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2.
Trials ; 22(1): 600, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488853

RESUMO

BACKGROUND: Canadians of South Asian (SA) origin comprise the largest racialized group in Canada, representing 25.6% of what Statistics Canada terms "visible minority populations". South Asian Canadians are disproportionately impacted by the social determinants of health, and this can result in high rates of mood and anxiety disorders. These factors can negatively impact mental health and decrease access to care, thereby increasing mental health inequities. Cognitive Behavioural Therapy (CBT) in its current form is not suitable for persons from the non-western cultural backgrounds. Culturally adapted Cognitive Behavioural Therapy (CaCBT) is an evidence-based practice. CaCBT is more effective than standard CBT and can reduce dropouts from therapy compared with standard CBT. Thus, CaCBT can increase access to mental health services and improve outcomes for immigrant, refugee and ethno-cultural and racialized populations. Adapting CBT for growing SA populations in Canada will ensure equitable access to effective and culturally appropriate interventions. METHODS: The primary aim of the study is to develop and evaluate CaCBT for Canadian South Asian persons with depression and anxiety and to gather data from stakeholders to develop guidelines to culturally adapt CBT. This mixed methods study will use three phases: (1) cultural adaptation of CBT, (2) pilot feasibility of CaCBT and (3) implementation and evaluation of CaCBT. Phase 1 will use purposive sampling to recruit individuals from four different groups: (1) SA patients with depression and anxiety, (b) caregivers and family members of individuals affected by anxiety and depression, (c) mental health professionals and (d) SA community opinion leaders. Semi-structured interviews will be conducted virtually and analysis of interviews will be informed by an ethnographic approach. Phase 2 will pilot test the newly developed CaCBT for feasibility, acceptability and effectiveness via quantitative methodology and a randomized controlled trial, including an economic analysis. Phase 3 will recruit therapists to train and evaluate them in the new CaCBT. DISCUSSION: The outcome of this trial will benefit health services in Canada, in terms of helping to reduce the burden of depression and anxiety and provide better care for South Asians. We expect the results to help guide the development of better services and tailor existing services to the needs of other vulnerable groups. TRIAL REGISTRATION: ClinicalTrials.gov NCT04010890. Registered on July 8, 2019.


Assuntos
Terapia Cognitivo-Comportamental , Serviços Comunitários de Saúde Mental , Ansiedade/diagnóstico , Ansiedade/terapia , Grupo com Ancestrais do Continente Asiático , Canadá , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
3.
Medicine (Baltimore) ; 100(36): e26983, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34516490

RESUMO

ABSTRACT: The identification of single-nucleotide polymorphisms (SNPs) in genes putatively related to pathophysiological processes in major depressive disorder (MDD) might improve both diagnosis and personalized treatment strategies eventually leading to more effective interventions. Considering the important role of the glucocorticoid receptor and the related FK506 binding protein 51 (FKBP51) in the pathophysiology of MDD, we aimed to investigate putative associations between variants of FKBP5, the coding gene of FKBP51, with antidepressant treatment resistance and MDD susceptibility.Nine common SNPs of the FKBP5 gene prioritized based on location and, putative or known functions were genotyped in Han Chinese population, including MDD patients with or without antidepressant-treatment resistance and healthy controls. Associations of FKBP5 SNPs with MDD susceptibility and treatment response were examined in the whole group of MDD patients, as well as in subgroups stratified by antidepressant treatment resistance, compared with healthy controls.In total, 181 Han Chinese patients with MDD and 80 healthy controls were recruited. No significant SNP or haplotype associations were observed in the whole patient group. There were nominal significant differences both for the haplotype block with SNPs in strong LD (r2 > 0.8, P = .040) and haplotype block with SNPs in moderate LD (r2 > 0.1, P = .017) between the haplotype distributions of patients with antidepressant treatment resistance (n = 81) and healthy controls, but both significances did not survive multiple testing correction. Furthermore, no specific haplotype could be observed causing a significant difference in any combination between all comparisons.No associations were observed of FKBP5 variants with MDD or antidepressant treatment response. The lack of associations might be due to the relatively small sample size of this study (power ranged from 0.100 to 0.752). A follow-up study will need larger, better phenotyped, and more homogeneous samples to draw a definitive conclusion regarding the involvement of this gene in MDD.


