Montreal Neurological Institute‐HospitalMcGill UniversityMontrealQuebecCanada
| | - Ronaldo Garcia
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
| | | | - Simon G. Anderson
- The George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health ResearchUniversity of the West IndiesCave HillBarbados
| | - Giuseppe A. Chiarenza
- Centro Internazionale Disturbi di Apprendimento, Attenzione, Iperattività (CIDAAI)MilanItaly
| | | | | | - Janina R. Galler
- Division of Pediatric Gastroenterology and NutritionMassachusetts General Hospital for ChildrenBostonMassachusettsUSA
| | - Ludovico Minati
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
- Center for Mind/Brain Science (CIMeC)University of TrentoTrentoItaly
| | - Maria L. Bringas Vega
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
- Cuban Center for NeuroscienceLa HabanaCuba
| | - Pedro A. Valdes‐Sosa
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
- Cuban Center for NeuroscienceLa HabanaCuba
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14
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Sharwood LN, Waller M, Draper B, Shand F. Exploring community mental health service use following hospital-treated intentional self-harm among older Australians: a survival analysis. Int Psychogeriatr 2024; 36:405-414. [PMID: 37960921 DOI: 10.1017/s1041610223000959] [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] [Indexed: 11/15/2023]
Abstract
OBJECTIVES This study aimed to examine the impact of community mental health (CMH) care following index hospital-treated intentional self-harm (ISH) on all-cause mortality. A secondary aim was to describe patterns of CMH care surrounding index hospital-treated ISH. DESIGN A longitudinal whole-of-population record linkage study was conducted (2014-2019), with index ISH hospitalization (Emergency Department and/or hospital admissions) linked to all available hospital, deaths/cause of death, and CMH data. SETTING Australia's most populous state, New South Wales (NSW) comprised approximately 7.7 million people during the study period. CMH services are provided statewide, to assess and treat non-admitted patients, including post-discharge review. PARTICIPANTS Individuals with an index hospital presentation in NSW of ISH during the study period, aged 45 years or older. INTERVENTION CMH care within 14 days from index, versus not. MEASUREMENTS Cox-proportionate hazards regression analysis evaluated all-cause mortality risk, adjusted for relevant covariates. RESULTS Totally, 24,544 persons aged 45 years or older experienced a nonfatal hospital-treated ISH diagnosis between 2014 and 2019. CMH care was received by 56% within 14 days from index. Survival analysis demonstrated this was associated with 34% lower risk of death, adjusted for age, sex, marital status, index diagnosis, and 14-day hospital readmission (HR 0.66, 95% CI 0.58, 0.74, p < 0.001). Older males and chronic injury conveyed significantly greater risk of death overall. CONCLUSIONS CMH care within 14 days of index presentation for self-harm may reduce the risk of all-cause mortality. Greater effort is needed to engage older males presenting for self-harm in ongoing community mental health care.
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Affiliation(s)
- Lisa N Sharwood
- Black Dog Institute, University of New South Wales, Sydney, Kensington, NSW, Australia
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- School of Engineering, University of Technology Sydney, Sydney, NSW, Australia
- School of Population Health, University of NSW, Sydney
| | | | - Brian Draper
- Eastern Suburbs Older Persons' Mental Health Service, Randwick, NSW, 2031, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales,Sydney, NSW, Australia
| | - Fiona Shand
- Black Dog Institute, University of New South Wales, Sydney, Kensington, NSW, Australia
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15
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Pan Y, Wang H, Geng Y, Lai J, Hu S. Latent Profile Analysis of Suicidal Ideation in Chinese Individuals with Bipolar Disorder. Behav Sci (Basel) 2024; 14:360. [PMID: 38785851 PMCID: PMC11117804 DOI: 10.3390/bs14050360] [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: 02/16/2024] [Revised: 04/02/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Individuals with bipolar disorder (BD) have a greater suicide risk than the general population. In this study, we employed latent profile analysis (LPA) to explore whether Chinese individuals with different phases of BD differed at the levels of suicidal ideation. We recruited 517 patients. Depressive symptoms were measured using the 24-item Hamilton Depression Rating Scale (HAMD-24), and manic symptoms were evaluated using the Young Mania Rating Scale (YMRS). The extent of suicidal thoughts was determined through the Beck Scale for Suicide Ideation (BSSI). The scores of HAMD and YMRS were used to perform LPA. LPA categorized participants into three classes: one exhibiting severe depressive and mild manic symptomatology, another showing severe depressive and severe manic symptomatology, and the third one displaying severe depressive and intermediate manic symptomatology. Suicidal ideation levels were found to be remarkably elevated across all three classes. Additionally, the three classes showed no significant differences in terms of suicidal ideation. Our research confirms the link between depressive symptoms and suicide, independent of the manic symptoms. These findings carry meaning as they provide insight into the suicide risk profiles within different phases of BD.
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Affiliation(s)
- Yanmeng Pan
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (Y.P.); (H.W.); (Y.G.)
| | - Huaizhi Wang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (Y.P.); (H.W.); (Y.G.)
- School of Psychiatry, Wenzhou Medical University, Wenzhou 325035, China
| | - Yimeng Geng
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (Y.P.); (H.W.); (Y.G.)
| | - Jianbo Lai
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (Y.P.); (H.W.); (Y.G.)
| | - Shaohua Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (Y.P.); (H.W.); (Y.G.)
- Nanhu Brain-Computer Interface Institute, Hangzhou 310003, China
- Zhejiang Key Laboratory of Precision Psychiatry, Hangzhou 310003, China
- Brain Research Institute, Zhejiang University, Hangzhou 310003, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou 310003, China
- MOE Frontier Science Center for Brain Science and Brain-machine Integration, Zhejiang University, Hangzhou 310003, China
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310003, China
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16
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Girgis RE, Manandhar‐Shrestha NK, Krishnan S, Murphy ET, Loyaga‐Rendon R. Predictors of early mortality after lung transplantation for idiopathic pulmonary arterial hypertension. Pulm Circ 2024; 14:e12371. [PMID: 38646412 PMCID: PMC11027072 DOI: 10.1002/pul2.12371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/28/2024] [Accepted: 04/09/2024] [Indexed: 04/23/2024] Open
Abstract
Lung transplantation remains an important therapeutic option for idiopathic pulmonary arterial hypertension (IPAH), yet short-term survival is the poorest among the major diagnostic categories. We sought to develop a prediction model for 90-day mortality using the United Network for Organ Sharing database for adults with IPAH transplanted between 2005 and 2021. Variables with a p value ≤ 0.1 on univariate testing were included in multivariable analysis to derive the best subset model. The cohort comprised 693 subjects, of whom 71 died (10.2%) within 90 days of transplant. Significant independent predictors of early mortality were: extracorporeal circulatory support and/or mechanical ventilation at transplant (OR: 3; CI: 1.4-5), pulmonary artery diastolic pressure (OR: 1.3 per 10 mmHg; CI: 1.07-1.56), forced expiratory volume in the first second percent predicted (OR: 0.8 per 10%; CI: 0.7-0.94), recipient total bilirubin >2 mg/dL (OR: 3; CI: 1.4-7.2) and ischemic time >6 h (OR: 1.7, CI: 1.01-2.86). The predictive model was able to distinguish 25% of the cohort with a mortality of ≥20% from 49% with a mortality of ≤5%. We conclude that recipient variables associated with increasing severity of pulmonary vascular disease, including pretransplant advanced life support, and prolonged ischemic time are important risk factors for 90-day mortality after lung transplant for IPAH.
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Affiliation(s)
- Reda E. Girgis
- Richard Devos Heart and Lung Transplant ProgramCorewell Health and Michigan State University College of Human MedicineGrand RapidsMichiganUSA
| | - Nabin K. Manandhar‐Shrestha
- Richard Devos Heart and Lung Transplant ProgramCorewell Health and Michigan State University College of Human MedicineGrand RapidsMichiganUSA
| | - Sheila Krishnan
- Richard Devos Heart and Lung Transplant ProgramCorewell Health and Michigan State University College of Human MedicineGrand RapidsMichiganUSA
| | - Edward T. Murphy
- Richard Devos Heart and Lung Transplant ProgramCorewell Health and Michigan State University College of Human MedicineGrand RapidsMichiganUSA
| | - Renzo Loyaga‐Rendon
- Richard Devos Heart and Lung Transplant ProgramCorewell Health and Michigan State University College of Human MedicineGrand RapidsMichiganUSA
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Okada Y, Usui Y, Hayashi H, Nishikubo M, Toubai T, Uchida N, Tanaka M, Onizuka M, Takahashi S, Doki N, Uehara Y, Maruyama Y, Ishiwata K, Kawakita T, Sawa M, Eto T, Ishimaru F, Kato K, Fukuda T, Atsuta Y, Kanda J, Yakushijin K, Nakasone H. Development of an umbilical cord blood transplantation-specific nonrelapse mortality risk assessment score. Blood Adv 2024; 8:1359-1368. [PMID: 38163321 PMCID: PMC10945135 DOI: 10.1182/bloodadvances.2023011837] [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: 10/02/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024] Open
Abstract
ABSTRACT Higher rate of nonrelapse mortality (NRM) remains yet to be resolved in umbilical cord blood transplantation (UCBT). Considering that UCBT has some unique features compared with allogeneic hematopoietic cell transplantation from other graft sources, a UCBT-specific NRM risk assessment system is required. Thus, in this study, we sought to develop a UCBT-specific NRM Risk Assessment (CoBRA) score. Using a nationwide registry database, we retrospectively analyzed 4437 recipients who had received their first single-unit UCBT. Using the backward elimination method, we constructed the CoBRA score in a training cohort (n = 2687), which consisted of recipients age ≥55 years (score 2), hematopoietic cell transplantation-specific comorbidity index ≥3 (score 2), male recipient, graft-versus-host disease prophylaxis other than tacrolimus in combination with methotrexate, performance status (PS) 2 to 4, HLA allele mismatch ≥ 2, refined Disease Risk Index high risk, myeloablative conditioning, and CD34+ cell doses < 0.82 × 105/kg (score 1 in each). The recipients were categorized into 3 groups: low (0-4 points), intermediate (5-7 points), and high (8-11 points) groups according to the CoBRA score. In the validation cohort (n = 1750), the cumulative incidence of NRM at 2 years was 14.9%, 25.5%, and 47.1% (P < .001), and 2-year overall survival (OS) was 74.2%, 52.7%, and 26.3% (P < .001) in the low, intermediate, and high groups, respectively. In summary, the CoBRA score could predict the NRM risk as well as OS after UCBT. Further external validation will be needed to confirm the significance of the CoBRA score.
