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Yang L, Tibbo PG, Stewart SH, Simon P, Bullerwell M, Wang J. A cross-sectional study of the relationship between frequency of cannabis use and psychiatric symptoms among people seeking mental health and addiction services in Nova Scotia (2019-21). J Psychiatr Res 2024; 173:104-110. [PMID: 38518571 DOI: 10.1016/j.jpsychires.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/13/2024] [Accepted: 03/15/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Cannabis use may be a modifiable risk factor for mental health problems; however, the role of cannabis use frequency in population seeking mental health and addiction services remains unclear. This study aimed to: 1) compare the prevalence and functional impact of psychiatric symptoms among frequent, infrequent, and non-users of cannabis; and 2) evaluate the associations between cannabis use frequency and functional impact of psychiatric symptoms in help-seeking individuals. METHODS Data from the Mental Health and Addictions (MHA) Central Intake system in Nova Scotia, Canada was used. Participants aged 19-64 who received MHA Intake assessments from September 2019 to December 2021 with complete information about substance use were included (N = 20,611). Cannabis use frequency over past 30 days was categorized into frequent (>4 times a month), infrequent (≤4 times a month), and non-use. Psychiatric symptomatology consists of five domains: mood, anxiety, psychosis, cognition, and externalizing behaviors. Multivariate ordinal logistic regression was used to examine the associations between cannabis use frequency and functional impact of psychiatric symptoms. RESULTS Frequent and infrequent cannabis users had a higher prevalence of psychiatric symptoms in each domain than non-users, while no significant differences were found between frequent and infrequent users. Frequent cannabis use was associated with greater functional impact of psychiatric symptoms in each domain compared to non-users, while infrequent use was only associated with greater functional impact of externalizing behaviors. CONCLUSION Frequent cannabis use is associated with increased prevalence and functional impact of psychiatric symptoms among adults seeking mental health services.
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Affiliation(s)
- Lu Yang
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Canada; Early Psychosis Intervention Nova Scotia, Nova Scotia Health, Canada
| | - Sherry H Stewart
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Canada; Department of Psychiatry, Faculty of Medicine, Dalhousie University, Canada; Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, Canada
| | - Patryk Simon
- Mental Health and Addiction Program, Nova Scotia Health, Canada
| | | | - JianLi Wang
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Canada; Department of Psychiatry, Faculty of Medicine, Dalhousie University, Canada.
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Cheng C, Ren C, Li MZ, Liu YH, Yao RQ, Yu Y, Yu X, Wang JL, Wang LX, Leng YC, Zhang H, Du FF, Dong N, Wang FQ, Wu Y, Xu F, Zhu XM, Zhang GP, Dong K, Liu S, Yao XQ, Li C, Yao YM. Pharmacologically significant constituents collectively responsible for anti-sepsis action of XueBiJing, a Chinese herb-based intravenous formulation. Acta Pharmacol Sin 2024; 45:1077-1092. [PMID: 38267547 PMCID: PMC11053071 DOI: 10.1038/s41401-023-01224-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Sepsis, a life-threatening health issue, lacks effective medicine targeting the septic response. In China, treatment combining the intravenous herbal medicine XueBiJing with conventional procedures reduces the 28-day mortality of critically ill patients by modulating septic response. In this study, we identified the combined active constituents that are responsible for the XueBiJing's anti-sepsis action. Sepsis was induced in rats by cecal ligation and puncture (CLP). The compounds were identified based on their systemic exposure levels and anti-sepsis activities in CLP rats that were given an intravenous bolus dose of XueBiJing. Furthermore, the identified compounds in combination were assessed, by comparing with XueBiJing, for levels of primary therapeutic outcome, pharmacokinetic equivalence, and pharmacokinetic compatibility. We showed that a total of 12 XueBiJing compounds, unchanged or metabolized, circulated with significant systemic exposure in CLP rats that received XueBiJing. Among these compounds, hydroxysafflor yellow A, paeoniflorin, oxypaeoniflorin, albiflorin, senkyunolide I, and tanshinol displayed significant anti-sepsis activities, which involved regulating immune responses, inhibiting excessive inflammation, modulating hemostasis, and improving organ function. A combination of the six compounds, with the same respective doses as in XueBiJing, displayed percentage survival and systemic exposure in CLP rats similar to those by XueBiJing. Both the combination and XueBiJing showed high degrees of pharmacokinetic compatibility regarding interactions among the six active compounds and influences of other circulating XueBiJing compounds. The identification of XueBiJing's pharmacologically significant constituents supports the medicine's anti-sepsis use and provides insights into a polypharmacology-based approach to develop medicines for effective sepsis management.
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Affiliation(s)
- Chen Cheng
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Chao Ren
- Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing, 100853, China
- Department of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Mu-Zi Li
- School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Yi-Hui Liu
- School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Ren-Qi Yao
- Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing, 100853, China
| | - Yang Yu
- Tianjin Chasesun Pharmaceutical Co., Ltd, Tianjin, 301700, China
| | - Xuan Yu
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
- School of Pharmacy, University of Chinese Academy of Sciences, Shanghai, 201203, China
| | - Jian-Li Wang
- Tianjin Chasesun Pharmaceutical Co., Ltd, Tianjin, 301700, China
| | - Li-Xue Wang
- Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing, 100853, China
| | - Yu-Chun Leng
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
- School of Pharmacy, University of Chinese Academy of Sciences, Shanghai, 201203, China
| | - Hui Zhang
- Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing, 100853, China
| | - Fei-Fei Du
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Ning Dong
- Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing, 100853, China
| | - Feng-Qing Wang
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Yao Wu
- Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing, 100853, China
| | - Fang Xu
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Xiao-Mei Zhu
- Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing, 100853, China
| | - Gui-Ping Zhang
- Tianjin Chasesun Pharmaceutical Co., Ltd, Tianjin, 301700, China
| | - Kai Dong
- Tianjin Chasesun Pharmaceutical Co., Ltd, Tianjin, 301700, China
| | - Si Liu
- Tianjin Chasesun Pharmaceutical Co., Ltd, Tianjin, 301700, China
| | - Xiao-Qing Yao
- Tianjin Chasesun Pharmaceutical Co., Ltd, Tianjin, 301700, China
| | - Chuan Li
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China.
- School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
- School of Pharmacy, University of Chinese Academy of Sciences, Shanghai, 201203, China.
- Zhongshan Institute for Drug Discovery, Zhongshan, 528400, China.
- Haihe Laboratory of Modern Chinese Medicine, Tianjin, 301617, China.
| | - Yong-Ming Yao
- Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing, 100853, China.
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Nogovitsyn N, Ballester P, Lasby M, Dunlop K, Ceniti AK, Squires S, Rowe J, Ho K, Suh J, Hassel S, Souza R, Casseb RF, Harris JK, Zamyadi M, Arnott SR, Strother SC, Hall G, Lam RW, Poppenk J, Lebel C, Bray S, Metzak P, MacIntosh BJ, Goldstein BI, Wang J, Rizvi SJ, MacQueen G, Addington J, Harkness KL, Rotzinger S, Kennedy SH, Frey BN. An empirical analysis of structural neuroimaging profiles in a staging model of depression. J Affect Disord 2024; 351:631-640. [PMID: 38290583 DOI: 10.1016/j.jad.2024.01.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/16/2024] [Accepted: 01/26/2024] [Indexed: 02/01/2024]
Abstract
We examine structural brain characteristics across three diagnostic categories: at risk for serious mental illness; first-presenting episode and recurrent major depressive disorder (MDD). We investigate whether the three diagnostic groups display a stepwise pattern of brain changes in the cortico-limbic regions. Integrated clinical and neuroimaging data from three large Canadian studies were pooled (total n = 622 participants, aged 12-66 years). Four clinical profiles were used in the classification of a clinical staging model: healthy comparison individuals with no history of depression (HC, n = 240), individuals at high risk for serious mental illness due to the presence of subclinical symptoms (SC, n = 80), first-episode depression (FD, n = 82), and participants with recurrent MDD in a current major depressive episode (RD, n = 220). Whole-brain volumetric measurements were extracted with FreeSurfer 7.1 and examined using three different types of analyses. Hippocampal volume decrease and cortico-limbic thinning were the most informative features for the RD vs HC comparisons. FD vs HC revealed that FD participants were characterized by a focal decrease in cortical thickness and global enlargement in amygdala volumes. Greater total amygdala volumes were significantly associated with earlier onset of illness in the FD but not the RD group. We did not confirm the construct validity of a tested clinical staging model, as a differential pattern of brain alterations was identified across the three diagnostic groups that did not parallel a stepwise clinical staging approach. The pathological processes during early stages of the illness may fundamentally differ from those that occur at later stages with clinical progression.
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Affiliation(s)
- Nikita Nogovitsyn
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | - Pedro Ballester
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Mike Lasby
- Electrical and Software Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Katharine Dunlop
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Amanda K Ceniti
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON, Canada; Arthur Sommer Rotenberg Suicide & Depression Studies Program, St. Michael's Hospital, Toronto, ON, Canada
| | - Scott Squires
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Jessie Rowe
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Keith Ho
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON, Canada
| | - JeeSu Suh
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Stefanie Hassel
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Roberto Souza
- Electrical and Software Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Raphael F Casseb
- Neuroimaging Laboratory, University of Campinas, Campinas, SP, Brazil
| | | | - Mojdeh Zamyadi
- Rotman Research Institute, Baycrest, Toronto, ON, Canada
| | | | - Stephen C Strother
- Rotman Research Institute, Baycrest, Toronto, ON, Canada; Department of Medical Biophysics, University of Toronto, ON, Canada
| | - Geoffrey Hall
- Department of Psychology, Neuroscience & Behaviour, McMaster University, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Jordan Poppenk
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Catherine Lebel
- Department of Radiology, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, Calgary, AB, Canada; Child & Adolescent Imaging Research (CAIR) Program, Calgary, AB, Canada
| | - Signe Bray
- Department of Radiology, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, Calgary, AB, Canada; Child & Adolescent Imaging Research (CAIR) Program, Calgary, AB, Canada
| | - Paul Metzak
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Bradley J MacIntosh
- Rotman Research Institute, Baycrest, Toronto, ON, Canada; Hurvitz Brain Sciences Program, Physical Sciences Platform, Sunnybrook Research Institute, Toronto, Ontario, Canada; Computational Radiology & Artificial Intelligence (CRAI) Unit, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry and Pharmacology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - JianLi Wang
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Sakina J Rizvi
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON, Canada; Arthur Sommer Rotenberg Suicide & Depression Studies Program, St. Michael's Hospital, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Glenda MacQueen
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Kate L Harkness
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Susan Rotzinger
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON, Canada; Arthur Sommer Rotenberg Suicide & Depression Studies Program, St. Michael's Hospital, Toronto, ON, Canada; Krembil Research Centre, University Health Network, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Sidney H Kennedy
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON, Canada; Arthur Sommer Rotenberg Suicide & Depression Studies Program, St. Michael's Hospital, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Krembil Research Centre, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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Gholi Zadeh Kharrat F, Gagne C, Lesage A, Gariépy G, Pelletier JF, Brousseau-Paradis C, Rochette L, Pelletier E, Lévesque P, Mohammed M, Wang J. Explainable artificial intelligence models for predicting risk of suicide using health administrative data in Quebec. PLoS One 2024; 19:e0301117. [PMID: 38568987 PMCID: PMC10990247 DOI: 10.1371/journal.pone.0301117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/11/2024] [Indexed: 04/05/2024] Open
Abstract
Suicide is a complex, multidimensional event, and a significant challenge for prevention globally. Artificial intelligence (AI) and machine learning (ML) have emerged to harness large-scale datasets to enhance risk detection. In order to trust and act upon the predictions made with ML, more intuitive user interfaces must be validated. Thus, Interpretable AI is one of the crucial directions which could allow policy and decision makers to make reasonable and data-driven decisions that can ultimately lead to better mental health services planning and suicide prevention. This research aimed to develop sex-specific ML models for predicting the population risk of suicide and to interpret the models. Data were from the Quebec Integrated Chronic Disease Surveillance System (QICDSS), covering up to 98% of the population in the province of Quebec and containing data for over 20,000 suicides between 2002 and 2019. We employed a case-control study design. Individuals were considered cases if they were aged 15+ and had died from suicide between January 1st, 2002, and December 31st, 2019 (n = 18339). Controls were a random sample of 1% of the Quebec population aged 15+ of each year, who were alive on December 31st of each year, from 2002 to 2019 (n = 1,307,370). We included 103 features, including individual, programmatic, systemic, and community factors, measured up to five years prior to the suicide events. We trained and then validated the sex-specific predictive risk model using supervised ML algorithms, including Logistic Regression (LR), Random Forest (RF), Extreme Gradient Boosting (XGBoost) and Multilayer perceptron (MLP). We computed operating characteristics, including sensitivity, specificity, and Positive Predictive Value (PPV). We then generated receiver operating characteristic (ROC) curves to predict suicides and calibration measures. For interpretability, Shapley Additive Explanations (SHAP) was used with the global explanation to determine how much the input features contribute to the models' output and the largest absolute coefficients. The best sensitivity was 0.38 with logistic regression for males and 0.47 with MLP for females; the XGBoost Classifier with 0.25 for males and 0.19 for females had the best precision (PPV). This study demonstrated the useful potential of explainable AI models as tools for decision-making and population-level suicide prevention actions. The ML models included individual, programmatic, systemic, and community levels variables available routinely to decision makers and planners in a public managed care system. Caution shall be exercised in the interpretation of variables associated in a predictive model since they are not causal, and other designs are required to establish the value of individual treatments. The next steps are to produce an intuitive user interface for decision makers, planners and other stakeholders like clinicians or representatives of families and people with live experience of suicidal behaviors or death by suicide. For example, how variations in the quality of local area primary care programs for depression or substance use disorders or increased in regional mental health and addiction budgets would lower suicide rates.
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Affiliation(s)
- Fatemeh Gholi Zadeh Kharrat
- Institut Intelligence et Données (IID), Université Laval, Québec, Québec, Canada
- Institut National de Santé Publique du Québec (INSPQ), Québec, Québec, Canada
| | - Christian Gagne
- Institut Intelligence et Données (IID), Université Laval, Québec, Québec, Canada
| | - Alain Lesage
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Québec, Canada
| | - Geneviève Gariépy
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
- Montreal Mental Health University Institute Research Center, Montreal, Canada
| | - Jean-François Pelletier
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Québec, Canada
| | - Camille Brousseau-Paradis
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Québec, Canada
| | - Louis Rochette
- Institut National de Santé Publique du Québec (INSPQ), Québec, Québec, Canada
| | - Eric Pelletier
- Institut National de Santé Publique du Québec (INSPQ), Québec, Québec, Canada
| | - Pascale Lévesque
- Institut National de Santé Publique du Québec (INSPQ), Québec, Québec, Canada
| | - Mada Mohammed
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - JianLi Wang
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Canada
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Vasiliadis HM, Spagnolo J, Bartram M, Fleury MJ, Gouin JP, Grenier S, Roberge P, Shen-Tu G, Vena JE, Lamoureux-Lamarche C, Wang J. Factors associated with change in moderate or severe symptoms of anxiety and depression in community-living adults and older adults during the COVID-19 pandemic. Can J Public Health 2024; 115:230-243. [PMID: 38117417 PMCID: PMC11006639 DOI: 10.17269/s41997-023-00832-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 10/24/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES Few are the longitudinal studies on the changes in moderate or severe symptoms of anxiety or depression (MSS-ANXDEP) from before to during the COVID-19 pandemic in Canada. The aim was to study the change in MSS-ANXDEP and associated sociodemographic, economic, psychosocial, health behaviour and lifestyle, and clinical factors. METHODS The current sample includes 59,997 adults aged ≥ 35 years participating in the 2018 and 2020 health surveys of the 5 established cohorts of the Canadian Partnership for Tomorrow's Health (CanPath). MSS-ANXDEP was based on a cutoff score ≥ 10 on the 7-item Generalized Anxiety Disorder Scale and Patient Health Questionnaire (PHQ-8). Change in MSS-ANXDEP was categorized as follows: no MSS-ANXDEP, remitted, incident, and persistent. Multinomial regressions were used to study MSS-ANXDEP as a function of sociodemographic, economic, psychosocial, health behaviours and lifestyle, and clinical factors. RESULTS Sociodemographic and economic (i.e. age, gender, cohort, race/ethnicity, lower income, decreased in income, work status, being an essential worker), lifestyle and health behaviours (i.e. smoking, cannabis and alcohol use, drinking more alcohol), psychosocial (i.e. provide help to others, information and instrumental support, and change in relationships with friends, family, and partner) and clinical factors (i.e. lifetime mental disorder and multimorbidity) were associated with remitted, incident, and persistent MSS-ANXDEP. CONCLUSION Health and socio-economic factors were associated with changes in symptoms of anxiety and depression during the pandemic, further increasing inequities in mental health needs. Public health campaigns on the importance of healthy behaviours should continue and health policies should reduce economic and social barriers to integrated substance use and mental health care.
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Affiliation(s)
- Helen-Maria Vasiliadis
- Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Québec, Canada.
