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Zheng F, Liu S, Yin Q, Zheng Y, Yang J, Huang H, Chen L, Wang Y, Chen X, Wang C. Long-term impact of self-compassion training with core stability exercise on patients with nonspecific chronic low back pain: A randomized controlled trial. J Psychosom Res 2024; 181:111678. [PMID: 38643684 DOI: 10.1016/j.jpsychores.2024.111678] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 04/14/2024] [Accepted: 04/15/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVE To compare the long-term effectiveness of self-compassion therapy (SCT) combined with core stability exercise (CSE) versus CSE alone in managing nonspecific chronic low back pain (NCLBP). METHODS The combined group received SCT and CSE, while the exercise group only received CSE. Treatment was administered once weekly for four weeks, followed by one year of follow-up. The primary outcomes were changes in functional limitations (measured by Roland and Morris Disability Questionnaire scores[RMDQ]) and self-reported back pain (measured by the Numeric Pain Rating Scale[NRS]) at 52 weeks, with assessments also conducted at 2, 4, and 16 weeks. RESULTS 52 (83.9%) completed the follow-up assessments and were included in the analysis (42 women [80.8%]; mean [SD] age,35.3 [10.0] years). In the combined group, the baseline mean (SD) RMDQ score was 9.3 (4.1),5.7 (5.8) at 2 weeks, 3.8 (3.4) at 4 weeks, 3.8 (3.7) at 16 weeks, and 2.4 (2.7) at 52 weeks. For the exercise group, the RMDQ scores were 8.2 (3.3) at baseline, 6.2 (4.2) at 2 weeks, 5.5 (4.7) at 4 weeks, 4.4 (4.5) at 16 weeks, and 5.2 (5.6) at 52 weeks. The estimated mean difference between the groups at 52 weeks was -3.356 points (95% CI, -5.835 to -0.878; P = 0.009), favoring the combined group. NRS scores showed similar changes. CONCLUSION The addition of self-compassion therapy enhances the long-term efficacy of core stability training for NCLBP (Preregistered at chictr.org.cn:ChiCTR2100042810).
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Affiliation(s)
- Fuming Zheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Shufeng Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Qunhui Yin
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Yiyi Zheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Jiajia Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Haoxuan Huang
- Department of psychology, Sun Yat-Sen University, Guangzhou 510006, China
| | - Lichang Chen
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Yuyin Wang
- Department of psychology, Sun Yat-Sen University, Guangzhou 510006, China.
| | - Xi Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
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Zhang W, Jin D, Guo X, Qin X, Liu X. Geoenvironmental properties of a Cr(VI)-contaminated soil treated by alkali-activated GGBS under freeze-thaw cycles: Insights into Cr species transformation and microscopic mechanism. Sci Total Environ 2023; 903:166450. [PMID: 37634723 DOI: 10.1016/j.scitotenv.2023.166450] [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] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023]
Abstract
Stabilization/solidification is the most frequently used method for treating soils contaminated by heavy metals; however, degradation of the treatment will occur under freeze-thaw (F-T) cycles. In this paper, a low-carbon emission by-product, ground granulated blast furnace slag (GGBS), was adopted as a binder to treat Cr(VI)-contaminated soil after alkali excitation. Built on the usage scenarios of subgrade materials, the impact of F-T cycles and initial water content on the geoenvironmental properties of the treated soils, including leaching toxicity, unconfined compressive strength (UCS), pH, Eh, and permeability, were discussed. To investigate the mechanisms of the changing properties, this study analyzed the chemical morphology of Cr, the micromorphology of the reaction products, and the pore characteristics. The results demonstrated that negative impact of F-T cycles on treatment effectiveness was low at the optimal water content. After 28 F-T cycles, the Cr(VI) component increased by 6.4 %, and the leached Cr concentration showed a significant increase, especially for specimens with low water content. A new solid phase with mixed valence Mn(III/IV), mainly composed of birnessite and manganite, was observed via microscopic analysis. During the first 3 F-T cycles, the content of hydration gel increased by 0.18 %, and the cumulative pore volume decreased such that the UCS increased by an average of 1.2 MPa. This study demonstrated that a few F-T cycles would result in a secondary alkali-activated GGBS reaction, enhancing the treatment effect. However, additional F-T cycles would create an oxidizing environment under which the initially precipitated Cr(III) would react with manganese oxide, resulting in more Cr(VI) released. The degree of reoxidation was closely related to the initial water content of the solidified soil.
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Affiliation(s)
- Wenjie Zhang
- College of Civil and Architectural Engineering, Taizhou University, 318000 Taizhou, PR China.
| | - Dian Jin
- School of Mechanics and Engineering Science, Shanghai University, 200444 Shanghai, PR China.
| | - Xingzhang Guo
- Geotechnical and Structural Engineering Research Center, Shandong University, Jinan, Shandong, PR China
| | - Xiang'ao Qin
- School of Mechanics and Engineering Science, Shanghai University, 200444 Shanghai, PR China
| | - Xiangning Liu
- School of Mechanics and Engineering Science, Shanghai University, 200444 Shanghai, PR China
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Zhang Y, Ju J, Wu J. Self-locking stand-alone cage versus cage-plate fixation in monosegmental anterior cervical discectomy and fusion with a minimum 2-year follow-up: a systematic review and meta-analysis. J Orthop Surg Res 2023; 18:403. [PMID: 37269002 DOI: 10.1186/s13018-023-03885-4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/27/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Currently, self-locking stand-alone cages (SSC) are commonly applied in anterior cervical discectomy and fusion (ACDF), as are cage-plate constructs (CPC). However, it remains controversial concerning the long-term effectiveness of both apparatuses. Our purpose is to compare long-term effectiveness of SSC with CPC in monosegmental ACDF. METHODS Four electronic databases were queried to identify studies comparing SSC versus CPC in monosegmental ACDF. The meta-analysis was carried out with the use of the Stata MP 17.0 software package. RESULTS Ten trials with 979 patients were included. Compared to CPC, SSC significantly reduced operative time, intraoperative blood loss, duration of hospitalisation, cervical Cobb angle at final follow-up, 1-month postoperative dysphagia rate, and incidence of adjacent segment degeneration (ASD) at final follow-up. No significant difference was found regarding 1-month postoperative cervical Cobb angle, JOA scores, NDI scores, fusion rate and cage subsidence rate at final follow-up. CONCLUSION Both devices achieved similar long-term effectiveness in monosegmental ACDF regarding JOA scores, NDI scores, fusion rate and cage subsidence rate. SSC had significant advantages over CPC in reducing surgical duration, intraoperative bleeding, duration of hospitalisation, as well as rates of dysphagia and ASD after surgery. Therefore, SSC is a better option than CPC in monosegmental ACDF. However, SSC is inferior to CPC in maintaining cervical curvature at long-term follow-up. Whether radiological changes affect clinical symptoms needs confirmation in trials with longer follow-up.
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Affiliation(s)
- Yu Zhang
- Department of Orthopaedics, Jingjiang People's Hospital, The Seventh Affiliated Hospital of Yangzhou University, Jingjiang, Taizhou, Jiangsu Province, 214500, China
| | - Jidong Ju
- Department of Orthopaedics, Jingjiang People's Hospital, The Seventh Affiliated Hospital of Yangzhou University, Jingjiang, Taizhou, Jiangsu Province, 214500, China
| | - Jinchun Wu
- Department of Orthopaedics, Jingjiang People's Hospital, The Seventh Affiliated Hospital of Yangzhou University, Jingjiang, Taizhou, Jiangsu Province, 214500, China.
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Hu H, Tang CS, Shen Z, Pan X, Gu K, Fan X, Lv C, Mu W, Shi B. Enhancing lead immobilization by biochar: Creation of "surface barrier" via bio-treatment. Chemosphere 2023; 327:138477. [PMID: 36966928 DOI: 10.1016/j.chemosphere.2023.138477] [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: 01/10/2023] [Revised: 03/07/2023] [Accepted: 03/20/2023] [Indexed: 06/18/2023]
Abstract
The long-term effectiveness of heavy metal immobilization is always a concern. This study proposes a completely novel approach to enhance the stability of heavy metals by combined biochar and microbial induced carbonate precipitation (MICP) technology, to create a "surface barrier" of CaCO3 layer on biochar after lead (Pb2+) immobilization. Aqueous sorption studies and chemical and micro-structure tests were used to verify the feasibility. Rice straw biochar (RSB700) was produced at 700 °C, which shows high immobilization capacity of Pb2+ (maximum of 118 mg g-1). But the stable fraction only accounts for 4.8% of the total immobilized Pb2+ on biochar. After MICP treatment, the stable fraction of Pb2+ significantly increased to a maximum of 92.5%. Microstructural tests confirm the formation of CaCO3 layer on biochar. The CaCO3 species are predominantly calcite and vaterite. Higher Ca2+ and urea concentrations in cementation solution resulted in higher CaCO3 yield but lower Ca2+ utilization efficiency. The main mechanism of the "surface barrier" to enhance Pb2+ stability on biochar was likely the encapsulation effect: it physically blocked the contact between acids and Pb2+ on biochar, and chemically buffer the acidic attack from the environment. The performance of the "surface barrier" depends on both the yield of CaCO3 and their distribution uniformity on biochar's surface. This study shed lights on the potential application of the "surface barrier" strategy combining biochar and MICP technologies for enhanced heavy metal immobilization.
