9701
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Amenyah SD, Murphy J, Fenge LA. Evaluation of a health-related intervention to reduce overweight, obesity and increase employment in France and the United Kingdom: a mixed-methods realist evaluation protocol. BMC Public Health 2021; 21:582. [PMID: 33761929 PMCID: PMC7987742 DOI: 10.1186/s12889-021-10523-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 03/01/2021] [Indexed: 12/03/2022] Open
Abstract
Background Obesity, overweight and unemployment are interlinked, with debilitating effects on mortality, health, wellbeing and quality of life. Existing interventions to reduce overweight, obesity and unemployment have addressed these challenges independent of each other with limited success. The Adding to Social capital and individual Potential In disadvantaged REgions (ASPIRE) project will develop an innovative model using a combination of skills training and health and wellbeing interventions to improve health, wellbeing, quality of life and reduce overweight, obesity and unemployment in England and France. The aim of this paper is to outline the protocol for evaluating the ASPIRE project to examine the effectiveness of the intervention and clarify the mechanisms and contextual factors which interact to achieve outcomes. Methods A mixed-method realist evaluation using a single-group before-and-after design will be used. The evaluation will consist of development of an initial programme theory, theory validation and refinement using quantitative and qualitative data to understand the causal mechanisms, contexts of implementation and their interactions that result in outcomes observed in ASPIRE. Primary outcomes that will be assessed are change in body weight and body mass index, reemployment and a rise on the ASPIRE participation ladder. The ASPIRE participation ladders consists of a series of 5 steps to engage participants in the project. The first step on the ladder is joining an ASPIRE hub with paid employment as the final step on the ladder. Secondary outcomes will be physical activity, diet quality, self-efficacy and health-related quality of life. Both quantitative and qualitative approaches are appropriate in this study because the use of validated questionnaires and objective measures will demonstrate how much the intervention addressed outcomes related to weight loss and reemployment and the qualitative data (photovoice) will provide insights into the contexts and experiences that are unique to participants in the project. Discussion The results from this evaluation will provide an understanding of how a model of health-related interventions which improve health, wellbeing and maintenance of a healthy lifestyle could reduce overweight, obesity and unemployment. The findings will enable the adaptation of this model for effective implementation in different contexts and circumstances. Trial registration ISRCTN registry: Study ID: ISRCTN17609001, 24th February 2021 (Retrospectively registered). Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10523-3.
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Affiliation(s)
- Sophia D Amenyah
- Faculty of Health and Social Sciences, 5th Floor, Bournemouth Gateway Building, Bournemouth University, St Paul's Lane, Bournemouth, BH8 8GP, UK.
| | - Jane Murphy
- Faculty of Health and Social Sciences, 5th Floor, Bournemouth Gateway Building, Bournemouth University, St Paul's Lane, Bournemouth, BH8 8GP, UK
| | - Lee-Ann Fenge
- Faculty of Health and Social Sciences, 5th Floor, Bournemouth Gateway Building, Bournemouth University, St Paul's Lane, Bournemouth, BH8 8GP, UK
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9702
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Arowosegbe OO, Röösli M, Künzli N, Saucy A, Adebayo-Ojo TC, Jeebhay MF, Dalvie MA, de Hoogh K. Comparing Methods to Impute Missing Daily Ground-Level PM 10 Concentrations between 2010-2017 in South Africa. Int J Environ Res Public Health 2021; 18:3374. [PMID: 33805155 DOI: 10.3390/ijerph18073374] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/11/2021] [Accepted: 03/22/2021] [Indexed: 11/16/2022]
Abstract
Good quality and completeness of ambient air quality monitoring data is central in supporting actions towards mitigating the impact of ambient air pollution. In South Africa, however, availability of continuous ground-level air pollution monitoring data is scarce and incomplete. To address this issue, we developed and compared different modeling approaches to impute missing daily average particulate matter (PM10) data between 2010 and 2017 using spatiotemporal predictor variables. The random forest (RF) machine learning method was used to explore the relationship between average daily PM10 concentrations and spatiotemporal predictors like meteorological, land use and source-related variables. National (8 models), provincial (32) and site-specific (44) RF models were developed to impute missing daily PM10 data. The annual national, provincial and site-specific RF cross-validation (CV) models explained on average 78%, 70% and 55% of ground-level PM10 concentrations, respectively. The spatial components of the national and provincial CV RF models explained on average 22% and 48%, while the temporal components of the national, provincial and site-specific CV RF models explained on average 78%, 68% and 57% of ground-level PM10 concentrations, respectively. This study demonstrates a feasible approach based on RF to impute missing measurement data in areas where data collection is sparse and incomplete.
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9703
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Wickramasinghe DP, Xavier C, Samarasekera DN. The Worldwide Epidemiology of Acute Appendicitis: An Analysis of the Global Health Data Exchange Dataset. World J Surg 2021; 45:1999-2008. [PMID: 33755751 DOI: 10.1007/s00268-021-06077-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND This study aims to describe the worldwide epidemiology and changing disease trends of acute appendicitis (AA). METHODS Epidemiological data on the incidence of AA and deaths were collected from the Global Health Data Exchange repository from 1990 to 2019. Data were stratified by age, sex and Socio-Demographic Index (SDI). RESULTS In 2019, there were an estimated 17.7 million cases (incidence 228/100,000) with over 33,400 deaths (0.43/100,000). Both the absolute number and the incidence had increased from 1990 to 2019 (+ 38.8% and + 11.4%, respectively). The number of deaths and deaths per 100,000 declined during this period (- 21.8% and - 46.2%, respectively). These trends were largely similar in all 5 SDI groups. There was a significant difference in the incidence of AA between the SDI groups, with low SDI group having the lowest and high SDI group having the highest. The high SDI group had the lowest mortality rate (Kruskall-Wallis test, p < 0.001). The peak incidence was in the 15-19-year age group. The mortality rate increased exponentially from the third decade of life. CONCLUSIONS The mortality rate of AA is declining worldwide, while the incidence is increasing. The peak incidence is in the 15-19-year group.
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Affiliation(s)
| | - Chrisjit Xavier
- Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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9704
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Ekholuenetale M, Nzoputam CI, Barrow A. Prevalence and Socioeconomic Inequalities in Eight or More Antenatal Care Contacts in Ghana: Findings from 2019 Population-Based Data. Int J Womens Health 2021; 13:349-360. [PMID: 33790659 PMCID: PMC8001171 DOI: 10.2147/ijwh.s306302] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 02/15/2021] [Accepted: 03/14/2021] [Indexed: 11/26/2022] Open
Abstract
Background For the prevention of complications and death during pregnancy, adequate antenatal care (ANC) contacts are important. To achieve optimal obstetric care, the latest ANC guidance recommends eight or more ANC contacts. The aim of this analysis is to investigate the prevalence and socio-economic differences of eight or more Ghanaian ANC contacts. Methods A total sample of 1404 women of reproductive age who had given birth after eight or more ANC contacts had been initiated, taking into account 9 months of gestation, was studied. The Ghana Malaria Indicator Survey of 2019 (GMIS) was used. In the univariate analysis, percentage was used. The curve and concentration index of Lorenz were used to assess socio-economic disparities for eight or more ANC contacts. Statistical significance was set at 5%. Results The weighted prevalence of eight or more ANC contacts was 41.9% (95% CI: 37.9–45.9%). The prevalence of eight or more ANC contacts among the poorest, poorer, middle, richer and richest households was 34.0%, 36.1%, 35.8%, 42.4% and 59.6%, respectively. Similarly, 33.0%, 37.7% and 42.6% prevalence of eight or more ANC contacts were estimated among women with no formal education, primary, secondary or higher, respectively. In addition, women from rich household had greater coverage of eight or more ANC contacts (Conc. Index= 0.089; SE= 0.019) and educated women had greater coverage of eight or more ANC contacts in Ghana (Conc. Index= 0.053; SE= 0.017) (all p<0.001). Conclusion Eight or more ANC contacts from the WHO in 2016 have yet to be fully institutionalized in Ghana. In order to increase access to the recommended prenatal care and for a healthy pregnancy experience, measures that resolve disparities in healthcare usage need to be prioritized for the country. Efforts should be made to expand the health insurance services available, as well as to enact policies that will increase free health care particularly among the poor and uneducated women.
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Affiliation(s)
- Michael Ekholuenetale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Chimezie Igwegbe Nzoputam
- Department of Community Health, Center of Excellence in Reproductive Health Innovation (CERHI), College of Medical Sciences, University of Benin, Benin City, Nigeria
| | - Amadou Barrow
- Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, University of the Gambia, Kanifing, The Gambia
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9705
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Mohd-Shaharuddin N, Lim YAL, Ngui R, Nathan S. Expression of Ascaris lumbricoides putative virulence-associated genes when infecting a human host. Parasit Vectors 2021; 14:176. [PMID: 33757548 PMCID: PMC7985925 DOI: 10.1186/s13071-021-04680-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ascaris lumbricoides is the most common causative agent of soil-transmitted helminth infections worldwide, with an estimated 450 million people infected with this nematode globally. It is suggested that helminths are capable of evading and manipulating the host immune system through the release of a spectrum of worm proteins which underpins their long-term survival in the host. We hypothesise that the worm overexpresses these proteins when infecting adults compared to children to cirvumvent the more robust defence mechanisms of adults. However, little is known about the parasite's genes and encoded proteins involved during A. lumbricoides infection. Hence, this study was conducted to assess the expression profile of putative virulence-associated genes during an active infection of adults and children. METHODS In this study, quantitative PCR was performed to evaluate the expression profile of putative virulence-associated genes in A. lumbricoides isolated from infected children and adults. The study was initiated by collecting adult worms expelled from adults and children following anthelminthic treatment. High-quality RNA was successfully extracted from each of six adult worms expelled by three adults and three children, respectively. Eleven putative homologues of helminth virulence-associated genes reported in previous studies were selected, primers were designed and specific amplicons of A. lumbricoides genes were noted. The expression profiles of these putative virulence-associated genes in A. lumbricoides from infected adults were compared to those in A. lumbricoides from infected children. RESULTS The putative virulence-associated genes VENOM, CADHERIN and PEBP were significantly upregulated at 166-fold, 13-fold and fivefold, respectively, in adults compared to children. Conversely, the transcription of ABA-1 (fourfold), CATH-L (threefold) and INTEGRIN (twofold) was significantly suppressed in A. lumbricoides from infected adults. CONCLUSIONS On the basis of the expression profile of the putative virulence-associated genes, we propose that the encoded proteins have potential roles in evasion mechanisms, which could guide the development of therapeutic interventions.
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Affiliation(s)
| | - Yvonne Ai Lian Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Romano Ngui
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sheila Nathan
- Department of Biological Sciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Selangor, Malaysia.
