12,986 results on '"Mika A"'
Search Results
2. Association of alcohol-induced loss of consciousness and overall alcohol consumption with risk for dementia
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Marie Zins, May A. Beydoun, Jane E. Ferrie, Séverine Sabia, Lars Alfredsson, Gill Livingston, Markus Jokela, Pyry N Sipilä, Mika Kivimäki, Solja T. Nyberg, Aki Koskinen, Marcel Goldberg, G. David Batty, Jaana Pentti, Archana Singh-Manoux, Peter Westerholm, Timo E. Strandberg, Anders Knutsson, Sakari Suominen, Jussi Vahtera, Ari Väänänen, Andrew Sommerlad, Joni V Lindbohm, Sarah Floud, Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Department of Psychology and Logopedics, HUS Internal Medicine and Rehabilitation, Timo Strandberg / Principal Investigator, Department of Medicine, and Helsinki University Hospital Area
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Male ,Unconsciousness ,SWEDISH ,Cohort Studies ,0302 clinical medicine ,Risk Factors ,030212 general & internal medicine ,Finland ,Original Investigation ,DAMAGE ,education.field_of_study ,Hazard ratio ,Public Health, Global Health, Social Medicine and Epidemiology ,General Medicine ,Middle Aged ,Alcoholism ,Online Only ,Female ,France ,Public Health ,medicine.symptom ,MIDLIFE ,Cohort study ,Adult ,Adolescent ,Population ,Binge drinking ,03 medical and health sciences ,mental disorders ,medicine ,Dementia ,Humans ,CORONARY-HEART-DISEASE ,Risk factor ,education ,BINGE DRINKING ,METAANALYSIS ,Aged ,Proportional Hazards Models ,Sweden ,DECLINE ,Ethanol ,Proportional hazards model ,business.industry ,Research ,Klinisk medicin ,medicine.disease ,COGNITIVE IMPAIRMENT ,LIFE-STYLE FACTORS ,United Kingdom ,Featured ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,3121 General medicine, internal medicine and other clinical medicine ,Clinical Medicine ,business ,FOLLOW-UP ,030217 neurology & neurosurgery ,Demography - Abstract
Key Points Question Are alcohol-induced loss of consciousness and heavy weekly alcohol consumption associated with increased risk of future dementia? Findings In this multicohort study of 131 415 adults, a 1.2-fold excess risk of dementia was associated with heavy vs moderate alcohol consumption. Those who reported having lost consciousness due to alcohol consumption, regardless of their overall weekly consumption, had a 2-fold increased risk of dementia compared with people who had not lost consciousness and were moderate drinkers. Meaning The findings of this study suggest that alcohol-induced loss of consciousness is a long-term risk factor for dementia among both heavy and moderate drinkers., Importance Evidence on alcohol consumption as a risk factor for dementia usually relates to overall consumption. The role of alcohol-induced loss of consciousness is uncertain. Objective To examine the risk of future dementia associated with overall alcohol consumption and alcohol-induced loss of consciousness in a population of current drinkers. Design, Setting, and Participants Seven cohort studies from the UK, France, Sweden, and Finland (IPD-Work consortium) including 131 415 participants were examined. At baseline (1986-2012), participants were aged 18 to 77 years, reported alcohol consumption, and were free of diagnosed dementia. Dementia was examined during a mean follow-up of 14.4 years (range, 12.3-30.1). Data analysis was conducted from November 17, 2019, to May 23, 2020. Exposures Self-reported overall consumption and loss of consciousness due to alcohol consumption were assessed at baseline. Two thresholds were used to define heavy overall consumption: greater than 14 units (U) (UK definition) and greater than 21 U (US definition) per week. Main Outcomes and Measures Dementia and alcohol-related disorders to 2016 were ascertained from linked electronic health records. Results Of the 131 415 participants (mean [SD] age, 43.0 [10.4] years; 80 344 [61.1%] women), 1081 individuals (0.8%) developed dementia. After adjustment for potential confounders, the hazard ratio (HR) was 1.16 (95% CI, 0.98-1.37) for consuming greater than 14 vs 1 to 14 U of alcohol per week and 1.22 (95% CI, 1.01-1.48) for greater than 21 vs 1 to 21 U/wk. Of the 96 591 participants with data on loss of consciousness, 10 004 individuals (10.4%) reported having lost consciousness due to alcohol consumption in the past 12 months. The association between loss of consciousness and dementia was observed in men (HR, 2.86; 95% CI, 1.77-4.63) and women (HR, 2.09; 95% CI, 1.34-3.25) during the first 10 years of follow-up (HR, 2.72; 95% CI, 1.78-4.15), after excluding the first 10 years of follow-up (HR, 1.86; 95% CI, 1.16-2.99), and for early-onset (, This cohort study examines the association of overall consumption of alcohol and resultant loss of consciousness with risk for dementia.
