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1.
PLoS One ; 19(7): e0306772, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38976673

RESUMO

The objective of this meta-epidemiological study was to develop a rating that captures participants' motivation at the study level in digital health intervention (DHI) randomised controlled trials (RCTs). The rating was used to investigate whether participants' motivation is associated with the effect estimates in DHI RCTs for cancer patients. The development of the rating was based on a bottom-up approach involving the collection of information that captures participants' baseline motivation in empirical studies from the Smartphone-RCCT Database. We specified three indicators for rating: indicator 1 captures whether the study team actively selects or enhances the motivation of the potential study participants; indicator 2 captures the study participants' active engagement before the treatment allocation; and indicator 3 captures the potential bond and trust between the study participants and the person/institution referring to the study. The rating of each indicator and the overall rating varies between high motivation, moderate motivation, and low motivation. We applied the rating across 27 DHI RCTs with cancer patients. We performed meta-regression analysis to examine the effect of patient motivation on quality of life (QoL), psychological outcomes, and attrition. The intraclass correlation coefficient (ICC) indicated moderate to poor inter-rater reliability. The meta-regression showed that cancer patients' overall motivation before engaging in the intervention was associated with the treatment effect of QoL. Patient motivation was not found to be associated with psychological outcomes or attrition. Subgroup analyses revealed that the clinical effects of DHIs were more prevalent in the high-motivation subgroups, whereas the low-motivation subgroups were unlikely to show intervention benefits. The likelihood of dropouts from DHIs seems to be especially high among the low-bond (indicator 3) subgroup. We suggest using single indicators since they reflect specific content. Better reporting about baseline motivation is required to enable meaningful interpretations in not only primary studies but also in evidence syntheses.


Assuntos
Motivação , Neoplasias , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Neoplasias/psicologia , Neoplasias/terapia , Neoplasias/epidemiologia , Estudos Epidemiológicos , Telemedicina , Smartphone , Saúde Digital
2.
BMJ Open ; 14(6): e081315, 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-38908852

RESUMO

INTRODUCTION: In trials, subgroup analyses are used to examine whether treatment effects differ by important patient characteristics. However, which subgroups are most commonly reported has not been comprehensively described. DESIGN AND SETTINGS: Using a set of trials identified from the US clinical trials register (ClinicalTrials.gov), we describe every reported subgroup for a range of conditions and drug classes. METHODS: We obtained trial characteristics from ClinicalTrials.gov via the Aggregate Analysis of ClinicalTrials.gov database. We subsequently obtained all corresponding PubMed-indexed papers and screened these for subgroup reporting. Tables and text for reported subgroups were extracted and standardised using Medical Subject Headings and WHO Anatomical Therapeutic Chemical codes. Via logistic and Poisson regression models we identified independent predictors of result reporting (any vs none) and subgroup reporting (any vs none and counts). We then summarised subgroup reporting by index condition and presented all subgroups for all trials via a web-based interactive heatmap (https://ihwph-hehta.shinyapps.io/subgroup_reporting_app/). RESULTS: Among 2235 eligible trials, 23% (524 trials) reported subgroups. Follow-up time (OR, 95%CI: 1.13, 1.04-1.24), enrolment (per 10-fold increment, 3.48, 2.25-5.47), trial starting year (1.07, 1.03-1.11) and specific index conditions (eg, hypercholesterolaemia, hypertension, taking asthma as the reference, OR ranged from 0.15 to 10.44), predicted reporting, sponsoring source and number of arms did not. Results were similar on modelling any result reporting (except number of arms, 1.42, 1.15-1.74) and the total number of subgroups. Age (51%), gender (45%), racial group (28%) were the most frequently reported subgroups. Characteristics related to the index condition (severity/duration/types etc) were frequently reported (eg, 69% of myocardial infarction trials reported on its severity/duration/types). However, reporting on comorbidity/frailty (five trials) and mental health (four trials) was rare. CONCLUSION: Other than age, sex, race ethnicity or geographic location and characteristics related to the index condition, information on variation in treatment effects is sparse. PROSPERO REGISTRATION NUMBER: CRD42018048202.