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Affiliation(s)
- Yosuke Okada
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Yoshiaki Usui
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Hiromi Hayashi
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masashi Nishikubo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tomomi Toubai
- Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, Tokyo, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Makoto Onizuka
- Department of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Satoshi Takahashi
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Yasufumi Uehara
- Department of Hematology, Kitakyushu City Hospital Organization, Kitakyushu Municipal Medical Center, Fukuoka, Japan
| | - Yumiko Maruyama
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Japan
| | - Kazuya Ishiwata
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, Kajigaya, Japan
| | - Toshiro Kawakita
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Masashi Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Fumihiko Ishimaru
- Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
| | - Koji Kato
- Central Japan Cord Blood Bank, Aichi, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Junya Kanda
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | - Hideki Nakasone
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
- Division of Emerging Medicine for Integrated Therapeutics (EMIT), Center for Molecular Medicine, Jichi Medical University, Shimotsuke, Japan
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18
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Scaglione NM, Ward RM, Buben A, Turrisi R. Alcohol's Role in Sexual Decision Making in First-Year College Women: An Event-Level Assessment. PSYCHOLOGY OF WOMEN QUARTERLY 2024; 48:121-132. [PMID: 38895110 PMCID: PMC11185828 DOI: 10.1177/03616843231186319] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Sexual decision making is often grounded in social scripts that can be detrimental to women's healthy relationship and sexual development during the transition to college. Little is known about the malleable decision-making processes and drinking behaviors that influence sexual behaviors from day-to-day. We examined whether women were more likely to engage in sexual behaviors on days they had higher intentions and willingness to engage in sex or drink alcohol. We also explored interactions between sex- and alcohol-related decision constructs. Eighty-two first-year college women completed 14-days of ecological momentary assessment, reporting on alcohol- and sex-related intentions and willingness (3x daily) and daily drinking and sexual behaviors. We found partial support for our hypotheses: intentions and willingness to have sex were positively associated with sex behaviors, but willingness to drink was negatively associated with sex behaviors. Heavy drinking was associated with sexual behavior, even when women indicated no prior willingness to engage in sexual behavior on those days. Findings highlight the need to address event-level variability in sexual decision making, with a particular focus on how alcohol impacts these processes. Further, the robust association between sexual intentions and behavior suggests intention setting may be a particularly useful sexual empowerment education tool.
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Affiliation(s)
- Nichole M. Scaglione
- Department of Health Education and Behavior, University of Florida, Gainesville, FL
| | - Rose Marie Ward
- The Graduate School & Department of Psychology, University of Cincinnati, Cincinnati, OH
| | - Alex Buben
- Center for Behavioral Health Epidemiology, Implementation, and Evaluation Research, Community Health Research Division, RTI International, Research Triangle Park, NC
| | - Rob Turrisi
- Department of Biobehavioral Health & Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA
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19
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Nice J, Saltzman L, Thurman TR, Zani B. Latent class analysis of ART barriers among adolescents and young adults living with HIV in South Africa. AIDS Care 2024:1-9. [PMID: 38422434 DOI: 10.1080/09540121.2024.2307389] [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: 07/27/2023] [Accepted: 01/10/2024] [Indexed: 03/02/2024]
Abstract
This study examined adherence to antiretroviral therapy (ART) among adolescents and young adults living with HIV in South Africa. Using survey data from 857 youth on ART, the study employed latent class analysis to identify subgroups based on self-reported reasons for missed ART doses. Three distinct classes emerged: the largest class (85%) occasionally forgot to take their medication or missed a dose because others were around, the second class (9%) missed doses only due to feeling sick, and the third class (6%) faced multiple barriers such as forgetting, feeling sick, worrying about side effects, or doubting the effectiveness of ART. Youth who reported multiple barriers to adherence had significantly lower adjusted odds (AOR = 0.35, 95% CI = 0.16-0.78) of reporting 90% past month adherence compared to those who occasionally forgot their medication. Additionally, contextual factors such as food security, being treated well at the clinic, and being accompanied to the clinic were associated with higher odds of adherence. The findings highlight the importance of considering co-occurring barriers to adherence and tailoring interventions accordingly. Addressing contextual factors, such as ensuring food security and providing supportive clinic environments, is also crucial for promoting optimal adherence among adolescents and young adults living with HIV.
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Affiliation(s)
- Johanna Nice
- Highly Vulnerable Children Research Center, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
- International Health and Sustainable Development department, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Leia Saltzman
- Tulane University School of Social Work, New Orleans, LA, USA
| | - Tonya R Thurman
- Highly Vulnerable Children Research Center, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
- International Health and Sustainable Development department, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
- Tulane International LLC, Cape Town, South Africa
| | - Babalwa Zani
- Highly Vulnerable Children Research Center, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
- Tulane International LLC, Cape Town, South Africa
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20
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Sánchez J, Jaimes F, García E, Zakzuk J, Cardona R, Velasquez M. Risk calculator of the clinical response to antihistamines in chronic urticaria: Development and internal validation. PLoS One 2024; 19:e0295791. [PMID: 38394074 PMCID: PMC10889609 DOI: 10.1371/journal.pone.0295791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/28/2023] [Indexed: 02/25/2024] Open
Abstract
Early detection of CSU patients with low probability of a clinical response with antihistamines could undergo prompt initiation of therapeutic alternatives. The aim of the study was to develop and internally validate a model for predicting the clinical response to antihistamines in adult patients with chronic spontaneous urticaria (CSU), who consult allergology and dermatology care centers. A cohort of CSU patients, recruited from four participating centers, were followed up for 12 months. Fifteen candidate variables were selected to be included in the multivariate model and then internal validation was done with bootstrap analysis with 1000 simulations. The outcome variable, clinical response to antihistamines, was evaluated with the UAS (Urticaria Activity Score) scale for seven days: "No response to antihistamines" was defined as UAS7 ≥7 points after at least one month with a maximum dose of antihistamines, while "Response to antiH1" was defined as UAS7 ≤6 points for at least three months with the use of antiH1. A total of 790 patients were included. Among the different models analyzed, the model that included age, angioedema, anxiety/depression, time with the disease, NSAIDs (Non-steroidal anti-inflammatory drugs) intolerance, and UAS7 baseline was considered the one with the best performance (accuracy 0.675, HL 0.87, AUC 0.727). The internal validation analyses demonstrated good consistency of the model. In conclusion, this prediction model identifies the probability of response to antihistamines in patients with chronic spontaneous urticaria. The model could be useful for a personalized therapeutic approach according to individual patient risk.
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Affiliation(s)
- Jorge Sánchez
- Group of Clinical and Experimental Allergy, "IPS University" Clinic, University of Antioquia, Medellín, Colombia
| | - Fabian Jaimes
- Internal Medicine Department, “San Vicente” Clinic, University of Antioquia, Medellín, Colombia
| | | | - Josefina Zakzuk
- Health Economics Research Group, ALZAK Foundation, Immunological Research Institute, University of Cartagena, Cartagena, Colombia
| | - Ricardo Cardona
- Group of Clinical and Experimental Allergy, "IPS University" Clinic, University of Antioquia, Medellín, Colombia
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21
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Vrooman JC, Boelhouwer J, Gijsberts M. A contemporary class structure: Capital disparities in The Netherlands. PLoS One 2024; 19:e0296443. [PMID: 38295016 PMCID: PMC10830037 DOI: 10.1371/journal.pone.0296443] [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: 05/19/2023] [Accepted: 12/13/2023] [Indexed: 02/02/2024] Open
Abstract
The academic and public debate on social inequality has recently been fuelled by large disparities in income and wealth, profound changes in the labour market, and other emerging cleavages in post-industrial societies. This article contributes to the discussion by arguing that class divisions are theoretically based on four types of capital: people's economic means, their social capital, their cultural resources, and the combination of their health and attractiveness ('person capital'). From this premise, the social structure of the Netherlands is examined. A dedicated survey was linked to microdata from the national population register, tax authorities and benefit agencies. Using latent class analysis, we assess contingencies in the distribution of the different resources, and identify a structure consisting of six capital groups. The established upper echelon (15.5% of the adult population) has the most capital, followed by the privileged younger people (12.7%), the employed middle echelon (26.9%) and the comfortable retirees (16.6%). Total capital is lowest among the insecure workers (13.5%) and the precariat (14.8%). Each social class has a distinctive mix of the four types of capital, highlighting the need to look beyond economic differences in order to comprehend structural inequality. The results of this study also indicate that resource disparities between classes coincide with other forms of social hierarchy and contrasts by age. Moreover, the contemporary class structure is associated with divergent views and experiences among the Dutch. Classes with little capital tend to rate politics, society, and their own social position more negatively. In addition, they value self-enhancement and hedonism less than today's upper classes and report lower levels of well-being.
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Affiliation(s)
- J. Cok Vrooman
- The Netherlands Institute for Social Research|SCP, The Hague, The Netherlands
| | - Jeroen Boelhouwer
- Department of Sociology, Utrecht University, Utrecht, The Netherlands
| | - Mérove Gijsberts
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
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22
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Guimarães ACADM, Melo DDA, Nogueira da Cruz Silveira VNDC, Campos MAG, Santos EMD, França AKTDC, Santos AMD. Equations for Prediction of Body Adiposity in Patients With Chronic Kidney Disease Undergoing Hemodialysis. J Ren Nutr 2024:S1051-2276(24)00010-4. [PMID: 38296216 DOI: 10.1053/j.jrn.2023.12.007] [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: 02/05/2023] [Revised: 11/18/2023] [Accepted: 12/29/2023] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVES The prevalence of obesity in the population has increased and excess body adiposity is one of the main nutritional disorders in patients with chronic kidney disease (CKD) on hemodialysis (HD). The objective of this study was to develop equations using anthropometric measurements to predict the total and abdominal body adiposity of patients with CKD on HD. METHODS This is a cross-sectional study evaluating 323 patients with CKD on HD in city in northeastern Brazil. Measurements and anthropometric indicators were correlated with percentage of body fat (%BF) and visceral fat (VF, in kg) measured by dual energy X-ray absorptiometry. Multiple linear regression models based on different combinations of anthropometric measurements were adjusted to develop the equations, with subsequent cross-validation. RESULTS Of the 323 patients, 62.2% were male and 46.5% were aged between 40 and 59 years. The equation selected to estimate %BF included weight, height, waist and hip circumferences, and triceps and suprailiac skin folds, presenting high predictive capacity (R2 = 0.771). The equation selected to estimate VF included weight, height, waist circumference, hip circumference, and sum of skin folds (R22 = 0.796). CONCLUSIONS The proposed equations efficiently predicted the %BF and VF (kg) of patients with CKD on HD, thereby serving as viable indicators in clinical practice.
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Affiliation(s)
| | - Dejane de Almeida Melo
- Postgraduate Program in Nutrition at the Federal University of Pernambuco, Recife, PE, Brazil
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23
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Valentin S, Kleinegesse S, Bramley NR, Seriès P, Gutmann MU, Lucas CG. Designing optimal behavioral experiments using machine learning. eLife 2024; 13:e86224. [PMID: 38261382 PMCID: PMC10805374 DOI: 10.7554/elife.86224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 11/19/2023] [Indexed: 01/24/2024] Open
Abstract
Computational models are powerful tools for understanding human cognition and behavior. They let us express our theories clearly and precisely and offer predictions that can be subtle and often counter-intuitive. However, this same richness and ability to surprise means our scientific intuitions and traditional tools are ill-suited to designing experiments to test and compare these models. To avoid these pitfalls and realize the full potential of computational modeling, we require tools to design experiments that provide clear answers about what models explain human behavior and the auxiliary assumptions those models must make. Bayesian optimal experimental design (BOED) formalizes the search for optimal experimental designs by identifying experiments that are expected to yield informative data. In this work, we provide a tutorial on leveraging recent advances in BOED and machine learning to find optimal experiments for any kind of model that we can simulate data from, and show how by-products of this procedure allow for quick and straightforward evaluation of models and their parameters against real experimental data. As a case study, we consider theories of how people balance exploration and exploitation in multi-armed bandit decision-making tasks. We validate the presented approach using simulations and a real-world experiment. As compared to experimental designs commonly used in the literature, we show that our optimal designs more efficiently determine which of a set of models best account for individual human behavior, and more efficiently characterize behavior given a preferred model. At the same time, formalizing a scientific question such that it can be adequately addressed with BOED can be challenging and we discuss several potential caveats and pitfalls that practitioners should be aware of. We provide code to replicate all analyses as well as tutorial notebooks and pointers to adapt the methodology to different experimental settings.
