1
|
Wu Y, Mo H, Xu H, Wang Y, Wang J, Ma F, Xu B. Impact of HER2-low expression on the efficacy of endocrine therapy with or without CDK4/6 inhibitor in HR-positive/HER2-negative metastatic breast cancer: A prospective study. Thorac Cancer 2024; 15:965-973. [PMID: 38480513 PMCID: PMC11045331 DOI: 10.1111/1759-7714.15282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/16/2024] [Accepted: 02/29/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND CDK4/6 inhibitors in combination with traditional endocrine therapy (ET) have become the recommended first-line therapy for HR-positive/HER2-negative metastatic breast cancer (MBC). The aim of this prospective study was to evaluate the relationship between HER2-low expression and clinical outcomes in HR-positive/HER2-negative MBC patients receiving ET with or without CDK4/6 inhibitors. METHODS Between April 2016 and November 2019, 233 women with HR-positive/HER2-negative MBC who received ET with or without CDK4/6 inhibitors were enrolled into the study. The primary endpoint was progression-free survival (PFS). Statistical analysis included descriptive statistics, Kaplan-Meier curves, and Cox proportional hazards models. RESULTS HER2-low and HER2-zero subgroups in the CDK4/6 inhibitor plus ET cohort showed no significant difference in the median PFS (10.9 vs. 8.0 months; hazard ratio: 0.92; 95% confidence interval [CI]: 0.64-1. 30; p = 0.65), while HER2-low subgroup showed a significantly shorter median PFS compared to the HER2-zero subgroup in the ET alone cohort (5.6 vs. 17.0 months; hazard ratio: 2.82; 95% CI: 1.34-5.93; p = 0.0044). Moreover, the objective response rate was significantly lower in the HER2-low subgroup than the HER2-zero subgroup in the ET alone cohort (10.5% vs. 40.0%, p = 0.047). Lastly, no significant difference was observed in the overall survival between the HER2-low and HER2-zero subgroups in both cohorts. CONCLUSION This study suggested that HER2-low expression may predict the efficacy of ET but not that of CDK4/6 inhibitor plus ET in HR-positive/HER2-negative MBC patients. The results of this study highlight the importance of integrating HER2 status in tailoring personalized treatment strategies for HR-positive MBC.
Collapse
Affiliation(s)
- Yun Wu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Hongnan Mo
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Hangcheng Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Yan Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jiayu Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Fei Ma
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Binghe Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| |
Collapse
|
2
|
Goodman MO, Dashti HS, Lane JM, Windred DP, Burns A, Jones SE, Sofer T, Purcell SM, Zhu X, Ollila HM, Kyle SD, Spiegelhalder K, Peker Y, Huang T, Cain SW, Phillips AJK, Saxena R, Rutter MK, Redline S, Wang H. Causal Association Between Subtypes of Excessive Daytime Sleepiness and Risk of Cardiovascular Diseases. J Am Heart Assoc 2023; 12:e030568. [PMID: 38084713 PMCID: PMC10863774 DOI: 10.1161/jaha.122.030568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/03/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Excessive daytime sleepiness (EDS), experienced in 10% to 20% of the population, has been associated with cardiovascular disease and death. However, the condition is heterogeneous and is prevalent in individuals having short and long sleep duration. We sought to clarify the relationship between sleep duration subtypes of EDS with cardiovascular outcomes, accounting for these subtypes. METHODS AND RESULTS We defined 3 sleep duration subtypes of excessive daytime sleepiness: normal (6-9 hours), short (<6 hours), and long (>9 hours), and compared these with a nonsleepy, normal-sleep-duration reference group. We analyzed their associations with incident myocardial infarction (MI) and stroke using medical records of 355 901 UK Biobank participants and performed 2-sample Mendelian randomization for each outcome. Compared with healthy sleep, long-sleep EDS was associated with an 83% increased rate of MI (hazard ratio, 1.83 [95% CI, 1.21-2.77]) during 8.2-year median follow-up, adjusting for multiple health and sociodemographic factors. Mendelian randomization analysis provided supporting evidence of a causal role for a genetic long-sleep EDS subtype in MI (inverse-variance weighted β=1.995, P=0.001). In contrast, we did not find evidence that other subtypes of EDS were associated with incident MI or any associations with stroke (P>0.05). CONCLUSIONS Our study suggests the previous evidence linking EDS with increased cardiovascular disease risk may be primarily driven by the effect of its long-sleep subtype on higher risk of MI. Underlying mechanisms remain to be investigated but may involve sleep irregularity and circadian disruption, suggesting a need for novel interventions in this population.
Collapse
Affiliation(s)
- Matthew O. Goodman
- Division of Sleep and Circadian DisordersBrigham and Women’s HospitalBostonMA
- Department of Neurology and MedicineHarvard Medical School, Brigham and Women’s HospitalBostonMA
- Broad InstituteCambridgeMA
| | - Hassan S. Dashti
- Broad InstituteCambridgeMA
- Center for Genomic MedicineMassachusetts General Hospital and Harvard Medical SchoolBostonMA
- Department of Anesthesia, Critical Care and Pain MedicineMassachusetts General HospitalBostonMA
| | - Jacqueline M. Lane
- Division of Sleep and Circadian DisordersBrigham and Women’s HospitalBostonMA
- Department of Neurology and MedicineHarvard Medical School, Brigham and Women’s HospitalBostonMA
- Broad InstituteCambridgeMA
- Center for Genomic MedicineMassachusetts General Hospital and Harvard Medical SchoolBostonMA
| | - Daniel P. Windred
- School of Psychological SciencesTurner Institute for Brain and Mental Health, Monash UniversityMelbourneVictoriaAustralia
| | - Angus Burns
- Broad InstituteCambridgeMA
- Center for Genomic MedicineMassachusetts General Hospital and Harvard Medical SchoolBostonMA
- School of Psychological SciencesTurner Institute for Brain and Mental Health, Monash UniversityMelbourneVictoriaAustralia
| | - Samuel E. Jones
- Institute for Molecular Medicine Finland (FIMM)University of HelsinkiFinland
- University of Exeter Medical SchoolExeterUnited Kingdom
| | - Tamar Sofer
- Division of Sleep and Circadian DisordersBrigham and Women’s HospitalBostonMA
- Department of Neurology and MedicineHarvard Medical School, Brigham and Women’s HospitalBostonMA
- Department of BiostatisticsHarvard T.H. Chan School of Public HealthBostonMA
| | - Shaun M. Purcell
- Division of Sleep and Circadian DisordersBrigham and Women’s HospitalBostonMA
- Department of Neurology and MedicineHarvard Medical School, Brigham and Women’s HospitalBostonMA
- Broad InstituteCambridgeMA
- Department of PsychiatryBrigham and Women’s HospitalBostonMA
| | - Xiaofeng Zhu
- Department of Population and Quantitative Health SciencesCase Western Reserve UniversityClevelandOH
| | - Hanna M. Ollila
- Broad InstituteCambridgeMA
- Center for Genomic MedicineMassachusetts General Hospital and Harvard Medical SchoolBostonMA
- Department of Anesthesia, Critical Care and Pain MedicineMassachusetts General HospitalBostonMA
- Institute for Molecular Medicine Finland (FIMM)University of HelsinkiFinland
| | - Simon D. Kyle
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical NeurosciencesUniversity of OxfordUnited Kingdom
| | - Kai Spiegelhalder
- Department of Psychiatry and PsychotherapyMedical Centre–University of Freiburg, Faculty of Medicine, University of FreiburgFreiburgGermany
| | - Yuksel Peker
- Division of Sleep and Circadian DisordersBrigham and Women’s HospitalBostonMA
- Department of Neurology and MedicineHarvard Medical School, Brigham and Women’s HospitalBostonMA
- Department of Pulmonary MedicineKoç University School of MedicineIstanbulTurkey
- Sahlgrenska AcademyUniversity of GothenburgSweden
- Department of Clinical Sciences, Respiratory Medicine and Allergology, Faculty of MedicineLund UniversityLundSweden
- Division of Pulmonary, Allergy, and Critical Care MedicineUniversity of Pittsburgh School of MedicinePittsburghPA
| | - Tianyi Huang
- Department of Neurology and MedicineHarvard Medical School, Brigham and Women’s HospitalBostonMA
- Channing Division of Network MedicineBrigham and Women’s Hospital, Harvard Medical SchoolBostonMA
| | - Sean W. Cain
- School of Psychological SciencesTurner Institute for Brain and Mental Health, Monash UniversityMelbourneVictoriaAustralia
| | - Andrew J. K. Phillips
- School of Psychological SciencesTurner Institute for Brain and Mental Health, Monash UniversityMelbourneVictoriaAustralia
| | - Richa Saxena
- Broad InstituteCambridgeMA
- Center for Genomic MedicineMassachusetts General Hospital and Harvard Medical SchoolBostonMA
- Department of Anesthesia, Critical Care and Pain MedicineMassachusetts General HospitalBostonMA
| | - Martin K. Rutter
- Division of Endocrinology, Diabetes & Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUnited Kingdom
- Diabetes, Endocrinology and Metabolism CentreManchester University NHS Foundation Trust, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science CentreManchesterUnited Kingdom
| | - Susan Redline
- Division of Sleep and Circadian DisordersBrigham and Women’s HospitalBostonMA
- Department of Neurology and MedicineHarvard Medical School, Brigham and Women’s HospitalBostonMA
| | - Heming Wang
- Division of Sleep and Circadian DisordersBrigham and Women’s HospitalBostonMA
- Department of Neurology and MedicineHarvard Medical School, Brigham and Women’s HospitalBostonMA
- Broad InstituteCambridgeMA
| |
Collapse
|
3
|