Assuntos
Transtorno Depressivo Maior/tratamento farmacológico , Predisposição Genética para Doença , Proteínas de Ligação a Tacrolimo/genética , Adolescente , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Estudos de Casos e Controles , China , Transtorno Depressivo Maior/genética , Feminino , Haplótipos , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Polimorfismo de Nucleotídeo Único , Adulto Jovem
4.
Medicine (Baltimore) ; 100(36): e27116, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34516503

RESUMO

ABSTRACT: Low bone mineral density (BMD) was significantly related to the fracture of distal radius. Serum brain-derived neurotrophic factor (BDNF) level was closely related to BMD in spine and osteoporotic fractures. In this study, we aimed to explore the association of BDNF polymorphisms (rs6265 and rs7124442) with BMD and the fracture of distal radius.This retrospective study included 152 patients with distal radius fractures and 148 healthy controls. BDNF polymorphisms were detected via TaqMan allelic discrimination assay. BMD was evaluated through X-ray. Difference in features between cases and controls were compared adopting Chi-square test or t test. The associations of BDNF polymorphisms with fracture risk of distal radius and BMD were assessed employing χ2 test and expressed by odd ratios (ORs) with 95% confidence intervals (95% CIs).BMD was significantly decreased in patients with the fracture of distal radius than in healthy controls. The polymorphism rs6265 significantly increased the risk of distal radius fracture (adjustment: GA: OR = 1.724, 95%CI = 1.003 -2.951, P = .049; GG: OR = 2.415, 95%CI = 1.0219 -3.674, P = .005). Moreover, rs6265 genotypes GA (OR = 4.326, 95%CI = 1.725 -11.896, P = .003) and GG (OR = 13.285, 95%CI = 3.659 -51.072, P = .001) significantly increased BMD reduction. However, BDNF polymorphism rs7124442 had no obvious correlation with BMD or fracture risk.BMD was associated with BDNF rs6265 polymorphism. BDNF polymorphism rs6265 could elevate the risk of osteoporosis and distal radius fracture.


Assuntos
Doenças Ósseas Metabólicas/complicações , Predisposição Genética para Doença , Fraturas por Osteoporose/epidemiologia , Fraturas do Rádio/epidemiologia , Absorciometria de Fóton , Grupo com Ancestrais do Continente Asiático , Estudos de Casos e Controles , China/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Fraturas por Osteoporose/etiologia , Fraturas por Osteoporose/genética , Fraturas do Rádio/etiologia , Fraturas do Rádio/genética , Estudos Retrospectivos , Fatores de Risco
5.
BMC Ophthalmol ; 21(1): 293, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34362336

RESUMO

BACKGROUND: This study aimed to determine the morphological changes in Asian lower eyelid epiblepharon patients after surgery. METHODS: The medical records of 59 patients who underwent lower eyelid epiblepharon repair were reviewed retrospectively. Eighty-nine patients who underwent strabismus surgery were set as the control group. The photographs for each group were analyzed based on the following factors: inferior half area (IHA) of the eye, eyelash angular direction (EAD), angle between the eyelashes and the cornea, marginal reflex distance 1 (MRD1) and marginal reflex distance 2 (MRD2). RESULTS: After surgery, the medial EAD changed from 92.45° ± 20.21° (mean ± SD) to 79.43° ± 23.31°, while the central and lateral EADs were unchanged. IHA increased from 36.33 ± 9.78 mm3 to 43.06 ± 10.57 mm3, and MRD1 increased from 1.92 ± 0.99 mm to 2.50 ± 0.93 mm, whereas MRD2 did not change. The mean angle between the eyelashes and the cornea increased from 39.64° to 72.19° immediately postoperatively, but had reduced to 58.75° 3 months later, followed by no further significant change at the 6-month and 9-month postoperative follow-ups. CONCLUSIONS: There is morphological changes of the eyelid after lower eyelid epiblepharon surgery, with increases in the IHA and MRD1. In addition, contact between the eyelashes and the cornea occurred mainly in the medial portion of the eyelid the position, which everted and stabilized over 3 months. Thus, follow-up observations are required for at least 3 months to properly evaluate the surgical outcome.


Assuntos
Pestanas , Doenças Palpebrais , Grupo com Ancestrais do Continente Asiático , Criança , Córnea , Doenças Palpebrais/cirurgia , Humanos , Músculos Oculomotores , Estudos Retrospectivos
6.
Zhongguo Ying Yong Sheng Li Xue Za Zhi ; 37(3): 225-229, 2021 May.
Artigo em Chinês | MEDLINE | ID: mdl-34374231

