21 results on '"Duolao Wang"'
Search Results
2. Geographical specific association between lifestyles and multimorbidity among adults in China.
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Peixi Rong, Yukui Chen, Yusong Dang, Xinyu Duan, Mingxin Yan, Yaling Zhao, Fangyao Chen, Jing Zhou, Duolao Wang, and Leilei Pei
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Medicine ,Science - Abstract
The relationship between lifestyles and multimorbidity is well established, but previous studies have often neglected the role of spatial heterogeneity. Thus, this study is the first to explore this association in Chinese adults from a spatial perspective using a geographically weighted logistic regression (GWLR) model and describe the geographical characteristics across different regions. According to 2018 China Health and Retirement Longitudinal Study (CHARLS) database, a total of 7101 subjects were finally included, with 124 prefecture-level administrative regions in China. Non-spatial and GWLR model were used for analysis, and gender stratification analysis was also performed. Data were visualized through ArcGIS 10.7. The results showed that a total prevalence of approximately 5.13% of multimorbidity, and among participants with multimorbidity, the separate prevalence of hypertension, diabetes or high blood sugar, heart disease, and stroke were 4.45%, 2.32%, 3.02%, and 1.41%, respectively. The GWLR model indicated that current (OR: 1.202-1.220) and former smokers (OR: 1.168-1.206) may be important risk factors for multimorbidity in adults, especially in north and west among male. Past drinkers (OR: 1.233-1.240), especially in eastern China, contribute to the development of the multimorbidity in men but not in women. Vigorous-intensity activities (OR: 0.761-0.799) were negatively associated with multimorbidity in the west, with no gender difference. Depression (OR: 1.266-1.293) appeared to increase the risk for multimorbidity, with the weakest effects in central China and no gender difference. There was an interaction between light activities and gender (P = 0.024). The prevalence of multimorbidity differed across various areas of the province. The role of geographical variations in lifestyles and multimorbidity may provide valuable information for developing site-specific intervention strategies.
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- 2023
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3. Quality of life and well-being problems in secondary schoolgirls in Kenya: Prevalence, associated characteristics, and course predictors.
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Philip Spinhoven, Garazi Zulaika, Elizabeth Nyothach, Anna Maria van Eijk, David Obor, Eunice Fwaya, Linda Mason, Duolao Wang, Daniel Kwaro, and Penelope A Phillips-Howard
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Public aspects of medicine ,RA1-1270 - Abstract
BackgroundAdolescents in sub-Saharan Africa often report low levels of quality of life (QoL) and well-being, but reliable data are limited. This study examines which sociodemographic, health, and behavioral risk factors and adverse adolescent experiences are associated with, and predictive of, QoL in Kenyan secondary schoolgirls.Methods and findings3,998 girls at baseline in a randomised controlled trial in Siaya County, western Kenya were median age 17.1 years. Subjectively perceived physical, emotional, social and school functioning was assessed using the Pediatric Quality of Life (QoL) Inventory-23. Laboratory-confirmed and survey data were utilized to assess sociodemographic, health and behavioral characteristics, and adverse adolescent experiences. We identified a group of girls with Low QoL (n = 1126; 28.2%), Average QoL (n = 1445; 36.1%); and High QoL (n = 1427; 35.7%). Significantly higher scores on all well-being indicators in the LQoL compared with HQoL group indicated good construct validity (Odds Ratio's (ORs) varying from 3.31 (95% CI:2.41-4.54, p < .001) for feeling unhappy at home to 11.88 (95%CI:7.96-17.74, p< .001) for PHQ9 defined possible caseness (probable diagnosis) of depression. Adverse adolescent experiences were independently statistically significant in the LQoL compared to the HQoL group for threats of family being hurt (aOR = 1.35,1.08-1.68, p = .008), sexual harassment out of school (aOR = 2.17,1.79-2.64, p < .001), and for menstrual problems like unavailability of sanitary pads (aOR = 1.23,1.05-1.44, p = .008) and stopping activities due to menstruation (aOR = 1.77,1.41-2.24, p < .001). After 2-years follow-up of 906 girls in the LQoL group, 22.7% persisted with LQoL. Forced sex (aOR = 1.56,1.05-2.32, p = .028) and threats of family being hurt (aOR = 1.98,1.38-2.82, p < .001) were independent predictors of persistent LQoL problems.ConclusionsPersistent QoL problems in Kenyan adolescent girls are associated with adverse physical, sexual and emotional experiences and problems with coping with their monthly menstruation. A multi-factorial integral approach to reduce the rate of adverse adolescent experiences is needed, including provision of menstrual hygiene products.Trial registrationClinicalTrials.gov:NCT03051789.
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- 2022
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4. Factors associated with the prevalence of HIV, HSV-2, pregnancy, and reported sexual activity among adolescent girls in rural western Kenya: A cross-sectional analysis of baseline data in a cluster randomized controlled trial.