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9706
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Affiliation(s)
- Jean Jacques Noubiap
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
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9707
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Rushton J, Huntington B, Gilbert W, Herrero M, Torgerson PR, Shaw APM, Bruce M, Marsh TL, Pendell DL, Bernardo TM, Stacey D, Grace D, Watkins K, Bondad-Reantaso M, Devleesschauwer B, Pigott DM, Stone M, Mesenhowski S. Roll-out of the Global Burden of Animal Diseases programme. Lancet 2021; 397:1045-1046. [PMID: 33549170 DOI: 10.1016/s0140-6736(21)00189-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 01/21/2021] [Indexed: 12/19/2022]
Affiliation(s)
- J Rushton
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L3 5RF, UK.
| | - B Huntington
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L3 5RF, UK; Pengwern Animal Health Ltd, Wallasey Village, UK
| | - W Gilbert
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L3 5RF, UK
| | - M Herrero
- CSIRO Agriculture and Food, St Lucia, QLD, Australia
| | - P R Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
| | - A P M Shaw
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L3 5RF, UK; A P Consultants, Andover, UK
| | - M Bruce
- School of Veterinary Medicine, Centre for Animal Production and Health, Murdoch University, Murdoch, WA, Australia
| | - T L Marsh
- Paul G Allen School for Global Animal Health, Allen Center, School of Economic Sciences, Washington State University, WA, USA
| | - D L Pendell
- Department of Agricultural Economics, Kansas State University, Manhattan, KS, USA
| | - T M Bernardo
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - D Stacey
- School of Computer Science, University of Guelph, Guelph, ON, Canada
| | - D Grace
- Food and Markets Department, Natural Resources Institute, Faculty of Engineering and Science, University of Greenwich, Chatham Maritime, UK; International Livestock Research Institute, Nairobi, Kenya
| | - K Watkins
- FoodFirst LLC, Indianapolis, IN, USA
| | - M Bondad-Reantaso
- Fisheries Division, Food and Agriculture Organization of the United Nations, Rome, Italy
| | | | - D M Pigott
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - M Stone
- OIE World Organisation for Animal Health, Paris, France
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9708
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Gabet A, Grave C, Tuppin P, Chatignoux E, Béjot Y, Olié V. Impact of the COVID-19 pandemic and a national lockdown on hospitalizations for stroke and related 30-day mortality in France: A nationwide observational study. Eur J Neurol 2021; 28:3279-3288. [PMID: 33738913 PMCID: PMC8251122 DOI: 10.1111/ene.14831] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 01/04/2021] [Revised: 03/02/2021] [Accepted: 03/11/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE The aim of this nationwide study was to assess the impact of the COVID-19 pandemic on stroke hospitalization rates, patient characteristics and 30-day case fatality rates. METHODS All hospitalizations for stroke from January to June of each year from 2017 to 2020 were selected using International Classification of Diseases, 10th revision, codes I60 to I64 in the national hospital discharge database. Patient characteristics and management were described according to three time periods: pre-lockdown, lockdown, and post-lockdown. Weekly incidence rate ratios (IRRs) were computed to compare time trends in the rates of patients hospitalized for stroke as well as in-hospital and 30-day case fatality rates between the years 2017-2019 and 2020. RESULTS In 2020, between weeks 1 and 24, 55,308 patients were hospitalized for stroke in France. IRRs decreased by up to 30% for all age groups, sex, and stroke types during the lockdown compared to the period 2017-2019. Patients hospitalized during the second and third weeks of the lockdown had higher in-hospital case fatality rates compared to 2017-2019. In-hospital case fatality rates increased by almost 60% in patients aged under 65 years. Out-of-hospital 30-day case fatality rates increased between weeks 11 and 15 among patients who returned home after their hospitalization. Important changes in care management were found, including fewer stroke patients admitted to resuscitation units, more admitted to stroke care units, and a shorter mean length of hospitalization. CONCLUSIONS During the first weeks of the lockdown, rates of patients hospitalized for stroke fell by 30% and there were substantial increases of both in-hospital and out-of-hospital 30-day case fatality rates.
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9709
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Affiliation(s)
- S N Myatra
- Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - S Tripathy
- Department of Anaesthesia and Critical Care, AIIMS Bhubaneswar, Bhubaneswar, India
| | - S Einav
- Department of Anaesthesia and Intensive Care, Hebrew University Faculty of Medicine and General Intensive Care Unit, Shaare Zedek Medical Center, Jerusalem, Israel
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9710
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Pillon NJ, Loos RJF, Marshall SM, Zierath JR. Metabolic consequences of obesity and type 2 diabetes: Balancing genes and environment for personalized care. Cell 2021; 184:1530-1544. [PMID: 33675692 PMCID: PMC9191863 DOI: 10.1016/j.cell.2021.02.012] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/25/2020] [Accepted: 02/03/2021] [Indexed: 02/07/2023]
Abstract
The prevalence of type 2 diabetes and obesity has risen dramatically for decades and is expected to rise further, secondary to the growing aging, sedentary population. The strain on global health care is projected to be colossal. This review explores the latest work and emerging ideas related to genetic and environmental factors influencing metabolism. Translational research and clinical applications, including the impact of the COVID-19 pandemic, are highlighted. Looking forward, strategies to personalize all aspects of prevention, management and care are necessary to improve health outcomes and reduce the impact of these metabolic diseases.
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Affiliation(s)
- Nicolas J Pillon
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Ruth J F Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sally M Marshall
- Diabetes Research Group, Translational and Clinical Research Institute, Faculty of Clinical Medical Sciences, Newcastle University, 4(th) Floor William Leech Building, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Juleen R Zierath
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.
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9711
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Wu J, Lai T, Han H, Liu J, Wang S, Lyu J. Global, regional and national disability-adjusted life years due to HIV from 1990 to 2019: findings from the Global Burden of Disease Study 2019. Trop Med Int Health 2021; 26:610-620. [PMID: 33639020 DOI: 10.1111/tmi.13565] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Increasing life expectancy and decreasing mortality in patients with HIV infection are well documented. However, details of how many of the years of healthy life are damaged by HIV infection vs. good health have not been understood. We conducted this study to provide a comprehensive assessment of the levels and trends of the global burden, as measured by disability-adjusted life years (DALYs), of HIV infection. METHODS Data on HIV-related DALY were obtained from the Global Burden of Disease Study 2019. The absolute numbers and age-standardised rates of DALYs due to HIV were reported between 1990 and 2019. Estimated annual percentage changes in age-standardised rates by sex, region and nation were calculated to quantify the temporal trends in HIV burden. RESULTS Global HIV infection caused 47.63 million DALYs in 2019, presenting a 1.28-fold increase from 1990 to 2019. In 2019, years of life lost contributed to most of the total DALYs, but the increases in HIV-related years lived with disability have outpaced increases in years of life lost. The age-standardised rates of HIV-related DALYs in 2019 decreased as the sociodemographic indexes increased. The highest age-standardised rates were observed in sub-Saharan Africa, and the greatest increments over time were detected in Oceania. CONCLUSIONS Globally, HIV continues to cause enormous healthy life loss. The first and foremost strategy for controlling the HIV burden is still the reduction of premature deaths, and much effort needs to be exerted to mitigate the harm of comorbidities.
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Affiliation(s)
- Jiayuan Wu
- Department of Clinical Research, the Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Tianwen Lai
- Department of Pulmonary and Critical Care Medicine, the Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Huanqin Han
- Department of Infectious Disease, the Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jie Liu
- Department of Clinical Research, the Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.,School of Public Health, Guangdong Medical University, Zhanjiang, China
| | - Shuangmiao Wang
- Department of Clinical Research, the Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jun Lyu
- Department of Clinical Research, the Affiliated Hospital of Ji'nan University, Guangzhou, China
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9712
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Choi H, Mun S, Joo EJ, Lee KY, Kang HG, Lee J. Discovery of Screening Biomarkers for Major Depressive Disorder in Remission by Proteomic Approach. Diagnostics (Basel) 2021; 11:diagnostics11030539. [PMID: 33802981 PMCID: PMC8002827 DOI: 10.3390/diagnostics11030539] [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: 02/18/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 11/29/2022] Open
Abstract
Major depressive disorder (MDD) is a common disorder involving depressive mood and decreased motivation. Due to its high heterogeneity, novel biomarkers are required to diagnose MDD. In this study, a proteomic method was used to identify a new MDD biomarker. Using sequential window acquisition of all theoretical mass spectra acquisitions and multiple reaction monitoring analysis via mass spectrometry, relative and absolute quantification of proteins in the sera was performed. The results of the relative quantitation by sequential window acquisition for all theoretical mass spectra data showed that seven proteins were significantly differently expressed between MDD patients and other patients with remission status. However, absolute quantification by multiple reaction monitoring analysis identified prothrombin as the only significantly upregulated protein in the depressive state compared to remission (p < 0.05) and was, thus, subsequently selected as an MDD biomarker. The area under the curve for prothrombin was 0.66. Additionally, increased prothrombin/thrombin induced hyper-activation of platelets via activating protease-activated receptors, a feature associated with MDD; specifically, activated platelets secrete various molecules related to MDD, including brain-derived neurotropic factors and serotonin. Therefore, prothrombin is a potential screening, prognostic, and diagnostic marker for MDD.
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Affiliation(s)
- Hyebin Choi
- Department of Senior Healthcare, Graduate School, Eulji University, Seongnam 13135, Korea; (H.C.); (S.M.)
| | - Sora Mun
- Department of Senior Healthcare, Graduate School, Eulji University, Seongnam 13135, Korea; (H.C.); (S.M.)
| | - Eun-Jeong Joo
- Department of Neuropsychiatry, School of Medicine, Eulji University, Daejeon 34824, Korea; (E.-J.J.); (K.Y.L.)
- Department of Psychiatry, Uijeongbu Eulji Medical Center, Eulji University, Gyeonggi 11759, Korea
| | - Kyu Young Lee
- Department of Neuropsychiatry, School of Medicine, Eulji University, Daejeon 34824, Korea; (E.-J.J.); (K.Y.L.)
- Department of Psychiatry, Eulji General Hospital, Seoul 01830, Korea
| | - Hee-Gyoo Kang
- Department of Senior Healthcare, Graduate School, Eulji University, Seongnam 13135, Korea; (H.C.); (S.M.)
- Department of Biomedical Laboratory Science, College of Health Science, Eulji University, Seongnam 13135, Korea
- Correspondence: (H.-G.K.); (J.L.); Tel.: +82-31-740-7315 (H.-G.K.); +82-42-259-1752 (J.L.)
| | - Jiyeong Lee
- Department of Biomedical Laboratory Science, College of Health Science, Eulji University, Uijeongbu 11759, Korea
- Correspondence: (H.-G.K.); (J.L.); Tel.: +82-31-740-7315 (H.-G.K.); +82-42-259-1752 (J.L.)
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9713
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Kiadaliri A. Avoidable deaths in Sweden, 1997-2018: temporal trend and the contribution to the gender gap in life expectancy. BMC Public Health 2021; 21:519. [PMID: 33731076 DOI: 10.1186/s12889-021-10567-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/30/2020] [Accepted: 03/05/2021] [Indexed: 11/29/2022] Open
Abstract
Background Avoidable mortality is considered as a potential indicator of the influences of public health policies and healthcare quality on population health. This study aimed to examine the trend in avoidable mortality and its influence on rising life expectancy (LE) and declining gender gap in LE (GGLE) in Sweden. Methods We extracted data on causes of death by age, sex, and year from national registry from 1997 to 2018. The UK Office for National Statistics definition was used to divide causes of death into five mutually exclusive categories: amenable, preventable, amenable & preventable, ischemic heart disease (IHD), and non-avoidable causes. We applied Joinpoint regression to analyse temporal trends in age-standardized mortality rates. The Arriaga method was applied to decompose changes in LE and GGLE by age group and causes of death. Results Average annual reductions in avoidable vs. non-avoidable mortality were 2.6% (95% CI:2.5, 2.7) vs. 1.4% (95% CI:1.3, 1.5) in men, and 1.6% (95% CI:1.4, 1.9) vs. 0.9% (95% CI:0.7, 1.0) in women over the study period. LE in men rose by 4.1 years between 1997 and 2018 (from 72.8 to 76.9 years), of which 2.4 years (59.3%) were attributable to reductions in avoidable mortality. Corresponding LE gain was 2.3 years in women (from 78.0 in 1997 to 80.3 in 2018) and avoidable mortality accounted for 1.0 year (45.6%) of this gain. Between 1997 and 2018, the GGLE narrowed by 1.9 years, of which 1.4 years (77.7%) were attributable to avoidable causes. Among avoidable causes, while preventable causes had the largest contribution to the GGLE, IHD had the greatest contributions to LE gains and the narrowing GGLE. Conclusions Our findings showed that avoidable causes had a substantial contribution to gain in LE with more profound gain in men than in women, resulting in narrowing the GGLE. Lower pace of reductions in preventable than amenable mortality highlights the need for improving the effectiveness of inter-sectoral health policies aimed at behavioural changes. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10567-5.
