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Plante TB, Juraschek SP, Howard G, Howard VJ, Tracy RP, Olson NC, Judd SE, Kamin Mukaz D, Zakai NA, Long DL, Cushman M. Cytokines, C-Reactive Protein, and Risk of Incident Hypertension in the REGARDS Study. Hypertension 2024; 81:1244-1253. [PMID: 38487890 PMCID: PMC11095906 DOI: 10.1161/hypertensionaha.123.22714] [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: 01/08/2024] [Accepted: 02/28/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Hypertension is a highly prevalent cardiovascular disease risk factor that may be related to inflammation. Whether adverse levels of specific inflammatory cytokines relate to hypertension is unknown. The present study sought to determine whether higher levels of IL (interleukin)-1β, IL-6, TNF (tumor necrosis factor)-α, IFN (interferon)-γ, IL-17A, and CRP (C-reactive protein) are associated with a greater risk of incident hypertension. METHODS The REGARDS study (Reasons for Geographic and Racial Difference in Stroke) is a prospective cohort study that recruited 30 239 community-dwelling Black and White adults from the contiguous United States in 2003 to 2007 (visit 1), with follow-up 9 years later in 2013 to 2016 (visit 2). We included participants without prevalent hypertension who attended follow-up 9 years later and had available laboratory measures and covariates of interest. Poisson regression estimated the risk ratio of incident hypertension by level of inflammatory biomarkers. RESULTS Among 1866 included participants (mean [SD] aged of 62 [8] years, 25% Black participants, 55% women), 36% developed hypertension. In fully adjusted models comparing the third to first tertile of each biomarker, there was a greater risk of incident hypertension for higher IL-1β among White (1.24 [95% CI, 1.01-1.53]) but not Black participants (1.01 [95% CI, 0.83-1.23]) and higher TNF-α (1.20 [95% CI, 1.02-1.41]) and IFN-γ (1.22 [95% CI, 1.04-1.42]) among all participants. There was no increased risk with IL-6, IL-17A, or CRP. CONCLUSIONS Higher levels of IL-1β, TNF-α, and IFN-γ, representing distinct inflammatory pathways, are elevated in advance of hypertension development. Whether modifying these cytokines will reduce incident hypertension is unknown.
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Affiliation(s)
- Timothy B. Plante
- Departments of Medicine (T.B.P., D.K.M., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
| | - Stephen P. Juraschek
- Department of Medicine, Beth Israel Lahey Clinic/Harvard Medical School, Boston, MA (S.P.J)
| | - George Howard
- Departments of Biostatistics (G.H., S.E.J.), School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Virginia J. Howard
- Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Russell P. Tracy
- Pathology and Laboratory Medicine (R.P.T., N.C.O., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
| | - Nels C. Olson
- Pathology and Laboratory Medicine (R.P.T., N.C.O., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
| | - Suzanne E. Judd
- Departments of Biostatistics (G.H., S.E.J.), School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Debora Kamin Mukaz
- Departments of Medicine (T.B.P., D.K.M., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
| | - Neil A. Zakai
- Departments of Medicine (T.B.P., D.K.M., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
- Pathology and Laboratory Medicine (R.P.T., N.C.O., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
| | - D. Leann Long
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC (D.L.L.)
| | - Mary Cushman
- Departments of Medicine (T.B.P., D.K.M., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
- Pathology and Laboratory Medicine (R.P.T., N.C.O., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
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Swain CTV, Masters M, Lynch BM, Patel AV, Rees-Punia E. Physical activity and pain in people with and without cancer. Cancer 2024; 130:2042-2050. [PMID: 38343307 DOI: 10.1002/cncr.35208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 05/18/2024]
Abstract
BACKGROUND Performing physical activity may provide analgesic benefit, although this effect is more established for noncancer pain rather than cancer pain. The relationship between physical activity and pain outcomes in adults with and without a history of cancer was examined. METHODS Totals of 51,439 adults without a cancer history and 10,651 adults with a cancer history from the Cancer Prevention Study II Nutrition Cohort were included. Exposures included self-reported moderate to vigorous physical activity (MVPA) as well as 2-year change in MVPA. Pain outcomes included pain intensity (primary outcome) and analgesic use (secondary outcome). RESULTS MVPA was inversely associated with pain intensity for adults with (odds ratio [OR], 0.84 [≥15 metabolic equivalent of task (MET) h/week vs. <7.5 MET h/week]; 95% confidence interval [CI], 0.76-0.93) and without (OR, 0.79; 95% CI, 0.75-0.82) a history of cancer. Compared to remaining inactive, participants who became sufficiently active (cancer: OR, 0.76; 95% CI, 0.68-0.86; no cancer: OR, 0.73; 95% CI, 0.69-0.77), became inactive (cancer: OR, 0.79; 95% CI, 0.71-0.88; no cancer: OR, 0.84; 95% CI, 0.80-0.89), or remained sufficiently active (cancer: OR, 0.66; 95% CI, 0.60-0.72; no cancer: OR, 0.62; 95% CI, 0.60-0.65) also reported less pain. Physical activity was not related to analgesic use. CONCLUSIONS The relationship between physical activity and pain intensity was not substantially different between people with and without a history of cancer. Cancer survivors who perform more activity, or who increase their activity, may experience less pain than cancer survivors who consistently perform less. PLAIN LANGUAGE SUMMARY People who have had cancer often experience ongoing pain. Being physically active may help reduce the intensity of the pain they experience.
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Affiliation(s)
- Christopher T V Swain
- Department of Physiotherapy, Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Matthew Masters
- Department of Population Science, American Cancer Society, Atlanta, Georgia, USA
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Alpa V Patel
- Department of Population Science, American Cancer Society, Atlanta, Georgia, USA
| | - Erika Rees-Punia
- Department of Population Science, American Cancer Society, Atlanta, Georgia, USA
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De la Torre K, Song M, Abe SK, Rahman MS, Islam MR, Saito E, Min S, Huang D, Chen Y, Gupta PC, Sawada N, Tamakoshi A, Shu X, Wen W, Sakata R, Kim J, Nagata C, Ito H, Park SK, Shin M, Pednekar MS, Tsugane S, Kimura T, Gao Y, Cai H, Wada K, Oze I, Shin A, Ahn Y, Ahsan H, Boffetta P, Chia KS, Matsuo K, Qiao Y, Rothman N, Zheng W, Inoue M, Kang D. Diabetes and gastric cancer incidence and mortality in the Asia Cohort Consortium: A pooled analysis of more than a half million participants. J Diabetes 2024; 16:e13561. [PMID: 38751364 PMCID: PMC11096812 DOI: 10.1111/1753-0407.13561] [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: 12/15/2023] [Revised: 02/19/2024] [Accepted: 03/14/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Evidence suggests a possible link between diabetes and gastric cancer risk, but the findings remain inconclusive, with limited studies in the Asian population. We aimed to assess the impact of diabetes and diabetes duration on the development of gastric cancer overall, by anatomical and histological subtypes. METHODS A pooled analysis was conducted using 12 prospective studies included in the Asia Cohort Consortium. Among 558 981 participants (median age 52), after a median follow-up of 14.9 years and 10.5 years, 8556 incident primary gastric cancers and 8058 gastric cancer deaths occurred, respectively. Cox proportional hazard regression models were used to estimate study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) and pooled using random-effects meta-analyses. RESULTS Diabetes was associated with an increased incidence of overall gastric cancer (HR 1.15, 95% CI 1.06-1.25). The risk association did not differ significantly by sex (women vs men: HR 1.31, 95% CI 1.07-1.60 vs 1.12, 1.01-1.23), anatomical subsites (noncardia vs cardia: 1.14, 1.02-1.28 vs 1.17, 0.77-1.78) and histological subtypes (intestinal vs diffuse: 1.22, 1.02-1.46 vs 1.00, 0.62-1.61). Gastric cancer risk increased significantly during the first decade following diabetes diagnosis (HR 4.70, 95% CI 3.77-5.86), and decreased with time (nonlinear p < .01). Positive associations between diabetes and gastric cancer mortality were observed (HR 1.15, 95% CI 1.03-1.28) but attenuated after a 2-year time lag. CONCLUSION Diabetes was associated with an increased gastric cancer incidence regardless of sex, anatomical subsite, or subtypes of gastric cancer. The risk of gastric cancer was particularly high during the first decade following diabetes diagnosis.
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Grants
- R37 CA070867 NCI NIH HHS
- 30-A-15,23-A-31(toku),26-A-2,29-A-4 National Cancer Center Japan Research and Development Fund
- 24H1080 National Cancer Center Korea Research Grant
- 0520160-1 National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea
- 23-A-31 Ministry of Health, Labour and Welfare of Japan
- NRF-2016R1A2B4014552 National Research Foundation of Korea
- The Japanese Ministry of the Environment
- Ministry of Education, Culture, Sports, Science and Technology, Japan
- International Agency for Research on Cancer, Lyon, France
- 2210990 National Cancer Center Korea Research Grant
- US Department of Energy
- UM1 CA173640 NCI NIH HHS
- UM1 CA182910 NCI NIH HHS
- Ministry of Education, Culture, Sports, Science and Technology, Japan
- Ministry of Health, Labour and Welfare of Japan
- National Research Foundation of Korea
- Division of Cancer Prevention, National Cancer Institute
- The Japanese Ministry of the Environment
- International Agency for Research on Cancer, Lyon, France
- US Department of Energy
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Affiliation(s)
- Katherine De la Torre
- Department of Biomedical SciencesSeoul National University Graduate SchoolSeoulKorea
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
| | - Minkyo Song
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMarylandUSA
- Laboratory of Epidemiology and Population SciencesNational Institute on Aging, National Institute of HealthBaltimoreMarylandUSA
| | - Sarah Krull Abe
- Division of PreventionNational Cancer Center Institute for Cancer ControlTokyoJapan
| | - Md. Shafiur Rahman
- Division of PreventionNational Cancer Center Institute for Cancer ControlTokyoJapan
- Research Center for Child Mental Development, Hamamatsu University School of MedicineTokyoJapan
| | - Md. Rashedul Islam
- Division of PreventionNational Cancer Center Institute for Cancer ControlTokyoJapan
- Hitotsubashi Institute for Advanced Study, Hitotsubashi UniversityTokyoJapan
| | - Eiko Saito
- Institute for Global Health Policy Research, National Center for Global Health and MedicineTokyoJapan
| | - Sukhong Min
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
| | - Dan Huang
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate SchoolSeoulKorea
| | - Yu Chen
- Department of Population Health and Environmental MedicineNYU Grossman School of MedicineNew YorkNew YorkUSA
| | | | - Norie Sawada
- Division of Cohort ResearchNational Cancer Center Institute for Cancer ControlTokyoJapan
| | - Akiko Tamakoshi
- Department of Public HealthHokkaido University Faculty of MedicineSapporoJapan
| | - Xiao‐Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center Vanderbilt‐Ingram Cancer CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center Vanderbilt‐Ingram Cancer CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Ritsu Sakata
- Radiation Effects Research FoundationHiroshimaJapan
| | - Jeongseon Kim
- Graduate School of Cancer Science and Policy, National Cancer CenterGoyangKorea
| | - Chisato Nagata
- Department of Epidemiology and Preventive MedicineGifu University Graduate School of MedicineGifuJapan
| | - Hidemi Ito
- Department of Preventive Medicine, Division of Cancer Information and ControlAichi Cancer Center Research InstituteNagoyaJapan
- Division of Descriptive Cancer EpidemiologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Sue K. Park
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
| | - Myung‐Hee Shin
- Department of Social and Preventive MedicineSungkyunkwan University School of MedicineSeoulKorea
| | | | - Shoichiro Tsugane
- Division of Cohort ResearchNational Cancer Center Institute for Cancer ControlTokyoJapan
- International University of Health and Welfare Graduate SchoolTokyoJapan
| | - Takashi Kimura
- Department of Public HealthHokkaido University Faculty of MedicineSapporoJapan
| | - Yu‐Tang Gao
- Department of EpidemiologyShanghai Cancer InstituteShanghaiChina
- Renji Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center Vanderbilt‐Ingram Cancer CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Keiko Wada
- Department of Epidemiology and Preventive MedicineGifu University Graduate School of MedicineGifuJapan
| | - Isao Oze
- Division of Cancer Epidemiology and PreventionAichi Cancer Center Research InstituteNagoyaJapan
| | - Aesun Shin
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
- Cancer Research Institute, Seoul National UniversitySeoulKorea
| | - Yoon‐Ok Ahn
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
| | - Habibul Ahsan
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinoisUSA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook UniversityStony BrookNew YorkUSA
- Department of Medical and Surgical SciencesUniversity of BolognaBolognaItaly
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of SingaporeSingaporeSingapore
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and PreventionAichi Cancer Center Research InstituteNagoyaJapan
- Department of Cancer EpidemiologyNagoya University Graduate School of Medicine NagoyaNagoyaJapan
| | - You‐Lin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMarylandUSA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center Vanderbilt‐Ingram Cancer CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Manami Inoue
- Division of PreventionNational Cancer Center Institute for Cancer ControlTokyoJapan
| | - Daehee Kang
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate SchoolSeoulKorea
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Kim JH, Goh MS, Song JH, Chang M. Alteration of Keratinized Mucosa Dimensions in the Early Healing Period after Implant Placement: A 6-month Prospective Study. Int J Oral Maxillofac Implants 2024; 0:1-27. [PMID: 38728148 DOI: 10.11607/jomi.10912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
PURPOSE This study aimed to assess the alteration in keratinized mucosa (KM) dimensions in the early healing period after implant placement, and the influence of variables obtained during implant surgery on KM alteration. MATERIALS AND METHODS Study participants were consecutively recruited from patients who had received implants following a non-submerged surgical protocol. The implant had to be installed in the extraction socket that had healed for more than 6 months without any soft or hard tissue augmentation. Keratinized mucosa width (KMW), keratinized mucosa thickness (KMT), soft tissue level (STL), and probing pocket depth (PPD) were measured at implant placement and 3 and 6 months after implant surgery. The influence of variables obtained during implant surgery on the 6-month KMW alteration was assessed. RESULTS A total of 66 implants in 55 patients who completed the follow-up examination after 6 months were included in this study. KMW, KMT, and STL significantly decreased at 3- and 6-months examination by 0.7-1.2 mm. KMW was reduced by 24.6%. Mesial PPD significantly increased between the 3- and 6-months follow-up. In the multivariate generalized estimating estimations analysis, the implant diameter negatively influenced the 6-month KMW alteration, but the KMW at implant surgery positively influenced the 6-month KMW alteration. CONCLUSIONS The KMW decreased significantly at 3 and 6 months after implant placement. If the initial KMW was wider, the KMW was reduced more at 6 months after implant placement. Therefore, it is important to carefully monitor KMW alterations during the early healing period to ensure optimal esthetics and peri-implant tissue health.
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Williams SE, Ginty AT. A stress-is-enhancing mindset is associated with lower traumatic stress symptoms during the COVID-19 pandemic. Anxiety Stress Coping 2024; 37:293-304. [PMID: 37968945 DOI: 10.1080/10615806.2023.2282092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 11/06/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND A stress-is-enhancing mindset is associated with lower perceived stress and better coping. However, work examining the prospective associations of stress mindset on perceived traumatic stress symptoms during a stressful real-world life event is limited. The present prospective study explored whether stress-is-enhancing mindset measured before the onset of the COVID-19 global pandemic was associated with later traumatic stress symptoms in response to the COVID-19 global pandemic. METHODS University students (N = 179; 68% female; Mage = 19.31, SD = 0.79 years) completed the Stress Mindset Measure (SMM) prior to COVID-19 pandemic onset as part of a larger study. The Impact of Event Scale-Revised (IES-R) with respect to the COVID-19 pandemic was completed 1 year into the pandemic. RESULTS SMM negatively predicted the IES-R subscales intrusion, avoidance, and hyperarousal such that a more stress-is-enhancing mindset was associated with lower intrusion, avoidance, and hyperarousal following the onset of COVID-19. CONCLUSIONS Results suggest a more positive stress mindset is associated with fewer traumatic stress symptoms following a traumatic life event. Altering stress mindset may be an avenue for future interventions to cope with stress.
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Affiliation(s)
- Sarah E Williams
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
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Norton GR, An DW, Aparicio LS, Yu YL, Wei FF, Niiranen TJ, Liu C, Stolarz-Skrzypek K, Wojciechowska W, Jula AM, Rajzer M, Martens DS, Verhamme P, Li Y, Kawecka-Jaszcz K, Nawrot TS, Staessen JA, Woodiwiss AJ. Mortality and Cardiovascular End Points In Relation to the Aortic Pulse Wave Components: An Individual-Participant Meta-Analysis. Hypertension 2024; 81:1065-1075. [PMID: 38390718 PMCID: PMC11025606 DOI: 10.1161/hypertensionaha.123.22036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/11/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Wave separation analysis enables individualized evaluation of the aortic pulse wave components. Previous studies focused on the pressure height with overall positive but differing results. In the present analysis, we assessed the associations of the pressure of forward and backward (Pfor and Pref) pulse waves with prospective cardiovascular end points, with extended analysis for time to pressure peak (Tfor and Tref). METHODS Participants in 3 IDCARS (International Database of Central Arterial Properties for Risk Stratification) cohorts (Argentina, Belgium, and Finland) aged ≥20 years with valid pulse wave analysis and follow-up data were included. Pulse wave analysis was done using the SphygmoCor device, and pulse wave separation was done using the triangular method. The primary end points consisted of cardiovascular mortality and nonfatal cardiovascular and cerebrovascular events. Multivariable-adjusted Cox regression was used to calculate hazard ratios. RESULTS A total of 2206 participants (mean age, 57.0 years; 55.0% women) were analyzed. Mean±SDs for Pfor, Pref, Tfor, and Tfor/Tref were 31.0±9.1 mm Hg, 20.8±8.4 mm Hg, 130.8±35.5, and 0.51±0.11, respectively. Over a median follow-up of 4.4 years, 146 (6.6%) participants experienced a primary end point. Every 1 SD increment in Pfor, Tfor, and Tfor/Tref was associated with 27% (95% CI, 1.07-1.49), 25% (95% CI, 1.07-1.45), and 32% (95% CI, 1.12-1.56) higher risk, respectively. Adding Tfor and Tfor/Tref to existing risk models improved model prediction (∆Uno's C, 0.020; P<0.01). CONCLUSIONS Pulse wave components were predictive of composite cardiovascular end points, with Tfor/Tref showing significant improvement in risk prediction. Pending further confirmation, the ratio of time to forward and backward pressure peak may be useful to evaluate increased afterload and signify increased cardiovascular risk.
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Affiliation(s)
- Gavin R. Norton
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (G.R.N., A.J.W.)
| | - De-Wei An
- Department of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (D.-W.A., Y.L.)
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (D.-W.A, Y.-L.Y., K.S.-S., J.A.S.)
- Research Unit Environment and Health, Department of Public Health and Primary Care (D.-W.A, Y.-L.Y., T.S.N.), University of Leuven, Belgium
| | - Lucas S. Aparicio
- Servicio de Clínica Médica, Sección Hipertensión Arterial, Hospital Italiano de Buenos Aires, Argentina (L.S.A.)
| | - Yu-Ling Yu
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (D.-W.A, Y.-L.Y., K.S.-S., J.A.S.)
- Research Unit Environment and Health, Department of Public Health and Primary Care (D.-W.A, Y.-L.Y., T.S.N.), University of Leuven, Belgium
| | - Fang-Fei Wei
- The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China (F.-F.W., C.L.)
| | - Teemu J. Niiranen
- Department of Chronic Disease Prevention, Finnish Institute for Health and Welfare, Turku, Finland (T.J.N., A.M.J.)