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Garazi Zulaika, Elizabeth Nyothach, Anna Maria van Eijk, David Obor, Linda Mason, Duolao Wang, Tao Chen, Emily Kerubo, Valarie Opollo, Isaac Ngere, Samuel Omondi Owino, Boaz Oyaro, Feiko O Ter Kuile, Daniel Kwaro, and Penelope Phillips-Howard
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Medicine - Abstract
BackgroundAdolescence is a sensitive time for girls' sexual and reproductive health (SRH), as biological changes occur concurrently with heightening pressures for sexual activity. In western Kenya, adolescent girls are vulnerable to acquiring sexually transmitted infections (STIs), such as HIV and herpes simplex virus type 2 (HSV-2), and to becoming pregnant prior to reaching adulthood. This study examines associations between individual, household, and partner-related risk factors and the prevalence of sex, adolescent pregnancy, HIV, and HSV-2.Methods and findingsWe report baseline findings among 4,138 girls attending secondary school who were enrolled between 2017 and 2018 in the Cups or Cash for Girls (CCG) cluster randomized controlled trial in Siaya County, rural western Kenya. Laboratory confirmed biomarkers and survey data were utilized to assess the effects of girls' individual, household, and partner characteristics on the main outcome measures (adolescent reported sex, prior pregnancy, HIV, and HSV-2) through generalized linear model (GLM) analysis. Complete data were available for 3,998 girls (97%) with median age 17.1 years (interquartile range [IQR] 16.3 to 18.0 years); 17.2% were HSV-2 seropositive (n = 686) and 1.7% tested positive for HIV (n = 66). Sexual activity was reported by 27.3% girls (n = 1,090), of whom 12.2% had been pregnant (n = 133). After adjustment, orphanhood (adjusted risk ratio [aRR] 2.81, 95% confidence interval [CI] 1.18 to 6.71, p-value [p] = 0.020), low body mass index (BMI) (aRR 2.07; CI: 1.00 to 4.30, p = 0.051), and age (aRR 1.34, 1.18 to 1.53, p < 0.001) were all associated with HIV infection. Girls reporting light menstrual bleeding (aRR 2.42, 1.22 to 4.79, p = 0.012) for fewer than 3 days (aRR 2.81, 1.16 to 6.82, p = 0.023) were over twice as likely to have HIV. Early menarche (aRR 2.05, 1.33 to 3.17, p = 0.001) was associated with adolescent pregnancy and HSV-2-seropositive girls reported higher rates of pregnancy (aRR 1.62, CI: 1.16 to 2.27, p = 0.005). High BMI was associated with HSV-2 (aRR 1.24, 1.05 to 1.46, p = 0.010) and sexual activity (aRR 1.14, 1.02 to 1.28, p = 0.016). High levels of harassment were detected in the cohort (41.2%); being touched indecently conveyed the strongest association related to reported sexual activity (aRR 2.52, 2.26 to 2.81, p < 0.001). Study limitations include the cross-sectional design of the study, which informs on the SRH burdens found in this population but limits causal interpretation of associations, and the self-reported exposure ascertainment, which may have led to possible underreporting of risk factors, most notably prior sexual activity.ConclusionsOur findings indicate that adolescent girls attending school in Kenya face frequent harassment for sex and are at high risk of pregnancy and HSV-2, with girls experiencing early menarche particularly vulnerable. Targeted interventions, such as earlier sexual education programs, are warranted to address their vulnerability to SRH harms.Trial registrationClinicalTrials.gov NCT03051789.
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- 2021
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5. Applicability and cost-effectiveness of the Systolic Blood Pressure Intervention Trial (SPRINT) in the Chinese population: A cost-effectiveness modeling study.
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Chao Li, Kangyu Chen, Victoria Cornelius, Ewan Tomeny, Yang Wang, Xiaowei Yang, Xiaodan Yuan, Rui Qin, Dahai Yu, Zhenqiang Wu, Duolao Wang, and Tao Chen
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Medicine - Abstract
BackgroundThe Systolic Blood Pressure Intervention Trial (SPRINT) showed significant reductions in death and cardiovascular disease (CVD) risk with a systolic blood pressure (SBP) goal of Methods and findingsWe used nationally representative baseline data from the China Health and Retirement Longitudinal Study (CHARLS) (2011-2012) to estimate the prevalence and number of Chinese adults aged 45 years and older who meet SPRINT criteria. A validated microsimulation model was employed to project costs, clinical outcomes, and quality-adjusted life-years (QALYs) among SPRINT-eligible adults, under 2 alternative treatment strategies (SBP goal of ConclusionsAlthough adoption of the SPRINT treatment strategy would increase the number of Chinese adults requiring SBP treatment intensification, this approach has the potential to prevent CVD events, to produce gains in life-years, and to be cost-effective under common thresholds.
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- 2021
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6. Geographical variations in maternal dietary patterns during pregnancy associated with birth weight in Shaanxi province, Northwestern China.
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Yini Liu, Huihui Zhang, Yaling Zhao, Fangyao Chen, Baibing Mi, Jing Zhou, Yulong Chen, Duolao Wang, and Leilei Pei
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Medicine ,Science - Abstract
The geographical variation of maternal dietary patterns related to birth outcomes is important for improving the health of mothers and children; however, it is currently unknown. Thus, the objective of the study was to investigate geographical variations of maternal dietary pattern during pregnancy, and evaluate the spatial varying association of maternal dietary patterns in pregnancy with abnormal birth weight. A population-based cross-sectional study was conducted in Shaanxi province in Northwest China in 2013 to evaluate the relationship between abnormal birth weight and dietary pattern using the Geographically Weighted Logistic Regression (GWLR). Three dietary patterns during pregnancy were extracted through factor analysis, explaining approximately 45.8% of the variability of food intake. Approximately 81.6% of mothers with higher scores on the equilibrium pattern was more unlikely to have small for gestational age (SGA) infants, with the lower OR observed in Central and South Shaanxi. The snacks pattern was positively associated with low birth weight (LBW) for 23.2% of participants, with the highest OR in Central Shaanxi. Among about 80.0% of participants with higher scores on the snacks pattern living in South and Central Shaanxi, there was a higher risk for SGA. The OR values tend to descend from South to North Shaanxi. The OR values of the negative association between prudent pattern and LBW decreased from South to North Shaanxi among approximately 59.3% of participants. The prudent pattern was also negatively associated with the increasing risk of fetal macrosomia among 19.2% of participants living mainly in South Shaanxi. The association of maternal dietary patterns during pregnancy with abnormal birth weight varied geographically across Shaanxi province. The findings emphasize the importance of geographical distribution to improve the dietary patterns among disadvantaged pregnant women.
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- 2021
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7. Pneumococcal colonisation is an asymptomatic event in healthy adults using an experimental human colonisation model.