RESUMO

Objective: To investigate the relationship between mitochondrial DNA (mtDNA) variation and high altitude essential hypertension(HAEH) in the Chinese Tajik population. Methods: Fifty-three patients with HAEH and 46 healthy subjects were enrolled from the Chinese Tajik population. The mtDNA fragments were amplificated by polymerase chain reaction, and products were sequenced to acquire full sequence of mtDNA. The mtDNA sequences of all subjects were compared to the Cambridge sequence to explore mtDNA variations and analyze difference between HAEH and healthy controls. Online softwares were applied to predict function changes caused by positive associated mtDNA variations. Results: Compared to the control group, the frequency of haplogroup U4b was significant higher in HAEH group(P=0.023,OR=7.062,CI(95%)=1.306-38.182), and the frequencies of 8 mutations from haplogroup U4b showed a significant difference between the HAEH group and control group (all with P values below 0.05). The mt DNA15693T>C mutation was the only missense mutation, which affected amino acid 316 in mitochondrial cytochrome b (MTCYB) by changing it from methionine to threonine. Bioinformatics analysis indicated that the mutation in MTCYB may play a biological role through affecting the second structure of protein. Conclusion: MtDNA subhaplogroup U4b is a genetic factor for HAEH in the Chinese Tajik population, and mtDNA15693T>C mutation may be an important molecular mechanism of HAEH.


Assuntos
DNA Mitocondrial , Predisposição Genética para Doença , Altitude , Grupo com Ancestrais do Continente Asiático/genética , China , DNA Mitocondrial/genética , Hipertensão Essencial/genética , Haplótipos , Humanos , Mutação
7.
Artigo em Inglês | MEDLINE | ID: mdl-34353881

RESUMO

INTRODUCTION: Cost-effectiveness analyses are becoming increasingly important in Japan following the introduction of a health technology assessment scheme. The study objective was to develop an economic model to evaluate the cost-effectiveness of two interventions for type 2 diabetes in a Japanese population. RESEARCH DESIGN AND METHODS: The Japan Diabetes Complications Study/Japanese Elderly Diabetes Intervention Trial risk engine (JJRE) Cost-Effectiveness Model (JJCEM) was developed, incorporating validated risk equations in Japanese patients with type 2 diabetes from the JJRE. Weibull regression models were developed for progression of the model outcomes, and a targeted literature review was performed to inform default values for utilities and costs. To illustrate outcomes, two simulated analyses were performed in younger (aged 40 years) and older (aged 80 years) Japanese populations, comparing a hypothetical treatment with placebo. RESULTS: The model considers a population based on user-defined values for 11 baseline characteristic parameters and simulates rates of diabetic complications over a defined time horizon. Costs, quality-adjusted life years, and an incremental cost-effectiveness ratio are estimated. The model provides disaggregated results for two competing interventions, allowing visualization of the key drivers of cost and utility. A scatterplot of simulations and cost-effectiveness acceptability curve are generated for each analysis. CONCLUSIONS: This is the first cost-effectiveness model for East Asian patients with type 2 diabetes, developed using Japan-specific risk equations. This population constitutes the largest share of the global population with diabetes, making this model highly relevant. The model can be used to evaluate the cost-effectiveness of anti-diabetic interventions in patients with type 2 diabetes in Japan and other East Asian populations.


Assuntos
Complicações do Diabetes , Diabetes Mellitus Tipo 2 , Idoso , Grupo com Ancestrais do Continente Asiático , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Hipoglicemiantes , Japão/epidemiologia , Modelos Econômicos
8.
Zhonghua Zhong Liu Za Zhi ; 43(8): 833-837, 2021 Aug 23.
Artigo em Chinês | MEDLINE | ID: mdl-34407587

RESUMO

Objective: To investigate the impact and clinical significance of the revised 2019 Chinese HER-2 testing guidelines on the detecting result evaluation of invasive breast cancers with equivocal HER-2 immunostaining by using fluorescence in situ hybridization (FISH). Methods: A total of 569 cases of invasive breast cancers with HER-2 (+ + ) immunostaining evaluated according to the immunohistochemistry (IHC) guidelines of 2014 edition and 2019 edition from May to November 2019 were collected and further detected by FISH. The results of HER-2/CEPl7 double probe were respectively interpreted according to both the 2014 and 2019 Chinese HER-2 testing guidelines and the results were compared. Results: According to the 2014 guidelines, the number of HER-2 positive, equivocal and negative cases were 139 (24.43%), 67 (11.78%), and 363 (63.80%), respectively. Whereas according to the 2019 guidelines, 115 cases (20.21%) were the first group, 9 cases (1.58%) were the second group, 15 cases (2.64%) were the third group, 67 cases (11.78%) were the fourth group, and 363 cases were (63.80%) the fifth group, of which 130 cases (22.85%) were positive and 439 cases (77.15%) were negative by FISH detecting. Compared with the guideline of 2014 edition, the HER-2 positive rate of FISH detection reduced from 24.43% (139/569) to 22.85% (130/559) according to the application of the guideline of 2019 edition, but the difference was not statistically significant (P=0.567), while the negative rate increased from 63.80% (363/569) to 77.15% (439/569), with a statistically significant difference (P<0.05). Forty-three cases with incomplete weak to medium intensity of IHC membrane staining which were HER-2 (+ + ) according to 2014 guideline were changed to IHC (+ ) on the basis of the 2019 guideline. According to the FISH guideline of 2014 edition, 1 case (2.33%) was positive, 6 cases (13.95%) was equivocal and 36 cases (83.72%) was negative, while according to the 2019 FISH guideline, all of the 43 cases were negative. Conclusions: According to the guideline of 2019 edition, a proportion of cases changes from HER-2 (+ + ) to (+ ), and the HER-2 positive rate of FISH test decreases slightly, the negative rate increases, the equivocal result is eliminated, which provides a definite reference for screening patients who will be benefited from the targeted treatment of HER-2.