Assuntos
Ensaios Clínicos como Assunto , Humanos , Doença Crônica , Estudos Epidemiológicos , Projetos de Pesquisa
3.
Nutrients ; 16(11)2024 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-38892637

RESUMO

Self-reported measures of height and weight are often used in large epidemiological studies. However, concerns remain regarding the validity and reliability of these self-reported measures. The aim of this systematic review was to summarise and evaluate the comparative validity of measured and self-reported weight and height data and to recommend strategies to improve the reliability of self-reported-data collection across studies. This systematic review adopted the PRISMA guidelines. Four online sources, including PubMed, Medline, Google Scholar, and CINAHL, were utilised. A total of 17,800 articles were screened, and 10 studies were eligible to be included in the SLR based on the defined inclusion and exclusion criteria. The findings from the studies revealed good agreement between measured and self-reported weight and height based on intra-class correlation coefficient and Bland-Altman plots. Overall, measured weight and height had higher validity and reliability (ICC > 0.9; LOA < 1 SD). However, due to biases such as social pressure and self-esteem issues, women underreported their weight, while men overreported their height. In essence, self-reported measures remain valuable indicators to supplement the restricted direct anthropometric data, particularly in large-scale surveys. However, it is essential to address potential sources of bias.


Assuntos
Estatura , Peso Corporal , Autorrelato , Humanos , Reprodutibilidade dos Testes , Feminino , Masculino , Estudos Epidemiológicos , Adulto
4.
Environ Sci Technol ; 58(25): 10920-10931, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38861590

RESUMO

Distinguishing the effects of different fine particulate matter components (PMCs) is crucial for mitigating their effects on human health. However, the sparse distribution of locations where PM is collected for component analysis makes it challenging to investigate the relevant health effects. This study aimed to investigate the agreement between data-fusion-enhanced exposure assessment and site monitoring data in estimating the effects of PMCs on gestational diabetes mellitus (GDM). We first improved the spatial resolution and accuracy of exposure assessment for five major PMCs (EC, OM, NO3-, NH4+, and SO42-) in the Pearl River Delta region by a data fusion model that combined inputs from multiple sources using a random forest model (10-fold cross-validation R2: 0.52 to 0.61; root mean square error: 0.55 to 2.26 µg/m3). Next, we compared the associations between exposures to PMCs during pregnancy and GDM in a hospital-based cohort of 1148 pregnant women in Heshan, China, using both site monitoring data and data-fusion model estimates. The comparative analysis showed that the data-fusion-based exposure generated stronger estimates of identifying statistical disparities. This study suggests that data-fusion-enhanced estimates can improve exposure assessment and potentially mitigate the misclassification of population exposure arising from the utilization of site monitoring data.


Assuntos
Material Particulado , Material Particulado/análise , Humanos , China , Feminino , Rios/química , Gravidez , Poluentes Atmosféricos/análise , Monitoramento Ambiental/métodos , Estudos Epidemiológicos , Exposição Ambiental , Diabetes Gestacional/epidemiologia
5.
PLoS One ; 19(6): e0306098, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38935698

RESUMO

INTRODUCTION: Expert opinion is widely used in clinical guidelines. No research has ever been conducted investigating the use of expert opinion in international infectious disease guidelines. This study aimed to create an analytical map by describing the prevalence and utilization of expert opinion in infectious disease guidelines and analyzing the methodological aspects of these guidelines. METHODS: In this meta-epidemiological study, systematic searches in PubMed and Trip Medical Database were performed to identify clinical guidelines on infectious diseases, published between January 2018 and May 2023 in English, by international organizations. Data extracted included guideline characteristics, expert opinion utilization, and methodological details. Prevalence and rationale of expert opinion use were analyzed descriptively. Methodological differences between groups were analyzed with Chi-square and Mann-Whitney U Test. RESULTS: The analysis covered 66 guidelines with 2296 recommendations, published/endorsed by 136 organizations. Most guidelines (79%) used systematic literature searches, 42% provided search strategies, and 38% presented screening flow diagrams and conducted risk of bias assessments. 48.5% of the guidelines allowed expert opinion, most of which included expert opinion as part of the evidence hierarchy within the grading system. Guidelines allowing expert opinion, compared to those which do not, issued more recommendations per guideline (48.82 vs.19.13, p<0.001), and reported fewer screening flow diagrams (25% vs. 65%, p = 0.002), and less risk of bias assessments (19% vs.78%, p<0.001). CONCLUSIONS: Expert opinion is utilized in half of assessed guidelines, often integrated into the evidence hierarchy within the grading system. Its utilization varies considerably in methodology, form, and terminology between guidelines. These findings highlight a pressing need for additional research and guidance, to improve and advance the standardization of infectious disease guidelines.


