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Gong D, Chen X, Yang L, Zhang Y, Zhong Q, Liu J, Yan C, Cai Y, Yang W, Wang J. From normal population to prediabetes and diabetes: study of influencing factors and prediction models. Front Endocrinol (Lausanne) 2023; 14:1225696. [PMID: 37964953 PMCID: PMC10640999 DOI: 10.3389/fendo.2023.1225696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/29/2023] [Indexed: 11/09/2023] Open
Abstract
Objective The purpose of this study is to investigate the independent influencing factors of the transition from normal population to prediabetes, and from prediabetes to diabetes, and to further construct clinical prediction models to provide a basis for the prevention and management of prediabetes and diabetes. Materials and methods The data for this study were based on clinical information of participants from the Health Management Center of Peking University Shenzhen Hospital. Participants were classified into normal group, prediabetes group, and diabetes group according to their functional status of glucose metabolism. Spearman's correlation coefficients were calculated for the variables, and a matrix diagram was plotted. Further, univariate and multivariate logistic regression analysis were conducted to explore the independent influencing factors. The independent influencing factors were used as predictors to construct the full-variable prediction model (Full.model) and simplified prediction model (Simplified.model). Results This study included a total of 5310 subjects and 22 variables, among which there were 1593(30%) in the normal group, 3150(59.3%) in the prediabetes group, and 567(10.7%) in the diabetes group. The results of the multivariable logistic regression analysis showed that there were significant differences in 9 variables between the normal group and the prediabetes group, including age(Age), body mass index(BMI), systolic blood pressure(SBP), urinary glucose(U.GLU), urinary protein(PRO), total protein(TP), globulin(GLB), alanine aminotransferase(ALT), and high-density lipoprotein cholesterol(HDL-C). There were significant differences in 7 variables between the prediabetes group and the diabetes group, including Age, BMI, SBP, U.GLU, PRO, triglycerides(TG), and HDL.C. The Full.model and Simplified.model constructed based on the above influencing factors had moderate discriminative power in both the training set and the test set. Conclusion Age, BMI, SBP, U.GLU, PRO, TP, and ALT are independent risk factors, while GLB and HDL.C are independent protective factors for the development of prediabetes in the normal population. Age, BMI, SBP, U.GLU, PRO, and TG are independent risk factors, while HDL.C is an independent protective factor for the progression from prediabetes to diabetes. The Full.model and Simplified.model developed based on these influencing factors have moderate discriminative power.
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Affiliation(s)
- Di Gong
- Shenzhen Eye Hospital, Jinan University, Shenzhen, Guangdong, China
- The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, Guangdong, China
| | - Xiaohong Chen
- Center of Health Management, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Lin Yang
- Center of Health Management, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Yongjian Zhang
- Center of Health Management, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Qianqian Zhong
- Center of Health Management, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Jing Liu
- Center of Health Management, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Chen Yan
- Shenzhen Eye Hospital, Jinan University, Shenzhen, Guangdong, China
| | - Yongjiang Cai
- Center of Health Management, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Weihua Yang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Jiantao Wang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
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Li XF, Shi YM, Niu R, Shao XN, Wang JF, Shao XL, Zhang FF, Wang YT. Risk analysis in peripheral clinical T1 non-small cell lung cancer correlations between tumor-to-blood standardized uptake ratio on 18F-FDG PET-CT and primary tumor pathological invasiveness: a real-world observational study. Quant Imaging Med Surg 2022; 12:159-171. [PMID: 34993068 DOI: 10.21037/qims-21-394] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/09/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Sublobar resection is not suitable for patients with pathological invasiveness [including lymph node metastasis (LNM), visceral pleural invasion (VPI), and lymphovascular invasion (LVI)] of peripheral clinical T1 (cT1) non-small cell lung cancer (NSCLC), while primary tumor maximum standardized uptake value (SUVmax) on 18F-FDG PET-CT is related to pathological invasiveness, the significance differed among different institutions is still challenging. This study explored the relationship between the tumor-to-blood standardized uptake ratio (SUR) of 18F-FDG PET-CT and primary tumor pathological invasiveness