- Centre de recherche Charles-Le Moyne, Longueuil, Québec, Canada.
| | - Jessica Spagnolo
- Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Centre de recherche Charles-Le Moyne, Longueuil, Québec, Canada
| | - Mary Bartram
- Mental Health Commission of Canada, Ottawa, Ontario, Canada
- School of Public Policy & Administration, Carleton University, Ottawa, Ontario, Canada
| | - Marie-Josée Fleury
- Douglas Mental Health University Institute, Verdun, Québec, Canada
- McGill University, Montreal, Québec, Canada
| | - Jean-Philippe Gouin
- Department of Psychology, Concordia University, Montreal, Québec, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Québec, Canada
| | - Sébastien Grenier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Québec, Canada
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Pasquale Roberge
- Département de médecine familiale et d'urgence, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Grace Shen-Tu
- Alberta's Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Jennifer E Vena
- Alberta's Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Catherine Lamoureux-Lamarche
- Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Centre de recherche Charles-Le Moyne, Longueuil, Québec, Canada
| | - JianLi Wang
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
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6
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Vasiliadis HM, Spagnolo J, Bartram M, Fleury MJ, Gouin JP, Grenier S, Roberge P, Shen-Tu G, Vena JE, Lamoureux-Lamarche C, Wang J. Correction: Factors associated with change in moderate or severe symptoms of anxiety and depression in community-living adults and older adults during the COVID-19 pandemic. Can J Public Health 2024; 115:244. [PMID: 38347372 PMCID: PMC11006630 DOI: 10.17269/s41997-024-00864-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Affiliation(s)
- Helen-Maria Vasiliadis
- Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Québec, Canada.
- Centre de recherche Charles-Le Moyne, Longueuil, Québec, Canada.
| | - Jessica Spagnolo
- Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Centre de recherche Charles-Le Moyne, Longueuil, Québec, Canada
| | - Mary Bartram
- Mental Health Commission of Canada, Ottawa, Ontario, Canada
- School of Public Policy & Administration, Carleton University, Ottawa, Ontario, Canada
| | - Marie-Josée Fleury
- Douglas Mental Health University Institute, Verdun, Québec, Canada
- McGill University, Montreal, Québec, Canada
| | - Jean-Philippe Gouin
- Department of Psychology, Concordia University, Montreal, Québec, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Québec, Canada
| | - Sébastien Grenier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Québec, Canada
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Pasquale Roberge
- Département de médecine familiale et d'urgence, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Grace Shen-Tu
- Alberta's Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Jennifer E Vena
- Alberta's Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Catherine Lamoureux-Lamarche
- Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Centre de recherche Charles-Le Moyne, Longueuil, Québec, Canada
| | - JianLi Wang
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
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Song PP, Zhang XL, Li XL, Xu D, Wang JL, Chu MM, Wang MY, Jia TM, Du KX, Dong Y. [Clinical and genetic spectrum of 6 cases with asparagine synthetase deficiency]. Zhonghua Er Ke Za Zhi 2024; 62:368-373. [PMID: 38527509 DOI: 10.3760/cma.j.cn112140-20230915-00193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Objective: To explore the clinical and genetic characteristics of asparagine synthase deficiency. Methods: Case series studies. Retrospective analysis and summary of the clinical data of 6 cases with asparagine synthase deficiency who were diagnosed by genetic testing and admitted to the Third Affiliated Hospital of Zhengzhou University from May 2017 to April 2023 were analyzed retrospectively. The main clinical features, laboratory and imaging examination characteristics of the 6 cases were summarized, and the gene variation sites of them were analyzed. Results: All of the 6 cases were male, with onset ages ranging from 1 month to 1 year and 4 months. All of the 6 cases had cognitive and motor developmental delay, with 3 cases starting with developmental delay, 3 cases starting with convulsions and later experiencing developmental arrest or even regression. All of 6 cases had epilepsy, in whom 2 cases with severe microcephaly developed epileptic encephalopathy in the early stages of infancy with spasms as the main form of convulsions, 4 cases with mild or no microcephaly gradually evolved into convulsions with no fever after multiple febrile convulsions with focal seizures, tonic clonic seizures and tonic seizure as the main forms of convulsions. Three cases of 4 gradually developed into stagnation or even regression of development and ataxia after multiple convulsions with no fever. There were normal cranial imaging in 2 cases, dysplasia of the brains in 1 cases, frontal lobe apex accompanied by abnormal white matter signal in the frontal lobe and thin corpus callosum in 1 case, thin corpus callosum and abnormal lateral ventricular morphology in 1 case, and normal in early stage, but gradually developing into cerebellar atrophy at the age of 5 years and 9 months in 1 case. Two cases underwent visual evoked potential tests, the results of which were both abnormal. Three cases underwent auditory evoked potential examination, with 1 being normal and 2 being abnormal. All of 6 cases had variations in the asparagine synthase gene, with 2 deletion variations and 7 missense variations. The variations of 2 cases had not been reported so far, including c.1341_1343del and c.1283A>G, c.1165_1167del and c.1075G>A. The follow-up time ranged from 3 months to 53 months. Two cases who had severe microcephaly died in infancy, while the other 4 cases with mild or no microcephaly were in survival states until the follow-up days but the control of epilepsy was poor. Conclusions: Asparagine synthase deficiency has a certain degree of heterogeneity in clinical phenotype. Children with obvious microcephaly often present as severe cases, while children with mild or no microcephaly have relatively mild clinical manifestations. The variation of asparagine synthetase gene is mainly missense variation.
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Affiliation(s)
- P P Song
- Department of Pediatrics, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450002, China
| | - X L Zhang
- Department of Pediatrics, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450002, China
| | - X L Li
- Department of Pediatrics, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450002, China
| | - D Xu
- Department of Pediatrics, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450002, China
| | - J L Wang
- Department of Pediatrics, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450002, China
| | - M M Chu
- Department of Pediatrics, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450002, China
| | - M Y Wang
- Department of Pediatrics, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450002, China
| | - T M Jia
- Department of Pediatrics, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450002, China
| | - K X Du
- Department of Pediatrics, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450002, China
| | - Y Dong
- Department of Pediatrics, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450002, China
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8
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Njoroge W, Maina R, Frank E, Atwoli L, Wu Z, Ngugi AK, Sen S, Wang J, Wong S, Baker JA, Weinheimer-Haus EM, Khakali L, Aballa A, Orwa J, Nyongesa MK, Shah J, Waljee AK, Abubakar A, Merali Z. Correction: Use of mobile technology to identify behavioral mechanisms linked to mental health outcomes in Kenya: protocol for development and validation of a predictive model. BMC Res Notes 2024; 17:72. [PMID: 38475887 DOI: 10.1186/s13104-024-06731-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Affiliation(s)
- Willie Njoroge
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
- Department of Psychology, Southwest University, Chongqing, China
| | - Rachel Maina
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya.
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands.
| | - Elena Frank
- Michigan Neuroscience Institute, University of Michigan, Michigan, USA
| | - Lukoye Atwoli
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
- Department of Medicine, Medical College East Africa, The Aga Khan University, Nairobi, Kenya
| | - Zhenke Wu
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Anthony K Ngugi
- Department of Population Health, Aga Khan University, Srijan Sen, Nairobi, Kenya
| | - Srijan Sen
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - JianLi Wang
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Stephen Wong
- Computing and Data Innovation Office, Aga Khan University, Nairobi, Kenya
| | - Jessica A Baker
- Center for Global Health Equity, University of Michigan, Ann Arbor, MI, USA
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Eileen M Weinheimer-Haus
- Center for Global Health Equity, University of Michigan, Ann Arbor, MI, USA
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Linda Khakali
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
- Department of Sociology, University of Nairobi, Nairobi, Kenya
| | - Andrew Aballa
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - James Orwa
- Department of Population Health, Aga Khan University, Srijan Sen, Nairobi, Kenya
| | - Moses K Nyongesa
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Jasmit Shah
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Akbar K Waljee
- Center for Global Health Equity, University of Michigan, Ann Arbor, MI, USA
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
- Neurosciences Unit, Kenya Medical Research Institute?Wellcome TrustResearch Programme, Kilifi, Kenya
| | - Zul Merali
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
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9
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Wang JL, Zhang BY, Qi MY, Meng HF, Jin TY, Chen Z, Duan WR. [Clinical evaluation methods for craniovertebral junction abnormalities]. Zhonghua Wai Ke Za Zhi 2024; 62:260-264. [PMID: 38291643 DOI: 10.3760/cma.j.cn112139-20230717-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Craniovertebral junction malformation is a congenital malformation located in the foramen magnum and upper cervical spine, including bone and nerve malformation, resulting in motor and sensory disorders, cerebellar and lower cranial nerves, etc. The evaluation methods of clinical symptoms and efficacy of craniovertebral junction malformation are important for the surgical indications and effects, mainly including the evaluation of clinical symptoms and the quality of life. At present, the commonly used methods in clinical work and literature are the Japanese orthopaedic association scores, visual analogue scales, 36-item short-form health survey, etc. Most of these clinical evaluations are not aimed at craniovertebral junction diseases but focus on the description of a certain type of clinical symptoms. Chicago Chiari outcome scale and syringomyelia outcome scale of Xuanwu hospital are dedicated to Craniovertebral junction malformation, but more clinical studies are needed to prove their effectiveness. Based on the literature reports, this article reviewed the previous clinical evaluation methods of craniovertebral junction malformation and discusses their applications and limitations.
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Affiliation(s)
- J L Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University; Spine Center, China International Neuroscience Institute, Beijing 100032, China
| | - B Y Zhang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University; Spine Center, China International Neuroscience Institute, Beijing 100032, China
| | - M Y Qi
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University; Spine Center, China International Neuroscience Institute, Beijing 100032, China
| | - H F Meng
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University; Spine Center, China International Neuroscience Institute, Beijing 100032, China
| | - T Y Jin
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University; Spine Center, China International Neuroscience Institute, Beijing 100032, China
| | - Z Chen
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University; Spine Center, China International Neuroscience Institute, Beijing 100032, China
| | - W R Duan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University; Spine Center, China International Neuroscience Institute, Beijing 100032, China
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10
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Adu MK, da Luz Dias R, Obuobi-Donkor G, Ezeanozie N, Sridharan S, Morrison J, Simon P, Taylor B, MacKinnon M, Gossen S, Awara M, White M, Shalaby R, Agyapong B, Eboreime E, Wang J, Feng C, Wozney L, Koto P, Warford J, Murphy GT, Agyapong VIO. Reducing wait times and avoiding unnecessary use of high-cost mental health services through a Rapid Access and Stabilization Program: protocol for a program evaluation study. BMC Health Serv Res 2024; 24:247. [PMID: 38413957 PMCID: PMC10898149 DOI: 10.1186/s12913-024-10697-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 02/08/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Emergency psychiatric care, unplanned hospital admissions, and inpatient health care are the costliest forms of mental health care. According to Statistics Canada (2018), almost 18% (5.3 million) of Canadians reported needing mental health support. However, just above half of this figure (56.2%) have reported their needs were fully met. In light of this evidence there is a pressing need to provide accessible mental health services in flexible yet cost-effective ways. To further expand capacity and access to mental health care in the province, Nova Scotia Health has launched a novel mental health initiative for people in need of mental health care without requiring emergency department visits or hospitalization. This new service is referred to as the Rapid Access and Stabilization Program (RASP). This study evaluates the effectiveness and impact of the RASP on high-cost health services utilization (e.g. ED visits, mobile crisis visits, and inpatient treatments) and related costs. It also assesses healthcare partners' (e.g. healthcare providers, policymakers, community leaders) perceptions and patient experiences and satisfaction with the program and identifies sociodemographic characteristics, psychological conditions, recovery, well-being, and risk measures in the assisted population. METHOD This is a hypothesis-driven program evaluation study that employs a mixed methods approach. A within-subject comparison (pre- and post-evaluation study) will examine health services utilization data from patients attending RASP, one year before and one year after their psychiatry assessment at the program. A controlled between-subject comparison (cohort study) will use historical data from a control population will examine whether possible changes in high-cost health services utilization are associated with the intervention (RASP). The primary analysis involves extracting secondary data from provincial information systems, electronic medical records, and regular self-reported clinical assessments. Additionally, a qualitative sub-study will examine patient experience and satisfaction, and health care partners' impressions. DISCUSSION We expect that RASP evaluation findings will demonstrate a minimum 10% reduction in high-cost health services utilization and corresponding 10% cost savings, and also a reduction in the wait times for patient consultations with psychiatrists to less than 30 calendar days, in both within-subject and between-subject comparisons. In addition, we anticipate that patients, healthcare providers and healthcare partners would express high levels of satisfaction with the new service. CONCLUSION This study will demonstrate the results of the Mental Health and Addictions Program (MHAP) efforts to provide stepped-care, particularly community-based support, to individuals with mental illnesses. Results will provide new insights into a novel community-based approach to mental health service delivery and contribute to knowledge on how to implement mental health programs across varying contexts.
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Affiliation(s)
- Medard K Adu
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Raquel da Luz Dias
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Gloria Obuobi-Donkor
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Ngozi Ezeanozie
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS, Canada
| | - Sanjana Sridharan
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS, Canada
| | - Jason Morrison
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS, Canada
| | - Patryk Simon
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS, Canada
| | - Bryanne Taylor
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS, Canada
| | - Monica MacKinnon
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS, Canada
| | - Shiloh Gossen
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS, Canada
| | - Mahmoud Awara
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS, Canada
| | - Mattew White
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS, Canada
| | - Reham Shalaby
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Belinda Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - JianLi Wang
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Cindy Feng
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Lori Wozney
- Mental Health and Addictions Program, IWK Health, Halifax, NS, Canada
| | - Prosper Koto
- Research, Innovation and Discovery, Nova Scotia Health, Halifax, NS, Canada
| | - Jordan Warford
- Research, Innovation and Discovery, Nova Scotia Health, Halifax, NS, Canada
| | | | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS, Canada.
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11
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Zhao ZX, Zhang YQ, Chen X, Wang X, Wang JL, Wu BJ, Ren XY, Li Y. [Spontaneous otogenic pneumocephalus: a case report]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2024; 59:169-171. [PMID: 38369796 DOI: 10.3760/cma.j.cn115330-20230816-00048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Affiliation(s)
- Z X Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
| | - Y Q Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
| | - X Chen
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
| | - X Wang
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
| | - J L Wang
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
| | - B J Wu
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
| | - X Y Ren
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
| | - Y Li
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
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12
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Vasiliadis HM, Spagnolo J, Fleury MJ, Gouin JP, Roberge P, Bartram M, Grenier S, Shen-Tu G, Vena JE, Wang J. Factors associated with mental health service use during the pandemic: Initiation and barriers. Int J Soc Psychiatry 2024; 70:59-69. [PMID: 37646244 PMCID: PMC10860360 DOI: 10.1177/00207640231194489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
BACKGROUND Scarce are the studies focusing on initiation of new mental health service use (MHSU) and distinguishing individuals who have sought services but have been unsuccessful in accessing these. AIMS Assessing the factors associated with initiating new MHSU as compared to no MHSU due to self-reported no need, no MHSU due to health system and personal barriers and MHSU using resources already in place. METHODS The sample included participants (n = 16,435) in the five established regional cohorts of the Canadian Partnership for Tomorrow's Health (CanPath) who responded to the CanPath COVID-19 health surveys (May-December 2020 and January-June 2021). Multinomial regression analyses were carried out to study MHSU since the pandemic (March 2020) as a function of predisposing, enabling and need factors. Analyses were carried out in the overall sample and restricted to those with moderate and severe symptoms (MSS) of depression and/or anxiety (n = 2,237). RESULTS In individuals with MSS of depression and/or anxiety, 14.4% reported initiating new MHSU, 22.0% had no MHSU due to barriers and personal reasons and 36.7% had no MHSU due to self-reported no need. Age, living alone, lower income, a decrease in income during the pandemic and health professional status were associated with MHSU. Younger adults were more likely to initiate MHSU during the pandemic than older adults who reported not being comfortable to seek mental health care or self-reported no need. Individuals living alone and with lower income were more likely to report not being able to find an appointment for mental health care. CONCLUSIONS Awareness campaigns focusing on older adults that explain the importance of seeking treatment is needed, as well as sensitising health professionals as to the importance of informing and aiding individuals at risk of social isolation and lower socio-economic status as to available mental health resources and facilitating access to care.