Assuntos
Neoplasias da Mama , Grupo com Ancestrais do Continente Asiático , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/genética , China , Feminino , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente
9.
J Cross Cult Gerontol ; 36(3): 229-252, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34417957

RESUMO

While activity participation in later life has attracted considerable attention from policymakers and scholars, indoor and outdoor engagement among older Chinese migrants in Europe is understudied. Using in-depth interviews with 21 older Chinese migrants in the Netherlands and seven in Belgium, this study is among the first to explore older Chinese migrants' activity participation experiences from the perspective of Confucianism, the cornerstone of Chinese culture. More specifically, the impact of four acknowledged principles of Confucianism are considered: hierarchical relationships, family system, benevolence and emphasis on education. The findings show that, like a double-edged sword, these four principles have positive and negative effects on older Chinese migrants' activity participation. Hierarchical relationships promote formal organisational participation, yet concurrently dividing the Chinese community into smaller subgroups and endangering solidarity within the community. With regard to family system, which emphasizes intergenerational responsibility and obligation, older Confucianist migrants prioritise taking care of their grandchildren, resulting in less time to participate in outdoor activities. Benevolence, the third principle of Confucianism, restrains older Chinese migrants from political participation while encouraging them to attend community meetings where food is shared. Lastly, emphasis on education, of which self-cultivation is an important aspect, helps older Chinese migrants overcome feelings of loneliness and makes them prefer self-learning activity above formal learning settings (e.g. language learning) organised by the government. The article ends with policy recommendations on how to increase older Chinese migrants' outdoor activities.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Relações Interpessoais , Participação Social/psicologia , Migrantes/psicologia , Idoso , Bélgica/epidemiologia , China/etnologia , Confucionismo , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Apoio Social
10.
Artigo em Inglês | MEDLINE | ID: mdl-34444498

RESUMO

In September 2020, de la Monte and colleagues published the article "Betel Quid Health Risks of Insulin Resistance Diseases in Poor Young South Asian Native and Immigrant Populations" [...].


Assuntos
Emigrantes e Imigrantes , Resistência à Insulina , Areca , Grupo com Ancestrais do Continente Asiático , Humanos , Saúde Pública
11.
Nutrients ; 13(8)2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34444913

RESUMO

This study was performed to investigate the association between coffee consumption and risk of colorectal cancer in a Korean population and examine whether the association can be altered by adjustment for intake of coffee additives. We conducted a case-control study involving 923 colorectal cancer cases and 1846 controls matched by sex and age (within 5 years). A semi-quantitative food frequency questionnaire was used to assess coffee intakes. High coffee consumption was associated with lower odds of developing colorectal cancer (≥3 cups/day vs. no drinks, OR = 0.68; 95% CI: 0.49-0.96). When we additionally controlled for consumption of coffee additives including sugar and cream, the inverse association became stronger (≥3 cups/day vs. no drinks, OR = 0.22; 95% CI: 0.14-0.33), and a significant inverse linear trend was shown (Ptrend < 0.0001). The inverse associations were observed for proximal (Ptrend = 0.0001) and distal (Ptrend = 0.0003) colon cancer, and rectal cancer (Ptrend < 0.0001) in the stratified analysis by anatomical sub-sites. Regarding sex, inverse associations between coffee consumption and colorectal cancer were found for men (Ptrend < 0.0001) and women (Ptrend = 0.0021). In the stratified analysis by obese status of subjects, inverse linear trends were observed in both non-obese and obese people (Ptrend < 0.0001). High coffee consumption may be associated with a lower risk of colorectal cancer in the Korean population and the degree of decrease in the odds of developing colorectal cancer changes by adjustment for intake of coffee additives.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Café/efeitos adversos , Neoplasias Colorretais/etiologia , Dieta/efeitos adversos , Dieta/estatística & dados numéricos , Idoso , Estudos de Casos e Controles , Neoplasias Colorretais/epidemiologia , Dieta/etnologia , Inquéritos sobre Dietas , Ingestão de Líquidos/etnologia , Feminino , Aditivos Alimentares/efeitos adversos , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Razão de Chances , República da Coreia/epidemiologia , Fatores de Risco
12.
Biomed Res Int ; 2021: 3629624, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34337005