in peripheral cT1 NSCLC patients. METHODS This retrospective study included 174 patients with suspected lung neoplasms who underwent preoperative 18F-FDG PET-CT. We compared the differences of the clinicopathological variables, metabolic and morphological parameters in the pathological invasiveness and less-invasiveness group. We performed a trend test for these parameters based on the tertiles of SUR. The relationship between SUR and pathological invasiveness was evaluated by univariate and multivariate logistics regression models (included unadjusted, simple adjusted, and fully adjusted models), odds ratios (ORs), and 95% confidence intervals (95% CIs) were calculated. A smooth fitting curve between SUR and pathological invasiveness was produced by the generalized additive model (GAM). RESULTS Thirty-eight point five percent of patients had pathological invasiveness and tended to have a higher SUR value than the less-invasiveness group [6.50 (4.82-11.16) vs. 4.12 (2.04-6.61), P<0.001]. The trend of SUVmax, mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), mean CT value (CTmean), size of the primary tumor, neuron-specific enolase (NSE), the incidence of LNM, adenocarcinoma (AC), and poor differentiation in the tertiles of SUR value were statistically significant (P were <0.001, <0.001, 0.010, <0.001, <0.001, 0.002, 0.033, <0.001, 0.002, and <0.001, respectively). Univariate analysis showed that the risk of pathological invasiveness increased significantly with increasing SUR [OR: 1.13 (95% CI: 1.06-1.21), P<0.001], and multivariate analysis demonstrated SUR, as a continuous variable, was still significantly related to pathological invasiveness [OR: 1.09 (95% CI: 1.01-1.18), P=0.032] after adjusting for confounding covariates. GAM revealed that SUR tended to be linearly and positively associated with pathological invasiveness and E-value analysis suggested robustness to unmeasured confounding. CONCLUSIONS SUR is linearly and positively associated with primary tumor pathological invasiveness independent of confounding covariates in peripheral cT1 NSCLC patients and could be used as a supplementary risk maker to assess the risk of pathological invasiveness.
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Affiliation(s)
- Xiao-Feng Li
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Department of Radiology, Xuzhou Cancer Hospital, Xuzhou, China
| | - Yun-Mei Shi
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Rong Niu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xiao-Nan Shao
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jian-Feng Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xiao-Liang Shao
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Fei-Fei Zhang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yue-Tao Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Changzhou Key Laboratory of Molecular Imaging, Changzhou, China
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Sun RC, Mehl SC, Anbarasu CR, Portuondo JI, Espinoza AF, Whitlock R, Mazziotti MV. Intercostal cryoablation during Nuss procedure: A large volume single surgeon's experience and outcomes. J Pediatr Surg 2021; 56:2229-2234. [PMID: 33853732 DOI: 10.1016/j.jpedsurg.2021.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/09/2021] [Accepted: 03/05/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recent studies have shown intercostal cryoablation(IC) during the Nuss procedure decreases hospital length of stay(LOS) and opioid administration. However, few studies have also evaluated the risk of postoperative complications related to IC. METHODS We performed a single center retrospective analysis of all patients who underwent Nuss procedure by one surgeon from 2/2016 to 2/2020, comparing intraoperative IC to other pain management modalities(non-IC). Primary outcomes were postoperative complications, hospital LOS, and opioid administration. Multivariate analysis was performed with outcomes reported as regression coefficients(RC) or odds ratios(OR) with 95% confidence interval. RESULTS IC was associated with decreased hospital LOS (RC -1.91[-2.29 to -1.54], less hospital opioid administration (RC -4.28[-5.13 to -3.43]), and less discharge opioid administration (RC -3.82[-5.23 to -2.41]). With respect to postoperative complications, IC decreased the odds of urinary retention (OR 0.16[0.06 to 0.44]); however, increased the odds of slipped bars requiring reoperation (OR 36.65[5.04-266.39]). CONCLUSIONS Our single surgeon experience controls for surgeon variability and demonstrates intraoperative IC for the Nuss procedure is an effective pain management modality that decreases hospital LOS and opioid use during hospitalization and at discharge; however, it is associated with increased odds of slipped bars requiring reoperation. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Raphael C Sun
- Department of Surgery, Division of Pediatric Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States; Department of Surgery, Baylor College of Medicine, Houston, TX, United States.