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Affiliation(s)
- Simon Valentin
- School of Informatics, University of EdinburghEdinburghUnited Kingdom
| | | | - Neil R Bramley
- Department of Psychology, University of EdinburghEdinburghUnited Kingdom
| | - Peggy Seriès
- School of Informatics, University of EdinburghEdinburghUnited Kingdom
| | - Michael U Gutmann
- School of Informatics, University of EdinburghEdinburghUnited Kingdom
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24
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Wan B, Shen J, Chen J, Weng L, Zhao P, Deng Y, Zhang L, Zhang F, Wang Y, Li X, Chang F, Ding H, Lu Y. Quantifying stakeholders' preference for implantable medical devices in China: a discrete choice experiment. Int J Technol Assess Health Care 2024; 40:e8. [PMID: 38221900 PMCID: PMC10859836 DOI: 10.1017/s0266462323002799] [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: 09/08/2023] [Revised: 10/23/2023] [Accepted: 11/14/2023] [Indexed: 01/16/2024]
Abstract
OBJECTIVES This study aims to gain insight into each attribute as presented in the value of implantable medical devices, quantify attributes' strength and their relative importance, and identify the determinants of stakeholders' preferences. METHODS A mixed-methods design was used to identify attributes and levels reflecting stakeholders' preference toward the value of implantable medical devices. This design combined literature reviewing, expert's consultation, one-on-one interactions with stakeholders, and a pilot testing. Based on the design, six attributes and their levels were settled. Among 144 hypothetical profiles, 30 optimal choice sets were developed, and healthcare professionals (decision-makers, health technology assessment experts, hospital administrators, medical doctors) and patients as stakeholders in China were surveyed. A total of 134 respondents participated in the survey. Results were analyzed by mixed logit model and conditional logit model. RESULTS The results of the mixed logit model showed that all the six attributes had a significant impact on respondents' choices on implantable medical devices. Respondents were willing to pay the highest for medical devices that provided improvements in clinical safety, followed by increased clinical effectiveness, technology for treating severe diseases, improved implement capacity, and innovative technology (without substitutes). CONCLUSIONS The findings of DCE will improve the current evaluation on the value of implantable medical devices in China and provide decision-makers with the relative importance of the criteria in pricing and reimbursement decision-making of implantable medical devices.
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Affiliation(s)
- Bin Wan
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Jiaojie Shen
- School of Pharmacy, Nanjing Medical University, Nanjing, China
| | - Jiali Chen
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China
| | - Linjia Weng
- Department of Medicine Pricing and Bidding and Purchasing, National Healthcare Security Administration, Beijing, China
| | - Peng Zhao
- Jiangsu Province Medical Insurance Fund Management Center, Jiangsu Province Healthcare Security Administration, Nanjing, China
| | - Yunfei Deng
- Department of Medical Insurance Monitoring, Nanjing Healthcare Security Administration, Nanjing, China
| | - Lingli Zhang
- School of Pharmacy, Nanjing Medical University, Nanjing, China
| | - Feiyi Zhang
- Department of Health Insurance Management, The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing, China
| | - Yingpeng Wang
- Department of Health Insurance Management, The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing, China
| | - Xin Li
- School of Pharmacy, Nanjing Medical University, Nanjing, China
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China
| | - Feng Chang
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Haixia Ding
- School of Pharmacy, Nanjing Medical University, Nanjing, China
| | - Yun Lu
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
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25
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Givens RC. Racial disparities across multiple stages of the deceased organ donation process. Am J Transplant 2024:S1600-6135(24)00068-6. [PMID: 38211654 DOI: 10.1016/j.ajt.2023.12.024] [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: 09/25/2023] [Revised: 12/23/2023] [Accepted: 12/28/2023] [Indexed: 01/13/2024]
Abstract
Pervasive structural violence causes higher organ failure rates among Black Americans and an excess of Black potential deceased organ donors. Underuse of Black donors would exacerbate organ shortages that disproportionately harm Black transplant candidates. This study investigates racial differences in transit between distinct donation steps among 132 968 potential donors across 557 hospitals and 6 organ procurement organizations (OPOs) from 2015 through 2021. Multilevel multistate modeling with patient covariates and OPO random effects shows adjusted likelihoods (95% confidence interval) of non-Black versus Black patients transitioning from OPO referral to approach of 1.39 (1.35, 1.44), approach to authorization: 1.64 (1.56, 1.72), authorization to procurement: 1.10 (1.04, 1.16), and procurement to transplant: 1.00 (0.95, 1.06). Overall organ utilization rates for Black, Latino, White, and other OPO referrals were 5.89%, 8.18%, 6.79%, and 5.24%, respectively. Adjusting for patient covariates and hospital and OPO random effects, multilevel logistic models estimated that compared with Black patients, Latino, White, and other patients had odds ratios of organ utilization of 1.81 (1.61, 2.03), 3.19 (2.91, 3.50), and 1.24 (1.05, 1.47), respectively. Nationwide in 2022, donor conversion disparities likely lost more than 1700 donors-two-thirds of whom would have been Black. Achieving racial equity for transplant candidates will require reducing racial disparities in organ donation.
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Affiliation(s)
- Raymond C Givens
- Department of Medicine, Emory University School of Medicine, Emory University, Atlanta, Georgia, 30322, USA.
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26
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Vergaelen M, Manzella S, Vonck K, Craey E, Spanoghe J, Sprengers M, Carrette E, Wadman WJ, Delbeke J, Boon P, Larsen LE, Raedt R. Increased Dentate Gyrus Excitability in the Intrahippocampal Kainic Acid Mouse Model for Temporal Lobe Epilepsy. Int J Mol Sci 2024; 25:660. [PMID: 38203829 PMCID: PMC10779277 DOI: 10.3390/ijms25010660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
The intrahippocampal kainic acid (IHKA) mouse model is an extensively used in vivo model to investigate the pathophysiology of mesial temporal lobe epilepsy (mTLE) and to develop novel therapies for drug-resistant epilepsy. It is characterized by profound hippocampal sclerosis and spontaneously occurring seizures with a major role for the injected damaged hippocampus, but little is known about the excitability of specific subregions. The purpose of this study was to electrophysiologically characterize the excitability of hippocampal subregions in the chronic phase of the induced epilepsy in the IHKA mouse model. We recorded field postsynaptic potentials (fPSPs) after electrical stimulation in the CA1 region and in the dentate gyrus (DG) of hippocampal slices of IHKA and healthy mice using a multielectrode array (MEA). In the DG, a significantly steeper fPSP slope was found, reflecting higher synaptic strength. Population spikes were more prevalent with a larger spatial distribution in the IHKA group, reflecting a higher degree of granule cell output. Only minor differences were found in the CA1 region. These results point to increased neuronal excitability in the DG but not in the CA1 region of the hippocampus of IHKA mice. This method, in which the excitability of hippocampal slices from IHKA mice is investigated using a MEA, can now be further explored as a potential new model to screen for new interventions that can restore DG function and potentially lead to novel therapies for mTLE.
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Affiliation(s)
- Marijke Vergaelen
- 4BRAIN, Department of Head and Skin, Ghent University, 9000 Ghent, Belgium
| | - Simona Manzella
- 4BRAIN, Department of Head and Skin, Ghent University, 9000 Ghent, Belgium
| | - Kristl Vonck
- 4BRAIN, Department of Head and Skin, Ghent University, 9000 Ghent, Belgium
| | - Erine Craey
- 4BRAIN, Department of Head and Skin, Ghent University, 9000 Ghent, Belgium
| | - Jeroen Spanoghe
- 4BRAIN, Department of Head and Skin, Ghent University, 9000 Ghent, Belgium
| | - Mathieu Sprengers
- 4BRAIN, Department of Head and Skin, Ghent University, 9000 Ghent, Belgium
| | - Evelien Carrette
- 4BRAIN, Department of Head and Skin, Ghent University, 9000 Ghent, Belgium
| | - Wytse Jan Wadman
- 4BRAIN, Department of Head and Skin, Ghent University, 9000 Ghent, Belgium
| | - Jean Delbeke
- 4BRAIN, Department of Head and Skin, Ghent University, 9000 Ghent, Belgium
| | - Paul Boon
- 4BRAIN, Department of Head and Skin, Ghent University, 9000 Ghent, Belgium
| | - Lars Emil Larsen
- 4BRAIN, Department of Head and Skin, Ghent University, 9000 Ghent, Belgium
- MEDISIP, Department of Electronics and Information Systems, Ghent University, 9000 Ghent, Belgium
| | - Robrecht Raedt
- 4BRAIN, Department of Head and Skin, Ghent University, 9000 Ghent, Belgium
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Zamboni L, Portoghese I, Casari R, Fusina F, Santin L, Lecca LI, Campagnari S, Carli S, Zandonai T, Lugoboni F. High-dose benzodiazepine use and QTc interval prolongation, a latent class analysis study. Sci Rep 2024; 14:155. [PMID: 38168538 PMCID: PMC10762262 DOI: 10.1038/s41598-023-50489-3] [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] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
Benzodiazepine (BDZ) addiction is a widespread and multifaceted phenomenon. For many patients, especially females, the concomitant use of other drugs also increases their risk of QTc prolongation, possibly leading to complications such as seizures and even sudden death. However, the relationship between BDZ use and QTc prolongation is currently unclear. The present study aims to examine patterns of polysubstance use among a sample of Italian adults with BDZ dependence in relation with their QTc prolongation risk. We used Latent Class Analysis (LCA) on data collected from 251 inpatients of the Addiction Medicine Unit in Verona to group patients into three classes according to their substance use and their QTc prolongation risk. Results showed no significant relationship between QTc prolongation and BDZ use in any of the classes considered. We conclude that BDZs, even if used long-term and at high dosages, can be considered safe in terms of cardiovascular complications for patients.
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Affiliation(s)
- Lorenzo Zamboni
- Unit of Addiction Medicine, Department of Internal Medicine, G.B. Rossi Hospital, Verona, Italy.
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy.
| | - Igor Portoghese
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, Cagliari , Italy
| | - Rebecca Casari
- Unit of Addiction Medicine, Department of Internal Medicine, G.B. Rossi Hospital, Verona, Italy
| | - Francesca Fusina
- Department of General Psychology, University of Padova, Padua, Italy
| | - Laura Santin
- Unit of Addiction Medicine, Department of Internal Medicine, G.B. Rossi Hospital, Verona, Italy
| | - Luigi Isaia Lecca
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, Cagliari , Italy
| | - Simone Campagnari
- Unit of Addiction Medicine, Department of Internal Medicine, G.B. Rossi Hospital, Verona, Italy
| | - Silvia Carli
- Unit of Addiction Medicine, Department of Internal Medicine, G.B. Rossi Hospital, Verona, Italy
| | - Thomas Zandonai
- Department of Pharmacology, Paediatrics and Organic Chemistry, Miguel Hernández University of Elche, Elche, Spain
- Addiction Science Lab at the Department of Psychology and Cognitive Science , University of Trento, Trento, Italy
| | - Fabio Lugoboni
- Unit of Addiction Medicine, Department of Internal Medicine, G.B. Rossi Hospital, Verona, Italy
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Flores-Moreno I, Puertas M, Ruiz-Medrano J, Almazán-Alonso E, García-Zamora M, Ruiz-Moreno JM. Influence of posterior staphyloma in myopic maculopathy and visual prognosis. Eye (Lond) 2024; 38:145-152. [PMID: 37365301 PMCID: PMC10764733 DOI: 10.1038/s41433-023-02648-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND/OBJECTIVES Posterior staphyloma is a hallmark of high myopia and its presence associates to greater degrees of myopic maculopathy. Nonetheless, its development, repercussion on visual function and relationship with maculopathy components, is still unclear. The objective was to analyze the impact of posterior staphyloma on the incidence and severity of myopic maculopathy and its repercussion on visual prognosis. SUBJECTS/METHODS Cross-sectional study conducted on 473 consecutive eyes of 259 highly myopic patients examined at Puerta de Hierro-Majadahonda University Hospital (Madrid, Spain). All patients underwent complete ophthalmologic examination including best corrected visual acuity (BCVA), axial length (AL), myopic maculopathy classification according to ATN system (atrophic/traction/neovascularization), determined the presence of posterior staphyloma, pathologic myopia (PM) and severe PM. Multimodal imaging were performed including fundus photography, optical coherence tomography (OCT), OCT-angiography, fundus autofluorescence and/ or fluorescein angiography. RESULTS Out of the total, 70.65% were female patients (n = 173/259), mean BCVA was 0.41 ± 0.54 logMAR units and mean AL was 29.3 ± 2.6 mm (26-37.6). Posterior staphyloma was present in 69.4% of eyes. Eyes with posterior staphyloma compared to non-staphyloma were older (p < 0.05), had greater AL (p < 0.01), worse BCVA (p < 0.01) and higher stage in ATN components (p < 0.01). Moreover, compound subgroup showed worse BCVA (p < 0.01) and greater stage in each of the ATN components (p < 0.01). Staphylomas with macular involvement presented worse BCVA (p < 0.01), higher AL (p < 0.01), and greater ATN (p < 0.05). The risk of posterior staphyloma presence in eyes with PM and severe PM eyes was 89.8% and 96.7%, respectively. Posterior staphyloma was the best predictor for BCVA in myopic patients (p < 0.01). CONCLUSIONS Posterior staphyloma's presence determines high risk of myopic maculopathy and therefore worse visual prognosis, especially those with macular involvement. Posterior staphyloma represented the best predictor for BCVA in highly myopic patients.