RESUMO

Background: Age-related hearing impairment (ARHI) is considered an unpreventable disorder. We aimed to detect specific genetic variants that are potentially related to ARHI via genome-wide association study (GWAS). Methods: A sample of 131 dizygotic twins was genotyped for single-nucleotide polymorphism- (SNP-) based GWAS. Gene-based test was performed using VEGAS2. Pathway enrichment analysis was conducted by PASCAL. Results: The twins are with a median age of 49 years, of which 128 were females and 134 were males. rs6633657 was the only SNP that reached the genome-wide significance level for better ear hearing level (BEHL) at 2.0 kHz (P = 1.19 × 10-8). Totally, 9, 10, 42, 7, 17, and 5 SNPs were suggestive evidence level for (P < 1 × 10-5) BEHLs at 0.5, 1.0, 2.0, 4.0, and 8.0 kHz and pure tone average (PTA), respectively. Several promising genetic regions in chromosomes (near the C20orf196, AQPEP, UBQLN3, OR51B5, OR51I2, OR52D1, GLTP, GIT2, and PARK2) nominally associated with ARHI were identified. Gene-based analysis revealed 165, 173, 77, 178, 170, and 145 genes nominally associated with BEHLs at 0.5, 1.0, 2.0, 4.0, and 8.0 kHz and PTA, respectively (P < 0.05). For BEHLs at 0.5, 1.0, and 2.0 kHz, the main enriched pathways were phosphatidylinositol signaling system, regulation of ornithine decarboxylase, eukaryotic translation initiation factor (EIF) pathway, amine compound solute carrier (SLC) transporters, synthesis of phosphoinositides (PIPS) at the plasma membrane, and phosphatidylinositols (PI) metabolism. Conclusions: The genetic variations reported herein are significantly involved in functional genes and regulatory domains that mediate ARHI pathogenesis. These findings provide clues for the further unraveling of the molecular physiology of hearing functions and identifying novel diagnostic biomarkers and therapeutic targets of ARHI.


Assuntos
Envelhecimento/genética , Grupo com Ancestrais do Continente Asiático/genética , Estudo de Associação Genômica Ampla , Presbiacusia/genética , Gêmeos Dizigóticos/genética , Idoso , China , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único/genética
13.
BMJ Open ; 11(8): e041879, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34413096

RESUMO

OBJECTIVE: This meta-analysis was conducted to estimate the overall prevalence of sarcopenia in older Chinese adults. DESIGN: Systematic review and meta-analysis. PARTICIPANTS: A literature research was conducted using the PubMed, Web of Science, China National Knowledge Infrastructure, CQVIP and Wanfang databases. The following search terms in the abstract were used: "sarcopenia" in combination with the terms "prevalence," "epidemiology" and "China." All studies published from January 2010 to November 2020 were included. The random-effect model was used to estimate the prevalence of sarcopenia. The sex-specific prevalence of sarcopenia at a 95% CI was also calculated using different criteria for defining sarcopenia. PRIMARY OUTCOME MEASURES: The overall prevalence of sarcopenia in older Chinese adults. RESULTS: In total, 23 articles were included in this meta-analysis involving 21 564 participants. On the basis of the Asian Working Group for Sarcopenia criterion, the overall prevalence of sarcopenia among the elderly in China was 14% (95% CI 11% to 18%); the prevalence was higher in Chinese women than in men (15% vs 14%). CONCLUSIONS: This systematic review is the first estimation of the pooled prevalence of sarcopenia in older Chinese adults. Our results suggest that China has a large number of patients with sarcopenia. These findings would be useful for sarcopenia prevention in China. There is a high degree of heterogeneity, and although there are a large number of cases and could be an emerging public health issue, more research is required to make these claims. PROSPERO REGISTRATION NUMBER: CRD42020223405.