| | - Steven C Mehl
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
| | - Centura R Anbarasu
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
| | - Jorge I Portuondo
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
| | - Andres F Espinoza
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
| | - Richard Whitlock
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
| | - Mark V Mazziotti
- Department of Surgery, Division of Pediatric Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States; Department of Surgery, Baylor College of Medicine, Houston, TX, United States
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Jie W, Lin G, Liu Z, Zhou H, Lin L, Liang G, Ou M, Lin M. The Relationship Between Enlarged Perivascular Spaces and Cognitive Function: A Meta-Analysis of Observational Studies. Front Pharmacol 2020; 11:715. [PMID: 32499704 PMCID: PMC7243265 DOI: 10.3389/fphar.2020.00715] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/30/2020] [Indexed: 01/11/2023] Open
Abstract
Enlarged perivascular spaces (ePVS), visible on magnetic resonance imaging (MRI), are associated with aortic pulse wave changes produced by arterial stiffening. However, the relationship between ePVS and cognition is still unclear. We aimed to benchmark current knowledge of associations between ePVS and cognitive function using a meta-analysis of all available published data. We searched three databases for studies examining ePVS and cognition, identified seven studies involving 7,816 participants, plotted multivariate-adjusted odds ratio (OR) and 95% CI and generated summary OR with a fixed effects model. EPVS were related to the risk of impaired cognition (OR = 1.387, 95% CI = 1.198–1.606, z=4.38, P<0.001) with low heterogeneity. There was publication bias, which could be corrected by trimming and supplementation (OR=1.297, 95% CI= 1.130–1.490). EPVS were associated with impaired cognition and may be a sign of cognitive impairment rather than particular diseases. More studies are required to validate ePVS as a measurable risk marker for cognition using consistent methods to determinea characteristic appearance of ePVS.
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Affiliation(s)
- Wanxin Jie
- Department of Neurology, Institute of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Guanghong Lin
- Medical Intensive Care Unit, Central People's Hospital of Zhanjiang, Zhanjiang, China
| | - Zhou Liu
- Department of Neurology, Institute of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Haihong Zhou
- Department of Neurology, Institute of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Lifeng Lin
- Department of Neurology, Institute of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Guocong Liang
- Department of Neurology, Institute of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Mingqian Ou
- Department of Neurology, Institute of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Meijun Lin
- Department of Neurology, Institute of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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Zhang Y, Jing L, Sun C, Fang J, Feng Y. Human factors related to major road traffic accidents in China. Traffic Inj Prev 2019; 20:796-800. [PMID: 31710507 DOI: 10.1080/15389588.2019.1670817] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 07/30/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Abstract
Objective: The goals of this research are to: (i) investigate the contributing factors of major road traffic accidents using a human factors classification that follows the ideas of the human factors analysis and classification system (HFACS); (ii) quantitatively examine the relationships between the human factors of the cross levels in an entire system.Methods: This study examined 234 major road traffic accidents recorded in 27 Chinese provinces from 1997 to 2014. Odds ratio (OR) was used to quantitatively analyze the relationships among the contributing factors.Results: The frequencies of unsafe acts, violations, and inadequate regulation are the highest in five categories, 15 subcategories, and 63 indicators, respectively. This study has demonstrated a number of associations between the upper and adjacent lower levels. At the outside factors level, "failure to provide supervision for regulatory" can be viewed as a strong predictor to "formal accountability for actions," "norms and rules," and "values and beliefs." At the organizational influences level, "formal accountability for actions," "norms and rules," and "values and beliefs" were strong predictors. At the unsafe supervision level, "failure to provide oversight," "failure to initiate corrective action," and "failure to enforce rules and regulations" had strong prediction on "fatigue driving." At the preconditions for unsafe acts level, "visual limitation", "fatigue driving," and "vehicle faults" were strong predictors.Conclusions: The generic HFACS failure types were interpreted and applied successfully to the road safety context, and such examination of major accidents has provided significant findings concerning the main contributing factors of those accidents. Using the OR technique, this study has demonstrated a number of associations between the upper level and adjacent lower levels in the entire system and has found the routes to failure, which is particularly important for developing countermeasures and remediation strategies, as it ensures that these countermeasures are targeted to a wider range of systems. Furthermore, these findings demonstrate the efficiency and applicability of the HFACS as a retrospective tool for the analysis of major road traffic accidents.
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Affiliation(s)
- Yingyu Zhang
- School of Management, Qufu Normal University, Rizhao, China
| | - Linlin Jing
- School of Management, Qufu Normal University, Rizhao, China
| | - Chang Sun
- School of Management, Qufu Normal University, Rizhao, China
| | - Jianlei Fang
- School of Management, Northeast Forestry University, Harbin, China
| | - Yan Feng
- School of Management, China University of Mining and Technology, Xuzhou, China
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