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Ashleigh Trimble, Victoria Connor, Ryan E Robinson, Daniella McLenaghan, Carole A Hancock, Duolao Wang, Stephen B Gordon, Daniela M Ferreira, Angela D Wright, and Andrea M Collins
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Medicine ,Science - Abstract
IntroductionPneumococcal colonisation is regarded as a pre-requisite for developing pneumococcal disease. In children previous studies have reported pneumococcal colonisation to be a symptomatic event and described a relationship between symptom severity/frequency and colonisation density. The evidence for this in adults is lacking in the literature. This study uses the experimental human pneumococcal challenge (EHPC) model to explore whether pneumococcal colonisation is a symptomatic event in healthy adults.MethodsHealthy participants aged 18-50 were recruited and inoculated intra-nasally with either Streptococcus pneumoniae (serotypes 6B, 23F) or saline as a control. Respiratory viral swabs were obtained prior to inoculation. Nasal and non-nasal symptoms were then assessed using a modified Likert score between 1 (no symptoms) to 7 (cannot function). The rate of symptoms reported between the two groups was compared and a correlation analysis performed.ResultsData from 54 participants were analysed. 46 were inoculated with S. pneumoniae (29 with serotype 6B, 17 with serotype 23F) and 8 received saline (control). In total, 14 became experimentally colonised (30.4%), all of which were inoculated with serotype 6B. There was no statistically significant difference in nasal (p = 0.45) or non-nasal symptoms (p = 0.28) between the inoculation group and the control group. In those who were colonised there was no direct correlation between colonisation density and symptom severity. In the 22% (12/52) who were co-colonised, with pneumococcus and respiratory viruses, there was no statistical difference in either nasal or non-nasal symptoms (virus positive p = 0.74 and virus negative p = 1.0).ConclusionPneumococcal colonisation using the EHPC model is asymptomatic in healthy adults, regardless of pneumococcal density or viral co-colonisation.
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- 2020
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8. Socioeconomic determinants of rural women's desired fertility: A survey in rural Shaanxi, China.
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Jieqiong Wei, Jianhong Xue, and Duolao Wang
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Medicine ,Science - Abstract
There has been evidence demonstrating that China has had a persistently low and below-replacement level fertility since early 1990s, causing concerns of a rapidly aging population and sustainability of the Chinese economy. To avoid adverse effects of excessively low fertility, the Chinese government has recently changed its family planning policy from "one-child policy" to "two-child policy." Nonetheless, the effectiveness of the newly initiated two-child policy is questionable if women's average desired number of children or desired fertility for their lifetime is below the threshold fertility allowed by the two-child policy. Therefore, this study argues that it would be interesting and pertinent to know women's fertility desires under the circumstances of no policy restrictions and understand major factors that may affect their desired fertility. Based on a multi-stage stratified cluster sampling survey with 2,516 women respondents in rural Shaanxi, this study tries to estimate desired fertility of rural women and evaluate the impact of important socioeconomic factors on their desired fertility. The results of this study reveal that the average lifetime desired fertility for rural women of childbearing age in Shaanxi is about 1.71, below the total fertility rate at the replacement level. The findings of this study suggest that women's marriage age, the pecuniary costs of having children, women's income forgone for having children, and social security benefits available for rural residents at retirement age, are significantly and negatively related to desired fertility. However, rural women's cultural views towards fertility are significantly but positively related to their desired fertility. This study further confirms that China has entered an era of low fertility, and thus, any policy restrictions on fertility may no longer be necessary. Instead, government programs which support childbearing and childrearing are needed to prevent excessive low fertility and rapid aging of the population.
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- 2018
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9. Iron status and anaemia in Sri Lankan secondary school children: A cross-sectional survey.
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Angela Allen, Stephen Allen, Rexan Rodrigo, Lakshman Perera, Wei Shao, Chao Li, Duolao Wang, Nancy Olivieri, David J Weatherall, and Anuja Premawardhena
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Medicine ,Science - Abstract
BackgroundIron deficiency, the most common micronutrient disorder and cause of anaemia globally, impairs growth, cognition, behaviour and resistance to infection.Methods/resultsAs part of a national survey of inherited haemoglobin variants in 7526 students from 72 secondary schools purposefully selected from the 25 districts of Sri Lanka, we studied 5912 students with a normal haemoglobin genotype. Median age was 16.0 (IQR 15.0-17.0) years and 3189 (53.9%) students were males. Most students were Sinhalese (65.7%), with fewer Tamils (23.1%) and Muslims (11.2%). Anaemia occurred in 470 students and was more common in females (11.1%) than males (5.6%). Haemoglobin, serum ferritin, transferrin receptor and iron were determined in 1196 students with low red cell indices and a structured sample of those with normal red cell indices (n = 513). The findings were weighted to estimate the frequencies of iron deficiency and iron deficiency anaemia classified according to WHO criteria. Iron depletion (serum ferritin 28.1 nmol/l) in 11.6% students. Iron deficiency anaemia (cellular iron deficiency with low haemoglobin) occurred in only 130/2794 (4.6%) females and 28/2789 (1.0%) males. Iron biomarkers were normal in 83/470 (14.6%) students with anaemia. In multiple regression analysis, the odds for iron depletion and cellular iron deficiency were about one-third in males compared with females, and the odds for iron deficiency anaemia were about one fifth in males compared to females. Tamil ethnicity and age ConclusionsLow iron status and anaemia remain common problems in Sri Lankan secondary school students especially females, younger students and the socioeconomically disadvantaged Tamil population. More research is needed to identify factors other than low iron status that contribute to anaemia in adolescents.
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- 2017
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10. Association between the Infant and Child Feeding Index (ICFI) and nutritional status of 6- to 35-month-old children in rural western China.
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Pengfei Qu, Baibing Mi, Duolao Wang, Ruo Zhang, Jiaomei Yang, Danmeng Liu, Shaonong Dang, and Hong Yan
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Medicine ,Science - Abstract
The objective of this study was to determine the relationship between the quality of feeding practices and children's nutritional status in rural western China.A sample of 12,146 pairs of 6- to 35-month-old children and their mothers were recruited using stratified multistage cluster random sampling in rural western China. Quantile regression was used to analyze the relationship between the Infant and Child Feeding Index (ICFI) and children's nutritional status.In rural western China, 24.37% of all infants and young children suffer from malnutrition. Of this total, 19.57%, 8.74% and 4.63% of infants and children are classified as stunting, underweight and wasting, respectively. After adjusting for covariates, the quantile regression results suggested that qualified ICFI (ICFI > 13.8) was associated with all length and HAZ quantiles (P
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- 2017
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11. Bidirectional relationships between retention and health-related quality of life in Chinese mainland patients receiving methadone maintenance treatment.