Assuntos
Sarcopenia , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Sarcopenia/epidemiologia
14.
Medicine (Baltimore) ; 100(33): e26879, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34414940

RESUMO

ABSTRACT: The current study aimed to investigate circulating glucose-regulated protein 78 (GRP78) as well as CCAAT/enhancer-binding protein homologous protein (CHOP) concentrations in Chinese type 2 diabetes mellitus (T2DM) patients, especially those with microalbuminuria. We recruited 67 patients with T2DM and 63 control subjects. We determined circulating GRP78 and CHOP concentrations by ELISA, collected anthropometric data, and measured biochemical parameters in a clinical laboratory. Compared with control groups, patients with T2DM showed decreased circulating levels of GRP78 (0.21 [0.16-0.24] vs 0.16 [0.16-0.19] ng/mL, P < .01) and CHOP ([0.29 ±â€Š0.02] vs [0.27 ±â€Š0.03]ng/mL, P < .01). Reduction in circulating GRP78 and CHOP levels was more pronounced in patients with more severe categories of albuminuria. Amounts of circulating GRP78 correlated directly with serum fasting c-peptide, cystatin-c (Cys-c), creatinine (Cr), blood urea nitrogen (BUN), and uric acid, and inversely with glomerular filtration rates. Circulating CHOP level was positively correlated with age, Cr, BUN, Cys-c, and urinary microalbumin/creatinine (UmALB/Cr). Circulating GRP78 was predicted independently by Cr, BUN, serum uric acid, estimated glomerular filtration rate, and Cys-c, while CHOP depended on age, Cr, BUN, estimated glomerular filtration rate, UmALB/Cr, and Cys-c. After controlling for confounding factors, circulating GRP78 and CHOP expression were significantly associated with diabetic kidney disease (binary logistic regression, P < .01). Patients with T2DM showed increased circulating GRP78 and CHOP concentrations. Receiver operating characteristic areas under the curve for predicting diabetic kidney disease based on GRP78 and CHOP were 0.686 (95% CI: 0.558-0.813) and 0.670 (0.524-0.816), respectively.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Nefropatias Diabéticas/sangue , Estresse do Retículo Endoplasmático , Proteínas de Choque Térmico/sangue , Fator de Transcrição CHOP/sangue , Idoso , Grupo com Ancestrais do Continente Asiático , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
Medicine (Baltimore) ; 100(32): e26883, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397907

RESUMO

BACKGROUND AND PURPOSE: This study aimed to evaluate the comparative efficacy and safety of 4 non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin in Asians with non-valvular atrial fibrillation in real-world practice through a network meta-analysis of observational studies. METHODS: We searched multiple comprehensive databases (PubMed, Embase, and Cochrane library) for studies published until August 2020. Hazard ratios and 95% confidence intervals were used for the pooled estimates. Efficacy outcomes included ischemic stroke (IS), stroke/systemic embolism (SSE), myocardial infarction (MI), and all-cause mortality, and safety outcomes included major bleeding, gastrointestinal (GI) bleeding, and intracerebral hemorrhage (ICH). The P score was calculated for ranking probabilities. Subgroup analyses were separately performed in accordance with the dosage range of NOACs ("standard-" and "low-dose"). RESULTS: A total of 11, 6, and 8 studies were allocated to the total population, standard-dose group, and low-dose group, respectively. In the total study population, edoxaban ranked the best in terms of IS and ICH prevention and apixaban ranked the best for SSE, major bleeding, and GI bleeding. In the standard-dose regimen, apixaban ranked the best in terms of IS and SSE prevention. For major bleeding, GI bleeding, and ICH, edoxaban ranked the best. In the low-dose regimen, edoxaban ranked the best for IS, SSE, GI bleeding, and ICH prevention. For major bleeding prevention, apixaban ranked best. CONCLUSIONS: All 4 NOACs had different efficacy and safety outcomes according to their type and dosage. Apixaban and edoxaban might be relatively better and more well-balanced treatment for Asian patients with non-valvular atrial fibrillation.


Assuntos
Fibrilação Atrial , Inibidores do Fator Xa , Acidente Vascular Cerebral , Varfarina/farmacologia , Anticoagulantes/farmacologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Fibrilação Atrial/etiologia , Fibrilação Atrial/prevenção & controle , Inibidores do Fator Xa/classificação , Inibidores do Fator Xa/farmacologia , Humanos , Avaliação de Resultados em Cuidados de Saúde , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológico
16.
JAMA Netw Open ; 4(8): e2121931, 2021 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-34459907