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Affiliation(s)
- Helen-Maria Vasiliadis
- Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche Charles-Le Moyne, Longueuil, QC, Canada
| | - Jessica Spagnolo
- Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche Charles-Le Moyne, Longueuil, QC, Canada
| | - Marie-Josée Fleury
- Douglas Mental Health University Institute, Verdun, QC, Canada
- McGill University, Montreal QC, Canada
| | - Jean-Philippe Gouin
- Department of Psychology, Concordia University, Montreal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Pasquale Roberge
- Département de médecine de famille et de médecine d’urgence, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Mary Bartram
- Mental Health Commission of Canada, Ottawa, ON, Canada
- School of Public Policy & Administration, Carleton University, Ottawa, ON, Canada
| | - Sébastien Grenier
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
- Département de psychologie, Université de Montréal, Montréal, QC, Canada
| | - Grace Shen-Tu
- Alberta’s Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Jennifer E. Vena
- Alberta’s Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - JianLi Wang
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
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13
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Jalali S, Liu L, Wang J, Kennedy SH, MacQueen G, Lebel C, Goldstein BL, Bray S, Addington J. Factors Associated with Transition to Serious Mental Illness. Can J Psychiatry 2024; 69:79-88. [PMID: 37606525 PMCID: PMC10789229 DOI: 10.1177/07067437231195959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
OBJECTIVE There is increasing interest in early intervention and detection strategies for youth at-risk of developing a serious mental illness (SMI). Little is known about early factors that may be related to the later development of a SMI; thus, the aim of this study was to determine what clinical factors might relate to the development of in this study psychosis, bipolar disorder and severe or recurrent major depression in at-risk youth. METHOD The sample consisted of 162 youth aged 12-26 years at different stages of risk. Thirty-one participants developed a SMI during the study. Those who made a transition were compared on a range of baseline clinical and functional measures with those who did not make the transition. A Cox regression model was used to assess the association between measures and later development of a SMI. RESULTS Female sex, attenuated psychotic symptoms as assessed with the Scale of Psychosis-Risk Symptoms (SOPS) and ratings on the K-10 Distress Scale, were found to be significantly associated with the later transition to mental illness. Females were 2.77 times more likely to transition compared to males. For the SOPS and K-10 scales, there is a 14% increase in the transition rate relative to a one-scale increase in SOPS and a 7% increase in the transition rate relative to a one-point increase in the K-10. CONCLUSIONS Results from these longitudinal data provide further insight into the specific clinical measures that may be pertinent in early detection of mental illnesses.
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Affiliation(s)
- Sara Jalali
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Lu Liu
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - JianLi Wang
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sidney H. Kennedy
- Department of Psychiatry, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada
- Arthur Sommer Rotenberg Chair in Suicide and Depression Studies, St. Michael's Hospital, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Glenda MacQueen
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Catherine Lebel
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada
| | - Benjamin l. Goldstein
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Departments of Psychiatry and Pharmacology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Signe Bray
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
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14
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Pan P, Wang JL, Zhai WH, Ma QL, Yang DL, Feng SZ, Han MZ, Pang AM, Jiang EL. [Clinical analysis of 14 patients aged ≤ 50 years with high-risk multiple myeloma treated with allogeneic hematopoietic stem cell transplantation]. Zhonghua Xue Ye Xue Za Zhi 2024; 45:28-34. [PMID: 38527835 DOI: 10.3760/cma.j.cn121090-20230928-00148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Objective: To evaluate the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in young patients with high-risk multiple myeloma (HRMM) and analyzed the factors affecting patient prognosis. Methods: In this retrospective study, we analyzed the clinical data of 14 patients with HRMM with cytogenetic abnormalities or high-risk biological factors who underwent allo-HSCT at the Hematopoietic Stem Cell Transplantation Center of the Institute of Hematology & Blood Diseases Hospital between November 2016 and November 2022. Results: There were seven males and seven females included in the study, with a median age of 39.5 (31-50) years at the time of allo-HSCT. The median number of treatment lines before transplantation was 2 (1-6) . Before allo-HSCT, 42.9% (6/14) of the patients did not achieve complete remission, while 35.7% (5/14) of the patients achieved measurable residual disease positivity. After transplantation, all patients were evaluated for their treatment response, and the overall response rate was 100% (14/14) . All 14 patients successfully underwent allo-HSCT, with median engraftment times for neutrophils and platelets of 11 (10-14) days and 13 (9-103) days, respectively. Acute grade Ⅱ-Ⅳ graft-versus-host disease (GVHD) occurred in five patients (35.7%) , and two patients (14.3%) developed moderate-to-severe chronic GVHD. The median follow-up time after allo-HSCT was 18.93 (4.10-72.53) months, with an expected 2-year transplant-related mortality rate of 7.1% (95% CI 0%-21.1%) and an expected 2-year overall survival rate of 92.9% (95% CI 80.3%-100.0%) . Moreover, the expected 1-year and 2-year progression-free survival rates were 92.9% (95% CI 80.3%-100.0%) and 66.0% (95% CI 39.4%-100.0%) , respectively, and the 2-year cumulative incidence of relapse was 28.9% (95% CI 0%-56.7%) . Upfront allo-HSCT following complete remission after induced therapy and the presence of chronic GVHD might be favorable prognostic factors. Conclusion: allo-HSCT is an effective treatment for improving the prognosis of young patients with HRMM.
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Affiliation(s)
- P Pan
- State Key Laboratory of Experimental Hematlogy, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Insitute of Hematology & Blood Disarses Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - J L Wang
- State Key Laboratory of Experimental Hematlogy, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Insitute of Hematology & Blood Disarses Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - W H Zhai
- State Key Laboratory of Experimental Hematlogy, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Insitute of Hematology & Blood Disarses Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - Q L Ma
- State Key Laboratory of Experimental Hematlogy, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Insitute of Hematology & Blood Disarses Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - D L Yang
- State Key Laboratory of Experimental Hematlogy, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Insitute of Hematology & Blood Disarses Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - S Z Feng
- State Key Laboratory of Experimental Hematlogy, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Insitute of Hematology & Blood Disarses Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - M Z Han
- State Key Laboratory of Experimental Hematlogy, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Insitute of Hematology & Blood Disarses Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - A M Pang
- State Key Laboratory of Experimental Hematlogy, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Insitute of Hematology & Blood Disarses Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - E L Jiang
- State Key Laboratory of Experimental Hematlogy, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Insitute of Hematology & Blood Disarses Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
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Wei J, Wang YX, Guan TK, Wang QY, Zhang J, Zhang JY, Wang JL, Chen QJ, Zhang GQ. Bacterial communities during composting cultivation of oyster mushroom Pleurotus floridanus using broken eggs as the nitrogen source and study of agronomic and nutritional properties. Front Microbiol 2024; 14:1274032. [PMID: 38282740 PMCID: PMC10822690 DOI: 10.3389/fmicb.2023.1274032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/31/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction Broken eggs are a byproduct of the poultry industry and a potential nitrogen source for mushroom cultivation. However, its feasibility needs to be evaluated experimentally. Methods In this study, a series of different addition amounts (0, 1.8, 3.6, 5.3 and 8.5%, w/w) of broken egg mixture (BEM) were applied in the composting cultivation process of oyster mushroom. The physicochemical properties and bacterial communities of composting substrate, and agronomic and nutritional properties of fruiting bodies were determined. Results and discussion The results showed that the BEM addition significantly (P < 0.05) increased the total nitrogen content in the composted substrate, and the contents of crude protein, total amino acids and essential amino acids of mushrooms. The P3 treatment (initial C/N of 26:1) showed the highest biological efficiency (BE) of 100.19% and a low contamination rate (CR) of 7.00%, while the higher dosage of BEM (P4 and P5) led to a sharp decrease in BE and a sharp increase in CR. High throughput sequencing revealed that the addition of BEM significantly (P < 0.05) changed the bacterial communities in the substrate at the beginning of composting. Streptococcus and Lactococcus were predominant bacterial genera in BEM treatments at the beginning stage of composting, while Acinetobacter became predominant at the ending stage. The co-occurrence network analysis showed that the P3 treatment demonstrated a much more complex bacterial community. The structural equation model analysis indicated that the addition of BEM affected the bacterial communities and nitrogen metabolism during composting, which further affected agronomic and nutritional properties of oyster mushrooms. An appropriate amount of BEM combined with composting processes can significantly improve the yield and quality of oyster mushroom, providing a new way for efficient utilization of BEM.
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Affiliation(s)
| | | | | | | | | | | | | | - Qing-Jun Chen
- College of Plant Science and Technology, Beijing Key Laboratory for Agricultural Application and New Technique, Beijing University of Agriculture, Beijing, China
| | - Guo-Qing Zhang
- College of Plant Science and Technology, Beijing Key Laboratory for Agricultural Application and New Technique, Beijing University of Agriculture, Beijing, China
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Zhai ZY, Yang L, Li H, Li LW, Shen ZH, Zhang XB, Wang ZQ, Wang JL. [Effects of preoperative diagnostic hysteroscopy on peritoneal cytology and prognosis in patients with non-endometrioid carcinoma]. Zhonghua Fu Chan Ke Za Zhi 2023; 58:903-910. [PMID: 38123196 DOI: 10.3760/cma.j.cn112141-20230831-00080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Objective: To explore the effects of preoperative hysteroscopic guided biopsy and segmental diagnosis and curettage on the risk of abdominal dissemination and prognosis of non-endometrioid carcinoma. Methods: The clinical and pathological data of 97 patients who underwent surgical treatment and were pathologically confirmed as non-endometrioid carcinoma (including serous carcinoma, clear cell carcinoma, mixed adenocarcinoma, and undifferentiated carcinoma, etc.) from October 2008 to December 2021 in Peking University People's Hospital, were collected for retrospective analysis. According to preoperative diagnostic methods, they were divided into hysteroscopic group (n=44) and non-hysteroscopic group (n=53). The impact of hysteroscopy examination on peritoneal cytology and prognosis was analyzed. Results: (1) There were no statistical differences in age, body mass index, tumor size, pathological characteristics, and treatment methods between the hysteroscopic group and the non-hysteroscopic group (all P>0.05), but the proportion of stage Ⅰ-Ⅱ patients in the hysteroscopic group was significantly higher than that in the non-hysteroscopic group [68% (30/44) vs 47% (25/53); χ2=4.32, P=0.038]. (2) Among 97 patients, 25 (26%, 25/97) of them were cytologically positive for ascites. The hysteroscopic group had a lower positive rate of peritoneal cytology than that in the non-hysteroscopy group, which was significantly different [11% (5/44) vs 38% (20/53); χ2=8.74, P=0.003]. Stratification according to surgical and pathological stages showed that the positive rate of peritoneal cytology in the hysteroscopic group (3%, 1/30) was lower than that in the non-hysteroscopic group (12%, 3/25) in the 55 patients with stage Ⅰ-Ⅱ, and that in the hysteroscopic group (4/14) was also lower than that in the non-hysteroscopic group (61%, 17/28) in the 42 patients with stage Ⅲ-Ⅳ. There were no significant differences (all P>0.05). (3) The 5-year disease-free survival (DFS) rate of the hysteroscopic group and the non-hysteroscopic group were respectively 72.7% and 60.4%, and there was no significant difference between the two groups (P=0.186). After stratification according to staging, the 5-year DFS rate were respectively 90.0% and 72.0% (P=0.051) between the hysteroscopic and non-hysteroscopic groups of patients in stage Ⅰ-Ⅱ, and 35.7% and 50.0% (P=0.218) between the hysteroscopic and non-hysteroscopic groups of patients in stage Ⅲ-Ⅳ, in which there were not statistically significant differences. The 5-year overall survival (OS) rate were respectively 86.4% and 81.1% between the hysteroscopic group and the non-hysteroscopic group, with no significant difference between the two groups (P=0.388). The 5-year OS rate were respectively 93.3% and 96.0% in the hysteroscopic group and non-hysteroscopic group for patients with stage Ⅰ-Ⅱ(P=0.872), and 71.4% and 67.9% in the hysteroscopic group and non-hysteroscopic group in patients with stage Ⅲ-Ⅳ (P=0.999), with no statistical significance. Conclusions: Diagnostic hysteroscopy do not increase the rate of positive peritoneal cytology result at the time of surgery in this cohort, and no significant correlation between preoperative hysteroscopy examination and poor prognosis of non-endometrioid carcinoma is observed. Therefore, preoperative hysteroscopic guided biopsy and segmental diagnosis and curettage in non-endometrioid carcinoma maybe safe.
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Affiliation(s)
- Z Y Zhai
- Department of Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - L Yang
- Department of Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - H Li
- Department of Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - L W Li
- Department of Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - Z H Shen
- Department of Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - X B Zhang
- Department of Pathology, Peking University People's Hospital, Beijing 100044, China
| | - Z Q Wang
- Department of Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - J L Wang
- Department of Gynecology, Peking University People's Hospital, Beijing 100044, China
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Wang JL, Zhang HX, Wei JL, Ma QL, Pang AM, Yang DL, Zhai WH, Chen X, He Y, Feng SZ, Han MZ, Zhang RL, Jiang EL. [Efficacy and safety of allogeneic hematopoietic stem cell transplantation for the treatment of primary myelofibrosis]. Zhonghua Yi Xue Za Zhi 2023; 103:3665-3669. [PMID: 38018066 DOI: 10.3760/cma.j.cn112137-20231007-00666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Objective: To evaluate the efficacy and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for the treatment of primary myelofibrosis (PMF) patients. Methods: A total of 14 cases of PMF who underwent allo-HSCT from December 2008 to December 2022 were analyzed retrospectively, including 8 males and 6 females with a median age [M(Q1, Q3)]of 36 (24, 42) years. Three-year overall survival (OS), disease free survival (DFS), cumulative incidence of relapse (CIR), transplantation-related mortality (TRM) were analyzed. Meanwhile, the complications were followed up by telephone and outpatient appointments for 49.6 (9.0,93.1) months. Results: All patients received myeloablative conditioning regimens (MAC). All patients had successful engraftment, and the median time of neutrophils and platelet engraftment were 13.5 (11.8, 18.0) days and 19.5 (13.5, 24.5) days, respectively. Ⅱ-Ⅳ acute graft versus host disease (GVHD) occurred in 3 cases, while chronic GVHD in 8 cases. The rate of 3-year OS,DFS,CIR and TRM were (92.9±6.9)%, (76.0±12.2)%, (38.6±2.7)% and (7.1±0.5)% respectively after a median follow-up time of 1 489.0 (270.3,2 794.8) days. Two patients died from treatment-related complications, one of which died 39 days after transplantation due to heart failure caused by severe anemia, the other patient died 6 years after relapse due to pulmonary infection. Conclusion: Allo-HSCT can be used as a safe and effective approach to treat PMF.
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Affiliation(s)
- J L Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - H X Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - J L Wei
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Q L Ma
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - A M Pang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - D L Yang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - W H Zhai
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - X Chen
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Y He
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - S Z Feng
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - M Z Han
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - R L Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - E L Jiang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
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He H, Wang JL, Jin M, Yuan ZQ, Teng M. [Study on the current status and relationship between psychological capital and compassion fatigue with work engagement of clinical nurses]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:818-824. [PMID: 38073208 DOI: 10.3760/cma.j.cn121094-20221017-00495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Objective: To explore the relationship between clinical nurses' psychological capital, compassion fatigue with work engagement, and analyze the mediating effect of psychological capital between compassion fatigue and work engagement, so as to provide scientific evidence for reducing compassion fatigue and improving work engagement of clinical nurses. Methods: From December 2021 to February 2022, 494 clinical nurses from 7 general hospitals in Sichuan Province were selected for the study using convenience sampling. The General Information Questionnaire, the Compassion Fatigue Short Scale, the Work Engagement Short Scale and the Psychological Capital Questionnaire for Nurses were used to conduct the survey. Pearson correlation was used to analyze the correlation between compassion fatigue, work engagement and psychological capital. And stepwise regression analysis and Bootstrap method were used to analyze the effects of compassion fatigue and psychological capital on work engagement as well as the mediating effect of psychological capital between compassion fatigue and work engagement. Results: Of the 494 clinical nurses, 33 (6.7%) were male and 461 (93.3%) were female, with an average age of (31.47±6.89) years old and an average working years (9.87±7.61) years. The average scores of psychological capital, compassion fatigue and work engagement of clinical nurses were (5.01±0.76), (3.19±2.08) and (4.60±1.37) points, respectively. Compassion fatigue was negatively correlated with psychological capital and work engagement (r=-0.608, -0.580, P<0.001), and work engagement was positively correlated with psychological capital (r=0.771, P<0.001). Compassion fatigue and psychological capital together accounted for 61.3% of the variation in work engagement, with the direct effects on work engagement were -0.206 (95%CI: -0.283--0.138, P<0.001) and 0.677 (95%CI: 0.599-0.744, P=0.001), respectively. Psychological capital partially mediated the relationship between compassion fatigue and work engagement, with a mediating effect of -0.397 (95%CI: -0.456--0.340, P<0.001), accounting for 65.8% of the total effect. Conclusion: The work engagement of clinical nurses is at a high level. Managers should take targeted measures to alleviate the symptoms of clinical nurses' compassion fatigue, improve their psychological capital, and then stabilize and improve their level of work engagement.