Assuntos
Doenças Transmissíveis , Prova Pericial , Guias de Prática Clínica como Assunto , Humanos , Doenças Transmissíveis/epidemiologia , Estudos Epidemiológicos
6.
Open Vet J ; 14(5): 1206-1215, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38938432

RESUMO

Background: Canine transmissible venereal tumor (CTVT) is a widely spread, contagious neoplasm commonly found in dogs. Mostly affects the external genitalia, however, it may also exhibit unusual clinical presentations. Aim: To describe the epidemiology, clinical appearance, cytologic and histopathologic features of dogs with TVT in Morocco. Methods: Within the realm of a nation-wide study on canine and feline tumors in Morocco between September 2020 and March 2023, dogs with histologically diagnosed TVT were identified and data on epidemiologic, clinical as well as cytologic, and histologic features were compiled and analyzed. Results: A total of 64 cases of canine TVT were diagnosed. 52 dogs were cross-breed (81.2%) while 4 Siberian Huskies (6.2%) and 3 German shepherds (4.7%) were the most affected pure-breed dogs. The median age of dogs at diagnosis was 3 years (range, 1-10years) and male gender was more common (male:female ratio; 1.3:1). Tumor was located exclusively in the genital area in 58 cases (90.6%), whereas 6 dogs (9.4%) had an atypical occurrence of TVT with locations including skin and nasal cavity. Cytology allowed for an early diagnosis in 2 cases. Histology revealed no differences between the genital and extragenital forms. Immunohistochemistry was necessary in 4 cases and revealed positive staining for vimentin and Alpha-1-antitrypsin, negative marking for CD3, CD20, and AE1/AE3, and low cytoplasmic labeling for lysozyme. Conclusion: CTVT is a widely distributed neoplasm in Morocco, mostly showing presence in young, cross-breed, and oftentimes stray dogs. An adequate understanding of this tumor's epidemiological features is necessary for its management and eradication.


Assuntos
Doenças do Cão , Tumores Venéreos Veterinários , Cães , Animais , Doenças do Cão/epidemiologia , Doenças do Cão/patologia , Marrocos/epidemiologia , Masculino , Feminino , Tumores Venéreos Veterinários/patologia , Tumores Venéreos Veterinários/epidemiologia , Estudos Epidemiológicos
8.
Medicina (Kaunas) ; 60(6)2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38929514

RESUMO

Background and Objective: This study aimed to identify the incidence of sarcopenia and disease risk factors in Korean adults and to provide data for sarcopenia prevention. Materials and Methods: Based on the Korea National Health and Nutrition Survey, 2008-2011, we selected 14,185 adults over the age of 20 who participated in sarcopenia diagnostic tests and health surveys. We analyzed sarcopenia risk factors using complex sample multi-logistic regression analysis. Results: The prevalence of sarcopenia in Korea was 31.3%, with 20.2% in men and 40.4% in women. In men, there was a higher risk of sarcopenia in those of older age, without a spouse, with a low body mass index (BMI), who never engage in resistance exercise, or who do mid-level intensity resistance exercises. In women, sarcopenia risk was higher in those in their 20s compared to those in their 60s, and risk factors included a low BMI, high-density lipoprotein cholesterol and waist circumference measurements, alcohol consumption, aerobic exercise, and resistance exercise. Conclusions: Interventions and lifestyle improvements will help prevent the onset of sarcopenia in elderly men and young women with risk factors such as a low BMI.


Assuntos
Índice de Massa Corporal , Sarcopenia , Humanos , Sarcopenia/epidemiologia , República da Coreia/epidemiologia , Feminino , Masculino , Estudos Transversais , Fatores de Risco , Pessoa de Meia-Idade , Prevalência , Adulto , Idoso , Fatores Sexuais , Estudos Epidemiológicos , Exercício Físico , Modelos Logísticos
9.
BMJ Open ; 14(5): e084716, 2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38697762