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Affiliation(s)
- Huicong Hu
- School of Earth Sciences and Engineering, Nanjing University, Nanjing, 210023, China
| | - Chao-Sheng Tang
- School of Earth Sciences and Engineering, Nanjing University, Nanjing, 210023, China.
| | - Zhengtao Shen
- School of Earth Sciences and Engineering, Nanjing University, Nanjing, 210023, China.
| | - Xiaohua Pan
- School of Earth Sciences and Engineering, Nanjing University, Nanjing, 210023, China
| | - Kai Gu
- School of Earth Sciences and Engineering, Nanjing University, Nanjing, 210023, China
| | - Xiaoliang Fan
- School of Earth Sciences and Engineering, Nanjing University, Nanjing, 210023, China
| | - Chao Lv
- School of Earth Sciences and Engineering, Nanjing University, Nanjing, 210023, China
| | - Wen Mu
- School of Earth Sciences and Engineering, Nanjing University, Nanjing, 210023, China
| | - Bin Shi
- School of Earth Sciences and Engineering, Nanjing University, Nanjing, 210023, China
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Gall R, Jain N, Soong W, Settipane RA, Xia C, Zhang Y, Haselkorn T, Jacob-Nara JA, Siddiqui S. Dupilumab-Treated Patients with Asthma in the Real World: The RAPID Global Registry. Adv Ther 2023; 40:1292-1298. [PMID: 36626107 PMCID: PMC9988992 DOI: 10.1007/s12325-022-02399-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 08/15/2022] [Accepted: 12/01/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Dupilumab, a fully human monoclonal antibody, blocks the shared receptor component for interleukin-4 and interleukin-13, key and central drivers of type 2 inflammation. In clinical studies, dupilumab reduced the risk of severe asthma exacerbations, and improved forced expiratory volume in 1 s and quality of life in patients with uncontrolled moderate-to-severe asthma. OBJECTIVES The objectives of RAPID (NCT04287621) are to characterize patients with asthma initiating dupilumab in routine clinical practice and to collect information on long-term effectiveness and safety in these patients. METHODS RAPID is a global, prospective, observational registry that will enroll approximately 1000 patients (aged ≥ 12 years) with asthma from 150 sites globally. Dupilumab treatment will be initiated in routine clinical practice according to country-specific prescribing information, per physician discretion as part of routine care. Patients will be followed prospectively for up to 3 years, with postbaseline assessments at months 1 and 3, and every 3 months thereafter. PLANNED OUTCOMES Baseline data collected will include patient demographics, disease characteristics, and medication history. Patient adherence and persistence will be recorded alongside health-care resource utilization, and effectiveness of dupilumab will be assessed (clinician assessment) as per standard of care. Quality of life, asthma control, type 2 inflammatory comorbidities, work productivity, and physical activity limitation will be assessed. Incidence and severity of adverse events will be recorded. CONCLUSION RAPID is the first global registry to characterize patients beginning dupilumab treatment for asthma in clinical practice and will expand on prior clinical studies by providing real-world data. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier NCT04287621.
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Affiliation(s)
- Rebecca Gall
- , 1 Rockwood Rd, Sleepy Hollow, New York, NY, 10591, USA.
| | - Neal Jain
- Arizona Allergy and Immunology Research, Gilbert, AZ, USA
| | - Weily Soong
- AllerVie Health-Alabama Allergy and Asthma Center, Birmingham, AL, USA
| | | | | | - Yi Zhang
- Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA
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Dayan D, Bendayan A, Nizri E, Abu-Abeid S, Lahat G, Abu-Abeid A. One Anastomosis Gastric Bypass Compared with Sleeve Gastrectomy in Elderly Patients: Safety and Long-term Outcomes. Obes Surg 2023; 33:570-6. [PMID: 36547857 DOI: 10.1007/s11695-022-06421-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/07/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND As life expectancy increases, more elderly patients are being considered for metabolic bariatric surgery. We aimed to assess the safety and long-term effectiveness of one anastomosis gastric bypass (OAGB) compared to sleeve gastrectomy (SG). METHODS Single-center retrospective comparative study of OAGB and SG (2012-2019) in patients aged ≥ 65 years. RESULTS In all, 124 patients underwent OAGB (n = 41) and SG (n = 83). Mean age was 67.6 ± 2.8 and 67.6 ± 2.6 years (p = 0.89), respectively. Baseline characteristics were comparable, except lower rates of hypertension (HTN) and non-alcoholic fatty liver disease in OAGB than SG patients (43.9% vs. 74.6%; p < 0.001, and 39.0% vs. 89.1%; p < 0.001, respectively). Body mass index (BMI) of OAGB and SG patients decreased from 41.8 ± 7.8 and 43.3 ± 5.9 kg/m2 (p = 0.25) to 28.6 ± 4.7 and 33.2 ± 5.3 (p < 0.001), at long-term follow-up, respectively. Excess weight loss (EWL) > 50% was achieved in 80.6% and 43.2% of OAGB and SG patients, with a mean EWL of 67.2% ± 22.3 and 45.8% ± 18.0 (p < 0.001) and a mean total weight loss (TWL) of 30.7% ± 10.4 and 21.9% ± 8.1 (p < 0.001), respectively. Resolution rates of obesity-associated medical problems were similar, except type 2 diabetes (T2D) and HTN, which were 86.6% and 73.3% in OAGB, compared with 29.7% and 36.3% in SG patients (p < 0.001 and p = 0.001), respectively. Major early complication rates were comparable (2.4% vs. 3.6%; p = 0.73, respectively). Revision for late complications was required in two OAGB patients. CONCLUSIONS OAGB in the elderly is safe and results in better long-term weight reduction and resolution of T2D and HTN than SG.
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Pahwa R, Aldred J, Merola A, Gupta N, Terasawa E, Garcia-Horton V, Steffen DR, Kandukuri PL, Bao Y, Ladhani O, Yan CH, Chaudhari V, Isaacson SH. Long-term results of carbidopa/levodopa enteral suspension across the day in advanced Parkinson's disease: Post-hoc analyses from a large 54-week trial. Clin Park Relat Disord 2023; 8:100181. [PMID: 36594071 DOI: 10.1016/j.prdoa.2022.100181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/26/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Carbidopa/levodopa enteral suspension (CLES) previously demonstrated reduction in total daily OFF from baseline by over 4 hours in advanced Parkinson's disease patients across 54 weeks. Evidence on CLES's long-term effectiveness on patterns of motor-symptom control throughout the day remains limited. Methods We present post-hoc analyses of a large, open-label study of CLES monotherapy (N = 289). Diary data recorded patients' motor states at 30-minute intervals over 3 days at baseline and weeks 4, 12, 24, 36, and 54. Adjusted generalized linear mixed models assessed changes from baseline at each timepoint for four outcome measures: time to ON without troublesome dyskinesia (ON-woTD) after waking, motor-symptom control as measured by motor states' durations throughout the day, number of motor-state transitions, and presence of extreme fluctuations (OFF to ON with TD). Results Patients demonstrated short-term (wk4) and sustained (wk54) improvement in all outcomes compared to baseline. At weeks 4 and 54, patients were more likely to reach ON-woTD over the course of their day (HR: 1.86 and 2.51, both P < 0.0001). Across 4-hour intervals throughout the day, patients also experienced increases in ON-woTD (wk4: 58-65 min; wk54: 60-78 min; all P < 0.0001) and reductions in OFF (wk4: 50-61 min; wk54: 56-68 min; all P < 0.0001). At weeks 4 and 54, patients' motor-state transitions were reduced by about half (IRR: 0.53 and 0.49, both P < 0.0001), and fewer patients experienced extreme fluctuations (OR: 0.22 and 0.15, both P < 0.0001). Conclusion CLES monotherapy was associated with significant long-term reductions in motor-state fluctuations, faster time to ON-woTD upon awakening, and increased symptom control throughout the day.
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Key Words
- ADL, Activities of daily living
- APD, Advanced Parkinson's disease
- CGI-S, Clinical Global Impression of disease severity
- CLES, Carbidopa/levodopa enteral suspension
- Carbidopa/levodopa enteral suspension
- Carbidopa/levodopa intestinal gel
- Duodopa
- Duopa
- Dyskinesia
- HR, Hazard ratio
- IRR, Incidence rate ratio
- Long-term effectiveness
- OFF, “Off” time
- ON, “On” time
- ON-wTD, “On” time with troublesome dyskinesia
- ON-woTD, “On” time without troublesome dyskinesia
- OR, Odds ratio
- PD, Parkinson’s disease
- PEG-J, Percutaneous endoscopic gastrojejunostomy
- Parkinson’s disease
- QoL, Quality of life
- RCT, Randomized controlled trial
- SD, Standard deviation
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Jacksch C, Zeuner KE, Helmers AK, Witt K, Deuschl G, Paschen S. Long-term efficacy with deep brain stimulation of the globus pallidus internus in cervical dystonia: a retrospective monocentric study. Neurol Res Pract 2022; 4:48. [PMID: 36184607 DOI: 10.1186/s42466-022-00214-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cervical dystonia (CD) is characterized by involuntary contractions of the cervical muscles. Data on long-term effectiveness of deep brain stimulation (DBS) are rare. The aim of this study was to evaluate the longitudinal ten years treatment efficacy of DBS in the globus pallidus internus (GPI). METHODS A retrospective single-center data analysis was performed on patients with idiopathic CD, who were treated with GPI DBS for at least 10 years. TWSTR severity score and individual sub-items were compared between pre and post DBS surgery (n = 15) over time. RESULTS There was a significant and persistent positive effect regarding the severity of TWSTRS between the conditions immediately before and 1, 5, and 10 years after establishment of GPI DBS (mean difference: 6.6-7 ± 1.6). Patients with increasing CD complexity showed a poorer response to established treatment forms, such as injection of botulinum toxin and were thus DBS candidates. Especially a predominant torticollis was significantly improved by DBS. CONCLUSION GPI DBS is an effective procedure especially in severely affected patients with a positive 10-year outcome. It should be considered in more complex CD-forms or predominant torticollis.
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Lorentzen V, Fagermo K, Handegård BH, Neumer SP, Skre I. Long-term effectiveness and trajectories of change after treatment with SMART, a transdiagnostic CBT for adolescents with emotional problems. BMC Psychol 2022; 10:167. [PMID: 35791020 PMCID: PMC9258229 DOI: 10.1186/s40359-022-00872-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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 06/27/2022] [Indexed: 11/14/2022] Open
Abstract
Background There is a need for long-term effectiveness trials of transdiagnostic treatments. This study investigates the effectiveness and diagnosis-specific trajectories of change in adolescent patients attending SMART, a 6-week transdiagnostic CBT for anxiety and depression, with 6-month follow-up. Methods A randomized controlled trial with waiting list control (WLC) was performed at three child and adolescent mental health outpatient services (CAMHS) in Norway. Referred adolescents (N = 163, age = 15.72, 90.3% females) scoring 6 or more on the emotional disorders subscale of the Strengths and Difficulties Questionnaire (SDQ) were randomly assigned to treatment or to WLC. Long-term follow-up (N = 83, baseline age = 15.57, 94% females) was performed 6 months after treatment completion (Mean = 7.1 months, SD = 2.5). Linear mixed model analysis was used to assess time by group effects in patients with no diagnosis, probable anxiety, depressive disorder, and combined anxiety and depressive disorder. Results Almost one third (31%) obtained full recovery according to the inclusion criterium (SDQ emotional). There was highly significant change in all outcome variables. Effect sizes (ES) were largest for general functioning, measured with CGAS (ES: d = 2.19), and on emotional problems measured with SDQ (ES: d = 2.10), while CORE-17, BDI-II and CGAS all obtained ES’s close to 1. There were no significant time by diagnostic group interactions for any outcomes, indicating similar trajectories of change, regardless of diagnostic group. Waiting 6 weeks for treatment had no significant impact on long-term treatment effects. Limitations Possible regression to the mean. Attrition from baseline to follow-up. Conclusions Six weeks of transdiagnostic treatment for adolescents with emotional problems showed highly significant change in emotional symptoms and functioning at 6-month follow-up. Patients with anxiety, depression, combined anxiety and depression, and emotional problems with no specific diagnoses, all had similar trajectories of change. Hence this transdiagnostic SMART treatment can be recommended for adolescent patients with symptoms within the broad spectrum of emotional problems. Trial registration: ClinicalTrials.gov Identifier: NCT02150265. First registered May 29, 2014.