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9714
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Ferrara P, Cortesi PA, Di Laura D, Maggioni AP, Mantovani LG. Cost-Effectiveness Analysis of Rivaroxaban Plus Aspirin Compared with Aspirin Alone in Patients with Coronary and Peripheral Artery Diseases in Italy. Clin Drug Investig 2021; 41:459-68. [PMID: 33725323 DOI: 10.1007/s40261-021-01023-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2021] [Indexed: 10/28/2022]
Abstract
BACKGROUND Rivaroxaban is a selective inhibitor of coagulation factor Xa and its combination with aspirin showed better outcomes in the prevention of recurrent cardiovascular disease than aspirin alone. OBJECTIVE This analysis aimed to economically compare the cost effectiveness of rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily) with aspirin alone in patients with coronary artery disease (CAD) or peripheral artery disease (PAD) and related subgroups. METHODS The analysis simulates the perspective of the Italian National Healthcare Service and used a state-transition decision Markov model. Clinical efficacy data and health events risks were gathered from the COMPASS trial. Health outcomes and costs (in Euros) were evaluated over a lifetime horizon and were discounted at 3.5% per annum. Direct healthcare costs entered the analysis. Results were expressed in terms of incremental cost-effectiveness ratio (ICER), defined as cost per quality-adjusted life-year (QALY) gained. One-way deterministic and probabilistic sensitivity analyses were performed. RESULTS For the CAD or PAD population, rivaroxaban plus aspirin was more effective and costly compared with aspirin alone. Incremental costs and efficacy produced an ICER of €16,522 per QALY gained. Analyses found similar trends for the PAD and CAD groups, with respective ICERs of €8003 and €18,599, while ICERs for the other groups were lower than €13,000 per QALY. Sensitivity analyses confirmed these findings. CONCLUSION Compared with aspirin alone, rivaroxaban plus aspirin is cost effective in preventing recurrent cardiovascular events in all patients with CAD or PAD, from the Italian perspective. These results could help clinicians and decision makers to develop improved strategies for cardiovascular disease prevention.
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9715
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Echeazarra L, Pereira J, Saracho R. TensioBot: a Chatbot Assistant for Self-Managed in-House Blood Pressure Checking. J Med Syst 2021; 45:54. [PMID: 33723721 DOI: 10.1007/s10916-021-01730-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/09/2021] [Indexed: 11/27/2022]
Abstract
Hypertension is a chronic condition that can lead to serious health problems. Patients with High Blood Pressure (HBP) are often asked to have their BP checked at home. The traditional at-home procedure has some drawbacks, such as forgetting to check or write down the values, errors in transcribing the numbers, or the impossibility of immediately notifying medical staff of out-of-range BP values. To facilitate self-measurements by patients at home we devised TensioBot, a Telegram based chatbot. The bot sends patients reminders to check their BP, advice on good monitoring practices, measurement tracking, medical alerts and allows healthcare professionals to access up-to-date measurement information. TensioBot has been tested for two years in a randomized controlled trial with 112 patients (55 using the bot and 57 in the control group). We found that, although the bot group showed similar results in terms of adherence to the BP checking schedule, bot users scored better in terms of knowledge and skills on BP checking best practices. Participants rated the bot very positively, perceived it as useful and easy to use, and continued to use it after the intervention. Moreover, all data being equal, we describe some other benefits of using a chatbot for self-managed in-house BP control, both for patients and healthcare professionals and systems.
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9716
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GBD 2019 Hearing Loss Collaborators. Hearing loss prevalence and years lived with disability, 1990-2019: findings from the Global Burden of Disease Study 2019. Lancet 2021; 397:996-1009. [PMID: 33714390 DOI: 10.1016/S0140-6736(21)00516-X] [Citation(s) in RCA: 307] [Impact Index Per Article: 102.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/02/2021] [Accepted: 02/23/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. METHODS We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. FINDINGS An estimated 1·57 billion (95% uncertainty interval 1·51-1·64) people globally had hearing loss in 2019, accounting for one in five people (20·3% [19·5-21·1]). Of these, 403·3 million (357·3-449·5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430·4 million (381·7-479·6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127·1 million people [112·3-142·6]). Of all people with a hearing impairment, 62·1% (60·2-63·9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65·8% of the variation in national age-standardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2·45 billion (2·35-2·56) people will have hearing loss, a 56·1% (47·3-65·2) increase from 2019, despite stable age-standardised prevalence. INTERPRETATION As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings. FUNDING Bill & Melinda Gates Foundation and WHO.
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9717
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Affiliation(s)
- Blake S Wilson
- Department of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, NC 27710, USA.
| | - Debara L Tucci
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
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9718
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Majeed A, Xiong J, Teopiz KM, Ng J, Ho R, Rosenblat JD, Phan L, Cao B, McIntyre RS. Efficacy of dextromethorphan for the treatment of depression: a systematic review of preclinical and clinical trials. Expert Opin Emerg Drugs 2021; 26:63-74. [PMID: 33682569 DOI: 10.1080/14728214.2021.1898588] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The large percentage of adults with major depressive disorder (MDD) insufficiently responding and/or tolerating conventional monoamine-based antidepressants invites the need for mechanistically novel treatments. Convergent evidence implicates glutamatergic signaling as a potential therapeutic target in MDD. AREAS COVERED The synthesis herein of preclinical and clinical studies indicates that dextromethorphan (DXM) is well tolerated and exhibits clinically significant antidepressant effects; DXM combined with bupropion has demonstrated replicated and relatively rapid onset efficacy in adults with MDD. DXM efficacy has been preliminarily reported in adults with bipolar depression. The combination of DXM and bupropion represents a pharmacokinetic and pharmacodynamic synergy which may account for the rapidity of action in MDD. EXPERT OPINION The combination of DXM and bupropion is a safe, well tolerated and efficacious treatment option in adults with MDD. Priority questions are whether DXM/bupropion is uniquely effective across discrete domains of psychopathology (e.g. anhedonia, reward processing, general cognitive systems) and/or whether it is able to significantly improve patient-reported outcomes (e.g. quality of life, psychosocial functioning). The availability of ketamine/esketamine and DXM/bupropion instantiates the relevance of glutamate as a treatment target in MDD. Studies in bipolar depression with DXM/bupropion are warranted as well as in MDD with suicidality.
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Affiliation(s)
- Amna Majeed
- Temerty Faculty of Medicine, University of Toronto, Canada
| | - Jiaqi Xiong
- Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Kayla M Teopiz
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Jason Ng
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada
| | - Roger Ho
- Institute for Health Innovation and Technology (Ihealthtech), National University of Singapore, Singapore, Singapore.,Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joshua D Rosenblat
- Department of Pharmacology, University of Toronto, Toronto, Canada.,Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada
| | - Lee Phan
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada
| | - Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University (SWU), P. R. China
| | - Roger S McIntyre
- Department of Pharmacology, University of Toronto, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada.,Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada.,Brain and Cognition Discovery Foundation, Toronto, Canada
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9719
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McCormick I, Mactaggart I, Resnikoff S, Muirhead D, Murthy GV, Silva JC, Bastawrous A, Stern J, Blanchet K, Wang N, Yusufu M, Cooper A, Gichangi M, Burton MJ, Ramke J. Eye health indicators for universal health coverage: results of a global expert prioritisation process. Br J Ophthalmol 2021; 106:893-901. [PMID: 33712481 PMCID: PMC9234411 DOI: 10.1136/bjophthalmol-2020-318481] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 12/22/2022]
Abstract
IntroductionIn its recent World Report on Vision, the WHO called for an updated approach to monitor eye health as part of universal health coverage (UHC). This project sought to develop a consensus among eye health experts from all world regions to produce a menu of indicators for countries to monitor eye health within UHC.MethodsWe reviewed the literature to create a long-list of indicators aligned to the conceptual framework for monitoring outlined in WHO’s World Report on Vision. We recruited a panel of 72 global eye health experts (40% women) to participate in a two-round, online prioritisation exercise. Two-hundred indicators were presented in Round 1 and participants prioritised each on a 4-point Likert scale. The highest-ranked 95 were presented in Round 2 and were (1) scored against four criteria (feasible, actionable, reliable and internationally comparable) and (2) ranked according to their suitability as a ‘core’ indicator for collection by all countries. The top 30 indicators ranked by these two parameters were then used as the basis for the steering group to develop a final menu.ResultsThe menu consists of 22 indicators, including 7 core indicators, that represent important concepts in eye health for 2020 and beyond, and are considered feasible, actionable, reliable and internationally comparable.ConclusionWe believe this list can inform the development of new national eye health monitoring frameworks, monitor progress on key challenges to eye health and be considered in broader UHC monitoring indices at national and international levels.
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Affiliation(s)
- Ian McCormick
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Islay Mactaggart
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Debbie Muirhead
- The Fred Hollows Foundation Melbourne, Melbourne, Victoria, Australia
| | - G V Murthy
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- Indian Institutes of Public Health, Hyderabad, India
| | | | - Andrew Bastawrous
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Jude Stern
- International Agency for the Prevention of Blindness, London, UK
| | - Karl Blanchet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | | | - Michael Gichangi
- Ophthalmic Services Unit, Kenya Ministry of Health, Nairobi, Kenya
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- Moorfields Eye Hospital, London, UK
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
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9720
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Li F, Lin Q, Li M, Chen L, Li Y. The Association between Blood Pressure Trajectories and Risk of Cardiovascular Diseases among Non-Hypertensive Chinese Population: A Population-Based Cohort Study. Int J Environ Res Public Health 2021; 18:2909. [PMID: 33809125 PMCID: PMC7999224 DOI: 10.3390/ijerph18062909] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/05/2021] [Accepted: 03/10/2021] [Indexed: 11/16/2022]
Abstract
Although previous studies have discussed the association between trajectories of blood pressure (BP) and risk of cardiovascular diseases (CVDs), the association among the non-hypertensive general population of youth and middle age has not been elucidated. We used the growth mixture model to explore the trajectories of BP among the non-hypertensive Chinese population and applied Cox regression to evaluate the association between trajectories of BP and the risk of stroke or myocardial infarction (MI). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were categorized into three classes, respectively. Statistically significant associations were observed between SBP trajectories and stroke (range of adjusted hazard ratios (aHR): 1.369-3.837) or MI (rang of aHR = 6.047-13.017). Association between DBP trajectories and stroke (aHR: 3.685) or MI (range of aHR = 1.312-2.821) were also observed, although they did not reach statistical significance. Trajectories of SBP were more important risk factors than that of DBP in stroke and MI in our study population. BP management is important among pre-hypertensive adults to prevent stroke and MI when they age. Well-designed research with a larger sample size is required to confirm our findings and develop efficient methods to prevent CVDs.
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Affiliation(s)
- Fang Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China;
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha 410078, China
| | - Qian Lin
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410078, China; (Q.L.); (M.L.)
| | - Mingshu Li
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410078, China; (Q.L.); (M.L.)
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China;
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha 410078, China
| | - Yingjun Li
- Department of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical College, Hangzhou 310053, China
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9721
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Li PF, McEvoy MA, McKiernan S, Schofield PW, MacDonald-Wicks LK, Patterson AJ. Diet Quality and Cognitive Performance in Australian Adults Aged 55-85 Years: A Cross-Sectional Analysis of the Hunter Community Study Cohort. Nutrients 2021; 13:909. [PMID: 33799630 DOI: 10.3390/nu13030909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/02/2021] [Accepted: 03/08/2021] [Indexed: 11/17/2022] Open
Abstract
There is a lack of evidence to determine if diet quality is associated with cognitive performance in older adults. Therefore, the aim of this study was to examine whether diet quality is associated with cognitive performance among older adults. A cross-sectional, secondary analysis of baseline data from the Hunter Community Study (HCS), comparing diet quality, measured using the Australian Recommended Food Score (ARFS), along with validated cognitive performance instruments the Audio Recorded Cognitive Screen (ARCS) and the Mini-Mental State Examination (MMSE) were undertaken in adults aged 55–85 years, living in Newcastle, NSW, Australia. Adjusted linear regression analyses showed that, compared with the lowest ARFS quintile, those in the highest quintile had an ARCS score 5.883 units greater (p < 0.001; R2 = 0.0098). Furthermore, when quintiles of ARFS score were tested against each ARCS sub-scale score, statistically significant associations were observed with the greatest effect for the Memory (β = 4.055; p = 0.001; R2 = 0.0065) and Attention (β = 4.136; p = 0.002; R2 = 0.0047) domains. No statistically significant associations were observed between quintiles of ARFS and MMSE score in the adjusted linear regression analyses. In conclusion, a positive association was observed between diet quality and cognitive performance within this sample of older Australian adults. Further investigation of the above association over time, when follow-up data becomes available, in longitudinal analysis is recommended.