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Affiliation(s)
- Ignacio Flores-Moreno
- Puerta de Hierro-Majadahonda University Hospital, Majadahonda (Madrid), Spain
- Clínica Suárez Leoz, Madrid, Spain
| | - Mariluz Puertas
- Puerta de Hierro-Majadahonda University Hospital, Majadahonda (Madrid), Spain.
| | - Jorge Ruiz-Medrano
- Puerta de Hierro-Majadahonda University Hospital, Majadahonda (Madrid), Spain
- Miranza Corporation, Madrid, Spain
| | | | - María García-Zamora
- Puerta de Hierro-Majadahonda University Hospital, Majadahonda (Madrid), Spain
| | - José M Ruiz-Moreno
- Puerta de Hierro-Majadahonda University Hospital, Majadahonda (Madrid), Spain
- Miranza Corporation, Madrid, Spain
- Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain
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29
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Li X, Luan S, Zhang C, Kong W, Xiao X, Zhang H, Zhou J, Yang Y, Xu Y, Qiang Y, Fang P, Shen Y, Yuan Y. A novel tumor staging system incorporating cN status for stratifying early stage esophageal squamous cell carcinoma patients after trimodal therapy. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:107264. [PMID: 37977046 DOI: 10.1016/j.ejso.2023.107264] [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: 09/19/2023] [Revised: 10/23/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUNDS The aim of this study is to investigate the prognostic value of cN status for early stage esophageal squamous cell carcinoma (ESCC) patients after neoadjuvant chemoradiotherapy (nCRT) and construct a new staging model for individual survival prediction. METHODS Patients with ESCC who underwent nCRT and esophagectomy were included in this study. Both the Akaike Information Criterion (AIC) and the Bayesian Information Criterion (BIC) were meticulously ascertained to assess the cogency of each oncological staging system. A discernible abatement in the values of AIC and BIC signifies a model endowed with enhanced predictive prowess and exemplary veracity. RESULTS A new staging model was established based on ypTNM stage and cN status by precisely stratifying ypI ESCC patients. The novel ypTNM-cN staging demonstrated superior overall survival trend alignment over the AJCC 8th ypTNM staging, with a notably lower AIC of 3143.014 versus 3149.950. This superiority was supported by a BIC of 3146.605 against 3153.541. In the context of disease-free survival outcomes, the emergent ypTNM-cN staging, with an AIC value registering at 3196.057 and a BIC value at 3199.648, distinctively eclipsed the AJCC 8th ypTNM staging, which documented values of 3203.853 and 3207.444, respectively. CONCLUSION We constructed a new staging system based on ypTNM stage and cN status to precisely stratify the patients with ypI stage. Our new ypTNM-cN staging system provides new insights for classifying stage ypI ESCC and shows reliable classification efficacy for all ESCC patients after nCRT and surgery.
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Affiliation(s)
- Xiaokun Li
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Siyuan Luan
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Chi Zhang
- Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Weili Kong
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Xiao
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Haowen Zhang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jianfeng Zhou
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yushang Yang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yang Xu
- Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yong Qiang
- Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Pinhao Fang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Shen
- Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
| | - Yong Yuan
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.
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Carvalho GB, Brandão-Lima PN, Payolla TB, Lucena SEF, Sarti FM, Fisberg RM, Rogero MM. Circulating MiRNAs Are Associated With Low-grade Systemic Inflammation and Leptin Levels in Older Adults. Inflammation 2023; 46:2132-2146. [PMID: 37464054 DOI: 10.1007/s10753-023-01867-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/17/2023] [Accepted: 06/27/2023] [Indexed: 07/20/2023]
Abstract
Inflammaging refers to the low-grade systemic inflammation that occurs with aging present in chronic non-communicable diseases. MicroRNAs (miRNAs) are potential biomarkers for these diseases in older adults. This study aimed to assess the expression of 21 circulating miRNAs and their associations with inflammatory biomarkers in older adults. This cross-sectional study was performed with 200 individuals participating in ISA-Nutrition. The systemic low-grade inflammation score (SIS) was calculated from the plasma concentration of 10 inflammatory biomarkers. Circulating miRNA expression was assessed using the Fluidigm method. Wilcoxon-Mann-Whitney test was employed to determine differences in SIS among groups distributed according to sex and presence of MetS. Spearman's correlation was used to estimate correlations among SIS, leptin levels, miRNA expression, and variables of interest. Analyses were performed using software R version 4.2.3, with a significance level of 0.05. The final sample consisted of 193 individuals with a mean age of 69.1 (SE = 0.5) years, being 64.7% individuals with metabolic syndrome (MetS). Positive correlations were observed between leptin concentration and metabolic risk factors, and leptin concentration was higher in individuals with MetS compared to those without MetS. The expression of 15 circulating miRNAs was negatively correlated with leptin concentration. GLMs showed negative associations between miRNAs (miR-15a, miR-16, miR-223, miR-363, miR-532), leptin, and/or SIS values; and only miR-21 showed positive association with SIS values. The results suggest the presence of peripheral leptin resistance associated with low-grade inflammation and plasma expression of miRNAs in older adults. These findings suggest the potential role of miRNAs as biomarkers for cardiometabolic risk.
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Affiliation(s)
- Gabrielli B Carvalho
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr. Arnaldo Avenue, São Paulo, SP, 01246-904, Brazil
| | - Paula N Brandão-Lima
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr. Arnaldo Avenue, São Paulo, SP, 01246-904, Brazil
| | - Tanyara B Payolla
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr. Arnaldo Avenue, São Paulo, SP, 01246-904, Brazil
| | - Sadraque E F Lucena
- Department of Statistics and Actuarial Sciences, Federal University of Sergipe, Marechal Rondon Avenue, São Cristóvão, SE, 49100-000, Brazil
| | - Flávia M Sarti
- School of Arts, Sciences and Humanities, University of São Paulo, 1000 Arlindo Bettio Avenue, São Paulo, SP, 03828-000, Brazil
| | - Regina M Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr. Arnaldo Avenue, São Paulo, SP, 01246-904, Brazil
| | - Marcelo M Rogero
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr. Arnaldo Avenue, São Paulo, SP, 01246-904, Brazil.
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Lee J, Clause A, Kandler K. Structural and Functional Development of Inhibitory Connections from the Medial Nucleus of the Trapezoid Body to the Superior Paraolivary Nucleus. J Neurosci 2023; 43:7766-7779. [PMID: 37734946 PMCID: PMC10648534 DOI: 10.1523/jneurosci.0920-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/21/2023] [Accepted: 09/13/2023] [Indexed: 09/23/2023] Open
Abstract
The medial nucleus of the trapezoid body (MNTB) in the auditory brainstem is the principal source of synaptic inhibition to several functionally distinct auditory nuclei. Prominent projections of individual MNTB neurons comprise the major binaural nuclei that are involved in the early processing stages of sound localization as well as the superior paraolivary nucleus (SPON), which contains monaural neurons that extract rapid changes in sound intensity to detect sound gaps and rhythmic oscillations that commonly occur in animal calls and human speech. While the processes that guide the development and refinement of MNTB axon collaterals to the binaural nuclei have become increasingly understood, little is known about the development of MNTB collaterals to the monaural SPON. In this study, we investigated the development of MNTB-SPON connections in mice of both sexes from shortly after birth to three weeks of age, which encompasses the time before and after hearing onset. Individual axon reconstructions and electrophysiological analysis of MNTB-SPON connectivity demonstrate a dramatic increase in the number of MNTB axonal boutons in the SPON before hearing onset. However, this proliferation was not accompanied by changes in the strength of MNTB-SPON connections or by changes in the structural or functional topographic precision. However, following hearing onset, the spread of single-axon boutons along the tonotopic axis increased, indicating an unexpected decrease in the tonotopic precision of the MNTB-SPON pathway. These results provide new insight into the development and organization of inhibition to SPON neurons and the regulation of developmental plasticity in diverging inhibitory pathways.SIGNIFICANCE STATEMENT The superior paraolivary nucleus (SPON) is a prominent auditory brainstem nucleus involved in the early detection of sound gaps and rhythmic oscillations. The ability of SPON neurons to fire at the offset of sound depends on strong and precise synaptic inhibition provided by glycinergic neurons in the medial nucleus of the trapezoid body (MNTB). Here, we investigated the anatomic and physiological maturation of MNTB-LSO connectivity in mice before and after the onset of hearing. We observed a period of bouton proliferation without accompanying changes in topographic precision before hearing onset. This was followed by bouton elimination and an unexpected decrease in the tonotopic precision after hearing onset. These results provide new insight into the development of inhibition to the SPON.
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Affiliation(s)
- Jongwon Lee
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
| | - Amanda Clause
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
| | - Karl Kandler
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15261
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Ding N, Ye Z, Jin X, Zhang G, Yu Q, Liu Y. Assessing the cognition, attitudes and intentions of volunteers regarding unrelated peripheral blood stem cell donation: The UPBSC-DQ instrument in Chinese. Heliyon 2023; 9:e20663. [PMID: 37885714 PMCID: PMC10598484 DOI: 10.1016/j.heliyon.2023.e20663] [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: 08/23/2022] [Revised: 10/03/2023] [Accepted: 10/03/2023] [Indexed: 10/28/2023] Open
Abstract
Objectives This study aimed to develop and validate the Unrelated Peripheral Blood Stem Cell Donation Questionnaire (UPBSC-DQ) (an instrument in Chinese) to assess the degree of cognition, attitude and intention of enrolled volunteers towards UPBSC donation. Methods The development process of the UPBSC-DQ was performed in a stepwise approach that included extensive literature retrieval, expert revision, and pretesting with 442 students. We conducted an online cross-sectional survey using the final version of the UPBSC-DQ among 336 participants. The reliability of the questionnaire was assessed by Cronbach's α and corrected item-total correlation (CITC), and the validity was evaluated by a correlation coefficient matrix, confirmatory factor analysis (CFA), and t-test. Results The UPBSC-DQ consists of four domains: basic information, cognitive, attitude, and intention. The Cronbach's α values were 0.88 and 0.86 for the attitude and intention scales, respectively, indicating strong internal consistency and good reliability. Correlation analysis and CFA showed good structure and content validity. Interitem correlations indicated that each item had only a weak correlation with the other scales. Conclusions The UPBSC-DQ is a reliable and valid assessment questionnaire for individuals' attitudes and intentions towards UPBSC donation. The questionnaire showed good to high reliability, content and construct validity.