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Kaina Zhou, Duolao Wang, Hengxin Li, Xiaoli Wei, Juan Yin, Peifeng Liang, Lingling Kou, Mengmeng Hao, Lijuan You, Xiaomei Li, and Guihua Zhuang
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Medicine ,Science - Abstract
This study aimed to explore the bidirectional relationships between retention and health-related quality of life (HRQoL) in patients from mainland China receiving methadone maintenance treatment (MMT). This prospective cohort study recruited 1,212 eligible MMT patients from the two largest MMT clinics (one privately and another publicly funded) in Xi'an. This study started in March 2012 with a 2-year follow-up until March 2014. Retention was assessed by repeated terminations, past treatment duration, premature terminations, and follow-up treatment duration. HRQoL was evaluated using the Chinese (simple) short-form 36 health survey version 2 (SF-36v2) and the quality of life scale for drug addicts (QOL-DAv2.0). Linear and Cox regression analyses were used to explore relationships between retention and HRQoL. A general linear model was used to further examine the global effect of past treatment duration on HRQoL. Multivariate analyses showed that repeated terminations had no significant impact on HRQoL scores in MMT patients; however, past treatment time (year) influenced the SF-36v2PCS (P = 0.004): treatment for ≥4 years showed a lower SF-36v2PCS score (regression coefficient: -2.39; 95% confidence interval [CI]: -3.80, -0.97; P = 0.001) than treatment for 49 (hazard ratio: 0.83; 95% CI: 0.69, 0.98; P = 0.03) were 17% less likely to terminate MMT than those with scores of ≤49. In conclusion, retention and HRQoL tended to have a bidirectional relationship, which should be considered in the development of retention and health-management programs for patients with MMT.
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- 2017
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12. Scheduled Intermittent Screening with Rapid Diagnostic Tests and Treatment with Dihydroartemisinin-Piperaquine versus Intermittent Preventive Therapy with Sulfadoxine-Pyrimethamine for Malaria in Pregnancy in Malawi: An Open-Label Randomized Controlled Trial.
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Mwayiwawo Madanitsa, Linda Kalilani, Victor Mwapasa, Anna M van Eijk, Carole Khairallah, Doreen Ali, Cheryl Pace, James Smedley, Kyaw-Lay Thwai, Brandt Levitt, Duolao Wang, Arthur Kang'ombe, Brian Faragher, Steve M Taylor, Steve Meshnick, and Feiko O Ter Kuile
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Medicine - Abstract
BackgroundIn Africa, most plasmodium infections during pregnancy remain asymptomatic, yet are associated with maternal anemia and low birthweight. WHO recommends intermittent preventive therapy in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). However, sulfadoxine-pyrimethamine (SP) efficacy is threatened by high-level parasite resistance. We conducted a trial to evaluate the efficacy and safety of scheduled intermittent screening with malaria rapid diagnostic tests (RDTs) and treatment of RDT-positive women with dihydroartemisinin-piperaquine (DP) as an alternative strategy to IPTp-SP.Methods and findingsThis was an open-label, two-arm individually randomized superiority trial among HIV-seronegative women at three sites in Malawi with high SP resistance. The intervention consisted of three or four scheduled visits in the second and third trimester, 4 to 6 wk apart. Women in the IPTp-SP arm received SP at each visit. Women in the intermittent screening and treatment in pregnancy with DP (ISTp-DP) arm were screened for malaria at every visit and treated with DP if RDT-positive. The primary outcomes were adverse live birth outcome (composite of small for gestational age, low birthweight [ConclusionsScheduled screening for malaria parasites with the current generation of RDTs three to four times during pregnancy as part of focused antenatal care was not superior to IPTp-SP in this area with high malaria transmission and high SP resistance and was associated with higher fetal loss and more malaria at delivery.Trial registrationPan African Clinical Trials Registry PACTR201103000280319; ISRCTN Registry ISRCTN69800930.
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- 2016
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13. Single Doses up to 800 mg of E-52862 Do Not Prolong the QTc Interval--A Retrospective Validation by Pharmacokinetic-Pharmacodynamic Modelling of Electrocardiography Data Utilising the Effects of a Meal on QTc to Demonstrate ECG Assay Sensitivity.
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Jörg Täubel, Georg Ferber, Ulrike Lorch, Duolao Wang, Mariano Sust, and A John Camm
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Medicine ,Science - Abstract
E-52862 is a Sigma-1 receptor antagonist (S1RA) currently under investigation as a potential analgesic medicine. We successfully applied a concentration-effect model retrospectively to a four-way crossover Phase I single ascending dose study and utilized the QTc shortening effects of a meal to demonstrate assay sensitivity by establishing the time course effects from baseline in all four periods, independently from any potential drug effects.Thirty two healthy male and female subjects were included in four treatment periods to receive single ascending doses of 500 mg, 600 mg or 800 mg of E-52862 or placebo. PK was linear over the dose range investigated and doses up to 600 mg were well tolerated. The baseline electrocardiography (ECG) measurements on Day-1 were time-matched with ECG and pharmacokinetic (PK) samples on Day 1 (dosing day).In this conventional mean change to time-matched placebo analysis, the largest time-matched difference to placebo QTcI was 1.44 ms (90% CI: -4.04, 6.93 ms) for 500 mg; -0.39 ms (90% CI: -3.91, 3.13 ms) for 600 mg and 1.32 ms (90% CI: -1.89, 4.53 ms) for 800 mg of E-52862, thereby showing the absence of any QTc prolonging effect at the doses tested. In addition concentration-effect models, one based on the placebo corrected change from baseline and one for the change of QTcI from average baseline with time as fixed effect were fitted to the data confirming the results of the time course analysis.The sensitivity of this study to detect small changes in the QTc interval was confirmed by demonstrating a shortening of QTcF of -8.1 (90% CI: -10.4, -5.9) one hour and -7.2 (90% CI: -9.4, -5.0) three hours after a standardised meal.EU Clinical Trials Register EudraCT 2010 020343 13.
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- 2015
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14. Severity of anemia among children under 36 months old in rural western China.