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Affiliation(s)
- Veronica Lorentzen
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway. .,Department of Child and Adolescent Psychiatry, Divisions of Child and Adolescent Health, University Hospital of North Norway, P.O. Box 19, 9038, Tromsø, Norway.
| | - Kenneth Fagermo
- Department of Child and Adolescent Psychiatry, Divisions of Child and Adolescent Health, University Hospital of North Norway, P.O. Box 19, 9038, Tromsø, Norway
| | - Bjørn Helge Handegård
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Simon-Peter Neumer
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, 9037, Tromsø, Norway.,Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, 0484, Oslo, Norway
| | - Ingunn Skre
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway.,Department of General Psychiatry, University Hospital of North-Norway, P.O. Box 6124, 9291, Tromsø, Norway
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Wang L, Huang J, Li G, Luo J, Bolan NS, Hou D. Long-term immobilization of soil metalloids under simulated aging: Experimental and modeling approach. Sci Total Environ 2022; 806:150501. [PMID: 34583080 DOI: 10.1016/j.scitotenv.2021.150501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 07/01/2021] [Revised: 09/16/2021] [Accepted: 09/17/2021] [Indexed: 06/13/2023]
Abstract
Aging is an inevitable natural process, leading to faded performances of soil amendments. Understanding long-term aging features is crucial for the risk management of contaminated soil. In this study, a novel quantitative aging method, namely, the "soil coin" method, was developed, which can simulate the effects of natural aging on metal(loid) immobilization performances. To better depict the aging features, two models on the basis of conditional probability-induced failure were developed. To effectively immobilize soil arsenic (As) and antimony (Sb), magnesium (Mg) and iron (Fe) oxides were simultaneously introduced to either fresh or pre-oxidized biochar via a facile method. Although post-application aging is harmful, pre-aging (i.e., pre-oxidation using H2O2) in turn served as an effective means to introduce more metal oxides, thereby rendering better short-term and long-term effectiveness for metalloid immobilization. Experimental and modeling approaches suggested that precipitation accounted for long-term immobilization, while a constant aging rate is the key feature for a promising soil amendment. It is suggested that to further calibrate this method and better understand the immobilization performances in the long run, more evidence from the field is needed.
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Affiliation(s)
- Liuwei Wang
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Jide Huang
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Guangbing Li
- Environmental Science and Technology Consultation Center of Tongren, Tongren, Guizhou, China
| | - Jian Luo
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA 30332-0355, USA
| | - Nanthi S Bolan
- School of Agriculture and Environment, The University of Western Australia, Perth, Western Australia 6001, Australia; The UWA Institute of Agriculture, The University of Western Australia, Perth, Western Australia 6001, Australia
| | - Deyi Hou
- School of Environment, Tsinghua University, Beijing 100084, China.
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Kurosawa M, Sekine M, Yamaguchi M, Kudo R, Hanley SJB, Hara M, Adachi S, Ueda Y, Miyagi E, Ikeda S, Yagi A, Enomoto T. Long-term effectiveness of HPV vaccination against HPV infection in young Japanese women: real-world data. Cancer Sci 2022; 113:1435-1440. [PMID: 35100477 PMCID: PMC8990292 DOI: 10.1111/cas.15282] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/04/2022] [Accepted: 01/18/2022] [Indexed: 11/28/2022] Open
Abstract
In Japan, public funding for HPV vaccination began in 2010 for girls aged 13–16 years (birth cohort years 1994–1997) and women born in 1994 who turned 25 in 2019. We aimed to verify the long‐term effectiveness of the bivalent HPV vaccine in women aged 25 years. Subjects were women aged 25–26 years who underwent cervical cancer screening and HPV testing in Niigata from 2019 to 2020 (birth cohort years 1993–1994). Information on vaccination status and sexual behavior was obtained from a questionnaire and municipal records. We compared the HPV infection rates of the vaccinated and unvaccinated groups. Of the 429 registrants, 150 (35.0%) and 279 (65.0%) were vaccinated and unvaccinated, respectively. The average period from HPV vaccination to HPV testing was 102.7 months (8.6 years), with a median of 103 months (range 92–109 months). The HPV high‐risk infection rate was 21.3% (32/150) in the vaccinated group and 23.7% (66/279) in the unvaccinated group (P = 0.63). The HPV16/18 infection rate was 0% (0/150) in the vaccinated group and 5.4% (15/279) in the unvaccinated group, showing a significant difference (P = 0.0018), and the vaccine effectiveness was 100%. The cross‐protective type HPV31/45/52 infection rate in the vaccinated group was significantly lower than that in the unvaccinated group (3.3% vs. 10.0%, P = 0.013). There was no significant difference in the mean age at sexual debut and the number of previous sexual partners between the two groups. We have demonstrated the long‐term 9‐year effectiveness of the bivalent vaccine against HPV infection for the first time in Japan.
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Affiliation(s)
- Megumi Kurosawa
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masayuki Sekine
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Manako Yamaguchi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Risa Kudo
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Sharon J B Hanley
- Hokkaido University Center for Environmental and Health Sciences, Sapporo, Japan
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Sosuke Adachi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yutaka Ueda
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Sayaka Ikeda
- Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Asami Yagi
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Gaspar A, Koron N, Silva J, Brandi H. Vaginal erbium laser for treatment of stress urinary incontinence: optimization of treatment regimen for a sustained long-term effect. Lasers Med Sci 2022. [PMID: 35067817 DOI: 10.1007/s10103-021-03474-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
Stress urinary incontinence (SUI) is a common health problem that affects roughly 35% of women in the reproductive period. A prospective uncontrolled study was conducted to assess the long-term efficacy and safety of a non-ablative Er:YAG laser treatment of SUI. Forty-three patients participated in the study. All women underwent three sessions of IncontiLase® procedure, and efficacy of laser treatment was assessed by 1-h pad test, 24-h pad test, 3-day voiding diary, and ICIQ-UI SF questionnaire at multiple follow-ups. Statistical analysis was performed using one-way repeated measures ANOVA. Patients were questioned about discomfort during treatment and any adverse events following the laser procedures. All outcome measures showed a significant change over a period of the entire clinical trial. Eighteen-month follow-up revealed a fading of the effect, which was alleviated by single-session maintenance treatments every 6 months. There were no serious adverse events reported during the study. All reported side effects were mild and transient. The application of non-ablative Er:YAG laser for SUI treatment significantly improves the SUI symptoms. High improvement rates and patient satisfaction can be maintained with single-session maintenance treatments performed every 6 months. Long-term safety profile of multiple non-ablative Er:YAG laser treatment is shown. NCT04348994, 16.04.2020, retrospectively registered.
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13
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Graat I, Mocking R, Figee M, Vulink N, de Koning P, Ooms P, Mantione M, van den Munckhof P, Schuurman R, Denys D. Long-term Outcome of Deep Brain Stimulation of the Ventral Part of the Anterior Limb of the Internal Capsule in a Cohort of 50 Patients With Treatment-Refractory Obsessive-Compulsive Disorder. Biol Psychiatry 2021; 90:714-720. [PMID: 33131717 DOI: 10.1016/j.biopsych.2020.08.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/20/2020] [Accepted: 08/20/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Deep brain stimulation (DBS) is an effective intervention for patients with severe treatment-refractory obsessive-compulsive disorder (OCD). Our aim was to examine long-term effectiveness and tolerability of DBS and its impact on functioning and well-being. METHODS Fifty patients with severe treatment-refractory OCD received DBS of the ventral part of the anterior limb of the internal capsule and were followed for at least 3 years following implantation (mean 6.8 ± 3 years). Primary effectiveness was assessed by change in Yale-Brown Obsessive Compulsive Scale scores. Secondary effectiveness measures included Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, World Health Organization Quality of Life Scale-Brief Version, Global Assessment of Functioning, and a scale assessing functioning in work, family, and social life. Adverse effects of DBS were examined with a structured interview (n = 38). RESULTS At long-term follow-up, OCD symptoms decreased by 39% (p < .001), and half of the patients were responders (≥35% decrease of Yale-Brown Obsessive Compulsive Scale score). Anxiety and depressive symptoms decreased significantly, with reductions of 48% and 50%, respectively. The World Health Organization Quality of Life Scale-Brief Version general score improved significantly, as did 3 of 4 subdomains. Both clinician- and patient-rated functioning improved substantially (p < .001). The unemployment rate decreased from 78% at baseline to 58% at last follow-up (z = -1.90, p = .058), and 21 patients stopped or decreased psychotropic medication (z = -2.887, p = .004). Long-term adverse effects included cognitive complaints and fatigue. Serious adverse events included 1 suicide attempt, related to comorbid depression. CONCLUSIONS Our results provide evidence that DBS of the ventral part of the anterior limb of the internal capsule is effective and tolerable for treatment-refractory OCD in the long term and improves functioning and overall well-being.
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Affiliation(s)
- Ilse Graat
- Department of Psychiatry, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, the Netherlands.
| | - Roel Mocking
- Department of Psychiatry, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, the Netherlands
| | - Martijn Figee
- Department of Psychiatry, Mount Sinai Hospital, New York, New York
| | - Nienke Vulink
- Department of Psychiatry, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, the Netherlands
| | - Pelle de Koning
- Department of Psychiatry, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, the Netherlands
| | - Pieter Ooms
- Department of Psychiatry, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, the Netherlands
| | - Mariska Mantione
- Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Pepijn van den Munckhof
- Department of Neurosurgery, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, the Netherlands
| | - Rick Schuurman
- Department of Neurosurgery, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, the Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, the Netherlands
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Ding N, Jiao N. Long-term effectiveness of reverse linear perspective markings on crash mitigation in car-following: Evidence from naturalistic observations. Accid Anal Prev 2021; 159:106273. [PMID: 34218196 DOI: 10.1016/j.aap.2021.106273] [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: 04/10/2021] [Revised: 06/16/2021] [Accepted: 06/21/2021] [Indexed: 06/13/2023]
Abstract
Perceptual markings on roads are verified with short-term effectiveness for accident prevention. However, the long-term performance of them is seldomly investigated, which unintentionally impedes its more widely recognition and application as a low-cost and readily achievable countermeasure. Also, the previous perceptual markings were only tested for speed reduction effect, little is known concerning their influence on headway adjustment. Given this, in this study, we investigated the short-, medium-, and long-term performance of the reverse linear perspective markings (RLPMs) on driving behaviors and safety benefits in car-following. The RLPMs were a form of markings pattern that can produce reverse linear perspective visual information on the lane and lead to distance underestimation. The RLPMs were permanently installed on a straight and a curve segment of a freeway in China, and the naturalistic vehicle flow data one day, four months, one year, two years, and three years after the installation of the RLPMs were collected. The statistical analyses of general and sectional relative differences of speed, distance headway and time headway suggest that 1) the speed reduced and distance and time headways increased in short-, medium-, and long-term as compared with the baseline on both the straight and curve segments; 2) the long-term performance of RLPMs significantly weakened as compared with the short-term performance, yet sustained to 0.50 m/s in speed reduction, 3.77 m in distance headway increase, and 0.097 s in time headway increase on average within the observations in one year and above on the straight segment; similar sustained performance of 0.47 m/s in speed reduction, 2.60 m in distance headway increase, and 0.072 s in time headway increase were observed on the curve segment; 3) the RLPMs were tested to have positive and relatively endured effectiveness on mitigating crash risk in car-following measured by two surrogate safety indicators based on time-to-crash (TTC) and deceleration rate to avoid a crash (DRAC). The findings of this study suggest the RLPMs could be an especially applaudable form of perceptual markings as they are relatively effective in the long-term and are multifunctional in intervening speed, distance, headway, and crash risk. This study also emphasizes the challenge of more field tests and observations on the long-term performance of the perceptual markings, and the thorough considerations of the visual perception mechanism behind the markings to achieve an alternative solution to the long-term issue.