Zhao J, Tian L, Xia B, Mi N, He Q, Yang M, Wang D, Wu S, Li Z, Zhang S, Zhang X, Yue P, Lin Y, Zhao H, Zhang B, Ma Z, Jiang N, Li M, Yuan J, Nie P, Lu L, Meng W. Cholecystectomy is associated with a higher risk of irritable bowel syndrome in the UK Biobank: a prospective cohort study. Front Pharmacol 2023; 14:1244563. [PMID: 38143491 PMCID: PMC10749201 DOI: 10.3389/fphar.2023.1244563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/28/2023] [Indexed: 12/26/2023] Open
Abstract
Background: Recent studies have shown that bile acids are essential in irritable bowel syndrome (IBS) pathology, and cholecystectomy has direct effects on bile acid metabolism. However, whether cholecystectomy increases the risk of IBS remains unclear. We aimed to investigate the association between cholecystectomy and IBS risk in the UK Biobank (UKB). Methods: This study is a prospective analysis of 413,472 participants who were free of IBS, inflammatory bowel disease, cancer, or common benign digestive tract diseases. We identified incidents of IBS through self-reporting or links to primary healthcare and hospitalization data. We evaluated hazard ratios (HRs) adjusted for sociodemographic characteristics, health behaviours, comorbidities, and medications. Results: During a median follow-up period of 12.7 years, we observed 15,503 new cases of IBS. Participants with a history of cholecystectomy had a 46% higher risk of IBS than those without (HR = 1.46, 95% CI: 1.32-1.60), and further subtype analysis showed that the risk of IBS with diarrhoea was significantly higher than the risk of IBS without diarrhoea (HR = 1.71, 95% CI: 1.30-2.25 vs. HR = 1.42, 95% CI: 1.28-1.58). The overall covariate-adjusted HRs for IBS were similar between the group with both cholecystectomy and gallstones (HR = 1.45, 95% CI: 1.32-1.58) and the group with cholecystectomy without gallstones (HR = 1.50, 95% CI: 1.36-1.67) when the group without both cholecystectomy and gallstones was used as a reference. The overall covariate-adjusted HR was not significantly different in the group without cholecystectomy with gallstones (HR = 1.18, 95% CI: 0.95-1.47). The positive association of cholecystectomy with IBS risk did not change when stratifying the data based on age, sex, BMI, smoking, alcohol consumption, healthy diet, quality sleep, physical activity, type 2 diabetes, hypertension, hyperlipidaemia, mental illness, NSAID intake, or acid inhibitor intake. Sensitivity analyses, including propensity score matching analysis and lagging the exposure for two or four years, indicated that the effects were robust. Conclusion: Cholecystectomy was associated with a higher risk of IBS, especially IBS with diarrhoea. Additional prospective randomized controlled and experimental studies are warranted to further validate the association and to explore the relevant biological mechanisms.
Collapse
Affiliation(s)
- Jinyu Zhao
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Liang Tian
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Bin Xia
- Scientific Research Center, Big Data Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China
- Clinical Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China
- Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Ningning Mi
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Qiangsheng He
- Scientific Research Center, Big Data Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China
- Clinical Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China
- Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Man Yang
- Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Danni Wang
- Scientific Research Center, Big Data Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Siqing Wu
- School of Medicine, Shenzhen Campus of Sun Yat-Sen University, Shenzhen, China
| | - Zijun Li
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Shiyong Zhang
- Department of Joint Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xianzhuo Zhang
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Ping Yue
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Yanyan Lin
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Haitong Zhao
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Baoping Zhang
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Zelong Ma
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Ningzu Jiang
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Matu Li
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Jinqiu Yuan
- Scientific Research Center, Big Data Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China
- Clinical Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China
- Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Peng Nie
- Department of Gastric Surgery, Gansu Wuwei Tumour Hospital, Wuwei Academy of Medical Science, Wuwei, Gansu, China
| | - Linzhi Lu
- Wuwei Oncology Hospital, Wuwei, Gansu, China
| | - Wenbo Meng
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| |
Collapse
|
4
|
Zaribafzadeh H, Webster WL, Vail CJ, Daigle T, Kirk AD, Allen PJ, Henao R, Buckland DM. Development, Deployment, and Implementation of a Machine Learning Surgical Case Length Prediction Model and Prospective Evaluation. Ann Surg 2023; 278:890-895. [PMID: 37264901 PMCID: PMC10631498 DOI: 10.1097/sla.0000000000005936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To implement a machine learning model using only the restricted data available at case creation time to predict surgical case length for multiple services at different locations. BACKGROUND The operating room is one of the most expensive resources in a health system, estimated to cost $22 to $133 per minute and generate about 40% of hospital revenue. Accurate prediction of surgical case length is necessary for efficient scheduling and cost-effective utilization of the operating room and other resources. METHODS We introduced a similarity cascade to capture the complexity of cases and surgeon influence on the case length and incorporated that into a gradient-boosting machine learning model. The model loss function was customized to improve the balance between over- and under-prediction of the case length. A production pipeline was created to seamlessly deploy and implement the model across our institution. RESULTS The prospective analysis showed that the model output was gradually adopted by the schedulers and outperformed the scheduler-predicted case length from August to December 2022. In 33,815 surgical cases across outpatient and inpatient platforms, the operational implementation predicted 11.2% fewer underpredicted cases and 5.9% more cases within 20% of the actual case length compared with the schedulers and only overpredicted 5.3% more. The model assisted schedulers to predict 3.4% more cases within 20% of the actual case length and 4.3% fewer underpredicted cases. CONCLUSIONS We created a unique framework that is being leveraged every day to predict surgical case length more accurately at case posting time and could be potentially utilized to deploy future machine learning models.
Collapse
Affiliation(s)
- Hamed Zaribafzadeh
- Department of Biostatistics and Bioinformatics, and Department of Surgery, Duke University, Durham, NC
| | | | | | - Thomas Daigle
- Duke Health Technology Solutions, Duke University Health System, Durham, NC
| | | | | | - Ricardo Henao
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC
| | - Daniel M. Buckland
- Department of Surgery, Duke University, Durham, NC
- Department of Emergency Medicine and Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC
| |
Collapse
|
5
|
Issack FH, Hassen SM, Tefera AT, Teshome H, Gebreselassie KH, Mummed FO. Short-term recurrence rate of male urethral stricture and its predictors after treatment with optical internal urethrotomy: Prospective Cohort Study at a tertiary center in Ethiopia. Ann Med Surg (Lond) 2023; 85:4715-4719. [PMID: 37811100 PMCID: PMC10553156 DOI: 10.1097/ms9.0000000000001253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 08/19/2023] [Indexed: 10/10/2023] Open
Abstract
Abstract Background Although optical internal urethrotomy is popular among the urologists due to its simplicity and safety, urethroplasty is considered the gold standard treatment for urethral strictures. This study aims to determine the 1-year recurrence rate of urethral strictures after optical urethrotomy and identify predictors of recurrence in a tertiary center in Ethiopia. Methods A prospective observational cohort study was conducted on 80 male patients who underwent optical urethrotomy from November 2019 to August 2020 in a tertiary center in Ethiopia. Logistic regression was used to analyze the association between dependent and independent variables, with a P-value of <0.05 considered statistically significant. Results The mean and median age (±SD) of patients at the time of the procedure were 54.76 (±14.74) and 58 years with a range [20-78], respectively. Urethral discharge was the most common etiology identified in 39 (48.75%) of patients. Eleven (13.75%) patients had no identifiable etiology for their urethral stricture disease.The majority of patients presented with at least one voiding lower urinary tract symptoms.Sixty-eight (85%) patients out of the total had a single stricture and 12 (15%) had multiple strictures. The location of the stricture was in the bulbar urethra on cystourethrography in 83% of the patients. The 1-year recurrence rate of urethral stricture after optical urethrotomy was 35% in our study.The number of strictures and the presence of hypertension were independent predictors of recurrence of urethral stricture within 1-year after treatment with optical urethrotomy (AOR=15.35, 95% CI: 2.92-80.61, P=0.00; AOR=19.47, 95% CI: 2.11-178.98, P=0.01, respectively). Conclusions Our study identified that multiple strictures, and the presence of hypertension are associated with an increased recurrence rate in the first postoperative year.