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Wenlong Gao, Hong Yan, Duolao Wang, Shaonong Dang, and Leilei Pei
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Medicine ,Science - Abstract
OBJECTIVE: To describe severity of anemia and explore its determinants among children under 36 months old in rural western China. STUDY DESIGN: The family information of 6711 children was collected and their hemoglobin was measured in 2005. A generalized estimated equation (GEE) linear model was used to identify the determinants of severity of childhood anemia. RESULTS: The prevalence of mild, moderate and severe anemia among these children was 27.4%, 21.9% and 3.2% respectively. GEE model analysis showed that province-level region and severity of maternal anemia affected the severity of childhood anemia not only in 0-5 months but also beyond 5 months. In addition, children aged 0-5 months in families using iron pot (coefficient = -0.26 95%CI -0.41,-0.12) had seldom more severe anemia, and children aged 6-36 months in families more than 4 members (coefficient = -0.03 95%CI -0.06,-0.01) or of Han ethnicity (coefficient = -0.08 95%CI -0.13,-0.04) seldom had more severe anemia but boys (coefficient = 0.03 95%CI 0.01,0.06) or younger children (6-11 month vs 30-36 month: coefficient = 0.23 95%CI 0.17, 0.28; 12-17 month vs 30-36 month: coefficient = 0.19 95%CI 0.15,0.24; 18-23 vs 30-36 month: coefficient = 0.09 95%CI 0.04,0.13) had more severe anemia. CONCLUSION: The prevalence of moderate-to-severe anemia in these children was about 25%. Province-level region, iron pot use, family size, ethnicity, age and gender of children and severity of maternal anemia were important determinants of the severity of childhood anemia. These findings have some important implications for health policy decision for childhood anemia in rural western China.
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- 2013
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15. Care-seeking pattern for diarrhea among children under 36 months old in rural western China.
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Wenlong Gao, Shaonong Dang, Hong Yan, and Duolao Wang
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Medicine ,Science - Abstract
OBJECTIVE: To explore the caretakers' care-seeking pattern and its determinants among children under 36 months old with diarrhea in rural western China. METHODS: The data of 14112 households was collected in 45 counties of 10 provinces of western China from June to August 2005. A generalized estimated equation (GEE) linear model was used to identify the determinants of the care-seeking. RESULTS: Village-level and township-level care were sought for childhood diarrhea by 67.02% of the caretakers. GEE model analysis shows that compared with the caretakers of the children delivered at county-level or above hospitals, those of the children delivered at home seldom sought a higher level care (-0.23, 95%CI: -0.45,-0.01, p = 0.040); that the age of the children was negatively associated with seeking a higher level care (12 vs 36 months: 0.35, 95%CI: 0.16,0.55, p
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- 2012
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16. Applicability and cost-effectiveness of the Systolic Blood Pressure Intervention Trial (SPRINT) in the Chinese population: A cost-effectiveness modeling study
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Victoria Cornelius, Zhenqiang Wu, Duolao Wang, Ewan Tomeny, Tao Chen, Xiaodan Yuan, Yang Wang, Dahai Yu, Rui Qin, Xiaowei Yang, Kangyu Chen, and Chao Li
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Male ,Economics ,Cost effectiveness ,Cost-Benefit Analysis ,Myocardial Infarction ,Social Sciences ,Blood Pressure ,Cardiovascular Medicine ,030204 cardiovascular system & hematology ,Vascular Medicine ,Medical Conditions ,0302 clinical medicine ,Antihypertensive Drug Therapy ,Prevalence ,Medicine and Health Sciences ,030212 general & internal medicine ,Stroke ,11 Medical and Health Sciences ,Aged, 80 and over ,Pharmaceutics ,Incidence ,Incidence (epidemiology) ,Standard treatment ,Drugs ,General Medicine ,Cost-effectiveness analysis ,Middle Aged ,w_20.5 ,Cardiovascular Therapy ,Sprint ,Cardiovascular Diseases ,Hypertension ,wg_120 ,Medicine ,Female ,Life Sciences & Biomedicine ,Research Article ,China ,medicine.medical_specialty ,Cost-Effectiveness Analysis ,Cardiology ,wg_20 ,03 medical and health sciences ,Medicine, General & Internal ,Drug Therapy ,General & Internal Medicine ,Internal medicine ,medicine ,Humans ,Adverse effect ,Antihypertensive Agents ,Aged ,Heart Failure ,Pharmacology ,Science & Technology ,business.industry ,medicine.disease ,R1 ,Economic Analysis ,Blood pressure ,wg_100 ,business ,Antihypertensives - Abstract
Background The Systolic Blood Pressure Intervention Trial (SPRINT) showed significant reductions in death and cardiovascular disease (CVD) risk with a systolic blood pressure (SBP) goal of, Tao Chen and colleagues estimate the cost-effectiveness of intensive blood pressure intervention in Chinese populations at high risk for cardiovascular disease., Author summary Why was this study done? The Systolic Blood Pressure Intervention Trial (SPRINT) has previously demonstrated significant reductions in death and cardiovascular disease (CVD) risk with a systolic blood pressure (SBP) goal of < 120 mm Hg (intensive treatment) compared with a SBP goal of
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- 2021
17. Factors associated with the prevalence of HIV, HSV-2, pregnancy, and reported sexual activity among adolescent girls in rural western Kenya: A cross-sectional analysis of baseline data in a cluster randomized controlled trial
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Daniel Kwaro, Penelope A. Phillips-Howard, Garazi Zulaika, Anna Maria van Eijk, Linda Mason, Samuel Omondi Owino, Elizabeth Nyothach, Emily Kerubo, Duolao Wang, David Obor, Feiko O. ter Kuile, Tao Chen, Valarie Opollo, Isaac Ngere, and Boaz Oyaro