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Affiliation(s)
- Naikan Ding
- Department of Civil Engineering, Nagoya University, Nagoya 4648603, Japan; School of Civil Engineering and Architecture, Wuhan Institute of Technology, Wuhan 430205, China.
| | - Nisha Jiao
- Planning Research Office, Department of Transport of Hubei Province, Wuhan 430030, China
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15
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Chimenti MS, Conigliaro P, Caso F, Costa L, Ortolan A, Triggianese P, Tasso M, Fonti GL, Lorenzin MG, Perricone R, Ramonda R. Long-term effectiveness and drug survival of golimumab in patients affected by psoriatic arthritis with cutaneous involvement. Clin Rheumatol 2021; 41:75-84. [PMID: 34410550 PMCID: PMC8724144 DOI: 10.1007/s10067-021-05874-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/19/2021] [Accepted: 07/28/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To determine the effectiveness of golimumab (GLM) in improving joint, periarticular structures and cutaneous manifestations in patients with moderate to severe psoriatic arthritis (PsA) with cutaneous psoriasis in different real-life clinical settings and 48-month drug survival. METHODS Clinical and laboratory records were collected from PsA patients treated with GLM at baseline (T0) and after 6, 12, 24, 36, and 48 months of treatment. Comparisons were performed using a paired t-test or Wilcoxon test. Drug survival rates were analyzed using Kaplan-Meier estimates. p value < 0.05 was considered statistically significant. RESULTS Data from 105 patients were collected. PsO occurred in 80% of patients and enthesitis in 78%, peripheral and axial arthritis in 63.8% and 35.3%, respectively, while erosions in 36.2%. The main comorbidities were cardiovascular diseases (31.4%) and metabolic syndrome (MetS) (19%). A statistically significant improvement in articular and cutaneous psoriasis was registered at T48 of GLM-therapy in clinical (DAPSA p < 0.0001; PASI p < 0.01; BASDAI p < 0.0001) and laboratory (CRP < 0.05) indexes. Gender (p = 0.652), BMI (p = 0.655), smoking habit (p = 0.466), and line of treatment (p = 0.208) did not affect treatment efficacy nor persistence. At T48, 42% of patients discontinued GLM: the most frequent reason was an insufficient response or loss of efficacy (28.6%). CONCLUSION A 48-month GLM high drug persistence of PsA patients was observed in real-life, in patients presenting high disease activity, elevated prevalence of comorbidities, and more than one line of treatment at baseline. Patients' characteristics as gender, smoke, BMI, different lines of treatment, and concomitant methotrexate treatment affected treatment persistence, making GLM effective and safe in moderate-severe PsA in a long-term real-life setting. Key Points • Golimumab was effective in psoriatic arthritis, including both musculoskeletal and cutaneous manifestations. • Golimumab effectiveness and drug survival were not affected by comorbidities and patient-related characteristics. • The 4-year drug survival curves confirm the efficacy and safety of golimumab in psoriatic arthritis patients in a real-life setting.
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Affiliation(s)
- Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, Department of Medicina Dei Sistemi, University of Rome Tor Vergata, Via Montpellier 1, Rome, Italy.
| | - Paola Conigliaro
- Rheumatology, Allergology and Clinical Immunology, Department of Medicina Dei Sistemi, University of Rome Tor Vergata, Via Montpellier 1, Rome, Italy
| | - Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Augusta Ortolan
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, Padua, Italy
| | - Paola Triggianese
- Rheumatology, Allergology and Clinical Immunology, Department of Medicina Dei Sistemi, University of Rome Tor Vergata, Via Montpellier 1, Rome, Italy
| | - Marco Tasso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Giulia Lavinia Fonti
- Rheumatology, Allergology and Clinical Immunology, Department of Medicina Dei Sistemi, University of Rome Tor Vergata, Via Montpellier 1, Rome, Italy
| | - Maria Grazia Lorenzin
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, Padua, Italy
| | - Roberto Perricone
- Rheumatology, Allergology and Clinical Immunology, Department of Medicina Dei Sistemi, University of Rome Tor Vergata, Via Montpellier 1, Rome, Italy
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, Padua, Italy
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16
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Hou R, Wang L, Shen Z, Alessi DS, Hou D. Simultaneous reduction and immobilization of Cr(VI) in seasonally frozen areas: Remediation mechanisms and the role of ageing. J Hazard Mater 2021; 415:125650. [PMID: 34088176 DOI: 10.1016/j.jhazmat.2021.125650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/24/2020] [Revised: 03/05/2021] [Accepted: 03/10/2021] [Indexed: 06/12/2023]
Abstract
Among the toxic metals, hexavalent chromium [Cr(VI)] has attracted much attention due to its high mobility and toxicity, rendering considerable challenges for long-term remediation. In this study, the soil was collected from a dichromate contaminated industrial site in Liaoning Province, a seasonally frozen area in northern China, and subjected to frequent freeze-thaw cycles. Three additives, including (i) ferrous sulfate; (ii) calcium polysulfide; and (iii) combined biochar and calcium polysulfide were applied to reduce and immobilize Cr(VI) in the soils. The samples underwent 28 days of incubation followed by 16 freeze-thaw cycles. The toxicity characteristic leaching procedure (TCLP) and simulated acid rain leaching were adopted to test the remediation performances. It was observed that all three treatments can significantly reduce and immobilize Cr(VI) after short-term incubation, while biochar with abundant functional groups could adsorb and reduce Cr(VI) effectively. Notably, the concentration of Cr(VI) in TCLP leachates after incubation in combined treatment decreased by 67.87% and 37.27%, respectively, compared with the application of ferrous sulfate or calcium polysulfide alone. Freeze-thaw cycles induced the disintegration of soil particles and increased the risk of contaminant mobilization. Conversely, biochar particles has become finer and even produced nanoparticles with ageing, accompanied by the increase in oxygen-containing surface functional groups. Additionally, the specific surface area increased with the pyrolysis of biochar, which further enhanced the retention of soil colloidal particles and suppressed the migration of contaminants. Therefore, the cumulative release of Cr(VI) in the combined treatment (i.e., 10.97 ~ 32.97 mg/kg) was much lower than that of the other two treatments after freeze-thaw ageing. Overall, the combination of biochar and calcium polysulfide displayed advantages in the reduction and immobilization of Cr(VI), and offered a long-term, effective strategy for the remediation of Cr(VI) contaminated soils in cold regions.
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Affiliation(s)
- Renjie Hou
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Liuwei Wang
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Zhengtao Shen
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Daniel S Alessi
- Department of Earth and Atmospheric Sciences, University of Alberta, Edmonton T6G 2E3, Canada
| | - Deyi Hou
- School of Environment, Tsinghua University, Beijing 100084, China.
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17
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Ter Huurne ED, de Haan HA, Postel MG, DeJong CAJ, VanDerNagel JEL, van der Palen J. Long-term effectiveness of web-based cognitive behavioral therapy for patients with eating disorders. Eat Weight Disord 2021; 26:911-919. [PMID: 32449152 DOI: 10.1007/s40519-020-00929-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/13/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the long-term effectiveness of a web-based therapist-delivered cognitive behavioral therapy (CBT) for patients with eating disorders (ED). METHODS We used follow-up data from a randomized controlled trial that evaluated a web-based CBT on ED psychopathology and related health, compared to a waiting list control (WL) condition. As participants of the WL condition started the intervention after their waiting period, follow-up data included participants from both groups. The primary outcome was change from baseline, at 3, 6, and 12-month intervals in ED psychopathology, analyzed using mixed models for repeated measures. Secondary outcomes included body dissatisfaction, BMI, physical health, mental health, self-esteem, quality of life, and social functioning. RESULTS The population comprised 212 participants in total, in three subgroups: bulimia nervosa (BN; n = 44), binge eating disorder (BED; n = 83), and ED not otherwise specified (EDNOS; n = 85). Treatment effects were sustained during follow-up, with generally large effect sizes for the reduction of ED psychopathology and body dissatisfaction, and small to moderate effect sizes for physical and mental health, self-esteem, social functioning, and quality of life. Most effects were found for all three subgroups, except for long-term improvements in self-esteem and quality of life among participants with BN and EDNOS. CONCLUSION This study showed long-term sustainability of treatment effects up to 1-year post-treatment of a web-based therapist-delivered CBT for patients with various ED. LEVEL OF EVIDENCE Level IV, evidence obtained from multiple time series analysis, with intervention. UNIQUE CLINICAL TRIAL NUMBER NTR2415-Dutch Trial Registry ( http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2415 ).