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- 2023
3. HUBUNGAN PREEKLAMSIA DENGAN KEJADIAN BERAT BADAN LAHIR RENDAH
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Tria Nopi Herdiani, Ratna Susanti, Mika Oktarina, and Ida Rahmawati
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Contingency table ,medicine.medical_specialty ,education.field_of_study ,Eclampsia ,newborns ,business.industry ,Cross-sectional study ,Obstetrics ,Incidence (epidemiology) ,Birth weight ,Population ,medicine.disease ,Preeclampsia ,preeclampsia ,Low birth weight ,Medicine ,low birth weight ,Public Health ,medicine.symptom ,business ,education ,reproductive and urinary physiology - Abstract
Preeclampsia and eclampsia is a complication in the labor process whose incidence is always high. The purpose of this study was to study the relationship between Birth Weight and the incidence of preeclampsia in RSUD dr. M. Yunus, Bengkulu city in 2017. The type of research used in this study is Survey Analytic using the Cross Sectional method. The population in this study was overall in the hospital of Dr. M. Yunus City of Bengkulu in January to December in 2017 which is 362 babies. The sampling technique in this study was 78 proportional sampling. The data used is secondary data obtained from the patient register at Dr. M Yunus Hospital in Bengkulu. Data were analyzed using univariate and bivariate analysis with Chi-Square test (2) and Contingency Coefficient (C) test. The results obtained: Of the 78 newborns sampled there were 60 infants (76.9%) normal birth weight, 55 people (70.5%) did not experience preeclampsia, there was a significant relationship between preeclampsia and low infant weight in RSUD dr. M. Yunus Bengkulu in the tight category. It is expected that health workers can maintain and improve the quality of their abilities and skills to deal with babies with low birth weight born by preeclampsia patients or other patients.
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- 2023
4. Rhabdomyolysis Caused by Gefitinib Overdose
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Koichiro Asano, Jun Tanaka, Kyoko Niimi, Tsuyoshi Oguma, Shohei Obayashi, Katsuyoshi Tomomatsu, Naoki Hayama, Mika Urata, and Yoko Ito
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Lung Neoplasms ,Antineoplastic Agents ,Rhabdomyolysis ,Egfr tki ,Gefitinib ,Carcinoma, Non-Small-Cell Lung ,Rare case ,Internal Medicine ,Humans ,Medicine ,Epidermal growth factor receptor ,Lung cancer ,Protein Kinase Inhibitors ,biology ,business.industry ,General Medicine ,medicine.disease ,respiratory tract diseases ,ErbB Receptors ,Mutation ,Quinazolines ,Cancer research ,biology.protein ,business ,Tyrosine kinase ,medicine.drug - Abstract
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are common therapeutic agents for EGFR mutation-positive advanced non-small-cell lung cancer. There has been no report of rhabdomyolysis caused by an overdose of EGFR-TKIs. We herein review the existing literature on the subject and report a rare case of rhabdomyolysis due to an overdose of gefitinib, an EGFR-TKI.
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- 2022
5. A Young Patient with Microscopic Polyangiitis Requiring Hemodialysis with Complications of Repeated Episodes of Posterior Reversible Encephalopathy Syndrome Probably Due to Different Etiologies
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Shigeyuki Arai, Mika Kawagoe, Yoshifuru Tamura, Yoshihide Fujigaki, Shinichiro Asakawa, Hiroshi Murata, Shigeru Shibata, Wataru Ono, Shunya Uchida, and Chiaki Ohata
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Nausea ,medicine.medical_treatment ,Microscopic Polyangiitis ,Renal Dialysis ,Vertigo ,Internal Medicine ,medicine ,Humans ,Dialysis ,biology ,business.industry ,Posterior reversible encephalopathy syndrome ,General Medicine ,biology.organism_classification ,medicine.disease ,Blood pressure ,Anesthesia ,Hypertension ,Female ,Rituximab ,Posterior Leukoencephalopathy Syndrome ,Hemodialysis ,medicine.symptom ,Microscopic polyangiitis ,business ,medicine.drug - Abstract
A young woman with microscopic polyangiitis (MPA) requiring hemodialysis showed repeated posterior reversible encephalopathy syndrome (PRES) with spatiotemporal multiple lesions over a period of two months. The first PRES episode with confusion and the second PRES episode with vertigo and nausea were caused by MPA, hypertension and renal failure. These symptoms were improved by the reinforcement of MPA treatment and blood pressure management. The third PRES episode with nausea, headache, seizure and visual changes was induced by rituximab infusion and hypertension. The PRES was improved with blood pressure and convulsant management. These conditions are challenging to diagnose and treat.