RESUMO

Importance: Significant differences in hesitancy to receive COVID-19 vaccination by race/ethnicity have been observed in several settings. Racial/ethnic differences in COVID-19 vaccine hesitancy among health care workers (HCWs), who face occupational and community exposure to COVID-19, have not been well described. Objective: To assess hesitancy to COVID-19 vaccination among HCWs across different racial/ethnic groups and assess factors associated with vaccine hesitancy. Design, Setting, and Participants: This survey study was conducted among HCWs from 2 large academic hospitals (ie, a children's hospital and an adult hospital) over a 3-week period in November and December 2020. Eligible participants were HCWs with and without direct patient contact. A 3-step hierarchical multivariable logistic regression was used to evaluate associations between race/ethnicity and vaccine hesitancy controlling for demographic characteristics, employment characteristics, COVID-19 exposure risk, and being up to date with routine vaccinations. Data were analyzed from February through March 2021. Main Outcomes and Measures: Vaccine hesitancy, defined as not planning on, being unsure about, or planning to delay vaccination, served as the outcome. Results: Among 34 865 HCWs eligible for this study, 12 034 individuals (34.5%) completed the survey and 10 871 individuals (32.2%) completed the survey and reported their race/ethnicity. Among 10 866 of these HCWs with data on sex, 8362 individuals (76.9%) were women, and among 10 833 HCWs with age data, 5923 individuals (54.5%) were younger than age 40 years. (Percentages for demographic and clinical characteristics are among the number of respondents for each type of question.) There were 8388 White individuals (77.2%), 882 Black individuals (8.1%), 845 Asian individuals (7.8%), and 449 individuals with other or mixed race/ethnicity (4.1%), and there were 307 Hispanic or Latino individuals (2.8%). Vaccine hesitancy was highest among Black HCWs (732 individuals [83.0%]) and Hispanic or Latino HCWs (195 individuals [63.5%]) (P < .001). Among 5440 HCWs with vaccine hesitancy, reasons given for hesitancy included concerns about side effects (4737 individuals [87.1%]), newness of the vaccine (4306 individuals [79.2%]), and lack of vaccine knowledge (4091 individuals [75.2%]). The adjusted odds ratio (aOR) for vaccine hesitancy was 4.98 (95% CI, 4.11-6.03) among Black HCWs, 2.10 (95% CI, 1.63-2.70) among Hispanic or Latino HCWs, 1.48 (95% CI, 1.21-1.82) among HCWs with other or mixed race/ethnicity, and 1.47 (95% CI, 1.26-1.71) among Asian HCWs compared with White HCWs (P < .001). The aOR was decreased among Black HCWs when adjusting for employment characteristics and COVID-19 exposure risk (aOR, 4.87; 95% CI, 3.96-6.00; P < .001) and being up to date with prior vaccines (aOR, 4.48; 95% CI, 3.62-5.53; P < .001) but not among HCWs with other racial/ethnic backgrounds. Conclusions and Relevance: This study found that vaccine hesitancy before the authorization of the COVID-19 vaccine was increased among Black, Hispanic or Latino, and Asian HCWs compared with White HCWs. These findings suggest that interventions focused on addressing vaccine hesitancy among HCWs are needed.


Assuntos
Vacinas contra COVID-19 , COVID-19/prevenção & controle , Grupos de Populações Continentais , Grupos Étnicos , Pessoal de Saúde , Hospitais de Ensino , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Adulto , Afro-Americanos , Grupo com Ancestrais do Continente Asiático , Criança , Grupo com Ancestrais do Continente Europeu , Feminino , Hispano-Americanos , Humanos , Masculino , Motivação , SARS-CoV-2
18.
Health Qual Life Outcomes ; 19(1): 205, 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34446001