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RNA viruses ,Rural Population ,Pregnancy Rate ,Epidemiology ,Physiology ,Cross-sectional study ,Maternal Health ,Social Sciences ,HIV Infections ,Overweight ,Pathology and Laboratory Medicine ,Adolescents ,Families ,Endocrinology ,Sociology ,Immunodeficiency Viruses ,Pregnancy ,Reproductive Physiology ,Risk Factors ,Medicine and Health Sciences ,Prevalence ,Cluster Analysis ,Children ,Reproductive health ,education.field_of_study ,Schools ,Obstetrics and Gynecology ,General Medicine ,Medical Microbiology ,Herpes Simplex Virus-2 ,HIV epidemiology ,Viral Pathogens ,Viruses ,Cohort ,Menarche ,Medicine ,Female ,Pathogens ,medicine.symptom ,Research Article ,Herpesviruses ,Sociodemographic Factors ,Adolescent ,Sexual Behavior ,Population ,Microbiology ,Education ,Retroviruses ,medicine ,Humans ,education ,Microbial Pathogens ,Menstrual Cycle ,Herpes Genitalis ,Endocrine Physiology ,business.industry ,Lentivirus ,Organisms ,Biology and Life Sciences ,HIV ,medicine.disease ,Kenya ,Herpes Simplex Virus ,Cross-Sectional Studies ,Age Groups ,Adolescent Behavior ,Medical Risk Factors ,Relative risk ,People and Places ,Women's Health ,Population Groupings ,DNA viruses ,business ,Demography - Abstract
Background Adolescence is a sensitive time for girls’ sexual and reproductive health (SRH), as biological changes occur concurrently with heightening pressures for sexual activity. In western Kenya, adolescent girls are vulnerable to acquiring sexually transmitted infections (STIs), such as HIV and herpes simplex virus type 2 (HSV-2), and to becoming pregnant prior to reaching adulthood. This study examines associations between individual, household, and partner-related risk factors and the prevalence of sex, adolescent pregnancy, HIV, and HSV-2. Methods and findings We report baseline findings among 4,138 girls attending secondary school who were enrolled between 2017 and 2018 in the Cups or Cash for Girls (CCG) cluster randomized controlled trial in Siaya County, rural western Kenya. Laboratory confirmed biomarkers and survey data were utilized to assess the effects of girls’ individual, household, and partner characteristics on the main outcome measures (adolescent reported sex, prior pregnancy, HIV, and HSV-2) through generalized linear model (GLM) analysis. Complete data were available for 3,998 girls (97%) with median age 17.1 years (interquartile range [IQR] 16.3 to 18.0 years); 17.2% were HSV-2 seropositive (n = 686) and 1.7% tested positive for HIV (n = 66). Sexual activity was reported by 27.3% girls (n = 1,090), of whom 12.2% had been pregnant (n = 133). After adjustment, orphanhood (adjusted risk ratio [aRR] 2.81, 95% confidence interval [CI] 1.18 to 6.71, p-value [p] = 0.020), low body mass index (BMI) (aRR 2.07; CI: 1.00 to 4.30, p = 0.051), and age (aRR 1.34, 1.18 to 1.53, p < 0.001) were all associated with HIV infection. Girls reporting light menstrual bleeding (aRR 2.42, 1.22 to 4.79, p = 0.012) for fewer than 3 days (aRR 2.81, 1.16 to 6.82, p = 0.023) were over twice as likely to have HIV. Early menarche (aRR 2.05, 1.33 to 3.17, p = 0.001) was associated with adolescent pregnancy and HSV-2–seropositive girls reported higher rates of pregnancy (aRR 1.62, CI: 1.16 to 2.27, p = 0.005). High BMI was associated with HSV-2 (aRR 1.24, 1.05 to 1.46, p = 0.010) and sexual activity (aRR 1.14, 1.02 to 1.28, p = 0.016). High levels of harassment were detected in the cohort (41.2%); being touched indecently conveyed the strongest association related to reported sexual activity (aRR 2.52, 2.26 to 2.81, p < 0.001). Study limitations include the cross-sectional design of the study, which informs on the SRH burdens found in this population but limits causal interpretation of associations, and the self-reported exposure ascertainment, which may have led to possible underreporting of risk factors, most notably prior sexual activity. Conclusions Our findings indicate that adolescent girls attending school in Kenya face frequent harassment for sex and are at high risk of pregnancy and HSV-2, with girls experiencing early menarche particularly vulnerable. Targeted interventions, such as earlier sexual education programs, are warranted to address their vulnerability to SRH harms. Trial registration ClinicalTrials.gov NCT03051789., In a cross sectional analysis, Garazi Zulaika and colleagues study associations between risk factors and prevalence of sexual activity, pregnancy, and HIV and HSV-2 infections among adolescent girls in rural Kenya., Author summary Why was this study done? Girls in low- and middle-income countries (LMICs) face severe health risks from becoming pregnant prior to reaching adulthood and from exposure to sexually transmitted infections (STIs) such as HIV and herpes simplex virus type 2 (HSV-2). Key factors found to be linked to adolescent sexual and reproductive health (SRH) in LMICs include household wealth, age at first sex, and schooling. Evidence of a positive association between girls’ SRH, and their education and economic potential has strengthened international resolve to identify risks and improve conditions that adolescent girls face in these settings. What did the researchers do and find? We collected data from 3,998 girls attending 96 public secondary day schools in 2017 and 2018 as part of the baseline assessment of a randomized controlled study. We explored whether girls’ personal characteristics were associated with SRH harms, namely adolescent sex, early pregnancy, and acquisition of HIV and HSV-2. We found biological factors including girls experiencing early menarche, having lighter periods, and body mass index (BMI); household level factors including being unhappy at home, being orphaned, and coming from poorer households; and social factors including experiencing harassment for sex both in and out of school or being touched indecently were significantly associated with girls’ sexual and reproductive harms, such as pregnancy, HSV-2, and/or HIV. What do these findings mean? These findings illustrate that the burden of SRH harms faced by adolescent girls attending school in rural western Kenya is high. Interventions and programs to improve SRH and continued education need to address both environmental and biological risk factors among vulnerable populations.