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Affiliation(s)
- Elke D Ter Huurne
- Tactus Addiction Treatment, Enschede, The Netherlands. .,Nijmegen Institute for Scientist-Practitioners in Addiction, Nijmegen, The Netherlands. .,Faculty of Physical Science and Health, Saxion University of Applied Science, Enschede, The Netherlands.
| | - Hein A de Haan
- Tactus Addiction Treatment, Enschede, The Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction, Nijmegen, The Netherlands
| | - Marloes G Postel
- Tactus Addiction Treatment, Enschede, The Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction, Nijmegen, The Netherlands.,Department of Psychology Health and Technology, University of Twente, Enschede, The Netherlands
| | - Cor A J DeJong
- Nijmegen Institute for Scientist-Practitioners in Addiction, Nijmegen, The Netherlands.,Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Joanne E L VanDerNagel
- Tactus Addiction Treatment, Enschede, The Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction, Nijmegen, The Netherlands.,Department of Human Media Interaction, University of Twente, Enschede, The Netherlands
| | - Job van der Palen
- Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands.,Department of Research Methodology, Measurement and Data Analysis, University of Twente, Enschede, The Netherlands
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Kojanova M, Cetkovska P, Strosova D, Fialova J, Arenberger P, Dolezal T, Gkalpakiotis S. Real-World Evidence From More Than 1000 Patients Treated With Adalimumab For Moderate-to-Severe Psoriasis in the Czech Republic. Dermatol Ther (Heidelb) 2021; 11:543-553. [PMID: 33666877 PMCID: PMC8018917 DOI: 10.1007/s13555-021-00499-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/02/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction The study aimed to evaluate the real-world effectiveness of adalimumab as well as investigate the persistence of treatment and identify factors, which may affect it. Methods More than 1150 patients (4363.1 patient-years) with psoriasis who had been treated with adalimumab since the start of the BIOREP registry in the Czech Republic were included in this analysis. Treatment effectiveness was defined as improvement in Psoriasis Area and Severity Index (PASI). The analysis was performed during the years 2005 and 2018. Patients were on on-label dose. Results After 12 and 96 months of therapy, 84% and 88% of patients had a 75% reduction in PASI score from baseline, respectively. Drug survival was analyzed according to the number of previous biological therapies, and results showed 75% and 58.1% survival rate for biologically naïve patients in the 20th and 80th month of treatment, respectively. The negative predictors of adalimumab survival were the female gender, obesity, baseline PASI score and the number of previous biological therapies. Conclusions Baseline factors including PASI, number of previous biological therapies, and sex were associated with shorter adalimumab survival. This long-term study shows that adalimumab is effective and has high treatment persistence.
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Affiliation(s)
- Martina Kojanova
- Department of Dermatovenereology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic.
| | - Petra Cetkovska
- Department of Dermatovenereology, Faculty of Medicine and University Hospital, Charles University, Pilsen, Czech Republic
| | | | - Jorga Fialova
- Department of Dermatovenereology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | | | - Spyridon Gkalpakiotis
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
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Karjalainen P, Santalahti P, Aronen ET, Kiviruusu O. Parent- and teacher-reported long-term effects of parent training on child conduct problems in families with child protection and other support services: a randomized controlled trial. Child Adolesc Psychiatry Ment Health 2021; 15:7. [PMID: 33573694 DOI: 10.1186/s13034-021-00358-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This randomized controlled trial (RCT) evaluated the long-term effectiveness of the Incredible Years® (IY) Parenting Program in modifying children's externalizing problems among families in Child Protection Services (CPS) and using other special support services. We also examined whether parent-reported effects of the IY® generalize to the daycare/school setting as reported by teachers. METHODS Participants in the study were 3-7-year-old children with behavioural problems (N = 102 at baseline, N = 89 at one-year follow-up). Participants were randomized to intervention (N = 50) and control groups (N = 52) after the baseline assessment. The intervention group received 19-week IY® Parenting Program. The effectiveness of the intervention was analyzed using linear mixed model. RESULTS Our previously reported pre-post intervention effects on CBCL (Child Behavior Checklist) and ECBI (Eyberg Child Behavior Inventory) were not sustained to the one-year follow-up. Child conduct problems decreased from baseline to follow-up in both intervention and control groups. The positive changes were not observed at daycare/school from baseline to post-intervention or to the one-year follow-up, and there were no significant differences in changes between the groups. CONCLUSIONS Evidence-based parenting program IY® seems to be an effective intervention for child conduct problems in the short term in families in the CPS context, but sustaining the positive effects and generalizing them to the daycare/school context are challenging. TRIAL REGISTRATION The trial is registered in the ClinicalTrials.gov registry (NCT03239990), Registered August 4th, 2017; https://clinicaltrials.gov/ct2/results?cond=&term=NCT03239990&cntry=&state=&city=&dist=.
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Wang J, Shi L, Zhai L, Zhang H, Wang S, Zou J, Shen Z, Lian C, Chen Y. Analysis of the long-term effectiveness of biochar immobilization remediation on heavy metal contaminated soil and the potential environmental factors weakening the remediation effect: A review. Ecotoxicol Environ Saf 2021; 207:111261. [PMID: 32950873 DOI: 10.1016/j.ecoenv.2020.111261] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [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: 06/25/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 06/11/2023]
Abstract
Currently, the research and application of biochar in the remediation of heavy metal contaminated soil has become a hotspot, especially regarding the remediation of agricultural land. Biochar has been proved to be effective in reducing the content of available heavy metals in the soil as well as the heavy metals in plants. However, the long-term effectiveness of biochar immobilization has not been widely studied. In this review, retrospective search was carried out on the published literature results concerning remediation effects of biochar on different areas of heavy metal contaminated soil in the recent years, its application in field remediation (several years), and some potential abiotic and biotic factors that may weaken the immobilization effects of biochar. This results indicate that: (1) biochar is widely used in the remediation of heavy metal contaminated soil in different areas and has excellent immobilization effect. (2) Most of the research demonstrate that the immobilization effect of biochar is effective for 2-3 years or according to few results even for 5 years. However, there have been various reports claiming that the immobilization effect of biochar decreases with time. (3) Abiotic factors such as acid rain, flooded environment, changes in soil condition (pH, redox and dissolved organic matter) and changes in biochar (Cl- and alkali leaching) can significantly weaken the immobilization effect of biochar. (4) Biotic factors such as plant roots, earthworms and soil microorganisms can also significantly reduce the immobilization effect of biochar. Therefore, field experiments having longer time span with biochar need to be further carried out, and the developmental research of modified biochar with a more stable immobilization effect also needs further attention.
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Affiliation(s)
- Jie Wang
- College of Life Sciences, Nanjing Agricultural University, Nanjing, 210095, China
| | - Liang Shi
- College of Life Sciences, Nanjing Agricultural University, Nanjing, 210095, China
| | - Lulu Zhai
- College of Life Sciences, Nanjing Agricultural University, Nanjing, 210095, China
| | - Haowen Zhang
- College of Life Sciences, Nanjing Agricultural University, Nanjing, 210095, China
| | - Shengxiao Wang
- College of Life Sciences, Nanjing Agricultural University, Nanjing, 210095, China
| | - Jianwen Zou
- Jiangsu Key Laboratory of Low Carbon Agriculture and GHGs Mitigation, College of Resources & Environmental Sciences, Nanjing Agricultural University, Nanjing, 210095, China
| | - Zhenguo Shen
- College of Life Sciences, Nanjing Agricultural University, Nanjing, 210095, China; Jiangsu Collaborative Innovation Center for Solid Organic Waste Resource, Nanjing Agricultural University, Nanjing, 210095, China
| | - Chunlan Lian
- Asian Natural Environmental Science Center, The University of Tokyo, 1-1-8 Midoricho, Nishitokyo, Tokyo, 188-0002, Japan
| | - Yahua Chen
- College of Life Sciences, Nanjing Agricultural University, Nanjing, 210095, China; Jiangsu Collaborative Innovation Center for Solid Organic Waste Resource, Nanjing Agricultural University, Nanjing, 210095, China; National Joint Local Engineering Research Center for Rural Land Resources Use and Consolidation, Nanjing Agricultural University, Nanjing, 210095, China.
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Hou R, Wang L, O'Connor D, Tsang DCW, Rinklebe J, Hou D. Effect of immobilizing reagents on soil Cd and Pb lability under freeze-thaw cycles: Implications for sustainable agricultural management in seasonally frozen land. Environ Int 2020; 144:106040. [PMID: 32798797 DOI: 10.1016/j.envint.2020.106040] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [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: 05/07/2020] [Revised: 07/19/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
Agricultural soil contamination in seasonally frozen land threatens food security. It is necessary to investigate the effects of freeze-thaw cycles on heavy metal bioavailability so as to select suitable immobilization agents. In this study, the soil was collected from a mid-latitude agricultural site in Liaoning Province, China, which was spiked with cadmium (Cd2+) and lead (Pb2+). Four immobilization treatments were set up, including (i) corn stover biochar, (ii) organic fertilizer, (iii) combined biochar and organic fertilizer, and (iv) the control group. The immobilized soils were subjected to 16 freeze-thaw cycles to temperatures of -10 °C, -20 °C, and -30 °C. It was found that freeze-thaw cycling increased the labile cadmium (Cd) and lead (Pb) content in the soil (i.e., exchangeable). The organic fertilizer treatment performed best in short-term immobilization, which was demonstrated by the amount of diethylenetriaminepentaacetic acid (DTPA) extractable lead (Pb) being 17.3-53.3% lower than that of the other treatments, and 7.2-31.5% lower for cadmium (Cd). Biochar, on the other hand, displayed better long-term performance under freeze-thaw cycling. This is probably because the biochar's organic carbon content is relatively stable, and therefore, releases relatively little dissolved organic carbon (DOC) which could re-mobilize heavy metals. Furthermore, additional sorption sites are formed and the abundance of oxygen-containing functional groups increased when biochar breaks down during freeze-thaw cycles. Overall, the joint application of biochar and organic fertilizer had the greatest immobilization effect, which inhibited the cracking of soil aggregates, reduced the labile metal content, and displayed both short- and long-term immobilization effectiveness. It is suggested that combined biochar and organic fertilizer may offer an effective strategy for the sustainable agricultural management of cadmium (Cd) and lead (Pb) contaminated in seasonally frozen land.
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Affiliation(s)
- Renjie Hou
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Liuwei Wang
- School of Environment, Tsinghua University, Beijing 100084, China
| | - David O'Connor
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Daniel C W Tsang
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Jörg Rinklebe
- University of Wuppertal, School of Architecture and Civil Engineering, Institute of Foundation Engineering, Water- and Waste-Management, Laboratory of Soil- and Groundwater-Management, Pauluskirchstraße 7, Wuppertal 42285, Germany; Department of Environment, Energy and Geoinformatics, Sejong University, 98 Gunja-Dong, Seoul, Republic of Korea
| | - Deyi Hou
- School of Environment, Tsinghua University, Beijing 100084, China.