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Affiliation(s)
- H He
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - J L Wang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - M Jin
- Operating Room, The Third People's Hospital of Chengdu, Chengdu 610014, China
| | - Z Q Yuan
- Department of Nursing, Sichuan Nursing Vocational College, Deyang 618099, China
| | - M Teng
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
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Ma J, Hou YH, Liao ZY, Ma Z, Zhang XX, Wang JL, Zhu YB, Shan HL, Wang PY, Li CB, Lv YL, Wei YL, Dou JZ. Neuroprotective Effects of Leptin on the APP/PS1 Alzheimer's Disease Mouse Model: Role of Microglial and Neuroinflammation. Degener Neurol Neuromuscul Dis 2023; 13:69-79. [PMID: 37905186 PMCID: PMC10613410 DOI: 10.2147/dnnd.s427781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/05/2023] [Indexed: 11/02/2023] Open
Abstract
Background Microglia are closely linked to Alzheimer's disease (AD) many years ago; however, the pathological mechanisms of AD remain unclear. The purpose of this study was to determine whether leptin affected microglia in the hippocampus of young and aged male APP/PS1 mice. Objective In a transgenic model of AD, we investigated the association between intraperitoneal injection of leptin and microglia. Methods We intraperitoneal injection of leptin (1mg/kg) every day for one week and analyzed inflammatory markers in microglia in the hippocampus of adult (6 months) and aged (12 months) APP/PS1 mice. Results In all leptin treatment group, the brain Aβ levels were decrease. We found increased levels of IL-1β, IL-6 and microglial activation in the hippocampus of adult mice. Using aged mice as an experimental model for chronic neuroinflammation and leptin resistance, the number of Iba-1+ microglia and the levels of IL-1β/IL-6 in the hippocampus were greatly increased as compared to the adult. But between the leptin treatment and un-treatment, there were no difference. Conclusion Leptin signaling would regulate the activation of microglia and the release of inflammatory factors, but it is not the only underlying mechanism in the neuroprotective effects of AD pathogenesis.
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Affiliation(s)
- Jing Ma
- Department of Neurology, Chengde Medical University Affiliated Hospital, Chengde Medical University, Chengde, People’s Republic of China
| | - Yi-Hui Hou
- Department of Neurology, Chengde Medical University Affiliated Hospital, School of Medicine, Chengde Medical University, Chengde, People’s Republic of China
| | - Zhe-Yan Liao
- Department of Neurology, Chengde Medical University Affiliated Hospital, School of Medicine, Chengde Medical University, Chengde, People’s Republic of China
| | - Zheng Ma
- Department of Neurology, Chengde Medical University Affiliated Hospital, Chengde Medical University, Chengde, People’s Republic of China
| | - Xiao-Xuan Zhang
- Department of Neurology, Chengde Medical University Affiliated Hospital, Chengde Medical University, Chengde, People’s Republic of China
| | - Jian-Li Wang
- Department of Hepatobiliary Surgery, Chengde Medical University Affiliated Hospital, Chengde Medical University, Chengde, People’s Republic of China
| | - Yun-Bo Zhu
- Department of Neurology, Chengde Medical University Affiliated Hospital, Chengde Medical University, Chengde, People’s Republic of China
| | - Hai-Lei Shan
- Department of Neurology, Chengde Medical University Affiliated Hospital, Chengde Medical University, Chengde, People’s Republic of China
| | - Ping-Yue Wang
- Department of Neurology, Chengde Medical University Affiliated Hospital, Chengde Medical University, Chengde, People’s Republic of China
| | - Cheng-Bo Li
- Department of Neurology, Chengde Medical University Affiliated Hospital, Chengde Medical University, Chengde, People’s Republic of China
| | - Ying-Lei Lv
- Department of Neurology, Chengde Medical University Affiliated Hospital, Chengde Medical University, Chengde, People’s Republic of China
| | - Yi-Lan Wei
- Department of Neurology, Chengde Medical University Affiliated Hospital, Chengde Medical University, Chengde, People’s Republic of China
| | - Jie-Zhi Dou
- Department of Neurology, Chengde Medical University Affiliated Hospital, Chengde Medical University, Chengde, People’s Republic of China
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Li LL, Li H, Li J, Zhang XB, Wang ZQ, Shen DH, Wang JL. [Risk factor analysis of lymph node metastasis in endometrial carcinoma combined with molecular types]. Zhonghua Fu Chan Ke Za Zhi 2023; 58:733-741. [PMID: 37849254 DOI: 10.3760/cma.j.cn112141-20230317-00125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Objective: To investigate the relationships between molecular types of the cancer genome atlas (TCGA) of patients with endometrial carcinoma (EC) and lymph node metastasis and other clinicopathological features. Methods: The clinical pathological information of 295 patients with EC who underwent initial inpatient surgical treatment and accepted the detection of the molecular types of TCGA with next-generation sequencing technology at Peking University People's Hospital were collected during April 2016 and May 2022. The TCGA molecular typing of EC was divided into four types: POLE-ultramutated (15 cases), high microsatellite instability (MSI-H; 50 cases), copy-number low (CNL; 175 cases), and copy-number high (CNH; 55 cases). The differences of clinical pathological features among different molecular types and the risk factors of lymph node metastasis were analyzed retrospectively. Results: Among 295 patients with EC, the average age was (56.9±0.6) years. (1) There was a statistically significant difference in lymph node metastasis (0, 8.0%, 10.3% and 25.5%) among the four molecular types (χ2=12.524, P=0.006). There were significant differences in age, stage, pathological type, grade (only endometrioid carcinoma), myometrium invasion, lymphatic vascular space infiltration, and estrogen receptor among the EC patients of four molecular types (all P<0.05). Among them, while in the patients with CNH type, the pathological grade was G3, the pathological type was non-endometrioid carcinoma, and the proportion of myographic infiltration depth ≥1/2 were higher (all P<0.05). (2) Univariate analysis suggested that pathological type, grade, myometrium infiltration depth, cervical interstitial infiltration, lymphatic vascular space infiltration, and progesterone receptor were all factors which significantly influence lymph node metastasis (all P<0.01); multivariate analysis suggested that the lymphatic vascular space infiltration was an independent risk factor for lymph node metastasis (OR=5.884, 95%CI: 1.633-21.211; P=0.007). (3) The factors related to lymph node metastasis were different in patients with different molecular types. In the patients with MSI-H, the non-endometrioid carcinoma of pathological type was independent risk factor for lymph node metastasis (OR=29.010, 95%CI: 2.067-407.173; P=0.012). In the patients with CNL, myometrium infiltration depth≥1/2 (OR=4.995, 95%CI: 1.225-20.376; P=0.025), lymphatic vascular space infiltration (OR=14.577, 95%CI: 3.603-58.968; P<0.001) were the independent risk factors for lymph node metastasis. While in the CNH type patients pathological type of non-endometrioid carcinoma (OR=7.451, 95%CI: 1.127-49.281; P=0.037), cervical interstitial infiltration (OR=22.938, 95%CI: 1.207-436.012; P=0.037), lymphatic vascular space infiltration (OR=9.404, 95%CI: 1.609-54.969; P=0.013), were the independent risk factors for lymph node metastasis. Conclusions: POLE-ultramutated EC patients have the lowest risk of lymph node metastasis, and CNH patients have the highest risk of lymph node metastasis. The risk factors of lymph node metastasis of different molecular types are different. According to preoperative pathological and imaging data, lymph node metastasis is more likely to occur in patients with non-endometrioid carcinoma in MSI-H and CNH type patients, and lymph node metastasis is more likely to occur in patients with myometrium infiltration depth ≥1/2 in CNL type patients.
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Affiliation(s)
- L L Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - H Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - J Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - X B Zhang
- Department of Pathology, Peking University People's Hospital, Beijing 100044, China
| | - Z Q Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - D H Shen
- Department of Pathology, Peking University People's Hospital, Beijing 100044, China
| | - J L Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
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Shen DH, Wang JL. [Put emphasis on the development and application of molecular typing of endometrial carcinoma]. Zhonghua Fu Chan Ke Za Zhi 2023; 58:729-732. [PMID: 37849253 DOI: 10.3760/cma.j.cn112141-20230905-00087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
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Zhai WH, Zhang LN, Wang JL, He Y, Jiang EL, Feng SZ, Han MZ. [Toxoplasma gondii infection after allogeneic hematopoietic stem cell transplantation in patients with hematological diseases: 2 cases report and literature reviews]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:861-863. [PMID: 38049341 PMCID: PMC10694075 DOI: 10.3760/cma.j.issn.0253-2727.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Indexed: 12/06/2023]
Affiliation(s)
- W H Zhai
- State Key Laboratory of Experimental Hematology, National Clinical Research Centre for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin Institutes of Health Science, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - L N Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Centre for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin Institutes of Health Science, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - J L Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Centre for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin Institutes of Health Science, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - Y He
- State Key Laboratory of Experimental Hematology, National Clinical Research Centre for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin Institutes of Health Science, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - E L Jiang
- State Key Laboratory of Experimental Hematology, National Clinical Research Centre for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin Institutes of Health Science, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - S Z Feng
- State Key Laboratory of Experimental Hematology, National Clinical Research Centre for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin Institutes of Health Science, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - M Z Han
- State Key Laboratory of Experimental Hematology, National Clinical Research Centre for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Tianjin Institutes of Health Science, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
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Wang Y, Zhang X, Liu Y, Jiang F, Liu Y, Xu F, Duan X, Li Q, Zhao W, Xu R, Wang J, Liu C, Liu Y. The influence of parental rearing style on the incidence of panic disorder, major depressive disorder and the comorbidity among Chinese college students. J Affect Disord 2023; 338:100-106. [PMID: 37290524 DOI: 10.1016/j.jad.2023.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/21/2023] [Accepted: 06/04/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Panic disorder (PD), major depressive disorder (MDD), and the comorbidity (PD&MDD) in college students have caused a heavy disease burden for individuals and families. However, little was known for the comorbidity, especially the impact of parental rearing style on the incidence of the PD&MDD comorbidity. METHODS A cohort study was conducted among 6652 Chinese college students. Composite International Diagnostic Interview (CIDI-3.0) was used for disease diagnosis. The parental rearing styles were measured by the Egna Minnen Beträffande Uppfostran (EMBU) scale and factor analysis was used to reduce the dimension of the EMBU scale. Multinomial logistic regression models were used to determine the relationships between parenting styles and disease incidence. SPSS version 26.0 was used for all statistical analyses. RESULTS The 1-year incidence of PD, MDD, and PD&MDD comorbidity was 0.27 %, 2.04 %, and 0.21 %, respectively. Emotional warmth mode (OR = 0.753, 95%CI: 0.631-0.899, P < 0.01) were only negatively correlated with major depressive disorder. However, punishment denial mode (OR = 1.857, 95%CI: 1.316-2.620, P < 0.01) and over-participation mode (OR = 1.862, 95%CI: 1.176-2.949, P < 0.01) were positively correlated with the comorbidity of panic disorder and major depressive disorder. LIMITATIONS The limited follow-up period was only 1 year in this study which had impacted the collection of new onset cases. CONCLUSIONS Parental rearing style has a long-term influence on the psychiatric status of college students. Parenting style interventions working as the second level of mental disorder prevention will play an important role in MDD, PD and comorbidity prevention.
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Affiliation(s)
- Yiju Wang
- School of Mental Health, Jining Medical University, Jining, Shandong, China
| | - Xiuzhen Zhang
- Shandong Daizhuang Hospital, Jining, Shandong, China
| | - Yanzhi Liu
- School of Clinical Medicine, Jining Medical University, Jining, Shandong, China
| | - Fengxia Jiang
- Jining Veterans Military Hospital, Yanzhou, Shandong, China
| | - Yujia Liu
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Fangfang Xu
- School of Mental Health, Jining Medical University, Jining, Shandong, China
| | - Ximing Duan
- School of Mental Health, Jining Medical University, Jining, Shandong, China; Center of Evidence-Based Medicine, Jining Medical University, Jining, Shandong, China
| | - Qingqing Li
- School of Mental Health, Jining Medical University, Jining, Shandong, China
| | - Weiyan Zhao
- School of Mental Health, Jining Medical University, Jining, Shandong, China; Center of Evidence-Based Medicine, Jining Medical University, Jining, Shandong, China
| | - Ruixue Xu
- School of Mental Health, Jining Medical University, Jining, Shandong, China; School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - JianLi Wang
- School of Mental Health, Jining Medical University, Jining, Shandong, China; Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Chuanxin Liu
- School of Mental Health, Jining Medical University, Jining, Shandong, China.
| | - Yan Liu
- School of Mental Health, Jining Medical University, Jining, Shandong, China; Center of Evidence-Based Medicine, Jining Medical University, Jining, Shandong, China.
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Jin TY, Wang JL, Zhang BY, Qi MY, Chen Z, Duan WR. [The measurement and application of imaging evaluation parameters for cranio-cervical junction osseous and neural abnormalities:a review]. Zhonghua Wai Ke Za Zhi 2023; 61:1026-1031. [PMID: 37767671 DOI: 10.3760/cma.j.cn112139-20230713-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Cranio-cervical junction (CVJ) anomalies encompass a spectrum of bone,soft tissue,and neural structural abnormalities,including basilar invagination,platybasia,atlantoaxial dislocation,tonsillar herniation,and occipito-cervical fusion.Given the frequent coexistence of these anomalies and the intricate anatomical variations involved,precise imaging techniques and evaluation parameters are crucial for accurate disease characterization and treatment assessment.Since the 1930s,various parameters,such as the McRae line,Chamberlain line,Wackenheim line,and clivo-axial angle,have been widely employed for evaluating basilar invagination and platybasia.The advent of MRI and CT has further expanded the repertoire of parameters,including sagittal tilt,coronal tilt,medullary spinal angle,and intricate multi-axis evaluation systems.In this review,we summarize the relevant imaging parameters and their corresponding measurement techniques from previous literature,emphasizing high-sensitivity,consistent,and evidence-based parameters.This study aims to provide valuable insights for the imaging evaluation of CVJ anomalies.
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Affiliation(s)
- T Y Jin
- Department of Neurosurgery,Xuanwu Hospital,Capital Medical University;Spine Center,China International Neuroscience Institute (CHINA-INI),Beijing,100032,China
| | - J L Wang
- Department of Neurosurgery,Xuanwu Hospital,Capital Medical University;Spine Center,China International Neuroscience Institute (CHINA-INI),Beijing,100032,China
| | - B Y Zhang
- Department of Neurosurgery,Xuanwu Hospital,Capital Medical University;Spine Center,China International Neuroscience Institute (CHINA-INI),Beijing,100032,China
| | - M Y Qi
- Department of Neurosurgery,Xuanwu Hospital,Capital Medical University;Spine Center,China International Neuroscience Institute (CHINA-INI),Beijing,100032,China
| | - Z Chen
- Department of Neurosurgery,Xuanwu Hospital,Capital Medical University;Spine Center,China International Neuroscience Institute (CHINA-INI),Beijing,100032,China
| | - W R Duan
- Department of Neurosurgery,Xuanwu Hospital,Capital Medical University;Spine Center,China International Neuroscience Institute (CHINA-INI),Beijing,100032,China
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Njoroge W, Maina R, Frank E, Atwoli L, Wu Z, Ngugi AK, Sen S, Wang J, Wong S, Baker JA, Weinheimer-Haus EM, Khakali L, Aballa A, Orwa J, K Nyongesa M, Shah J, Waljee AK, Abubakar A, Merali Z. Use of mobile technology to identify behavioral mechanisms linked to mental health outcomes in Kenya: protocol for development and validation of a predictive model. BMC Res Notes 2023; 16:226. [PMID: 37735439 PMCID: PMC10515076 DOI: 10.1186/s13104-023-06498-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE This study proposes to identify and validate weighted sensor stream signatures that predict near-term risk of a major depressive episode and future mood among healthcare workers in Kenya. APPROACH The study will deploy a mobile application (app) platform and use novel data science analytic approaches (Artificial Intelligence and Machine Learning) to identifying predictors of mental health disorders among 500 randomly sampled healthcare workers from five healthcare facilities in Nairobi, Kenya. EXPECTATION This study will lay the basis for creating agile and scalable systems for rapid diagnostics that could inform precise interventions for mitigating depression and ensure a healthy, resilient healthcare workforce to develop sustainable economic growth in Kenya, East Africa, and ultimately neighboring countries in sub-Saharan Africa. This protocol paper provides an opportunity to share the planned study implementation methods and approaches. CONCLUSION A mobile technology platform that is scalable and can be used to understand and improve mental health outcomes is of critical importance.
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Affiliation(s)
- Willie Njoroge
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
- Department of Psychology, Southwest University, Chongqing, China
| | - Rachel Maina
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya.