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- 2022
6. A Resuscitated Case of Acute Myocardial Infarction with both Familial Hypercholesterolemia Phenotype Caused by Possibly Oligogenic Variants of the PCSK9 and ABCG5 Genes and Type I CD36 Deficiency
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Ryosuke Ito, Mika Hori, Masahiro Koseki, Tetsuji Miura, Takeshi Kujiraoka, Hiroaki Hattori, Ryo Nishikawa, Takeshi Okada, Atsuko Muranaka, Mariko Harada-Shiba, Masato Furuhashi, Masatsune Ogura, and Nobuaki Kokubu
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Proband ,medicine.medical_specialty ,Mutation ,biology ,business.industry ,PCSK9 ,Biochemistry (medical) ,Familial hypercholesterolemia ,030204 cardiovascular system & hematology ,medicine.disease_cause ,medicine.disease ,Phenotype ,Gene product ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Internal medicine ,Internal Medicine ,medicine ,ABCG5 ,biology.protein ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
A 56-year-old postmenopausal woman with out-of-hospital cardiac arrest caused by acute myocardial infraction was successfully resuscitated by intensive treatments and recovered without any neurological disability. She was diagnosed as having familial hypercholesterolemia (FH) based on a markedly elevated low-density lipoprotein cholesterol (LDL-C) level and family history of premature coronary artery disease. Genetic testing in her family members showed that a variant of the proprotein convertase subtilisin/kexin type 9 (PCSK9) gene (c.2004C>A, p.S668R), which had been previously reported as having uncertain significance, was associated with FH, indicating that the variant is a potential candidate for the FH phenotype. Next-generation sequencing analysis for the proband also showed that there was a heterozygous mutation of the ATP-binding cassette sub-family G member 5 (ABCG5) gene (c.1166G>A, R389H), which has been reported to increase LDL-C level and the risk of cardiovascular disease. She was also diagnosed as having type 1 CD36 deficiency based on a lack of myocardial uptake of 123 I-labeled 15-(p-iodophenyl)-3-R,S-methyl-pentadecanoic acid in scintigraphy and the absence of CD36 antigen in both monocytes and platelets in flow cytometry. She had a homozygous mutation of the CD36 gene (c.1126-5_1127delTTTAGAT), which occurs in a canonical splice site (acceptor) and is predicted to disrupt or distort the normal gene product. To our knowledge, this is the first report of a heterozygous FH phenotype caused by possibly oligogenic variants of the PCSK9 and ABCG5 genes complicated with type I CD36 deficiency caused by a novel homozygous mutation. Both FH phenotype and CD36 deficiency might have caused extensive atherosclerosis, leading to acute myocardial infarction in the present case.
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- 2022
7. Enhanced loading dose of teicoplanin for three days is required to achieve a target trough concentration of 20 μg/mL in patients receiving continuous venovenous haemodiafiltration with a low flow rate
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Mika Ishihara, Hiroki Ikeuchi, Kaoru Ichiki, Yoshiko Takahashi, Kaori Ishikawa, Shinichi Nishi, Takashi Ueda, Motoi Uchino, Takeshi Ide, Naruhito Otani, Kumiko Yamada, Yoshio Takesue, Shingo Takubo, Takeshi Kimura, Toshie Tsuchida, Kazuhiko Nakajima, and Kenta Takeda
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Methicillin-Resistant Staphylococcus aureus ,Microbiology (medical) ,Continuous Renal Replacement Therapy ,medicine.diagnostic_test ,Teicoplanin ,business.industry ,Staphylococcal Infections ,Lower risk ,Loading dose ,Anti-Bacterial Agents ,Regimen ,Cmin ,Infectious Diseases ,Therapeutic drug monitoring ,Anesthesia ,medicine ,Humans ,Vancomycin ,Pharmacology (medical) ,Trough Concentration ,business ,medicine.drug - Abstract
Introduction Because of its lower risk of renal toxicity than vancomycin, teicoplanin is the preferred treatment for methicillin-resistant Staphylococcus aureus infection in patients undergoing continuous venovenous haemodiafiltration (CVVHDF) in whom renal function is expected to recover. The dosing regimen for achieving a trough concentration (Cmin) of ≥20 μg/mL remains unclear in patients on CVVHDF using the low flow rate adopted in Japan. Methods The study was conducted in patients undergoing CVVHDF with a flow rate of Results Overall, 60 patients were eligible for study inclusion. The proportion of patients achieving the Cmin target was significantly higher for the enhanced regimen than for the high-dose regimen (52.9% versus 8.3%, p = 0.003). In multivariate analysis, the enhanced regimen (odds ratio [OR] = 39.93, 95% confidence interval [CI] = 5.03–317.17) and hypoalbuminaemia (OR = 0.04, 95% CI = 0.01–0.44) were independent predictors of the achievement of Cmin ≥ 20 μg/mL. Conclusions An enhanced teicoplanin regimen was proposed to treat complicated or invasive infections by methicillin-resistant Staphylococcus aureus in patients receiving CVVHDF even with a low flow rate.