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Affiliation(s)
- NaNi Ding
- Wenzhou Vocational College of Science and Technology, Wenzhou, Zhejiang, China
| | - ZhuoNi Ye
- The Second Affiliated College of Clinical Medical, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - XinQian Jin
- Wenzhou Vocational College of Science and Technology, Wenzhou, Zhejiang, China
| | - GuoHua Zhang
- College of Psychiatry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - QiuLin Yu
- The First Affiliated College of Clinical Medical, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - YuPeng Liu
- Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Guo R, Zhang S, Yu S, Li X, Liu X, Shen Y, Wei J, Wu Y. Inclusion of frailty improved performance of delirium prediction for elderly patients in the cardiac intensive care unit (D-FRAIL): A prospective derivation and external validation study. Int J Nurs Stud 2023; 147:104582. [PMID: 37672971 DOI: 10.1016/j.ijnurstu.2023.104582] [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: 10/17/2022] [Revised: 07/29/2023] [Accepted: 07/30/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND The elderly patients admitted to cardiac intensive care unit (CICU) are at relatively high risk for developing delirium. A simple and reliable predictive model can benefit them from early recognition of delirium followed by timely and appropriate preventive strategies. OBJECTIVE To explore the role of frailty in delirium prediction and develop and validate a delirium predictive model including frailty for elderly patients in CICU. DESIGN A prospective, observational cohort study. SETTINGS CICU at China-Japan Friendship Hospital from March 1, 2022 to August 25, 2022 (derivation cohort); CICU at Beijing Anzhen Hospital affiliated to Capital Medical University from March 14, 2023 to May 8, 2023 (external validation cohort). PARTICIPANTS A total of 236 and 90 participants were enrolled in the derivation and external validation cohorts, respectively. Participants in the derivation cohort were assigned into either the delirium (n = 70) or non-delirium group (n = 166) based on the occurrence of delirium. METHODS The simplified Chinese version of the Confusion Assessment Method for the Diagnosis of Delirium in the Intensive Care Unit was used to assess delirium twice a day at 8:00-10:00 and 18:00-20:00 until the onset of delirium or discharge from the CICU. Frailty was assessed using the FRAIL scale during the first 24 h in the CICU. Other possible risk factors were collected prospectively through patient interviews and medical records review. After processing missing data via multiple imputations, univariate analysis and bootstrapped forward stepwise logistic regression were performed to select optimal predictors and develop the models. The models were internally validated using bootstrapping and evaluated comprehensively via discrimination, calibration, and clinical utility in both the derivation and external validation cohorts. RESULTS The study developed D-FRAIL predictive model using FRAIL score, hearing impairment, Acute Physiology and Chronic Health Evaluation-II score, and fibrinogen. The area under the receiver operating characteristic curve (AUC) was 0.937 (95% confidence interval [CI]: 0.907-0.967) and 0.889 (95%CI: 0.840-0.938) even after bootstrapping in the derivation cohort. Inclusion of frailty was demonstrated to improve the model performance greatly with the AUC increased from 0.851 to 0.937 (p < 0.001). In the external validation cohort, the AUC of D-FRAIL model was 0.866 (95%CI: 0.782-0.907). Calibration plots and decision curve analysis suggested good calibration and clinical utility of the D-FRAIL model in both the derivation and external validation cohorts. CONCLUSIONS For elderly patients in the CICU, FRAIL score is an independent delirium predictor and the D-FRAIL model demonstrates superior performance in predicting delirium.
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Affiliation(s)
- Rongrong Guo
- School of Nursing, Capital Medical University, Beijing 100069, China
| | - Shan Zhang
- School of Nursing, Capital Medical University, Beijing 100069, China
| | - Saiying Yu
- School of Nursing, Capital Medical University, Beijing 100069, China
| | - Xiangyu Li
- School of Nursing, Capital Medical University, Beijing 100069, China
| | - Xinju Liu
- Cardiac Intensive Care Unit, China-Japan Friendship Hospital, Beijing 100029, China
| | - Yanling Shen
- Surgical Intensive Care Unit, China-Japan Friendship Hospital, Beijing 100029, China
| | - Jinling Wei
- Cardiac Intensive Care Unit, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing 100029, China
| | - Ying Wu
- School of Nursing, Capital Medical University, Beijing 100069, China.
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Wittkopf S, Langmann A, Roessner V, Roepke S, Poustka L, Nenadić I, Stroth S, Kamp-Becker I. Conceptualization of the latent structure of autism: further evidence and discussion of dimensional and hybrid models. Eur Child Adolesc Psychiatry 2023; 32:2247-2258. [PMID: 36006478 PMCID: PMC10576682 DOI: 10.1007/s00787-022-02062-y] [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: 01/18/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022]
Abstract
Autism spectrum disorder (ASD) might be conceptualized as an essentially dimensional, categorical, or hybrid model. Yet, current empirical studies are inconclusive and the latent structure of ASD has explicitly been examined only in a few studies. The aim of our study was to identify and discuss the latent model structure of behavioral symptoms related to ASD and to address the question of whether categories and/or dimensions best represent ASD symptoms. We included data of 2920 participants (1-72 years of age), evaluated with the Autism Diagnostic Observation Schedule (Modules 1-4). We applied latent class analysis, confirmatory factor analysis, and factor mixture modeling and evaluated the model fit by a combination of criteria. Based on the model selection criteria, the model fits, the interpretability as well as the clinical utility we conclude that the hybrid model serves best for conceptualization and assessment of ASD symptoms. It is both grounded in empirical evidence and in clinical usefulness, is in line with the current classification system (DSM-5) and has the potential of being more specific than the dimensional approach (decreasing false positive diagnoses).
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Affiliation(s)
- Sarah Wittkopf
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University, Marburg, Germany
| | - Anika Langmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University, Marburg, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Technical University Dresden, Dresden, Germany
| | - Stefan Roepke
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Medical Clinic, Philipps-University Marburg, Marburg, Germany
| | - Sanna Stroth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University, Marburg, Germany.
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University, Marburg, Germany
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Scopazzini MS, Cave RNR, Mutch CP, Ross DA, Bularga A, Chase-Topping M, Woolhouse M, Koch O, Perry MR, Mackintosh CL. Scottish Index of Multiple Deprivation (SIMD) indicators as predictors of mortality among patients hospitalised with COVID-19 disease in the Lothian Region, Scotland during the first wave: a cohort study. Int J Equity Health 2023; 22:205. [PMID: 37794428 PMCID: PMC10552319 DOI: 10.1186/s12939-023-02017-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 09/18/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Sars-CoV-2, the causative agent of COVID-19, has led to more than 226,000 deaths in the UK and multiple risk factors for mortality including age, sex and deprivation have been identified. This study aimed to identify which individual indicators of the Scottish Index of Multiple Deprivation (SIMD), an area-based deprivation index, were predictive of mortality. METHODS This was a prospective cohort study of anonymised electronic health records of 710 consecutive patients hospitalised with Covid-19 disease between March and June 2020 in the Lothian Region of Southeast Scotland. Data sources included automatically extracted data from national electronic platforms and manually extracted data from individual admission records. Exposure variables of interest were SIMD quintiles and 12 indicators of deprivation deemed clinically relevant selected from the SIMD. Our primary outcome was mortality. Age and sex adjusted univariable and multivariable analyses were used to determine measures of association between exposures of interest and the primary outcome. RESULTS After adjusting for age and sex, we found an increased risk of mortality in the more deprived SIMD quintiles 1 and 3 (OR 1.75, CI 0.99-3.08, p = 0.053 and OR 2.17, CI 1.22-3.86, p = 0.009, respectively), but this association was not upheld in our multivariable model containing age, sex, Performance Status and clinical parameters of severity at admission. Of the 12 pre-selected indicators of deprivation, two were associated with greater mortality in our multivariable analysis: income deprivation rate categorised by quartile (Q4 (most deprived): 2.11 (1.20-3.77) p = 0.011)) and greater than expected hospitalisations due to alcohol per SIMD data zone (1.96 (1.28-3.00) p = 0.002)). CONCLUSIONS SIMD as an aggregate measure of deprivation was not predictive of mortality in our cohort when other exposure measures were accounted for. However, we identified a two-fold increased risk of mortality in patients residing in areas with greater income-deprivation and/or number of hospitalisations due to alcohol. In areas where aggregate measures fail to capture pockets of deprivation, exploring the impact of specific SIMD indicators may be helpful in targeting resources to residents at risk of poorer outcomes from Covid-19.
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Affiliation(s)
- Marcello S Scopazzini
- Clinical Infection Research Group, NHS Lothian Infection Service, Western General Hospital, Edinburgh, UK.
- London School of Hygiene and Tropical Medicine, London, UK.
| | | | - Callum P Mutch
- Clinical Infection Research Group, NHS Lothian Infection Service, Western General Hospital, Edinburgh, UK
| | - Daniella A Ross
- Clinical Infection Research Group, NHS Lothian Infection Service, Western General Hospital, Edinburgh, UK
| | - Anda Bularga
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Margo Chase-Topping
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, UK
| | | | - Oliver Koch
- Clinical Infection Research Group, NHS Lothian Infection Service, Western General Hospital, Edinburgh, UK
| | - Meghan R Perry
- Clinical Infection Research Group, NHS Lothian Infection Service, Western General Hospital, Edinburgh, UK
| | - Claire L Mackintosh
- Clinical Infection Research Group, NHS Lothian Infection Service, Western General Hospital, Edinburgh, UK
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Enríquez-Mier-Y-Terán FE, Chatterjee A, Antic T, Oto A, Karczmar G, Bourne R. Multi-model sequential analysis of MRI data for microstructure prediction in heterogeneous tissue. Sci Rep 2023; 13:16486. [PMID: 37779137 PMCID: PMC10543593 DOI: 10.1038/s41598-023-43329-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 09/22/2023] [Indexed: 10/03/2023] Open
Abstract
We propose a general method for combining multiple models to predict tissue microstructure, with an exemplar using in vivo diffusion-relaxation MRI data. The proposed method obviates the need to select a single 'optimum' structure model for data analysis in heterogeneous tissues where the best model varies according to local environment. We break signal interpretation into a three-stage sequence: (1) application of multiple semi-phenomenological models to predict the physical properties of tissue water pools contributing to the observed signal; (2) from each Stage-1 semi-phenomenological model, application of a tissue microstructure model to predict the relative volumes of tissue structure components that make up each water pool; and (3) aggregation of the predictions of tissue structure, with weightings based on model likelihood and fractional volumes of the water pools from Stage-1. The multiple model approach is expected to reduce prediction variance in tissue regions where a complex model is overparameterised, and bias where a model is underparameterised. The separation of signal characterisation (Stage-1) from biological assignment (Stage-2) enables alternative biological interpretations of the observed physical properties of the system, by application of different tissue structure models. The proposed method is exemplified with human prostate diffusion-relaxation MRI data, but has potential application to a wide range of analyses where a single model may not be optimal throughout the sampled domain.