- Department of Medicine, Turku University Hospital and University of Turku, Finland (T.J.N., A.M.J.)
| | - Chen Liu
- The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China (F.-F.W., C.L.)
| | - Katarzyna Stolarz-Skrzypek
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (D.-W.A, Y.-L.Y., K.S.-S., J.A.S.)
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (K.S.-S., W.W., K.K.-J., M.R.)
| | - Wiktoria Wojciechowska
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (K.S.-S., W.W., K.K.-J., M.R.)
| | - Antti M. Jula
- Department of Chronic Disease Prevention, Finnish Institute for Health and Welfare, Turku, Finland (T.J.N., A.M.J.)
- Department of Medicine, Turku University Hospital and University of Turku, Finland (T.J.N., A.M.J.)
| | - Marek Rajzer
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (K.S.-S., W.W., K.K.-J., M.R.)
| | - Dries S. Martens
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium (D.S.M., T.S.N)
| | - Peter Verhamme
- Center for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences (P.V.), University of Leuven, Belgium
| | - Yan Li
- Department of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (D.-W.A., Y.L.)
| | - Kalina Kawecka-Jaszcz
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (K.S.-S., W.W., K.K.-J., M.R.)
| | - Tim S. Nawrot
- Research Unit Environment and Health, Department of Public Health and Primary Care (D.-W.A, Y.-L.Y., T.S.N.), University of Leuven, Belgium
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium (D.S.M., T.S.N)
| | - Jan A. Staessen
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (D.-W.A, Y.-L.Y., K.S.-S., J.A.S.)
- Biomedical Science Group, Faculty of Medicine (J.A.S.), University of Leuven, Belgium
| | - Angela J. Woodiwiss
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (G.R.N., A.J.W.)
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Scime NV, Turner S, Miliku K, Simons E, Moraes TJ, Field CJ, Turvey SE, Subbarao P, Mandhane PJ, Azad MB. Association of Human Milk Fatty Acid Composition with Maternal Cardiometabolic Diseases: An Exploratory Prospective Cohort Study. Breastfeed Med 2024; 19:357-367. [PMID: 38501380 DOI: 10.1089/bfm.2024.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Background: Human milk fatty acids derive from maternal diet, body stores, and mammary synthesis and may reflect women's underlying cardiometabolic health. We explored whether human milk fatty acid composition was associated with maternal cardiometabolic disease (CMD) during pregnancy and up to 5 years postpartum. Materials and Methods: We analyzed data from the prospective CHILD Cohort Study on 1,018 women with no preexisting CMD who provided breast milk samples at 3-4 months postpartum. Milk fatty acid composition was measured using gas-liquid chromatography. Maternal CMD (diabetes or hypertension) was classified using questionnaires and birth records as no CMD (reference outcome group; 81.1%), perinatal CMD (developed and resolved during the perinatal period; 14.9%), persistent CMD (developed during, and persisted beyond, the perinatal period; 2.9%), and incident CMD (developed after the perinatal period; 1.1%). Multinomial logistic regression was used to model associations between milk fatty acid composition (individual, summary, ratios, and patterns identified using principal component analysis) and maternal CMD, adjusting for pre-pregnancy anthropometry and race/ethnicity. Results: Medium-chain saturated fatty acids (MC-SFA), lauric (C12:0; odds ratio [OR] = 0.73, 95% confidence interval [CI] = 0.60-0.89) and myristic acid (C14:0; OR = 0.80, 95% CI = 0.66-0.97), and the high MC-SFA principal component pattern (OR = 0.86, 95% CI = 0.76-0.96) were inversely associated with perinatal CMD. Long-chain polyunsaturated fatty acids adrenic acid (C22:4n-6) was positively associated with perinatal (OR = 1.21, 95% CI = 1.01-1.44) and persistent CMD (OR = 1.56, 95% CI = 1.08-2.25). The arachidonic (C20:4n-6)-to-docosahexaenoic acid (C22:6n-3) ratio was inversely associated with incident CMD (OR = 0.52, 95% CI = 0.28-0.96). Conclusions: These exploratory findings highlight a potential novel utility of breast milk for understanding women's cardiometabolic health.
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Affiliation(s)
- Natalie V Scime
- Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Sarah Turner
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kozeta Miliku
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Elinor Simons
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Theo J Moraes
- Division of Respiratory Medicine, Department of Pediatrics, SickKids Research Institute, Toronto, Ontario, Canada
| | - Catherine J Field
- Department of Agricultural Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Stuart E Turvey
- BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
- Division of Allergy and Immunology, Department of Pediatrics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Padmaja Subbarao
- Division of Respiratory Medicine, Department of Pediatrics, SickKids Research Institute, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Piushkumar J Mandhane
- Department of Pediatrics, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Meghan B Azad
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
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8
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Akeda K, Takegami N, Yamada J, Fujiwara T, Murata K, Kono T, Sudo T, Imanishi T, Kurata T, Kawakita E, Sakakibara T, Kondo T, Takegami K, Sato M, Sudo A. Influence of Central Sensitization on Surgical Outcomes of Patients With Degenerative Cervical Myelopathy After Posterior Decompression Surgery: A Multicenter Prospective Study. Global Spine J 2024; 14:1277-1286. [PMID: 36350595 DOI: 10.1177/21925682221139813] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
STUDY DESIGN Multicenter prospective study. OBJECTIVE The influence of central sensitization (CS) on neurological symptoms and surgical outcomes in patients with degenerative cervical myelopathy (DCM) remains unknown. This study aimed to investigate the effects of preoperative CS on surgical outcomes of patients with DCM following posterior decompression surgery. METHODS 77 consecutive patients with DCM (mean age 67.1) who received posterior decompression surgery were included in this study. The participants completed CS inventory (CSI) scores and the following patient-reported outcome measures (PROMs) preoperatively and 12 months postoperatively: the Japanese Orthopaedic Association (JOA) score for cervical myelopathy and JOA cervical myelopathy evaluation questionnaire (JOACMEQ) for cervical spinal diseases. The association of preoperative CSI scores with preoperative and postoperative PROMs was analyzed, and their changes were statistically evaluated. RESULTS The preoperative CSI score was significantly decreased at 12 months postoperatively, and it was significantly associated with the JOA score and JOACMEQ preoperatively and at 12 months postoperatively. However, no significant association was observed between preoperative CSI and the postoperative change of any PROMs at 12 months. The posterior decompression surgery significantly improved the JOA scores and 'lower extremity function' and 'quality of life (QOL)' domains of the JOACMEQ, independent of the severity of preoperative CSI score. Multiple regression analysis demonstrated that preoperative CSI was significantly associated with the 'QOL' domain of JOACMEQ and original JOA score at 12 months postoperatively. CONCLUSION The CSI score can be an auxiliary indicator of surgical outcomes of patients with DCM following posterior decompression surgery.
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Affiliation(s)
- Koji Akeda
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
- Department of Orthopedic Surgery, Iwasaki Hospital, Tsu, Japan
| | - Norihiko Takegami
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Junichi Yamada
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
- Department of Orthopedic Surgery, Iwasaki Hospital, Tsu, Japan
| | - Tatsuhiko Fujiwara
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Koichiro Murata
- Department of Orthopedic Surgery, Tomidahama Hospital, Yokkaichi, Japan
| | - Toshifumi Kono
- Department of Orthopedic Surgery, Tomidahama Hospital, Yokkaichi, Japan
| | - Takao Sudo
- Department of Orthopedic Surgery, Murase Hospital, Suzuka, Japan
| | - Takao Imanishi
- Department of Orthopedic Surgery, Murase Hospital, Suzuka, Japan
| | - Tatsuya Kurata
- Department of Orthopedic Surgery, Sakakibara Onsen Hospital, Tsu, Japan
| | - Eiji Kawakita
- Department of Orthopedic Surgery, Saiseikai Matsusaka General Hospital, Matsusaka, Japan
| | | | - Tetsushi Kondo
- Department of Orthopedic Surgery, Murase Hospital, Suzuka, Japan
| | - Kenji Takegami
- Department of Orthopedic Surgery, Saiseikai Matsusaka General Hospital, Matsusaka, Japan
| | - Masayoshi Sato
- Department of Orthopedic Surgery, Iga City General Hospital, Japan
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
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9
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Major CG, Rodríguez DM, Sánchez-González L, Rodríguez-Estrada V, Morales-Ortíz T, Torres C, Pérez-Rodríguez NM, Medina-Lópes NA, Alexander N, Mabey D, Ryff K, Tosado-Acevedo R, Muñoz-Jordán J, Adams LE, Rivera-Amill V, Rolfes M, Paz-Bailey G. Investigating SARS-CoV-2 Incidence and Morbidity in Ponce, Puerto Rico: Protocol and Baseline Results From a Community Cohort Study. JMIR Res Protoc 2024; 13:e53837. [PMID: 38640475 PMCID: PMC11034577 DOI: 10.2196/53837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/19/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND A better understanding of SARS-CoV-2 infection risk among Hispanic and Latino populations and in low-resource settings in the United States is needed to inform control efforts and strategies to improve health equity. Puerto Rico has a high poverty rate and other population characteristics associated with increased vulnerability to COVID-19, and there are limited data to date to determine community incidence. OBJECTIVE This study describes the protocol and baseline seroprevalence of SARS-CoV-2 in a prospective community-based cohort study (COPA COVID-19 [COCOVID] study) to investigate SARS-CoV-2 infection incidence and morbidity in Ponce, Puerto Rico. METHODS In June 2020, we implemented the COCOVID study within the Communities Organized to Prevent Arboviruses project platform among residents of 15 communities in Ponce, Puerto Rico, aged 1 year or older. Weekly, participants answered questionnaires on acute symptoms and preventive behaviors and provided anterior nasal swab samples for SARS-CoV-2 polymerase chain reaction testing; additional anterior nasal swabs were collected for expedited polymerase chain reaction testing from participants that reported 1 or more COVID-19-like symptoms. At enrollment and every 6 months during follow-up, participants answered more comprehensive questionnaires and provided venous blood samples for multiantigen SARS-CoV-2 immunoglobulin G antibody testing (an indicator of seroprevalence). Weekly follow-up activities concluded in April 2022 and 6-month follow-up visits concluded in August 2022. Primary study outcome measures include SARS-CoV-2 infection incidence and seroprevalence, relative risk of SARS-CoV-2 infection by participant characteristics, SARS-CoV-2 household attack rate, and COVID-19 illness characteristics and outcomes. In this study, we describe the characteristics of COCOVID participants overall and by SARS-CoV-2 seroprevalence status at baseline. RESULTS We enrolled a total of 1030 participants from 388 households. Relative to the general populations of Ponce and Puerto Rico, our cohort overrepresented middle-income households, employed and middle-aged adults, and older children (P<.001). Almost all participants (1021/1025, 99.61%) identified as Latino/a, 17.07% (175/1025) had annual household incomes less than US $10,000, and 45.66% (463/1014) reported 1 or more chronic medical conditions. Baseline SARS-CoV-2 seroprevalence was low (16/1030, 1.55%) overall and increased significantly with later study enrollment time (P=.003). CONCLUSIONS The COCOVID study will provide a valuable opportunity to better estimate the burden of SARS-CoV-2 and associated risk factors in a primarily Hispanic or Latino population, assess the limitations of surveillance, and inform mitigation measures in Puerto Rico and other similar populations. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/53837.
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Affiliation(s)
- Chelsea G Major
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Dania M Rodríguez
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Liliana Sánchez-González
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | | | | | - Carolina Torres
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
- Kāpili Services, LLC, Alaka`ina Foundation Family of Companies, Orlando, FL, United States
| | - Nicole M Pérez-Rodríguez
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Nicole A Medina-Lópes
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Neal Alexander
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - David Mabey
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Kyle Ryff
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Rafael Tosado-Acevedo
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Jorge Muñoz-Jordán
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Laura E Adams
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | | | - Melissa Rolfes
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gabriela Paz-Bailey
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
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10
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Swartz EE, Myers JL, Lee JS, Broglio SP, Furutani T, Oshiro R, Gioia GA, Brothers D, Glodowski K, Lloansi I, Meyer L, Murata N. Head Impact Exposure in Hawaiian High School Football: Influence of Adherence Rates on a Helmetless Tackling and Blocking Training Intervention. J Athl Train 2024:500046. [PMID: 38632840 DOI: 10.4085/1062-6050-0014.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
CONTEXT High school football remains a popular, physically demanding sport despite the known risks for acute brain and neck injury. Impacts to the head also raise concerns about their cumulative effects and long-term health consequences. OBJECTIVE To examine the effectiveness of a helmetless tackling training program to reduce head impact exposure in football participants. DESIGN A three-year, quasi-experimental, prospective cohort (clinicaltrials.gov #NCTXXX) study. SETTING Honolulu (XXX, XXX) area public and private secondary schools with varsity and junior varsity football. PATIENTS OR OTHER PARTICIPANTS Football participants (n=496) ages 14 to 18 years old. Intervention(s) Participants wore new football helmets furnished with head impact sensor technology. Teams employed a season-long helmetless tackling and blocking intervention in Years 2 and 3 consisting of a 3-phase, systematic progression of 10 instructional drills. MAIN OUTCOME MEASURE(S) Head impact frequency per athlete exposure (ImpAE), location, and impact magnitude per participant intervention adherence levels (60% and 80%). RESULTS An overall regression analysis revealed a significant negative association between ImpAE and adherence (p=0.003, beta=-1.21, SE=0.41). In year 3, a longitudinal data analysis of weekly ImpAE data resulted in an overall difference between the adherent and non-adherent groups (p=0.040 at 80%; p=0.004 at 60%), mainly due to decreases in top and side impacts. Mean cumulative impact burden for the adherent group (n=131: 2,105.84g ± 219.76,) was significantly (p=0.020) less than the non-adherent group (n=90: 3,158.25g ± 434.80) at the 60% adherence level. CONCLUSIONS Participants adhering to the intervention on at least a 60% level experienced a 34% to 37% significant reduction in the number of head impacts (per exposure) through the season. These results provide additional evidence that a helmetless tackling and blocking training intervention (utilizing the HuTT® program) reduces head impact exposure in high school football players. Adherence to an intervention is crucial for achieving intended outcomes.
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Affiliation(s)
- Erik E Swartz
- Vice Dean & Ruth S. Ammon Professor School of Health Sciences, Ruth S. Ammon College of Education and Health Sciences Adelphi University Harvey Hall 116, 1 South Avenue Garden City, NY 11530 Phone: 516.877.4094
| | - Jay L Myers
- Assistant Professor, Department of Biology Southern New Hampshire University
| | - Jong Soo Lee
- Associate Professor, Department of Mathematics and Statistics University of Massachusetts Lowell
| | - Steven P Broglio
- Associate Dean, Professor, School of Kinesiology Director, U-M Concussion Center University of Michigan
| | - Troy Furutani
- Program Manager, Hawaii Concussion Awareness and Management Program, Department of Kinesiology and Rehabilitation Science University of Hawai'i at Manoa
| | - Ross Oshiro
- Program Coordinator, Hawaii Concussion Awareness & Management Program, Department of Kinesiology & Rehabilitation Science University of Hawai'i at Manoa
| | - Gerard A Gioia
- SCORE Program, Children's National Hospital, Professor, Depts of Pediatrics and Psychiatry George Washington University School of Medicine
| | - Darian Brothers
- Graduate Assistant, Department of Kinesiology and Rehabilitation Science University of Hawai'i at Manoa
| | - Kiera Glodowski
- Graduate Assistant, Department of Kinesiology and Rehabilitation Science University of Hawai'i at Manoa
| | - Ivet Lloansi
- Graduate Assistant, Department of Kinesiology and Rehabilitation Science University of Hawai'i at Manoa
| | - Lauren Meyer
- Graduate Assistant, Department of Kinesiology and Rehabilitation Science University of Hawai'i at Manoa
| | - Nathan Murata
- Dean, College of Education University of Hawai'i at Manoa
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Kicic-Starcevich E, Hancock DG, Iosifidis T, Agudelo-Romero P, Caparros-Martin JA, Karpievitch YV, Silva D, Turkovic L, Le Souef PN, Bosco A, Martino DJ, Kicic A, Prescott SL, Stick SM. Airway epithelium respiratory illnesses and allergy (AERIAL) birth cohort: study protocol. Front Allergy 2024; 5:1349741. [PMID: 38666051 PMCID: PMC11043573 DOI: 10.3389/falgy.2024.1349741] [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: 12/05/2023] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Introduction Recurrent wheezing disorders including asthma are complex and heterogeneous diseases that affect up to 30% of all children, contributing to a major burden on children, their families, and global healthcare systems. It is now recognized that a dysfunctional airway epithelium plays a central role in the pathogenesis of recurrent wheeze, although the underlying mechanisms are still not fully understood. This prospective birth cohort aims to bridge this knowledge gap by investigating the influence of intrinsic epithelial dysfunction on the risk for developing respiratory disorders and the modulation of this risk by maternal morbidities, in utero exposures, and respiratory exposures in the first year of life. Methods The Airway Epithelium Respiratory Illnesses and Allergy (AERIAL) study is nested within the ORIGINS Project and will monitor 400 infants from birth to 5 years. The primary outcome of the AERIAL study will be the identification of epithelial endotypes and exposure variables that influence the development of recurrent wheezing, asthma, and allergic sensitisation. Nasal respiratory epithelium at birth to 6 weeks, 1, 3, and 5 years will be analysed by bulk RNA-seq and DNA methylation sequencing. Maternal morbidities and in utero exposures will be identified on maternal history and their effects measured through transcriptomic and epigenetic analyses of the amnion and newborn epithelium. Exposures within the first year of life will be identified based on infant medical history as well as on background and symptomatic nasal sampling for viral PCR and microbiome analysis. Daily temperatures and symptoms recorded in a study-specific Smartphone App will be used to identify symptomatic respiratory illnesses. Discussion The AERIAL study will provide a comprehensive longitudinal assessment of factors influencing the association between epithelial dysfunction and respiratory morbidity in early life, and hopefully identify novel targets for diagnosis and early intervention.