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- 2022
8. Does Urinary Catheterization Affect the Quality of Death in Patients with Advanced Cancer? A Secondary Analysis of a Multicenter Prospective Cohort Study
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Takahiro, Higashibata, Jun, Hamano, Takayuki, Hisanaga, Shingo, Hagiwara, Miho, Shimokawa, Ritsuko, Yabuki, Naosuke, Yokomichi, Junichi, Shimoinaba, Rena, Kamura, Mika, Baba, Hiromi, Funaki, Masanori, Mori, Tatsuya, Morita, Satoru, Tsuneto, Yoshiyuki, Kizawa, and Hiroyuki, Otani
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medicine.medical_specialty ,Palliative care ,medicine.medical_treatment ,Urinary system ,Population ,Urinary incontinence ,Urinary catheterization ,Neoplasms ,Humans ,Medicine ,Prospective Studies ,Prospective cohort study ,education ,General Nursing ,education.field_of_study ,business.industry ,Palliative Care ,General Medicine ,Hospitalization ,Clinical trial ,Anesthesiology and Pain Medicine ,Emergency medicine ,Propensity score matching ,Female ,medicine.symptom ,Urinary Catheterization ,business - Abstract
Background: Patients with life-limiting illnesses frequently experience urinary difficulties, and urinary catheterization is one of the interventions for managing them. However, evidence supporting the effects of urinary catheters on the quality of death (QoD) is lacking in this population. Objectives: To investigate whether urinary catheterization affects QoD in patients with advanced cancer in palliative care units. Design: A secondary analysis of a multicenter, prospective cohort study. Setting/Subjects: The study enrolled consecutive patients with advanced cancer admitted to palliative care units in Japan between January and December 2017. Those who were not catheterized on admission and who died while in a palliative care unit were analyzed. Measurements: QoD was evaluated at death using the Good Death Scale (GDS). Results: Of 885 patients, 297 (33.6%) were catheterized during their palliative care unit stay. Females and patients with a long palliative care unit stay were more likely to be catheterized. In inverse probability-weighted propensity score analysis, patients with urinary catheterization during their palliative care unit stay had higher total GDS scores than those without catheterization (coefficient 0.410, 95% confidence interval 0.068-0.752). In subgroup analyses stratified by sex, age, and length of palliative care unit stay, urinary catheterization was associated with higher total GDS scores in patients younger than 65 years of age and those who died after a palliative care unit stay of 21 days or fewer. Conclusions: This study suggested that urinary catheterization during a palliative care unit stay may have a positive impact on overall QoD in patients with advanced cancer. This study was registered in the UMIN Clinical Trials Registry (UMIN000025457).