Collapse
Affiliation(s)
- Feysel H. Issack
- Department of Surgery, St Paul’s Hospital Millennium Medical College, Swaziland Street, Addis Ababa, Ethiopia
| | | | | | | | | | | |
Collapse
|
6
|
Choi SW, Sreeja SR, Le TD, Shivappa N, Hebert JR, Kim MK. Association between inflammatory potential of diet and periodontitis disease risks: Results from a Korean population-based cohort study. J Clin Periodontol 2023; 50:952-963. [PMID: 37085969 DOI: 10.1111/jcpe.13817] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 03/20/2023] [Accepted: 04/03/2023] [Indexed: 04/23/2023]
Abstract
AIM To examine the association between a pro-inflammatory diet, estimated using the energy-adjusted dietary inflammatory index (E-DII), and the risk of periodontitis. MATERIALS AND METHODS Study subjects from the Korean Genome and Epidemiology Study Health Examinee (KoGES_HEXA) cohort were included for cross-sectional analysis (n = 168,378) using multivariate logistic regression and prospective analysis (n = 160,397) using Cox proportional hazard models respectively. DII and E-DII scores were calculated based on the intake reported on a validated semi-quantitative food frequency questionnaire (SQ-FFQ). RESULTS Cox proportional hazard models revealed a significantly increased risk of incident periodontitis in individuals consuming high E-DII (more pro-inflammatory) diets in the total population (HRquartile4vs1 = 1.29; 95% CI: 1.13-1.48; ptrend <.001) and in both men (HRquartile4vs1 = 1.36; 95% CI: 1.07-1.73; ptrend = 0.02) and women (HRquartile4vs1 = 1.27; 95% CI: 1.08-1.50; ptrend = .002). The association remained significant even after excluding cases diagnosed early in the follow-up. In the cross-sectional analysis, a significant association was observed between the E-DII score and the prevalence of periodontitis among all study subjects (ORquartile4vs1 = 1.17; 95% CI: 1.03-1.34; ptrend = 0.01) and men (ORquartile4vs1 = 1.28; 95%CI: 1.01-1.63; ptrend <.001); however, the association did not reach statistical significance in women (ORquartile4vs1 = 1.13; 95% CI: 0.96-1.33; ptrend <.001). CONCLUSIONS Findings from the current study support the hypothesis that diets with high pro-inflammatory potential increase the risk of periodontitis.
Collapse
Affiliation(s)
- Sung Weon Choi
- Oral Oncology Clinic, Research Institute, and Hospital, National Cancer Center, Goyang, South Korea
| | - Sundara Raj Sreeja
- Department of Cancer Epidemiology, National Cancer Center, Goyang, South Korea
| | - Trong-Dat Le
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - James R Hebert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - Mi Kyung Kim
- Department of Cancer Epidemiology, National Cancer Center, Goyang, South Korea
| |
Collapse
|
7
|
Kamineni M, Ötleş E, Oh J, Rao K, Young VB, Li BY, West LR, Hooper DC, Shenoy ES, Guttag JG, Wiens J, Makar M. Prospective evaluation of data-driven models to predict daily risk of Clostridioides difficile infection at 2 large academic health centers. Infect Control Hosp Epidemiol 2023; 44:1163-1166. [PMID: 36120815 PMCID: PMC10024639 DOI: 10.1017/ice.2022.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Many data-driven patient risk stratification models have not been evaluated prospectively. We performed and compared the prospective and retrospective evaluations of 2 Clostridioides difficile infection (CDI) risk-prediction models at 2 large academic health centers, and we discuss the models' robustness to data-set shifts.
Collapse
Affiliation(s)
- Meghana Kamineni
- Electrical Engineering and Computer Science Department, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Erkin Ötleş
- Medical Scientist Training Program, University of Michigan Medical School, Ann Arbor, Michigan
- Department of Industrial and Operations Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan
| | - Jeeheh Oh
- Division of Computer Science and Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan
| | - Krishna Rao
- Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, Michigan
| | - Vincent B Young
- Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, Michigan
| | - Benjamin Y Li
- Medical Scientist Training Program, University of Michigan Medical School, Ann Arbor, Michigan
- Division of Computer Science and Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan
| | - Lauren R West
- Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - David C Hooper
- Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Erica S Shenoy
- Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - John G Guttag
- Electrical Engineering and Computer Science Department, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Jenna Wiens
- Division of Computer Science and Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan
| | - Maggie Makar
- Electrical Engineering and Computer Science Department, Massachusetts Institute of Technology, Cambridge, Massachusetts
- Division of Computer Science and Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan
| |
Collapse
|
8
|
Hong C, Huh D, Schnall R, Garofalo R, Kuhns LM, Bruce J, Batey DS, Radix A, Belkind U, Hidalgo MA, Hirshfield S, Pearson CR. Changes in high-risk sexual behavior, HIV and other STI testing, and PrEP use during the COVID-19 pandemic in a longitudinal cohort of adolescent men who have sex with men 13 to 18 years old in the United States. AIDS Behav 2023; 27:1133-1139. [PMID: 36156174 PMCID: PMC9511439 DOI: 10.1007/s10461-022-03850-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 12/31/2022]
Abstract
The COVID-19 pandemic has disrupted sexual health services among those most vulnerable to HIV acquisition, such as adolescent men who have sex with men (AMSM). We sought to characterize the changes in sexual-risk behaviors, HIV and other STI testing, and pre-exposure prophylaxis (PrEP) use among a longitudinal cohort of AMSM aged 13 to 18 years before and during the COVID-19 pandemic. We observed a significant decline in HIV testing and a marginal decrease in other STI testing since the pandemic began in March 2020. Outreach efforts and innovative remote delivery of sexual health services are needed to support access to healthcare services among AMSM as the pandemic persists.
Collapse
Affiliation(s)
- Chenglin Hong
- Department of Social Welfare, UCLA Luskin School of Public Affairs, 3250 Public Affairs Building, 90095-1656, Los Angeles, CA, USA
| | - David Huh
- Indigenous Wellness Research Institute, School of Social Work, University of Washington, 4101 15th Ave NE, 98105, Seattle, WA, USA
| | - Rebecca Schnall
- School of Nursing, Columbia University, 10032, New York, NY, USA
| | - Robert Garofalo
- Division of Adolescent & Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, 60611, Chicago, IL, USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
| | - Lisa M Kuhns
- Division of Adolescent & Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, 60611, Chicago, IL, USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
| | - Josh Bruce
- Birmingham AIDS Outreach, 205 32nd Street, 35233, Birmingham, AL, USA
| | - D Scott Batey
- Department of Social Work, University of Alabama at Birmingham, 1720 2nd Avenue, 3154, 35294, South, Birmingham, UH, Alabama, USA
| | - Asa Radix
- Callen-Lorde Community Health Center, 356 West 18th Street, 10011, New York, NY, USA
| | - Uri Belkind
- Callen-Lorde Community Health Center, 356 West 18th Street, 10011, New York, NY, USA
| | - Marco A Hidalgo
- Division of General Internal Medicine and Health Services Research, Medicine-Pediatrics Section, Department of Medicine, David Geffen School of Medicine at UCLA, 911 Broxton Avenue, 90024, Los Angeles, CA, USA
| | - Sabina Hirshfield
- STAR Program, Department of Medicine, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC 1240, 11203-2012, Brooklyn, NY, USA
| | - Cynthia R Pearson
- Indigenous Wellness Research Institute, School of Social Work, University of Washington, 4101 15th Ave NE, 98105, Seattle, WA, USA
| |
Collapse
|
9
|
Watts EL, Perez-Cornago A, Fensom GK, Smith-Byrne K, Noor U, Andrews CD, Gunter MJ, Holmes MV, Martin RM, Tsilidis KK, Albanes D, Barricarte A, Bueno-de-Mesquita HB, Cohn BA, Deschasaux-Tanguy M, Dimou NL, Ferrucci L, Flicker L, Freedman ND, Giles GG, Giovannucci EL, Haiman CA, Hankey GJ, Holly JMP, Huang J, Huang WY, Hurwitz LM, Kaaks R, Kubo T, Le Marchand L, MacInnis RJ, Männistö S, Metter EJ, Mikami K, Mucci LA, Olsen AW, Ozasa K, Palli D, Penney KL, Platz EA, Pollak MN, Roobol MJ, Schaefer CA, Schenk JM, Stattin P, Tamakoshi A, Thysell E, Tsai CJ, Touvier M, Van Den Eeden SK, Weiderpass E, Weinstein SJ, Wilkens LR, Yeap BB. Circulating insulin-like growth factors and risks of overall, aggressive and early-onset prostate cancer: a collaborative analysis of 20 prospective studies and Mendelian randomization analysis. Int J Epidemiol 2023; 52:71-86. [PMID: 35726641 PMCID: PMC9908067 DOI: 10.1093/ije/dyac124] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous studies had limited power to assess the associations of circulating insulin-like growth factors (IGFs) and IGF-binding proteins (IGFBPs) with clinically relevant prostate cancer as a primary endpoint, and the association of genetically predicted IGF-I with aggressive prostate cancer is not known. We aimed to investigate the associations of IGF-I, IGF-II, IGFBP-1, IGFBP-2 and IGFBP-3 concentrations with overall, aggressive and early-onset prostate cancer. METHODS Prospective analysis of biomarkers using the Endogenous Hormones, Nutritional Biomarkers and Prostate Cancer Collaborative Group dataset (up to 20 studies, 17 009 prostate cancer cases, including 2332 aggressive cases). Odds ratios (OR) and 95% confidence intervals (CI) for prostate cancer were estimated using conditional logistic regression. For IGF-I, two-sample Mendelian randomization (MR) analysis was undertaken using instruments identified using UK Biobank (158 444 men) and outcome data from PRACTICAL (up to 85 554 cases, including 15 167 aggressive cases). Additionally, we used colocalization to rule out confounding by linkage disequilibrium. RESULTS In observational analyses, IGF-I was positively associated with risks of overall (OR per 1 SD = 1.09: 95% CI 1.07, 1.11), aggressive (1.09: 1.03, 1.16) and possibly early-onset disease (1.11: 1.00, 1.24); associations were similar in MR analyses (OR per 1 SD = 1.07: 1.00, 1.15; 1.10: 1.01, 1.20; and 1.13; 0.98, 1.30, respectively). Colocalization also indicated a shared signal for IGF-I and prostate cancer (PP4: 99%). Men with higher IGF-II (1.06: 1.02, 1.11) and IGFBP-3 (1.08: 1.04, 1.11) had higher risks of overall prostate cancer, whereas higher IGFBP-1 was associated with a lower risk (0.95: 0.91, 0.99); these associations were attenuated following adjustment for IGF-I. CONCLUSIONS These findings support the role of IGF-I in the development of prostate cancer, including for aggressive disease.