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands.
| | - Elena Frank
- Michigan Neuroscience Institute, University of Michigan, Michigan, USA
| | - Lukoye Atwoli
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
- Department of Medicine, Medical College East Africa, the Aga Khan University, Nairobi, Kenya
| | - Zhenke Wu
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Anthony K Ngugi
- Department of Population Health, Aga Khan University, Nairobi, Kenya
| | - Srijan Sen
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - JianLi Wang
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Stephen Wong
- Computing and Data Innovation Office, Aga Khan University, Nairobi, Kenya
| | - Jessica A Baker
- Center for Global Health Equity, University of Michigan, Ann Arbor, MI, USA
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Eileen M Weinheimer-Haus
- Center for Global Health Equity, University of Michigan, Ann Arbor, MI, USA
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Linda Khakali
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
- Department of Sociology, University of Nairobi, Nairobi, Kenya
| | - Andrew Aballa
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - James Orwa
- Department of Population Health, Aga Khan University, Nairobi, Kenya
| | - Moses K Nyongesa
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Jasmit Shah
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Akbar K Waljee
- Center for Global Health Equity, University of Michigan, Ann Arbor, MI, USA
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
- Neurosciences Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Zul Merali
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
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Wang J, Yang L, Tibbo P, Simon P, Bullerwell M. The Health and Psychosocial Profiles of Adults Who Sought Mental Health and Addiction Specialty Services Through a Centralized Intake Process in Nova Scotia in 2020 and 2021. Can J Psychiatry 2023; 68:613-622. [PMID: 36855805 PMCID: PMC10411361 DOI: 10.1177/07067437231159768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVES (1) To calculate the proportions of people who sought mental health and addiction (MHA) specialty services in Nova Scotia, overall and by sex and age. (2) To describe the health and psychosocial profiles of the MHA Intake clients. (3) To identify factors associated with acceptance for MHA services. METHODS The data of the Nova Scotia MHA Intake clients aged 19 to 64 years old in 2020 (N = 10,178) and in 2021 (N = 12,322) were used. The proportions of unique clients in the general population were calculated based on 2021 census data. The percentages of primary presenting concerns, the presence and frequency of psychiatric symptoms in the past month, suicide risk levels, current or past provisional psychiatric diagnosis, medical problems, and psychosocial stressors were calculated. Logistic regression was conducted to identify factors associated with the acceptance of MHA services after the assessment. RESULTS It was found that 1.48% and 2.33% of Nova Scotians aged 19 to 64 contacted the MHA Intake in 2020 and 2021. Over 66% were self-referrals, followed by physician referrals (28.34%). Mood (28.3%), anxiety (25.17%), and substance use (19.81%) were the top three presenting concerns for the contact. Many clients had a current or past provisional psychiatric diagnosis (58.7% in 2020, 61.8% in 2021). Among the clients, 74.67% and 68.29% reported at least 1 psychosocial stressor in 2020 and 2021, respectively. The clients with a current or past psychiatric diagnosis, suicide risk, and 2 or more psychosocial stressors, those who lived outside of Central Zone, and who had employee assistance program benefits/private insurance, were more likely to be qualified and accepted for MHA services than others. CONCLUSIONS The Intake clients have complex health and psychosocial profiles. Future studies are needed to monitor the trajectories of the clients to reduce inequities in receiving MHA services and improve client outcomes.
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Affiliation(s)
- JianLi Wang
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Halifax, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Halifax, Canada
| | - Lu Yang
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Halifax, Canada
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Phil Tibbo
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Halifax, Canada
- Early Psychosis Intervention Nova Scotia, Nova Scotia Health, Halifax, Nova Scotia, Halifax, Canada
| | - Patryk Simon
- Mental Health and Addiction Program, Nova Scotia Health, Halifax, Nova Scotia, Halifax, Canada
| | - Michele Bullerwell
- Mental Health and Addiction Program, Nova Scotia Health, Halifax, Nova Scotia, Halifax, Canada
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Chen F, Di W, Hu YJ, Li CZ, Wang F, Duan H, Liu J, Yao SZ, Zhang YZ, Guo RX, Wang JD, Wang JL, Zhang YQ, Wang M, Lin ZQ, Lang JH. [Evaluation of the efficacy and safety of Nocardia rubra cell wall skeleton immunotherapy for cervical high-risk HPV persistent infection]. Zhonghua Fu Chan Ke Za Zhi 2023; 58:536-545. [PMID: 37474327 DOI: 10.3760/cma.j.cn112141-20230331-00154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Objective: To evaluate the efficacy and safety of Nocardia rubra cell wall skeleton (Nr-CWS) in the treatment of persistent cervical high-risk human papillomavirus (HR-HPV) infection. Methods: A randomized, double blind, multi-center trial was conducted. A total of 688 patients with clinically and pathologically confirmed HR-HPV infection of the cervix diagnosed in 13 hispital nationwide were recruited and divided into: (1) patients with simple HR-HPV infection lasting for 12 months or more; (2) patients with cervical intraepithelial neoplasia (CIN) Ⅰ and HR-HPV infection lasting for 12 months or more; (3) patients with the same HR-HPV subtype with no CINⅡ and more lesions after treatment with CINⅡ or CIN Ⅲ (CINⅡ/CIN Ⅲ). All participants were randomly divided into the test group and the control group at a ratio of 2∶1. The test group was locally treated with Nr-CWS freeze-dried powder and the control group was treated with freeze-dried powder without Nr-CWS. The efficacy and negative conversion rate of various subtypes of HR-HPV were evaluated at 1, 4, 8, and 12 months after treatment. The safety indicators of initial diagnosis and treatment were observed. Results: (1) This study included 555 patients with HR-HPV infection in the cervix (included 368 in the test group and 187 in the control group), with an age of (44.1±10.0) years. The baseline characteristics of the two groups of subjects, including age, proportion of Han people, weight, composition of HR-HPV subtypes, and proportion of each subgroup, were compared with no statistically significant differences (all P>0.05). (2) After 12 months of treatment, the effective rates of the test group and the control group were 91.0% (335/368) and 44.9% (84/187), respectively. The difference between the two groups was statistically significant (χ2=142.520, P<0.001). After 12 months of treatment, the negative conversion rates of HPV 16, 18, 52, and 58 infection in the test group were 79.2% (84/106), 73.3% (22/30), 83.1% (54/65), and 77.4% (48/62), respectively. The control group were 21.6% (11/51), 1/9, 35.1% (13/37), and 20.0% (8/40), respectively. The differences between the two groups were statistically significant (all P<0.001). (3) There were no statistically significant differences in vital signs (body weight, body temperature, respiration, pulse rate, systolic blood pressure, diastolic blood pressure, etc.) and laboratory routine indicators (blood cell analysis, urine routine examination) between the test group and the control group before treatment and at 1, 4, 8, and 12 months after treatment (all P>0.05); there was no statistically significant difference in the incidence of adverse reactions related to the investigational drug between the two groups of subjects [8.7% (32/368) vs 8.0% (15/187), respectively; χ2=0.073, P=0.787]. Conclusion: External use of Nr-CWS has good efficacy and safety in the treatment of high-risk HPV persistent infection in the cervix.
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Affiliation(s)
- F Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, National Clinical Medical Research Center for Obstetrics and Gynecology, Beijing 100730, China
| | - W Di
- Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong University, Shanghai 200001, China
| | - Y J Hu
- Department of Gynecological Oncology, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin 300199, China
| | - C Z Li
- Department of Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University (Shandong Provincial Hospital), Jinan 250021, China
| | - F Wang
- Department of Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University (Shandong Provincial Hospital), Jinan 250021, China
| | - H Duan
- Gynecological Minimally Invasive Surgery Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100006, China
| | - J Liu
- Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China
| | - S Z Yao
- Department of Gynecology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Y Z Zhang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - R X Guo
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - J D Wang
- Department of Gynecological Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100006, China
| | - J L Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - Y Q Zhang
- Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - M Wang
- Department of Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Z Q Lin
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510289, China
| | - J H Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, National Clinical Medical Research Center for Obstetrics and Gynecology, Beijing 100730, China
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Xu HY, Yu XP, Wang JL, Hu JB, Hu HJ. [Clinical study on early predictors of concurrent bile duct injury following TACE in patients with liver cancer]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:710-715. [PMID: 37580253 DOI: 10.3760/cma.j.cn501113-20230607-00249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
Objective: To explore the predictive factors of concurrent bile duct injury following transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods: A retrospective study was conducted on 483 HCC patients in relation to TACE postoperative complications. A total of 21 cases of bile duct injury were observed following the TACE procedure. Laboratory data, imaging data, and clinically relevant medical histories were recorded before and after one week following the TACE procedure and follow-up. The χ (2) test, or Fisher's exact probability method, was used for categorical variables. The mean of the two samples was compared using a paired t-test or Wilcoxon rank sum test. The comparison of multiple mean values was conducted using an analysis of variance. Results: Twenty-one cases with bile duct injury had intrahepatic bile duct dilatation, bile tumors, hilar biliary duct stenoses, and other manifestations. 14.3% (3/21) of patients showed linear high-density shadows along the bile duct on a plain CT scan, while 76.2% (16/21) of patients had ALP > 200 U/L one week following TACE procedure, and bile duct injury occurred in later follow-up. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and γ-glutamyl transferase (GGT) were significantly increased in all patients following TACE procedure (t = -2.721, P = 0.014; t = -2.674, P = 0.015; t = -3.079, P = 0.006; t = -3.377, P = 0.003, respectively). Conclusion: The deposition of iodized oil around the bile duct on plain CT scan presentation or the continuous increase of ALP (> 200 U/L) one week following TACE procedure has a certain predictive value for the later bile duct injury.
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Affiliation(s)
- H Y Xu
- Department of Radiology, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, China
| | - X P Yu
- Department of Pathology, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, China
| | - J L Wang
- Department of Radiology, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, China
| | - J B Hu
- Department of Radiology, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, China
| | - H J Hu
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310000, China
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Zhai ZY, Li H, Li LW, Shen ZH, Zhang XB, Wang ZQ, Wang JL. [Prognosis analysis of radical or modified radical hysterectomy and simple hysterectomy in patients with stage Ⅱ endometrial cancer]. Zhonghua Fu Chan Ke Za Zhi 2023; 58:442-450. [PMID: 37357603 DOI: 10.3760/cma.j.cn112141-20230314-00120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Objective: To compare the prognosis and perioperative situation of patients with stage Ⅱ endometrial cancer (EC) between radical hysterectomy/modified radical hysterectomy (RH/mRH) and simple hysterectomy (SH). Methods: A total of 47 patients diagnosed EC with stage Ⅱ [International Federation of Gynecology and Obstetrics (FIGO) 2009] by postoperative pathology, from January 2006 to January 2021 in Peking University People's Hospital, were analyzed retrospectively. The patients were (54.4±10.7) years old, and the median follow-up time was 65 months (ranged 9-138 months). They were divided into RH/mRH group (n=14) and SH group (n=33) according to the scope of operation. Then the prognosis of patients between the groups were compared, and the independent prognostic factors of stage Ⅱ EC were explored. Results: (1) The proportions of patients with hypertension in RH/mRH group and SH group were 2/14 and 45% (15/33), the amounts of intraoperative blood loss were (702±392) and (438±298) ml, and the incidence of postoperative complications were 7/14 and 15% (5/33), respectively. There were significant differences (all P<0.05). (2) The median follow-up time of RH/mRH group and SH group were 72 vs 62 months, respectively (P=0.515). According to Kaplan-Meier analysis and log-rank method, the results showed that there were no significant difference in 5-year progression-free survival (PFS) rate (94.3% vs 84.0%; P=0.501), and 5-year overall survival rate (92.3% vs 92.9%; P=0.957) between the two groups. Cox survival analysis indicated that age, pathological type, serum cancer antigen 125 (CA125), and estrogen receptor (ER) status were associated with 5-year PFS rate (all P<0.05). But the scope of hysterectomy (RH/mRH and SH) did not affect the 5-year PFS rate of stage Ⅱ EC patients (P=0.508). And level of serum CA125 and ER status were independent prognostic factors for 5-year PFS rate (all P<0.05). Conclusions: This study could not find any survival benefit from RH/mRH for stage Ⅱ EC, but increases the incidence of postoperative complications. Therefore, the necessity of extending the scope of hysterectomy is questionable.
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Affiliation(s)
- Z Y Zhai
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - H Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - L W Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - Z H Shen
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - X B Zhang
- Department of Pathology, Peking University People's Hospital, Beijing 100044, China
| | - Z Q Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - J L Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
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Ni WY, Wang JL, Yun J, Xie WQ, Ma C, Su SH. [The status and influencing factors of presenteeism among clinical nurses: a systematic review]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:286-293. [PMID: 37248183 DOI: 10.3760/cma.j.cn121094-20220617-00326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Objective: To systematically review the status and factors influencing presenteeism among clinical nurses. Methods: In December 2021, CNKI, CBM, Wanfang, VIP, Web of Science, PubMed, Embase, The Cochrane Library, CINAHL, PsyclNFO and other databases were electronically searched to cross sectional studies on the current situation and factors influencing the occurrence of presenteeism among clinical nurses. The search terms mainly included presenteeism, sick at work, Stanford Presenteeism Scale, nurse, level, risk factor, influence, et al. And the search time was from the establishment of the database to November 30, 2021. Literature screening, data extraction and evaluation of the risk of bias in the included literature were done independently by two researchers, and meta-analysis was performed using Stata 15.1 software. Results: A total of 29 studies involving 13 535 clinical nurses were included.The results of the meta-analysis showed that the score of presenteeism was 17.99 [95% CI (17.02-18.95), P =0.000]. Subgroup analysis showed that presenteeism scores were higher in articles published before 2020 (ES=19.28, 95%CI: 18.41-20.15, P=0.000) and in the group of nurses aged 36 to 40 years (ES=19.27, 95%CI: 17.35~21.19, P=0.000), female (ES= 17.04, 95%CI: 14.70-19.39, P=0.000), secondary school education (ES=21.01, 95%CI: 17.76-24.26, P= 0.007), married (ES=17.49, 95%CI: 15.13-19.85, P=0.000), working for 5 to 10 years (ES=17.78, 95%CI: 16.54-19.02, P=0.000), contract (ES=17.05, 95%CI: 15.23-18.87, P=0.000), working in pediatrics (ES= 16.65, 95% CI: 15.31-17.99, P=0.000) and European region (ES =21.21, 95% CI: 20.50-21.93, P=0.000) . Conclusion: Current evidence suggests that clinical nurses are at high risk of presenteeism, which is affected by variety of factors. The managers should pay attention to the physical and mental health of nurses, identify high-risk factors as early as possible and take measures to reduce the occurrence of presenteeism and improve the quality of nursing.
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Affiliation(s)
- W Y Ni
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - J L Wang
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - J Yun
- Chengdu University of Traditional Chinese Medicine Hospital, Chengdu 610032, China
| | - W Q Xie
- Department of Hospital Infection Control Disinfection Supply Room, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - C Ma
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - S H Su
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
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Vasiliadis HM, Spagnolo J, Fleury MJ, Gouin JP, Roberge P, Bartram M, Grenier S, Shen-Tu G, Vena JE, Wang J. Mental health service use and associated predisposing, enabling and need factors in community living adults and older adults across Canada. BMC Health Serv Res 2023; 23:357. [PMID: 37046270 PMCID: PMC10091342 DOI: 10.1186/s12913-023-09335-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/23/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVES Using Andersen's model of health care seeking behavior, we examined the predisposing, enabling, and need factors associated with mental health service use (MHSU) during the first wave of the COVID-19 pandemic across Canada. METHODS The sample included n = 45,542 participants in the 5 established regional cohorts of the Canadian Partnership for Tomorrow's Health (CanPath) and who responded to the CanPath COVID-19 health survey (May-December 2020), with complete data on MHSU. Multivariable logistic regression analyses were carried out to study MHSU as a function of predisposing, enabling, and need factors. Analyses were stratified by regional cohort. RESULTS Among the need factors, individuals reporting moderate/severe symptoms of depression and anxiety and poorer self-rated mental health were more likely to report MHSU. Among the enabling factors, receipt of informational/financial/practical support was associated with increased MHSU. While income was not consistently associated with MHSU, reported decrease in income was marginally associated with reduced MHSU. Among the predisposing factors, identifying as female or other gender minority was associated with increased MHSU, as was the presence of past-year cannabis use. In contrast, older age and alcohol consumption were associated with reduced MHSU. CONCLUSION Need factors were consistently associated with MHSU. Although income inequities in MHSU were not observed, changes such as reduced income during the pandemic may lead to barriers in accessing mental health services. Future research should focus on better identifying contextual enabling factors and policies that overcome financial barriers to MHSU.
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Affiliation(s)
- Helen-Maria Vasiliadis
- Département des sciences de la santé communautaire, Université de Sherbrooke, 2500, boul. de l'Université, J1K 2R1, Sherbrooke (Québec), Canada.