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- 2022
9. Anatomic Risk Factors for S1 Segment Superior Cerebellar Artery Aneurysm Rupture: A Radiologic Study on 81 Consecutive Patients
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Danil A. Kozyrev, Sajjad Muhammad, Hanna Kaukovalta, Daniel Hänggi, Felix Goehre, Riku Kivisaari, Ferzat Hijazy, Christoph Schwartz, Mika Niemelä, and Behnam Rezai Jahromi
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medicine.medical_specialty ,Subarachnoid hemorrhage ,Aneurysm, Ruptured ,030218 nuclear medicine & medical imaging ,Aneurysm rupture ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Risk Factors ,medicine.artery ,medicine ,Basilar artery ,Humans ,cardiovascular diseases ,Superior cerebellar artery ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Intracranial Aneurysm ,medicine.disease ,University hospital ,Cerebral Angiography ,Basilar Artery ,Radiological weapon ,Angiography ,cardiovascular system ,Surgery ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery - Abstract
Due to treatment associated risks, it is still debatable which unruptured aneurysm should be treated. Anatomic and morphologic characteristics may aid to predict the rupture risk of superior cerebellar artery (SCA) aneurysm and possibly support in decision- making during treatment.To identify morphologic characteristics that could predict the rupture of SCA aneurysms.A retrospective analysis of computed tomography angiography images of 81 consecutive patients harboring SCA aneurysm who were treated between 1980 to 2014 at Helsinki University Hospital was performed.Of the 81 analyzed SCA aneurysms, 30 (37%) were unruptured and remaining 51 (63%) presented with subarachnoid hemorrhage. The mean ± SD size of unruptured SCA aneurysms was 6.2 ± 6.3 mm; mean size of ruptured SCA aneurysms was 5.9 ± 5.4 mm. The mean ± SD aspect ratio was 0.9 ± 0.3 in unruptured and 1.14 ± 0.44 in ruptured SCA aneurysms. The mean ± SD degree angle between basilar artery and aneurysm was 74.7 ± 24.4 in unruptured and 65.9 ± 23 ruptured SCA aneurysms. Patients with ruptured SCA aneurysm showed significantly higher aspect ratio (Mann-Whitney U, P = 0.01) and smaller aneurysm to basilar artery angle (Mann-Whitney U, P = 0.039). Aspect ratio1.1 had 2.3 times higher risk of rupture (odds ration [OR] 2.3, 95% confidence interval [CI] 0.84-6.34). An aneurysm to basilar angle70 degrees had 2.8 times higher risk of rupture (OR 2.75, 95% CI 1.086-6.96).Ruptured SCA aneurysms are usually small in size. Higher aspect ratio and smaller angle between SCA aneurysm and basilar artery had significantly higher risk of SCA (S1 segment) aneurysm rupture.
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- 2022
10. The methods and use of questionnaires for the diagnosis of dental phobia by Japanese dental practitioners specializing in special needs dentistry and dental anesthesiology: a cross-sectional study
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Mika Ogawa, Takao Ayuse, Terumi Ayuse, Toshiaki Fujisawa, and Shuntaro Sato
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Male ,medicine.medical_specialty ,Cross-sectional study ,Dentists ,Special needs dentistry ,Special needs ,Dental Phobia ,Professional Role ,Japan ,Anesthesiology ,Surveys and Questionnaires ,Dental Anxiety ,medicine ,Humans ,General Dentistry ,business.industry ,Questionnaire ,Dental practitioner ,Dental phobia ,RK1-715 ,stomatognathic diseases ,Cross-Sectional Studies ,Family medicine ,Dentistry ,business ,Dental anesthesiology - Abstract