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Affiliation(s)
| | - David G. Hancock
- Wal-yan RespiratoryResearch Centre, Telethon Kids Institute, Perth, WA, Australia
- Department of Respiratory and Sleep Medicine, Perth Children’s Hospital, Nedlands, WA, Australia
- School of Medicine, The University of Western Australia, Nedlands, WA, Australia
| | - Thomas Iosifidis
- Wal-yan RespiratoryResearch Centre, Telethon Kids Institute, Perth, WA, Australia
- School of Population Health, Curtin University, Bentley, WA, Australia
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine, The University of Western Australia, Nedlands, WA, Australia
| | - Patricia Agudelo-Romero
- Wal-yan RespiratoryResearch Centre, Telethon Kids Institute, Perth, WA, Australia
- European Virus Bioinformatics Centre, Jena, Germany
| | | | | | - Desiree Silva
- School of Medicine, The University of Western Australia, Nedlands, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
- Department of Paediatrics and Neonatology, Joondalup Health Campus, Joondalup, WA, Australia
- School of Medicine and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | | | - Peter N. Le Souef
- Wal-yan RespiratoryResearch Centre, Telethon Kids Institute, Perth, WA, Australia
- Department of Respiratory and Sleep Medicine, Perth Children’s Hospital, Nedlands, WA, Australia
| | - Anthony Bosco
- School of Population Health, Curtin University, Bentley, WA, Australia
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, United States
- Department of Immunobiology, The University of Arizona College of Medicine, Tucson, AZ, United States
| | - David J. Martino
- Wal-yan RespiratoryResearch Centre, Telethon Kids Institute, Perth, WA, Australia
| | - Anthony Kicic
- Wal-yan RespiratoryResearch Centre, Telethon Kids Institute, Perth, WA, Australia
- School of Population Health, Curtin University, Bentley, WA, Australia
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine, The University of Western Australia, Nedlands, WA, Australia
| | - Susan L. Prescott
- School of Medicine, The University of Western Australia, Nedlands, WA, Australia
- European Virus Bioinformatics Centre, Jena, Germany
| | - Stephen M. Stick
- Wal-yan RespiratoryResearch Centre, Telethon Kids Institute, Perth, WA, Australia
- Department of Respiratory and Sleep Medicine, Perth Children’s Hospital, Nedlands, WA, Australia
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine, The University of Western Australia, Nedlands, WA, Australia
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Zhang Y, Zheng Y, Ni P, Liang S, Li X, Yu H, Wei W, Qi X, Yu X, Xue R, Zhao L, Deng W, Wang Q, Guo W, Li T. New role of platelets in schizophrenia: predicting drug response. Gen Psychiatr 2024; 37:e101347. [PMID: 38616969 PMCID: PMC11015174 DOI: 10.1136/gpsych-2023-101347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/29/2024] [Indexed: 04/16/2024] Open
Abstract
Background Elevated platelet count (PLTc) is associated with first-episode schizophrenia and adverse outcomes in individuals with precursory psychosis. However, the impact of antipsychotic medications on PLTc and its association with symptom improvement remain unclear. Aims We aimed to investigate changes in PLTc levels following antipsychotic treatment and assess whether PLTc can predict antipsychotic responses and metabolic changes after accounting for other related variables. Methods A total of 2985 patients with schizophrenia were randomised into seven groups. Each group received one of seven antipsychotic treatments and was assessed at 2, 4 and 6 weeks. Clinical symptoms were evaluated using the positive and negative syndrome scale (PANSS). Additionally, we measured blood cell counts and metabolic parameters, such as blood lipids. Repeated measures analysis of variance was used to examine the effect of antipsychotics on PLTc changes, while structural equation modelling was used to assess the predictive value of PLTc on PANSS changes. Results PLTc significantly increased in patients treated with aripiprazole (F=6.00, p=0.003), ziprasidone (F=7.10, p<0.001) and haloperidol (F=3.59, p=0.029). It exhibited a positive association with white blood cell count and metabolic indicators. Higher baseline PLTc was observed in non-responders, particularly in those defined by the PANSS-negative subscale. In the structural equation model, PLTc, white blood cell count and a latent metabolic variable predicted the rate of change in the PANSS-negative subscale scores. Moreover, higher baseline PLTc was observed in individuals with less metabolic change, although this association was no longer significant after accounting for baseline metabolic values. Conclusions Platelet parameters, specifically PLTc, are influenced by antipsychotic treatment and could potentially elevate the risk of venous thromboembolism in patients with schizophrenia. Elevated PLTc levels and associated factors may impede symptom improvement by promoting inflammation. Given PLTc's easy measurement and clinical relevance, it warrants increased attention from psychiatrists. Trial registration number ChiCTR-TRC-10000934.
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Affiliation(s)
- Yamin Zhang
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Yanghao Zheng
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
| | - Peiyan Ni
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Sugai Liang
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Xiaojing Li
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Hua Yu
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Wei Wei
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Xueyu Qi
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Xueli Yu
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Rui Xue
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Liansheng Zhao
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wei Deng
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Qiang Wang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wanjun Guo
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Tao Li
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
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Zhang Y, Sun Y, Yu Q, Song S, Brenna JT, Shen Y, Ye K. Higher ratio of plasma omega-6/omega-3 fatty acids is associated with greater risk of all-cause, cancer, and cardiovascular mortality: A population-based cohort study in UK Biobank. eLife 2024; 12:RP90132. [PMID: 38578269 PMCID: PMC10997328 DOI: 10.7554/elife.90132] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
Background Circulating omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) have been associated with various chronic diseases and mortality, but results are conflicting. Few studies examined the role of omega-6/omega-3 ratio in mortality. Methods We investigated plasma omega-3 and omega-6 PUFAs and their ratio in relation to all-cause and cause-specific mortality in a large prospective cohort, the UK Biobank. Of 85,425 participants who had complete information on circulating PUFAs, 6461 died during follow-up, including 2794 from cancer and 1668 from cardiovascular disease (CVD). Associations were estimated by multivariable Cox proportional hazards regression with adjustment for relevant risk factors. Results Risk for all three mortality outcomes increased as the ratio of omega-6/omega-3 PUFAs increased (all Ptrend <0.05). Comparing the highest to the lowest quintiles, individuals had 26% (95% CI, 15-38%) higher total mortality, 14% (95% CI, 0-31%) higher cancer mortality, and 31% (95% CI, 10-55%) higher CVD mortality. Moreover, omega-3 and omega-6 PUFAs in plasma were all inversely associated with all-cause, cancer, and CVD mortality, with omega-3 showing stronger effects. Conclusions Using a population-based cohort in UK Biobank, our study revealed a strong association between the ratio of circulating omega-6/omega-3 PUFAs and the risk of all-cause, cancer, and CVD mortality. Funding Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institute of Health under the award number R35GM143060 (KY). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Affiliation(s)
- Yuchen Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, University of GeorgiaAthens, GeorgiaUnited States
| | - Yitang Sun
- Department of Genetics, University of GeorgiaAthens, GeorgiaUnited States
| | - Qi Yu
- Department of Biostatistics and Bioinformatics, Emory UniversityAtlanta, GeorgiaUnited States
| | - Suhang Song
- Department of Health Policy and Management, College of Public Health, University of GeorgiaAthens, GeorgiaUnited States
| | - J Thomas Brenna
- Division of Nutritional Sciences, Cornell UniversityIthaca, New YorkUnited States
- Dell Pediatric Research Institute and the Depts of Pediatrics, of Nutrition, and of Chemistry, University of Texas at AustinAustin, TexasUnited States
| | - Ye Shen
- Department of Epidemiology and Biostatistics, College of Public Health, University of GeorgiaAthens, GeorgiaUnited States
| | - Kaixiong Ye
- Department of Genetics, University of GeorgiaAthens, GeorgiaUnited States
- Institute of Bioinformatics, University of GeorgiaAthens, GeorgiaUnited States
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Sesso HD, Rautiainen S, Park SJ, Kim E, Lee IM, Glynn RJ, Buring JE, Christen WG. Intake of Blueberries, Anthocyanins, and Risk of Eye Disease in Women. J Nutr 2024; 154:1404-1413. [PMID: 38432561 PMCID: PMC11007733 DOI: 10.1016/j.tjnut.2024.02.028] [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: 12/15/2023] [Revised: 02/12/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Blueberries and anthocyanins, their key bioactive component, may improve eye health. However, few long-term studies have examined blueberries and anthocyanins with cataract and age-related macular degeneration (AMD). OBJECTIVES To investigate the prospective association between blueberry and anthocyanin intake with incident cataract, total AMD, and visually significant AMD among middle-aged and older women. METHODS A total of 36,653 and 35,402 women initially free of AMD and cataract, respectively, aged ≥45 y from the Women's Health Study provided semiquantitative food frequency questionnaire data on blueberry intake categorized as none, 1-3 servings/mo, 1 serving/wk, or ≥2 servings/wk, plus a combined category of ≥1 serving/wk. Total anthocyanin intake and major subclasses were energy-adjusted and categorized into quintiles. Self-reported risk factors of eye disease were adjusted in multivariable hazard ratios (HRs) (95% confidence intervals [CIs]) of confirmed cataract, AMD, and visually significant AMD with mean follow-up of 11 y. RESULTS Among the participants, 10.5% consumed ≥1 serving/wk of blueberries, with mean total anthocyanin intake of 11.2 mg/d. Compared to no blueberry intake, women consuming 1-3 servings/mo, 1 serving/wk, and ≥2 servings/wk had corresponding multivariable HRs of total AMD of 0.90 (95% CI: 0.73, 1.11), 0.71 (95% CI: 0.50, 1.00), and 0.36 (95% CI: 0.14, 0.93) (Ptrend = 0.011); those consuming ≥1 servings/wk had an HR of 0.68 (95% CI: 0.47, 0.98). A similar magnitude of HRs were found for visually significant AMD (Ptrend = 0.012) but not for cataract. There were no significant associations between increasing total anthocyanin quintiles and total and visually significant AMD, but there was a modest inverse association with cataract (Ptrend = 0.022), driven by a 10% reduction in cataract in the upper 2 quintiles. CONCLUSIONS Greater blueberry intake significantly reduced total AMD, but not visually significant AMD or cataract. However, the magnitude of effect for visually significant AMD was similar to total AMD. There was a modest but significant inverse association between dietary anthocyanin intake with cataract but not AMD.
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Affiliation(s)
- Howard D Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Susanne Rautiainen
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Sarah Jaehwa Park
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Eunjung Kim
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - I-Min Lee
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Robert J Glynn
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - William G Christen
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
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15
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Zhong C, Rando J, Patti MA, Braun JM, Chen A, Xu Y, Lanphear BP, Yolton K, Croen LA, Fallin MD, Hertz-Picciotto I, Newschaffer CJ, Lyall K. Gestational thyroid hormones and autism-related traits in the EARLI and HOME studies. Autism Res 2024; 17:716-727. [PMID: 38436527 DOI: 10.1002/aur.3115] [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: 05/25/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024]
Abstract
Thyroid hormones are essential for neurodevelopment. Few studies have considered associations with quantitatively measured autism spectrum disorder (ASD)-related traits, which may help elucidate associations for a broader population. Participants were drawn from two prospective pregnancy cohorts: the Early Autism Risk Longitudinal Investigation (EARLI), enrolling pregnant women who already had a child with ASD, and the Health Outcomes and Measures of the Environment (HOME) Study, following pregnant women from the greater Cincinnati, OH area. Gestational thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were measured in mid-pregnancy 16 (±3) weeks gestation serum samples. ASD-related traits were measured using the Social Responsiveness Scale (SRS) at ages 3-8 years. The association was examined using quantile regression, adjusting for maternal and sociodemographic factors. 278 participants (132 from EARLI, 146 from HOME) were included. TSH distributions were similar across cohorts, while FT4 levels were higher in EARLI compared to HOME. In pooled analyses, particularly for those in the highest SRS quantile (95th percentile), higher FT4 levels were associated with increasing SRS scores (β = 5.21, 95% CI = 0.93, 9.48), and higher TSH levels were associated with decreasing SRS scores (β = -6.94, 95% CI = -11.04, -2.83). The association between TSH and SRS remained significant in HOME for the 95% percentile of SRS scores (β = -6.48, 95% CI = -12.16, -0.80), but not EARLI. Results for FT4 were attenuated when examined in the individual cohorts. Our results add to evidence that gestational thyroid hormones may be associated with ASD-related outcomes by suggesting that relationships may differ across the distribution of ASD-related traits and by familial likelihood of ASD.
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Affiliation(s)
- Caichen Zhong
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Juliette Rando
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Marisa A Patti
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Joseph M Braun
- School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yingying Xu
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Lisa A Croen
- Kaiser Permanente Northern California, Oakland, California, USA
| | - M Daniele Fallin
- Emory Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, UC Davis School of Medicine, Sacramento, California, USA
| | - Craig J Newschaffer
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
- College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
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16
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Tavender E, Eapen N, Wang J, Rausa VC, Babl FE, Phillips N. Triage tools for detecting cervical spine injury in paediatric trauma patients. Cochrane Database Syst Rev 2024; 3:CD011686. [PMID: 38517085 PMCID: PMC10958760 DOI: 10.1002/14651858.cd011686.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
BACKGROUND Paediatric cervical spine injury (CSI) after blunt trauma is rare but can have severe consequences. Clinical decision rules (CDRs) have been developed to guide clinical decision-making, minimise unnecessary tests and associated risks, whilst detecting all significant CSIs. Several validated CDRs are used to guide imaging decision-making in adults following blunt trauma and clinical criteria have been proposed as possible paediatric-specific CDRs. Little information is known about their accuracy. OBJECTIVES To assess and compare the diagnostic accuracy of CDRs or sets of clinical criteria, alone or in comparison with each other, for the evaluation of CSI following blunt trauma in children. SEARCH METHODS For this update, we searched CENTRAL, MEDLINE, Embase, and six other databases from 1 January 2015 to 13 December 2022. As we expanded the index test eligibility for this review update, we searched the excluded studies from the previous version of the review for eligibility. We contacted field experts to identify ongoing studies and studies potentially missed by the search. There were no language restrictions. SELECTION CRITERIA We included cross-sectional or cohort designs (retrospective and prospective) and randomised controlled trials that compared the diagnostic accuracy of any CDR or clinical criteria compared with a reference standard for the evaluation of paediatric CSI following blunt trauma. We included studies evaluating one CDR or comparing two or more CDRs (directly and indirectly). We considered X-ray, computed tomography (CT) or magnetic resonance imaging (MRI) of the cervical spine, and clinical clearance/follow-up as adequate reference standards. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts for relevance, and carried out eligibility, data extraction and quality assessment. A third review author arbitrated. We extracted data on study design, participant characteristics, inclusion/exclusion criteria, index test, target condition, reference standard and data (diagnostic two-by-two tables) and calculated and plotted sensitivity and specificity on forest plots for visual examination of variation in test accuracy. We assessed methodological quality using the Quality Assessment of Diagnostic Accuracy Studies Version 2 tool. We graded the certainty of the evidence using the GRADE approach. MAIN RESULTS We included five studies with 21,379 enrolled participants, published between 2001 and 2021. Prevalence of CSI ranged from 0.5% to 1.85%. Seven CDRs were evaluated. Three studies reported on direct comparisons of CDRs. One study (973 participants) directly compared the accuracy of three index tests with the sensitivities of NEXUS, Canadian C-Spine Rule and the PECARN retrospective criteria being 1.00 (95% confidence interval (CI) 0.48 to 1.00), 1.00 (95% CI 0.48 to 1.00) and 1.00 (95% CI 0.48 to 1.00), respectively. The specificities were 0.56 (95% CI 0.53 to 0.59), 0.52 (95% CI 0.49 to 0.55) and 0.32 (95% CI 0.29 to 0.35), respectively (moderate-certainty evidence). One study (4091 participants) compared the accuracy of the PECARN retrospective criteria with the Leonard de novo model; the sensitivities were 0.91 (95% CI 0.81 to 0.96) and 0.92 (95% CI 0.83 to 0.97), respectively. The specificities were 0.46 (95% CI 0.44 to 0.47) and 0.50 (95% CI 0.49 to 0.52) (moderate- and low-certainty evidence, respectively). One study (270 participants) compared the accuracy of two NICE (National Institute for Health and Care Excellence) head injury guidelines; the sensitivity of the CG56 guideline was 1.00 (95% CI 0.48 to 1.00) compared to 1.00 (95% CI 0.48 to 1.00) with the CG176 guideline. The specificities were 0.46 (95% CI 0.40 to 0.52) and 0.07 (95% CI 0.04 to 0.11), respectively (very low-certainty evidence). Two additional studies were indirect comparison studies. One study (3065 participants) tested the accuracy of the NEXUS criteria; the sensitivity was 1.00 (95% CI 0.88 to 1.00) and specificity was 0.20 (95% CI 0.18 to 0.21) (low-certainty evidence). One retrospective study (12,537 participants) evaluated the PEDSPINE criteria and found a sensitivity of 0.93 (95% CI 0.78 to 0.99) and specificity of 0.70 (95% CI 0.69 to 0.72) (very low-certainty evidence). We did not pool data within the broader CDR categories or investigate heterogeneity due to the small quantity of data and the clinical heterogeneity of studies. Two studies were at high risk of bias. We identified two studies that are awaiting classification pending further information and two ongoing studies. AUTHORS' CONCLUSIONS There is insufficient evidence to determine the diagnostic test accuracy of CDRs to detect CSIs in children following blunt trauma, particularly for children under eight years of age. Although most studies had a high sensitivity, this was often achieved at the expense of low specificity and should be interpreted with caution due to a small number of CSIs and wide CIs. Well-designed, large studies are required to evaluate the accuracy of CDRs for the cervical spine clearance in children following blunt trauma, ideally in direct comparison with each other.
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Affiliation(s)
- Emma Tavender
- Emergency Research, Murdoch Children's Research Institute, Melbourne, Australia
- Departments of Paediatrics and Critical Care, University of Melbourne, Melbourne, Australia
| | - Nitaa Eapen
- Emergency Research, Murdoch Children's Research Institute, Melbourne, Australia
| | - Junfeng Wang
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Vanessa C Rausa
- Emergency Research, Murdoch Children's Research Institute, Melbourne, Australia
| | - Franz E Babl
- Emergency Research, Murdoch Children's Research Institute, Melbourne, Australia
- Departments of Paediatrics and Critical Care, University of Melbourne, Melbourne, Australia
- Emergency Department, The Royal Children's Hospital, Melbourne, Australia
| | - Natalie Phillips
- Emergency Department, Queensland Children's Hospital, Children's Health Queensland, Brisbane, Australia
- Child Health Research Centre, University of Queensland, Brisbane, Australia
- Biomechanics and Spine Research Group, Centre for Children's Health Research, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia
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17
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Galarneau JM, Durand-Moreau Q, Cherry N. Reported harassment and mental ill-health in a Canadian prospective cohort of women and men in welding and electrical trades. Ann Work Expo Health 2024; 68:231-242. [PMID: 38169001 PMCID: PMC10941725 DOI: 10.1093/annweh/wxad083] [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: 10/06/2023] [Revised: 12/04/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES Experience of psychosocial environments by workers entering trade apprenticeships may differ by gender. We aimed to document perceived harassment and to investigate whether this related to mental ill-health. METHODS Cohorts of workers in welding and electrical trades were established, women recruited across Canada and men from Alberta. Participants were recontacted every 6 months for up to 3 years (men) or 5 years (women). At each contact, they were asked about symptoms of anxiety and depression made worse by work. After their last regular contact, participants received a "wrap-up" questionnaire that included questions on workplace harassment. In Alberta, respondents who consented were linked to the administrative health database that recorded diagnostic codes for each physician contact. RESULTS One thousand eight hundred and eighty five workers were recruited, 1,001 in welding trades (447 women), and 884 in electrical trades (438 women). One thousand four hundred and nineteen (75.3%) completed a "wrap up" questionnaire, with 1,413 answering questions on harassment. Sixty percent of women and 32% of men reported that they had been harassed. Those who reported harassment had more frequently recorded episodes of anxiety and depression made worse by work in prospective data. In Alberta, 1,242 were successfully matched to administrative health records. Those who reported harassment were more likely to have a physician record of depression since starting their trade. CONCLUSIONS Tradeswomen were much more likely than tradesmen to recall incidents of harassment. The results from record linkage, and from prospectively collected reports of anxiety and depression made worse by work, support a conclusion that harassment resulted in poorer mental health.