Collapse
Affiliation(s)
- Eleanor L Watts
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Georgina K Fensom
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Karl Smith-Byrne
- Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Urwah Noor
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Colm D Andrews
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Michael V Holmes
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK
| | - Richard M Martin
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Aurelio Barricarte
- Group of Epidemiology of Cancer and Other Chronic Diseases, Navarra Public Health Institute, Pamplona, Spain
- Group of Epidemiology of Cancer and Other Chronic Diseases, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
| | - H Bas Bueno-de-Mesquita
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Utrecht, The Netherlands
| | - Barbara A Cohn
- Child Health and Development Studies, Public Health Institute, Berkeley, CA, USA
| | - Melanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center, University of Paris, Bobigny, France
| | - Niki L Dimou
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | | | - Leon Flicker
- WA Centre for Health & Ageing, Medical School, University of Western Australia, Perth, WA, Australia
- Western Australian Centre for Health and Ageing, University of Western Australia, Perth, WA, Australia
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christopher A Haiman
- Department of Preventive Medicine, Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Graham J Hankey
- WA Centre for Health & Ageing, Medical School, University of Western Australia, Perth, WA, Australia
| | - Jeffrey M P Holly
- IGFs & Metabolic Endocrinology Group, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jiaqi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Lauren M Hurwitz
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tatsuhiko Kubo
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | - Robert J MacInnis
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Satu Männistö
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - E Jeffrey Metter
- Department of Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Kazuya Mikami
- Departmemt of Urology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Anja W Olsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Cancer Society, Research Center, Copenhagen, Denmark
| | - Kotaro Ozasa
- Departmemt of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Kathryn L Penney
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael N Pollak
- Departments of Medicine and Oncology, McGill University, Montreal, QC, Canada
| | - Monique J Roobol
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Jeannette M Schenk
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Akiko Tamakoshi
- Department of Public Health, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Elin Thysell
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Chiaojung Jillian Tsai
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Center, University of Paris, Bobigny, France
| | - Stephen K Van Den Eeden
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Urology, University of CaliforniaSan Francisco, San Francisco, CA, USA
| | - Elisabete Weiderpass
- Director’s Office, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Bu B Yeap
- WA Centre for Health & Ageing, Medical School, University of Western Australia, Perth, WA, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, Australia
| |
Collapse
|
10
|
Yang J, Nie D, Chen Y, Liu Z, Li M, Gong C, Liu Q. The role of smoking and alcohol in mediating the effect of gastroesophageal reflux disease on lung cancer: A Mendelian randomization study. Front Genet 2023; 13:1054132. [PMID: 36726719 PMCID: PMC9885128 DOI: 10.3389/fgene.2022.1054132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/07/2022] [Indexed: 01/19/2023] Open
Abstract
Observational studies have suggested a positive association between gastroesophageal reflux disease and lung cancer, but due to the existence of confounders, it remains undetermined whether gastroesophageal reflux disease (GERD) has a causal association with lung cancer. Therefore, Mendelian randomization (MR) analyses were applied to investigate the relationship between the two conditions. Two-sample Mendelian randomization analysis was utilized with summary genetic data from the European Bioinformatics Institute (602,604 individuals) and International Lung Cancer Consortium, which provides information on lung cancer and its histological subgroups. Furthermore, we used two-step Mendelian randomization and multivariable Mendelian randomization to estimate whether smoking initiation (311,629 cases and 321,173 controls) and alcohol intake frequency (n = 462,346) mediate any effect of gastroesophageal reflux disease on lung cancer risk. The Mendelian randomization analyses indicated that gastroesophageal reflux disease was associated with and significantly increased the risk of lung cancer (ORIVW = 1.35, 95% CI = 1.18-1.54; p = 1.36 × 10-5). Smoking initiation and alcohol intake frequency mediated 35% and 3% of the total effect of gastroesophageal reflux disease on lung cancer, respectively. The combined effect of these two factors accounted for 60% of the total effect. In conclusion, gastroesophageal reflux disease is associated with an increased risk of lung cancer, and interventions to reduce smoking and alcohol intake may reduce the incidence of lung cancer.
Collapse
Affiliation(s)
- Jing Yang
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Duorui Nie
- Graduate school of Hunan University of Chinese Medicine, Changsha, China
| | - Yujing Chen
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zixing Liu
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mengzhao Li
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chun Gong
- The First Affiliated Hospital, Hunan University of Chinese Medicine, Changsha, Hunan, China,*Correspondence: Chun Gong, ; Qiong Liu,
| | - Qiong Liu
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China,*Correspondence: Chun Gong, ; Qiong Liu,
| |
Collapse
|
11
|
Lin CC, Linscott RJ. Longitudinal mediation by perceived burden of the pathway from thwarted belonging to suicidal ideation. Suicide Life Threat Behav 2022; 52:1193-1204. [PMID: 36029099 PMCID: PMC10086865 DOI: 10.1111/sltb.12914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 05/12/2022] [Accepted: 08/10/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Whereas the interpersonal theory of suicide entails the assumption that thwarted belongingness and perceived burdensomeness are equally important, mutually moderating, proximal causes of active ideation, evidence suggests these may not be co-moderating processes. We tested an alternative perspective, hypothesizing that burden mediates the longitudinal relationship of thwarted belonging with active ideation. METHODS A 6-week, four-wave prospective online survey was completed by 298 undergraduates. We tested cross-sectional and cross-lagged panel models (CLPM, with and without random effects) with belonging, burden, and ideation at 2-week lags, and post hoc models with burden as a concurrent mediator of ideation. RESULTS Approximately 28% of undergraduates reported active ideation at baseline. Cross-sectionally, thwarted belonging had no direct influence on ideation but indirectly affected ideation via burden. This result was not confirmed in the 2-week CLPM analyses. In post hoc analyses, we found belonging operated indirectly via later burden to influence contemporaneous ideation. CONCLUSIONS Findings suggest thwarted belonging influences active ideation indirectly via perceived burden. The effect of burden as a mediator appears to depend on its temporal proximity to ideation. Future research should delimit the period during which perceived burden is an active mediator, accommodate dual-process approaches, and explore other mediation alternatives to co-moderation.
Collapse
Affiliation(s)
- Chao-Cheng Lin
- Department of Psychology, University of Otago, Dunedin, New Zealand.,Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan
| | | |
Collapse
|
12
|
Watts EL, Perez-Cornago A, Knuppel A, Tsilidis KK, Key TJ, Travis RC. Prospective analyses of testosterone and sex hormone-binding globulin with the risk of 19 types of cancer in men and postmenopausal women in UK Biobank. Int J Cancer 2021; 149:573-584. [PMID: 33720423 DOI: 10.1002/ijc.33555] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 12/16/2022]
Abstract
We investigated the associations of estimated free and total circulating testosterone and sex hormone-binding globulin (SHBG) with cancer risk in men and postmenopausal women, using a pan-cancer approach, including 19 cancers in UK Biobank. Risk was estimated using multivariable-adjusted Cox regression in up to 182 608 men and 122 112 postmenopausal women who were cancer-free at baseline. Participants diagnosed with cancer within 2 years of baseline were excluded. Hazard ratios (HRs) and confidence intervals (CIs) were corrected for regression dilution bias using repeat measurements. We accounted for multiple testing using the false discovery rate. In men, higher free testosterone was associated with higher risks of melanoma and prostate cancer (HR per 50 pmol/L increase = 1.35, 95% CI 1.14-1.61 and 1.10, 1.04-1.18, respectively). Higher total testosterone was associated with an elevated risk of liver cancer (HR per 5 nmol/L = 2.45, 1.56-3.84), and higher SHBG was associated with a higher risk of liver cancer (HR per 10 nmol/L = 1.56, 1.31-1.87) and a lower risk of prostate cancer (0.93, 0.91-0.96); the associations with liver cancer were partially attenuated after excluding men diagnosed within 4.7 years from baseline. In postmenopausal women, free and total testosterone and SHBG were associated with risks of endometrial (HR per 10 pmol/L = 1.59, 1.32-1.90; HR per 0.5 nmol/L = 1.34, 1.18-1.52 and HR per 25 nmol/L = 0.78, 0.67-0.91, respectively) and breast cancer (1.32, 1.22-1.43; 1.24, 1.17-1.31 and 0.88, 0.83-0.94, respectively). We report a novel association of free testosterone with malignant melanoma in men, and confirm known associations between testosterone and risks for prostate, breast and endometrial cancers. The association with liver cancer in men may be attributable to reverse causation.