Background: Dental phobia is covered by medical insurance; however, the diagnostic methods are not standardized in Japan. Therefore, the aim of this study was to investigate the methods and use of questionnaires for the diagnosis of dental phobia by Japanese dental practitioners specializing in special needs dentistry and dental anesthesiology. Methods: We conducted an online survey to obtain information from the members of the Japanese Society for Disability and Oral Health (JSDH, n = 5134) and the Japanese Dental Society of Anesthesiology (JDSA, n = 2759). Response items included gender, qualification, affiliation type, methods of diagnosis and management of dental phobia, use of questionnaire, need to establish standardized diagnostic method for dental phobia, and others. The chi-squared test was used to compare answers between the three groups: JSDH only, JDSA only, and both JSDH and JDSA. Multiple logistic regression analysis was conducted to identify factors associated with the use of an assessment questionnaire. Results: Data were obtained from 614 practitioners (JSDH only, n = 329; JDSA only, n = 195; both JSDH and JDSA: n = 90, response rate: 7.8% [614/7,893], men: n = 364 [58.5%]). Only 9.7% of practitioners used questionnaires to quantify the level of dental anxiety. The members of both JSDH and JDSA group used questionnaires more frequently than members of the JSDH only (19% and 7.1%, respectively; Bonferroni corrected p, BMC Oral Health, 22, art. no. 38; 2022
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- 2022
11. Origins of bloodstream infections following fecal microbiota transplantation: a strain-level analysis
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Joshua A Fein, David Bomze, Arnon Nagler, Adi Eshel, Roni Shouval, Mika Geva, Omry Koren, Ivetta Danylesko, Avichai Shimoni, Tsila Zuckerman, Israel Henig, Ilan Youngster, and Itai Sharon
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High rate ,biology ,Pseudomonas aeruginosa ,business.industry ,Microbiota ,Strain (biology) ,Graft vs Host Disease ,Bacteremia ,Hematology ,Fecal bacteriotherapy ,Fecal Microbiota Transplantation ,Bacterial translocation ,biology.organism_classification ,medicine.disease_cause ,Microbiology ,Acinetobacter baumannii ,Immunocompromised Host ,medicine ,Humans ,business ,Escherichia coli ,Enterococcus faecium - Abstract
We observed high rates of bloodstream infections (BSIs) following fecal microbiota transplantation (FMT) for graft-versus-host-disease (33 events in 22 patients). To trace the BSIs' origin, we applied a metagenomic bioinformatic pipeline screening donor and recipient stool samples for bacteremia-causing strains in 13 cases. Offending strains were not detected in FMT donations. Enterococcus faecium, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii could be detected in stool samples before emerging in the blood. In this largest report of BSIs post-FMT, we present an approach that may be applicable for evaluating BSI origin following microbiota-based interventions. Our findings support FMT safety in immunocompromised patients but do not rule out FMT as an inducer of bacterial translocation.