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Li J, Wang L, Luo J, Li H, Rao P, Cheng Y, Wang X, Huang C. Optical capture and defibrillation in rats with monocrotaline-induced myocardial fibrosis 1 year after a single intravenous injection of adeno-associated virus channelrhodopsin-2. Heart Rhythm 2020; 18:109-117. [PMID: 32781160 DOI: 10.1016/j.hrthm.2020.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/28/2020] [Accepted: 08/04/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Optogenetics uses light to regulate cardiac rhythms and terminate malignant arrhythmias. OBJECTIVE The purpose of this study was to investigate the long-term validity of optical capture properties based on virus-transfected channelrhodopsin-2 (ChR2) and evaluate the effects of optogenetic-based defibrillation in an in vivo rat model of myocardial fibrosis enhanced by monocrotaline (MCT). METHODS Fifteen infant rats received jugular vein injection of adeno-associated virus (AAV). After 8 weeks, 5 rats were randomly selected to verify the effectiveness ChR2 transfection. The remaining rats were administered MCT at 11 months. Four weeks after MCT, the availability of 473-nm blue light to capture heart rhythm in these rats was verified again. Ventricular tachycardia (VT) and ventricular fibrillation (VF) were induced by burst stimulation on the basis of enhanced myocardial fibrosis, and the termination effects of the optical manipulation were tested. RESULTS Eight weeks after AAV injection, there was ChR2 expression throughout the ventricular myocardium as reflected by both fluorescence imaging and optical pacing. Four weeks after MCT, significant myocardial fibrosis was achieved. Light could still trigger the corresponding ectopic heart rhythm, and the pulse width and illumination area could affect the light capture rate. VT/VF was induced successfully in 1-year-observation rats, and the rate of termination of VT/VF under light was much higher than that of spontaneous termination. CONCLUSION Viral ChR2 transfection can play a long-term role in the rat heart, and light can successfully regulate heart rhythm and defibrillate after cardiac fibrosis.
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Affiliation(s)
- Jianyi Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China
| | - Long Wang
- Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China; Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China
| | - Junmiao Luo
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China
| | - Haitao Li
- Department of Cardiology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, People's Republic of China
| | - Panpan Rao
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China
| | - Yue Cheng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China
| | - Xi Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China.
| | - Congxin Huang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China; Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China; Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China.
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Houniet-de Gier M, Beckerman H, van Vliet K, Knoop H, de Groot V. Testing non-inferiority of blended versus face-to-face cognitive behavioural therapy for severe fatigue in patients with multiple sclerosis and the effectiveness of blended booster sessions aimed at improving long-term outcome following both therapies: study protocol for two observer-blinded randomized clinical trials. Trials 2020; 21:98. [PMID: 31959235 PMCID: PMC6971870 DOI: 10.1186/s13063-019-3825-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 10/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cognitive behavioural therapy (CBT) has been found to be effective in reducing fatigue severity in MS patients directly following treatment. However, long-term effects are inconsistent leaving room for improvement. In addition, individual face-to-face CBT draws heavily on limited treatment capacity, and the travel distance to the treatment centre can be burdensome for patients. Therefore, we developed "MS Fit", a blended CBT for MS-related fatigue, based on a face-to-face CBT protocol found effective in a previous study, and "MS Stay Fit", internet-based booster sessions to improve long-term effectiveness of CBT for MS-related fatigue. This article presents the protocol of two randomised clinical trials (RCTs) conducted within one study investigating (1) the non-inferiority of MS Fit compared with evidence-based face-to-face CBT for MS-related fatigue and (2) the effectiveness of MS Stay Fit on the long-term outcome of fatigue compared with no booster sessions. METHODS/DESIGN The first part of this study is an observer-blinded non-inferiority multicentre RCT, in which 166 severely fatigued MS patients will be randomly assigned (1:1 ratio, computer-generated sequence) to either face-to-face CBT or blended CBT (MS Fit) for fatigue. The primary endpoint is at 20 weeks after baseline. After this post-treatment assessment, patients will be randomly assigned again (1:1 ratio, computer generated sequence) to either MS Stay Fit consisting of two booster sessions at 2 and 4 months after end of treatment or no booster sessions. The primary endpoint of the second study is 52 weeks after baseline. Primary outcome measure in both studies is fatigue severity assessed with the fatigue severity subscale of the Checklist Individual Strength (CIS20r). Outcomes will be assessed at baseline (T0), at the end of treatment (T20), and after 39 and 52 weeks (T39 and T52). DISCUSSION If MS Fit is found to be non-inferior to face-to-face CBT, it will improve the accessibility of this treatment. In addition, the study aims to test whether it is possible to improve long-term effectiveness of CBT for MS-related fatigue with MS Stay Fit. TRIAL REGISTRATION Dutch Trial Register (NTR6966), registered 18 January 2018 https://www.trialregister.nl/trial/6782 WORLD HEALTH ORGANIZATION (WHO) TRIAL REGISTRATION DATA SET: All items from the WHO Trial Registration Data Set can be found within the protocol.
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Affiliation(s)
- Marieke Houniet-de Gier
- Department of Rehabilitation Medicine, MS Center Amsterdam, Amsterdam Neuroscience Research Institute, Amsterdam University Medical Centers, Vrije Universiteit, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
- Department of Medical Psychology, MS Center Amsterdam, Amsterdam Neuroscience Research Institute, Amsterdam University Medical Centers, Vrije Universiteit, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Heleen Beckerman
- Department of Rehabilitation Medicine, MS Center Amsterdam, Amsterdam Neuroscience Research Institute, Amsterdam University Medical Centers, Vrije Universiteit, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Kimberley van Vliet
- Department of Rehabilitation Medicine, MS Center Amsterdam, Amsterdam Neuroscience Research Institute, Amsterdam University Medical Centers, Vrije Universiteit, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Vincent de Groot
- Department of Rehabilitation Medicine, MS Center Amsterdam, Amsterdam Neuroscience Research Institute, Amsterdam University Medical Centers, Vrije Universiteit, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
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van Dongen JM, Persoon S, Jongeneel G, Bosmans JE, Kersten MJ, Brug J, Nollet F, Chinapaw MJM, Buffart LM. Long-term effectiveness and cost-effectiveness of an 18-week supervised exercise program in patients treated with autologous stem cell transplantation: results from the EXIST study. J Cancer Surviv 2019; 13:558-69. [PMID: 31286387 DOI: 10.1007/s11764-019-00775-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/12/2019] [Indexed: 01/05/2023]
Abstract
Purpose To evaluate the long-term effectiveness and cost-effectiveness of a supervised 18-week high-intensity exercise program compared with usual care in patients treated with autologous stem cell transplantation. Methods One hundred nine patients were randomly assigned to the exercise intervention (n = 54) or the usual care control group (n = 55). Data on cardiorespiratory fitness (VO2peak), handgrip strength, general fatigue, and health-related quality of life (quality-adjusted life years [QALYs]) were collected at baseline (T0), after completion of the exercise intervention or at a similar time point in the control group (T1) and 12 months later (T2). Cost questionnaires were used to assess societal costs. Long-term effectiveness (at T2) was evaluated using linear mixed model analyses. For the economic evaluation, missing data were imputed using multiple imputation, and data were analyzed using linear mixed models. Results At T2, no statistically significant differences were found between the intervention and control group for VO2peak (0.12; 95%CI − 1.89; 2.14 ml/min/kg), handgrip strength (− 1.08; 95%CI− 2.47; 2.31), and general fatigue (− 0.69; 95%CI − 2.52; 1.14). During 12-months follow-up, no significant between-group differences in QALYs and societal costs were found (QALYs − 0.07; 95%CI − 0.17; 0.04; costs 529; 95%CI − 3205;4452). Intervention costs were €1340 per patient. For all outcomes, the probability of the intervention being cost-effective was low at reasonable values of willingness-to-pay. Conclusion We found no evidence for the exercise intervention being effective on physical fitness and fatigue, nor cost-effective from a societal perspective. Trial registration The study was prospectively registered on 27 May 2010 at the Netherlands Trial Register (NTR2341). Implications for Cancer Survivors The current exercise intervention should not be recommended to patients recently treated with autologous stem cell transplantation.
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Vincenti S, de Waure C, Raponi M, Teleman AA, Boninti F, Bruno S, Boccia S, Damiani G, Laurenti P. Environmental surveillance of Legionella spp. colonization in the water system of a large academic hospital: Analysis of the four-year results on the effectiveness of the chlorine dioxide disinfection method. Sci Total Environ 2019; 657:248-253. [PMID: 30543973 DOI: 10.1016/j.scitotenv.2018.12.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 07/27/2018] [Revised: 11/16/2018] [Accepted: 12/04/2018] [Indexed: 06/09/2023]
Abstract
The prevention of Legionella colonization of water systems is one of the goals of hospital management. Among chemical disinfection methods, chlorine dioxide (ClO2) has been largely used to control Legionella spp. in water systems. We performed a retrospective study to analyse data deriving from the surveillance plan of the water system in a large academic hospital in Rome (Italy) during the period August 2011 and August 2018. We collected the data deriving from the routine water samples used to monitor Legionella spp. colonization. Data from the water samples collected from 163 selected sampling points (hot water tanks, the return loop and distal outlets) was analysed using a life table analysis in order to investigate the duration of the effectiveness of the ClO2 method in eradicating Legionella spp. The colonization of the water sample by Legionella spp. was considered as the outcome. Our results show that in 81,59% of the sampling points Legionella spp. were never detected at four years of follow up. Chemical and physical characteristics of the water were also compared between the samples which were positive for Legionella spp. and those which were not. No association was found between these factors. The knowledge of the duration over time of the effectiveness of the ClO2 disinfection method could support decision-making processes in the framework of Risk Management activities in hospitals. Future studies could also be conducted in hospitals to compare the long-term cost-effectiveness of different Legionella spp. colonization prevention methods.
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Affiliation(s)
- Sara Vincenti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Roma, Italy
| | - Chiara de Waure
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Roma, Italy
| | - Matteo Raponi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Roma, Italy.
| | - Adele Anna Teleman
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Roma, Italy
| | - Federica Boninti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Roma, Italy
| | - Stefania Bruno
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Roma, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Roma, Italy
| | - Stefania Boccia
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Roma, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Roma, Italy
| | - Gianfranco Damiani
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Roma, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Roma, Italy
| | - Patrizia Laurenti
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Roma, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Roma, Italy
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Frison V, Simioni N, Marangoni A, Balzano S, Vinci C, Zenari L, De Moliner L, Tadiotto F, D'Ambrosio M, Confortin L, Marin N, Lombardi S, Costa S, Prosperini G, Lapolla A. Clinical Impact of 5 Years of Liraglutide Treatment on Cardiovascular Risk Factors in Patients with Type 2 Diabetes Mellitus in a Real-Life Setting in Italy: An Observational Study. Diabetes Ther 2018; 9:2201-2208. [PMID: 30238228 PMCID: PMC6250628 DOI: 10.1007/s13300-018-0503-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 08/03/2018] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Based on existing data regarding the durability of liraglutide in type 2 diabetes, this study aimed to assess its long-term effectiveness at 5 years and its overall impact on cardiovascular (CV) risk. METHODS This was a multicenter retrospective observational study. Liraglutide was used under routine clinical practice conditions. Changes from baseline to 60 months in HbA1c, fasting plasma glucose (FPG), body weight, blood pressure, and lipid profile were assessed. United Kingdom Prospective Diabetes Study (UKPDS) scores were calculated at baseline and after 60 months to assess changes in the estimated 5- and 10-year risk for fatal and nonfatal coronary heart disease (CHD) and fatal and nonfatal stroke. RESULTS Overall, 103 patients (age 59.0 ± 7.9 years, diabetes duration 10.4 ± 6.8 years) were involved in the study. After 60 months, HbA1c levels were reduced by - 1.0 ± 1.2%, FPG levels by - 24.5 ± 43.4 mg/dl, body weight by - 5.3 ± 6.4 kg, systolic blood pressure by - 6.5 ± 18.5 mmHg, diastolic blood pressure by - 3.6 ± 11.8 mmHg, and total cholesterol by - 16.9 ± 37.4 mg/dl. The proportion of patients achieving HbA1c levels of < 7% increased from 12.7% to 39.8% (p = 0.02). Based on the UKPDS scores, statistically significant reductions in the 5- and 10-year risk of nonfatal CHD and fatal CHD were found, with no change in the 5- and 10-year risk of fatal and nonfatal stroke. CONCLUSION In patients prolonging treatment with liraglutide for 5 years, the benefits in relation to metabolic control and CV risk factors are maintained. The UKPDS risk scores suggest that liraglutide is associated with a reduced CHD risk, but not with a reduced stroke risk.