RESUMO

INTRODUCTION: General practitioners (GPs) are mostly the first point of contact for patients with health problems in Germany. There is only a limited epidemiological overview data that describe the GP consultation hours based on other than billing data. Therefore, the aim of Saxon Epidemiological Study in General Practice-6 (SESAM-6) is to examine the frequency of reasons for encounter, prevalence of long-term diagnosed diseases and diagnostic and therapeutic decisions in general practice. This knowledge is fundamental to identify the healthcare needs and to develop strategies to improve the GP care. The results of the study will be incorporated into the undergraduate, postgraduate and continuing medical education for GP. METHODS AND ANALYSIS: This cross-sectional study SESAM-6 is conducted in general practices in the state of Saxony, Germany. The study design is based on previous SESAM studies. Participating physicians are assigned to 1 week per quarter (over a survey period of 12 months) in which every fifth doctor-patient contact is recorded for one-half of the day (morning or afternoon). To facilitate valid statements, a minimum of 50 GP is required to document a total of at least 2500 doctor-patient contacts. Univariable, multivariable and subgroup analyses as well as comparisons to the previous SESAM data sets will be conducted. ETHICS AND DISSEMINATION: The study was approved by the Ethics Committee of the Technical University of Dresden in March 2023 (SR-EK-7502023). Participation in the study is voluntary and will not be remunerated. The study results will be published in peer-reviewed scientific journals, preferably with open access. They will also be disseminated at scientific and public symposia, congresses and conferences. A final report will be published to summarise the central results and provided to all study participants and the public.


Assuntos
Medicina Geral , Humanos , Estudos Transversais , Medicina Geral/estatística & dados numéricos , Alemanha/epidemiologia , Estudos Epidemiológicos , Projetos de Pesquisa , Encaminhamento e Consulta/estatística & dados numéricos
10.
J Integr Med ; 22(3): 223-234, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38714484

RESUMO

BACKGROUND: Previously published meta-epidemiological studies focused on Western medicine have identified some trial characteristics that impact the treatment effect of randomized controlled trials (RCTs). Nevertheless, it remains unclear if similar associations exist in RCTs on Chinese herbal medicine (CHM). Further, Chinese medicine-related characteristics have not been explored yet. OBJECTIVE: To investigate trial characteristics related to treatment effect estimates on CHM RCTs. SEARCH STRATEGY: This meta-epidemiological study searched 5 databases for systematic reviews on CHM treatment published between January 2011 and July 2021. INCLUSION CRITERIA: An eligible systematic review should only include RCTs of CHM and conduct at least one meta-analysis. DATA EXTRACTION AND ANALYSIS: Two reviewers independently conducted data extraction on general characteristics of systematic reviews, meta-analyses and included RCTs. They also assessed the risk of bias of RCTs using the Cochrane risk of bias tool. A two-step approach was used for data analyses. The ratio of odds ratios (ROR) and difference in standardized mean differences (dSMD) with 95% confidence interval (CI) were applied to present the difference in effect estimates for binary and continuous outcomes, respectively. RESULTS: Ninety-one systematic reviews, comprising 1338 RCTs were identified. For binary outcomes, RCTs incorporated with syndrome differentiation (ROR: 1.23; 95 % CI: [1.07, 1.39]), adopting Chinese medicine formula (ROR: 1.19; 95% CI: [1.03, 1.34]), with low risk of bias on incomplete outcome data (ROR: 1.29; 95% CI: [1.06, 1.52]) and selective outcome reporting (ROR: 1.12; 95% CI: [1.01, 1.24]), as well as a trial size ≥ 100 (ROR: 1.23; 95% CI: [1.04, 1.42]) preferred to show larger effect estimates. As for continuous outcomes, RCTs with Chinese medicine diagnostic criteria (dSMD: 0.23; 95% CI: [0.06, 0.41]), judged as high/unclear risk of bias on allocation concealment (dSMD: -0.70; 95% CI: [-0.99, -0.42]), with low risk of bias on incomplete outcome data (dSMD: 0.30; 95% CI: [0.18, 0.43]), conducted at a single center (dSMD: -0.33; 95% CI: [-0.61, -0.05]), not using intention-to-treat analysis (dSMD: -0.75; 95% CI: [-1.43, -0.07]), and without funding support (dSMD: -0.22; 95% CI: [-0.41, -0.02]) tended to show larger effect estimates. CONCLUSION: This study provides empirical evidence for the development of a specific critical appraisal tool for risk of bias assessments on CHM RCTs. Please cite this article as: Wang BH, Lin YL, Gao YY, Song JL, Qin L, Li LQ, Liu WQ, Zhong CCW, Jiang MY, Mao C, Yang XB, Chung VCH, Wu IXY. Trial characteristics and treatment effect estimates in randomized controlled trials of Chinese herbal medicine: A meta-epidemiological study. J Integr Med. 2024; 22(3): 223-234.