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- 2021
18. Geographical variations in maternal dietary patterns during pregnancy associated with birth weight in Shaanxi province, Northwestern China
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Leilei Pei, Yulong Chen, Baibing Mi, Duolao Wang, Yini Liu, Fangyao Chen, Jing Zhou, Yaling Zhao, and Huihui Zhang
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Physiology ,Maternal Health ,Population Dynamics ,Logistic regression ,Fetal Macrosomia ,Families ,0302 clinical medicine ,Pregnancy ,Medicine and Health Sciences ,Birth Weight ,wq_200 ,030212 general & internal medicine ,Children ,education.field_of_study ,Multidisciplinary ,Geography ,Obstetrics and Gynecology ,ws_420 ,Physiological Parameters ,Infant, Small for Gestational Age ,Medicine ,Female ,medicine.symptom ,Infants ,Research Article ,Adult ,China ,Science ,Birth weight ,Population ,Mothers ,030209 endocrinology & metabolism ,wa_310 ,Food Preferences ,03 medical and health sciences ,medicine ,Fetal macrosomia ,Humans ,education ,Nutrition ,Population Biology ,Body Weight ,Biology and Life Sciences ,Infant, Low Birth Weight ,medicine.disease ,Geographic Distribution ,Diet ,Low birth weight ,Food ,Age Groups ,People and Places ,Earth Sciences ,Women's Health ,Small for gestational age ,Population Groupings ,Demography - Abstract
The geographical variation of maternal dietary patterns related to birth outcomes is important for improving the health of mothers and children; however, it is currently unknown. Thus, the objective of the study was to investigate geographical variations of maternal dietary pattern during pregnancy, and evaluate the spatial varying association of maternal dietary patterns in pregnancy with abnormal birth weight. A population-based cross-sectional study was conducted in Shaanxi province in Northwest China in 2013 to evaluate the relationship between abnormal birth weight and dietary pattern using the Geographically Weighted Logistic Regression (GWLR). Three dietary patterns during pregnancy were extracted through factor analysis, explaining approximately 45.8% of the variability of food intake. Approximately 81.6% of mothers with higher scores on the equilibrium pattern was more unlikely to have small for gestational age (SGA) infants, with the lower OR observed in Central and South Shaanxi. The snacks pattern was positively associated with low birth weight (LBW) for 23.2% of participants, with the highest OR in Central Shaanxi. Among about 80.0% of participants with higher scores on the snacks pattern living in South and Central Shaanxi, there was a higher risk for SGA. The OR values tend to descend from South to North Shaanxi. The OR values of the negative association between prudent pattern and LBW decreased from South to North Shaanxi among approximately 59.3% of participants. The prudent pattern was also negatively associated with the increasing risk of fetal macrosomia among 19.2% of participants living mainly in South Shaanxi. The association of maternal dietary patterns during pregnancy with abnormal birth weight varied geographically across Shaanxi province. The findings emphasize the importance of geographical distribution to improve the dietary patterns among disadvantaged pregnant women.
- Published
- 2021
19. Scheduled Intermittent Screening with Rapid Diagnostic Tests and Treatment with Dihydroartemisinin-Piperaquine versus Intermittent Preventive Therapy with Sulfadoxine-Pyrimethamine for Malaria in Pregnancy in Malawi: An Open-Label Randomized Controlled Trial
- Author
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Doreen Ali, Duolao Wang, Kyaw L. Thwai, Brandt Levitt, Steve Meshnick, Mwayiwawo Madanitsa, Steve M. Taylor, Linda Kalilani, Victor Mwapasa, Anna Maria van Eijk, Cheryl Pace, Brian Faragher, James Smedley, Carole Khairallah, Feiko O. ter Kuile, and Arthur R Kang’ombe
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Malawi ,Plasmodium ,medicine.medical_treatment ,Maternal Health ,Biochemistry ,law.invention ,Labor and Delivery ,Families ,0302 clinical medicine ,Dihydroartemisinin/piperaquine ,Randomized controlled trial ,law ,Pregnancy ,Medicine and Health Sciences ,030212 general & internal medicine ,Children ,Protozoans ,Obstetrics ,Malarial Parasites ,Obstetrics and Gynecology ,General Medicine ,Artemisinins ,3. Good health ,Drug Combinations ,Pyrimethamine ,Quinolines ,Medicine ,Female ,Live birth ,Infants ,medicine.drug ,Research Article ,Adult ,medicine.medical_specialty ,wc_20 ,Adolescent ,Sulfadoxine ,030231 tropical medicine ,qv_38 ,qv_34 ,03 medical and health sciences ,Antimalarials ,Young Adult ,Parasite Groups ,parasitic diseases ,medicine ,Parasitic Diseases ,Humans ,Hemoglobin ,Intermittent preventive therapy ,business.industry ,Diagnostic Tests, Routine ,Organisms ,Biology and Life Sciences ,Proteins ,medicine.disease ,Tropical Diseases ,Sulfadoxine/pyrimethamine ,Parasitic Protozoans ,Surgery ,wc_750 ,Malaria ,Age Groups ,Pregnancy Complications, Parasitic ,People and Places ,Birth ,Women's Health ,Parasitology ,Population Groupings ,wq_256 ,business ,Apicomplexa - Abstract
Background In Africa, most plasmodium infections during pregnancy remain asymptomatic, yet are associated with maternal anemia and low birthweight. WHO recommends intermittent preventive therapy in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). However, sulfadoxine-pyrimethamine (SP) efficacy is threatened by high-level parasite resistance. We conducted a trial to evaluate the efficacy and safety of scheduled intermittent screening with malaria rapid diagnostic tests (RDTs) and treatment of RDT-positive women with dihydroartemisinin-piperaquine (DP) as an alternative strategy to IPTp-SP. Methods and Findings This was an open-label, two-arm individually randomized superiority trial among HIV-seronegative women at three sites in Malawi with high SP resistance. The intervention consisted of three or four scheduled visits in the second and third trimester, 4 to 6 wk apart. Women in the IPTp-SP arm received SP at each visit. Women in the intermittent screening and treatment in pregnancy with DP (ISTp-DP) arm were screened for malaria at every visit and treated with DP if RDT-positive. The primary outcomes were adverse live birth outcome (composite of small for gestational age, low birthweight [, In an open-label randomized controlled trial, Feiko O. ter Kuile and colleagues found that ISTp-DP was not superior to IPTp-SP in an area with high malaria transmission and high SP resistance., Author Summary Why Was This Study Done? Malaria infection during the course of pregnancy can have devastating consequences on the mother and unborn child. Intermittent preventive treatment in pregnancy (IPTp) with the antimalarial sulfadoxine-pyrimethamine (SP) is one of the main interventions to protect pregnant women during pregnancy in malaria endemic areas in sub-Saharan Africa. The effectiveness of SP, however, is threatened by increasing resistance of the malaria parasite to this drug in east and southern Africa. We conducted this study to evaluate if an alternative strategy consisting of screening pregnant women for malaria with rapid diagnostic tests at regular intervals during pregnancy and then treating the test-positive women with dihydroartemisinin-piperaquine (DP) would reduce the risk of malaria infection and the adverse consequences to the mother and newborn. This strategy is called intermittent screening and treatment in pregnancy (ISTp). What Did the Researchers Do and Find? Our team conducted a two-arm, open-label trial to compare the effect of the new ISTp with DP (ISTp-DP) strategy against the existing IPTp with SP (IPTp-SP) strategy (the control arm) in 1,873 pregnant women in southern Malawi, where almost all of the malaria parasites were highly resistant to SP. We found that the rate of malaria infection was high in both groups and that the new ISTp-DP strategy was not any better than the existing IPTp-SP strategy in terms of reducing malaria infection or improving pregnancy outcomes; in fact, women in the ISTp-DP arm had more malaria than women in the IPTp-SP arm. What Do These Findings Mean? ISTp-DP with the current generation of rapid diagnostic tests is not a viable alternative strategy to replace IPTp-SP in malaria endemic areas in sub-Saharan Africa, despite the high levels of resistance to SP. IPTp with SP should still be used as one of the interventions against malaria in pregnancy in sub-Saharan Africa. Further studies to explore alternative drugs that can replace SP for IPTp will be required in these areas of high SP resistance.