Collapse
Affiliation(s)
- Eleanor L Watts
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Anika Knuppel
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Konstantinos K Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| |
Collapse
|
13
|
Wang SM, Freedman ND, Katki HA, Matthews C, Graubard BI, Kahle LL, Abnet CC. Gastroesophageal reflux disease: A risk factor for laryngeal squamous cell carcinoma and esophageal squamous cell carcinoma in the NIH-AARP Diet and Health Study cohort. Cancer 2021; 127:1871-1879. [PMID: 33615447 PMCID: PMC8406665 DOI: 10.1002/cncr.33427] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/30/2020] [Accepted: 12/16/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Prior studies have suggested that gastroesophageal reflux disease (GERD) may be associated with risk of squamous cancers of the larynx and esophagus; however, most of these studies have had methodological limitations or insufficient control for potential confounders. METHODS We prospectively examined the association between GERD and esophageal adenocarcinoma (EADC), esophageal squamous cell carcinoma (ESCC), and laryngeal squamous cell carcinoma (LSCC) in 490,605 participants of the NIH-AARP Diet and Health Study cohort who were 50-71 years of age at baseline. Exposure to risk factors were obtained from the baseline questionnaire. GERD diagnosis was extracted among eligible participants via linkage to Medicare diagnoses codes and then multiply imputed for non-Medicare-eligible participants. Hazard ratios (HRs) and 95% CIs of GERD were computed using Cox regression. RESULTS From 1995 to 2011, we accrued 931 cases of EADC, 876 cases of LSCC, and 301 cases of ESCC in this cohort and estimated multivariable-adjusted HRs of 2.23 (95% CI, 1.72-2.90), 1.91 (95% CI, 1.24-2.94), and 1.99 (95% CI, 1.39-2.84) for EADC, LSCC, and ESCC, respectively. The associations were independent of sex, smoking status, alcohol intake, and follow-up time periods. We estimated that among the general population in the United States, 22.04% of people aged 50-71 years suffered from GERD. Using risk factor distributions for the United States from national survey data, 16.92% of LSCC cases and 17.32% of ESCC cases among individuals aged 50-71 years were estimated to be associated with GERD. CONCLUSION GERD is a common gastrointestinal disorder, but future prospective studies are needed to replicate our findings. If replicated, they may inform clinical surveillance of GERD patients and suggest new avenues for prevention of these malignancies.
Collapse
Affiliation(s)
- Shao-Ming Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Neal D Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Hormuzd A Katki
- Biostatistics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Charles Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Barry I Graubard
- Biostatistics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Lisa L Kahle
- Information Management Services Inc, Calverton, Maryland
| | - Christian C Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| |
Collapse
|
14
|
Watts EL, Fensom GK, Smith Byrne K, Perez‐Cornago A, Allen NE, Knuppel A, Gunter MJ, Holmes MV, Martin RM, Murphy N, Tsilidis KK, Yeap BB, Key TJ, Travis RC. Circulating insulin-like growth factor-I, total and free testosterone concentrations and prostate cancer risk in 200 000 men in UK Biobank. Int J Cancer 2021; 148:2274-2288. [PMID: 33252839 PMCID: PMC8048461 DOI: 10.1002/ijc.33416] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/09/2020] [Accepted: 11/16/2020] [Indexed: 12/12/2022]
Abstract
Insulin-like growth factor-I (IGF-I) and testosterone have been implicated in prostate cancer aetiology. Using data from a large prospective full-cohort with standardised assays and repeat blood measurements, and genetic data from an international consortium, we investigated the associations of circulating IGF-I, sex hormone-binding globulin (SHBG), and total and calculated free testosterone concentrations with prostate cancer incidence and mortality. For prospective analyses, risk was estimated using multivariable-adjusted Cox regression in 199 698 male UK Biobank participants. Hazard ratios (HRs) were corrected for regression dilution bias using repeat hormone measurements from a subsample. Two-sample Mendelian randomisation (MR) analysis of IGF-I and risk used genetic instruments identified from UK Biobank men and genetic outcome data from the PRACTICAL consortium (79 148 cases and 61 106 controls). We used cis- and all (cis and trans) SNP MR approaches. A total of 5402 men were diagnosed with and 295 died from prostate cancer (mean follow-up 6.9 years). Higher circulating IGF-I was associated with elevated prostate cancer diagnosis (HR per 5 nmol/L increment = 1.09, 95% CI 1.05-1.12) and mortality (HR per 5 nmol/L increment = 1.15, 1.02-1.29). MR analyses also supported the role of IGF-I in prostate cancer diagnosis (cis-MR odds ratio per 5 nmol/L increment = 1.34, 1.07-1.68). In observational analyses, higher free testosterone was associated with a higher risk of prostate cancer (HR per 50 pmol/L increment = 1.10, 1.05-1.15). Higher SHBG was associated with a lower risk (HR per 10 nmol/L increment = 0.95, 0.94-0.97), neither was associated with prostate cancer mortality. Total testosterone was not associated with prostate cancer. These findings implicate IGF-I and free testosterone in prostate cancer development and/or progression.
Collapse
Affiliation(s)
- Eleanor L. Watts
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Georgina K. Fensom
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Karl Smith Byrne
- Genetic Epidemiology GroupInternational Agency for Research on CancerLyonFrance
| | - Aurora Perez‐Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Naomi E. Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
- UK Biobank LtdStockportUK
| | - Anika Knuppel
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Marc J. Gunter
- Section of Nutrition and MetabolismInternational Agency for Research on CancerLyonFrance
| | - Michael V. Holmes
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
- Medical Research Council Population Health Research UnitUniversity of OxfordOxfordUK
| | - Richard M. Martin
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- Bristol Medical School, Department of Population Health SciencesUniversity of BristolBristolUK
- National Institute for Health Research (NIHR) Bristol Biomedical Research CentreUniversity Hospitals Bristol NHS Foundation Trust and the University of BristolBristolUK
| | - Neil Murphy
- Section of Nutrition and MetabolismInternational Agency for Research on CancerLyonFrance
| | - Konstantinos K. Tsilidis
- Department of Hygiene and EpidemiologyUniversity of Ioannina School of MedicineIoanninaGreece
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Bu B. Yeap
- Medical SchoolUniversity of Western AustraliaPerthAustralia
- Department of Endocrinology and DiabetesFiona Stanley HospitalPerthAustralia
| | - Timothy J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Ruth C. Travis
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| |
Collapse
|
15
|
Kaikkonen JE, Jula A, Viikari JSA, Juonala M, Hutri-Kähönen N, Kähönen M, Lehtimäki T, Raitakari OT. Associations of Serum Fatty Acid Proportions with Obesity, Insulin Resistance, Blood Pressure, and Fatty Liver: The Cardiovascular Risk in Young Finns Study. J Nutr 2021; 151:970-978. [PMID: 33561215 DOI: 10.1093/jn/nxaa409] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 06/18/2020] [Revised: 07/09/2020] [Accepted: 11/24/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The links between fatty acids (FAs) and cardiometabolic outcomes are topics of debate. OBJECTIVE Our aim was to investigate the associations between serum standardized FA percentages and cardiometabolic outcomes. METHODS We used cross-sectional (n = 2187-2200 subjects, age 24-39 y, women 54%) and 10-year prospective data (n = 975-1414 subjects) from the Young Finns Study. Outcomes included prevalent and incident obesity, insulin resistance (HOMA-IR index in the upper quintile), elevated blood pressure (BP; taking medication, or diastolic or systolic BP in the upper quintile), and incident nonalcoholic fatty liver. Logistic regression models were used to calculate ORs per SD increase in fatty acids (FAs). The models were adjusted for age and sex, and additionally for other potential confounders. RESULTS Several cross-sectional findings were also statistically significant in prospective models (Bonferroni corrected P < 0.003). In fully-adjusted models for obesity, these consisted of SFAs (OR: 1.28) and MUFAs (OR: 1.38), including palmitoleic (OR: 1.39) and oleic acids (OR: 1.37). Furthermore, PUFAs (OR: 0.70), including linoleic (OR: 0.67) and docosahexaenoic acids (OR: 0.75), were inversely related with obesity, whereas γ-linolenic acid (OR: 1.32) was positively associated with obesity. In age- and sex-adjusted models for insulin resistance, MUFAs (OR: 1.26) and oleic acid (OR: 1.25) were positively, and PUFAs (OR: 0.81), particularly linoleic acid (OR: 0.78), were inversely associated with HOMA-IR. Similarly with elevated BP, palmitic acid (OR: 1.22), MUFAs (OR: 1.28), and oleic acid (OR: 1.28) were positively associated with elevated BP, whereas PUFAs (OR: 0.77), n-6 (omega-6) PUFAs (OR: 0.79), and linoleic acid (OR: 0.77) were inversely associated. In fully-adjusted models for incident fatty liver, the most consistent predictors were high palmitic (OR: 1.61) and low linoleic acid (OR: 0.63) percentages. The n-6/n-3 (omega-3) PUFA ratio was not linked with any adverse outcomes. CONCLUSIONS High serum percentages of total SFAs and MUFAs and low PUFAs, but also several specific FAs, predict future unfavorable cardiometabolic outcomes in Finnish adults.