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Affiliation(s)
- Jean-Michel Galarneau
- Division of Preventive Medicine, University of Alberta, 8303-112st, Edmonton, T6G 2T4, Canada
- Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, T2N 1N4, Canada
| | - Quentin Durand-Moreau
- Division of Preventive Medicine, University of Alberta, 8303-112st, Edmonton, T6G 2T4, Canada
| | - Nicola Cherry
- Division of Preventive Medicine, University of Alberta, 8303-112st, Edmonton, T6G 2T4, Canada
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Yang J, Alshaikh E, Asa N, VonDeylen O, Desai N, Taylor HG, Pommering T, MacDonald JP, Cohen DM, Yeates KO. Exploring the association between cognitive activity and symptom resolution following concussion in adolescents aged 11-17 years. Br J Sports Med 2024; 58:328-333. [PMID: 38346776 DOI: 10.1136/bjsports-2023-107601] [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] [Accepted: 01/21/2024] [Indexed: 03/16/2024]
Abstract
OBJECTIVE As opposed to postconcussion physical activity, the potential influence of cognitive activity on concussion recovery is not well characterised. This study evaluated the intensity and duration of daily cognitive activity reported by adolescents following concussion and examined the associations between these daily cognitive activities and postconcussion symptom duration. METHODS This study prospectively enrolled adolescents aged 11-17 years with a physician-confirmed concussion diagnosis within 72 hours of injury from the emergency department and affiliated concussion clinics. Participants were followed daily until symptom resolution or a maximum of 45 days postinjury to record their daily cognitive activity (intensity and duration) and postconcussion symptom scores. RESULTS Participants (n=83) sustained their concussion mostly during sports (84%), had a mean age of 14.2 years, and were primarily male (65%) and white (72%). Participants reported an average of 191 (SD=148), 166 (SD=151) and 38 (SD=61) minutes of low-intensity, moderate-intensity and high-intensity daily cognitive activity postconcussion while still being symptomatic. Every 10 standardised minutes per hour increase in moderate-intensity or high-intensity cognitive activities postconcussion was associated with a 22% greater rate of symptom resolution (adjusted hazard ratio (aHR) 1.22, 95% CI 1.01 to 1.47). Additionally, each extra day's delay in returning to school postconcussion was associated with an 8% lower rate of symptom resolution (aHR 0.92, 95% CI 0.85 to 0.99). CONCLUSION In adolescents with concussion, more moderate-high intensity cognitive activity is associated with faster symptom resolution, and a delayed return to school is associated with slower symptom resolution. However, these relationships may be bidirectional and do not necessarily imply causality. Randomised controlled trials are needed to determine if exposure to early cognitive activity can promote concussion recovery in adolescents.
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Affiliation(s)
- Jingzhen Yang
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University College of Medcine, Columbus, Ohio, USA
| | - Enas Alshaikh
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Nichole Asa
- University of Washington, Seattle, Washington, USA
| | - Olivia VonDeylen
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Nikhil Desai
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Hudson Gerry Taylor
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University College of Medcine, Columbus, Ohio, USA
| | - Thomas Pommering
- Department of Pediatrics, The Ohio State University College of Medcine, Columbus, Ohio, USA
- Division of Sports Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - James P MacDonald
- Department of Pediatrics, The Ohio State University College of Medcine, Columbus, Ohio, USA
- Division of Sports Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Daniel M Cohen
- Department of Pediatrics, The Ohio State University College of Medcine, Columbus, Ohio, USA
- Division of Emergency Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Keith Owen Yeates
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
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19
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Ma X, Wang Q, Hu X, Wang X, Zhao Y, Liu X, Li J, Du Y, Wang M, Qiu C, Sun Q. Association of sdLDL-C With Incident Carotid Plaques With Stable and Vulnerable Morphology: A Prospective Cohort Study. Stroke 2024; 55:576-585. [PMID: 38214156 DOI: 10.1161/strokeaha.123.045601] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND Small dense low-density lipoprotein cholesterol (sdLDL-C) particles are more atherogenic than large and intermediate low-density lipoprotein cholesterol (LDL-C) subfractions. We sought to investigate the association of sdLDL-C and the sdLDL-C/LDL-C ratio with incident carotid plaques with stable and vulnerable morphology in rural China. METHODS This community-based cohort study used data from the RICAS study (Rose Asymptomatic Intracranial Artery Stenosis), which enrolled 887 participants (aged ≥40 years) who were living in Kongcun Town, Pingyin County, Shandong, and free of carotid plaques and had no history of clinical stroke or transient ischemic attack at baseline (2017). Incident carotid plaques and their vulnerability were detected by carotid ultrasound at follow-up (2021). Multivariable logistic regression models were used to explore the association of sdLDL-C or sdLDL-C/LDL-C ratio with incident carotid plaques while adjusting for demographic factors, vascular risk factors, and follow-up time. RESULTS Of the 887 participants (mean age [SD], 53.89 [8.67%] years; 54.34% women), 179 (20.18%) were detected with incident carotid plaques during an average follow-up of 3.94 years (SD=0.14). Higher sdLDL-C or sdLDL-C/LDL-C ratio, but not LDL-C, was significantly associated with an increased risk of incident carotid plaques. The upper tertile of sdLDL-C (versus lower tertile) was associated with the multivariate-adjusted odds ratio of 2.48 (95% CI, 1.00-6.15; P=0.049; P for linear trend=0.046) for carotid plaques with vulnerable morphology (n=41), and the association remained significant in participants with normal LDL-C (<130 mg/dL; n=693; upper versus lower tertile: odds ratio, 3.38 [95% CI, 1.15-9.90]; P=0.027; P for linear trend=0.025). Moreover, the sdLDL-C/LDL-C ratio was associated with a higher odds ratio of incident carotid plaques in participants without diabetes (P for interaction=0.014). CONCLUSIONS Higher sdLDL-C was associated with an increased risk of incident carotid plaques, especially carotid plaques with vulnerable morphology, even in participants with normal LDL-C. This suggests the potential of sdLDL-C as a therapeutic target for stroke prevention. REGISTRATION URL: https://www.chictr.org.cn; Unique identifier: ChiCTR1800017197.
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Affiliation(s)
- Xiaotong Ma
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Qiuting Wang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China (Q.W., Y.D., C.Q., Q.S.)
| | - Xinyan Hu
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Xiang Wang
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Yuanyuan Zhao
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Xiaohui Liu
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Jifeng Li
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Yifeng Du
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China (Q.W., Y.D., C.Q., Q.S.)
| | - Mo Wang
- Department of Vascular Surgery (M.W.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China (Q.W., Y.D., C.Q., Q.S.)
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Sweden (C.Q.)
| | - Qinjian Sun
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology (X.M., X.H., X.W., Y.Z., X.L., J.L., Y.D., Q.S.), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China (Q.W., Y.D., C.Q., Q.S.)
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Merrill SA, Webber SE, Merrill LJ, Shmookler AD. Improved outcomes and cost savings for patients with bleeding disorders: a quality improvement project. Res Pract Thromb Haemost 2024; 8:102401. [PMID: 38706779 PMCID: PMC11066543 DOI: 10.1016/j.rpth.2024.102401] [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: 03/04/2024] [Accepted: 03/28/2024] [Indexed: 05/07/2024] Open
Abstract
Background Providing optimal care for patients with bleeding disorders according to national standards remains a challenge at designated Hemophilia Treatment Centers (HTCs). Improved care may reduce bleeds and costs. Objectives To improve care and demonstrate cost savings by 1) reducing preventable hospitalizations and emergency room visits (PHER) for bleeding, 2) increasing use of prophylaxis in severe hemophilia, and 3) improving patient-HTC communication and primary care engagement. Methods Prospective quality improvement project using the Define, Measure, Analyze, Improve, and Control methodology to implement uniform guideline-based bleeding disorder care at a rural HTC (N = 88). Intervention used a standardized physician checklist, improved communication, and reserved physician time for urgent management. Outcomes were determined by retrospective chart review; urgent management was tracked prospectively. Results Intervention significantly reduced PHER by 85.4%. Use of prophylaxis in persons with severe hemophilia increased from 58.8% to 100%; attainment of a primary care physician and electronic portal enrollment met outcomes for intervention success. HTC clinic visit attendance was low at 55.2%. The majority of patients (71.6%) had at least 1 outpatient urgent episode (mean, 0.72 episode per year), and 93% had nonurgent management (mean, 9.3 episodes per year) occurring outside of a clinic visit. Hospital PHER factor cost in the group was reduced by 94.5%, from $11,800 to $640 per patient per year-a cost savings of $982,088 yearly. Conclusion This collaborative study shows that implementation of a carefully designed quality improvement project, such as uniform guidelines with focus on strengthening ambulatory management, led to improved outcomes and cost savings.
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Affiliation(s)
- Samuel A. Merrill
- Department of Medicine, Section of Hematology/Oncology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Sylvia E. Webber
- Department of Medicine, Section of Hematology/Oncology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Laura J. Merrill
- Department of Obstetrics and Gynecology, Weirton Medical Center, Weirton, West Virginia, USA
| | - Aaron D. Shmookler
- Department of Pathology and Laboratory Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, USA
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Takigawa Y, Matsui J, Igarashi T, Uchiyama M, Sasaki A. Investigating the early diagnosis of pancreatic cancer by surveillance of patients with "K-sign" of the pancreas by computed tomography: A prospective study. J Hepatobiliary Pancreat Sci 2024; 31:193-202. [PMID: 38235505 DOI: 10.1002/jhbp.1411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/05/2023] [Accepted: 11/19/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND We previously conducted a retrospective study investigating pancreatic morphological abnormalities that lead to early diagnosis of pancreatic cancer (PC) using computed tomography (CT). We reviewed 41 of 308 PC patients between 2011 and 2017 who had previously undergone CT to look for morphological changes leading to cancer development. In 24 patients (58.5%), a K-shaped constriction of the pancreas ("K-sign") was observed before the appearance of cancer. This study aimed to investigate whether an early PC diagnosis is possible by prospective CT follow-up of patients with the K-sign. METHODS We investigated PC development through prospective surveillance of patients exhibiting K-signs identified on CT. RESULTS Of approximately 87 000 CT scans performed between April 2019 and August 2022, the K-sign was observed in 54 patients. A total of 30 patients provided informed consent and were subsequently monitored using CT. Five patients (16.7%) were diagnosed with PC and underwent surgery after 3-24 months follow-up. Pathologically, four of five patients (80%) were diagnosed with early-stage pancreatic cancer (stage 0-IA). All patients exhibited defects in acinar structure, fibrous tissue, fat replacement, and inflammatory cells, suggesting their potential involvement in PC development. CONCLUSION The detection and surveillance of the K-sign may be helpful for early PC diagnosis.
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Affiliation(s)
- Yutaka Takigawa
- Department of Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Junichi Matsui
- Department of Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Takao Igarashi
- Department of Radiology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Masateru Uchiyama
- Department of Cardiovascular Surgery, Teikyo University, Tokyo, Japan
| | - Aya Sasaki
- Department of Pathology and Laboratory Medicine, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
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22
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Flores AC, Zhang X, Kris-Etherton PM, Sliwinski MJ, Shearer GC, Gao X, Na M. Metabolomics and Risk of Dementia: A Systematic Review of Prospective Studies. J Nutr 2024; 154:826-845. [PMID: 38219861 DOI: 10.1016/j.tjnut.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND The projected increase in the prevalence of dementia has sparked interest in understanding the pathophysiology and underlying causal factors in its development and progression. Identifying novel biomarkers in the preclinical or prodromal phase of dementia may be important for predicting early disease risk. Applying metabolomic techniques to prediagnostic samples in prospective studies provides the opportunity to identify potential disease biomarkers. OBJECTIVE The objective of this systematic review was to summarize the evidence on the associations between metabolite markers and risk of dementia and related dementia subtypes in human studies with a prospective design. DESIGN We searched PubMed, PsycINFO, and Web of Science databases from inception through December 8, 2023. Thirteen studies (mean/median follow-up years: 2.1-21.0 y) were included in the review. RESULTS Several metabolites detected in biological samples, including amino acids, fatty acids, acylcarnitines, lipid and lipoprotein variations, hormones, and other related metabolites, were associated with risk of developing dementia. Our systematic review summarized the adjusted associations between metabolites and dementia risk; however, our findings should be interpreted with caution because of the heterogeneity across the included studies and potential sources of bias. Further studies are warranted with well-designed prospective cohort studies that have defined study populations, longer follow-up durations, the inclusion of additional diverse biological samples, standardization of techniques in metabolomics and ascertainment methods for diagnosing dementia, and inclusion of other related dementia subtypes. CONCLUSIONS This study contributes to the limited systematic reviews on metabolomics and dementia by summarizing the prospective associations between metabolites in prediagnostic biological samples with dementia risk. Our review discovered additional metabolite markers associated with the onset of developing dementia and may help aid in the understanding of dementia etiology. The protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (https://www.crd.york.ac.uk/prospero/; registration ID: CRD42022357521).
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Affiliation(s)
- Ashley C Flores
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Xinyuan Zhang
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Penny M Kris-Etherton
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Martin J Sliwinski
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States; Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
| | - Greg C Shearer
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Xiang Gao
- School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.
| | - Muzi Na
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States.
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23
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Pantelatos RI, Stenberg J, Follestad T, Sandrød O, Einarsen CE, Vik A, Skandsen T. Improvement in Functional Outcome from 6 to 12 Months After Moderate and Severe Traumatic Brain Injury Is Frequent, But May Not Be Detected With the Glasgow Outcome Scale Extended. Neurotrauma Rep 2024; 5:139-149. [PMID: 38435078 PMCID: PMC10908320 DOI: 10.1089/neur.2023.0109] [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] [Indexed: 03/05/2024] Open
Abstract
The aims of this study were (1) to report outcome and change in outcome in patients with moderate and severe traumatic brain injury (mo/sTBI) between 6 and 12 months post-injury as measured by the Glasgow Outcome Scale Extended (GOSE), (2) to explore if demographic/injury-related variables can predict improvement in GOSE score, and (3) to investigate rate of improvement in Disability Rating Scale (DRS) score, in patients with a stable GOSE. All surviving patients ≥16 years of age who were admitted with mo/sTBI (Glasgow Coma Scale [GCS] score ≤13) to the regional trauma center in Central Norway between 2004 and 2019 were prospectively included (n = 439 out of 503 eligible). GOSE and DRS were used to assess outcome. Twelve-months post-injury, 13% with moTBI had severe disability (GOSE 2-4) versus 27% in sTBI, 26% had moderate disability (GOSE 5-6) versus 41% in sTBI and 62% had good recovery (GOSE 7-8) versus 31% in sTBI. From 6 to 12 months post-injury, 27% with moTBI and 32% with sTBI had an improvement, whereas 6% with moTBI and 6% with sTBI had a deterioration in GOSE score. Younger age and higher GCS score were associated with improved GOSE score. Improvement was least frequent for patients with a GOSE score of 3 at 6 months. In patients with a stable GOSE score of 3, an improvement in DRS score was observed in 22 (46%) patients. In conclusion, two thirds and one third of patients with mo/sTBI, respectively, had a good recovery. Importantly, change, mostly improvement, in GOSE score between 6 and 12 months was frequent and argues against the use of 6 months outcome as a time end-point in research. The GOSE does, however, not seem to be sensitive to actual change in function in the lower categories and a combination of outcome measures may be needed to describe the consequences after TBI.
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Affiliation(s)
- Rabea Iris Pantelatos
- Department of Neuromedicine, Movement Science, and Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jonas Stenberg
- Department of Neuromedicine, Movement Science, and Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Clinical Sciences, Danderyd Hospital, Division of Rehabilitation Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Radiology and Nuclear Medicine, Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Turid Follestad
- Clinical Research Unit Central Norway, Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Oddrun Sandrød
- Clinic of Anaesthesia and Intensive Care, Department of Intensive Care Medicine, Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Cathrine Elisabeth Einarsen
- Department of Neuromedicine, Movement Science, and Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Rehabilitation, Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Anne Vik
- Department of Neuromedicine, Movement Science, and Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Neuroclinic, Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Toril Skandsen
- Department of Neuromedicine, Movement Science, and Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Rehabilitation, Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Martín Andrés A, Gayá Moreno F, Álvarez Hernández M, Herranz Tejedor I. Miettinen and Nurminen score statistics revisited. J Biopharm Stat 2024:1-14. [PMID: 38335320 DOI: 10.1080/10543406.2024.2311242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 01/24/2024] [Indexed: 02/12/2024]
Abstract
It is commonly necessary to perform inferences on the difference, ratio, and odds ratio of two proportions p1 and p2 based on two independent samples. For this purpose, the most common asymptotic statistics are based on the score statistics (S-type statistics). As these do not correct the bias of the estimator of the product pi (1-pi), Miettinen and Nurminen proposed the MN-type statistics, which consist of multiplying the statistics S by (N-1)/N, where N is the sum of the two sample sizes. This paper demonstrates that the factor (N-1)/N is only correct in the case of the test of equality of two proportions, providing the estimation of the correct factor (AU-type statistics) and the minimum value of the same (AUM-type statistics). Moreover, this paper assesses the performance of the four-type statistics mentioned (S, MN, AU and AUM) in one and two-tailed tests, and for each of the three parameters cited (d, R and OR). We found that the AUM-type statistics are the best, followed by the MN type (whose performance was most similar to that of AU-type). Finally, this paper also provides the correct factors when the data are from a multinomial distribution, with the novelty that the MN and AU statistics are similar in the case of the test for the odds ratio.
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Koponen K, Kambur O, Joseph B, Ruuskanen MO, Jousilahti P, Salido R, Brennan C, Jain M, Meric G, Inouye M, Lahti L, Niiranen T, Havulinna AS, Knight R, Salomaa V. Role of Gut Microbiota in Statin-Associated New-Onset Diabetes-A Cross-Sectional and Prospective Analysis of the FINRISK 2002 Cohort. Arterioscler Thromb Vasc Biol 2024; 44:477-487. [PMID: 37970720 PMCID: PMC10805357 DOI: 10.1161/atvbaha.123.319458] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/31/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Dyslipidemia is treated effectively with statins, but treatment has the potential to induce new-onset type-2 diabetes. Gut microbiota may contribute to this outcome variability. We assessed the associations of gut microbiota diversity and composition with statins. Bacterial associations with statin-associated new-onset type-2 diabetes (T2D) risk were also prospectively evaluated. METHODS We examined shallow-shotgun-sequenced fecal samples from 5755 individuals in the FINRISK-2002 population cohort with a 17+-year-long register-based follow-up. Alpha-diversity was quantified using Shannon index and beta-diversity with Aitchison distance. Species-specific differential abundances were analyzed using general multivariate regression. Prospective associations were assessed with Cox regression. Applicable results were validated using gradient boosting. RESULTS Statin use associated with differing taxonomic composition (R2, 0.02%; q=0.02) and 13 differentially abundant species in fully adjusted models (MaAsLin; q<0.05). The strongest positive association was with Clostridium sartagoforme (β=0.37; SE=0.13; q=0.02) and the strongest negative association with Bacteroides cellulosilyticus (β=-0.31; SE=0.11; q=0.02). Twenty-five microbial features had significant associations with incident T2D in statin users, of which only Bacteroides vulgatus (HR, 1.286 [1.136-1.457]; q=0.03) was consistent regardless of model adjustment. Finally, higher statin-associated T2D risk was seen with [Ruminococcus] torques (ΔHRstatins, +0.11; q=0.03), Blautia obeum (ΔHRstatins, +0.06; q=0.01), Blautia sp. KLE 1732 (ΔHRstatins, +0.05; q=0.01), and beta-diversity principal component 1 (ΔHRstatin, +0.07; q=0.03) but only when adjusting for demographic covariates. CONCLUSIONS Statin users have compositionally differing microbiotas from nonusers. The human gut microbiota is associated with incident T2D risk in statin users and possibly has additive effects on statin-associated new-onset T2D risk.
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Affiliation(s)
- Kari Koponen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland (K.K., O.K., B.J., P.J., T.N., A.S.H., V.S.)
| | - Oleg Kambur
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland (K.K., O.K., B.J., P.J., T.N., A.S.H., V.S.)
| | - Bijoy Joseph
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland (K.K., O.K., B.J., P.J., T.N., A.S.H., V.S.)
| | | | - Pekka Jousilahti
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland (K.K., O.K., B.J., P.J., T.N., A.S.H., V.S.)
| | - Rodolfo Salido
- Department of Pediatrics (R.S., C.B., R.K.), University of California San Diego, La Jolla
- Department of Bioengineering (R.S., R.K.), University of California San Diego, La Jolla
| | - Caitriona Brennan
- Department of Pediatrics (R.S., C.B., R.K.), University of California San Diego, La Jolla
| | - Mohit Jain
- Department of Medicine and Pharmacology (M.J.), University of California San Diego, La Jolla
| | - Guillaume Meric
- Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, Australia (G.M., M.I.)
- Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, Australia (G.M.)
| | - Michael Inouye
- Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, Australia (G.M., M.I.)