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- 2022
12. Environmental performance of dewatered sewage sludge digestate utilization based on life cycle assessment
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Petteri Peltola, Ali Saud, Jouni Havukainen, Mika Horttanainen, and Thomas Fruergaard Astrup
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Combustion ,Sewage ,Life Cycle Assessment ,Animals ,media_common.cataloged_instance ,SDG 7 - Affordable and Clean Energy ,Cities ,European union ,Sewage sludge ,Waste Management and Disposal ,Life-cycle assessment ,media_common ,Life Cycle Stages ,Waste management ,business.industry ,Composting ,Anaerobic digestion ,Digestate ,Environmental science ,Arable land ,SDG 12 - Responsible Consumption and Production ,business ,Pyrolysis - Abstract
Due to the global trend of urbanization, the amount of sewage water is increasing in cities. This calls for efficient treatment of the resulting sewage sludge. To date, in the 27 European Union member countries (EU-27), the prevailing treatment method is application on arable land. Anaerobic digestion is one of the treatment methods being increasingly used nowadays. However, the resulting digestate requires further utilization. Therefore, in this study, the environmental performance of composting, combustion, and pyrolysis options for dewatered sewage sludge digestate is evaluated based on a life cycle assessment. The results show that digestate combustion and composting performed better than pyrolysis for most of the selected impact categories. However, pyrolysis of sewage sludge is still under development, and there are, to some degree, uncertainties in the data related to this technology; thus, more information for the performance assessment of pyrolysis is still required.
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- 2022
13. Effects of different surgical procedures for meniscus injury on two-year clinical and radiological outcomes after anterior cruciate ligament reconstructions. -TMDU MAKS study
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Tomoyuki Mochizuki, Shinichi Shirasawa, Toshifumi Watanabe, Hiroko Ueki, Mindae Kim, Daisuke Hatsushika, Hiroki Katagiri, Shingo Fukagawa, Masaaki Isono, Koji Asano, Masayuki Shimaya, Tadanori Shimizu, Katsuaki Yanagisawa, Yusuke Nakagawa, Kanehiro Hiyama, Toru Takahashi, Tomohiko Tateishi, Jun Kitahama, Shinpei Kondo, Hideyuki Koga, Tsuyoshi Nagase, Jae-Sung An, Kenta Katagiri, Takashi Hoshino, Jyu Neishin, Kei Inomata, Takeshi Muneta, Masafumi Horie, Masaya Hayashi, Etsuko Matsumura, Naoko Araya, Ryusuke Saito, Takashi Ogiuchi, Mai Katakura, Akiho Hoshino, Ichiro Sekiya, Koji Otabe, Mari Uomizu, Hideya Yoshimura, Toshiyuki Ohara, Masaki Amemiya, Kazumasa Kawata, Kaori Nakamura, Mika Yamaga, Aritoshi Yoshihara, Mio Udo, Arata Yuki, and Enichi Nakatsuru
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medicine.medical_specialty ,Anterior cruciate ligament ,Osteoarthritis ,Meniscus (anatomy) ,Lachman test ,Menisci, Tibial ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Meniscus ,Orthopedics and Sports Medicine ,030222 orthopedics ,Anterior Cruciate Ligament Reconstruction ,business.industry ,Anterior Cruciate Ligament Injuries ,Pivot-shift test ,musculoskeletal system ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Radiological weapon ,business ,Medial meniscus ,030217 neurology & neurosurgery ,Cohort study - Abstract
Background The treatment of meniscus injuries combined with anterior cruciate ligament (ACL) reconstruction would be important to improve outcomes after ACL reconstruction. However, the effects of treatment methods for meniscus after ACL reconstruction have not been thoroughly investigated. The objective of this study was to investigate the effects of treatment methods for meniscus on clinical and radiological outcomes at 2 years after ACL reconstruction. Methods Three-hundred and eighteen patients with primary ACL reconstruction using autologous hamstring tendon registered in our multicenter study database and who were followed up for 2 years were included. They were then divided into 3 groups, the no meniscal lesion/untreated group (n = 149), the meniscal repair group (n = 139), and the meniscal resection group (n = 30). Patient-based subjective evaluations (Lysholm score, Knee injury and Osteoarthritis Outcome score and International Knee Documentation Committee subjective score), objective evaluations (Lachman test, pivot shift test and KT measurement), and radiological measurements (medial and lateral joint space width) were compared among the 3 groups preoperatively and at 2 years follow-up. Results All subjective scores and objective evaluations significantly improved in all groups without significant differences among the groups postoperatively. Regarding radiological findings, the medial joint space width significantly decreased only in the resection group during the 2-year period, and the medial joint space width in the resection group was significantly smaller than that of the other groups at the 2-year follow-up. Moreover, the medial joint space width significantly decreased during the 2-year period when MM was resected. Conclusions In radiological findings, medial meniscus resection decreased medial joint space width two years after ACL reconstruction. On the other hand, treatment methods for meniscus neither significantly affected subjective nor objective findings until the 2-year follow-up. Level of evidence Ⅱ, Cohort study.
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- 2022
14. Serum free fatty acid levels and insulin resistance in patients undergoing one-anastomosis gastric bypass
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Adriana Mika, Maciej Sledzinski, Monika Proczko-Stepaniak, and Ivan Liakh
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Serum free fatty acid ,medicine.medical_specialty ,business.industry ,Urology ,Gastric bypass ,Gastroenterology ,Obstetrics and Gynecology ,Anastomosis ,medicine.disease ,Insulin resistance ,Internal medicine ,Medicine ,Glucose homeostasis ,Surgery ,In patient ,business - Abstract
One anastomosis gastric bypass (OAGB) leads to improvement in glucose homeostasis; however, the mechanism of this beneficial effect is not fully understood. Increased serum free fatty acid (FFA) concentrations in obese subjects contribute to the development of insulin resistance and type 2 diabetes.The authors hypothesized that improvement in glucose homeostasis after OAGB may be associated with a decrease in FFA concentration.Serum FFA levels were measured by gas chromatography-mass spectrometry before and 3 months after OAGB and, for comparison, in patients who underwent laparoscopic sleeve gastrectomy (LSG). Serum insulin was assayed by immunoenzymatic method, and other parameters by standard laboratory methods.OAGB resulted in a large decrease in FFA levels and great improvement in insulin sensitivity. These effects in patients after LSG were less prominent.Results suggest that decreased serum FFA levels after OAGB contribute to resolution of insulin sensitivity after this type of bariatric surgery.