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9722
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Abstract
PURPOSE OF REVIEW Malaria, Chagas Disease and Human African Trypanosomiasis are vector-borne protozoan illnesses, frequently associated with neurological manifestations. Intriguing but ignored, limited mainly to resource-limited, tropical settings, these disorders are now coming to light because of globalisation and improved diagnosis and treatment. Enhanced understanding of these illnesses has prompted this review. RECENT FINDINGS Methods of diagnosis have currently transitioned from blood smear examinations to immunological assays and molecular methods. Tools to assess neurological involvement, such as magnetic resonance imaging, are now increasingly available in regions and countries with high infection loads. Sleep and other electrophysiological technologies (electroencephalography, actigraphy) are also promising diagnostic tools but requiring field-validation. Access to treatments was formerly limited, even as limitations of agents used in the treatment are increasingly recognised. Newer agents are now being developed and trialled, encouraged by improved understanding of the disorders' molecular underpinnings. SUMMARY Prompt diagnosis and treatment are crucial in ensuring cure from the infections. Attention should also be due to the development of globally applicable treatment guidelines, the burden of neurological sequelae and elimination of the zoonoses from currently endemic regions.
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Affiliation(s)
- Gagandeep Singh
- Department of Neurology, Dayanand Medical College, Ludhiana, India.,NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Alfred K Njamnshi
- Neurology Department, Central Hospital Yaoundé/Neuroscience Lab, Faculty of Medicine and Biomedical Sciences (FMBS), The University of Yaoundé 1, Yaoundé, Cameroon.,Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon
| | - Josemir W Sander
- NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, London, UK.,Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, UK.,Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, Netherlands
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9723
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Bragazzi NL, Trabelsi K, Garbarino S, Ammar A, Chtourou H, Pacifico A, Malagoli P, Kocic H, Conic RRZ, Kridin K, Pigatto PDM, Damiani G. Can intermittent, time-restricted circadian fasting modulate cutaneous severity of dermatological disorders? Insights from a multicenter, observational, prospective study. Dermatol Ther 2021; 34:e14912. [PMID: 33629451 DOI: 10.1111/dth.14912] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/07/2021] [Accepted: 02/19/2021] [Indexed: 12/19/2022]
Abstract
The impact of intermittent circadian fasting (ICF) on skin disorders is far to be plenty deciphered. However, the circadian rhythm seems to exert a modulation on dermatoses severity, drug-response, and drug-related side effects. We aimed to evaluate ICF effect in the daily management of dermatological diseases. In this multicenter, prospective observational study we enrolled patients willing to undergo the 2018 ICF (from May 16 to June 14). Dermatoses severity were evaluated at the beginning of ICF (T0) and at the end of ICF (T1) by two independent board-certified dermatologists. Seventy-two patients suffering from different dermatoses volunteered to take part into the study. They displayed a mean age of 40.38 ± 12.46 years (median 41.0 years), 25 subjects were males (34.7% of the entire sample). The median weight change was 0 kg. The overall ICF effect size was -0.58 ([95% CI -0.83 to -0.33], P < .0001, medium effect size). Since in the present investigation no weight loss occurred, we could speculate that the impact of fasting in terms of improvements in the clinical symptoms could be rather due to the perturbation of the human biological clock. Despite our data remain preliminary, a chronobiological approach should be incorporated in the dermatological armamentarium.
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Affiliation(s)
- Nicola Luigi Bragazzi
- Department of Health Sciences (DISSAL), Postgraduate School of Public Health, University of Genoa, Genoa, Italy.,Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario, Canada.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genoa, Polyclinic Hospital San Martino IRCCS, Genoa, Italy
| | - Khaled Trabelsi
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genoa, Polyclinic Hospital San Martino IRCCS, Genoa, Italy
| | - Achraf Ammar
- Institute of Sport Science, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Hamdi Chtourou
- Institut Supérieur du Sport et de l'Education Physique de Sfax, Université de Sfax, Sfax, Tunisia.,Activité Physique, Sport et Santé, UR18JS01, Observatoire National du Sport, Tunis, Tunisia
| | - Alessia Pacifico
- Clinical Dermatology Department, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | | | - Hristina Kocic
- Department of Dermatology, University of Nis, Nis, Serbia
| | - Rosalynn R Z Conic
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Khalaf Kridin
- Department of Experimental Dermatology, Lubeck Institute, University of Lübeck, Lübeck, Germany
| | - Paolo Daniele Maria Pigatto
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Giovanni Damiani
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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9724
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Ibarra-Nava I, Flores-Rodriguez KG, Ruiz-Herrera V, Ochoa-Bayona HC, Salinas-Zertuche A, Padilla-Orozco M, Salazar-Montalvo RG. Ethnic disparities in COVID-19 mortality in Mexico: A cross-sectional study based on national data. PLoS One 2021; 16:e0239168. [PMID: 33690607 PMCID: PMC7946310 DOI: 10.1371/journal.pone.0239168] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/13/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Across the world, the COVID-19 pandemic has disproportionately affected racial and ethnic minorities. How ethnicity affects Indigenous peoples in Mexico is unclear. The aim of this cross-sectional study was to determine the mortality associated with ethnicity, particularly of Indigenous peoples, in a large sample of patients with COVID-19 in Mexico. METHODS We used open access data from the Mexican Ministry of Health, which includes data of all confirmed COVID-19 cases in the country. We used descriptive statistics to compare differences among different groups of patients. Logistic regression was used to calculate odds ratios while adjusting for confounders. RESULTS From February 28 to August 3, 2020, a total of 416546 adult patients were diagnosed with COVID-19. Among these, 4178 were Indigenous peoples. Among all patients with COVID-19, whether hospitalized or not, a higher proportion of Indigenous peoples died compared to non-Indigenous people (16.5% vs 11.1%, respectively). Among hospitalized patients, a higher proportion of Indigenous peoples died (37.1%) compared to non-Indigenous peoples (36.3%). Deaths outside the hospital were also higher among Indigenous peoples (3.7% vs 1.7%). A higher proportion of Indigenous peoples died in both the private and public health care sectors. The adjusted odds ratio for COVID-19 mortality among Indigenous peoples with COVID-19 was 1.13 (95% confidence interval 1.03 to 1.24). The adjusted odds ratio for COVID-19 mortality among Indigenous peoples with COVID-19 was higher among those who received only ambulatory care (1.55, 95% confidence interval 1.24 to 1.92). DISCUSSION In this large sample of patients with COVID-19, the findings suggest that Indigenous peoples in Mexico have a higher risk of death from COVID-19, especially outside the hospital. These findings suggest Indigenous peoples lack access to care more so than non-Indigenous people during the COVID-19 pandemic in Mexico.
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Affiliation(s)
- Ismael Ibarra-Nava
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Kathia G. Flores-Rodriguez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Violeta Ruiz-Herrera
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Hilda C. Ochoa-Bayona
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Alfonso Salinas-Zertuche
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Magaly Padilla-Orozco
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Raul G. Salazar-Montalvo
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
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9725
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Liu J, Guo M, Fan X. Ethanol induces necroptosis in gastric epithelial cells in vitro. J Food Biochem 2021; 45:e13692. [PMID: 33686694 DOI: 10.1111/jfbc.13692] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 02/19/2021] [Accepted: 02/21/2021] [Indexed: 11/27/2022]
Abstract
The stomach frequently suffers from acute gastric diseases after excessive ingestion of high-concentration alcoholic beverages, but little is known about the pathological mechanism by which ethanol affects the gastric mucosa. The aim of this study was to explore the mechanism of gastric epithelial cell death induced by relatively high concentrations of ethanol in vitro. Ethanol was demonstrated to induce rapid cell death in a concentration-dependent manner (Spearman r = .943, p = .017) and to activate the phosphorylation of key mediators in necroptosis pathway without influencing the key mediators in apoptosis pathway. The receptor-interacting serine-threonine kinase 1 (RIP1) kinase inhibitor necrostatin-1s (nec-1s) was found to reverse necroptotic cell death (from 65.5% necrosis to 35.8% necrosis, p = .006) and to inhibit the formation of necrosome complexes. These results indicate necroptosis rather than apoptosis pathway is an essential mechanism and is a novel therapeutic target in acute alcoholic gastric diseases. PRACTICAL APPLICATIONS: Alcohol consumption is related with a variety of diseases in many organs, but its pathological mechanism might be quite different due to the exposure extent between the stomach and other organs. Although there have been plenty of studies on alcoholic liver diseases and those in other organs, the pathological mechanism of alcoholic gastric diseases has been poorly investigated. Considering the unique distribution of ethanol on gastric mucosa, it is worthwhile to explore the specific cell death pattern of gastric epithelial cells under high-concentration ethanol treatment. Further investigation of the mechanisms of alcoholic gastric diseases would provide potential therapeutic strategies for the treatment of acute alcoholic gastric diseases as well as other acute alcoholic diseases.
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Affiliation(s)
- Jianning Liu
- State Laboratory of Cancer Biology and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Air Force Medical University, Xi'an, China.,Xi'an Gaoxin No. 1 High School, Xi'an, China
| | - Meng Guo
- State Laboratory of Cancer Biology and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Air Force Medical University, Xi'an, China
| | - Xiaotong Fan
- State Laboratory of Cancer Biology and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Air Force Medical University, Xi'an, China
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9726
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Shen BJ, Lo WC, Lin HH. Global burden of tuberculosis attributable to cancer in 2019: Global, regional, and national estimates. J Microbiol Immunol Infect 2021; 55:266-272. [PMID: 33789827 DOI: 10.1016/j.jmii.2021.02.005] [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: 11/18/2020] [Revised: 02/06/2021] [Accepted: 02/21/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cancer is an independent risk factor for tuberculosis (TB). The global burden of incident TB attributable to cancer has never been explored. We aimed to evaluate the cancer-attributable burden of TB. METHODS We estimated the population attributable fraction (PAF) by Levin's formula. The cancer prevalence rates were derived from the Institute for Health Metrics and Evaluation. The relative risk of TB in cancer patients was estimated by using the National Health Insurance Research Database in Taiwan. The global burden of incidence TB attributable to cancer was the weighted sum of PAFs multiplied by the incidence of TB retrieved from the World Health Organization. RESULTS Worldwide, the total of incident TB cases attributable to cancer was 115,478 cases with a 95% confidence interval (CI), 110,482-123,007, in 2019. The global PAF of TB due to cancer was 1.85% (95% CI, 1.77-1.97%). The three countries with the highest PAFs were Greenland (7.77%), Canada (7.75%), and the United States of America (6.79%), while the three countries with the highest attributable TB cases due to cancer were China (25,240), India (21,629), and Indonesia (13,917). Cancer of respiratory system contributed to 60,257 of TB cases. CONCLUSIONS This study comprehensively explored the impact of cancer on the global burden of TB. Efforts to reduce cancer risk, delay the occurrence of cancer, or treat latent TB infection in the cancer population could potentially reduce the burden of TB and rely on formulating integrated strategies.