Collapse
Affiliation(s)
- Jari E Kaikkonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Antti Jula
- National Institute for Health and Welfare, Turku, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University Hospital and Tampere University, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Tampere University, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab laboratories and Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center - Tampere, Tampere University, Tampere, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| |
Collapse
|
16
|
Andreu-Reinón ME, Chirlaque MD, Gavrila D, Amiano P, Mar J, Tainta M, Ardanaz E, Larumbe R, Colorado-Yohar SM, Navarro-Mateu F, Navarro C, Huerta JM. Mediterranean Diet and Risk of Dementia and Alzheimer's Disease in the EPIC-Spain Dementia Cohort Study. Nutrients 2021; 13:nu13020700. [PMID: 33671575 PMCID: PMC7927039 DOI: 10.3390/nu13020700] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/12/2021] [Accepted: 02/18/2021] [Indexed: 01/10/2023] Open
Abstract
The Mediterranean diet (MD) has shown to reduce the occurrence of several chronic diseases. To evaluate its potential protective role on dementia incidence we studied 16,160 healthy participants from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain Dementia Cohort study recruited between 1992-1996 and followed up for a mean (±SD) of 21.6 (±3.4) years. A total of 459 incident cases of dementia were ascertained through expert revision of medical records. Data on habitual diet was collected through a validated diet history method to assess adherence to the relative Mediterranean Diet (rMED) score. Hazard ratios (HR) of dementia by rMED levels (low, medium and high adherence levels: ≤6, 7-10 and ≥11 points, respectively) were estimated using multivariable Cox models, whereas time-dependent effects were evaluated using flexible parametric Royston-Parmar (RP) models. Results of the fully adjusted model showed that high versus low adherence to the categorical rMED score was associated with a 20% (HR = 0.80, 95%CI: 0.60-1.06) lower risk of dementia overall and HR of dementia was 8% (HR = 0.92, 0.85-0.99, p = 0.021) lower for each 2-point increment of the continuous rMED score. By sub-types, a favorable association was also found in women for non-AD (HR per 2-points = 0.74, 95%CI: 0.62-0.89), while not statistically significant in men for AD (HR per 2-points = 0.88, 0.76-1.01). The association was stronger in participants with lower education. In conclusion, in this large prospective cohort study MD was inversely associated with dementia incidence after accounting for major cardiovascular risk factors. The results differed by dementia sub-type, sex, and education but there was no significant evidence of effect modification.
Collapse
Affiliation(s)
- María Encarnación Andreu-Reinón
- Section of Neurology, Department of Internal Medicine, Rafael Méndez Hospital, Murcia Health Service, 30813 Lorca, Murcia, Spain
- Murcia Biomedical Research Institute (IMIB-Arrixaca), 30120 Murcia, Spain; (M.D.C.); (D.G.); (S.M.C.-Y.); (F.N.-M.); (C.N.); (J.M.H.)
- Correspondence: ; Tel.: +34-622-642-260; Fax: +34-968-44-24-21
| | - María Dolores Chirlaque
- Murcia Biomedical Research Institute (IMIB-Arrixaca), 30120 Murcia, Spain; (M.D.C.); (D.G.); (S.M.C.-Y.); (F.N.-M.); (C.N.); (J.M.H.)
- Department of Epidemiology, Murcia Regional Health Council, 30008 Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (P.A.); (E.A.)
- Department of Health and Social Sciences, University of Murcia, 30100 Murcia, Spain
| | - Diana Gavrila
- Murcia Biomedical Research Institute (IMIB-Arrixaca), 30120 Murcia, Spain; (M.D.C.); (D.G.); (S.M.C.-Y.); (F.N.-M.); (C.N.); (J.M.H.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (P.A.); (E.A.)
- Murcia Health Service, 30100 Murcia, Spain
| | - Pilar Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (P.A.); (E.A.)
- Public Health Division of Gipuzkoa, Basque Government, 20013 Donostia-San Sebastián, Spain
- Biodonostia Health Research Institute, 20014 San Sebastián, Spain;
| | - Javier Mar
- Biodonostia Health Research Institute, 20014 San Sebastián, Spain;
- Clinical Management Unit, OSI Alto Deba, 20500 Arrasate-Mondragón, Spain
- AP-OSIs Gipuzkoa Research Unit, OSI Alto Deba, 20500 Arrasate-Mondragón, Spain
- Health Services Research Network on Chronic Patients (REDISSEC), 48902 Bilbao, Spain
| | - Mikel Tainta
- CITA Alzheimer Foundation, 20019 Donostia-San Sebastián, Spain;
- Neurology Service, OSI Goierri-Alto Urola, 20700 Zumárraga, Spain
| | - Eva Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (P.A.); (E.A.)
- Public Health Institute of Navarra, IdiSNA, 31008 Pamplona, Spain;
| | - Rosa Larumbe
- Public Health Institute of Navarra, IdiSNA, 31008 Pamplona, Spain;
- Neuroepigenetics Laboratory, Navarrabiomed, Public University of Navarre (UPNA), 31008 Pamplona, Spain
- Department of Neurology, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain
| | - Sandra M. Colorado-Yohar
- Murcia Biomedical Research Institute (IMIB-Arrixaca), 30120 Murcia, Spain; (M.D.C.); (D.G.); (S.M.C.-Y.); (F.N.-M.); (C.N.); (J.M.H.)
- Department of Epidemiology, Murcia Regional Health Council, 30008 Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (P.A.); (E.A.)
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín 050010, Colombia
| | - Fernando Navarro-Mateu
- Murcia Biomedical Research Institute (IMIB-Arrixaca), 30120 Murcia, Spain; (M.D.C.); (D.G.); (S.M.C.-Y.); (F.N.-M.); (C.N.); (J.M.H.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (P.A.); (E.A.)
- Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Servicio Murciano de Salud, 30120 Murcia, Spain
| | - Carmen Navarro
- Murcia Biomedical Research Institute (IMIB-Arrixaca), 30120 Murcia, Spain; (M.D.C.); (D.G.); (S.M.C.-Y.); (F.N.-M.); (C.N.); (J.M.H.)
- Department of Health and Social Sciences, University of Murcia, 30100 Murcia, Spain
| | - José María Huerta
- Murcia Biomedical Research Institute (IMIB-Arrixaca), 30120 Murcia, Spain; (M.D.C.); (D.G.); (S.M.C.-Y.); (F.N.-M.); (C.N.); (J.M.H.)
- Department of Epidemiology, Murcia Regional Health Council, 30008 Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (P.A.); (E.A.)
| |
Collapse
|
17
|
Woodall WH, Rakovich G, Steiner SH. An overview and critique of the use of cumulative sum methods with surgical learning curve data. Stat Med 2020; 40:1400-1413. [PMID: 33316849 DOI: 10.1002/sim.8847] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 05/14/2020] [Revised: 11/20/2020] [Accepted: 11/20/2020] [Indexed: 11/07/2022]
Abstract
Cumulative sum (CUSUM) plots and methods have wide-ranging applications in healthcare. We review and discuss some issues related to the analysis of surgical learning curve (LC) data with a focus on three types of CUSUM statistical approaches. The underlying assumptions, benefits, and weaknesses of each approach are given. Our primary conclusion is that two types of CUSUM methods are useful in providing visual aids, but are subject to overinterpretation due to the lack of well-defined decision rules and performance metrics. The third type is based on plotting the CUSUM of the differences between observations and their average value. We show that this commonly applied retrospective method is frequently interpreted incorrectly and is thus unhelpful in the LC application. Curve-fitting methods are more suitable for meeting many of the goals associated with the study of surgical LCs.
Collapse
Affiliation(s)
| | - George Rakovich
- Maisonneuve-Rosemont Hospital, University of Montreal School of Medicine, Montreal, Quebec, Canada
| | - Stefan H Steiner
- Department of Statistics and Actuarial Sciences, University of Waterloo, Waterloo, Ontario, Canada
| |
Collapse
|
18
|
Ximenes CRC, Bergmann A, Lima JTDO, Lima WRP, de Britto MC, de Mello MJG, Thuler LCS. Prospective Analysis of Health-Related Quality of Life in Older Adults With Cancer. J Patient Exp 2020; 7:1519-1525. [PMID: 33457609 PMCID: PMC7786648 DOI: 10.1177/2374373519889246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate health-related quality of life (HRQoL) changes at 6 to 12 months after cancer diagnosis and to assess the impact of age in older adults with cancer. METHODS A cohort study using patients ≥60 years old diagnosed with cancer. Health-related quality of life scores were calculated according to the European Organisation for Research and Treatment of Cancer questionnaire. Student's t tests for paired samples and a binomial logistic regression were performed. RESULTS The study included 241 patients. At diagnosis, the affected HRQoL functions were physical and emotional functions, financial difficulties, pain, and insomnia. At follow-up, cognitive function (P < .001) and dyspnea (P = .004) worsened, while emotional function improved (P = .003). DISCUSSION At the 6 to 12 months of follow-up, older adult cancer patients showed worsening cognitive function and dyspnea and improved emotional function. These HRQoL changes were not associated with age.
Collapse
Affiliation(s)
| | - Anke Bergmann
- Research Center, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
| | | | | | | | | | | |
Collapse
|
19
|
Watts EL, Perez-Cornago A, Kothari J, Allen NE, Travis RC, Key TJ. Hematologic Markers and Prostate Cancer Risk: A Prospective Analysis in UK Biobank. Cancer Epidemiol Biomarkers Prev 2020; 29:1615-1626. [PMID: 32457180 PMCID: PMC7611250 DOI: 10.1158/1055-9965.epi-19-1525] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/12/2020] [Accepted: 05/19/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Risk factors for prostate cancer are not well understood. Red blood cell, platelet, and white blood cell indices may be markers of a range of exposures that might be related to prostate cancer risk. Therefore, we examined the associations of hematologic parameters with prostate cancer risk. METHODS Complete blood count data from 209,686 male UK Biobank participants who were free from cancer at study baseline were analyzed. Participants were followed up via data linkage. After a mean follow-up of 6.8 years, 5,723 men were diagnosed with prostate cancer and 323 men died from prostate cancer. Multivariable-adjusted Cox regression was used to estimate adjusted HRs and 95% confidence intervals (CI) for prostate cancer incidence and mortality by hematologic parameters, and corrected for regression dilution bias. RESULTS Higher red blood cell (HR per 1 SD increase = 1.09, 95% CI, 1.05-1.13) and platelet counts (HR = 1.07, 1.04-1.11) were associated with an increased risk of prostate cancer. Higher mean corpuscular volume (HR = 0.90, 0.87-0.93), mean corpuscular hemoglobin (HR = 0.90, 0.87-0.93), mean corpuscular hemoglobin concentration (HR = 0.87, 0.77-0.97), and mean sphered cell volume (HR = 0.91, 0.87-0.94) were associated with a lower prostate cancer risk. Higher white blood cell (HR = 1.14, 1.05-1.24) and neutrophil count (HR = 1.27, 1.09-1.48) were associated with prostate cancer mortality. CONCLUSIONS These associations of blood indices of prostate cancer risk and mortality may implicate shared common causes, including testosterone, nutrition, and inflammation/infection among several others in prostate cancer development and/or progression. IMPACT These associations provide insights into prostate cancer development and progression.