- Cambridge Baker Systems Genomics Initiative, Department of Public Health and Primary Care, University of Cambridge, United Kingdom (M.I.)
| | - Leo Lahti
- Department of Computing, University of Turku, Finland (M.O.R., L.L.)
| | - Teemu Niiranen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland (K.K., O.K., B.J., P.J., T.N., A.S.H., V.S.)
- Department of Medicine, Turku University Hospital and University of Turku, Finland (T.N.)
| | - Aki S. Havulinna
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland (K.K., O.K., B.J., P.J., T.N., A.S.H., V.S.)
- Institute for Molecular Medicine Finland, FiMM-HiLIFE, Helsinki, Finland (A.S.H.)
| | - Rob Knight
- Department of Pediatrics (R.S., C.B., R.K.), University of California San Diego, La Jolla
- Department of Bioengineering (R.S., R.K.), University of California San Diego, La Jolla
- Department of Computer Science and Engineering (R.K.), University of California San Diego, La Jolla
- Center for Microbiome Innovation (R.K.), University of California San Diego, La Jolla
| | - Veikko Salomaa
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland (K.K., O.K., B.J., P.J., T.N., A.S.H., V.S.)
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Riley SP, Swanson BT, Shaffer SM, Flowers DW, Hofbauer MA, Liebano RE. Does manual therapy meaningfully change quantitative sensory testing and patient reported outcome measures in patients with musculoskeletal impairments related to the spine?: A 'trustworthy' systematic review and meta-analysis. J Man Manip Ther 2024; 32:51-66. [PMID: 37622723 PMCID: PMC10795556 DOI: 10.1080/10669817.2023.2247235] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVES To perform a 'trustworthy' systematic review (SR) with meta-analysis on the potential mechanisms of manual therapy used to treat spinal impairments. DESIGN SR with meta-analysis. LITERATURE SEARCH Articles published between January 2010 and October 2022 from CENTRAL, CINAHL, MEDLINE, PubMed, ProQuest, and PEDro. METHODS This SR included English-language randomized clinical trials (RCTs) involving manual therapy to treat spinal impairments in adults. The primary outcome was pressure pain thresholds (PPTs). To synthesize RCTs with high confidence in estimated effects using the GRADE, RCTs with questionable prospective, external, and internal validity, and high risk of bias (RoB) were excluded. RESULTS Following title and abstract screening, 89 full-text RCTs were reviewed. Twenty-two studies included the criteria of interest. Sixteen were not prospectively registered, two contained discussion/conclusions judged to be inconsistent with the registry, and one was rated as having a high RoB. Three studies met the inclusion criteria; heterogeneous interventions and locations for PPT testing prevented synthesis into practice recommendations. The two studies with high confidence in estimated effects had small effect sizes, and one study had confidence intervals that crossed zero for the outcome measures of interest. DISCUSSION Standardized PPT testing, as a potential measure of centrally mediated pain, could provide clues regarding the mechanisms of manual therapy or help identify/refine research questions. CONCLUSION High-quality RCTs could not be synthesized into strong conclusions secondary to the dissimilarity in research designs. Future research regarding quantitative sensory testing should develop RCTs with high confidence in estimated effects that can be translated into strong recommendations.
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Affiliation(s)
- Sean P. Riley
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA
- Hartford Healthcare Rehabilitation Network, Glastonbury, CT, USA
- Doctor of Physical Therapy Program, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Brian T. Swanson
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA
| | - Stephen M. Shaffer
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA
| | - Daniel W. Flowers
- Doctor of Physical Therapy Program, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Margaret A. Hofbauer
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA
| | - Richard E. Liebano
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA
- Duke Center for Excellence in Manual and Manipulative Therapy, Durham, NC, USA
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Chen P, Eikelboom JW, Tan C, Zhang W, Xu Y, Bai J, Wang J, Wang T, Gong X, Liu K, Chen X, Wang X, Zhu L, Zhao X, Yang N, Jiang J, Pu J, Zhao B, Chen Z, Li B, Wang G, Lu C, Ying L, Jiang M, Zhu X, Ma J, Dong Z, Li C, Zong J, Zhang F, Zhu J, Huang J, Kong X, Yu H, Li C. Single Bolus r-SAK Before Primary PCI for ST-Segment-Elevation Myocardial Infarction. Circ Cardiovasc Interv 2024; 17:e013455. [PMID: 38258563 DOI: 10.1161/circinterventions.123.013455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/14/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND It is uncertain whether adjunctive thrombolysis is beneficial for patients with ST-segment-elevation myocardial infarction undergoing percutaneous coronary intervention (PCI) within 120 minutes of presentation. This study was to determine whether in patients presenting with ST-segment-elevation myocardial infarction a single bolus recombinant staphylokinase (r-SAK) before timely PCI leads to improved patency of the infarct-related artery and reduces the infarct size. METHODS This is an open-label, prospective, multicenter, randomized study. We enrolled patients aged 18 to 75 years who were within 12 hours of symptom onset of ST-segment-elevation myocardial infarction and expected to undergo PCI within 120 minutes. Patients were administered loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive 5 mg bolus of r-SAK or normal saline intravenously before PCI. The primary end point was Thrombolysis in Myocardial Infarction flow grade 2 to 3 or grade 3 in the infarct-related artery 60 minutes after thrombolysis. The infarct size was detected by cardiac magnetic resonance 5 days after randomization. The safety end point was major bleeding (Bleeding Academic Research Consortium ≥3) during 30-day follow-up. RESULTS A total of 283 patients were screened from 8 centers and 200 were randomized (median age, 58.5 years; 14% female). The median symptom to thrombolysis time was 252.5 (interquartile range, 142.8-423.8) minutes and thrombolysis to coronary arteriography was 50.0 (interquartile range, 37.0-66.0) minutes. Patients randomized to r-SAK compared with normal saline more often had Thrombolysis in Myocardial Infarction flow grade 2 to 3 (69.0% versus 29.0%; P<0.001) and Thrombolysis in Myocardial Infarction flow grade 3 (51.0% versus 18.0%; P<0.001) and had smaller infarct size (21.91±10.84% versus 26.85±12.37%; P=0.016). There was no increase in major bleeding (r-SAK, 1.0% versus control, 3.0%; P=0.616). CONCLUSIONS A single bolus r-SAK before primary PCI for ST-segment-elevation myocardial infarction improves infarct-related artery patency and reduces infarct size without increasing major bleeding. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT05023681.
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Affiliation(s)
- Pengsheng Chen
- Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China
- Department of Cardiology, Xuzhou Central Hospital, Jiangsu, China (P.C.)
| | - John W Eikelboom
- Department of Medicine, McMaster University or Thrombosis Service, Hamilton General Hospital, ON, Canada (J.W.E.)
| | - Chunyue Tan
- Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China
| | - Wenhao Zhang
- Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China
| | - Yi Xu
- Radiology (Y.X., J.W., X. Zhu), the First Affiliated Hospital of Nanjing Medical University, China
| | - Jianling Bai
- Department of Biostatistics, Nanjing Medical University, Jiangsu, China (J.B., H.Y.)
| | - Jun Wang
- Radiology (Y.X., J.W., X. Zhu), the First Affiliated Hospital of Nanjing Medical University, China
| | - Tong Wang
- Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China
- Department of Cardiology, the First People's Hospital of Yancheng, Jiangsu, China (T.W.)
| | - Xiaoxuan Gong
- Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China
| | - Kun Liu
- Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China
- Department of Cardiology, the First People's Hospital of Lianyungang, Jiangsu, China (K.L., B.Z.)
| | - Xin Chen
- Department of Cardiology, the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Jiangsu, China (X.C., Z.C.)
| | - Xiaoyan Wang
- Department of Cardiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China (X.W., B.L.)
| | - Li Zhu
- Department of Cardiology, Taizhou People's Hospital, Jiangsu, China (L.Z., G.W.)
| | - Xin Zhao
- Department of Cardiology, the Second Hospital of Dalian Medical University, Liaoning, China (X. Zhao, C. Lu)
| | - Naiquan Yang
- Department of Cardiology, Huai'an Second People's Hospital Affiliated to Xuzhou Medical University, Jiangsu, China (N.Y., L.Y.)
| | - Jun Jiang
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, China (J.J.)
| | - Jun Pu
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, China (J.P., M.J.)
| | - Bo Zhao
- Department of Cardiology, the First People's Hospital of Lianyungang, Jiangsu, China (K.L., B.Z.)
| | - Zengguang Chen
- Department of Cardiology, the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Jiangsu, China (X.C., Z.C.)
| | - Baihong Li
- Department of Cardiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China (X.W., B.L.)
| | - Guoyu Wang
- Department of Cardiology, Taizhou People's Hospital, Jiangsu, China (L.Z., G.W.)
| | - Chuan Lu
- Department of Cardiology, the Second Hospital of Dalian Medical University, Liaoning, China (X. Zhao, C. Lu)
| | - Lianghong Ying
- Department of Cardiology, Huai'an Second People's Hospital Affiliated to Xuzhou Medical University, Jiangsu, China (N.Y., L.Y.)
| | - Meng Jiang
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, China (J.P., M.J.)
| | - Xiaomei Zhu
- Radiology (Y.X., J.W., X. Zhu), the First Affiliated Hospital of Nanjing Medical University, China
| | - Jiazheng Ma
- Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China
| | - Zhou Dong
- Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China
| | - Chen Li
- Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China
| | - Jiaxin Zong
- Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China
| | - Fumin Zhang
- Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China
| | - Jun Zhu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China (J. Zhu)
| | - Jun Huang
- Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China
| | - Xiangqing Kong
- Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China
| | - Hao Yu
- Department of Biostatistics, Nanjing Medical University, Jiangsu, China (J.B., H.Y.)
| | - Chunjian Li
- Departments of Cardiology (P.C., C.T., W.Z., T.W., X.G., K.L., J.M., Z.D., Chen Li, J. Zong, F.Z., J.H., X.K., Chunjian Li), the First Affiliated Hospital of Nanjing Medical University, China
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Bond JC, Coleman CM, Yland JJ, Wesselink AK, Wang T, Willis M, Hatch EE, Rothman KJ, Savitz D, Eisenberg ML, Wise LA. Preconception sleep duration, non-daytime work schedules, and incidence of spontaneous abortion: a prospective cohort study. Hum Reprod 2024; 39:413-424. [PMID: 38059518 DOI: 10.1093/humrep/dead249] [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: 11/16/2022] [Revised: 10/25/2023] [Indexed: 12/08/2023] Open
Abstract
STUDY QUESTION To what extent do self-reported sleep duration and non-daytime work schedules in either partner affect the rate of spontaneous abortion (SAB)? SUMMARY ANSWER Incidence of SAB had little association with female sleep duration and a modest positive association with male short sleep duration, female work at night, and discrepant work schedules among partners. WHAT IS KNOWN ALREADY Several studies have reported an association between short sleep duration in either partner and reproductive health outcomes, including fecundability. Moreover, certain types of female occupational exposures during pregnancy have been associated with an increased risk of SAB. No studies have evaluated SAB risk in relation to male sleep and work schedules, or joint exposures within a couple. STUDY DESIGN, SIZE, DURATION This prospective cohort study included 9357 female participants and 2602 of their male partners residing in North America (June 2013 to April 2023). PARTICIPANTS/MATERIALS, SETTING, METHODS Participants enrolled when they were attempting pregnancy and completed self-administered baseline questionnaires about their average sleep duration and work schedules. Among those who conceived, we ascertained SAB and gestational age at loss via follow-up questionnaires. We used multivariable Cox proportional hazards models with gestational weeks as the time scale to estimate hazard ratios (HRs) and 95% CIs relating SAB with sleep duration and non-daytime work schedules for female and male participants, and the couple. We used inverse probability weighting to account for potential selection bias due to the possibility of differential participation of male partners with respect to the exposures. MAIN RESULTS AND THE ROLE OF CHANCE Compared to female participants with recommended sleep (7-8.9 h), those reporting short sleep duration (<6 h) did not have a higher rate of SAB (HR 0.88, 95% CI 0.69, 1.13). Short self-reported sleep duration among male participants was modestly associated with a higher rate of SAB (adjusted and weighted HR 1.30, 95% CI 0.96, 1.75). Female night work at night (adjusted HR 1.19, 95% CI 1.02, 1.38) and male non-daytime work (adjusted and weighted HR 1.26, 95% CI 1.00, 1.59) were associated with modestly higher rates of SAB, whereas female rotating shift work was not (adjusted HR 0.91, 0.78, 1.05) compared with daytime workers. Couples in which work schedules were discrepant had an elevated rate of SAB if the male partner worked a non-daytime shift (adjusted and weighted HR 1.46, 95% CI 1.13, 1.88) compared with couples in which both members worked during the day. The corresponding HR if only the female partner worked a non-daytime shift was 1.21 (95% CI 0.92, 1.58). LIMITATIONS, REASONS FOR CAUTION Data on sleep duration and work schedules were based on self-report, which is vulnerable to misclassification, particularly since participants were asked to report their average sleep duration during the past month. Work exposures were heterogeneous, as many different types of employment may require night and shift work and may have different associations with SAB. WIDER IMPLICATIONS OF THE FINDINGS Our findings are consistent with previous research indicating that some types of female employment schedules may be associated with SAB incidence. This is the first study to indicate a relationship between SAB and male employment schedules, indicating that discrepant work schedules within a couple might be relevant. STUDY FUNDING/COMPETING INTEREST(S) This work was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development grants R01HD105863 (PIs: L.A.W. and M.L.E.), R01HD086742 (PIs: L.A.W. and E.E.H.), and R21HD072326 (PI: L.A.W.). PRESTO has received in-kind donations from Swiss Precision Diagnostics and Kindara.com for primary data collection. L.A.W. is a consultant for AbbVie, Inc. and the Gates Foundation. M.L.E. is an advisor for and holds stock in Ro, Hannah, Dadi, Underdog, Vseat, & Doveras. The other authors have no competing interests to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- J C Bond
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - C M Coleman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - J J Yland
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - A K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - T Wang
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - M Willis
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - E E Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - K J Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - D Savitz
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - M L Eisenberg
- Department of Urology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - L A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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Mineo C, Shaul PW. New Player in an Old Field? Ecto-F 1-ATPase in Antidiabetic Actions of HDL in Pancreatic β-Cells. Arterioscler Thromb Vasc Biol 2024; 44:419-422. [PMID: 38095108 PMCID: PMC10842905 DOI: 10.1161/atvbaha.123.320426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Affiliation(s)
- Chieko Mineo
- Center for Pulmonary and Vascular Biology, Dept. of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
- Dept. of Cell Biology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
| | - Philip W. Shaul
- Center for Pulmonary and Vascular Biology, Dept. of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
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Tinti L, Lawson T, Molteni E, Kondziella D, Rass V, Sharshar T, Bodien YG, Giacino JT, Mayer SA, Amiri M, Muehlschlegel S, Venkatasubba Rao CP, Vespa PM, Menon DK, Citerio G, Helbok R, McNett M. Research considerations for prospective studies of patients with coma and disorders of consciousness. Brain Commun 2024; 6:fcae022. [PMID: 38344653 PMCID: PMC10853976 DOI: 10.1093/braincomms/fcae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 01/04/2024] [Accepted: 01/26/2024] [Indexed: 03/02/2024] Open
Abstract
Disorders of consciousness are neurological conditions characterized by impaired arousal and awareness of self and environment. Behavioural responses are absent or are present but fluctuate. Disorders of consciousness are commonly encountered as a consequence of both acute and chronic brain injuries, yet reliable epidemiological estimates would require inclusive, operational definitions of the concept, as well as wider knowledge dissemination among involved professionals. Whereas several manifestations have been described, including coma, vegetative state/unresponsive wakefulness syndrome and minimally conscious state, a comprehensive neurobiological definition for disorders of consciousness is still lacking. The scientific literature is primarily observational, and studies-specific aetiologies lead to disorders of consciousness. Despite advances in these disease-related forms, there remains uncertainty about whether disorders of consciousness are a disease-agnostic unitary entity with a common mechanism, prognosis or treatment response paradigm. Our knowledge of disorders of consciousness has also been hampered by heterogeneity of study designs, variables, and outcomes, leading to results that are not comparable for evidence synthesis. The different backgrounds of professionals caring for patients with disorders of consciousness and the different goals at different stages of care could partly explain this variability. The Prospective Studies working group of the Neurocritical Care Society Curing Coma Campaign was established to create a platform for observational studies and future clinical trials on disorders of consciousness and coma across the continuum of care. In this narrative review, the author panel presents limitations of prior observational clinical research and outlines practical considerations for future investigations. A narrative review format was selected to ensure that the full breadth of study design considerations could be addressed and to facilitate a future consensus-based statement (e.g. via a modified Delphi) and series of recommendations. The panel convened weekly online meetings from October 2021 to December 2022. Research considerations addressed the nosographic status of disorders of consciousness, case ascertainment and verification, selection of dependent variables, choice of covariates and measurement and analysis of outcomes and covariates, aiming to promote more homogeneous designs and practices in future observational studies. The goal of this review is to inform a broad community of professionals with different backgrounds and clinical interests to address the methodological challenges imposed by the transition of care from acute to chronic stages and to streamline data gathering for patients with disorders of consciousness. A coordinated effort will be a key to allow reliable observational data synthesis and epidemiological estimates and ultimately inform condition-modifying clinical trials.
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Affiliation(s)
- Lorenzo Tinti
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan 20156, Italy
| | - Thomas Lawson
- Critical Care, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Erika Molteni
- Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EU, UK
| | - Daniel Kondziella
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen 2100, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen 2200, Denmark
| | - Verena Rass
- Department of Neurology, Neuro-Intensive Care Unit, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Tarek Sharshar
- Neuro-Intensive Care Medicine, Anaesthesiology and ICU Department, GHU-Psychiatry and Neurosciences, Pole Neuro, Sainte-Anne Hospital, Institute of Psychiatry and Neurosciences of Paris, INSERM U1266, Université Paris Cité, Paris 75006, France
| | - Yelena G Bodien
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, MA 02129, USA
| | - Joseph T Giacino
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, MA 02129, USA
| | - Stephan A Mayer
- Department of Neurology, New York Medical College, Valhalla, NY 10595, USA
- Department of Neurosurgery, New York Medical College, Valhalla, NY 10595, USA
| | - Moshgan Amiri
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen 2100, Denmark
| | - Susanne Muehlschlegel
- Department of Neurology and Anesthesiology/Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Chethan P Venkatasubba Rao
- Division of Vascular Neurology and Neurocritical Care, Baylor College of Medicine and CHI Baylor St Luke’s Medical Center, Houston, TX 77030, USA
| | - Paul M Vespa
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - David K Menon
- Division of Anaesthesia, University of Cambridge, Cambridge CB2 1TN, UK
| | - Giuseppe Citerio
- NeuroIntensive Care, IRCSS Fondazione San Gerardo dei Tintori, Monza 20900, Italy
- School of Medicine and Surgery, Università Milano Bicocca, Milan 20854, Italy
| | - Raimund Helbok
- Department of Neurology, Neuro-Intensive Care Unit, Medical University of Innsbruck, Innsbruck 6020, Austria
- Department of Neurology, Johannes Kepler University, Linz 4040, Austria
| | - Molly McNett
- College of Nursing, The Ohio State University, Columbus, OH 43210, USA
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Miyachi H, Ooka T, Pérez-Losada M, Camargo CA, Hasegawa K, Zhu Z. Nasopharyngeal airway long noncoding RNAs of infants with bronchiolitis and subsequent risk of developing childhood asthma. J Allergy Clin Immunol 2024:S0091-6749(24)00077-0. [PMID: 38272372 DOI: 10.1016/j.jaci.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/12/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Severe bronchiolitis (ie, bronchiolitis requiring hospitalization) during infancy is a major risk factor for developing childhood asthma. However, the biological mechanisms linking these 2 conditions remain unclear. OBJECTIVE We sought to investigate the longitudinal relationship between nasopharyngeal airway long noncoding RNA (lncRNA) in infants with severe bronchiolitis and subsequent asthma development. METHODS In this multicenter prospective cohort study of infants with severe bronchiolitis, we performed RNA sequencing of nasopharyngeal airway lncRNAs at index hospitalization. First, we identified differentially expressed lncRNAs (DE-lncRNAs) associated with asthma development by age 6 years. Second, we investigated the associations of DE-lncRNAs with asthma-related clinical characteristics. Third, to characterize the function of DE-lncRNAs, we performed pathway analysis for mRNA targeted by DE-lncRNAs. Finally, we examined the associations of DE-lncRNAs with nasal cytokines at index hospitalization. RESULTS Among 343 infants with severe bronchiolitis (median age, 3 months), we identified 190 DE-lncRNAs (false-discovery rate [FDR] < 0.05) associated with asthma development (eg, LINC02145, RAMP2-AS1, and PVT1). These DE-lncRNAs were associated with asthma-related clinical characteristics (FDR < 0.05), for example, respiratory syncytial virus or rhinovirus infection, infant eczema, and IgE sensitization. Furthermore, DE-lncRNAs were characterized by asthma-related pathways, including mitogen-activated protein kinase, FcɛR, and phosphatidylinositol 3-kinase (PI3K)-protein kinase B signaling pathways (FDR < 0.05). These DE-lncRNAs were also associated with nasal cytokines (eg, IL-1β, IL-4, and IL-13; FDR < 0.05). CONCLUSIONS In a multicenter cohort study of infants with severe bronchiolitis, we identified nasopharyngeal airway lncRNAs associated with childhood asthma development, characterized by asthma-related clinical characteristics, asthma-related pathways, and nasal cytokines. Our approach identifies lncRNAs underlying the bronchiolitis-asthma link and facilitates the early identification of infants at high risk of subsequent asthma development.