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Affiliation(s)
- Francisco E Enríquez-Mier-Y-Terán
- School of Biomedical Engineering, Faculty of Engineering, The University of Sydney, Sydney, 2008, Australia
- The Brain and Mind Centre, The University of Sydney, Sydney, 2050, Australia
| | - Aritrick Chatterjee
- Department of Radiology, University of Chicago, 5841 South Maryland Avenue, MC 2026, Chicago, 60637, IL, USA
- Sanford J. Grossman Center of Excellence in Prostate Imaging and Image Guided Therapy, University of Chicago, Chicago, 60637, IL, USA
| | - Tatjana Antic
- Department of Pathology, University of Chicago, Chicago, 60637, IL, USA
| | - Aytekin Oto
- Department of Radiology, University of Chicago, 5841 South Maryland Avenue, MC 2026, Chicago, 60637, IL, USA
| | - Gregory Karczmar
- Department of Radiology, University of Chicago, 5841 South Maryland Avenue, MC 2026, Chicago, 60637, IL, USA
| | - Roger Bourne
- Discipline of Medical Imaging Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, Australia.
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Carbonneau R, Vitaro F, Brendgen M, Tremblay RE. Longitudinal patterns of polysubstance use throughout adolescence: association with adult substance use and psychosocial outcomes controlling for preadolescent risk factors in a male cohort. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1469-1481. [PMID: 36881129 DOI: 10.1007/s00127-023-02454-8] [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: 03/14/2022] [Accepted: 02/27/2023] [Indexed: 03/08/2023]
Abstract
PURPOSE Inconsistent reports raise the question of the extent to which poor adult outcomes are associated with adolescent polysubstance use (PSU: alcohol, marijuana, other illicit drugs) above and beyond earlier risk factors. METHODS Early adulthood substance-related and psychosocial outcomes were examined in association with age 13 to 17 developmental patterns of PSU in boys from urban, low SES neighborhoods (N = 926). Three classes obtained by latent growth modeling described low/non-users (N = 565, 61.0%), lower risk PSU (later onset, occasional use, 2 ≤ substances; N = 223, 24.1%), and higher risk PSU (earlier onset, frequent use, 3 ≥ substances; N = 138, 14.9%). Preadolescent individual, familial and social predictors of adolescent PSU patterns were used as covariates. RESULTS Adolescent PSU contributed to both age-24 substance-related outcomes (frequency of alcohol, drug use, and getting drunk, risky behaviors under influence, and use-related problems) and psychosocial outcomes (no high school diploma, professional or financial strain, ASP symptoms, criminal record) over and above preadolescent risk factors. Controlling for preadolescent risk factors, adolescent PSU made a more important contribution to adult substance use outcomes (increasing the risk by about 110%) than to psychosocial outcomes (16.8% risk increase). PSU classes showed poorer adjustment for all age-24 substance use, and for various psychosocial outcomes than low/non-users. Higher risk polysubstance users also reported poorer outcomes than their lower risk peers for most substance use outcomes, and for professional or financial strain and criminal record. CONCLUSION Findings highlight the contribution of adolescent PSU in a dose-response fashion, over and above preadolescent risk factors, on both homotypic and heterotypic outcomes in early adulthood.
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Affiliation(s)
- Rene Carbonneau
- Department of Pediatrics, Faculty of Medicine, University of Montreal, 3050 Edouard-Montpetit, Suite 225, Montréal, QC, H3T 1J7, Canada.
- Sainte-Justine Hospital Research Center, Montréal, Canada.
- Research Unit on Children's Psychosocial Maladjustment, University of Montreal, Montréal, Canada.
| | - Frank Vitaro
- Sainte-Justine Hospital Research Center, Montréal, Canada
- Research Unit on Children's Psychosocial Maladjustment, University of Montreal, Montréal, Canada
- School of Psychoeducation, University of Montreal, Montréal, Canada
| | - Mara Brendgen
- Sainte-Justine Hospital Research Center, Montréal, Canada
- Research Unit on Children's Psychosocial Maladjustment, University of Montreal, Montréal, Canada
- Department of Psychology, University of Quebec in Montreal, Montréal, Canada
| | - Richard E Tremblay
- Department of Pediatrics, Faculty of Medicine, University of Montreal, 3050 Edouard-Montpetit, Suite 225, Montréal, QC, H3T 1J7, Canada
- Sainte-Justine Hospital Research Center, Montréal, Canada
- Research Unit on Children's Psychosocial Maladjustment, University of Montreal, Montréal, Canada
- Department of Psychology, University of Montreal, Montréal, Canada
- School of Public Health and Population Sciences, University College Dublin, Dublin, Ireland
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Ramaswamy S, Gilles N, Gruessner AC, Burton D, Fraser MA, Weingast S, Kunnakkat S, Afable A, Kaufman D, Singer J, Balucani C, Levine SR. User-Centered Mobile Applications for Stroke Survivors (MAPPS): A Mixed-Methods Study of Patient Preferences. Arch Phys Med Rehabil 2023; 104:1573-1579. [PMID: 37295706 DOI: 10.1016/j.apmr.2023.05.009] [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: 07/18/2022] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Investigate stroke survivors' (SS) preferences for a hypothetical mHealth app for post-stroke care and to study the influence of demographic variables on these preferences. DESIGN Mixed-methods, sequential, observational study. SETTING Focus groups (phase 1) were conducted to identify SS perceptions and knowledge of mHealth applications (apps). Using grounded theory approach, recurring themes were identified. A multiple-choice questionnaire of 5 desired app features was generated using these themes and mailed to SS (national survey, phase 2). SS' demographics and perceived usefulness (yes/no) for each feature were recorded. In-person usability testing (phase 3) was conducted to identify areas of improvement in user interfaces of existing apps. Summative telephone interviews (phase 4) were conducted for final impressions supplementary to national survey. PARTICIPANTS SS aged >18 years recruited from study hospital, national stroke association database, stroke support and advocacy groups. Non-English speakers and those unable to communicate were excluded. INTERVENTIONS None. MAIN OUTCOME MEASURES (1) Percentage of SS (phase 2) identifying proposed app features to be useful. (2) Influence of age, sex, race, education, and time since stroke on perceived usefulness. RESULTS Ninety-six SS participated in focus groups. High cost, complexity, and lack of technical support were identified as barriers to adoption of mHealth apps. In the national survey (n=1194), ability to track fitness and diet (84%) and communication (70%) were the most and least useful features, respectively. Perceived usefulness was higher among younger SS (P<.001 to .006) and SS of color (African American and Hispanic) (ORs 1.73-4.41). Simple design and accommodation for neurologic deficits were main recommendations from usability testing. CONCLUSIONS SS are willing to adopt mHealth apps that are free of cost and provide technical support. Apps for SS should perform multiple tasks and be of simple design. Greater interest for the app's features among SS of color may provide opportunities to address health inequities.
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Affiliation(s)
- Srinath Ramaswamy
- Department of Neurology, SUNY Downstate Health Sciences University, Brooklyn, NY.
| | - Nadege Gilles
- Department of Neurology, SUNY Downstate Health Sciences University, Brooklyn, NY
| | | | - Dee Burton
- Department of Neurology, SUNY Downstate Health Sciences University, Brooklyn, NY
| | | | - Sarah Weingast
- Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Saroj Kunnakkat
- Department of Neurology, Case Western Reserve University, Cleveland, OH
| | - Aimee Afable
- Department of Community Health Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - David Kaufman
- Department of Medical Informatics, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Jonathan Singer
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX
| | | | - Steven R Levine
- Department of Neurology, SUNY Downstate Health Sciences University, Brooklyn, NY
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Gebremichael B, Lassi ZS, Begum M, Mittinty M, Zhou SJ. Patterns and Predictors of Low-Calorie Sweetener Consumption during Pregnancy: Findings from a National Survey. Nutrients 2023; 15:4196. [PMID: 37836480 PMCID: PMC10574556 DOI: 10.3390/nu15194196] [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: 09/05/2023] [Revised: 09/20/2023] [Accepted: 09/23/2023] [Indexed: 10/15/2023] Open
Abstract
Recently, the World Health Organization recommended avoiding low-calorie sweeteners (LCS) during pregnancy due to concerns that it may be linked to adverse pregnancy outcomes and offspring wellbeing. This study examined the patterns and predictors of LCS consumption among pregnant women in Australia. A survey was conducted among 422 pregnant women aged 18-50 years. Sociodemographic, lifestyle, dietary intake including LCS consumption, pregnancy-related characteristics, and awareness about the health effects of LCS were assessed. We used latent class analysis and multinomial logistic regression to identify LCS consumption patterns and predictors of consumption patterns, respectively. The mean (SD) age of the women was 30 (4.6) years. Three LCS consumption patterns were identified: infrequent or non-consumers representing 50% of the women, moderate consumers encompassing 40% of the women, and the remaining were habitual consumers. Over two-thirds (71%) of women were not aware of the potential adverse effects of LCS, and only a quarter of them were concerned about the possible adverse effects on their health and their offspring. Increasing age and living with a medical condition decreased the likelihood of moderate consumption by 7% and 55%, respectively. Frequent sugar-sweetened beverage consumption and gestational diabetes predicted habitual LCS consumption. This research suggested widespread LCS consumption among pregnant women in Australia, but lower awareness of its potential adverse health effects. Interventions to increase awareness of potential adverse effects are warranted.
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Affiliation(s)
- Bereket Gebremichael
- Department of Food and Nutrition, School of Agriculture, Food and Wine, The University of Adelaide, Glen Osmond, Adelaide, SA 5064, Australia;
- Robinson Research Institute, The University of Adelaide, Adelaide, SA 5006, Australia; (Z.S.L.); (M.B.)
- College of Health Science, Addis Ababa University, Addis Ababa AA 1000, Ethiopia
| | - Zohra S. Lassi
- Robinson Research Institute, The University of Adelaide, Adelaide, SA 5006, Australia; (Z.S.L.); (M.B.)
- School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Mumtaz Begum
- Robinson Research Institute, The University of Adelaide, Adelaide, SA 5006, Australia; (Z.S.L.); (M.B.)
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Murthy Mittinty
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia;
| | - Shao-Jia Zhou
- Department of Food and Nutrition, School of Agriculture, Food and Wine, The University of Adelaide, Glen Osmond, Adelaide, SA 5064, Australia;
- Robinson Research Institute, The University of Adelaide, Adelaide, SA 5006, Australia; (Z.S.L.); (M.B.)
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Wang J, Huang X, Guo D. Predictors and a novel predictive model for intravascular immunoglobulin resistance in Kawasaki disease. Ital J Pediatr 2023; 49:126. [PMID: 37749617 PMCID: PMC10521414 DOI: 10.1186/s13052-023-01531-7] [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] [Accepted: 09/12/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Early identification of intravenous immunoglobulin (IVIG) resistance contributes to better management of Kawasaki disease (KD). This study aims to establish an effective prediction model for IVIG resistance in the Chinese population. METHODS A total of 658 eligible patients diagnosed with KD were enrolled in this study, with 461 in the training cohort and 197 in the validation cohort. The demographic characteristics and potential risk factors were compared between IVIG-responsive and resistant groups. Predictors were selected by the Akaike information criterion. The nomogram's performance was evaluated by calibration curve, decision curve analysis, and operating characteristic curve. RESULTS White blood cell counts (WBC), neutrophil-lymphocyte ratio (N/L ratio), hematocrit (HCT), albumin (ALB), total bilirubin (TBIL), lactate dehydrogenase (LDH), and creatinine (Cr) were detected as predictors of IVIG resistance. A predictive nomogram incorporating these predictors was constructed using the training cohort. The calibration curve and decision curve analysis showed good discrimination and calibration of the proposed nomogram in both training and validation sets, and the area under the receiver operating characteristic curve (AUROC) in both sets was 75.8% and 74.2%, respectively. CONCLUSION This study identified WBC, N/L ratio, HCT, ALB, TBIL, LDH, and Cr as predictors for IVIG resistance in patients with KD. The proposed novel nomogram with a high level of accuracy and reliability may benefit clinical decision-making upon treatment initiation.