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Affiliation(s)
- Vera Frison
- UO Diabetologia, Ospedale di Cittadella, Cittadella, PD, Italy
| | | | - Alberto Marangoni
- US Diabetologia, Ospedale San Bassiano, Bassano del Grappa, VI, Italy
| | - Sara Balzano
- US Diabetologia, Ospedale San Bassiano, Bassano del Grappa, VI, Italy
| | - Carmela Vinci
- UOD, Ospedale San Donà di Piave, San Donà di Piave, VE, Italy
| | - Luciano Zenari
- UO Diabetologia Ospedale Sacro Cuore Don Calabria, Negrar, VR, Italy
| | - Lorena De Moliner
- Centro Diabetologico, Ospedale S. Maria del Carmine, Rovereto, TN, Italy
| | - Federica Tadiotto
- UOSD Ospedali Riuniti Padova sud Madre Teresa di Calcutta, Monselice, PD, Italy
| | - Michele D'Ambrosio
- UOSD Ospedali Riuniti Padova sud Madre Teresa di Calcutta, Monselice, PD, Italy
| | - Loris Confortin
- UOSD, Presidio Ospedaliero di Castelfranco Veneto, Castelfranco Veneto, TV, Italy
| | - Narciso Marin
- UOSD, Presidio Ospedaliero di Castelfranco Veneto, Castelfranco Veneto, TV, Italy
| | - Simonetta Lombardi
- UOSD Diabetologia ed Endocrinologia Distretto Ovest ULSS 8 Berica, Conselve, Italy
| | - Silvana Costa
- UOSD Diabetologia ed Endocrinologia Distretto Ovest ULSS 8 Berica, Conselve, Italy
| | - Giuseppe Prosperini
- CORESEARCH-Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy.
| | - Annunziata Lapolla
- UOC Diabetologia e Dietologia, Presidio Sanitario dei Colli, Padua, Italy
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Rehn S, Eslick GD, Brakoulias V. A Meta-Analysis of the Effectiveness of Different Cortical Targets Used in Repetitive Transcranial Magnetic Stimulation (rTMS) for the Treatment of Obsessive-Compulsive Disorder (OCD). Psychiatr Q 2018; 89:645-665. [PMID: 29423665 DOI: 10.1007/s11126-018-9566-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Randomised and sham-controlled trials (RCTs) of repetitive transcranial magnetic stimulation (rTMS) in the treatment of obsessive-compulsive disorder (OCD) have yielded conflicting results, which may be due to the variability in rTMS parameters used. We performed an updated systematic review and meta-analysis on the effectiveness of rTMS for the treatment of OCD and aimed to determine whether certain rTMS parameters, such as cortical target, may be associated with higher treatment effectiveness. After conducting a systematic literature review for RCTs on rTMS for OCD through to 1 December 2016 using MEDLINE, PubMed, Web of Science, PsycINFO, Google, and Google Scholar, we performed a random-effects meta-analysis with the outcome measure as pre-post changes in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores. To determine whether rTMS parameters may have influenced treatment effectiveness, studies were further analysed according to cortical target, stimulation frequency, and length of follow-up. Data were obtained from 18 RCTs on rTMS in the treatment of OCD. Overall, rTMS yielded a modest effect in reducing Y-BOCS scores with Hedge's g of 0.79 (95% CI = 0.43-1.15, p < 0.001). Stimulation of the supplementary motor area yielded the greatest reductions in Y-BOCS scores relative to other cortical targets. Subgroup analyses suggested that low frequency rTMS was more effective than high frequency rTMS. The effectiveness of rTMS was also greater at 12 weeks follow-up than at four weeks follow-up. Our meta-analysis implies that low frequency rTMS applied over the supplementary motor area may offer the greatest effectiveness in the treatment of OCD. The therapeutic effects of rTMS also appear to persist post-treatment and may offer beneficial long-term effectiveness. With our findings, it is suggested that future large-scale studies focus on the supplementary motor area and include follow-up periods of 12 weeks or more.
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Affiliation(s)
- Simone Rehn
- School of Psychology, The University of Sydney, Sydney, NSW, Australia. .,Department of Psychiatry, Nepean Hospital, Level 5 South Block, PO Box 63, Penrith/Sydney, NSW, 2751, Australia.
| | - Guy D Eslick
- The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Sydney/Penrith, NSW, Australia
| | - Vlasios Brakoulias
- Sydney Medical School - Nepean, Discipline of Psychiatry, The University of Sydney, Sydney/Penrith, NSW, Australia
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Mac Lochlainn DJ, McKechnie DGJ, Mehta AB, Hughes DA. The utility of the FIPI score in predicting long-term clinical outcomes in patients with Fabry disease receiving enzyme replacement therapy with agalsidase alfa. Mol Genet Metab 2018; 123:154-158. [PMID: 29055531 DOI: 10.1016/j.ymgme.2017.10.001] [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: 08/13/2017] [Revised: 10/02/2017] [Accepted: 10/02/2017] [Indexed: 11/19/2022]
Abstract
Fabry disease is a rare X-linked lysosomal storage disorder in which there is deficiency of alpha galactosidase A. Enzyme replacement therapy (ERT) is commercially available and has been demonstrated to improve cardiac and renal outcomes. Predictive scores, such as the Fabry International Prognostic Index (FIPI), have been developed to stratify disease severity; however, these have not been validated to predict outcomes in patients receiving ERT. We show that the FIPI score at baseline can predict outcomes in a group of patients on long-term ERT.
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Affiliation(s)
| | | | - Atul B Mehta
- Lysosomal Storage Disorders Unit, Royal Free London NHS Foundation Trust, University College London, London, United Kingdom
| | - Derralynn A Hughes
- Lysosomal Storage Disorders Unit, Royal Free London NHS Foundation Trust, University College London, London, United Kingdom.
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Beck M, Hughes D, Kampmann C, Pintos-Morell G, Ramaswami U, West ML, Giugliani R. Long-term outcomes with agalsidase alfa enzyme replacement therapy: Analysis using deconstructed composite events. Mol Genet Metab Rep 2018; 14:31-5. [PMID: 29159077 DOI: 10.1016/j.ymgmr.2017.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/23/2017] [Accepted: 10/23/2017] [Indexed: 01/11/2023] Open
Abstract
This is a retrospective analysis of Fabry Outcome Survey data from children/adults (n = 677) receiving agalsidase alfa enzyme replacement therapy for a median of 3 years, examining cerebrovascular, cardiac, and renal morbidity endpoints separately. Cardiac events occurred at younger ages than cerebrovascular or renal events, cerebrovascular events were more frequent in females than males, and males were more likely to experience cardiac and renal events at a younger age than females.
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30
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Wang X, Wang W, Wang P. Long-term effectiveness of the integrated schistosomiasis control strategy with emphasis on infectious source control in China: a 10-year evaluation from 2005 to 2014. Parasitol Res 2016; 116:521-528. [PMID: 27812902 DOI: 10.1007/s00436-016-5315-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 10/26/2016] [Indexed: 01/24/2023]
Abstract
Schistosomiasis is a neglected tropical parasitic disease of great public health significance worldwide. Currently, mass drug administration with praziquantel remains the major strategy for global schistosomiasis control programs. Since 2005, an integrated strategy with emphasis on infectious source control was implemented for the control of schistosomiasis japonica, a major public health concern in China, and pilot studies have demonstrated that such a strategy is effective to reduce the prevalence of Schistosoma japonicum infection in both humans and bovines. However, there is little knowledge on the long-term effectiveness of this integrated strategy for controlling schistosomiasis japonica. The aim of this study was to evaluate the long-term effectiveness of the integrated strategy for schistosomiasis control following the 10-year implementation, based on the data from the national schistosomiasis control program released by the Ministry of Health, People's Republic of China. In 2014, there were 5 counties in which the transmission of schistosomiasis japonica had not been interrupted, which reduced by 95.2% as compared to that in 2005 (105 counties). The number of schistosomiasis patients and acute cases reduced by 85.5 and 99.7% in 2014 (115,614 cases and 2 cases) as compared to that in 2005 (798,762 cases and 564 cases), and the number of bovines and S. japonicum-infected bovines reduced by 47.9 and 98% in 2014 (919,579 bovines and 666 infected bovines) as compared to that in 2005 (1,764,472 bovines and 33,736 infected bovines), respectively. During the 10-year implementation of the integrated strategy, however, there was a minor fluctuation in the area of Oncomelania hupensis snail habitats, and there was only a 5.6% reduction in the area of snail habitats in 2014 relative to in 2005. The results of the current study demonstrate that the 10-year implementation of the integrated strategy with emphasis on infectious source has greatly reduced schistosomiasis-related morbidity in humans and bovines. It is concluded that the new integrated strategy has remarkable long-term effectiveness on the transmission of schistosomiasis japonica in China, which facilitates the shift of the national schistosomiasis control program from transmission control to transmission interruption and elimination. However, such a strategy seems to have little effect on the shrinking of areas of snail habitats.
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Affiliation(s)
- Xiaoli Wang
- Jingzhou Hospital of Traditional Chinese Medicine, Jingzhou City, Hubei, 434000, China
| | - Wei Wang
- Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Wuxi City, Jiangsu Province, 214064, China.,Jiangsu Provincial Key Laboratory on Parasites and Vector Control Technology, Wuxi City, Jiangsu Province, 214064, China.,Jiangsu Institute of Parasitic Diseases, Wuxi City, Jiangsu Province, 214064, China
| | - Peng Wang
- Wuxi No. 2 Hospital Affiliated to Nanjing Medical University, No. 68 Zhongshan Road, Wuxi City, Jiangsu Province, 214002, China.