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Affiliation(s)
- Hideaki Miyachi
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Tadao Ooka
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Department of Health Sciences, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Marcos Pérez-Losada
- Department of Biostatistics and Bioinformatics, Computational Biology Institute, The George Washington University, Washington, DC
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Zhaozhong Zhu
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
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Orban E, Li LY, Gilbert M, Napp AK, Kaman A, Topf S, Boecker M, Devine J, Reiß F, Wendel F, Jung-Sievers C, Ernst VS, Franze M, Möhler E, Breitinger E, Bender S, Ravens-Sieberer U. Mental health and quality of life in children and adolescents during the COVID-19 pandemic: a systematic review of longitudinal studies. Front Public Health 2024; 11:1275917. [PMID: 38259801 PMCID: PMC10800626 DOI: 10.3389/fpubh.2023.1275917] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Background The COVID-19 pandemic has significantly impacted the mental health of children and families, i.e., due to measures like social distancing and remote schooling. While previous research has shown negative effects on mental health and health-related quality of life (HRQoL), most studies have focused on pre-post comparisons in the early pandemic stages. This systematic review aims to examine longitudinal studies to understand the long-term impacts of the pandemic on children and adolescents. Methods This systematic review adhered to the PRISMA guidelines and was preregistered in the international prospective register of systematic reviews (Record ID: CRD42022336930). We systematically searched PubMed/MEDLINE, Web of Science, PsycINFO, PSYNDEX, and the WHO-COVID-19 database and included studies published up to August 30, 2022. Based on pre-defined eligibility criteria, longitudinal and prospective studies that assessed the mental health or quality of life of children or adolescents (0-19 years) in the general population over a longer time span (at two or more measurement points) during the COVID-19 pandemic were included in the review. The methodological quality of the included studies was assessed using an adapted version of the Effective Public Health Practice Project (EPHPP) checklist. Narrative data synthesis was used to summarize the findings. Results A total of 5,099 results were obtained from literature searches, with 4,935 excluded during title/abstract screening. After reviewing 163 full-text articles, 24 publications were included in the review. Sample sizes ranged between n = 86 and n = 34,038. The length of the investigated time periods and the number of assessment points, as well as outcomes, varied. The majority of studies were of moderate methodological quality. Mental health outcomes were more frequently studied compared to measures of HRQoL. The findings from these studies mostly suggest that children and adolescents experienced heightened mental health problems, specifically internalizing symptoms like anxiety and depression. Further, there was a decline in their overall HRQoL over the course of the COVID-19 pandemic that did not necessarily subside when lockdowns ended. Conclusion It is crucial to continue monitoring the mental health and well-being of children and adolescents following the pandemic to identify groups at risks and plan interventions. This should ideally be conducted by large systematic studies, using validated instruments, and encompassing representative samples to obtain reliable and comprehensive insights with the aim of improving youth mental health care.
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Affiliation(s)
- Ester Orban
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lydia Yao Li
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martha Gilbert
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ann-Kathrin Napp
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sabine Topf
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maren Boecker
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Child and Adolescent Psychiatry, Child Neuropsychology Section, University Hospital RWTH Aachen, Aachen, Germany
| | - Janine Devine
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Reiß
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Flora Wendel
- Faculty of Medicine, Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Caroline Jung-Sievers
- Faculty of Medicine, Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Vanessa Sophie Ernst
- Institute for Community Medicine, Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Marco Franze
- Institute for Community Medicine, Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Eva Möhler
- Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Eva Breitinger
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Yusuf A, Aditya RS, Sulistyorini A, Rahmatika QT, Sunaryo EYAB, Masfi A, Afiani N, Widjayanti Y, Ramadhan MP, Evi N, AlMutairi RI, Al Razeeni DM. Stakeholder Recommendations for Sports-Focused Undergraduate Nursing Curriculum: A Qualitative Study. Adv Med Educ Pract 2024; 15:1-13. [PMID: 38192542 PMCID: PMC10771788 DOI: 10.2147/amep.s418529] [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] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/01/2023] [Indexed: 01/10/2024]
Abstract
Background Growing demand for nurses in the sports medicine field has raised awareness in preparing prospective nurses with the basic concepts of sports nursing. Recognizing this need, nursing study program need to continue to evolve and the first step begin with the analysis of the major concepts related to various domains involved in the curriculum. Stakeholders are the most important people to get involved in the curriculum development process. Objective The purpose of this paper is to explore stakeholders' recommendation for establishing a strategy that would best enable the development of sports-focused undergraduate nursing curriculum. Methods We conducted a focus group discussion using a a series of open-ended questions. Nineteen stakeholders participated in this study. Data was analyzed using a thematic analysis. Results The results of this study found three themes consisting of sports nursing, advanced sports nursing, and sports in the discipline of nursing. On the theme of sports nursing, several sub-themes were obtained, the concept of sports nursing, the basics of sports physiology, adaptation of physiology to sports, psychology and sports injuries, problems in sports, education in sports, pathology in sports, and assistance in sports injuries. Conclusion Identifying, understanding, and managing Stakeholder involvement in curriculum development is the main driver for creating nursing study programs that focus on sports nursing. Nursing can contribute to sports and create more specific areas of expertise. Sports nursing.
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Affiliation(s)
- Ah Yusuf
- Faculty of Nursing, Universitas Airlangga Surabaya, Surabaya, Indonesia
| | | | | | | | | | - Achmad Masfi
- Faculty of Sport Science, Universitas Negeri Malang, Malang, Indonesia
| | - Nurma Afiani
- Faculty of Sport Science, Universitas Negeri Malang, Malang, Indonesia
| | - Yhenti Widjayanti
- Faculty of Sport Science, Universitas Negeri Malang, Malang, Indonesia
| | | | - Nurul Evi
- Faculty of Sport Science, Universitas Negeri Malang, Malang, Indonesia
| | - Reem Iafi AlMutairi
- Department of Public Health, School of Public Health and Health Informatics, Hail University, Hail, Saudi Arabia
| | - Daifallah M Al Razeeni
- Department of EMS, Vice Dean for Academic Affair Prince Sultan Bin Abdulaziz College for EMS (PSEMS), King Saud University (KSU), Riyadh, Saudi Arabia
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Liu J, Zhao XY, Xu LP, Zhang XH, Wang Y, Mo XD, Zhang YY, Zhao XS, Cheng YF, Liu KY, Huang XJ, Chang YJ. The impact of donor-specific anti-HLA antibody levels on primary poor graft function and graft rejection in rituximab desensitized haploidentical stem cell transplantation. HLA 2024; 103:e15300. [PMID: 37985437 DOI: 10.1111/tan.15300] [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: 06/05/2023] [Revised: 10/11/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023]
Abstract
This study investigates the influence of donor-specific anti-HLA antibodies (DSA) levels on primary poor graft function (PGF) and graft rejection (GR) after haploidentical stem cell transplantation (haplo-SCT) with rituximab desensitization. A total of 155 DSA-positive haplo-SCT candidates with mean fluorescence intensity (MFI) between 2000 and 10,000 were enrolled in this prospective clinical trial. Receiver operating characteristic (ROC) curves determined the optimal DSA MFI cutoff for identifying high-risk patients. Patients were categorized into two groups: DSA low-level group (2000 ≤ DSA MFI < 5000, Group A) and high-level group (5000 ≤ DSA MFI ≤ 10,000, Group B). The incidence of primary PGF was 6.5% (2.6%-10.3%), while GR incidence was 0.6% (0.0%-1.9%). Group A had significantly lower primary PGF rates than Group B (2.3% [0.0%-5.7%] vs. 12.9% [4.8%-21.0%], p = 0.017). Only one patient in Group B experienced GR. High DSA levels (5000 ≤ MFI ≤ 10,000) were identified as the sole independent risk factor for primary PGF and GR after haplo-SCT with rituximab desensitization (HR = 7.282, 95% CI 1.517-34.953, p = 0.013). The 4-year cumulative incidence of relapse, non-relapse mortality, disease-free survival, and overall survival were 14.7% (11.6%-17.8%), 16.3% (13.1%-19.4%), 69.0% (65.9%-76.2%), and 70.6% (66.4%-74.8%), respectively. DSA levels have an impact on efficiency of rituximab desensitization, and a DSA MFI threshold is provided for predicting primary PGF and GR.
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Affiliation(s)
- Jing Liu
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Xiang-Yu Zhao
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Lan-Ping Xu
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Xiao-Hui Zhang
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Yu Wang
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Xiao-Dong Mo
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Yuan-Yuan Zhang
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Xiao-Su Zhao
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Yi-Fei Cheng
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Kai-Yan Liu
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Xiao-Jun Huang
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
- Peking-Tsinghua Center for Life Sciences, Beijing, China
- Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Chinese Academy of Medical Sciences, Beijing, China
| | - Ying-Jun Chang
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
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Kaur H, Merkel A, Hackett CT, Finoli L, Seidl E, Reardon C, Cerejo R. Freezing Tenecteplase Into Aliquots to Reduce Waste in Acute Ischemic Stroke. Stroke 2024; 55:e1-e2. [PMID: 38063015 DOI: 10.1161/strokeaha.123.044345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Affiliation(s)
- Harsimran Kaur
- AHN Neuroscience Institute, Allegheny Health Network, Pittsburgh, PA (H.K., C.T.H., R.C.)
| | - Alison Merkel
- AHN Pharmacy, Allegheny General Hospital, Pittsburgh, PA (A.M., L.F., E.S., C.R.)
| | - Christopher T Hackett
- AHN Neuroscience Institute, Allegheny Health Network, Pittsburgh, PA (H.K., C.T.H., R.C.)
| | - Lauren Finoli
- AHN Pharmacy, Allegheny General Hospital, Pittsburgh, PA (A.M., L.F., E.S., C.R.)
| | - Edward Seidl
- AHN Pharmacy, Allegheny General Hospital, Pittsburgh, PA (A.M., L.F., E.S., C.R.)
| | - Caitlin Reardon
- AHN Pharmacy, Allegheny General Hospital, Pittsburgh, PA (A.M., L.F., E.S., C.R.)
| | - Russell Cerejo
- AHN Neuroscience Institute, Allegheny Health Network, Pittsburgh, PA (H.K., C.T.H., R.C.)
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Espeland A, Kristoffersen PM, Bråten LCH, Grøvle L, Grotle M, Haugen AJ, Rolfsen MP, Hellum C, Zwart JA, Storheim K, Assmus J, Vetti N. Longitudinal Relationship Between Reduced Modic Change Edema and Disability and Pain in Patients With Chronic Low Back Pain. Spine (Phila Pa 1976) 2023; 48:1699-1708. [PMID: 37759351 PMCID: PMC10662590 DOI: 10.1097/brs.0000000000004837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
STUDY DESIGN Secondary analyses of a randomized trial [Antibiotics In Modic changes (MCs) study]. OBJECTIVE To assess whether or not reduced MC edema over time is related to reduced disability and pain in patients with chronic low back pain (LBP). SUMMARY OF BACKGROUND DATA It is not clear whether or not reduced MC edema implies improved clinical outcomes. PATIENTS AND METHODS Linear regression was conducted separately in 2 subgroups with MC edema at baseline on short tau inversion recovery (STIR) or T1/T2-weighted magnetic resonance imaging, respectively. Independent variable: reduced edema (yes/no) at 1 year on STIR or T1/T2-series, respectively. Dependent variable: 1-year score on the Roland-Morris Disability Questionnaire (RMDQ), Oswestry Disability Index (ODI), or 0 to 10 numeric rating scale for LBP intensity, adjusted for the baseline score, age, smoking, body mass index, physical workload, and baseline edema on STIR (STIR analysis only). Post hoc, we, in addition, adjusted all analyses for baseline edema on STIR, treatment group (amoxicillin/placebo), and prior disc surgery-or for disc degeneration. RESULTS Among patients with MC edema on STIR at baseline (n = 162), reduced edema on STIR was not significantly related to the RMDQ ( B : -1.0, 95% CI: -2.8, 0.8; P = 0.27), ODI ( B :-1.4, 95% CI: -5.4, 2.6; P = 0.50), or LBP intensity scores ( B : -0.05, 95% CI: -0.8, 0.7; P = 0.90) after 1 year. Among patients with MC edema on T1/T2-series at baseline (n = 116), reduced edema on T1/T2 ( i.e ., reduced volume of the type 1 part of MCs) was not significantly related to RMDQ ( B: -1.7, 95% CI: -3.8, 0.3; P = 0.10) or ODI score ( B : -2.3, 95% CI: -7.1, 2.5; P = 0.34) but was significantly related to LBP intensity at 1 year ( B : -0.9, 95% CI: -1.8, -0.04; P = 0.04; correlation coefficient: 0.24). The post hoc analyses supported these results. CONCLUSION Reduced MC edema over 1 year was not significantly associated with pain-related disability but was (on T1/T2-series) significantly but weakly related to reduced LBP intensity. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- Ansgar Espeland
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Per Martin Kristoffersen
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Lars Christian Haugli Bråten
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Nydalen, Oslo, Norway
| | - Lars Grøvle
- Department of Rheumatology, Østfold Hospital Trust, Grålum, Norway
| | - Margreth Grotle
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Nydalen, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Centre for Intelligent Musculoskeletal Health, Oslo Metropolitan University, Oslo, Norway
| | | | - Mads Peder Rolfsen
- Faculty of Medicine, University of Oslo, Blindern, Oslo, Norway
- Department of Orthopedic Surgery, Oslo University Hospital, Nydalen, Oslo, Norway
| | - Christian Hellum
- Department of Orthopedic Surgery, Oslo University Hospital, Nydalen, Oslo, Norway
| | - John-Anker Zwart
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Nydalen, Oslo, Norway
- Faculty of Medicine, University of Oslo, Blindern, Oslo, Norway
| | - Kjersti Storheim
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Nydalen, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Centre for Intelligent Musculoskeletal Health, Oslo Metropolitan University, Oslo, Norway
| | - Jörg Assmus
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Nils Vetti
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Lück HJ, Schmidt M, Hesse T, Hoffmann O, Heinrich BJ, Park-Simon TW, Grischke EM, Weide R, Müller-Huesmann H, Lüdtke-Heckenkamp K, Fischer D, Zemlin C, Kögel M, Wu J, Schmitz H, Engelbrecht C, Jackisch C. Incidence and Resolution of Eribulin-Induced Peripheral Neuropathy (IRENE) in Locally Advanced or Metastatic Breast Cancer: Prospective Cohort Study. Oncologist 2023; 28:e1152-e1159. [PMID: 37555463 PMCID: PMC10712709 DOI: 10.1093/oncolo/oyad191] [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: 12/22/2022] [Accepted: 05/04/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Eribulin, a halichondrin-class microtubule dynamics inhibitor, is a preferred treatment option for patients with advanced breast cancer who have been pretreated with an anthracycline and a taxane. Peripheral neuropathy (PN) is a common side effect of chemotherapies for breast cancer and other tumors. The Incidence and Resolution of Eribulin-Induced Peripheral Neuropathy (IRENE) noninterventional postauthorization safety study assessed the incidence and severity of PN in patients with breast cancer treated with eribulin. PATIENTS AND METHODS IRENE is an ongoing observational, single-arm, prospective, multicenter, cohort study. Adult patients (≥18 years of age) with locally advanced or metastatic breast cancer and disease progression after 1-2 prior chemotherapeutic regimen(s) for advanced disease were treated with eribulin. Patients with eribulin-induced PN (new-onset PN or worsening of preexisting PN) were monitored until death or resolution of PN. Primary endpoints included the incidence, severity, and time to resolution of eribulin-induced PN. Secondary endpoints included time to disease progression and safety. RESULTS In this interim analysis (data cutoff date: July 1, 2019), 67 (32.4%) patients experienced any grade eribulin-induced PN, and 12 (5.8%) patients experienced grade ≥3 eribulin-induced PN. Median time to resolution of eribulin-induced PN was not reached. Median time to disease progression was 4.6 months (95% CI, 4.0-6.5). Treatment-emergent adverse events (TEAEs) occurred in 195 (93.8%) patients and serious TEAEs occurred in 107 (51.4%) patients. CONCLUSION The rates of any grade and grade ≥3 eribulin-induced PN observed in this real-world study were consistent with those observed in phase III randomized clinical trials. No new safety findings were observed.