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Affiliation(s)
- Bing-Jie Shen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Radiation Oncology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan; School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
| | - Wei-Cheng Lo
- Master Program in Applied Molecular Epidemiology, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Hsien-Ho Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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9727
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Bertrams W, Jung AL, Maxheim M, Schmeck B. [Role of genetic factors in pneumonia and COVID-19]. Pneumologe (Berl) 2021; 18:212-217. [PMID: 33716601 PMCID: PMC7934978 DOI: 10.1007/s10405-021-00385-2] [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] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 11/25/2022]
Abstract
Die Pneumonie ist die Infektionskrankheit mit der weltweit höchsten Mortalität. Die häufigsten Erreger sind Bakterien, es gibt jedoch auch epidemisch oder pandemisch auftretende virale Lungenentzündungen durch Influenza- oder Coronaviren, wie die aktuelle Pandemie durch das SARS Coronavirus 3766 Fälle (SARS-CoV-2). Wichtige Herausforderungen liegen neben dem Auftreten von Antibiotikaresistenzen und Immunpathologien etwa in der Sepsis in der Betrachtung der Suszeptibilität individueller Patienten: Hier werden vor allen Dingen das Lebensalter, Medikamente und Komorbiditäten betrachtet. Es gibt jedoch auch klare Hinweise für genetische Einflüsse auf das individuelle Risiko, an einer Pneumonie zu erkranken oder einen schweren Verlauf der Erkrankung zu entwickeln. In diesem Beitrag wollen wir die genetischen Einflüsse auf die Pneumonie und ihre klinische Bedeutung darstellen.
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Affiliation(s)
- Wilhelm Bertrams
- Institut für Lungenforschung, Universities of Gießen and Marburg Lung Center (UGMLC), Philipps-Universität Marburg, Hans-Meerwein-Str. 2, 35043 Marburg, Deutschland
| | - Anna Lena Jung
- Institut für Lungenforschung, Universities of Gießen and Marburg Lung Center (UGMLC), Philipps-Universität Marburg, Hans-Meerwein-Str. 2, 35043 Marburg, Deutschland
| | - Michael Maxheim
- Klinik für Innere Medizin mit Schwerpunkt Pneumologie, Universitätsklinikum Marburg, Philipps-Universität Marburg, Marburg, Deutschland
| | - Bernd Schmeck
- Institut für Lungenforschung, Universities of Gießen and Marburg Lung Center (UGMLC), Philipps-Universität Marburg, Hans-Meerwein-Str. 2, 35043 Marburg, Deutschland
- Klinik für Innere Medizin mit Schwerpunkt Pneumologie, Universitätsklinikum Marburg, Philipps-Universität Marburg, Marburg, Deutschland
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9728
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Wyper GMA, Assunção RMA, Colzani E, Grant I, Haagsma JA, Lagerweij G, Von der Lippe E, McDonald SA, Pires SM, Porst M, Speybroeck N, Devleesschauwer B. Burden of Disease Methods: A Guide to Calculate COVID-19 Disability-Adjusted Life Years. Int J Public Health 2021; 66:619011. [PMID: 34744580 PMCID: PMC8565264 DOI: 10.3389/ijph.2021.619011] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/12/2021] [Indexed: 12/21/2022] Open
Affiliation(s)
- Grant M. A. Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland
- *Correspondence: Grant M. A. Wyper,
| | - Ricardo M. A. Assunção
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Edoardo Colzani
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Ian Grant
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, Scotland
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Giske Lagerweij
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Elena Von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Scott A. McDonald
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Sara M. Pires
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Michael Porst
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Niko Speybroeck
- Research Institute of Health and Society, Catholic University of Louvain, Brussels, Belgium
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
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9729
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Dadaczynski K, Hering T. Health Promoting Schools in Germany. Mapping the Implementation of Holistic Strategies to Tackle NCDs and Promote Health. Int J Environ Res Public Health 2021; 18:2623. [PMID: 33807890 PMCID: PMC7967522 DOI: 10.3390/ijerph18052623] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/23/2021] [Accepted: 03/01/2021] [Indexed: 11/25/2022]
Abstract
Noncommunicable diseases (NCDs) and their underlying risk factors are seen as major public health problems that threaten health and welfare systems worldwide. The holistic and resource oriented Health Promoting School (HPS) approach can serve as an appropriate framework for the prevention and control of NCDs. The paper aimed to map the implementation of HPS activities in German schools and to examine associations with potential influencing factors. A series of cross-sectional online studies including five federal states and 5006 school principals (40.2% males, 50.8% females) from primary and secondary public schools was conducted from 2013 to 2018. Principal component analysis (PCA) resulted in two factors of HPS implementation (F1: concrete HPS action, F2: capacity building for HPS). Comparing both factors, a lower implementation level could be identified for HPS capacity building with lowest mean values found for regular teacher training and intersectoral collaboration. Multiple binary regression analyses revealed significant associations between low HPS implementation and male gender (OR: 1.36 to 1.42), younger age (OR: 1.47 to 1.90), secondary school (OR: 1.78 to 3.13) and federal state (Lower Saxony = OR: 1.27 to 1.45; Schleswig-Holstein = OR: 1.95 to 2.46). Moreover, low access to resources, decision-latitude and perceived educational benefits were independently associated with both factors of HPS implementation. Based on the results of this study, there is a need to support schools in their capacity building for health (e.g., regular teacher training, cooperation with local health services). Moreover, considering the core mission of schools, more evidence of the educational impact of health promotion and its translation into the language of education is needed for secondary schools in particular.
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Affiliation(s)
- Kevin Dadaczynski
- Department of Nursing and Health Science, Fulda University of Applied Sciences, 36037 Fulda, Germany
- Centre for Applied Health Science, Leuphana University Lueneburg, 21337 Lueneburg, Germany
| | - Thomas Hering
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, 39676 Stendal, Germany;
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9730
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Masquelier B, Hug L, Sharrow D, You D, Mathers C, Gerland P, Alkema L. Global, regional, and national mortality trends in youth aged 15-24 years between 1990 and 2019: a systematic analysis. Lancet Glob Health 2021; 9:e409-e417. [PMID: 33662320 PMCID: PMC7966666 DOI: 10.1016/s2214-109x(21)00023-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/11/2020] [Accepted: 01/08/2021] [Indexed: 11/30/2022]
Abstract
Background The global health community is devoting considerable attention to adolescents and young people, but risk of death in this population is poorly measured. We aimed to reconstruct global, regional, and national mortality trends for youths aged 15–24 years between 1990 and 2019. Methods In this systematic analysis, we used all publicly available data on mortality in the age group 15–24 years for 195 countries, as compiled by the UN Inter-agency Group for Child Mortality Estimation. We used nationally representative vital registration data, estimated the completeness of death registration, and extracted mortality rates from surveys with sibling histories, household deaths reported in censuses, and sample registration systems. We used a Bayesian B-spline bias-reduction model to generate trends in 10q15, the probability that an adolescent aged 15 years would die before reaching age 25 years. This model treats observations of the 10q15 probability as the product of the actual risk of death and an error multiplier that varies depending on the data source. The main outcome that we assessed was the levels of and trends in youth mortality and the global and regional mortality rates from 1990 to 2019. Findings Globally, the probability of an individual dying between age 15 years and 24 years was 11·2 deaths (90% uncertainty interval [UI] 10·7–12·5) per 1000 youths aged 15 in 2019, which is about 2·5 times less than infant mortality (28·2 deaths [27·2–30·0] by age 1 year per 1000 live births) but is higher than the risk of dying from age 1 to 5 (9·7 deaths [9·1–11·1] per 1000 children aged 1 year). The probability of dying between age 15 years and 24 years declined by 1·4% per year (90% UI 1·1–1·8) between 1990 and 2019, from 17·1 deaths (16·5–18·9) per 1000 in 1990; by contrast with this total decrease of 34% (27–41), under-5 mortality declined by 59% (56–61) in this period. The annual number of deaths declined from 1·7 million (90% UI 1·7–1·9) in 1990 to 1·4 million (1·3–1·5) in 2019. In sub-Saharan Africa, the number of deaths increased by 20·8% from 1990 to 2019. Although 18·3% of the population aged 15–24 years were living in sub-Saharan Africa in 2019, the region accounted for 37·9% (90% UI 34·8–41·9) of all worldwide deaths in youth. Interpretation It is urgent to accelerate progress in reducing youth mortality. Efforts are particularly needed in sub-Saharan Africa, where the burden of mortality is increasingly concentrated. In the future, a growing number of countries will see youth mortality exceeding under-5 mortality if current trends continue. Funding UN Children's Fund, Bill & Melinda Gates Foundation, United States Agency for International Development.
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Affiliation(s)
| | - Lucia Hug
- Division of Data, Analytics, Planning and Monitoring, UNICEF, New York, NY, USA
| | - David Sharrow
- Division of Data, Analytics, Planning and Monitoring, UNICEF, New York, NY, USA
| | - Danzhen You
- Division of Data, Analytics, Planning and Monitoring, UNICEF, New York, NY, USA
| | - Colin Mathers
- Technical Advisory Group of the UN Inter-agency Group for Child Mortality Estimation, UN, New York, NY, USA
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9731
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Utaaker KS, Chaudhary S, Kifleyohannes T, Robertson LJ. Global Goat! Is the Expanding Goat Population an Important Reservoir of Cryptosporidium? Front Vet Sci 2021; 8:648500. [PMID: 33748221 PMCID: PMC7977713 DOI: 10.3389/fvets.2021.648500] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 12/31/2020] [Accepted: 02/08/2021] [Indexed: 12/03/2022] Open
Abstract
Goats are a primary or additional income source for many families in resource-poor areas. Although often considered inferior to other livestock, the resilience of goats and their ability to thrive in a range of environments means that that they are of particular value. Furthermore, goats emit less methane than other livestock species. In these same areas, it is well-documented that cryptosporidiosis has a substantial impact on infant morbidity and mortality, as well as reducing child growth and development. As Cryptosporidium also causes diarrheal disease in goats, the question arises whether goats may represent a reservoir of infection to humans. Epidemiological studies regarding the potential for transmission of Cryptosporidium between goats and humans have largely concluded that Cryptosporidium species infecting goats are not zoonotic. However, these studies are mostly from developed countries, where goat husbandry is smaller, management routines differ greatly from those of developing countries, contact between goats and their owners is more limited, and cryptosporidiosis has less impact on human health. In this article, background information on goat husbandry in different countries is provided, along with information on Cryptosporidium prevalence among goats, at both the species and sub-species levels, and the potential for zoonotic transmission. The intention is to indicate data gaps that should be filled and to increase awareness of the role of goats as providers for low-income families, often living in areas where cryptosporidiosis is endemic and where appropriate baseline interventions could have a positive impact, regardless of species of goat or parasite.
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Affiliation(s)
| | - Suman Chaudhary
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Tsegabirhan Kifleyohannes
- Parasitology, Department of Paraclinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Oslo, Norway.,Department of Veterinary Basic and Diagnostic Sciences, College of Veterinary Medicine, Mekelle University, Mekelle, Ethiopia
| | - Lucy Jane Robertson
- Parasitology, Department of Paraclinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Oslo, Norway
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9732
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Rao Z, Hua J, Li R, Fu Y, Li J, Xiao W, He J, Hu G. Changes in Six-Month Prevalence of Circulatory System Diseases among People Aged 20 Years and Older between 2013 and 2018 in Hunan, China. Int J Environ Res Public Health 2021; 18:ijerph18052599. [PMID: 33807674 PMCID: PMC7967526 DOI: 10.3390/ijerph18052599] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 11/30/2022]
Abstract
Recent changes in population-based prevalence for circulatory system diseases (CSDs) remain unreported either nationally or locally for China. Data were from the two-round health service household interview survey of Hunan Province, China, in 2013 and 2018. A Rao–Scott chi-square test was performed to examine prevalence differences across socio-demographic variables. The overall age-standardized prevalence of CSDs increased substantially between 2013 and 2018 for inhabitants aged 20 years and older (14.25% vs. 21.25%; adjusted odds ratio (OR) = 1.59, 95% CI: 1.24–2.04). Hypertensive disease was the most prevalent type of CSD, accounting for 87.24% and 83.83% of all CSDs in 2013 and in 2018, respectively. After controlling for other socio-demographic factors, the prevalence of CSDs was significantly higher in 2018 (adjusted OR = 1.40), urban residents (adjusted OR = 1.43), females (adjusted OR = 1.12) and older age groups (adjusted OR = 5.36 for 50–59 years, 9.51 for 60–69 years, 15.19 for 70–79 years, and 12.90 for 80 years and older) than in 2013, rural residents, males and the youngest age group (20–49 years). The recent increase in the overall age-standardized CSD prevalence and the large prevalence disparities across urban/rural residents, sex and age groups merit the attention of policymakers and researchers. Further prevention efforts are needed to curb the increasing tendency and to reduce the prevalence of disparities across socio-demographic groups.