- Published
- 2016
20. Single Doses up to 800 mg of E-52862 Do Not Prolong the QTc Interval--A Retrospective Validation by Pharmacokinetic-Pharmacodynamic Modelling of Electrocardiography Data Utilising the Effects of a Meal on QTc to Demonstrate ECG Assay Sensitivity
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Duolao Wang, A. John Camm, Jorg Taubel, Georg Ferber, Mariano Sust, and Ulrike Lorch
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Male ,Morpholines ,Analgesic ,lcsh:Medicine ,qv_38 ,Placebo ,QT interval ,law.invention ,qv_95 ,Electrocardiography ,Young Adult ,Double-Blind Method ,Randomized controlled trial ,Pharmacokinetics ,Heart Rate ,law ,qv_771 ,Heart rate ,Humans ,Receptors, sigma ,Medicine ,Dosing ,lcsh:Science ,Retrospective Studies ,Multidisciplinary ,Dose-Response Relationship, Drug ,business.industry ,lcsh:R ,Assay sensitivity ,Anesthesia ,Pyrazoles ,Female ,lcsh:Q ,business ,Research Article - Abstract
Background\ud E-52862 is a Sigma-1 receptor antagonist (S1RA) currently under investigation as a potential analgesic medicine. We successfully applied a concentration-effect model retrospectively to a four-way crossover Phase I single ascending dose study and utilized the QTc shortening effects of a meal to demonstrate assay sensitivity by establishing the time course effects from baseline in all four periods, independently from any potential drug effects.\ud \ud Methods\ud Thirty two healthy male and female subjects were included in four treatment periods to receive single ascending doses of 500 mg, 600 mg or 800 mg of E-52862 or placebo. PK was linear over the dose range investigated and doses up to 600 mg were well tolerated. The baseline electrocardiography (ECG) measurements on Day-1 were time-matched with ECG and pharmacokinetic (PK) samples on Day 1 (dosing day).\ud \ud Results\ud In this conventional mean change to time-matched placebo analysis, the largest time-matched difference to placebo QTcI was 1.44 ms (90% CI: -4.04, 6.93 ms) for 500 mg; -0.39 ms (90% CI: -3.91, 3.13 ms) for 600 mg and 1.32 ms (90% CI: -1.89, 4.53 ms) for 800 mg of E-52862, thereby showing the absence of any QTc prolonging effect at the doses tested. In addition concentration-effect models, one based on the placebo corrected change from baseline and one for the change of QTcI from average baseline with time as fixed effect were fitted to the data confirming the results of the time course analysis.\ud \ud Conclusion\ud The sensitivity of this study to detect small changes in the QTc interval was confirmed by demonstrating a shortening of QTcF of -8.1 (90% CI: -10.4, -5.9) one hour and -7.2 (90% CI: -9.4, -5.0) three hours after a standardised meal.\ud \ud Trial Registration\ud EU Clinical Trials Register EudraCT 2010 020343 13
- Published
- 2015
21. Association between the Infant and Child Feeding Index (ICFI) and nutritional status of 6- to 35-month-old children in rural western China
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Duolao Wang, Hong Yan, Pengfei Qu, Jiaomei Yang, Shaonong Dang, Baibing Mi, Danmeng Liu, and Ruo Zhang
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Male ,Rural Population ,0301 basic medicine ,Pediatrics ,Cross-sectional study ,Maternal Health ,lcsh:Medicine ,Geographical Locations ,Families ,0302 clinical medicine ,Medicine and Health Sciences ,030212 general & internal medicine ,Infant Nutritional Physiological Phenomena ,lcsh:Science ,Children ,Wasting ,Multidisciplinary ,Breast Feeding ,Child, Preschool ,Female ,Infant Food ,Cluster sampling ,medicine.symptom ,Underweight ,Child Nutritional Physiological Phenomena ,Infants ,Research Article ,China ,medicine.medical_specialty ,Asia ,Nutritional Status ,Mothers ,03 medical and health sciences ,medicine ,Humans ,Nutrition ,030109 nutrition & dietetics ,business.industry ,Malnutrition ,lcsh:R ,Infant ,Biology and Life Sciences ,Feeding Behavior ,medicine.disease ,Quantile regression ,Cross-Sectional Studies ,Age Groups ,People and Places ,Women's Health ,Population Groupings ,lcsh:Q ,Neonatology ,business ,Breast feeding ,Demography - Abstract
Background The objective of this study was to determine the relationship between the quality of feeding practices and children’s nutritional status in rural western China. Methods A sample of 12,146 pairs of 6- to 35-month-old children and their mothers were recruited using stratified multistage cluster random sampling in rural western China. Quantile regression was used to analyze the relationship between the Infant and Child Feeding Index (ICFI) and children’s nutritional status. Results In rural western China, 24.37% of all infants and young children suffer from malnutrition. Of this total, 19.57%, 8.74% and 4.63% of infants and children are classified as stunting, underweight and wasting, respectively. After adjusting for covariates, the quantile regression results suggested that qualified ICFI (ICFI > 13.8) was associated with all length and HAZ quantiles (P
- Published
- 2017
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