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Affiliation(s)
- Hans-Joachim Lück
- Gynecologic Oncology, Gynäkologisch-Onkologische Praxis am Pelikanplatz, Hannover, Germany
| | - Marcus Schmidt
- Department of Obstetrics and Gynecology, University Medical Center Mainz, Mainz, Germany
| | - Tobias Hesse
- Department of Gynecology, Agaplesion Diakonieklinikum Rotenburg gGmbH, Rotenburg (Wuemme), Germany
| | - Oliver Hoffmann
- Department of Gynecology and Obstetrics, Universitätsklinikum Essen, Essen, Germany
| | | | | | | | - Rudolf Weide
- Oncological Outpatient Department, Praxis für Hämatologie und Onkologie Koblenz, Koblenz, Germany
| | - Harald Müller-Huesmann
- Department of Hematology/Oncology, Brüderkrankenhaus St. Josef Paderborn, Paderborn, Germany
| | - Kerstin Lüdtke-Heckenkamp
- Department of Hematology/Oncology, Niels Stensen Clinics, Franziskus Hospital, Georgsmarienhütte, Germany
| | - Dorothea Fischer
- Department of Gynaecology and Obstetrics, Hospital Ernst von Bergmann, Potsdam, Germany
| | - Cosima Zemlin
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | | | - Jane Wu
- Biostatistics, Eisai Inc., Nutley, NJ, USA
| | | | | | - Christian Jackisch
- Department of Obstetrics and Gynecology, Sana Klinikum Offenbach GmbH, Offenbach, Germany
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Liman TG, Siegerink B, Piper S, Catar R, Moll G, Riemekasten G, Heidecke H, Heuschmann PU, Elkind MSV, Dragun D, Endres M. Vasoregulatory Autoantibodies and Clinical Outcome After Ischemic Stroke-PROSCIS-B. J Am Heart Assoc 2023; 12:e032441. [PMID: 38014691 PMCID: PMC10727313 DOI: 10.1161/jaha.123.032441] [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: 08/30/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Vasoregulatory autoantibodies including autoantibodies targeting G-protein-coupled receptors might play a functional role in vascular diseases. We investigated the impact of vasoregulatory autoantibodies on clinical outcome after ischemic stroke. METHODS AND RESULTS Data were used from the PROSCIS-B (Prospective Cohort With Incident Stroke-Berlin). Autoantibody-targeting receptors such as angiotensin II type 1 receptor (AT1R), endothelin-1 type A receptor, complement factor-3 and -5 receptors, vascular endothelial growth factor receptor-1 and -2, vascular endothelial growth factor A and factor B were measured. We explored associations of high antibody levels with (1) poor functional outcome defined as modified Rankin Scale >2 or Barthel Index <60 at 1 year after stroke, (2) Barthel Index scores over time using general estimating equations, and (3) secondary vascular events (recurrent stroke, myocardial infarction) or death up to 3 years using Cox proportional hazard models. We included 491 patients with ischemic stroke with data on autoantibody levels and outcome. In models adjusted for demographics and vascular risk factors, high autoantibody concentrations (quartile 4) targeting complement factor C3a receptor, vascular endothelial growth factor receptor-2, and vascular endothelial growth factor B were associated with poor functional outcome at 1 year: (odds ratio, 2.0 [95% CI, 1.1-3.6]; odds ratio, 1.8 [95% CI, 1.1-3.2]; and odds ratio, 2.1 [95% CI, 1.2-3.6], respectively) and with lower Barthel Index scores over 3 years (complement factor C3a receptor: adjusted β=-3.3 [95% CI, -5.7 to -0.5]; VEGF-B: adjusted β=-2.4 [95% CI, -4.8 to -0.06]). Patients with high autoantibody levels were not at higher risk for secondary vascular events or death. CONCLUSIONS High levels of autoantibodies against vascular endothelial growth factor receptor-2, vascular endothelial growth factor B, and complement factor C3a receptor measured are associated with poor functional outcome after stroke but not with recurrent vascular events or death. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT01363856.
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Affiliation(s)
- Thomas G. Liman
- Center for Stroke Research Berlin (CSB)Charité – Universitätsmedizin BerlinBerlinGermany
- Department of Neurology at Evangelical Hospital OldenburgCarl von Ossietzky UniversityOldenburgGermany
- German Center for Neurodegenerative Diseases (DZNE)Site BerlinGermany
| | - Bob Siegerink
- Leiden University Medical Center, Leiden UniversityDepartment of Clinical EpidemiologyLeidenThe Netherlands
| | - Sophie Piper
- Institute for Biometry and Clinical Epidemiology; Charité – Universitätsmedizin BerlinBerlinGermany
| | - Rusan Catar
- Department of Nephrology and Intensive Care MedicineCharité – Universitätsmedizin BerlinBerlinGermany
| | - Guido Moll
- Department of Nephrology and Intensive Care MedicineCharité – Universitätsmedizin BerlinBerlinGermany
| | - Gabriela Riemekasten
- Clinic for Rheumatology and Clinical ImmunologyUniversitätsklinikum Schleswig‐HolsteinLübeckGermany
| | | | - Peter U. Heuschmann
- Comprehensive Heart Failure CenterUniversity Hospital WürzburgWürzburgGermany
- Institute of Clinical Epidemiology and Biometry, University of WürzburgWürzburgGermany
| | - Mitchell S. V. Elkind
- Department of Neurology, Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | - Duska Dragun
- Department of Nephrology and Intensive Care MedicineCharité – Universitätsmedizin BerlinBerlinGermany
| | - Matthias Endres
- Center for Stroke Research Berlin (CSB)Charité – Universitätsmedizin BerlinBerlinGermany
- Department of Neurology with Experimental NeurologyCharité – Universitätsmedizin BerlinBerlinGermany
- German Center for Neurodegenerative Diseases (DZNE)Site BerlinGermany
- German Centre for Cardiovascular Research (DZHK)BerlinGermany
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Olson DM. Comment Regarding the 2023 Guideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage. Stroke 2023; 54:3214-3215. [PMID: 38011236 DOI: 10.1161/strokeaha.123.044106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Affiliation(s)
- DaiWai M Olson
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas
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Cagnazzo C, Basiricò M, Palermo F, Fagioli F. Observational studies - The Cinderella of the Italian research system. Tumori 2023; 109:524-528. [PMID: 37029687 DOI: 10.1177/03008916231166469] [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: 04/09/2023]
Abstract
Observational trials are crucial to assess the generalizability in the real world of evidence deriving from registration studies. Despite the unquestionable importance of this type of studies, Italian researchers have had to face many obstacles over the years, mainly due to ambiguous definitions and to a complex but at the same time incomplete legislation. The regulatory adjustments to the European Regulation 536/2014 have further complicated the operating and operational framework, making observational research a real "Cinderella" of the Italian system.
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Affiliation(s)
- Celeste Cagnazzo
- Dipartimento Patologia e Cura del Bambino, Regina Margherita AOU Città della Salute e della Scienza di Torino, Presidio Infantile Regina Margherita, Turin, Italy
| | - Marco Basiricò
- Dipartimento Patologia e Cura del Bambino, Regina Margherita AOU Città della Salute e della Scienza di Torino, Presidio Infantile Regina Margherita, Turin, Italy
| | - Federica Palermo
- SS Clinical Trial Center Fondazione, IRCCS Istituto Nazionale Tumori di Milano, Milan, Italy
| | - Franca Fagioli
- Dipartimento Patologia e Cura del Bambino, Regina Margherita AOU Città della Salute e della Scienza di Torino, Presidio Infantile Regina Margherita, Turin, Italy
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Karthic A, Orgil Z, Tram NK, Rice-Weimer J, Stevens J, Olbrecht VA. Application of behavioral economic strategies to enhance recruitment into a pediatric randomized clinical trial for postoperative pain relief: A randomized clinical trial. Paediatr Anaesth 2023; 33:1091-1098. [PMID: 37712489 DOI: 10.1111/pan.14755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION A major challenge in conducting clinical trials is recruitment. Trial under-enrollment leads to underpowered studies. Behavioral economics offers strategies that may enhance trial recruitment. This study assessed the impact of behavioral economic strategies versus a standard biological approach to recruit children into a randomized clinical trial assessing a biofeedback-based virtual reality intervention for postoperative pain management. We hypothesized the behavioral economics-informed approach would increase enrollment into the future trial, intention to adhere to therapy, acceptability of the intervention, and perceived efficacy while decreasing perception of treatment burden and risk. METHODS This single-center, prospective, randomized trial recruited patients 12-18 years old undergoing surgery requiring postoperative admission and narcotic administration. Patient-parent dyads were randomized to watch a behavioral economics-informed (n = 64) or standard biological (n = 66) recruitment video about a study designed to assess impact of a virtual reality pain management intervention. RESULTS There was no difference in rates of intention to enroll in the study between groups (behavioral economics: 75%, control: 79%, p = 0.744) or in median response scores to questions regarding intention to adhere to therapy (4.0 [3.0, 4.0] vs. 4.0 [3.0, 4.0], p=0.084), acceptability of therapy (4.0 [3.0, 4.0] vs. 4.0 [3.0, 4.0], p = 0.376), perceptions of treatment burden (3.0 [3.0, 4.0] vs. 4.0 [3.0, 4.0], p=0.251), and efficacy (3.0 [3.0, 4.0] vs. 3.0 [3.0, 4.0], p = 0.914). Patients in the behavioral economics group were less likely to perceive risk associated with virtual reality versus the control group (behavioral economics: 2.0 [1.0, 2.0], control: 2.0 [2.0, 3.0], p = 0.023). DISCUSSION A behavioral economics-informed video did not increase patients' intentions to enroll into a clinical trial assessing the impact of virtual reality intervention for postoperative pain management. CONCLUSION Either approach would be sufficient for patient recruitment for this type of clinical trial since the overall intention to enroll rate was 77%.
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Affiliation(s)
- Anitra Karthic
- Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Zandantsetseg Orgil
- Department of Clinical Research Services, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Nguyen K Tram
- Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Julie Rice-Weimer
- Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Jack Stevens
- Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Vanessa A Olbrecht
- Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
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Kandasamy M, Chan M, Xiang H, Chan L, Ridley L. Comparison of diagnostic accuracy of ultra low-dose computed tomography and X-ray of the kidneys, ureters and bladder for urolithiasis in the follow-up setting. J Med Imaging Radiat Oncol 2023. [PMID: 37997533 DOI: 10.1111/1754-9485.13605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023]
Abstract
INTRODUCTION Urolithiasis is frequently followed up with a low-dose computed tomography of the kidneys ureters and bladder (LD-CTKUB) with doses typically less than 3 millisieverts. Although X-ray is a lower dose (0.5-1.1 mSv) alternative for follow up, it has lower diagnostic accuracy and is limited to radiopaque calculi. This study aims to compare the diagnostic accuracy of sub-millisievert ultra-low dose CT (ULD-CTKUB) against X-ray KUB for the follow up of urolithiasis when both are compared against the standard of care of a low-dose CT KUB (LD-CTKUB). METHODS This prospective study included patients with a known diagnosis of urolithiasis on prior CTKUB presenting for follow up. Each patient underwent a repeat reference LD-CTKUB, ULD-CTKUB and X-ray KUB. All imaging studies were interpreted by three readers. The radiation dose and quantitative noise was calculated for each CT. Both CT and X-ray were assessed for the presence, number and size of all calculi ≥2 mm. RESULTS A total of 58 patients were included in this study. LD-CTKUB identified 197 calculi. ULD-CTKUB in our study had a mean effective dose of 0.5 mSv compared to X-ray KUB where doses range in the literature from 0.5 to 1.1 mSv. Per-patient pooled analysis for intrarenal calculi when comparing ULD-CTKUB versus X-ray KUB against a reference LD-CTKUB found a sensitivity of 90% versus 67% (P < 0.01) and specificity of 93% versus 98% (P = 0.18) respectively. For ureteric calculi, the sensitivity was 67% versus 33% (P < 0.01) and specificity 94% versus 94% (P = 1.00) respectively. Per-stone pooled analysis detection rate was 79% for ULD-CTKUB versus 48% for X-ray (P < 0.01) when each was compared to the reference LD-CTKUB. Interobserver agreement was high for intrarenal calculi and moderate for ureteric calculi. CONCLUSION Sub-millisievert ULD-CTKUB had lower doses and higher sensitivity than X-ray in patients requiring follow up of known urolithiasis.
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Affiliation(s)
- Mayooran Kandasamy
- Department of Radiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Michael Chan
- Department of Radiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - Hao Xiang
- Department of Radiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Lewis Chan
- Department of Urology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Lloyd Ridley
- Department of Radiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
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Chai D, Liu Z, Wang L, Duan H, Zhao C, Xu C, Zhang D, Zhao Q, Ma P. Effectiveness of Medication Reconciliation in a Chinese Hospital: A Pilot Randomized Controlled Trial. J Multidiscip Healthc 2023; 16:3641-3650. [PMID: 38034875 PMCID: PMC10683647 DOI: 10.2147/jmdh.s432522] [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: 08/22/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023] Open
Abstract
Background Implementing medication reconciliation (MR) was complex and challenging because of the variability in the guidance provided for conducting. The processes of MR adopted in China were different from that recommended by the World Health Organization. A pilot study to inform the design of a future randomized controlled trial to determine the effectiveness of these two workflows was undertaken. Methods Patients taking at least one home/regular medication for hypertension, diabetes, or coronary heart disease were recruited at admission, and then were randomized using a computer-generated random number in a closed envelope. In the study group, the pharmacist reviewed electronic medical record systems before communication with patients. In the control group, pharmacists communicated with patients at patient's admission. The time investment of pharmacists for MR process, the number of unintended medication discrepancies, and physician acceptance were tested as outcome measures. Results One hundred and forty adult patients were randomized, of which 66 patients in the intervention received MR within 24 hours, while 58 patients in control received MR at some point during admission. The most common condition in the study group was hypertension (coronary heart disease in the control group). The workflow of the study group can save an average 7 minutes per patient compared with the WHO recommended process [17.5 minutes (IQR 14.00, 28.25) vs 24.5 minutes (IQR17.75, 35.25), p = 0.004]. The number of unintended discrepancies was 42 in the study group and 34 in the control group (p = 0.33). Physicians' acceptance in the study and control groups were 87.5% and 92.3%, respectively (p = 0.87). Conclusion The results suggest that changes in outcome measures were in the appropriate direction and that the time limit for implementing MR can be set within 48 hours. A future multi-centre RCT study to determine the effectiveness of MR is feasible and warranted.
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Affiliation(s)
- Dongyan Chai
- Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou, HenanPeople’s Republic of China
- International Medical Center of Henan Province, Henan Provincial People’s Hospital, Zhengzhou, Henan, People’s Republic of China
| | - Zhihui Liu
- Department of General Practice, Henan Provincial People’s Hospital, Zhengzhou, Henan, People’s Republic of China
| | - Liuyi Wang
- Department of General Practice, Henan Provincial People’s Hospital, Zhengzhou, Henan, People’s Republic of China
| | - Hongyan Duan
- International Medical Center of Henan Province, Henan Provincial People’s Hospital, Zhengzhou, Henan, People’s Republic of China
- Department of General Practice, Henan Provincial People’s Hospital, Zhengzhou, Henan, People’s Republic of China
| | - Chenglong Zhao
- Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou, HenanPeople’s Republic of China
| | - Chengyang Xu
- International Medical Center of Henan Province, Henan Provincial People’s Hospital, Zhengzhou, Henan, People’s Republic of China
| | - Dongyan Zhang
- Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou, HenanPeople’s Republic of China
| | - Qiongrui Zhao
- Department of Clinical Research Service Center, Henan Provincial People’s Hospital, Zhengzhou, Henan, People’s Republic of China
| | - Peizhi Ma
- Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou, HenanPeople’s Republic of China
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Fu L, Huang J, Li D, Wang H, Xing L, Wei T, Hou R, Lu H. Effects of Using Sitting Position versus Lithotomy Position during the Second Stage of Labour on Maternal and Neonatal Outcomes and the Childbirth Experience of Chinese Women: A Prospective Cohort Study. Healthcare (Basel) 2023; 11:2996. [PMID: 37998488 PMCID: PMC10671611 DOI: 10.3390/healthcare11222996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/01/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023] Open
Abstract
Existing research concerning the effects of the sitting birth position during the second stage of labour on maternal and neonatal outcomes remains controversial, and there is a lack of studies to explore its effect on the childbirth experience. The objective of this study is to explore whether the sitting birth position would influence maternal and neonatal outcomes, as well as the childbirth experience. The prospective cohort design was conducted in the study from February to June 2023, a total of 222 women (including primiparous women and multiparous women) were enrolled in our study, and they were divided into the sitting position cohort (n = 106) or the lithotomy position cohort (n = 116). The pre-designed questionnaire and Childbirth Experience Questionnaire (CEQ) were used for data collection during hospitalisation. Chi-square, Fisher's exact test, t-tests, or the Mann-Whitney U test were utilised to assess differences between groups. Multivariate linear regression and logistic regression were employed to control possible confounders. The study found that primiparous women in the sitting position cohort had a shorter duration of the second stage of labour, higher spontaneous vaginal birth rates, lower episiotomy rates, and a better childbirth experience (p < 0.01). After adjusting for confounding factors through multiple linear and logistic regression analyses, the results remained consistent with those reported above. No neonate in each cohort had Apgar scores at 1 min and 5 min postpartum less than 7 or a Cord artery pH less than 7.00, regardless of parity. Based on the findings, we recommend that women could take the sitting birth position into account when giving birth for a positive childbirth experience, especially for primiparous women. The study could also serve as a reference for healthcare providers in the management of childbirth positions and the development of high-quality maternal care.
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Affiliation(s)
- Li Fu
- School of Nursing, Peking University, Beijing 100191, China;
| | - Jing Huang
- Division of Care for Long Term Conditions, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London SE1 8WA, UK;
| | - Danxiao Li
- Department of Obstetrics and Gynaecology, Peking University People’s Hospital, Beijing 100044, China; (D.L.); (L.X.)
| | - Huide Wang
- Department of Obstetrics, Beijing Hospital, Beijing 100730, China; (H.W.); (T.W.)
| | - Lili Xing
- Department of Obstetrics and Gynaecology, Peking University People’s Hospital, Beijing 100044, China; (D.L.); (L.X.)
| | - Tao Wei
- Department of Obstetrics, Beijing Hospital, Beijing 100730, China; (H.W.); (T.W.)
| | - Rui Hou
- School of Nursing, Peking University, Beijing 100191, China;
| | - Hong Lu
- School of Nursing, Peking University, Beijing 100191, China;
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Mazidi M, Wright N, Yao P, Kartsonaki C, Millwood IY, Fry H, Said S, Pozarickij A, Pei P, Chen Y, Avery D, Du H, Schmidt DV, Yang L, Lv J, Yu C, Chen J, Hill M, Holmes MV, Howson JMM, Peto R, Collins R, Bennett DA, Walters RG, Li L, Clarke R, Chen Z. Plasma Proteomics to Identify Drug Targets for Ischemic Heart Disease. J Am Coll Cardiol 2023; 82:1906-1920. [PMID: 37940228 PMCID: PMC10641761 DOI: 10.1016/j.jacc.2023.09.804] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/11/2023] [Accepted: 09/05/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Integrated analyses of plasma proteomic and genetic markers in prospective studies can clarify the causal relevance of proteins and discover novel targets for ischemic heart disease (IHD) and other diseases. OBJECTIVES The purpose of this study was to examine associations of proteomics and genetics data with IHD in population studies to discover novel preventive treatments. METHODS We conducted a nested case-cohort study in the China Kadoorie Biobank (CKB) involving 1,971 incident IHD cases and 2,001 subcohort participants who were genotyped and free of prior cardiovascular disease. We measured 1,463 proteins in the stored baseline samples using the OLINK EXPLORE panel. Cox regression yielded adjusted HRs for IHD associated with individual proteins after accounting for multiple testing. Moreover, cis-protein quantitative loci (pQTLs) identified for proteins in genome-wide association studies of CKB and of UK Biobank were used as instrumental variables in separate 2-sample Mendelian randomization (MR) studies involving global CARDIOGRAM+C4D consortium (210,842 IHD cases and 1,378,170 controls). RESULTS Overall 361 proteins were significantly associated at false discovery rate <0.05 with risk of IHD (349 positively, 12 inversely) in CKB, including N-terminal prohormone of brain natriuretic peptide and proprotein convertase subtilisin/kexin type 9. Of these 361 proteins, 212 had cis-pQTLs in CKB, and MR analyses of 198 variants in CARDIOGRAM+C4D identified 13 proteins that showed potentially causal associations with IHD. Independent MR analyses of 307 cis-pQTLs identified in Europeans replicated associations for 4 proteins (FURIN, proteinase-activated receptor-1, Asialoglycoprotein receptor-1, and matrix metalloproteinase-3). Further downstream analyses showed that FURIN, which is highly expressed in endothelial cells, is a potential novel target and matrix metalloproteinase-3 a potential repurposing target for IHD. CONCLUSIONS Integrated analyses of proteomic and genetic data in Chinese and European adults provided causal support for FURIN and multiple other proteins as potential novel drug targets for treatment of IHD.