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Affiliation(s)
- Junjie Wang
- Department of Pediatric Endocrinology, Quanzhou Women's and Children's Hospital, Quanzhou, China
| | - Xiaohui Huang
- Department of Operating Room, Quanzhou Women's and Children's Hospital, Quanzhou, China
| | - Donghao Guo
- Department of Cardiology, Shanghai Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
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Rojewski A, Schweiger M, Sgouralis I, Comstock M, Pressé S. An accurate probabilistic step finder for time-series analysis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.19.558535. [PMID: 37786687 PMCID: PMC10541599 DOI: 10.1101/2023.09.19.558535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Noisy time-series data is commonly collected from sources including Förster Resonance Energy Transfer experiments, patch clamp and force spectroscopy setups, among many others. Two of the most common paradigms for the detection of discrete transitions in such time-series data include: hidden Markov models (HMMs) and step-finding algorithms. HMMs, including their extensions to infinite state-spaces, inherently assume in analysis that holding times in discrete states visited are geometrically-or, loosely speaking in common language, exponentially-distributed. Thus the determination of step locations, especially in sparse and noisy data, is biased by HMMs toward identifying steps resulting in geometric holding times. In contrast, existing step-finding algorithms, while free of this restraint, often rely on ad hoc metrics to penalize steps recovered in time traces (by using various information criteria) and otherwise rely on approximate greedy algorithms to identify putative global optima. Here, instead, we devise a robust and general probabilistic (Bayesian) step-finding tool that neither relies on ad hoc metrics to penalize step numbers nor assumes geometric holding times in each state. As the number of steps themselves in a time-series are, a priori unknown, we treat these within a Bayesian nonparametric (BNP) paradigm. We find that the method developed, Bayesian Nonparametric Step (BNP-Step), accurately determines the number and location of transitions between discrete states without any assumed kinetic model and learns the emission distribution characteristic of each state. In doing so, we verify that BNP-Step can analyze sparser data sets containing higher noise and more closely-spaced states than otherwise resolved by current state-of-the-art methods. What is more, BNP-Step rigorously propagates measurement uncertainty into uncertainty over state transition locations, numbers, and emission levels as characterized by the posterior. We demonstrate the performance of BNP-Step on both synthetic data as well as data drawn from force spectroscopy experiments.
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Affiliation(s)
- Alex Rojewski
- Department of Physics, Arizona State University, Tempe, Arizona
- Center for Biological Physics, Arizona State University, Tempe, Arizona
| | - Maxwell Schweiger
- Department of Physics, Arizona State University, Tempe, Arizona
- Center for Biological Physics, Arizona State University, Tempe, Arizona
| | - Ioannis Sgouralis
- Department of Mathematics, University of Tennessee, Knoxville, Knoxville, Tennessee
| | - Matthew Comstock
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan
| | - Steve Pressé
- Department of Physics, Arizona State University, Tempe, Arizona
- Center for Biological Physics, Arizona State University, Tempe, Arizona
- School of Molecular Sciences, Arizona State University, Tempe, Arizona
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Geng S, Chen X, Bai K, Ding J, Li H, Shi S. Association of the Clínica Universidad de Navarra-Body Adiposity Estimator With Type 2 Diabetes: A Retrospective Cohort Study. Int J Public Health 2023; 68:1606063. [PMID: 37810434 PMCID: PMC10551821 DOI: 10.3389/ijph.2023.1606063] [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: 04/04/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives: Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) is considered to be a more accurate indicator of body fat estimation. We aimed to investigate the association of CUN-BAE with the risk of type 2 diabetes mellitus (T2DM) and to compare the strength of the association between CUN-BAE, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and T2DM. Methods: The data were obtained from the annual health checkup database of residents in Xinzheng, China. From January 2011 to December 2021, 80,555 subjects aged ≥45 years met the inclusion criteria. Cox proportional hazard regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for CUN-BAE, BMI, WC, and WHtR in T2DM. Results: During a mean follow-up of 6.26 years, T2DM occurred in 12,967 subjects. The multivariable-adjusted HRs (95% CIs) of T2DM (highest vs. reference group) were 1.994 (1.811-2.196) for CUN-BAE, 1.751 (1.665-1.842) for WC, 1.715 (1.631-1.804) for WHtR, and 1.510 (1.436-1.588) for BMI, respectively. In addition, the risk of T2DM increased with baseline CUN-BAE (HR: 1.374; 95% CI: 1.328, 1.421), WC (HR: 1.236; 95% CI: 1.215, 1.256), WHtR (HR: 1.228; 95% CI: 1.208, 1.248), and BMI (HR: 1.175; 95% CI: 1.156, 1.195). Conclusion: Compared to BMI, WC or WHtR, CUN-BAE may more adequately reflect the adverse effects of adiposity on the risk of T2DM.
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Affiliation(s)
| | | | | | | | | | - Songhe Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
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Zajacova A, Pereira Filho A, Limani M, Grol-Prokopczyk H, Zimmer Z, Scherbakov D, Fillingim RB, Hayward MD, Gilron I, Macfarlane GJ. Self-Reported Pain Treatment Practices Among U.S. and Canadian Adults: Findings From a Population Survey. Innov Aging 2023; 7:igad103. [PMID: 38094928 PMCID: PMC10714903 DOI: 10.1093/geroni/igad103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Indexed: 02/01/2024] Open
Abstract
Background and Objectives Pain treatments and their efficacy have been studied extensively. Yet surprisingly little is known about the types of treatments, and combinations of treatments, that community-dwelling adults use to manage pain, as well as how treatment types are associated with individual characteristics and national-level context. To fill this gap, we evaluated self-reported pain treatment types among community-dwelling adults in the United States and Canada. We also assessed how treatment types correlate with individuals' pain levels, sociodemographic characteristics, and country of residence, and identified unique clusters of adults in terms of treatment combinations. Research Design and Methods We used the 2020 "Recovery and Resilience" United States-Canada general online survey with 2 041 U.S. and 2 072 Canadian community-dwelling adults. Respondents selected up to 10 pain treatment options including medication, physical therapy, exercise, etc., and an open-ended item was available for self-report of any additional treatments. Data were analyzed using descriptive, regression-based, and latent class analyses. Results Over-the-counter (OTC) medication was reported most frequently (by 55% of respondents, 95% CI 53%-56%), followed by "just living with pain" (41%, 95% CI 40%-43%) and exercise (40%, 95% CI 38%-41%). The modal response (29%) to the open-ended item was cannabis use. Pain was the most salient correlate, predicting a greater frequency of all pain treatments. Country differences were generally small; a notable exception was alcohol use, which was reported twice as often among U.S. versus Canadian adults. Individuals were grouped into 5 distinct clusters: 2 groups relied predominantly on medication (prescription or OTC), another favored exercise and other self-care approaches, one included adults "just living with" pain, and the cluster with the highest pain levels employed all modalities heavily. Discussion and Implications Our findings provide new insights into recent pain treatment strategies among North American adults and identify population subgroups with potentially unmet need for more adaptive and effective pain management.
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Affiliation(s)
- Anna Zajacova
- Department of Sociology, University of Western Ontario, London, Ontario, Canada
| | - Alvaro Pereira Filho
- Department of Political Science, University of Western Ontario, London, Ontario, Canada
| | - Merita Limani
- Department of Sociology, University of Western Ontario, London, Ontario, Canada
| | - Hanna Grol-Prokopczyk
- Department of Sociology, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Zachary Zimmer
- Department of Family Studies and Gerontology, Global Aging and Community Initiative, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Dmitry Scherbakov
- Integrative Pain Laboratory, School of Public Health, University of Haifa, Haifa, Israel
| | - Roger B Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, Florida, USA
| | - Mark D Hayward
- Department of Sociology, University of Texas at Austin, Austin, Texas, USA
| | - Ian Gilron
- Department of Anesthesiology and Perioperative Medicine, Queens University, Kingston, Ontario, Canada
| | - Gary J Macfarlane
- Department of Epidemiology, Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen, UK
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Brainard J, Smith LE, Potts HWW, Rubin GJ. The relationship between age and sex partner counts during the mpox outbreak in the UK, 2022. PLoS One 2023; 18:e0291001. [PMID: 37682827 PMCID: PMC10490899 DOI: 10.1371/journal.pone.0291001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Understanding the dynamics of an infectious disease outbreak linked to sexual activity requires valid expectations of likely counts of unique sex partners during the infectious period. Typically, age is the key demographic trait linked to expected partner count, with many transmission models removing adults from the sexually active pool abruptly at a pre-specified age threshold. Modelling the rate of decline in partner counts with age would benefit from a better description of empirical evidence. METHODS During the 2022 mpox epidemic in the UK, we asked individuals about their partner counts in the preceding three weeks, which is about the same as usual infectious period for persons with active mpox. We used negative binomial regression (all responses) and Weibull regression (non-zero responses) to analyse the relationship between age and partner counts, adjusted for other demographic data (such as education level and occupation), sub-dividing by three types of respondent: men who have sex with men (MSM), men who have sex with women, and women who have sex with men. RESULTS Most respondents had zero or one recent partner, all distributions were skewed. There was a relatively linear declining relationship between age and partner counts for heterosexual partnership groups, but a peak in partner counts and concurrency for MSMs in middle age years (age 35-54), especially for MSM who seemed to be in a highly sexually active subgroup. CONCLUSION Useful data were collected that can be used to describe sex partner counts during the British mpox epidemic and that show distinctive partner count relationships with age, dependent on partnership type.
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Affiliation(s)
- Julii Brainard
- Norwich Medical School, University of East Anglia Norwich, Norwich, United Kingdom
| | - Louise E. Smith
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Henry W. W. Potts
- Institute of Health Informatics, University College London, London, United Kingdom
| | - G. James Rubin
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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Iida M, Murai T, Kuno M, Osumi K, Nakanishi-Imai M, Okazaki D, Murase T, Kawakita D, Iwasaki S, Inagaki H, Tomita N, Shibamoto Y, Hiwatashi A. Importance of the Number and Location of Lymph Node Metastasis in Oropharyngeal Cancer. In Vivo 2023; 37:2210-2218. [PMID: 37652496 PMCID: PMC10500500 DOI: 10.21873/invivo.13321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND/AIM The 8th edition of the American Joint Committee on Cancer staging system classifies oropharyngeal cancer (OPC) by the expression of p16. The discrepancy observed in this system between pathological and clinical N-stages in p16-positive OPC has provoked controversy. Therefore, this study investigated prognostic factors not included in the new staging system for p16-positive OPC patients. PATIENTS AND METHODS Patients with non-metastatic OPC receiving radiotherapy were reviewed. Clinical lymph node statuses were reassessed based on contrast-enhanced computed tomography and fluorodeoxyglucose positron emission tomography. Overall survival (OS) and cause-specific survival (CSS) were analyzed using multivariate analyses to adjust baseline imbalances. RESULTS In total, 166 OPC patients were reviewed. Among them, 81 patients with p16-positive were analyzed. Three or more lymph node metastases (LNM) were observed in 21 p16-positive OPCs. Retropharyngeal lymph node metastasis (Rp) was found in 12. Three-year OS, CSS, and progression-free survival rates in p16-positive patients were 76, 88, and 81%, respectively. In multivariate analyses of p16-positive OPC, LNM ≥3 was a prognostic factor of OS (hazard ratio=9.30, p<0.001) and CSS (hazard ratio=17.80, p=0.005). Rp was associated with poor CSS (hazard ratio=8.73, p=0.03). In N0-1 p16-positive patients, LNM ≥3 trended to be associated with poor OS (hazard ratio=3.93, p=0.06). CSS in patients with Rp was unfavorable (hazard ratio=70.16, p=0.05). CONCLUSION LNM ≥3 and Rp may be predictive of OS and CCS in p16-positive OPC. These are also possibly used to subcategorize p16-positive cN0-1 OPC. Further validation of lymph node staging is needed to refine the clinical staging system.