- Centre de recherche Charles-Le Moyne, 150, place Charles‑Le Moyne, C. P. 200, J4K 0A8, Longueuil (Québec), Canada.
| | - Jessica Spagnolo
- Département des sciences de la santé communautaire, Université de Sherbrooke, 2500, boul. de l'Université, J1K 2R1, Sherbrooke (Québec), Canada
- Centre de recherche Charles-Le Moyne, 150, place Charles‑Le Moyne, C. P. 200, J4K 0A8, Longueuil (Québec), Canada
| | - Marie-Josée Fleury
- Douglas Mental Health University Institute, 6875 boul., H4H 1R3, LaSalleVerdun (Québec), Canada
- McGill University, 845 Sherbrooke St W, H3A 0G4, Montreal (Québec), Canada
| | - Jean-Philippe Gouin
- Department of Psychology, Concordia University, 7141 Sherbrooke West, H4B 1R6, Montreal (Québec), Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, 4545 Queen Mary Rd, H3W 1W6, Montreal (Québec), Canada
| | - Pasquale Roberge
- Département de médecine familiale et d'urgence, Université de Sherbrooke, 2500, boul. de l'Université, J1K 2R1, Sherbrooke (Québec), Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, 12e Avenue N Porte 6, J1H 5N4, Sherbrooke (Québec), Canada
| | - Mary Bartram
- Mental Health Commission of Canada, 350 Albert St #1210, K1R 1A4, Ottawa (Ontario), Canada
- School of Public Policy & Administration, Carleton University, 1125 Colonel By Drive, K1S 5B6, Ottawa (Ontario), Canada
| | - Sébastien Grenier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, 4545 Queen Mary Rd, H3W 1W6, Montreal (Québec), Canada
- Département de psychologie, Université de Montréal, 90, avenue Vincent d'Indy, H2V 2S9, Montréal (Québec), Canada
| | - Grace Shen-Tu
- Alberta's Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, 1820 Richmond Road SW, T2T 5C7, Calgary (Alberta), Canada
| | - Jennifer E Vena
- Alberta's Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, 1820 Richmond Road SW, T2T 5C7, Calgary (Alberta), Canada
| | - JianLi Wang
- Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, B3H 1V7, Halifax (Nova Scotia), Canada
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Xu F, Bian Y, Zhang GQ, Gao LY, Liu YF, Liu TX, Li G, Song RX, Su LJ, Zhou YJ, Cui JY, Yan XL, Guo FM, Zhang HY, Li QH, Zhao M, Ma LK, You BA, Wang G, Kong L, Ma JL, Zhou XF, Chang ZL, Tang ZY, Yu DY, Cheng K, Xue L, Li X, Pang JJ, Wang JL, Zhang HT, Yu XZ, Chen YG. [Safety and efficacy of the early administration of levosimendan in patients with acute non-ST-segment elevation myocardial infarction and elevated NT-proBNP levels: An Early Management Strategy of Acute Heart Failure (EMS-AHF)]. Zhonghua Nei Ke Za Zhi 2023; 62:374-383. [PMID: 37032132 DOI: 10.3760/cma.j.cn112138-20220420-00284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Objectives: To investigated the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and elevated levels of N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) with levosimendan within 24 hours of first medical contact (FMC). Methods: This multicenter, open-label, block-randomized controlled trial (NCT03189901) investigated the safety and efficacy of levosimendan as an early management strategy of acute heart failure (EMS-AHF) for patients with NSTEMI and high NT-proBNP levels. This study included 255 patients with NSTEMI and elevated NT-proBNP levels, including 142 males and 113 females with a median age of 65 (58-70) years, and were admitted in the emergency or outpatient departments at 14 medical centers in China between October 2017 and October 2021. The patients were randomly divided into a levosimendan group (n=129) and a control group (n=126). The primary outcome measure was NT-proBNP levels on day 3 of treatment and changes in the NT-proBNP levels from baseline on day 5 after randomization. The secondary outcome measures included the proportion of patients with more than 30% reduction in NT-proBNP levels from baseline, major adverse cardiovascular events (MACE) during hospitalization and at 6 months after hospitalization, safety during the treatment, and health economics indices. The measurement data parameters between groups were compared using the t-test or the non-parametric test. The count data parameters were compared between groups using the χ² test. Results: On day 3, the NT-proBNP levels in the levosimendan group were lower than the control group but were statistically insignificant [866 (455, 1 960) vs. 1 118 (459, 2 417) ng/L, Z=-1.25,P=0.21]. However, on day 5, changes in the NT-proBNP levels from baseline in the levosimendan group were significantly higher than the control group [67.6% (33.8%,82.5%)vs.54.8% (7.3%,77.9%), Z=-2.14, P=0.03]. There were no significant differences in the proportion of patients with more than 30% reduction in the NT-proBNP levels on day 5 between the levosimendan and the control groups [77.5% (100/129) vs. 69.0% (87/126), χ²=2.34, P=0.13]. Furthermore, incidences of MACE did not show any significant differences between the two groups during hospitalization [4.7% (6/129) vs. 7.1% (9/126), χ²=0.72, P=0.40] and at 6 months [14.7% (19/129) vs. 12.7% (16/126), χ²=0.22, P=0.64]. Four cardiac deaths were reported in the control group during hospitalization [0 (0/129) vs. 3.2% (4/126), P=0.06]. However, 6-month survival rates were comparable between the two groups (log-rank test, P=0.18). Moreover, adverse events or serious adverse events such as shock, ventricular fibrillation, and ventricular tachycardia were not reported in both the groups during levosimendan treatment (days 0-1). The total cost of hospitalization [34 591.00(15 527.46,59 324.80) vs. 37 144.65(16 066.90,63 919.00)yuan, Z=-0.26, P=0.80] and the total length of hospitalization [9 (8, 12) vs. 10 (7, 13) days, Z=0.72, P=0.72] were lower for patients in the levosimendan group compared to those in the control group, but did not show statistically significant differences. Conclusions: Early administration of levosimendan reduced NT-proBNP levels in NSTEMI patients with elevated NT-proBNP and did not increase the total cost and length of hospitalization, but did not significantly improve MACE during hospitalization or at 6 months.
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Affiliation(s)
- F Xu
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Acute Heart Failure Unit (AHFU), Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - Y Bian
- Department of Emergency Medicine, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - G Q Zhang
- Department of Emergency, China-Japan Friendship Hospital, Beijing 100029, China
| | - L Y Gao
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Acute Heart Failure Unit (AHFU), Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - Y F Liu
- Department of Emergency, Zibo Central Hospital, Zibo 255036, China
| | - T X Liu
- Department of Emergency, Weifang People's Hospital, Weifang 261041, China
| | - G Li
- Department of Emergency, China-Japan Friendship Hospital, Beijing 100029, China
| | - R X Song
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Acute Heart Failure Unit (AHFU), Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - L J Su
- Department of Emergency, Zibo Central Hospital, Zibo 255036, China
| | - Y J Zhou
- Department of Emergency, Weifang People's Hospital, Weifang 261041, China
| | - J Y Cui
- Department of Cardiology, Binzhou People's Hospital, Binzhou 256600, China
| | - X L Yan
- Emergency Medicine Department, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China
| | - F M Guo
- Department of Cardiology, Yantaishan Hospital, Yantai 264003,China
| | - H Y Zhang
- Department of Cardiology, the Central Hospital of Taian, Taian 271000, China
| | - Q H Li
- Department of Cardiology, Shenli Oilfield Central Hospital, Dongying 257000, China
| | - M Zhao
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - L K Ma
- Department of Cardiology, the First Affiliated Hospital of USTC (Anhui Provincial Hospital), Hefei 230001, China
| | - B A You
- Department of Cardiology, Qilu Hospital of Shandong University (Qingdao), Qingdao 266031, China
| | - G Wang
- Department of Emergency Medicine, Qilu Hospital of Shandong University (Qingdao), Qingdao 266031, China
| | - L Kong
- Department of Emergency Center, Affiliated Hospital, Shandong University of Traditional Chinese Medicine, Jinan 250011, China
| | - J L Ma
- Department of Emergency Center, Affiliated Hospital, Shandong University of Traditional Chinese Medicine, Jinan 250011, China
| | - X F Zhou
- Department of Cardiology, Weihai Municipal Hospital, Weihai 264200, China
| | - Z L Chang
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Acute Heart Failure Unit (AHFU), Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - Z Y Tang
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Acute Heart Failure Unit (AHFU), Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - D Y Yu
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Acute Heart Failure Unit (AHFU), Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - K Cheng
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Acute Heart Failure Unit (AHFU), Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - L Xue
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Acute Heart Failure Unit (AHFU), Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - X Li
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Acute Heart Failure Unit (AHFU), Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - J J Pang
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Acute Heart Failure Unit (AHFU), Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - J L Wang
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Acute Heart Failure Unit (AHFU), Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - H T Zhang
- Department of Surgical Intensive Care Unit, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing 100037, China
| | - X Z Yu
- Department of Emergency, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, China
| | - Y G Chen
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Acute Heart Failure Unit (AHFU), Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
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Zhong QM, Zheng YH, Wang JL. Seasonal flexibility of the gut structure and physiology in Eremias multiocellata. J Comp Physiol B 2023; 193:281-291. [PMID: 36995414 DOI: 10.1007/s00360-023-01485-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 03/09/2023] [Accepted: 03/21/2023] [Indexed: 03/31/2023]
Abstract
Although gut seasonal plasticity has been extensively reported, studies on physiological flexibility, such as water-salt transportation and motility in reptiles, are limited. Therefore, this study investigated the intestinal histology and gene expression involved in water-salt transport (AQP1, AQP3, NCC, and NKCC2) and motility regulation (nNOS, CHRM2, and ADRB2) in desert-dwelling Eremias multiocellata during winter (hibernating period) and summer (active period). The results showed that mucosal thickness, the villus width and height, the enterocyte height of the small intestine, and the mucosal and submucosal thicknesses of the large intestine were greater in winter than in summer. However, submucosal thickness of the small intestine and muscularis thickness of the large intestine were lower in winter than in summer. Furthermore, AQP1, AQP3, NCC, nNOS, CHRM2, and ADRB2 expressions in the small intestine were higher in winter than in summer; AQP1, AQP3, and nNOS expressions in the large intestine were lower in winter than in summer, with the upregulation of NCC and CHRM2 expressions; no significant seasonal differences were found in intestinal NKCC2 expression. These results suggest that (i) intestinal water-salt transport activity is flexible during seasonal changes where AQP1, AQP3 and NCC play a vital role, (ii) the intestinal motilities are attenuated through the concerted regulation of nNOS, CHRM2, and ADRB2, and (iii) the physiological flexibility of the small and large intestine may be discrepant due to their functional differences. This study reveals the intestinal regulation and adaptation mechanisms in E. multiocellata in response to the hibernation season.
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Affiliation(s)
- Qiu-Mei Zhong
- College of Biological Sciences and Engineering, North Minzu University, Yinchuan, 750021, China
- Key Laboratory of Ecological Protection of Agro-Pastoral Ecotones in the Yellow River Basin of National Ethnic Affairs Commission, Yinchuan, 750021, China
| | - Yang-Hui Zheng
- College of Biological Sciences and Engineering, North Minzu University, Yinchuan, 750021, China
- Key Laboratory of Ecological Protection of Agro-Pastoral Ecotones in the Yellow River Basin of National Ethnic Affairs Commission, Yinchuan, 750021, China
| | - Jian-Li Wang
- College of Biological Sciences and Engineering, North Minzu University, Yinchuan, 750021, China.
- Key Laboratory of Ecological Protection of Agro-Pastoral Ecotones in the Yellow River Basin of National Ethnic Affairs Commission, Yinchuan, 750021, China.
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Zhang W, Wang JL, Zeng ZL, Liang CL, Yang YZ, Xia RC. [Shen Shiwan : A translator for medicine in the Period of the Republic of China]. Zhonghua Yi Shi Za Zhi 2023; 53:119-123. [PMID: 37183627 DOI: 10.3760/cma.j.cn112155-20220328-00036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Shen Shiwan was a translator and physician for both Chinese medicine and western medicine in the period of the Republic of China. This paper examined the life and the main academic contributions of Shen Shiwan. It was found that Shen's main contribution were translating medical works, founding journals and opening the door of Chinese medicine to the world. Additionally, he introduced western medicine, such as pathology, fertility and nutrition to Chinese medical professionals. He also introduced the medical schools of Japanese traditional medicine (Chinese medicine in Japan, Han Yi) into China. Shen's contribution in medicine played an important role for the medical professionals in China in understanding the development of western medicine and Chinese medicine in Japan.
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Affiliation(s)
- W Zhang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences,Beijing 100700,China
| | - J L Wang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences,Beijing 100700,China
| | - Z L Zeng
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences,Beijing 100700,China
| | - C L Liang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences,Beijing 100700,China
| | - Y Z Yang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences,Beijing 100700,China
| | - R C Xia
- China Institute for History of Medicine and Medical Literature, China Academy of Chinese Medical Sciences,Beijing 100700,China
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Wang J, Gholi Zadeh Kharrat F, Pelletier JF, Rochette L, Pelletier E, Lévesque P, Massamba V, Brousseau-Paradis C, Mohammed M, Gariépy G, Gagné C, Lesage A. A case-control study on predicting population risk of suicide using health administrative data: a research protocol. BMJ Open 2023; 13:e066423. [PMID: 36849211 PMCID: PMC9972456 DOI: 10.1136/bmjopen-2022-066423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
INTRODUCTION Suicide has a complex aetiology and is a result of the interaction among the risk and protective factors at the individual, healthcare system and population levels. Therefore, policy and decision makers and mental health service planners can play an important role in suicide prevention. Although a number of suicide risk predictive tools have been developed, these tools were designed to be used by clinicians for assessing individual risk of suicide. There have been no risk predictive models to be used by policy and decision makers for predicting population risk of suicide at the national, provincial and regional levels. This paper aimed to describe the rationale and methodology for developing risk predictive models for population risk of suicide. METHODS AND ANALYSIS A case-control study design will be used to develop sex-specific risk predictive models for population risk of suicide, using statistical regression and machine learning techniques. Routinely collected health administrative data in Quebec, Canada, and community-level social deprivation and marginalisation data will be used. The developed models will be transformed into the models that can be readily used by policy and decision makers. Two rounds of qualitative interviews with end-users and other stakeholders were proposed to understand their views about the developed models and potential systematic, social and ethical issues for implementation; the first round of qualitative interviews has been completed. We included 9440 suicide cases (7234 males and 2206 females) and 661 780 controls for model development. Three hundred and forty-seven variables at individual, healthcare system and community levels have been identified and will be included in least absolute shrinkage and selection operator regression for feature selection. ETHICS AND DISSEMINATION This study is approved by the Health Research Ethnics Committee of Dalhousie University, Canada. This study takes an integrated knowledge translation approach, involving knowledge users from the beginning of the process.
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Affiliation(s)
- JianLi Wang
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | - Louis Rochette
- Institut national de sante publique du Quebec (INSPQ), Quebec City, Quebec, Canada
| | - Eric Pelletier
- Institut national de sante publique du Quebec (INSPQ), Quebec City, Quebec, Canada
| | - Pascale Lévesque
- Institut national de sante publique du Quebec (INSPQ), Quebec City, Quebec, Canada
| | - Victoria Massamba
- Institut national de sante publique du Quebec (INSPQ), Quebec City, Quebec, Canada
| | | | - Mada Mohammed
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Geneviève Gariépy
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Québec, Canada
| | - Christian Gagné
- Department of Electrical Engineering and Computer Engineering, Laval University, Quebec, Quebec, Canada
| | - Alain Lesage
- Institut universitaire en sante mentale de Montreal, Montreal, Québec, Canada
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Dias RDL, Shalaby R, Agyapong B, Obuobi-Donkor G, Adu MK, Eboreime E, Obeng Nkrumah S, Sridharan S, Simon P, Taylor B, Henderson N, White MD, Maguire H, Gray G, Rahman F, Fair J, Wadden N, Sulyman M, Williams O, Akinkunmi O, Edem D, Arenella P, Morrison J, Awara M, Natarajan A, Nunes A, Hajek T, O’Donavan C, Uher R, Wang J, Rusak B, Wozney L, Sampalli T, Grant D, Tomblin Murphy G, Warford J, Hodder S, Boe R, Agyapong VIO. Augmenting Mental Health Support for Patients Accessing Different Degrees of Formal Psychiatric Care through a Supportive Text Messaging Program: Protocol for a Randomized Controlled Trial. Methods Protoc 2023; 6:mps6010019. [PMID: 36827506 PMCID: PMC9959317 DOI: 10.3390/mps6010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/23/2022] [Accepted: 01/23/2023] [Indexed: 02/16/2023] Open
Abstract
Patients feel more vulnerable when accessing community mental health programs for the first time or after being discharged from psychiatric inpatient units. Long wait times for follow-up appointments, shortage of mental health professionals, lack of service integration, and scarcity of tailored support can weaken their connection to the health care system. As a result, patients can present low adherence, dissatisfaction with treatment, and recurrent hospitalizations. Finding solutions to avoid unnecessary high-cost services and providing tailored and cost-effective mental health interventions may reduce the health system burden and augment patient support. We propose implementing an add-on, supportive text messaging service (Text4Support), developed using cognitive-behavioural therapy (CBT) principles to augment mental health support for patients attending to or being discharged from psychiatric care in Nova Scotia, Canada. This randomized controlled trial aims to investigate the effectiveness of Text4Support in improving mental health outcomes and overall mental well-being compared with usual care. We also will examine the intervention's impact on health services utilization and patient satisfaction. The results from this study will provide evidence on stepped and technology-based mental health care, which will contribute to generating new knowledge about mental health innovations in various clinical contexts, which is not only helpful for the local context but to other jurisdictions in Canada and abroad that are seeking to improve their health care.