Assuntos
Medicamentos de Ervas Chinesas , Medicina Tradicional Chinesa , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Medicamentos de Ervas Chinesas/uso terapêutico , Estudos Epidemiológicos , Resultado do Tratamento
11.
PLoS One ; 19(5): e0300449, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38776272

RESUMO

Environmental exposures during the perinatal period are known to have a long-term effect on adult physical and mental health. One such influential environmental exposure is the time of year of birth which affects the amount of daylight, nutrients, and viral load that an individual is exposed to within this key developmental period. Here, we investigate associations between season of birth (seasonality), four mental health traits (n = 137,588) and multi-modal neuroimaging measures (n = 33,212) within the UK Biobank. Summer births were associated with probable recurrent Major Depressive Disorder (ß = 0.026, pcorr = 0.028) and greater mean cortical thickness in temporal and occipital lobes (ß = 0.013 to 0.014, pcorr<0.05). Winter births were associated with greater white matter integrity globally, in the association fibers, thalamic radiations, and six individual tracts (ß = -0.013 to -0.022, pcorr<0.05). Results of sensitivity analyses adjusting for birth weight were similar, with an additional association between winter birth and white matter microstructure in the forceps minor and between summer births, greater cingulate thickness and amygdala volume. Further analyses revealed associations between probable depressive phenotypes and a range of neuroimaging measures but a paucity of interactions with seasonality. Our results suggest that seasonality of birth may affect later-life brain structure and play a role in lifetime recurrent Major Depressive Disorder. Due to the small effect sizes observed, and the lack of associations with other mental health traits, further research is required to validate birth season effects in the context of different latitudes, and by co-examining genetic and epigenetic measures to reveal informative biological pathways.


Assuntos
Bancos de Espécimes Biológicos , Saúde Mental , Neuroimagem , Estações do Ano , Humanos , Feminino , Masculino , Reino Unido/epidemiologia , Pessoa de Meia-Idade , Adulto , Parto , Transtorno Depressivo Maior/diagnóstico por imagem , Transtorno Depressivo Maior/epidemiologia , Idoso , Estudos Epidemiológicos , Encéfalo/diagnóstico por imagem , Imageamento por Ressonância Magnética , Biobanco do Reino Unido
12.
Med Phys ; 51(6): 4472-4481, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38734989

RESUMO

BACKGROUND: In a dedicated effort to improve the assessment of clonal hematopoiesis (CH) and study leukemia risk following radiotherapy, we are developing a large-scale cohort study among cancer patients who received radiation. To that end, it will be critical to analyze dosimetric parameters of red bone marrow (ABM) exposure in relation to CH and its progression to myeloid neoplasms, requiring reconstruction method for ABM doses of a large-scale patients rapidly and accurately. PURPOSE: To support a large-scale cohort study on the assessment of clonal hematopoiesis and leukemia risk following radiotherapy, we present a new method for the rapid reconstruction of ABM doses of radiotherapy among cancer patients. METHODS: The key idea of the presented method is to segment patient bones rapidly and automatically by matching a whole-body computational human phantom, in which the skeletal system is divided into 34 bone sites, to patient CT images via 3D skeletal registration. The automatic approach was used to segment site-specific bones for 40 radiotherapy patients. Also, we segmented the bones manually. The bones segmented both manually and automatically were then combined with the patient dose matrix calculated by the treatment planning system (TPS) to derive patient ABM dose. We evaluated the performance of the automatic method in geometric and dosimetric accuracy by comparison with the manual approach. RESULTS: The pelvis showed the best geometric performance [volume overlap fraction (VOF): 52% (mean) with 23% (σ) and average distance (AD): 0.8 cm (mean) with 0.5 cm (σ)]. The pelvis also showed the best dosimetry performance [absorbed dose difference (ADD): 0.7 Gy (mean) with 1.0 Gy (σ)]. Some bones showed unsatisfactory performances such as the cervical vertebrae [ADD: 5.2 Gy (mean) with 10.8 Gy (σ)]. This impact on the total ABM dose, however, was not significant. An excellent agreement for the total ABM dose was indeed observed [ADD: 0.4 Gy (mean) with 0.4 Gy (σ)]. The computation time required for dose calculation using our method was robust (about one minute per patient). CONCLUSIONS: We confirmed that our method estimates ABM doses across treatment sites accurately, while providing high computational efficiency. The method will be used to reconstruct patient-specific ABM doses for dose-response assessment in a large cohort study. The method can also be applied to prospective dose calculation within a clinical TPS to support clinical decision making at the point of care.