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Affiliation(s)
| | | | | | | | | | | | | | - Guoqing Hu
- Correspondence: ; Tel.: +86-0731-84805414
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9733
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Ismael F, Zaramella B, Battagin T, Bizario JCS, Gallego J, Villela V, de Queiroz LB, Leal FE, Torales J, Ventriglio A, Marziali ME, Gonçalves PD, Martins SS, Castaldelli-Maia JM. Substance Use in Mild-COVID-19 Patients: A Retrospective Study. Front Public Health 2021; 9:634396. [PMID: 33748068 PMCID: PMC7969785 DOI: 10.3389/fpubh.2021.634396] [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: 11/27/2020] [Accepted: 02/05/2021] [Indexed: 01/24/2023] Open
Abstract
Background: There is a need for prospective studies investigating substance use variations in mild COVID-19 patients. These individuals represent the majority of patients affected by the disease and are routinely treated at home, facing periods of quarantine. Methods: This was a retrospective cohort study. All people who tested positive for COVID-19 and classified as mild cases (i.e., no alarm sign/symptom, no need for in-person consultation) during the treatment in the public health system of a Brazilian city with around 160,000 inhabitants were monitored by phone for all the COVID-19 symptoms listed by the Centers for Disease Control and Prevention (CDC) during the active phase of the disease (i.e., no longer experiencing symptoms, up to 14 days in mild cases). After this phase (median = 108 days after intake, IQR = 76–137), we asked these patients who were classified as experiencing mild COVID-19 (n = 993) about last-month substance use in three time-points: pre-COVID, just after COVID-19 acute phase (post-COVID acute phase) and in the period before survey (post-COVID follow-up phase). Results: The number of COVID-19 symptoms was not associated with pre- or post-infection substance use. Pre-COVID alcohol and non-medical benzodiazepine use were associated with specific COVID-19 symptoms. However, sensitivity analyses showed that such associations could be explained by previous psychiatric and medical profiles. Alcohol and tobacco use decreased and non-medical analgesics increased in the post-COVID acute phase. However, just alcohol use remained lower in the post-COVID follow-up period. Higher pre-COVID levels of tobacco and alcohol were associated with post-COVID follow-up cannabis and non-medical analgesic use, respectively. Non-medical benzodiazepine use had positive and negative bi-directional associations with cannabis and non-medical analgesic use, respectively. Conclusion: We were not able to find specific associations between substance use and COVID-19 symptomatology in the present study. Patients with mild COVID-19 should be monitored for substance use in the post-COVID-19 period, and preventive interventions for non-medical analgesic use should be implemented. Focused preventive interventions increasing the perceived risks of cannabis and non-medical benzodiazepine and analgesic use among people experiencing mild COVID-19 that reported previous substance use could be useful.
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Affiliation(s)
- Flavia Ismael
- Universidade Municipal de São Caetano do Sul, São Caetano do Sul, Brazil.,ABC Center for Mental Health Studies, Santo André, Brazil
| | - Beatriz Zaramella
- Universidade Municipal de São Caetano do Sul, São Caetano do Sul, Brazil
| | - Tatiane Battagin
- Universidade Municipal de São Caetano do Sul, São Caetano do Sul, Brazil
| | | | - Júlia Gallego
- Universidade Municipal de São Caetano do Sul, São Caetano do Sul, Brazil
| | - Victoria Villela
- Universidade Municipal de São Caetano do Sul, São Caetano do Sul, Brazil
| | | | - Fabio E Leal
- Universidade Municipal de São Caetano do Sul, São Caetano do Sul, Brazil
| | - Julio Torales
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, Asunción, Paraguay
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Megan E Marziali
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Priscila D Gonçalves
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - João M Castaldelli-Maia
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
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9734
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Simic R, Ratkovic N, Dragojevic Simic V, Savkovic Z, Jakovljevic M, Peric V, Pandrc M, Rancic N. Cost Analysis of Health Examination Screening Program for Ischemic Heart Disease in Active-Duty Military Personnel in the Middle-Income Country. Front Public Health 2021; 9:634778. [PMID: 33748069 PMCID: PMC7969704 DOI: 10.3389/fpubh.2021.634778] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 01/08/2021] [Indexed: 11/13/2022] Open
Abstract
Cardiovascular diseases, including ischemic heart disease, are the most common causes of morbidity and death in the world, including Serbia, as a middle-income European country. The aim of the study was to determine the costs of preventive examinations for ischemic heart disease in active-duty military personnel, as well as to assess whether this was justified from the point of view of the limited health resources allocated for the treatment of the Republic of Serbia population. This is a retrospective cost-preventive study which included 738 male active-duty military personnel, aged from 23 to 58. The costs of primary prevention of ischemic heart disease in this population were investigated. Out of 738 subjects examined, arterial hypertension was detected in 101 subjects (in 74 of them, arterial hypertension was registered for the first time, while 27 subjects were already subjected to pharmacotherapy for arterial hypertension). Average costs of all services during the periodic-health-examination screening program were €76.96 per subject. However, average costs of all services during the periodic-health-examination screening program for patients with newfound arterial hypertension and poorly regulated arterial hypertension were €767.54 per patient and €2,103.63 per patient, respectively. Since periodic-health-examination screening program in military personnel enabled not only discovery of patient with newfound arterial hypertension but also regular monitoring of those who are already on antihypertensive therapy, significant savings of €690.58 per patient and €2,026.67 per patient can be achieved, respectively. As financial resources for providing health care in Serbia, as a middle-income country, are limited, further efforts should be put on screening programs for ischemic heart disease due to possible significant savings.
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Affiliation(s)
- Radoje Simic
- Department for Plastic Surgery, Institute for Mother and Child Health Care of Serbia Dr. Vukan Cupic, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nenad Ratkovic
- Medical Faculty of the Military Medical Academy, University of Defence in Belgrade, Belgrade, Serbia.,Sector for Treatment, Military Medical Academy, Belgrade, Serbia
| | - Viktorija Dragojevic Simic
- Medical Faculty of the Military Medical Academy, University of Defence in Belgrade, Belgrade, Serbia.,Center for Clinical Pharmacology, Military Medical Academy, Belgrade, Serbia
| | - Zorica Savkovic
- Faculty of Special Education and Rehabilitation, University of Belgrade, Belgrade, Serbia
| | - Mihajlo Jakovljevic
- Institute of Comparative Economic Studies, Hosei University, Tokyo, Japan.,Department of Global Health Economics and Policy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Vitomir Peric
- Medical Faculty of the Military Medical Academy, University of Defence in Belgrade, Belgrade, Serbia
| | - Milena Pandrc
- Clinic for Cardiology, Military Medical Academy, Belgrade, Serbia
| | - Nemanja Rancic
- Medical Faculty of the Military Medical Academy, University of Defence in Belgrade, Belgrade, Serbia.,Center for Clinical Pharmacology, Military Medical Academy, Belgrade, Serbia
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9735
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Affiliation(s)
- Angela H E M Maas
- Chair of Women's Cardiac Health Program, Department of Cardiology, Radboud University Medical Center, Geert Grooteplein-Zuid 10, Route 616, 6525GA Nijmegen, The Netherlands
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9736
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Xia C, Xu X, Zhao X, Hu S, Qiao Y, Zhang Y, Hutubessy R, Basu P, Broutet N, Jit M, Zhao F. Effectiveness and cost-effectiveness of eliminating cervical cancer through a tailored optimal pathway: a modeling study. BMC Med 2021; 19:62. [PMID: 33653331 PMCID: PMC7927373 DOI: 10.1186/s12916-021-01930-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/27/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The World Health Assembly has adopted a global strategy to eliminate cervical cancer. However, neither the optimal pathway nor the corresponding economic and health benefits have been evaluated. We take China as an example to assess the optimal pathway towards elimination and the cost-effectiveness of tailored actions. METHODS A validated hybrid model was used to assess the costs and benefits of alternative strategies combining human papillomavirus vaccination, cervical screening, and treatment of pre-invasive lesions and invasive cancer for females with different immunization history. All Chinese females living or projected to be born during 2015-2100, under projected trends in aging, urbanization, and sexual activity, were considered. Optimal strategies were determined by cost-effectiveness efficiency frontiers. Primary outcomes were cervical cancer cases and deaths averted and incremental cost-effectiveness ratios (ICERs). We employed a lifetime horizon from a societal perspective. One-way and probabilistic sensitivity analyses evaluate model uncertainty. RESULTS The optimal pathway represents an integration of multiple tailored strategies from females with different immunization history. If China adopts the optimal pathway, the age-standardized incidence of cervical cancer is predicted to decrease to fewer than four new cases per 100,000 women (i.e., elimination) by 2047 (95% confidence interval 2043 to 2050). Compared to the status quo, the optimal pathway would avert a total of 7,509,192 (6,922,744 to 8,359,074) cervical cancer cases and 2,529,873 (2,366,826 to 2,802,604) cervical cancer deaths in 2021-2100, with the discounted ICER being $- 339 (- 687 to - 79) per quality-adjusted life-year. CONCLUSIONS By adopting an optimal pathway from 2021 (namely, the year of the first Chinese Centennial Goals) onwards, cervical cancer could be eliminated by the late 2040s (namely, ahead of the second Chinese Centennial Goals) while saving net economic costs in China.
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Affiliation(s)
- Changfa Xia
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.17 Pan-jia-yuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Xiaoqian Xu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.17 Pan-jia-yuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Xuelian Zhao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.17 Pan-jia-yuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Shangying Hu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.17 Pan-jia-yuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Youlin Qiao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.17 Pan-jia-yuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Yong Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.17 Pan-jia-yuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Raymond Hutubessy
- Department of Immunization, Vaccines and Biologicals (IVB), World Health Organization, Geneva, Switzerland
| | - Partha Basu
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - Nathalie Broutet
- Department of Reproductive Health and Research - WHO Special Research Programme on Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Mark Jit
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.,School of Public Health, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Fanghui Zhao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.17 Pan-jia-yuan South Lane, Chaoyang District, Beijing, 100021, China.
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9737
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9738
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Bikomeye JC, Rublee CS, Beyer KMM. Positive Externalities of Climate Change Mitigation and Adaptation for Human Health: A Review and Conceptual Framework for Public Health Research. Int J Environ Res Public Health 2021; 18:2481. [PMID: 33802347 PMCID: PMC7967605 DOI: 10.3390/ijerph18052481] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 12/17/2022]
Abstract
Anthropogenic climate change is adversely impacting people and contributing to suffering and increased costs from climate-related diseases and injuries. In responding to this urgent and growing public health crisis, mitigation strategies are in place to reduce future greenhouse gas emissions (GHGE) while adaptation strategies exist to reduce and/or alleviate the adverse effects of climate change by increasing systems' resilience to future impacts. While these strategies have numerous positive benefits on climate change itself, they also often have other positive externalities or health co-benefits. This knowledge can be harnessed to promote and improve global public health, particularly for the most vulnerable populations. Previous conceptual models in mitigation and adaptation studies such as the shared socioeconomic pathways (SSPs) considered health in the thinking, but health outcomes were not their primary intention. Additionally, existing guidance documents such as the World Health Organization (WHO) Guidance for Climate Resilient and Environmentally Sustainable Health Care Facilities is designed primarily for public health professionals or healthcare managers in hospital settings with a primary focus on resilience. However, a detailed cross sectoral and multidisciplinary conceptual framework, which links mitigation and adaptation strategies with health outcomes as a primary end point, has not yet been developed to guide research in this area. In this paper, we briefly summarize the burden of climate change on global public health, describe important mitigation and adaptation strategies, and present key health benefits by giving context specific examples from high, middle, and low-income settings. We then provide a conceptual framework to inform future global public health research and preparedness across sectors and disciplines and outline key stakeholders recommendations in promoting climate resilient systems and advancing health equity.