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Affiliation(s)
- Mohsen Mazidi
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Neil Wright
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Pang Yao
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Christiana Kartsonaki
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Iona Y Millwood
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Hannah Fry
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Saredo Said
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Alfred Pozarickij
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
| | - Yiping Chen
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Daniel Avery
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Huaidong Du
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Dan Valle Schmidt
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Ling Yang
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Jun Lv
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Key Laboratory of Epidemiology of Major (Peking University), Ministry of Education, Beijing, China
| | - Canqing Yu
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Key Laboratory of Epidemiology of Major (Peking University), Ministry of Education, Beijing, China
| | - Junshi Chen
- China National Center for Food Risk Assessment, Beijing, China
| | - Michael Hill
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Michael V Holmes
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | | | - Richard Peto
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Rory Collins
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Derrick A Bennett
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Robin G Walters
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Liming Li
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Key Laboratory of Epidemiology of Major (Peking University), Ministry of Education, Beijing, China
| | - Robert Clarke
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
| | - Zhengming Chen
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Medical Research Council Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
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Gottlieb M, Peksa GD, Carlson JN. Head impulse, nystagmus, and test of skew examination for diagnosing central causes of acute vestibular syndrome. Cochrane Database Syst Rev 2023; 11:CD015089. [PMID: 37916744 PMCID: PMC10620998 DOI: 10.1002/14651858.cd015089.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
BACKGROUND Dizziness is a common reason for people to seek medical care. Acute vestibular syndrome (AVS) is a specific type of dizziness, which can include severe vertigo, nausea and vomiting, nystagmus, or unsteadiness. Acute vestibular syndrome can be due to peripheral or central causes. It is important to determine the cause, as the intervention and outcomes differ if it is from a peripheral or central cause. Clinicians can assess for the cause using risk factors, patient history, examination findings, or advanced imaging, such as a magnetic resonance imaging (MRI). The head impulse, nystagmus, test of skew (HINTS) examination is a three-part examination performed by clinicians to determine if AVS is due to a peripheral or central cause. This includes assessing how the eyes move in response to rapidly turning a person's head (head impulse), assessing the direction of involuntary eye movements (nystagmus), and assessing whether the eyes are aligned or misaligned (test of skew). The HINTS Plus examination includes an additional assessment of auditory function. OBJECTIVES To assess the diagnostic accuracy of the HINTS and HINTS Plus examinations, with or without video assistance, for identifying a central etiology for AVS. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, Google Scholar, the International HTA database, and two trials registers to September 2022. SELECTION CRITERIA We included all retrospective and prospective diagnostic test accuracy studies that evaluated the HINTS or HINTS Plus test used in a primary care clinic, an urgent care clinic, the emergency department, or during inpatient hospitalization against a final diagnosis of a central etiology of AVS, as defined by the reference standard of advanced imaging or final diagnosis by a neurologist. DATA COLLECTION AND ANALYSIS Two review authors independently determined eligibility of each study according to eligibility criteria, extracted data, assessed the risk of bias, and determined the certainty of evidence. Disagreements were adjudicated by consensus or a third review author if needed. The primary outcome was the diagnostic accuracy of the HINTS and HINTS Plus examinations for identifying a central etiology for AVS, conducted clinically (clinician visual assessment) or with video assistance (e.g. video recording with goggles); we independently assessed the clinical and video-assisted examinations. Subgroup analyses were performed by provider type (e.g. physicians, non-physicians), time from symptom onset to presentation (e.g. less than 24 hours, longer than 24 hours), reference standard (e.g. advanced imaging, discharge diagnosis), underlying etiology (e.g. ischemic stroke, alternative etiologies [hemorrhagic stroke, intracranial mass]), study setting (e.g. outpatient [outpatient clinic, urgent care clinic, emergency department], inpatient), physician level of training (e.g. resident, fellow/attending), physician specialty (e.g. otolaryngology, emergency medicine, neurology, and neurologic subspecialist [e.g. neuro-ophthalmology, neuro-otology]), and individual diagnostic accuracy of each component of the examination (e.g. head impulse, direction-changing nystagmus, test of skew). We created 2 x 2 tables of the true positives, true negatives, false positives, and false negatives and used these data to calculate the sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio with 95% confidence intervals (95% CI) for each outcome. MAIN RESULTS We included 16 studies with a total of 2024 participants (981 women and 1043 men) with a mean age of 60 years. Twelve studies assessed the HINTS examination; five assessed the HINTS Plus examination. Thirteen studies were performed in the emergency department; half were performed by neurologists. The clinical HINTS examination (12 studies, 1890 participants) was 94.0% (95% confidence interval [CI] 82.0% to 98.2%) sensitive, and 86.9% (95% CI 75.3% to 93.6%) specific (low-certainty evidence). The video-assisted HINTS examination (3 studies, 199 participants) was 85.0% to 100% sensitive (low-certainty evidence), and 38.9% to 100% specific (very low-certainty evidence). The clinical HINTS Plus examination (5 studies, 451 participants) was 95.3% (95% CI 78.4% to 99.1%) sensitive, and 72.9% (95% CI 44.4% to 90.1%) specific (low-certainty evidence). The video-assisted HINTS Plus examination (2 studies, 163 participants) was 85.0% to 93.8% sensitive, and 28.6% to 38.9% specific (moderate-certainty evidence). Subgroup analyses were limited, as most studies were conducted in the emergency department, by physicians, and with MRI as a reference standard. Time from symptom onset to presentation varied across studies. Three studies were at high risk of bias and three studies were at unclear risk of bias for participant selection. Three studies were at unclear risk of bias for the index test. Four studies were at unclear risk of bias for the reference standard. Two studies were at unclear risk of bias for flow and timing. One study had unclear applicability concerns for participant selection. Two studies had high applicability concerns for the index test and two studies had unclear applicability concerns for the index test. No studies had applicability concerns for the reference standard. AUTHORS' CONCLUSIONS The HINTS and HINTS Plus examinations had good sensitivity and reasonable specificity for diagnosing a central cause for AVS in the emergency department when performed by trained clinicians. Overall, the evidence was of low certainty. There were limited data for the role of video-assistance or specific subgroups. Future research should include more high-quality studies of the HINTS and HINTS Plus examination; assessment of inter-rater reliability across users; accuracy across different providers, specialties, and experience; and direct comparison with no HINTS or MRI to assess the effect on clinical care.
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Affiliation(s)
- Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Gary D Peksa
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Jestin N Carlson
- Emergency Department, Allegheny Health Network, Erie, Pennsylvania, USA
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Schlager JG, Patzer K, Wallmichrath J, French LE, Kunrad E, Schlingmann S, Stiefel D, Kendziora B, Hartmann D. Surgical site infection in skin surgery-An observational study. Int Wound J 2023; 20:3514-3522. [PMID: 37156639 PMCID: PMC10588314 DOI: 10.1111/iwj.14224] [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: 12/05/2022] [Accepted: 04/21/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Surgical site infection (SSI) has a significant impact on patients' morbidity and aesthetic results. OBJECTIVE To identify risk factors for SSI in dermatologic surgery. PATIENTS AND METHODS This prospective, single-centre, observational study was performed between August 2020 and May 2021. Patients that presented for dermatologic surgery were included and monitored for the occurrence of SSI. For statistical analysis, we used a mixed effects logistic regression model. RESULTS Overall, 767 patients with 1272 surgical wounds were included in the analysis. The incidence of SSI was 6.1%. Significant risk factors for wound infection were defect size over 10cm2 (OR 3.64, 95% confidence interval [CI] 1.80-7.35), surgery of cutaneous malignancy (OR 2.96, CI 1.41-6.24), postoperative bleeding (OR 4.63, CI 1.58-13.53), delayed defect closure by local skin flap (OR 2.67, CI 1.13-6.34) and localisation of surgery to the ear (OR 7.75, CI 2.07-28.99). Wound localisation in the lower extremities showed a trend towards significance (OR 3.16, CI 0.90-11.09). Patient-related factors, such as gender, age, diabetes, or immunosuppression, did not show a statistically significant association with postoperative infection. CONCLUSION Large defects, surgery of cutaneous malignancy, postoperative bleeding, and delayed flap closure increase the risk for SSI. High-risk locations are the ears and lower extremities.
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Affiliation(s)
- Justin Gabriel Schlager
- Department of Dermatology and AllergyUniversity Hospital, Ludwig Maximilian University (LMU) MunichMunichGermany
| | - Kathrin Patzer
- Department of Dermatology and AllergyUniversity Hospital, Ludwig Maximilian University (LMU) MunichMunichGermany
| | - Jens Wallmichrath
- Department of Dermatology and AllergyUniversity Hospital, Ludwig Maximilian University (LMU) MunichMunichGermany
| | - Lars E. French
- Department of Dermatology and AllergyUniversity Hospital, Ludwig Maximilian University (LMU) MunichMunichGermany
- Dr. Philip Frost, Department of Dermatology and Cutaneous SurgeryUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Elena Kunrad
- Department of Dermatology and AllergyUniversity Hospital, Ludwig Maximilian University (LMU) MunichMunichGermany
| | - Sophia Schlingmann
- Department of Dermatology and AllergyUniversity Hospital, Ludwig Maximilian University (LMU) MunichMunichGermany
| | - Daniel Stiefel
- Department of Dermatology and AllergyUniversity Hospital, Ludwig Maximilian University (LMU) MunichMunichGermany
| | - Benjamin Kendziora
- Department of Dermatology and AllergyUniversity Hospital, Ludwig Maximilian University (LMU) MunichMunichGermany
| | - Daniela Hartmann
- Department of Dermatology and AllergyUniversity Hospital, Ludwig Maximilian University (LMU) MunichMunichGermany
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Mor-Avi V, Khandheria B, Klempfner R, Cotella JI, Moreno M, Ignatowski D, Guile B, Hayes HJ, Hipke K, Kaminski A, Spiegelstein D, Avisar N, Kezurer I, Mazursky A, Handel R, Peleg Y, Avraham S, Ludomirsky A, Lang RM. Real-Time Artificial Intelligence-Based Guidance of Echocardiographic Imaging by Novices: Image Quality and Suitability for Diagnostic Interpretation and Quantitative Analysis. Circ Cardiovasc Imaging 2023; 16:e015569. [PMID: 37955139 PMCID: PMC10659245 DOI: 10.1161/circimaging.123.015569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 10/13/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND We aimed to assess in a prospective multicenter study the quality of echocardiographic exams performed by inexperienced users guided by a new artificial intelligence software and evaluate their suitability for diagnostic interpretation of basic cardiac pathology and quantitative analysis of cardiac chamber and function. METHODS The software (UltraSight, Ltd) was embedded into a handheld imaging device (Lumify; Philips). Six nurses and 3 medical residents, who underwent minimal training, scanned 240 patients (61±16 years; 63% with cardiac pathology) in 10 standard views. All patients were also scanned by expert sonographers using the same device without artificial intelligence guidance. Studies were reviewed by 5 certified echocardiographers blinded to the imager's identity, who evaluated the ability to assess left and right ventricular size and function, pericardial effusion, valve morphology, and left atrial and inferior vena cava sizes. Finally, apical 4-chamber images of adequate quality, acquired by novices and sonographers in 100 patients, were analyzed to measure left ventricular volumes, ejection fraction, and global longitudinal strain by an expert reader using conventional methodology. Measurements were compared between novices' and experts' images. RESULTS Of the 240 studies acquired by novices, 99.2%, 99.6%, 92.9%, and 100% had sufficient quality to assess left ventricular size and function, right ventricular size, and pericardial effusion, respectively. Valve morphology, right ventricular function, and left atrial and inferior vena cava size were visualized in 67% to 98% exams. Images obtained by novices and sonographers yielded concordant diagnostic interpretation in 83% to 96% studies. Quantitative analysis was feasible in 83% images acquired by novices and resulted in high correlations (r≥0.74) and small biases, compared with those obtained by sonographers. CONCLUSIONS After minimal training with the real-time guidance software, novice users can acquire images of diagnostic quality approaching that of expert sonographers in most patients. This technology may increase adoption and improve accuracy of point-of-care cardiac ultrasound.
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Affiliation(s)
- Victor Mor-Avi
- University of Chicago Medical Center, IL (V.M.-A., J.I.C., B.G., K.H., R.M.L.)
| | - Bijoy Khandheria
- Cardiovascular Research, Advocate Aurora Research, Milwaukee, WI (B.K., D.I., H.J.H., A.K.)
| | - Robert Klempfner
- Department of Cardiology, Cardiac Rehabilitation Institute, Sheba Medical Center, Israel (R.K., M.M.)
| | - Juan I. Cotella
- University of Chicago Medical Center, IL (V.M.-A., J.I.C., B.G., K.H., R.M.L.)
| | - Merav Moreno
- Department of Cardiology, Cardiac Rehabilitation Institute, Sheba Medical Center, Israel (R.K., M.M.)
| | - Denise Ignatowski
- Cardiovascular Research, Advocate Aurora Research, Milwaukee, WI (B.K., D.I., H.J.H., A.K.)
| | - Brittney Guile
- University of Chicago Medical Center, IL (V.M.-A., J.I.C., B.G., K.H., R.M.L.)
| | - Hailee J. Hayes
- Cardiovascular Research, Advocate Aurora Research, Milwaukee, WI (B.K., D.I., H.J.H., A.K.)
| | - Kyle Hipke
- University of Chicago Medical Center, IL (V.M.-A., J.I.C., B.G., K.H., R.M.L.)
| | - Abigail Kaminski
- Cardiovascular Research, Advocate Aurora Research, Milwaukee, WI (B.K., D.I., H.J.H., A.K.)
| | | | - Noa Avisar
- UltraSight, Ltd, Rehovot, Israel (D.S., N.A., I.K.)
| | - Itay Kezurer
- UltraSight, Ltd, Rehovot, Israel (D.S., N.A., I.K.)
| | - Asaf Mazursky
- Faculty of Medicine, Ben-Gurion University of the Negev, Beer-Sheva, Israel (A.M., S.A.)
| | - Ran Handel
- Azrieli Faculty of Medicine in the Galilee Bar-Ilan University, Safed, Israel (R.H., Y.P.)
| | - Yotam Peleg
- Azrieli Faculty of Medicine in the Galilee Bar-Ilan University, Safed, Israel (R.H., Y.P.)
| | - Shir Avraham
- Faculty of Medicine, Ben-Gurion University of the Negev, Beer-Sheva, Israel (A.M., S.A.)
| | | | - Roberto M. Lang
- University of Chicago Medical Center, IL (V.M.-A., J.I.C., B.G., K.H., R.M.L.)
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49
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Fraser BJ, Blizzard L, Tomkinson GR, McGrath R, Dwyer T, Venn AJ, Magnussen CG. Tracking handgrip strength asymmetry from childhood to mid-life. Acta Paediatr 2023; 112:2408-2417. [PMID: 37531128 PMCID: PMC10952407 DOI: 10.1111/apa.16930] [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: 06/07/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 08/03/2023]
Abstract
AIM Determine if asymmetric handgrip strength exists in childhood and adulthood and quantify the degree of tracking of handgrip strength asymmetry over time. METHODS Participants from the Childhood Determinants of Adult Health Study had their right and left handgrip strength measured using handgrip dynamometry in childhood (1985: 9-15 y), young adulthood (2004-06: 26-36 y) and/or mid-adulthood (2014-19: 36-49 y). Handgrip strength asymmetry was calculated as: strongest handgrip strength/strongest handgrip strength on the other hand. Participants were categorised based on the degree of their asymmetry (0.0%-10.0%, 10.1%-20.0%, 20.1%-30.0%, >30.0%). Tracking was quantified using Spearman's correlations and log binomial regression. RESULTS Handgrip strength asymmetry was present in childhood and adulthood (>30.0% asymmetry: childhood = 6%, young adulthood = 3%, mid-adulthood = 4%). Handgrip strength asymmetry did not track between childhood and young- (r = 0.06, 95% CI = -0.02, 0.12) and mid-adulthood (r = 0.01, 95% CI = -0.09, 0.10). Tracking was more apparent between young- and mid-adulthood (r = 0.16, 95% CI = 0.09, 0.22). Participants with >30.0% asymmetry were at greater risk to maintain this status between childhood and young- (RR = 3.53, 95% CI = 1.15, 10.87) and mid-adulthood (RR = 2.14, 95% CI = 0.45, 10.20). CONCLUSION Although handgrip strength asymmetry tracked relatively poorly, asymmetric handgrip strength was apparent in children and adults. Handgrip strength asymmetry does not exclusively affect older adults and should be considered in protocols to better understand its role across the life course.
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Affiliation(s)
- Brooklyn J. Fraser
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA)University of South AustraliaAdelaideSouth AustraliaAustralia
| | - Leigh Blizzard
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
| | - Grant R. Tomkinson
- Alliance for Research in Exercise, Nutrition and Activity (ARENA)University of South AustraliaAdelaideSouth AustraliaAustralia
| | - Ryan McGrath
- Alliance for Research in Exercise, Nutrition and Activity (ARENA)University of South AustraliaAdelaideSouth AustraliaAustralia
- Healthy Aging North Dakota (HAND)North Dakota State UniversityFargoNorth DakotaUSA
- Department of Health, Nutrition, and Exercise SciencesNorth Dakota State UniversityFargoNorth DakotaUSA
- Fargo VA Healthcare SystemFargoNorth DakotaUSA
| | - Terence Dwyer
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
- The Nuffield Department of Women's & Reproductive HealthUniversity of OxfordOxfordUK
- Murdoch Children's Research InstituteMelbourneVictoriaAustralia
- Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneMelbourneVictoriaAustralia
| | - Alison J. Venn
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
| | - Costan G. Magnussen
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA)University of South AustraliaAdelaideSouth AustraliaAustralia
- Baker Heart and Diabetes InstituteMelbourneVictoriaAustralia
- Research Centre of Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland
- Centre for Population Health ResearchUniversity of Turku and Turku University HospitalTurkuFinland
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50
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de Oliveira Pinheiro CE, Carneiro E Silva RS, de Sousa FREG, Mantilla NPM, Silva NND, de Assis SF, do Prado PR. Causal validation of the risk for corneal injury in critically ill adults. Nurs Crit Care 2023; 28:1053-1060. [PMID: 35045203 DOI: 10.1111/nicc.12747] [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: 10/06/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The validity of a nursing diagnosis depends on a continuous investigation process in different populations to provide clinical evidence. The risk for corneal injury nursing diagnosis was approved in 2013 and only reviewed in 2017, demonstrating the need to perform a clinical validation to improve it. AIM To perform a causal validation of the risk for corneal injury nursing diagnosis in critically ill adults. STUDY DESIGN A prospective cohort study was performed in two intensive critical care units in Northern Brazil with adults aged over 18 years without corneal injury at admission. The patients were evaluated for 10 days, using a data collection tool composed of risk factors for the risk for corneal injury nursing diagnosis. The independent variables were described through absolute and relative frequency. The accuracy measures and risk factors were identified through Cox regression, considering a 95% confidence interval. RESULTS The nurses assessed 209 critically ill adults and identified that 76.0% of them presented the risk for corneal injury nursing diagnosis, with 16.3% developing a corneal injury, all having previously presented the risk for corneal injury nursing diagnosis. The risk factors identified were eyeball exposure (hazard ratio: 1.78; 95% CI: 1.27-2.51), Glasgow score < 6 (hazard ratio: 1.73; 95% CI: 1.15-2.60) and periorbital oedema (hazard ratio: 1.43; 95% CI: 1.03-1.99), with these factors showing high specificity, and the mechanical ventilation variable, showing high sensitivity, with ROC curve of .86. CONCLUSION Eyeball exposure, Glasgow score < 6 and periorbital oedema are the risk factors of the risk for corneal injury nursing diagnosis, in critically ill adults. These risk factors guide nursing interventions. This causal validation can improve the risk for corneal injury nursing diagnosis levels of evidence in the NANDA International Taxonomy. RELEVANCE TO CLINICAL PRACTICE It is necessary to guide nursing interventions for critically ill adults with lowered level of consciousness and corneal exposure for the prevention of corneal injury.
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Affiliation(s)
| | | | | | | | | | | | - Patrícia Rezende do Prado
- Federal University of Acre, Rio Branco, Brazil
- Post-doctoral Student at Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
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