Assuntos
Medula Óssea , Dosagem Radioterapêutica , Humanos , Medula Óssea/efeitos da radiação , Doses de Radiação , Estudos Epidemiológicos , Fatores de Tempo , Radiometria , Planejamento da Radioterapia Assistida por Computador/métodos , Tomografia Computadorizada por Raios X , Imagens de Fantasmas
13.
Front Public Health ; 12: 1367797, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38689765

RESUMO

Background/objectives: Engineered nanomaterials (ENMs) have been suggested as being capable of promoting inflammation, a key component in the pathways associated with carcinogenesis, cardiovascular disease, and other conditions. As a result, the risk assessment of biological markers as early-stage indicators has the potential to improve translation from experimental toxicologic findings to identifying evidence in human studies. The study aims to review the possible early biological changes in workers exposed to carbon black (CB), followed by an evidentiary quality evaluation to determine the predictive value of the biological markers. Methods: We conducted a literature search to identify epidemiological studies that assessed biological markers that were involved in the inflammatory process at early stages among workers with exposure to CB. We reviewed the studies with specific reference to the study design, statistical analyses, findings, and limitations. Results: We identified five Chinese studies that investigated the potential impact of exposure to CB on inflammatory markers, bronchial wall thickening, genomic instability, and lung function impairment in CB production workers. Of the five Chinese studies, four were cross-sectional; another study reported results at two-time points over six years of follow-up. The authors of all five studies concluded positive relationships between exposure and the inflammatory cytokine profiles. The weak to very weak correlations between biomarkers and early-stage endpoints were reported. Conclusion: Most inflammatory markers failed to satisfy the proposed evidentiary quality criteria. The significance of the results of the reviewed studies is limited by the cross-sectional study design, inconsistency in results, uncertain clinical relevance, and high occupational exposures. Based on this review, the risk assessment relying on inflammatory markers does not seem appropriate at this time. Nevertheless, the novel research warrants further exploration in assessing exposure to ENMs and corresponding potential health risks in occupational settings.


Assuntos
Biomarcadores , Estudos Epidemiológicos , Exposição Ocupacional , Fuligem , Humanos , Biomarcadores/sangue , Fuligem/análise , Medição de Risco , Exposição Ocupacional/efeitos adversos , Inflamação
14.
Eur J Clin Nutr ; 78(7): 630-638, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38605190

RESUMO

BACKGROUND/OBJECTIVES: Dietary habits are a significant predictor of hypertension (HTN). We aimed to evaluate the long-term association between adherence to the Mediterranean diet and HTN incidence. SUBJECTS/METHODS: This was a prospective study among 1415 non-hypertensive adults (44% men, age: 41 ± 13 years) followed up for 20 years. Anthropometric, lifestyle, and clinical parameters were evaluated at baseline. Adherence to the Mediterranean diet was evaluated both at baseline and 10 years through the MedDietScore (range: 0-55, higher values indicate greater adherence). RESULTS: At the 20-year follow-up, 314 new HTN cases were recorded. HTN incidence was 35.5%, 22.5%, and 8.7% in the lowest, middle, and upper tertile of baseline MedDietScore, respectively (p < 0.001). For each 1-point increase in baseline MedDietScore, the 20-year HTN risk decreased by 7% [relative risk (RR): 0.925, 95% confidence interval (CI): 0.906, 0.943], and this effect remained significant after adjustment for age, sex, and baseline lifestyle and clinical confounders, i.e., body mass index, physical activity, smoking, systolic and diastolic blood pressure, family history of HTN, and presence of hypercholesterolemia and diabetes mellitus (RR: 0.973, 95%CI: 0.949, 0.997). In a similar multiadjusted model, compared to subjects who were consistently away from the Mediterranean diet (in the lowest MedDietScore tertile both at baseline and 10 years), only those who were consistently close (in the middle and upper MedDietScore tertiles both at baseline and 10 years) exhibited a 47% lower 20-year HTN risk. CONCLUSION: A high adherence to the Mediterranean diet, particularly when longitudinally sustained, is associated with lower incidence of HTN.


Assuntos
Dieta Mediterrânea , Estudos Epidemiológicos , Hipertensão , Dieta Mediterrânea/estatística & dados numéricos , Hipertensão/epidemiologia , Hipertensão/prevenção & controle , Incidência , Estudos Prospectivos , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Seguimentos , Estudos Longitudinais
16.
PeerJ ; 12: e17128, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38562994