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31
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Luxembourg A, Kjaer SK, Nygard M, Ellison MC, Group T, Marshall JB, Radley D, Saah A. Design of a long-term follow-up effectiveness, immunogenicity and safety study of women who received the 9-valent human papillomavirus vaccine. Contemp Clin Trials 2016; 52:54-61. [PMID: 27777126 DOI: 10.1016/j.cct.2016.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 10/17/2016] [Accepted: 10/18/2016] [Indexed: 10/20/2022]
Abstract
The 9-valent human papillomavirus (HPV) (9vHPV) vaccine targets four HPV types (6/11/16/18) also covered by the quadrivalent HPV (qHPV) vaccine and five additional types (31/33/45/52/58). Vaccine efficacy to prevent HPV infection and disease was established in a Phase III clinical study in women 16-26years of age. A long-term follow-up (LTFU) study has been initiated as an extension of the Phase III clinical study to assess effectiveness of the 9vHPV vaccine up to at least 14years after the start of vaccination. It includes participants from Denmark, Norway and Sweden and uses national health registries from these countries to assess incidence of cervical pre-cancers and cancers due to the 7 oncogenic types in the vaccine (HPV 16/18/31/33/45/52/58). Incidences will be compared to the estimated incidence rate in an unvaccinated cohort of similar age and risk level. This LTFU study uses a unique design: it is an extension of a Phase III clinical study and also has elements of an epidemiological study (i.e., endpoints based on standard clinical practice; surveillance using searches from health registries); it uses a control chart method to determine whether vaccine effectiveness may be waning. Control chart methods which were developed in industrial and manufacturing settings for process and production monitoring, can be used to monitor disease incidence in real-time and promptly detect a decrease in vaccine effectiveness. Experience from this innovative study design may be applicable to other medicinal products when long-term outcomes need to be assessed, there is no control group, or outcomes are rare.
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Affiliation(s)
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Mari Nygard
- Department of Research, Cancer Registry of Norway, Oslo, Norway
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Lotte J, Bast T, Borusiak P, Coppola A, Cross JH, Dimova P, Fogarasi A, Graneß I, Guerrini R, Hjalgrim H, Keimer R, Korff CM, Kurlemann G, Leiz S, Linder-Lucht M, Loddenkemper T, Makowski C, Mühe C, Nicolai J, Nikanorova M, Pellacani S, Philip S, Ruf S, Sánchez Fernández I, Schlachter K, Striano P, Sukhudyan B, Valcheva D, Vermeulen RJ, Weisbrod T, Wilken B, Wolf P, Kluger G. Effectiveness of antiepileptic therapy in patients with PCDH19 mutations. Seizure 2016; 35:106-10. [PMID: 26820223 DOI: 10.1016/j.seizure.2016.01.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 12/15/2015] [Accepted: 01/04/2016] [Indexed: 10/22/2022] Open
Abstract
PURPOSE PCDH19 mutations cause epilepsy and mental retardation limited to females (EFMR) or Dravet-like syndromes. Especially in the first years of life, epilepsy is known to be highly pharmacoresistant. The aim of our study was to evaluate the effectiveness of antiepileptic therapy in patients with PCDH19 mutations. METHODS We report a retrospective multicenter study of antiepileptic therapy in 58 female patients with PCDH19 mutations and epilepsy aged 2-27 years (mean age 10.6 years). RESULTS The most effective drugs after 3 months were clobazam and bromide, with a responder rate of 68% and 67%, respectively, where response was defined as seizure reduction of at least 50%. Defining long-term response as the proportion of responders after 12 months of treatment with a given drug in relation to the number of patients treated for at least 3 months, the most effective drugs after 12 months were again bromide and clobazam, with a long-term response of 50% and 43%, respectively. Seventy-four percent of the patients became seizure-free for at least 3 months, 47% for at least one year. SIGNIFICANCE The most effective drugs in patients with PCDH19 mutations were bromide and clobazam. Although epilepsy in PCDH19 mutations is often pharmacoresistant, three quarters of the patients became seizure-free for at least for 3 months and half of them for at least one year. However, assessing the effectiveness of the drugs is difficult because a possible age-dependent spontaneous seizure remission must be considered.
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Affiliation(s)
- Jan Lotte
- Neuropädiatrie, Schön Klinik Vogtareuth, Germany.
| | | | - Peter Borusiak
- Department of Pediatrics, HELIOS Hospital Wuppertal, Witten/Herdecke University, Germany
| | - Antonietta Coppola
- Department of Clinical & Experimental Epilepsy, Great Ormond Street Hospital, University College London, England
| | - J Helen Cross
- Department of Clinical & Experimental Epilepsy, Great Ormond Street Hospital, University College London, England
| | - Petia Dimova
- Epilepsy Center, St. Ivan Rilski University Hospital, Sofia, Bulgaria
| | - Andras Fogarasi
- Neurology Department, Bethesda Children's Hospital, Budapest, Hungary
| | | | - Renzo Guerrini
- Child Neurology Unit, A. Meyer Children's Hospital, University of Florence, Italy
| | - Helle Hjalgrim
- Epilepsihospitalet Filadelfia, Danish Epilepsie Center, Dianalund, Denmark
| | | | - Christian M Korff
- Pediatric Neurology, Geneva University Hospitals, Geneva, Switzerland
| | | | - Steffen Leiz
- Neuropädiatrie, Kinderklinik Dritter Orden, München, Germany
| | | | - Tobias Loddenkemper
- Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, USA
| | - Christine Makowski
- Kinderklinik der Technischen Universität München, Klinikum Schwabing, Germany
| | | | - Joost Nicolai
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marina Nikanorova
- Epilepsihospitalet Filadelfia, Danish Epilepsie Center, Dianalund, Denmark
| | - Simona Pellacani
- Child Neurology Unit, A. Meyer Children's Hospital, University of Florence, Italy
| | | | - Susanne Ruf
- Neuropädiatrie, Universitätskinderklinik Tübingen, Germany
| | - Iván Sánchez Fernández
- Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, USA
| | - Kurt Schlachter
- Department of Pediatrics, Landeskrankenhaus Bregenz, Austria
| | - Pasquale Striano
- Pediatric Neurology, Institute Gaslini, University of Genova, Italy
| | - Biayna Sukhudyan
- "Arabkir" Medical Complex, Pediatric Neurology, Yerevan, Armenia
| | | | - R Jeroen Vermeulen
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Bernd Wilken
- Department of Pediatric Neurology, Kassel Hospital, Germany
| | - Philipp Wolf
- Department of Neuropediatrics, DRK-Children's Hospital, Siegen, Germany
| | - Gerhard Kluger
- Neuropädiatrie, Schön Klinik Vogtareuth, Germany; Paracelsus Medical University, Salzburg, Austria
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33
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Beck M, Hughes D, Kampmann C, Larroque S, Mehta A, Pintos-Morell G, Ramaswami U, West M, Wijatyk A, Giugliani R. Long-term effectiveness of agalsidase alfa enzyme replacement in Fabry disease: A Fabry Outcome Survey analysis. Mol Genet Metab Rep 2015; 3:21-7. [PMID: 26937390 PMCID: PMC4750577 DOI: 10.1016/j.ymgmr.2015.02.002] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 02/12/2015] [Indexed: 02/05/2023] Open
Abstract
Outcomes from 5 years of treatment with agalsidase alfa enzyme replacement therapy (ERT) for Fabry disease in patients enrolled in the Fabry Outcome Survey (FOS) were compared with published findings for untreated patients with Fabry disease. Data were extracted from FOS, a Shire-sponsored database, for comparison with data from three published studies. Outcomes evaluated were the annualized rate of change in estimated glomerular filtration rate (eGFR) and left ventricular mass indexed to height (LVMI) as well as time to and ages at a composite morbidity endpoint and at death. FOS data were extracted for 740 treated patients who were followed for a median of ~ 5 years. Compared with no treatment, patients treated with agalsidase alfa demonstrated slower decline in renal function and slower progression of left ventricular hypertrophy. Treated male patients with baseline eGFR < 60 mL/min/1.73 m2 had a mean (standard error of the mean [SEM]) annualized change in eGFR of − 2.86 (0.53) mL/min/1.73 m2/y compared with − 6.8 (1.5) in the published untreated cohort. The mean (SEM) rate of LVMI increase with treatment was 0.33 (0.10) g/m2.7/y in males and 0.48 (0.09) in females, compared with 4.07 (1.03) in untreated males and 2.31 (0.81) in untreated females. Morbidity occurred later in treated patients, with ~ 16% risk of a composite morbidity event (26% in males) after 24 months with ERT versus ~ 45% without treatment, with first events and deaths also occurring at older ages in patients administered ERT (e.g., estimated median survival in treated males was 77.5 years versus 60 years in untreated males). Findings from these retrospective comparisons of observational data and published literature support the long-term benefits of ERT with agalsidase alfa for Fabry disease in slowing the progression of renal impairment and cardiomyopathy. Treatment also appeared to delay the onset of morbidity and mortality. Interpretation of these findings should take into account that they are based on retrospective comparisons with previously published data.
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Key Words
- ACEI, Angiotensin-converting enzyme inhibitor
- ARB, Angiotensin receptor blocker
- Agalsidase alfa
- CI, Confidence interval
- ERT, Enzyme replacement therapy
- Enzyme replacement therapy
- FOS, Fabry Outcome Survey
- Fabry disease
- LVH, Left ventricular hypertrophy
- LVMI, Left ventricular mass indexed to height
- Long-term effectiveness
- MDRD, Modification of Diet in Renal Disease
- SE, Standard error
- SEM, Standard error of the mean
- eGFR, Estimated glomerular filtration rate
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Affiliation(s)
- Michael Beck
- University Medical Center, University of Mainz, Department of Paediatrics, Mainz, Germany
| | - Derralynn Hughes
- Royal Free London NHS Foundation Trust, University College of London, UK
| | - Christoph Kampmann
- University Medical Center, University of Mainz, Department of Paediatrics, Mainz, Germany
| | | | - Atul Mehta
- Royal Free London NHS Foundation Trust, University College of London, UK
| | - Guillem Pintos-Morell
- Department of Pediatrics, University Hospital "Germans Trias i Pujol," Badalona, Universitat Autònoma de Barcelona, Spain
| | - Uma Ramaswami
- Royal Free London NHS Foundation Trust, University College of London, UK
| | - Michael West
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Roberto Giugliani
- Medical Genetics Service HCPA/Dep Genet UFRGS and INAGEMP, Porto Alegre, Brazil
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