Collapse
Affiliation(s)
- Eleanor L Watts
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Jaimal Kothari
- Clinical Haematology, Oxford Cancer and Haematology Centre, Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Naomi E Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- UK Biobank Ltd, Cheadle, Stockport, United Kingdom
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
20
|
Pittalis C, Brugha R, Bijlmakers L, Mwapasa G, Borgstein E, Gajewski J. Patterns, quality and appropriateness of surgical referrals in Malawi. Trop Med Int Health 2020; 25:824-833. [PMID: 32324928 DOI: 10.1111/tmi.13406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Reliable referral systems are essential to the functionality and efficiency of the wider health care system in low- and middle-income countries (LMICs), particularly in surgery as the disease burden is growing while resources remain constrained and unevenly distributed. Yet, this is a critically under-researched area. This study aimed to provide a comprehensive assessment of surgical referral systems in a LMIC, Malawi, with a view to shedding light on this important aspect of public health and share lessons learned. METHODS We conducted a prospective analysis of all inter-hospital referrals received at Queen Elizabeth Central Hospital (QECH) in 2014-2015. A subsample of 255 referrals was assessed by three independent surgical experts against necessity and quality of the transfer to identify any inefficiencies in the referral process. RESULTS 1317 patients were referred to QECH during the study period (average 53/month), 80% sent by government district hospitals. One in 3 cases were referred unnecessarily, many of which could have been managed locally. In 82% of cases, there was no communication with QECH prior to referral, 41% had incorrect/incomplete diagnosis by the referring clinicians and 39% of referrals were not timely. CONCLUSIONS Our findings provide the first evidence on the state of the surgical referral system in Malawi and contribute to building the body of knowledge necessary to inform system improvements. Responses should include reducing inappropriate use of specialist care and ensuring better care pathways for surgical patients, especially in rural areas, where access to specialist expertise is not available at present.
Collapse
Affiliation(s)
- Chiara Pittalis
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ruairi Brugha
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Leon Bijlmakers
- Nijmegen International Centre for Health Systems Research and Education, Radboud University, Nijmegen, The Netherlands
| | - Gerald Mwapasa
- College of Medicine, University of Malawi, Blantyre, Malawi
| | - Eric Borgstein
- College of Medicine, University of Malawi, Blantyre, Malawi
| | - Jakub Gajewski
- Institute of Global Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| |
Collapse
|
21
|
Ernst R, Fischer K, de Godoi Rezende Costa Molino C, Orav EJ, Theiler R, Meyer U, Fischler M, Gagesch M, Ambühl PM, Freystätter G, Egli A, Bischoff-Ferrari HA. Polypharmacy and Kidney Function in Community-Dwelling Adults Age 60 Years and Older: A Prospective Observational Study. J Am Med Dir Assoc 2019; 21:254-259.e1. [PMID: 31501003 DOI: 10.1016/j.jamda.2019.07.007] [Citation(s) in RCA: 15] [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: 02/22/2019] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Information on the impact of polypharmacy on kidney function in older adults is limited. We prospectively investigated the association between intake of total number of drugs or nonsteroidal anti-inflammatory drugs (NSAIDs) and kidney function. DESIGN Our study is a prospective observational analysis of the 2-year Zurich Multiple Endpoint Vitamin D Trial in Knee Osteoarthritis Patients. SETTING AND PARTICIPANTS Of the 273 participants of the original trial, 270 participants (mean age 70.3 ± 6.4 years, 53% women) were included in this observational analysis. METHODS The associations between (1) total number of drugs (or NSAIDs) at baseline or (2) cumulative number of drugs (or NASAIDs) repeatedly measured over 24 months and kidney function repeatedly measured over 24 months as estimated glomerular filtration rate (eGFR) were investigated using multivariable-adjusted repeated-measures analysis. RESULTS Per drug at baseline, kidney function decreased by 0.64 mL/min/1.73 m2 eGFR (Beta = -0.64; 95% CI -1.19 to -0.08; P = .024) over 24 months. With every additional drug taken cumulatively over 24 months, kidney function decreased by 0.39 mL/min/1.73 m2 eGFR (Beta = -0.39; 95% CI -0.63 to -0.15; P = .002). In a high-risk subgroup, per NSAID taken cumulatively over 24 months, kidney function declined by 1.21 mL/min/1.73 m2 eGFR (Beta = -1.21; 95% CI -2.35 to -0.07; P = .021). CONCLUSIONS AND IMPLICATIONS For every additional drug prescribed among older adults, our study supports an independent and immediate harmful impact on kidney function. This negative impact seems to be about 3 times greater for NSAIDs compared with an additional average drug.
Collapse
Affiliation(s)
- Rahel Ernst
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Center on Aging and Mobility, University Hospital Zurich, City Hospital Waid Zurich, Zurich, Switzerland; Internal Medicine Clinic, City Hospital Waid, Zurich, Switzerland
| | - Karina Fischer
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Center on Aging and Mobility, University Hospital Zurich, City Hospital Waid Zurich, Zurich, Switzerland
| | - Caroline de Godoi Rezende Costa Molino
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Center on Aging and Mobility, University Hospital Zurich, City Hospital Waid Zurich, Zurich, Switzerland
| | - Endel J Orav
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Robert Theiler
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Center on Aging and Mobility, University Hospital Zurich, City Hospital Waid Zurich, Zurich, Switzerland
| | - Ursina Meyer
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Center on Aging and Mobility, University Hospital Zurich, City Hospital Waid Zurich, Zurich, Switzerland
| | - Manuel Fischler
- Internal Medicine Clinic, City Hospital Waid, Zurich, Switzerland
| | - Michael Gagesch
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Center on Aging and Mobility, University Hospital Zurich, City Hospital Waid Zurich, Zurich, Switzerland
| | - Patrice M Ambühl
- Institute of Nephrology, City Hospital Waid, Zurich, Switzerland
| | - Gregor Freystätter
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Center on Aging and Mobility, University Hospital Zurich, City Hospital Waid Zurich, Zurich, Switzerland
| | - Andreas Egli
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Center on Aging and Mobility, University Hospital Zurich, City Hospital Waid Zurich, Zurich, Switzerland
| | - Heike A Bischoff-Ferrari
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Center on Aging and Mobility, University Hospital Zurich, City Hospital Waid Zurich, Zurich, Switzerland; University Clinic for Acute Geriatric Care, City Hospital Waid, Zurich, Switzerland.
| |
Collapse
|
22
|
Wang S, Freedman ND, Loftfield E, Hua X, Abnet CC. Alcohol consumption and risk of gastric cardia adenocarcinoma and gastric noncardia adenocarcinoma: A 16-year prospective analysis from the NIH-AARP diet and health cohort. Int J Cancer 2018; 143:2749-2757. [PMID: 29992560 DOI: 10.1002/ijc.31740] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 03/20/2018] [Revised: 05/30/2018] [Accepted: 06/21/2018] [Indexed: 12/13/2022]
Abstract
The role of alcoholic beverages in the etiology of gastric cancer is unclear. Recent summaries showed a positive association between higher alcohol intake and gastric cancer risk, but the magnitude of association is small, there is moderate heterogeneity among studies, and most cases were from Asian populations. We prospectively investigated the associations of alcohol consumption with gastric cardia adenocarcinoma (GCA) and gastric noncardia adenocarcinoma (GNCA) in 490,605 adults, aged 50-71 years at baseline who participated in the NIH-AARP diet and health study. Alcohol consumption in the past year was assessed at baseline by questionnaire and defined as total grams of ethanol intake per day or as a categorical variable: nondrinker, up to or including one drink per day, one to three drinks per day and greater than three drinks per day. We used multivariable-adjusted Cox proportional hazards regression to calculate the hazard ratios (HR) and 95% confidence intervals (CI) for associations between alcohol intake and risk of gastric adenocarcinomas. Through 2011, 662 incident cases of GCA and 713 of GNCA occurred. We found no association between higher alcohol consumption and GCA or GNCA, when examined as total alcoholic beverage intake or individual beverage types of beer, wine and liquor. Furthermore, we observed no association by stratum of sex, ethnic group, educational level or smoking status. We did, however, observe lower risk of GNCA among participants who drank up to one drink per day (HR = 0.81, 95% CI: 0.67-0.97) compared to nondrinkers. In conclusion, alcohol consumption was not associated with increased risk of GCA or GNCA in this large U.S. cohort.