RESUMO

Background: Interaction identification is important in epidemiological studies and can be detected by including a product term in the model. However, as Rothman noted, a product term in exponential models may be regarded as multiplicative rather than additive to better reflect biological interactions. Currently, the additive interaction is largely measured by the relative excess risk due to interaction (RERI), the attributable proportion due to interaction (AP), and the synergy index (S), and confidence intervals are developed via frequentist approaches. However, few studies have focused on the same issue from a Bayesian perspective. The present study aims to provide a Bayesian view of the estimation and credible intervals of the additive interaction measures. Methods: Bayesian logistic regression was employed, and estimates and credible intervals were calculated from posterior samples of the RERI, AP and S. Since Bayesian inference depends only on posterior samples, it is very easy to apply this method to preventive factors. The validity of the proposed method was verified by comparing the Bayesian method with the delta and bootstrap approaches in simulation studies with example data. Results: In all the simulation studies, the Bayesian estimates were very close to the corresponding true values. Due to the skewness of the interaction measures, compared with the confidence intervals of the delta method, the credible intervals of the Bayesian approach were more balanced and matched the nominal 95% level. Compared with the bootstrap method, the Bayesian method appeared to be a competitive alternative and fared better when small sample sizes were used. Conclusions: The proposed Bayesian method is a competitive alternative to other methods. This approach can assist epidemiologists in detecting additive-scale interactions.


Assuntos
Teorema de Bayes , Simulação por Computador , Modelos Logísticos , Estudos Epidemiológicos , Tamanho da Amostra
17.
PLoS One ; 19(4): e0300881, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38557691

RESUMO

BACKGROUND: Orthodontic systematic reviews (SRs) include studies published mostly in English than non-English languages. Including only English studies in SRs may result in a language bias. This meta-epidemiological study aimed to evaluate the language bias impact on orthodontic SRs. DATA SOURCE: SRs published in high-impact orthodontic journals between 2017 and 2021 were retrieved through an electronic search of PubMed in June 2022. Additionally, Cochrane oral health group was searched for orthodontic systematic reviews published in the same period. DATA COLLECTION AND ANALYSIS: Study selection and data extraction were performed by two authors. Multivariable logistic regression was implemented to explore the association of including non-English studies with the SRs characteristics. For the meta-epidemiological analysis, one meta-analysis from each SRs with at least three trials, including one non-English trial was extracted. The average difference in SMD was obtained using a random-effects meta-analysis. RESULTS: 174 SRs were included in this study. Almost one-quarter (n = 45/174, 26%) of these SRs included at least one non-English study. The association between SRs characteristics and including non-English studies was not statistically significant except for the restriction on language: the odds of including non-English studies reduced by 89% in SRs with a language restriction (OR: 0.11, 95%CI: 0.01 0.55, P< 0.01). Out of the sample, only fourteen meta-analyses were included in the meta-epidemiological analysis. The meta-epidemiological analysis revealed that non-English studies tended to overestimate the summary SMD by approximately 0.30, but this was not statistically significant when random-effects model was employed due to substantial statistical heterogeneity (ΔSMD = -0.29, 95%CI: -0.63 to 0.05, P = 0.37). As such, the overestimation of meta-analysis results by including non-English studies was statistically non-significant. CONCLUSION: Language bias has non-negligible impact on the results of orthodontic SRs. Orthodontic systematic reviews should abstain from language restrictions and use sensitivity analysis to assess the impact of language on the conclusions, as non-English studies may have a lower quality.


Assuntos
Idioma , Publicações , Estudos Epidemiológicos , Viés
18.
J Matern Fetal Neonatal Med ; 37(1): 2343613, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38637273

RESUMO

INTRODUCTION: The importance of micronutrient intake during the preconceptional and early pregnancy period for both maternal and fetal outcomes is well-known, however, relevant data are not available for Greek pregnant women. The aim of the present study is to delineate the nutritional status preceding conception among a representative cohort of Greek pregnant women. METHODS: This was a prospective study of pregnant women from routine care, recruited at 11+0-13+6 gestational weeks, between December 2020 and October 2022, at the 3rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece. Eligible participants for the study included healthy pregnant women aged 20 years or older, possessing a proficient understanding of the Greek language, and not engaged in specific nutritional programs. A validated Food Frequency Questionnaire was applied to gather information regarding nutritional habits in the last 6 months prior to conception. The consumption of nutrients was compared to the reference intake levels suggested by the European Food Safety Authority. Further analyses between different participants' subgroups were performed. RESULTS: Overall, 1100 pregnant women (mean age: 32.4 ± 4.9 years) were enrolled. Almost all examined micronutrients' intake was significantly different from dietary reference values. Furthermore, nutrient adequacy ratio was below 60% in 6 out of 22 micronutrients examined, and Mean Adequacy Ratio was 93%. However, Mean Adequacy Ratio is characterized by extreme variance between the examined values. Iodine, folic acid, potassium, and vitamin D intake levels were significantly lower than the recommended intake levels (p < .001 for all), while vitamin K and niacin (p < .001 for both) were consumed in great extent. Sodium median intake, without calculating extra salt addition also exceeded the reference value levels (p = .03). Notably, magnesium intake exceeded the upper safety limits in 12.4% of the sample. CONCLUSION: Potential inadequacies in important micronutrients for uneventful pregnancy outcomes have been revealed.. Special attention is needed for magnesium to balance possible toxicity with evident benefits.