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Affiliation(s)
- Jean C. Bikomeye
- PhD Program in Public and Community Health, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
| | - Caitlin S. Rublee
- Department of Emergency Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
| | - Kirsten M. M. Beyer
- PhD Program in Public and Community Health, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
- Division of Epidemiology, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
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9739
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Hurley MV, Irwin S, Erwin J, Gibney A, Hallett R, Carter A, Woolf A. Delivering NICE Joint Pain Advice in the workplace. Musculoskeletal Care 2021; 19:555-563. [PMID: 33650771 PMCID: PMC9290526 DOI: 10.1002/msc.1539] [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: 12/22/2020] [Revised: 01/14/2021] [Accepted: 01/14/2021] [Indexed: 11/19/2022]
Abstract
Background Chronic joint pain is extremely prevalent, but its impact can be mitigated if people receive self‐management/lifestyle advice, especially about the importance of physical activity and maintaining a healthy weight. To reach the large number of people who needs support, we devised Joint Pain Advice (JPA), an intervention that can be delivered in a variety of health and community settings by a range of healthcare and non‐healthcare professionals. Here we extend JPA delivery into workplace settings. Method In each workplace, an advisor was trained to deliver JPA. This involved an initial assessment of participant's pain, musculoskeletal health and function (MSK‐HQ), number of days/week active for >30 min, and physical function. Participants were taught simple self‐management strategies, encouraged to adopt healthier lifestyles using motivational interviewing, goal‐settings and personalised action/coping plans. Participants were reviewed three times over 6 months, baseline outcomes reassessed, progress highlighted, health messages reinforced and action plans revised, if necessary. Results Twenty large public organisations or small/medium enterprises delivered JPA to 481 people. Satisfaction with the service was high; people found it acceptable, valued advice tailored to their individual needs and experienced tangible benefits—MSK‐HQ (9.5 points; CI 8.3 to 10.6), pain (−1.7; −2.2 to −1.7), physical function (−2.0; −2.2 to −1.7), activity levels and self‐confidence improved, whilst absenteeism and healthcare utilisation reduced. Conclusion Delivering advice about self‐management for chronic knee, hip and back pain in workplace settings using local health promotion or occupational health professionals and is practicable, beneficial and valued. JPA could benefit small, medium and large employers.
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Affiliation(s)
- Michael V Hurley
- Faculty of Health, Social Care and Education, St George's University of London and Kingston University, London, UK.,Musculoskeletal Programme, Health Innovation Network, London, UK
| | - Sally Irwin
- Musculoskeletal Programme, Health Innovation Network, London, UK
| | - Jo Erwin
- Bone & Joint Research Group, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - Amber Gibney
- Musculoskeletal Programme, Health Innovation Network, London, UK
| | - Rachel Hallett
- Faculty of Health, Social Care and Education, St George's University of London and Kingston University, London, UK
| | - Andrea Carter
- Musculoskeletal Programme, Health Innovation Network, London, UK
| | - Anthony Woolf
- Bone & Joint Research Group, Royal Cornwall Hospitals NHS Trust, Truro, UK
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9740
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Downs SM, Fox EL. Uneven decline in food system inequality. Nat Food 2021; 2:141-142. [PMID: 37117456 DOI: 10.1038/s43016-021-00247-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- Shauna M Downs
- Department of Urban-Global Public Health, Rutgers School of Public Health, Newark, NJ, USA.
| | - Elizabeth L Fox
- Master of Public Health Program, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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9741
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Abstract
Importance State cannabis laws are changing rapidly. Research is inconclusive about their association with rates of self-harm and assault. Existing studies have not considered variations in cannabis commercialization across states over time. Objective To evaluate the association of state medical and recreational cannabis laws with self-harm and assault, overall and by age and sex, while considering varying degrees of commercialization. Design, Setting, and Participants Using a cohort design with panel fixed-effects analysis, within-state changes in claims for self-harm and assault injuries before and after changes in cannabis laws were quantified in all 50 US states and the District of Columbia. Comprehensive claims data on commercial and Medicare Advantage health plan beneficiaries from January 1, 2003, to December 31, 2017, grouped by state and month, were evaluated. Data analysis was conducted from January 31, 2020, to January 21, 2021. Exposures Categorical variable that indexed the degree of cannabis legalization in each state and month based on law type (medical or recreational) and operational status of dispensaries (commercialization). Main Outcomes and Measures Claims for self-harm and assault injuries based on International Classification of Diseases codes. Results The analysis included 75 395 344 beneficiaries (mean [SD] age, 47 [22] years; 50% female; and median follow-up, 17 months [interquartile range, 8-36 months]). During the study period, 29 states permitted use of medical cannabis and 11 permitted recreational cannabis. Point estimates for populationwide rates of self-harm and assault injuries were higher in states legalizing recreational cannabis compared with states with no cannabis laws, but these results were not statistically significant (adjusted rate ratio [aRR] assault, recreational dispensaries: 1.27; 95% CI, 0.79-2.03;self-harm, recreational dispensaries aRR: 1.15; 95% CI, 0.89-1.50). Results varied by age and sex with no associations found except for states with recreational policies and self-harm among males younger than 40 years (aRR <21 years, recreational without dispensaries: 1.70; 95% CI, 1.11-2.61; aRR aged 21-39 years, recreational dispensaries: 1.46; 95% CI, 1.01-2.12). Medical cannabis was generally not associated with self-harm or assault injuries populationwide or among age and sex subgroups. Conclusions and Relevance Recreational cannabis legalization appears to be associated with relative increases in rates of claims for self-harm among male health plan beneficiaries younger than 40 years. There was no association between cannabis legalization and self-harm or assault, for any other age and sex group or for medical cannabis. States that legalize but still constrain commercialization may be better positioned to protect younger male populations from unintended harms.
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Affiliation(s)
| | - Mathew V. Kiang
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, California
| | - Holly Elser
- Medical student, Stanford University School of Medicine, Palo Alto, California
| | - Laura Schmidt
- Philip R. Lee Institute for Health Policy Studies and Department of Humanities and Social Sciences, University of California, San Francisco
| | - Keith Humphreys
- Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California
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9742
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Ademi Z, Ackerman IN, Zomer E, Liew D. Productivity-Adjusted Life-Years: A New Metric for Quantifying Disease Burden. Pharmacoeconomics 2021; 39:271-273. [PMID: 33428173 PMCID: PMC7797495 DOI: 10.1007/s40273-020-00999-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 05/08/2023]
Affiliation(s)
- Zanfina Ademi
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Ilana N Ackerman
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Ella Zomer
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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9743
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Dávila-Cervantes CA, Pardo-Montaño AM. The burden of injuries in Mexico: Secondary data analysis from the Global Burden of Disease Study, 1990 to 2019. Injury 2021; 52:467-477. [PMID: 33612252 DOI: 10.1016/j.injury.2021.02.027] [Citation(s) in RCA: 4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/25/2021] [Accepted: 02/12/2021] [Indexed: 02/08/2023]
Abstract
IMPORTANCE Injuries have been a major cause of premature mortality and short-term and long-term disability in Mexico. OBJECTIVE To report the findings from the Global Burden of Disease 2019 study on injuries in Mexico at a national and subnational scale from 1990 to 2019. METHODS Following the 2019 Global Burden of Disease study we examined injury mortality, premature mortality, years lived with disability and disability-adjusted life-years according to 14 subcategories. We calculated the Pearson correlation coefficient between the injury burden and the socio-demographic index. RESULTS While the number of deaths from injuries increased significantly, the changes in the age-standardized mortality rates trended towards declines. Interpersonal violence, road injuries, falls and self-harm accounted for 8 of every 10 deaths from injury in 2019. Injury mortality and the disability-adjusted life-years rates decreased nationally and in most states in the period as a whole, but have increased since 2007. The injury burden was higher for men in all age groups. Interpersonal violence caused the highest disability-adjusted life-years rate in males and road injuries in females. The socio-demographic index increased in all states, while the injury age-standardized disability-adjusted life-years rates between 1990 and 2019 decreased, but there was no statistical association between both indicators. DISCUSSION AND CONCLUSIONS This study represents a comprehensive review of injury burden of disease in Mexico. The injury burden decreased, but improved heterogeneously among states. To further reduce the injury burden of disease, it's necessary for federal, state and local governments to prioritize safety promotion and injury prevention programs, infrastructure improvements, legislation, and enforcement at a national and subnational level. Mexico's injury prevention efforts should also be tailored for specific age groups, such as males aged 20-49 years or females in the younger and older age groups, and high-burden areas.
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Affiliation(s)
- Claudio Alberto Dávila-Cervantes
- Latin American Faculty of Social Sciences Mexico. Carretera al Ajusco 377, Colonia Héroes de Padierna, Tlalpan, Mexico City, Mexico. 14200
| | - Ana Melisa Pardo-Montaño
- Institute of Geography, UNAM. Circuito de la Investigación Científica, Ciudad Universitaria, C.U., Coyoacán, Mexico City, Mexico. 04510.
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9744
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Sulaymon ID, Zhang Y, Hopke PK, Zhang Y, Hua J, Mei X. COVID-19 pandemic in Wuhan: Ambient air quality and the relationships between criteria air pollutants and meteorological variables before, during, and after lockdown. Atmos Res 2021; 250:105362. [PMID: 33199931 PMCID: PMC7657938 DOI: 10.1016/j.atmosres.2020.105362] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/06/2020] [Accepted: 11/10/2020] [Indexed: 05/02/2023]
Abstract
As a result of the lockdown (LD) control measures enacted to curtail the COVID-19 pandemic in Wuhan, almost all non-essential human activities were halted beginning on January 23, 2020 when the total lockdown was implemented. In this study, changes in the concentrations of the six criteria air pollutants (PM2.5, PM10, SO2, NO2, CO, and O3) in Wuhan were investigated before (January 1 to 23, 2020), during (January 24 to April 5, 2020), and after the COVID-19 lockdown (April 6 to June 20, 2020) periods. Also, the relationships between the air pollutants and meteorological variables during the three periods were investigated. The results showed that there was significant improvement in air quality during the lockdown. Compared to the pre-lockdown period, the concentrations of NO2, PM2.5, PM10, and CO decreased by 50.6, 41.2, 33.1, and 16.6%, respectively, while O3 increased by 149% during the lockdown. After the lockdown, the concentrations of PM2.5, CO and SO2 declined by an additional 19.6, 15.6, and 2.1%, respectively. However, NO2, O3, and PM10 increased by 55.5, 25.3, and 5.9%, respectively, compared to the lockdown period. Except for CO and SO2, WS had negative correlations with the other pollutants during the three periods. RH was inversely related with all pollutants. Positive correlations were observed between temperature and the pollutants during the lockdown. Easterly winds were associated with peak PM2.5 concentrations prior to the lockdown. The highest PM2.5 concentrations were associated with southwesterly wind during the lockdown, and northwesterly winds coincided with the peak PM2.5 concentrations after the lockdown. Although, COVID-19 pandemic had numerous negative effects on human health and the global economy, the reductions in air pollution and significant improvement in ambient air quality likely had substantial short-term health benefits. This study improves the understanding of the mechanisms that lead to air pollution under diverse meteorological conditions and suggest effective ways of reducing air pollution in Wuhan.