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Affiliation(s)
- Raquel da Luz Dias
- Department of Psychiatry, Nova Scotia Health, Halifax, NS B3H 2E2, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2E2, Canada
| | - Reham Shalaby
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Belinda Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Gloria Obuobi-Donkor
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2E2, Canada
| | - Medard K. Adu
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2E2, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | | | - Sanjana Sridharan
- Department of Psychiatry, Nova Scotia Health, Halifax, NS B3H 2E2, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2E2, Canada
| | - Patryk Simon
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Bryanne Taylor
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Neal Henderson
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Mathew D. White
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Hugh Maguire
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Gerald Gray
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Faisal Rahman
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Janah Fair
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Nadine Wadden
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Mutiat Sulyman
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Olugbenga Williams
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Oluseye Akinkunmi
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Dorothy Edem
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Pamela Arenella
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Jason Morrison
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2E2, Canada
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Mahmoud Awara
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Anand Natarajan
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Abraham Nunes
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Tomas Hajek
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Claire O’Donavan
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Rudolf Uher
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2E2, Canada
- Mental Health and Addictions Program, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - JianLi Wang
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2E2, Canada
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Nova Scotia Health Innovation Hub, Halifax, NS B3S 0H6, Canada
| | - Benjamin Rusak
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2E2, Canada
| | - Lori Wozney
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2E2, Canada
- Mental Health and Addictions Program, IWK Health, Halifax, NS B3K 6R8, Canada
| | - Tara Sampalli
- Nova Scotia Health Innovation Hub, Halifax, NS B3S 0H6, Canada
| | - Doris Grant
- Nova Scotia Health Innovation Hub, Halifax, NS B3S 0H6, Canada
| | | | - Jordan Warford
- Nova Scotia Health Innovation Hub, Halifax, NS B3S 0H6, Canada
| | - Samantha Hodder
- School of Nursing, Cape Breton University, Cape Breton, NS B1M 1A2, Canada
| | - Rachel Boe
- Addictions and Mental Health, Horizon Health Network, Fredericton, NB E3B 4R3, Canada
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, Nova Scotia Health, Halifax, NS B3H 2E2, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2E2, Canada
- Correspondence: or
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Shi C, Hou XM, Mai YL, Liu YJ, Luo JM, Li J, Feng RE, Shi JH, Wang JL, Tian XL, Yang YL. [Nontuberculous mycobacteria infection and pulmonary alveolar proteinosis in a patient with hematopoietic defects]. Zhonghua Jie He He Hu Xi Za Zhi 2023; 46:158-163. [PMID: 36740376 DOI: 10.3760/cma.j.cn112147-20220712-00594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A 28-year-old male with a history of leukopenia was admitted with complaints of fever, cough, and dyspnea for 3 months. Initial work-up identified reduced circulating levels of granulocytes, monocytes, lymphocytes, and NK cells. Computed tomography revealed bilateral reticulonodular opacities and mediastinal lymph node enlargement. Peripheral blood culture and mediastinal lymph node aspiration yielded Mycobacterium avium. Genetic testing revealed a heterozygous germline GATA2 mutation (c.1187G>A, R396Q). Despite standard anti-mycobacterial therapy, the patient's dyspnea worsened and subsequent imaging studies revealed diffuse ground-glass opacification. A transbronchial lung biopsy confirmed the development of pulmonary alveolar proteinosis. Bone marrow transplantation had not been performed due to the unavailability of suitable donors. The disease progressed after whole lung lavage, and the patient died at the age of 31 years from respiratory failure. The current case report emphasized the importance of raising awareness about the rare GATA2 deficiency, which is characterized by hematologic abnormalities, primary immunodeficiency, and pulmonary alveolar proteinosis.
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Affiliation(s)
- C Shi
- Department of Internal Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - X M Hou
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Y L Mai
- Department of Internal Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Y J Liu
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - J M Luo
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - J Li
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - R E Feng
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - J H Shi
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - J L Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - X L Tian
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Y L Yang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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Nie YD, Pan SQ, Wang H, Wang TY, Feng YY, Zhang Y, Guo FP, Liu HT, Zhang BQ, Zhao Y, Zhang T, Wang L, Fan JP, Tian XL, Zhang LQ, Wang JL. [Adult-onset immunodeficiency induced by anti-interferon-γ autoantibodies: report of 13 cases]. Zhonghua Jie He He Hu Xi Za Zhi 2023; 46:144-150. [PMID: 36740374 DOI: 10.3760/cma.j.cn112147-20220725-00625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective: To investigate the clinical characteristics of a group of patients with adult-onset immunodeficiency (AOID) induced by anti-interferon-γ autoantibodies (AIGA). Methods: Thirteen cases of AOID in a northern China medical center (Peking Union Medical College Hospital) from October 2020 to April 2022 were included. Data comprising clinical manifestations, laboratory results, infection sites and pathogens were collected. Results: Among the 13 patients, 5 were male. The median age of disease onset was 47 (14 to 71) years. The median time from symptom onset to diagnosis was 4 years (1 to 8 years). Four patients were from northern China, and 9 from southern China. Common symptoms included lymphadenopathy (13/13), fever (12/13), respiratory tract symptoms (12/13), and weight loss (11/13). Laboratory tests showed increased levels of white blood cell count (9/13), neutrophil count and proportion (9/13), erythrocyte sedimentation rate (ESR) (12/13), and C reactive protein (CRP) (11/13). The median plasma titers of AIGA upon diagnosis were 5681(3194, 13246). Sites of infection included lungs (12/13), lymph nodes (9/13), bones and joints (9/13), skin and soft tissue (7/13), blood flow and bone marrow (4/13), and glands (3/13). Most patients had nontuberculous mycobacteria (NTM) (12/13) infection. Seven patients had more than one pathogen. Conclusions: AOID also affects patients visiting northern China hospitals. AIGA screening is recommended among patients with disseminated NTM infections or recurrent infections.
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Affiliation(s)
- Y D Nie
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - S Q Pan
- Graduate School, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - H Wang
- School of Medicine, Tsinghua University, Beijing 100084, China
| | - T Y Wang
- Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - Y Y Feng
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - Y Zhang
- Department of International Medical Service, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - F P Guo
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - H T Liu
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - B Q Zhang
- Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - Y Zhao
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - T Zhang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - L Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - J P Fan
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - X L Tian
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - L Q Zhang
- School of Medicine, Tsinghua University, Beijing 100084, China
| | - J L Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
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Wang BY, Zhao WH, Chen YX, Cao XM, Yang Y, Zhang YL, Wang FX, Zhang PY, Lei B, Gu LF, Wang JL, Bai J, Xu Y, Wang XG, Zhang RL, Wei LL, Zhuang QC, Fan F, Zhang WG, He AL, Liu J. Five-year remission without disease progression in a patient with relapsed/refractory multiple myeloma with extramedullary disease treated with LCAR-B38M chimeric antigen receptor T cells in the LEGEND-2 study: a case report. J Med Case Rep 2022; 16:459. [PMID: 36496425 PMCID: PMC9741775 DOI: 10.1186/s13256-022-03636-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/04/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Multiple myeloma remains incurable despite treatment advancements over the last 20 years. LCAR-B38M Cells in Treating Relapsed/Refractory Multiple Myeloma was a phase 1, first-in-human, investigator-initiated study in relapsed/refractory multiple myeloma conducted at four sites in China. The study used LCAR-B38M chimeric antigen receptor-T cells expressing two B-cell maturation antigen-targeting single-domain antibodies designed to confer avidity, and a CD3ζ signaling domain with a 4-1BB costimulatory domain to optimize T-cell activation and proliferation. This chimeric antigen receptor construct is identical to ciltacabtagene autoleucel. In the LEGEND-2 study (n = 57, Xi'an site), overall response rate was 88%; median (95% CI) progression-free survival and overall survival were 19.9 (9.6-31.0) and 36.1 (26.4-not evaluable) months, respectively; and median follow-up was 25 months. This case study reports on a patient with relapsed/refractory multiple myeloma (λ light chain type) who was treated with LCAR-B38M chimeric antigen receptor T cells in the LEGEND-2 study (Xi'an site); he had received five prior lines of treatment and had extensive extramedullary lesions. CASE PRESENTATION The patient, a 56-year-old Asian male, received cyclophosphamide (500 mg daily × 3 days) as lymphodepletion therapy and a total dose of 0.5 × 106 chimeric antigen receptor + T cells/kg split into three infusions (days 1, 24, and 84 from June to August 2016). He experienced grade 2 cytokine release syndrome after the first infusion; all symptoms resolved with treatment. No cytokine release syndrome occurred following the second and third infusions. His λ light chain levels decreased and normalized 20 days after the first infusion, and extramedullary lesions were healed as of January 2018. He has sustained remission for 5 years and received no other multiple myeloma treatments after LCAR-B38M chimeric antigen receptor T cell infusion. As of 30 October 2020, the patient is still progression-free and has maintained minimal residual disease-negative (10-4) complete response status for 52 months. CONCLUSIONS This case provides support that treatment with LCAR-B38M chimeric antigen receptor T cells can result in long-term disease remission of 5 or more years without disease progression in a heavily pretreated patient with extensive extramedullary disease and no other treatment options.
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Affiliation(s)
- Bai-Yan Wang
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Wan-Hong Zhao
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Yin-Xia Chen
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Xing-Mei Cao
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Yun Yang
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Yi-Lin Zhang
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Fang-Xia Wang
- grid.452672.00000 0004 1757 5804The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Peng-Yu Zhang
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Bo Lei
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Liu-Fang Gu
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Jian-Li Wang
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Ju Bai
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Yan Xu
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Xu-Geng Wang
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Rui-Li Zhang
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Li-Li Wei
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | | | - Frank Fan
- Nanjing Legend Biotech, Nanjing, China
| | - Wang-Gang Zhang
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
| | - Ai-Li He
- grid.452672.00000 0004 1757 5804Department of Hematology and National-Local Joint Engineering Research Center of Biodiagnostics & Biotherapy, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jie Liu
- grid.452672.00000 0004 1757 5804Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi’an, 710004 China
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Wang JL, Wang SC, Zhang XX, Ni X. [Research progress on sirolimus in the treatment of lymphatic malformations]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:1520-1524. [PMID: 36707963 DOI: 10.3760/cma.j.cn115330-20220504-00244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- J L Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing 100045, China
| | - S C Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing 100045, China
| | - X X Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing 100045, China
| | - X Ni
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing 100045, China
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Wang JL, Ding BZ, Xia FF. Preoperative computed tomography-guided localization for multiple lung nodules: a Meta-analysis. MINIM INVASIV THER 2022; 31:1123-1130. [PMID: 36260704 DOI: 10.1080/13645706.2022.2133965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE Approximately 20% of patients with lung nodules (LNs) have multiple LNs (MLNs). This meta-analysis was performed to assess the safety and efficacy of computed tomography (CT)-guided localization of MLNs in comparison with those of single LN (SLN) localization. MATERIAL AND METHODS The PubMed, Embase, and Cochrane Library were searched to collect relevant articles published till February 2022. The meta-analysis was performed using the RevMan v5.3. RESULTS In total, seven studies met the inclusion criteria for this meta-analysis. No significant difference was observed between patients with MLNs and SLN in terms of pooled successful localization rate based on LNs (p = 0.64) and patients (p = 0.06). The pooled duration of localization was significantly shorter and the pooled pneumothorax and lung hemorrhage rates were significantly lower in the SLN group than in the MLNs group (p < 0.00001 for all). The pooled duration of hospital stay was comparable between the MLNs and SLN groups (p = 0.96). Significant heterogeneity was observed in the endpoints of duration of localization (I2 = 75%) and pneumothorax (I2 = 53%). CONCLUSIONS CT-guided simultaneous MLN localization is clinically safe and effective, despite requiring a longer procedural time and having higher incidence of pneumothorax and lung hemorrhage than SLN localization.
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Affiliation(s)
- Jian-Li Wang
- Department of Radiology, Beijing Huairou Hospital of Traditional Chinese Medicine, Beijing, China
| | - Bao-Zhong Ding
- Department of General Surgery, Binzhou People's Hospital, Binzhou, China
| | - Feng-Fei Xia
- Department of Interventional Vascular Surgery, Binzhou People's Hospital, Binzhou, China
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Zhong QM, Wang JL. Seasonal flexibility of kidney structure and factors regulating water and salt in Eremias multiocellata. Comp Biochem Physiol A Mol Integr Physiol 2022; 274:111301. [DOI: 10.1016/j.cbpa.2022.111301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/21/2022] [Accepted: 08/21/2022] [Indexed: 12/05/2022]
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Wang JL, Huang TZ, Zhao XL, Luo YS, Jiang TX. CoNoT: Coupled Nonlinear Transform-Based Low-Rank Tensor Representation for Multidimensional Image Completion. IEEE Trans Neural Netw Learn Syst 2022; PP:1-15. [PMID: 36367909 DOI: 10.1109/tnnls.2022.3217198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Recently, the transform-based tensor nuclear norm (TNN) methods have shown promising performance and drawn increasing attention in tensor completion (TC) problems. The main idea of these methods is to exploit the low-rank structure of frontal slices of the tensor under the transform. However, the transforms in TNN methods usually treat all modes equally and do not consider the different traits of different modes (i.e., spatial and spectral/temporal modes). To address this problem, we suggest a new low-rank tensor representation based on the coupled nonlinear transform (called CoNoT) for a better low-rank approximation. Concretely, spatial and spectral/temporal transforms in the CoNoT, respectively, exploit the different traits of different modes and are coupled together to boost the implicit low-rank structure. Here, we use the convolutional neural network (CNN) as the CoNoT, which can be learned solely from an observed multidimensional image in an unsupervised manner. Based on this low-rank tensor representation, we build a new multidimensional image completion model. Moreover, we also propose an enhanced version (called Ms-CoNoT) to further exploit the spatial multiscale nature of real-world data. Extensive experiments on real-world data substantiate the superiority of the proposed models against many state-of-the-art methods both qualitatively and quantitatively.
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Bo LL, Wang YQ, Liu YY, Li XD, Zhou R, Wang JL. [Analyze of obesity indicators and effect of fertility preservation treatment in patients with endometrial atypical hyperplasia and early endometrial cancer]. Zhonghua Fu Chan Ke Za Zhi 2022; 57:767-774. [PMID: 36299180 DOI: 10.3760/cma.j.cn112141-20220727-00487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To investigate the clinical features of obesity indicators in patients with endometrial atypical hyperplasia (EAH) and early endometrial cancer (EC) and analyze the relationship between these indexes and effect of fertility preservation therapy. Methods: The clinical data of patients with EAH, EC and endometrial benign lesions treated in Peking University People's Hospital from January 1, 2018 to June 30, 2021 who required fertility-sparing treatment were collected, and obesity indicators were calculated and analyzed retrospectively. Results: (1) Obesity indicators: the obesity [body mass index (BMI) ≥28 kg/m2] rate of patients with fertility preservation treatment was 40% (32/80), and abdominal obesity [waist circumference (WC) ≥80 cm] rate was 79% (63/80), and obesity indicators [BMI, WC, waist-hip ratio (WHR), weight height ratio (WHTR), body roundness index (BRI), lipid accumulation index (LAP), visceral adiposity index (VAI)] were higher than those with endometrial benign lesions (all P<0.001). (2) Related factors affecting the efficacy of fertility preservation treatment and their predictive value: EC, higher BMI, WC, WHR, WHTR and BRI were risk factors for lower complete remission rate after nine months' treatment (all P<0.05). The predictive values of BRI and WHTR combined with pathological type were superior to other indicators [area under the curve (AUC)=0.716; AUC=0.714]. (3) Relation of obesity indicators and glucolipid indicators:BMI, WC, WHR, WHTR, BRI, LAP and VAI were positively correlated with homeostasis model assessment-insulin resistance index, glycosylated hemoglobin, and triacylglycerol (all P<0.05); while VAI was negatively correlated with high density lipoprotein cholesterol (P<0.001). Conclusions: For patients with EAH and EC treated with fertility preservation therapy, abnormal obesity indexes affect the treatment effect. BRI and WHTR combined pathology have good predictive value for effect of fertility preservation treatment. In clinical practice, appropriate indicators could be selected to evaluate body shape, glucolipid metabolism and predict efficacy.