Assuntos
Micronutrientes , Oligoelementos , Gravidez , Feminino , Humanos , Adulto , Estudos Prospectivos , Grécia/epidemiologia , Magnésio , Dieta , Estudos Epidemiológicos
19.
PLoS One ; 19(4): e0301841, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38626103

RESUMO

The number of people suffering from scrub typhus, which is not of concern, is increasing year by year, especially in Yunnan Province, China. From June 1, 2021 to August 15, 2022, a total of 505 mammalian samples were collected from farm, forest, and residential habitats with high incidence of scrub typhus in Yunnan, China, for nPCR (nested PCR) and qPCR (quantitative real-time PCR) detection of Orientia tsutsugamushi. A total of 4 orders of murine-like animals, Rodentia (87.52%, n = 442), Insectivora (10.29%, n = 52), Lagomorpha (1.79%, n = 9) and Scandentia (0.40%, n = 2) were trapped. Comparing the qPCR infection rates in the three habitats, it was no significant difference that the infection rate of residential habitat (44.44%) and that of the farm habitat (45.05%, P>0.05), which is much larger than that of the forest habitat (3.08%) (P<0.001). Three genotypes (Karp-like, Kato-like and TA763-like) of O. tsutsugamushi were found from Yunnan, China in this study.


Assuntos
Orientia tsutsugamushi , Tifo por Ácaros , Humanos , Animais , Camundongos , Tifo por Ácaros/diagnóstico , Fazendas , China/epidemiologia , Orientia tsutsugamushi/genética , Roedores/genética , Reação em Cadeia da Polimerase em Tempo Real , Estudos Epidemiológicos , Florestas , Eulipotyphla/genética
20.
Eur Rev Med Pharmacol Sci ; 28(7): 2969-2975, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38639533

RESUMO

OBJECTIVE: The variant BA.2.86 of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing concern globally. The virus contains a large number of mutations, and transmission trends are rapidly changing globally. This study investigates the global epidemiological and transmission trends of SARS-CoV-2 new variant BA.2.86 in various continents and countries. MATERIALS AND METHODS: The data were recorded using key terms, including SARS-CoV-2, Omicron, BA.2.86, epidemiology, occurrence, incidence, prevalence, and transmission trends. The data on SARS-CoV-2 variant BA.2.86 were searched by the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), the Global Initiative on Sharing All Influenza Data (GSIAD), PubMed, and Web of Science. Initially, 40 documents were identified, and finally, 8 documents were included for the data analysis and discussion. The analysis of findings on transmission trends was based on the data from August 14, 2023, to February 28, 2024. RESULTS: The SARS-CoV-2, novel variant BA.2.86, crossed the international borders of 6 continents and 89 countries and infected 19,532 people. In Europe, 32 countries are affected and involved 12,667 people (64.85%), North and South America 18 countries with 3,515 cases (17.99%), Asia 27 countries with 2,063 people (10.56%), Oceania 2 countries with 689 cases (3.52%), and Africa 10 countries with 598 (3.06%) cases. The BA.2.86 rapidly spread and mainly affected the people in the United Kingdom 3,228 (16.52%), Sweden 2,380 (12.18%), USA 1,929 (9.87%), Denmark 1,621 (8.29%), Canada 1,516 (7.67%), France 833 (4.26%), Japan 810 (4.14%), Netherlands 725 (3.71%), Germany 681 (3.48%), Spain 665 (3.40%), South Korea 556 (2.84%), and Australia 512 (2.62%). CONCLUSIONS: The SARS-CoV-2, novel variant BA.2.86, spread over six continents and 89 countries and affected 19,532 people worldwide. The disease is more prevalent in the United Kingdom, United States of America, and European countries. The detection of the disease in multiple continents and countries suggests some degree of transmissibility. Global health authorities need to rethink their policies and implement strict strategies to eradicate emerging variants and minimize the global disease burden.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , SARS-CoV-2 , Estudos Epidemiológicos , Europa (Continente)
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