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Affiliation(s)
- Ishaq Dimeji Sulaymon
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yuanxun Zhang
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
- CAS Center for Excellence in Regional Atmospheric Environment, Chinese Academy of Sciences, Xiamen 361021, China
| | - Philip K Hopke
- Center for Air Resources Engineering and Science, Clarkson University, Potsdam, NY 13699, USA
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Yang Zhang
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jinxi Hua
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xiaodong Mei
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
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9745
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Ranzani OT, Pescarini JM, Martinez L, Garcia-Basteiro AL. Increasing tuberculosis burden in Latin America: an alarming trend for global control efforts. BMJ Glob Health 2021; 6:e005639. [PMID: 33762254 PMCID: PMC7993346 DOI: 10.1136/bmjgh-2021-005639] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 12/14/2022] Open
Affiliation(s)
- Otavio T Ranzani
- Barcelona Institute for Global Health, ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
- Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Julia M Pescarini
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Leonardo Martinez
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Alberto L Garcia-Basteiro
- Barcelona Institute for Global Health, ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
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9746
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Zhang T, Chen H, Yin X, He Q, Man J, Yang X, Lu M. Changing trends of disease burden of gastric cancer in China from 1990 to 2019 and its predictions: Findings from Global Burden of Disease Study. Chin J Cancer Res 2021; 33:11-26. [PMID: 33707924 PMCID: PMC7941685 DOI: 10.21147/j.issn.1000-9604.2021.01.02] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [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] [Indexed: 02/06/2023] Open
Abstract
Objective China is one of the countries with the heaviest burden of gastric cancer (GC) in the world. Understanding the epidemiological trends and patterns of GC in China can contribute to formulating effective prevention strategies. Methods The data on incidence, mortality, and disability-adjusted life-years (DALYs) of GC in China from 1990 to 2019 were obtained from the Global Burden of Disease Study (2019). The estimated annual percentage change (EAPC) was calculated to evaluate the temporal trends of disease burden of GC, and the package Nordpred in the R program was used to perform an age-period-cohort analysis to predict the numbers and rates of incidence and mortality in the next 25 years. Results The number of incident cases of GC increased from 317.34 thousand in 1990 to 612.82 thousand in 2019, while the age-standardized incidence rate (ASIR) of GC decreased from 37.56 per 100,000 in 1990 to 30.64 per 100,000 in 2019, with an EAPC of -0.41 [95% confidence interval (95% CI): -0.77, -0.06]. Pronounced temporal trends in mortality and DALYs of GC were observed. In the next 25 years, the numbers of new GC cases and deaths are expected to increase to 738.79 thousand and 454.80 thousand, respectively, while the rates of incidence and deaths should steadily decrease. The deaths and DALYs attributable to smoking were different for males and females. Conclusions In China, despite the fact that the rates of GC have decreased during the past three decades, the numbers of new GC cases and deaths increased, and will continue to increase in the next 25 years. Additional strategies are needed to reduce the burden of GC, such as screening and early detection, novel treatments, and the prevention of risk factors.
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Affiliation(s)
- Tongchao Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Hui Chen
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan 250012, China.,Clinical Research Center of Shandong University, Jinan 250012, China
| | - Xiaolin Yin
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Qiufeng He
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Jinyu Man
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan 250012, China.,Clinical Research Center of Shandong University, Jinan 250012, China
| | - Ming Lu
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.,Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan 250012, China.,Clinical Research Center of Shandong University, Jinan 250012, China
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9747
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Liu S, Huang Q, Zhang X, Dong W, Zhang W, Wu S, Yang D, Nan B, Zhang J, Shen H, Guo X, Deng F. Cardiorespiratory Effects of Indoor Ozone Exposure Associated with Changes in Metabolic Profiles among Children: A Repeated-Measure Panel Study. ACTA ACUST UNITED AC 2021; 2:100087. [PMID: 34557741 DOI: 10.1016/j.xinn.2021.100087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/20/2020] [Accepted: 01/31/2021] [Indexed: 12/12/2022]
Abstract
Ozone is one of the major gaseous pollutants associated with short-term adverse cardiopulmonary effects, even at concentrations below the current indoor air quality limits. However, the underlying biological mechanisms of cardiorespiratory changes with exposure to ozone remain unclear. To further explore molecular linkages between indoor ozone exposure and relevant cardiorespiratory effects, a repeated-measure panel study including 46 schoolchildren was conducted and real-time exposure measurements including ozone were performed inside classrooms every weekday during the study period. Repeated health measurements and urine sample collection were conducted in each participant. Ultra-high-performance liquid chromatography/tandem mass spectrometry and meet-in-metabolite approach were used in metabolomics analysis. Methods including mixed-effect models were adopted to identify metabolites associated with ozone exposure or health indices. Nine metabolites were found to be associated with ozone after mixed-effect model analysis, which are mainly involved in amino acid and bile acid metabolism. Boys may have a greater decrease in bile acid and RNA related metabolites. Four of the nine ozone-related metabolites were also associated with cardiorespiratory function indices. Furthermore, 26.67% of the positive association between ozone and heart rate was mediated by cholestane-3,7,12,25-tetrol-3-glucuronide. Exposure to ozone below the current indoor standards was associated with the deteriorated cardiovascular function by disturbing bile acid and endogenous nitric oxide-related oxidation and inflammation, and associated with the exacerbated airway inflammation by reducing GPx-related anti-oxidation. The results provide metabolic evidence of the cardiorespiratory effects of indoor ozone exposure. Indoor ozone pollution should be controlled further, and more attention should be paid to preventing its adverse health effects, especially in children. Indoor O3 exposure far below the indoor air quality limits disturbed amino acid and bile acid metabolism of children Exposure to indoor O3 at low concentrations was associated with the deteriorated HRV, BP by affecting bile acid- and endogenous NO-related oxidation and inflammation Exposure to indoor O3 at low concentrations was associated with the aggravated airway inflammation by reducing GPx-related anti-oxidation The cardiorespiratory effects of low-level ozone exposure indoors in children require additional attention Indoor ozone pollution should be controlled further and the current indoor ozone standards should be revised
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9748
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Zhao L, Yang L, Guo Y, Xiao J, Zhang J, Xu S. New Insights into Stroke Prevention and Treatment: Gut Microbiome. Cell Mol Neurobiol 2021. [PMID: 33635417 DOI: 10.1007/s10571-021-01047-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 01/22/2021] [Indexed: 02/07/2023]
Abstract
Stroke, a lethal neurological disease, accounts for a grave economic burden on society. Despite extensive basic and clinical studies on stroke prevention, a precise effective treatment approach for stroke at this stage remains unavailable. The majority of our body's gut microbiota plays a vital role in food digestion, immune regulation, and nervous system development, which is highly associated with the development of some diseases. Multiple clinical studies have documented variation in the composition of gut microbiota between stroke patients and healthy counterparts. Moreover, the intervention of intestinal symbiotic microorganisms via several mechanisms plays an active role in stroke prognosis. In the prevention and treatment of stroke, the gut microbiota gives off a seductive glow, this is a promising therapeutic target. This paper summarizes the current knowledge of stroke and gut microbiota, and systematically describes the possible mechanisms of interaction between stroke and gut microbiota, the relationship between stroke-related risk factors and gut microbiota, and the treatment of gut flora using microorganisms. Thus, it could valuably elucidate the correlation of gut microbiota with stroke incidence, providing stroke researchers with a new strategy for stroke prevention and treatment by regulating gut microbiota.
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9749
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Carandina A, Lazzeri G, Villa D, Di Fonzo A, Bonato S, Montano N, Tobaldini E. Targeting the Autonomic Nervous System for Risk Stratification, Outcome Prediction and Neuromodulation in Ischemic Stroke. Int J Mol Sci 2021; 22:2357. [PMID: 33652990 DOI: 10.3390/ijms22052357] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 02/07/2023] Open
Abstract
Ischemic stroke is a worldwide major cause of mortality and disability and has high costs in terms of health-related quality of life and expectancy as well as of social healthcare resources. In recent years, starting from the bidirectional relationship between autonomic nervous system (ANS) dysfunction and acute ischemic stroke (AIS), researchers have identified prognostic factors for risk stratification, prognosis of mid-term outcomes and response to recanalization therapy. In particular, the evaluation of the ANS function through the analysis of heart rate variability (HRV) appears to be a promising non-invasive and reliable tool for the management of patients with AIS. Furthermore, preclinical molecular studies on the pathophysiological mechanisms underlying the onset and progression of stroke damage have shown an extensive overlap with the activity of the vagus nerve. Evidence from the application of vagus nerve stimulation (VNS) on animal models of AIS and on patients with chronic ischemic stroke has highlighted the surprising therapeutic possibilities of neuromodulation. Preclinical molecular studies highlighted that the neuroprotective action of VNS results from anti-inflammatory, antioxidant and antiapoptotic mechanisms mediated by α7 nicotinic acetylcholine receptor. Given the proven safety of non-invasive VNS in the subacute phase, the ease of its use and its possible beneficial effect in hemorrhagic stroke as well, human studies with transcutaneous VNS should be less challenging than protocols that involve invasive VNS and could be the proof of concept that neuromodulation represents the very first therapeutic approach in the ultra-early management of stroke.
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9750
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Steinberg J, Southam L, Roumeliotis TI, Clark MJ, Jayasuriya RL, Swift D, Shah KM, Butterfield NC, Brooks RA, McCaskie AW, Bassett JHD, Williams GR, Choudhary JS, Wilkinson JM, Zeggini E. A molecular quantitative trait locus map for osteoarthritis. Nat Commun 2021; 12:1309. [PMID: 33637762 PMCID: PMC7910531 DOI: 10.1038/s41467-021-21593-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [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: 07/09/2020] [Accepted: 02/03/2021] [Indexed: 12/20/2022] Open
Abstract
Osteoarthritis causes pain and functional disability for over 500 million people worldwide. To develop disease-stratifying tools and modifying therapies, we need a better understanding of the molecular basis of the disease in relevant tissue and cell types. Here, we study primary cartilage and synovium from 115 patients with osteoarthritis to construct a deep molecular signature map of the disease. By integrating genetics with transcriptomics and proteomics, we discover molecular trait loci in each tissue type and omics level, identify likely effector genes for osteoarthritis-associated genetic signals and highlight high-value targets for drug development and repurposing. These findings provide insights into disease aetiopathology, and offer translational opportunities in response to the global clinical challenge of osteoarthritis.
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Affiliation(s)
- Julia Steinberg
- Institute of Translational Genomics, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia
- Wellcome Sanger Institute, Hinxton, United Kingdom
- School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Lorraine Southam
- Institute of Translational Genomics, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
- Wellcome Sanger Institute, Hinxton, United Kingdom
| | - Theodoros I Roumeliotis
- Wellcome Sanger Institute, Hinxton, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Matthew J Clark
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Raveen L Jayasuriya
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Diane Swift
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Karan M Shah
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Natalie C Butterfield
- Molecular Endocrinology Laboratory, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
| | - Roger A Brooks
- Division of Trauma & Orthopaedic Surgery, Department of Surgery, University of Cambridge, Cambridge, United Kingdom
| | - Andrew W McCaskie
- Division of Trauma & Orthopaedic Surgery, Department of Surgery, University of Cambridge, Cambridge, United Kingdom
| | - J H Duncan Bassett
- Molecular Endocrinology Laboratory, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
| | - Graham R Williams
- Molecular Endocrinology Laboratory, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
| | - Jyoti S Choudhary
- Wellcome Sanger Institute, Hinxton, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - J Mark Wilkinson
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom.
- Centre for Integrated Research into Musculoskeletal Ageing and Sheffield Healthy Lifespan Institute, University of Sheffield, Sheffield, United Kingdom.
| | - Eleftheria Zeggini
- Institute of Translational Genomics, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
- Wellcome Sanger Institute, Hinxton, United Kingdom.
- TUM School of Medicine, Technical University of Munich and Klinikum Rechts der Isar, Munich, Germany.
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