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Affiliation(s)
- L L Bo
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - Y Q Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - Y Y Liu
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - X D Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - R Zhou
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - J L Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
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Chen KN, Jiang JQ, Wang JL, Sun YC, Guo CB, Xu XL. [Preliminary measurement and analysis of the condylar movement envelope surface parameters in healthy adults]. Zhonghua Kou Qiang Yi Xue Za Zhi 2022; 57:1015-1021. [PMID: 36266074 DOI: 10.3760/cma.j.cn112144-20220630-00355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To measure and analyze parameters of the three-dimensional (3D) model of the condylar movement envelope surface (ES) and provide a reference for the design of the temporomandibular prosthesis. Methods: Thirty-four healthy adults aged (25.4±2.8) years were recruited from the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology as subjects. There were 9 males and 25 females, most of them were university students and others outside the university have received undergraduate education or above. Condylar movement ES were obtained using the previous method on the 3D trajectory of condyle. The simulations of condylar movement were projected according to opening movements, protrusion movements, and lateral movements respectively. The total area of the ES and the area proportions of models formed by above different mandibular movements were measured and calculated. The adults' head and maxillofacial 3D models reconstructed by cone beam CT were registered with ES in Geomagic Studio. The inner and outer poles of the condyle, the corrective sagittal axis of the ES, and the median sagittal plane (MSP) were calibrated in registration models using Geomagic Studio, and the parameters were measured as follows: the anteroposterior and medialateral diameters of the condyle, the anteroposterior diameters and the transverse diameters (anterior, middle and posterior parts) of the ES, the angles between the corrective sagittal axis of the ES and MSP (ES-MSP). Pearson correlation analysis was performed by SPSS 24.0. Results: The total area of the ES was (760±133) mm2, the opening movement part accounted for (63.3±15.2)%, the protrusion movement part accounted for (14.9±9.6)%, the lateral movement part accounted for (21.8±13.3)%. Parameter measurements were as follows: mediolateral diameters of condyle was (19.8±2.3) mm; anteroposterior diameter of the ES was (21.2±3.1) mm, the transverse diameters (anterior, middle and posterior parts) of the ES were (20.6±2.4), (20.4±2.4), (22.0±2.6) mm, respectively; the transverse diameters of the ES were about 2 mm larger than that of the condyle. The angle between the corrective sagittal axis of ES and the MSP was 6.8°±6.2°. The coefficient of variation (CV) in these parameters showed: CV of the transverse diameters (anterior, middle and posterior parts) of the ES and mediolateral diameter of the condyle were 0.98, 0.99, 0.93, respectively (P<0.001). CV of aera of ES and mediolateral diameter of the condyle was 0.64 (P=0.002). CV of aera of ES and anteroposterior diameter of ES was 0.62 (P=0.004). Conclusions: The 3D envelope surface model formed by mandibular opening movements accounted for the largest proportion of the ES. The corrective sagittal axis of the ES was at an angle to the MSP, the transverse diameters (anterior, middle and posterior parts) of the ES were approximately 2 mm larger than the mediolateral diameter of the condyle, the transverse diameters (anterior, middle and posterior parts) of the ES were highly positively correlated with the mediolateral diameter of the condyle.
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Affiliation(s)
- K N Chen
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - J Q Jiang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - J L Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Y C Sun
- Center of Digital Dentistry, Faculty of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - C B Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - X L Xu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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Wang YQ, Kang N, Li LW, Wang ZQ, Zhou R, Shen DH, Wang JL. [Significance of molecular classification in fertility-sparing treatment of endometrial carcinoma and atypical endometrial hyperplasia]. Zhonghua Fu Chan Ke Za Zhi 2022; 57:692-700. [PMID: 36177581 DOI: 10.3760/cma.j.cn112141-20220628-00419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To investigate the molecular classification of endometrial carcinoma (EC) and atypical endometrial hyperplasia (AEH) treated with fertility-sparing therapy, and to analyze its relationship with clinicopathological factors and treatment efficacy. Methods: A total of 46 EC and AEH patients who received fertility-sparing therapy and molecular classification tested by next generation sequencing in Peking University People's Hospital from June 2020 to December 2021, were retrospectively collected. The relationships between molecular classification and clinicopathological factors and treatment outcomes were analyzed. Results: (1) Of the 46 patients, including 40 EC and 6 AEH patients, 32 cases (71%, 32/45) had complete response (CR) after treatment, with median CR time of 8 months, 6 cases (13%, 6/45) had partial response, and 8 cases (25%, 8/32) had recurrence. (2) The cases were distributed as no specific molecular profile (NSMP) 34 cases (74%, 34/46) subtype mainly, high microsatellite instability (MSI-H) 7 cases (15%, 7/46), POLE ultra-mutated 3 cases (7%, 3/46), and copy number high (CNH) 2 cases (4%, 2/46). Patients with CNH had the hightest serum cancer antigen 125 (CA125) level [(34.3±35.2) kU/L]. MSI-H subtype had more family history of tumors (6/7), more with loss of mismatch repair (MMR) protein expression by immunohistochemical (7/7), and higher nuclear antigen associated with cell proliferation (Ki-67) expression level (3/3). (3) Patients in MSI-H subgroup had the lowest CR rate at 6 months (0/6; P=0.019), and survival analysis showed that they were less likely to achieve CR than those with NSMP subtype (P=0.022). Subgroup analysis of patients with NSMP showed that age ≥30 years related with longer treatment time to CR (P=0.010). In addition, CR was obtained after treatment in 2/3 POLE ultra-mutated cases and 2/2 CNH, respectively. Conclusions: Molecular classification relates with the treatment response in patients with EC and AEH treated with fertility-sparing therapy. Patients with MSI-H subtype have poor treatment efficacy, and patients with NSMP need to be further studied and predict treatment benefit. However, there are few cases in POLE ultra-mutated and CNH subtypes, which need further clinical research.
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Affiliation(s)
- Y Q Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - N Kang
- Department of Pathology, Peking University People's Hospital, Beijing 100044, China
| | - L W Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - Z Q Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - R Zhou
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - D H Shen
- Department of Pathology, Peking University People's Hospital, Beijing 100044, China
| | - J L Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
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Zhang S, Zhang X, Wu S, Zhang T, Ji HM, Zhang Q, Gao J, Pan C, Pang JJ, Xu F, Wang JL, Chen Y. [Analysis of clinical features and the outcome of in-hospital mortality of myocardial infarction with non-obstructive coronary arteries]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:873-880. [PMID: 36096704 DOI: 10.3760/cma.j.cn112148-20220531-00429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To compare the clinical features and the outcome of in-hospital mortality between patients with myocardial infarction with non-obstructive coronary arteries(MINOCA)and myocardial infarction with obstructive coronary artery disease (MI-CAD). Methods: This is a retrospective study. The clinical data of acute myocardial infarction (AMI) patients admitted to Qilu Hospital of Shandong University from January 2017 to May 2021, who underwent coronary angiography, were collected. Patients were divided into MINOCA group and MI-CAD group according to the degree of coronary stenosis (<50% or ≥50%). Baseline clinical characteristics, electrocardiograph during hospitalization, myocardial bridge, length of stay in hospital, discharge medication and the outcome of in-hospital mortality were collected and compared between the two groups. Univariate and multivariate logistic regression analysis was used to screen the related factors of MINOCA and the factors predicting the nosocomial death outcome of patients with AMI. Results: A total of 3 048 AMI patients were enrolled, age was 62 (54, 69) years, 741 (24.3%) patients were women including 165 patients (5.4%) in the MINOCA group and 2 883 patients (94.6%) in the MI-CAD group. Compared with MI-CAD patients, MINOCA patients were younger, had a higher proportion of females and a higher incidence of NSTEMI, and had a lower history of smoking, diabetes, coronary heart disease and myocardial infarction. Baseline inflammatory markers such as neutrophil count, monocyte count, neutrophil count/lymphocyte count (NLR), and monocyte count/high-density lipoprotein count (MHR) were lower, creatinine, N-terminal pro-brain B-type Natriuretic peptides (NT-proBNP), creatine kinase-MB, hypersensitive troponin I, fibrinogen, baseline blood glucose levels were lower, high-density lipoprotein cholesterol was higher, and the incidence of myocardial bridge, arrhythmia, tachycardia and atrial fibrillation was higher (P<0.05). The application rates of calcium antagonists and non-vitamin K antagonists oral anticoagulants were higher in MINOCA group (P<0.05), and there was no statistical difference in hospitalization days and in-hospital death between the two groups (P>0.05). Multiple logistic regression analysis showed that young age, female, non-smoker, no history of coronary heart disease and low MHR were risk factors of MINOCA (P<0.05). MINCOA was not associated with higher in-hospital death (P>0.05). Patients with AMI and a history of coronary heart disease, chronic renal failure, higher baseline blood glucose, higher NLR, and higher D-dimer were risk factors of in-hospital death (P<0.05). Conclusions: Compared with MI-CAD patients, MINOCA patients are younger, more likely to be female and non-smokers and on history of coronary heart disease, and have lower baseline MHR. MINOCA is often associated with myocardial bridge and atrial fibrillation. The incidence of in-hospital death in MINCOA patients is similar as in MI-CAD patients.
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Affiliation(s)
- S Zhang
- Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Health System, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Higher Education of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - X Zhang
- Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Health System, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Higher Education of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - S Wu
- Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Health System, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Higher Education of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - T Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - H M Ji
- Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Health System, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Higher Education of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - Q Zhang
- Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Health System, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Higher Education of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - J Gao
- Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Health System, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Higher Education of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - C Pan
- Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Health System, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Higher Education of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - J J Pang
- Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Health System, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Higher Education of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - F Xu
- Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Health System, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Higher Education of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - J L Wang
- Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Health System, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Higher Education of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
| | - Yuguo Chen
- Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Health System, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Higher Education of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Jinan 250012, China
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Metzak PD, Shakeel MK, Long X, Lasby M, Souza R, Bray S, Goldstein BI, MacQueen G, Wang J, Kennedy SH, Addington J, Lebel C. Brain connectomes in youth at risk for serious mental illness: an exploratory analysis. BMC Psychiatry 2022; 22:611. [PMID: 36109720 PMCID: PMC9476574 DOI: 10.1186/s12888-022-04118-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 07/06/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Identifying early biomarkers of serious mental illness (SMI)-such as changes in brain structure and function-can aid in early diagnosis and treatment. Whole brain structural and functional connectomes were investigated in youth at risk for SMI. METHODS Participants were classified as healthy controls (HC; n = 33), familial risk for serious mental illness (stage 0; n = 31), mild symptoms (stage 1a; n = 37), attenuated syndromes (stage 1b; n = 61), or discrete disorder (transition; n = 9) based on clinical assessments. Imaging data was collected from two sites. Graph-theory based analysis was performed on the connectivity matrix constructed from whole-brain white matter fibers derived from constrained spherical deconvolution of the diffusion tensor imaging (DTI) scans, and from the correlations between brain regions measured with resting state functional magnetic resonance imaging (fMRI) data. RESULTS Linear mixed effects analysis and analysis of covariance revealed no significant differences between groups in global or nodal metrics after correction for multiple comparisons. A follow up machine learning analysis broadly supported the findings. Several non-overlapping frontal and temporal network differences were identified in the structural and functional connectomes before corrections. CONCLUSIONS Results suggest significant brain connectome changes in youth at transdiagnostic risk may not be evident before illness onset.
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Affiliation(s)
- Paul D. Metzak
- grid.22072.350000 0004 1936 7697Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB Canada
| | - Mohammed K. Shakeel
- grid.22072.350000 0004 1936 7697Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB Canada ,grid.195094.00000 0000 9471 9454Department of Psychology, St.Mary’s University, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Mathison Centre, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6 Canada
| | - Xiangyu Long
- grid.22072.350000 0004 1936 7697Department of Radiology, University of Calgary, Calgary, AB Canada ,grid.413571.50000 0001 0684 7358Department of Radiology, Alberta Children’s Hospital Research Institute, Calgary, AB Canada ,Department of Radiology, Child and Adolescent Imaging Research Program, Calgary, AB Canada
| | - Mike Lasby
- grid.22072.350000 0004 1936 7697Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Electrical and Software Engineering, University of Calgary, Calgary, AB Canada
| | - Roberto Souza
- grid.22072.350000 0004 1936 7697Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Electrical and Software Engineering, University of Calgary, Calgary, AB Canada
| | - Signe Bray
- grid.22072.350000 0004 1936 7697Department of Radiology, University of Calgary, Calgary, AB Canada ,grid.413571.50000 0001 0684 7358Department of Radiology, Alberta Children’s Hospital Research Institute, Calgary, AB Canada ,Department of Radiology, Child and Adolescent Imaging Research Program, Calgary, AB Canada
| | - Benjamin I. Goldstein
- grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Center for Addiction and Mental Health, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Pharmacology, Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Glenda MacQueen
- grid.22072.350000 0004 1936 7697Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB Canada
| | - JianLi Wang
- grid.55602.340000 0004 1936 8200Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Nova Scotia, Canada
| | - Sidney H. Kennedy
- grid.231844.80000 0004 0474 0428Department of Psychiatry, University Health Network, Toronto, ON Canada ,grid.415502.7Department of Psychiatry, St. Michael’s Hospital, Toronto, ON Canada ,grid.415502.7Arthur Sommer Rotenberg Chair in Suicide and Depression Studies, St. Michael’s Hospital, Toronto, ON Canada ,grid.415502.7Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON Canada ,grid.231844.80000 0004 0474 0428Krembil Research Institute, University Health Network, Toronto, ON Canada
| | - Jean Addington
- grid.22072.350000 0004 1936 7697Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB Canada
| | - Catherine Lebel
- grid.22072.350000 0004 1936 7697Department of Radiology, University of Calgary, Calgary, AB Canada ,grid.413571.50000 0001 0684 7358Department of Radiology, Alberta Children’s Hospital Research Institute, Calgary, AB Canada ,Department of Radiology, Child and Adolescent Imaging Research Program, Calgary, AB Canada
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Yang L, Su Y, Dong S, Wu T, Zhang Y, Qiu H, Gu W, Qiu H, Xu Y, Wang J, Chen J, Fang Y. Concordance of the treatment patterns for major depressive disorders between the Canadian Network for Mood and Anxiety Treatments (CANMAT) algorithm and real-world practice in China. Front Pharmacol 2022; 13:954973. [PMID: 36120331 PMCID: PMC9471191 DOI: 10.3389/fphar.2022.954973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/08/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Antidepressant (AD) algorithm is an important tool to support treatment decision-making and improve management of major depressive disorder (MDD). However, little is known about its concordance with real-world practice. This study aimed to assess the concordance between the longitudinal treatment patterns and AD algorithm recommended by a clinical practice guideline in China. Methods: Data were obtained from the electronic medical records of Shanghai Mental Health Center (SMHC), one of the largest mental health institutions in China. We examined the concordance between clinical practice and the Canadian Network for Mood and Anxiety Treatments (CANMAT) algorithm among a cohort composed of 19,955 MDD patients. The longitudinal characteristics of treatment regimen and duration were described to identify the specific inconsistencies. Demographics and health utilizations of the algorithm-concordant and -discordant subgroups with optimized treatment were measured separately. Results: The overall proportion of algorithm-concordant treatment significantly increased from 84.45% to 86.03% during the year of 2015-2017. Among the patients who received recommended first-line drugs with subsequent optimized treatment (n = 2977), the concordance proportion was 27.24%. Mirtazapine and trazodone were the most used drugs for adjunctive strategy. Inadequate or extended duration before optimized treatment are common inconsistency. The median length of follow-up for algorithm-concordant (n = 811) and algorithm-discordant patients (n = 2166) were 153 days (Q1-Q3 = 79-328) and 368 days (Q1-Q3 = 181-577) respectively, and the average number of clinical visits per person-year was 13.07 and 13.08 respectively. Conclusion: Gap existed between clinical practice and AD algorithm. Improved access to evidence-based treatment is required, especially for optimized strategies during outpatient follow-up.
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Affiliation(s)
- Lu Yang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yousong Su
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sijia Dong
- Global Epidemiology, Office of Chief Medical Officer, Johnson & Johnson, Shanghai, China
| | - Tao Wu
- Global Epidemiology, Office of Chief Medical Officer, Johnson & Johnson, Beijing, China
| | - Yongjing Zhang
- Global Epidemiology, Office of Chief Medical Officer, Johnson & Johnson, Shanghai, China
| | - Hong Qiu
- Global Epidemiology, Office of Chief Medical Officer, Johnson & Johnson, Titusville, NJ, United States
| | - Wenjie Gu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Qiu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yifeng Xu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - JianLi Wang
- Departments of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Jun Chen
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Yiru Fang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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Wang J, Eccles H, Nannarone M, Schmitz N, Patten S, Lashewicz B. Does providing personalized depression risk information lead to increased psychological distress and functional impairment? Results from a mixed-methods randomized controlled trial. Psychol Med 2022; 52:2071-2079. [PMID: 33143794 DOI: 10.1017/s0033291720003955] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Multivariable risk algorithms (MVRP) predicting the personal risk of depression will form an important component of personalized preventive interventions. However, it is unknown whether providing personalized depression risk will lead to unintended psychological harms. The objectives of this study were to evaluate the impact of providing personalized depression risk on non-specific psychological distress and functional impairment over 12 months. METHODS A mixed-methods randomized controlled trial was conducted in 358 males and 354 females who were at high risk of having a major depressive episode according to sex-specific MVRPs, and who were randomly recruited across Canada. Participants were assessed at baseline, 6 and 12 months. RESULTS Over 93% of participants were interested in knowing their depression risk. The intervention group had a greater reduction in K10 score over 12 months than the control group; complete-case analysis found a significant between-group difference in mean K10 change score (d = 1.17, 95% CI 0.12-2.23) at 12 months. Participants in the intervention group also reported significantly less functional impairment in the domains of home and work/school activities, than did those in the control group. A majority of the qualitative interviewees commented that personalized depression risk information does not have a negative impact on physical and mental health. CONCLUSIONS This study found no evidence that providing personalized depression risk information will lead to worsening psychological distress, functional impairment, and absenteeism. Provision of personalized depression risk information may have positive impacts on non-specific psychological distress and functioning. TRIAL REGISTRATION ClinicalTrials.gov NCT02943876.
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Affiliation(s)
- JianLi Wang
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Heidi Eccles
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Molly Nannarone
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Norbert Schmitz
- Douglas Mental Health Research Institute, McGill University, Montreal, Canada
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada
| | - Scott Patten
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Bonnie Lashewicz
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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