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Affiliation(s)
- Masato Iida
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan;
- Department of Radiology, Toyokawa City Hospital, Toyokawa, Japan
| | - Taro Murai
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Department of Radiation Oncology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Mayu Kuno
- Department of Radiology, Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - Kenshiro Osumi
- Department of Radiology, Kariya Toyota General Hospital, Kariya, Japan
| | - Mikiko Nakanishi-Imai
- Department of Radiology, Japanese Red Cross Aichi Medical Center, Nagoya Daini Hospital, Nagoya, Japan
| | - Dai Okazaki
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Department of Radiation Oncology, Chukyo Hospital, Nagoya, Japan
| | - Takayuki Murase
- Department of Pathology and Molecular Diagnostics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Daisuke Kawakita
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shinichi Iwasaki
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroshi Inagaki
- Department of Pathology and Molecular Diagnostics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Natsuo Tomita
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | - Akio Hiwatashi
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Feng Z, van den Broek T, Perra O, Cramm JM, Nieboer AP. Longitudinal health behaviour patterns among adults aged ≥50 years in China and their associations with trajectories of depressive symptoms. Aging Ment Health 2023; 27:1843-1852. [PMID: 36444931 DOI: 10.1080/13607863.2022.2149694] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Against the background of the growing recognition of the need for a holistic perspective on health behaviour, we aim to identify longitudinal patterns of multiple health behaviours, and to assess associations of such patterns with depressive symptoms among older people in China. METHODS Using three waves of China Health and Retirement Longitudinal Study data (n = 8439), we performed latent class growth analyses (LCGAs) to identify longitudinal patterns of multiple health behaviours. Random-effects models were estimated to assess associations between health behaviour patterns and depressive symptoms. RESULTS The best fitting LCGA model had seven classes: (1) connected active non-smokers (average posterior probability: 21.8%), (2) isolated active non-smokers (24.7%), (3) isolated inactive non-smokers (17.0%), (4) isolated active smokers (14.5%), (5) connected active smokers (12.2%), (6) increasingly connected and active non-smokers (5.4%), and (7) moderately connected inactive smokers (4.4%). Depressive symptoms were highest in the four classes with lower probabilities of social participation across waves. No evidence was found of change over time in depressive symptomatology gaps between people with different health behaviour trajectories. CONCLUSION Health behaviour patterns characterized by consistently low social participation were associated with raised depressive symptomatology, suggesting that focusing on social participation may benefit later-life mental health promotion strategies.
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Affiliation(s)
- Zeyun Feng
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Thijs van den Broek
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Oliver Perra
- School of Nursing and Midwifery & Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, UK
| | - Jane Murray Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Anna Petra Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
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Bouton J, Fielding L, Major D, Deane E, Mayer J, Rhodes D. Retrospective evaluation of factors associated with emergency frequency and survival in equids presenting for emergency care (2019-2020): 3071 cases. J Vet Emerg Crit Care (San Antonio) 2023; 33:598-605. [PMID: 37561021 DOI: 10.1111/vec.13332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 06/30/2022] [Accepted: 07/06/2022] [Indexed: 08/11/2023]
Abstract
OBJECTIVE To determine factors associated with frequency and outcome of equid emergencies in private practice. DESIGN Retrospective study from February 2019 to January 2020. SETTING Private practice large animal hospital. ANIMALS A total of 3071 equids of various breeds and ages presenting for emergency care. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Variables included for analysis of daily emergency frequency included day of the week, month, and daily climate data. A Poisson regression model found the maximum temperature (P = 0.05), average barometric pressure (P = 0.005), and decreases in barometric pressure (P = 0.05) were associated with an increasing daily number of emergencies. Overall survival for all emergencies was 89% (2748/3071). Variables included for analysis of nonsurvival for emergencies included signalment, body system, clinical examination findings, laboratory data, and experience of the veterinarian. A logistic regression model for primary emergencies (nonreferral) found that increasing age, increasing heart rate, and decreased gastrointestinal sounds were associated with an increase in nonsurvival. Body system and experience of the veterinarian affected nonsurvival. A logistic regression model for all emergencies (primary and referral) found that absent gastrointestinal sounds and an increasing PCV were associated with increased nonsurvival. CONCLUSIONS The number of daily emergencies in this practice was affected by the month of the year and day of the week. Additionally, hotter days, increased barometric pressure, or drops in barometric pressure are likely to be associated with a higher emergency caseload. Nonsurvival of primary equid emergencies in private practice increases with age, higher heart rates, and decreased gastrointestinal sounds.
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Affiliation(s)
- Jessica Bouton
- Emergency and Critical Care, Loomis Basin Equine Medical Center, Penryn, California, USA
| | - Langdon Fielding
- Emergency and Critical Care, Loomis Basin Equine Medical Center, Penryn, California, USA
| | - Dustin Major
- Emergency and Critical Care, Loomis Basin Equine Medical Center, Penryn, California, USA
| | - Emma Deane
- Emergency and Critical Care, Loomis Basin Equine Medical Center, Penryn, California, USA
| | - Jennifer Mayer
- Emergency and Critical Care, Loomis Basin Equine Medical Center, Penryn, California, USA
| | - Diane Rhodes
- Emergency and Critical Care, Loomis Basin Equine Medical Center, Penryn, California, USA
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Tönsing C, Steiert B, Timmer J, Kreutz C. Likelihood-ratio test statistic for the finite-sample case in nonlinear ordinary differential equation models. PLoS Comput Biol 2023; 19:e1011417. [PMID: 37738254 PMCID: PMC10550180 DOI: 10.1371/journal.pcbi.1011417] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/04/2023] [Accepted: 08/08/2023] [Indexed: 09/24/2023] Open
Abstract
Likelihood ratios are frequently utilized as basis for statistical tests, for model selection criteria and for assessing parameter and prediction uncertainties, e.g. using the profile likelihood. However, translating these likelihood ratios into p-values or confidence intervals requires the exact form of the test statistic's distribution. The lack of knowledge about this distribution for nonlinear ordinary differential equation (ODE) models requires an approximation which assumes the so-called asymptotic setting, i.e. a sufficiently large amount of data. Since the amount of data from quantitative molecular biology is typically limited in applications, this finite-sample case regularly occurs for mechanistic models of dynamical systems, e.g. biochemical reaction networks or infectious disease models. Thus, it is unclear whether the standard approach of using statistical thresholds derived for the asymptotic large-sample setting in realistic applications results in valid conclusions. In this study, empirical likelihood ratios for parameters from 19 published nonlinear ODE benchmark models are investigated using a resampling approach for the original data designs. Their distributions are compared to the asymptotic approximation and statistical thresholds are checked for conservativeness. It turns out, that corrections of the likelihood ratios in such finite-sample applications are required in order to avoid anti-conservative results.
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Affiliation(s)
- Christian Tönsing
- Institute of Physics, University of Freiburg, Germany
- CIBSS Centre for Integrative Biological Signalling Studies, University of Freiburg, Germany
- FDM Freiburg Center for Data Analysis and Modeling, University of Freiburg, Germany
| | | | - Jens Timmer
- Institute of Physics, University of Freiburg, Germany
- CIBSS Centre for Integrative Biological Signalling Studies, University of Freiburg, Germany
- FDM Freiburg Center for Data Analysis and Modeling, University of Freiburg, Germany
| | - Clemens Kreutz
- CIBSS Centre for Integrative Biological Signalling Studies, University of Freiburg, Germany
- FDM Freiburg Center for Data Analysis and Modeling, University of Freiburg, Germany
- Faculty of Medicine and Medical Center, Institute of Medical Biometry and Statistics, University of Freiburg, Germany
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49
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Shaw ZA, Handley ED, Warmingham JM, Starr LR. Patterns of life stress and the development of ruminative brooding in adolescence: A person-centered approach. Dev Psychopathol 2023:1-13. [PMID: 37589100 PMCID: PMC10873479 DOI: 10.1017/s0954579423000974] [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] [Indexed: 08/18/2023]
Abstract
Research links life stressors, including acute, chronic, and early life stress, to the development of ruminative brooding. However, singular forms of life stress rarely occur in isolation, as adolescents typically encounter stressors that vary on important dimensions (e.g., types, timings, quantities) across development. The current study employs latent profile analysis (LPA) to identify natural clusters of life stress that, over time, may be differently associated with ruminative brooding. Evaluations of episodic, chronic, and early life stress were conducted with community-recruited mid-adolescents (N = 241, Mage = 15.90 years, 53% female) and their parents using the UCLA Life Stress Interview and lifetime adversity portions of the Youth Life Stress Interview. Analyses identified four distinct patterns: low stress, high peer stress, moderate home / family stress, and multifaceted / high school stress. Adolescents in the high peer stress and moderate home / family stress profiles were at highest risk for developing a brooding style over time. Despite high overall levels of stress, teens in the multifaceted / high school stress profile were at not at elevated risk for developing a brooding style. Findings demonstrate the utility of person-centered approaches to identify patterns of stress exposure that heighten risk for brooding over time.
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Affiliation(s)
- Zoey A Shaw
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Jennifer M Warmingham
- Department of Pediatrics, Columbia University, Irving Medical Center, New York, NY, USA
| | - Lisa R Starr
- Department of Psychology, University of Rochester, Rochester, NY, USA
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Tenaw Z, Gari T, Gebretsadik A. Sexual lives of reproductive-aged people with disabilities in Central Sidama National Regional State, Ethiopia: a mixed-methods study. BMC Public Health 2023; 23:1550. [PMID: 37582722 PMCID: PMC10428632 DOI: 10.1186/s12889-023-16511-z] [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: 03/23/2023] [Accepted: 08/10/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Sexuality is an important part of human life; people with disabilities have the same sexual desires as people without disabilities. However, the status of the sexual lives of reproductive-aged people with disabilities is unfolded in Ethiopia. Therefore, this study was aimed to assess sexual lives and its associated factors among reproductive-aged people with disabilities in central Sidama National Regional State, Ethiopia. METHODS A mixed-methods study was conducted among randomly selected 685 reproductive-age people with disabilities and fifteen (15) in-depth interviews among individuals who have sexual practice experience from June 20 to July 15, 2022. The quantitative data were collected through face-to-face interviewing techniques using a structured and semi-structured questionnaire. A multilevel logistic regression analysis model was employed to analyze the data. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report the measures of associations. The qualitative data were managed and analyzed using the phenomenological research analysis approach. RESULTS In this study, 59.9% (95% CI: 56.1, 63.5) of the people with disabilities have practiced sexual intercourse. Of these, 30.8% (95% CI: 27.4, 34.4) were males and 29.1% (95% CI: 25.7, 32.6) were females with disabilities. Being female (AOR = 2.81; 95% CI: 1.70, 4.62), having an occupation (AOR = 7.55; 95% CI: 4.03, 14.1), having a disability and being in a wheelchair (AOR = 0.27; 95% CI: 0.09, 0.82), having a good self-perception (AOR = 0.46; 95% CI: 0.28, 0.77), and having a rich economic status (AOR = 2.05; 95% CI: 1.08, 3.89) were factors associated with the sexual practice. The qualitative findings revealed that having sexuality information (training) is the facilitator, and community discrimination and low economic income are the barriers to sexual practice. CONCLUSION Sexual practice among people with disabilities is low in the Dale and Wonsho districts and Yirgalem city administration. Socio-demographic and economic factors and sexuality training are the associated factors. Therefore, creating job opportunities and economic empowerment, providing sexuality training, and creating community awareness are crucial to improving the sexual practice of reproductive-age people with disabilities.
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Affiliation(s)
- Zelalem Tenaw
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
| | - Taye Gari
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Achamyelesh Gebretsadik
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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