RESUMO

BACKGROUND: Although there is emerging data regarding the psychometric properties of the Child Health Utility-9D instrument, more evidence is required with respect to its validity for use in different country settings. The aim of this study was to examine the construct validity of the CHU-9D-CHN instrument in Chinese children. METHODS: Baseline Health-Related Quality of Life (HRQoL) and demographic data were collected from children recruited to the CHIRPY DRAGON obesity prevention intervention randomised controlled trial in China. HRQoL was measured using the Chinese version of the CHU-9D instrument (CHU-9D-CHN) and the PedsQL instrument. CHU-9D-CHN utility scores were generated using two scoring algorithms [UK and Chinese tariffs]. Discriminant validity, known-group validity and convergent validity were evaluated using non-parametric test for trend, Kruskal-Wallis test and Spearman correlation coefficient analysis respectively. RESULTS: Data was available for 1,539 children (mean age 6 years). The CHU-9D-CHN was sensitive to known group differences determined by the median PedsQL total score. Furthermore, the mean CHU-9D-CHN utility values decreased linearly with increasing levels of severity on each dimension of the PedsQL for emotional and social functioning domains. They decreased monotonically with increasing levels of severity on each dimension of the PedsQL for physical and school functioning domains (p < 0.001). Contrary to studies conducted in Western countries, and although not statistically significant, we found an indication that HRQoL, using both the CHU-9D-CHN and the PedsQL, was higher in children whose parents had lower levels of education, compared to those whose parents were university educated. The correlation between the CHU-9D-CHN utility values using UK and Chinese tariffs, and PedsQL total scores showed a statistically significant moderate positive correlation (Spearman's rho = 0.5221, p < 0.001 and Spearman's rho = 0.5316, p < 0.001), respectively. However, each CHU-9D-CHN dimension was either weakly, or very weakly correlated with each of the predetermined PedsQL domain functioning scores. CONCLUSIONS: Overall, the findings provide some support for the construct validity of the CHU-9D-CHN within a Chinese population aged 6-7 years. However, some uncertainty remains. We recommend future studies continue to test the validity of the CHU-9D in different country settings. TRIAL REGISTRATION: ISRCTN Identifier ISRCTN11867516, Registered on 19/08/2015.


Assuntos
Saúde da Criança/normas , Psicometria/métodos , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Grupo com Ancestrais do Continente Asiático , Criança , China , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Instituições Acadêmicas
19.
J Environ Manage ; 296: 113364, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34399553

RESUMO

The purpose of this study is to address the criticism that corporate environmental activities to meet the UN sustainable development goals (SDGs) are simply greenwashing. To this end, we clarify whether and why corporate environmental activities are effective in achieving SDGs from the stakeholder management perspective. Using data on Vietnamese companies, we first empirically clarify the influence of stakeholder pressure on a company's environmental management control system (EMCS) implementation as a comprehensive approach to environmental activities and maintaining a proactive attitude toward the SDGs. Second, we examine the influence of EMCS implementation on environmental performance with or without proactive attitudes. The main findings are as follows. Companies implementing EMCSs normally improve their environmental performance, and pressure from final consumers and the government is a precondition for this accomplishment. However, if these companies incorporate the SDGs into their business targets, they can actually improve their environmental performance somewhat further, and government pressure plays an important role in this additional accomplishment. Therefore, corporate environmental activities to meet the SDGs work better than existing activities in Vietnam, refuting the criticism of greenwashing. Importantly, the Vietnamese government as a powerful stakeholder has proactively promoted domestic structural change to achieve the SDGs and has enacted many policies to encourage companies to be proactive in their environmental activities.


Assuntos
Objetivos , Desenvolvimento Sustentável , Grupo com Ancestrais do Continente Asiático , Governo , Humanos , Organizações
20.
Fa Yi Xue Za Zhi ; 37(3): 358-365, 2021 Jun.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34379905

RESUMO

Abstract: Objective To study the genetic polymorphism of whole mitochondrial DNA (mtDNA) genomes in She population in Zhejiang and to explore the maternal genetic structure of the She population. Methods Whole mtDNA genomes of 231 unrelated individuals from She population in Zhejiang Province were sequenced. The number of mutations and population genetics parameters such as, the haplotype diversity (HD), discrimination power (DP), and random match probabilities (RMP) were analyzed. The mtDNA haplogroups of Zhejiang She population were classified, and the maternal genetic relationships between She and nine other Chinese populations were estimated. Results In 231 Zhejiang She samples, 8 507 mutations (702 types) were observed and the samples were classified into 94 haplogroups. The HD, DP and RMP values were 0.998 6, 0.994 2 and 0.005 8, respectively. The lowest genetic differentiation degree (Fst=0.006 89) was detected between Zhejiang She population and southern Han population. Principal component analysis (PCA) and median-joining network analysis showed that the genetic distance of Zhejiang She population with Guangxi Yao, Yunnan Dai and Southern Han populations was relatively close, but the population still had some unique genetic characteristics. Conclusion The whole mtDNA genomes are highly polymorphic in Zhejiang She population. The Zhejiang She population contains complex and diverse genetic components and has a relatively close maternal genetic relationship with Guangxi Yao, Yunnan Dai and Southern Han populations. Meanwhile, Zhejiang She population has kept its unique maternal genetic components.


Assuntos
DNA Mitocondrial , Sequenciamento de Nucleotídeos em Larga Escala , Grupo com Ancestrais do Continente Asiático/genética , China , DNA Mitocondrial/genética , Grupos Étnicos/genética , Feminino , Genética Populacional , Haplótipos , Humanos , Polimorfismo Genético
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