Collapse
Affiliation(s)
- ShaoMing Wang
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Neal D Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Erikka Loftfield
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Xing Hua
- Biostatistics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Christian C Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| |
Collapse
|
23
|
Guiroy A, Gagliardi M, Sícoli A, Masanés NG, Ciancio AM, Jalón P, Mezzadri JJ. [Spino-pelvic sagittal parameters in an asymptomatic population in Argentina]. Surg Neurol Int 2018; 9:S36-S42. [PMID: 29430329 PMCID: PMC5799942 DOI: 10.4103/sni.sni_365_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 09/27/2017] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES To assess and describe spinal and pelvic sagittal parameters in a series of 100 Argentinian volunteers. METHODS Lateral full-spine X-rays were obtained prospectively from 100 volunteers (30 males and 70 females), average age 34.1 years. All the volunteers were asymptomatic at the time of the study. Full-length left lateral spine radiographs (36'' cassette) were made using Kodak Elite CR equipment. The authors made determinations for the digital X-rays using Surgimap®, version 2.2.9.9.2. The following parameters were recorded: C7 SVA, C2-C7 CL, TK, LL, TPA, T1SPi, PI, PT, SS, L4-S1 angle, L1-L4 angle, PI-LL mismatch and CTPA. The data were analyzed using Medcalc 11.2 software. Descriptive statistics were calculated for each parameter according to its own measure score and distribution. Estimates of 95% reference and confidence intervals were calculated for each parameter. P = 0.05 was set as the threshold for statistical significance. Volunteers were classified using the Roussouly morphometric classification system. RESULTS Respective means for the above-listed variables were: CL -10.04, TK 30.14, T1SPi -6.5, L1-L4 -12.45, L4-S1 -46.16, CTPA 2.5, TPA 4.65, PT 11.22, PI 48.04, LL -59. 10, PI-LL -11.11, C7 SVA mm -23.68. Plus/minus two standard deviations (SD) for the variables were: CL (-33.26, 13.12); TK (17.15, 43.30); T1SPi (-11.78, -1.25), L1-L4 (-25.55, 0.25), L4-S1 (-64.44, -27.55), CTPA (0.33, 4.80), TPA (-8.64, 18.22), PT (-1.99, 24.75), PI (25.23, 71.44), LL (-78.74, -39.89), PI-LL (-29.10, 7.04), and C7 SVA mm (-79.45, 32.08). CONCLUSIONS In this prospective series of 100 adult volunteers, normal values for spinal and pelvic sagittal parameters were determined in Argentinian adults.
Collapse
Affiliation(s)
- Alfredo Guiroy
- Unidad de Patología Espinal, Servicio de Ortopedia y Traumatología, Hospital Español de Mendoza, Argentina,Sección Columna, División Neurocirugía, Hospital de Clínicas “José de San Martín”, Universidad de Buenos Aires, Argentina,Corresponding author
| | - Martín Gagliardi
- Sección Columna, División Neurocirugía, Hospital de Clínicas “José de San Martín”, Universidad de Buenos Aires, Argentina
| | - Alfredo Sícoli
- Unidad de Patología Espinal, Servicio de Ortopedia y Traumatología, Hospital Español de Mendoza, Argentina
| | - Nicolás Gonzalez Masanés
- Unidad de Patología Espinal, Servicio de Ortopedia y Traumatología, Hospital Español de Mendoza, Argentina
| | - Alejandro Morales Ciancio
- Unidad de Patología Espinal, Servicio de Ortopedia y Traumatología, Hospital Español de Mendoza, Argentina
| | - Pablo Jalón
- Sección Columna, División Neurocirugía, Hospital de Clínicas “José de San Martín”, Universidad de Buenos Aires, Argentina
| | - Juan José Mezzadri
- Sección Columna, División Neurocirugía, Hospital de Clínicas “José de San Martín”, Universidad de Buenos Aires, Argentina
| |
Collapse
|
24
|
Abstract
In this paper, we describe a Bayesian hierarchical Poisson model for the prospective analysis of data for infectious diseases. The proposed model consists of two components. The first component describes the behavior of disease during nonepidemic periods and the second component represents the increase in disease counts due to the presence of an epidemic. A novelty of our model formulation is that the parameters describing the spread of epidemics are allowed to vary in both space and time. We also show how syndromic information can be incorporated into the model to provide a better description of the data and more accurate one-step-ahead forecasts. These real-time forecasts can be used to identify high-risk areas for outbreaks and, consequently, to develop efficient targeted surveillance. We apply the methodology to weekly emergency room discharges for acute bronchitis in South Carolina.
Collapse
Affiliation(s)
- Ana Corberán-Vallet
- Department of Statistics and Operations Research, University of Valencia, Burjassot, Spain
| | - Andrew B Lawson
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, U.S.A
| |
Collapse
|
25
|
Chen HY, Reilly MP, Li M. Semiparametric odds ratio model for case-control and matched case-control designs. Stat Med 2013; 32:3126-42. [PMID: 23307592 DOI: 10.1002/sim.5742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 12/19/2012] [Indexed: 11/09/2022]
Abstract
We propose a semiparametric odds ratio model that extends Umbach and Weinberg's approach to exploiting gene-environment association model for efficiency gains in case-control designs to both discrete and continuous data. We directly model the gene-environment association in the control population to avoid estimating the intercept in the disease risk model, which is inherently difficult because of the scarcity of information on the parameter with the sampling designs. We propose a novel permutation-based approach to eliminate the high-dimensional nuisance parameters in the matched case-control design. The proposed approach reduces to the conditional logistic regression when the model for the gene-environment association is unrestricted. Simulation studies demonstrate good performance of the proposed approach. We apply the proposed approach to a study of gene-environment interaction on coronary artery disease.
Collapse
Affiliation(s)
- Hua Yun Chen
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, Chicago, IL 60612, USA.
| | | | | |
Collapse
|
26
|
Abdullah J, Abdullah MR. Suitability of Parkinson's patients for surgery in the north East coast of peninsular malaysia: a prospective analysis. Malays J Med Sci 2003; 10:74-7. [PMID: 23365504 PMCID: PMC3557113] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2001] [Revised: 12/15/2002] [Accepted: 12/30/2002] [Indexed: 06/01/2023] Open
Abstract
There is no report in the English literature on the criteria for neuroablation or neuroaugmentation for the treatment of Parkinson's disease in a developing country like Malaysia. A prospective study of patients with Parkinson's disease from the north-eastern peninsular Malaysia was done to assess their suitability of surgery. Age, race, duration of illness and dementia were considered important factors towards the success of such surgical procedures. A mathematical model is suggested for future cases deemed to be suitable for neuroaugmentative or ablative surgery.
Collapse
Affiliation(s)
| | - M. R. Abdullah
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| |
Collapse
|
27
|
Van Winkle W, Dey WP, Jinks SM, Bevlhimer MS, Coutant CC. A blueprint for the problem formulation phase of EPA-type ecological risk assessments for 316(b) determinations. ScientificWorldJournal 2002; 2 Suppl 1:271-98. [PMID: 12805899 PMCID: PMC6009690 DOI: 10.1100/tsw.2002.862] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The difference between management objectives focused on sustainability of fish populations and the indigenous aquatic community, and a management objective focused on minimizing entrainment and impingement losses accounts for much of the ongoing controversy surrounding paragraph 316(b). We describe the EPA's ecological risk assessment framework and recommend that this framework be used to more effectively address differences in management objectives and structure paragraph 316(b) determinations. We provide a blueprint for the problem formulation phase of EPA-type ecological risk assessments for cooling-water intake structures (CWIS) at existing power plant facilities. Our management objectives, assessment endpoints, conceptual model, and generic analysis plan apply to all existing facilities. However, adapting the problem formulation process for a specific facility requires consideration of the permitting agency's guidelines and level of regulatory concern, as well as site-specific ecological and technical differences. The facility-specific problem formulation phase is designed around the hierarchy of biological levels of organization in the generic conceptual model and the sequence of cause-effect events and risk hypotheses represented by this model. Problem formulation is designed to be flexible in that it can be tailored for facilities where paragraph 316(b) regulatory concern is low or high. For some facilities, we anticipate that the assessment can be completed based on consideration of susceptibility alone. At the other extreme, a high level of regulatory concern combined with the availability of extensive information and consideration of costly CWIS mitigation options may result in the ecological risk assessment relying on analyses at all levels. Decisions on whether to extend the ecological risk assessment to additional levels should be based on whether regulatory or generator concerns merit additional analyses and whether available information is adequate to support such analyses. In making these decisions, the functional dependence between levels of analysis must be considered in making the transition to the analysis phase and risk estimation component of the ecological risk assessment. Regardless of how the generic analysis plan is modified to develop a facility-specific analysis plan, the resulting plan should be viewed as a tool for comparing representative species and alternative CWIS options by focusing on relative changes (i.e., proportional or percent changes) in various measures. The analysis plan is specifically designed to encourage consideration of multiple lines of evidence and to characterize uncertainties in each line of evidence. Multiple lines of evidence from different levels of analysis, obtained using both prospective and retrospective techniques, provide a broader perspective on the magnitude of potential effects and associated uncertainties and risks. The implications of the EPA's recent (April 2002) proposed regulations for existing facilities on the applicability of this blueprint are briefly considered.
Collapse
Affiliation(s)
- Webster Van Winkle
- Van Winkle Environmental Consulting Co., 5163 N. Backwater Ave., Boise, ID 83703, USA.
| | | | | | | | | |
Collapse
|