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- 2022
15. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019
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Reitsma, Marissa B., Kendrick, Parkes J., Ababneh, Emad, Abbafati, Cristiana, Abbasi-Kangevari, Mohsen, Abdoli, Amir, Abedi, Aidin, Abhilash, E.S., Abila, Derrick Bary, Aboyans, Victor, Abu-Rmeileh, Niveen M.E., Adebayo, Oladimeji M., Advani, Shailesh M., Aghaali, Mohammad, Ahinkorah, Bright Opoku, Ahmad, Sohail, Ahmadi, Keivan, Ahmed, Haroon, Aji, Budi, Akunna, Chisom Joyqueenet, Al-Aly, Ziyad, Alanzi, Turki M., Alhabib, Khalid F., Ali, Liaqat, Alif, Sheikh Mohammad, Alipour, Vahid, Aljunid, Syed Mohamed, Alla, François, Allebeck, Peter, Alvis-Guzman, Nelson, Amin, Tarek Tawfik, Amini, Saeed, Amu, Hubert, Amul, Gianna Gayle Herrera, Ancuceanu, Robert, Anderson, Jason A., Ansari-Moghaddam, Alireza, Antonio, Carl Abelardo T., Antony, Benny, Anvari, Davood, Arabloo, Jalal, Arian, Nicholas D., Arora, Monika, Asaad, Malke, Ausloos, Marcel, Awan, Asma Tahir, Ayano, Getinet, Aynalem, Getie Lake, Azari, Samad, B, Darshan B., Badiye, Ashish D., Baig, Atif Amin, Bakhshaei, Mohammad Hossein, Banach, Maciej, Banik, Palash Chandra, Barker-Collo, Suzanne Lyn, Bärnighausen, Till Winfried, Barqawi, Hiba Jawdat, Basu, Sanjay, Bayati, Mohsen, Bazargan-Hejazi, Shahrzad, Behzadifar, Masoud, Bekuma, Tariku Tesfaye, Bennett, Derrick A., Bensenor, Isabela M., Berfield, Kathleen S. Sachiko, Bhagavathula, Akshaya Srikanth, Bhardwaj, Nikha, Bhardwaj, Pankaj, Bhattacharyya, Krittika, Bibi, Sadia, Bijani, Ali, Bintoro, Bagas Suryo, Biondi, Antonio, Birara, Setognal, Braithwaite, Dejana, Brenner, Hermann, Brunoni, Andre R., Burkart, Katrin, Butt, Zahid A., Caetano dos Santos, Florentino Luciano, Cámera, Luis Alberto, Car, Josip, Cárdenas, Rosario, Carreras, Giulia, Carrero, Juan J., Castaldelli-Maia, Joao Mauricio, Cattaruzza, Maria Sofia Sofia, Chang, Jung-Chen, Chen, Simiao, Chu, Dinh-Toi, Chung, Sheng-Chia, Cirillo, Massimo, Costa, Vera Marisa, Couto, Rosa A.S., Dadras, Omid, Dai, Xiaochen, Damasceno, Albertino Antonio Moura, Damiani, Giovanni, Dandona, Lalit, Dandona, Rakhi, Daneshpajouhnejad, Parnaz, Darega Gela, Jiregna, Davletov, Kairat, Derbew Molla, Meseret, Dessie, Getenet Ayalew, Desta, Abebaw Alemayehu, Dharmaratne, Samath Dhamminda, Dianatinasab, Mostafa, Diaz, Daniel, Do, Hoa Thi, Douiri, Abdel, Duncan, Bruce B., Duraes, Andre Rodrigues, Eagan, Arielle Wilder, Ebrahimi Kalan, Mohammad, Edvardsson, Kristina, Elbarazi, Iffat, El Tantawi, Maha, Esmaeilnejad, Saman, Fadhil, Ibtihal, Faraon, Emerito Jose A., Farinha, Carla Sofia e Sá, Farwati, Medhat, Farzadfar, Farshad, Fazlzadeh, Mehdi, Feigin, Valery L., Feldman, Rachel, Fernandez Prendes, Carlota, Ferrara, Pietro, Filip, Irina, Filippidis, Filippos, Fischer, Florian, Flor, Luisa Sorio, Foigt, Nataliya A., Folayan, Morenike Oluwatoyin, Foroutan, Masoud, Gad, Mohamed M., Gaidhane, Abhay Motiramji, Gallus, Silvano, Geberemariyam, Biniyam Sahiledengle, Ghafourifard, Mansour, Ghajar, Alireza, Ghashghaee, Ahmad, Giampaoli, Simona, Gill, Paramjit Singh, Glozah, Franklin N., Gnedovskaya, Elena V., Golechha, Mahaveer, Gopalani, Sameer Vali, Gorini, Giuseppe, Goudarzi, Houman, Goulart, Alessandra C., Greaves, Felix, Guha, Avirup, Guo, Yuming, Gupta, Bhawna, Gupta, Rajat Das, Gupta, Rajeev, Gupta, Tarun, Gupta, Vin, Hafezi-Nejad, Nima, Haider, Mohammad Rifat, Hamadeh, Randah R., Hankey, Graeme J., Hargono, Arief, Hartono, Risky Kusuma, Hassankhani, Hadi, Hay, Simon I., Heidari, Golnaz, Herteliu, Claudiu, Hezam, Kamal, Hird, Thomas R., Hole, Michael K., Holla, Ramesh, Hosseinzadeh, Mehdi, Hostiuc, Sorin, Househ, Mowafa, Hsiao, Thomas, Huang, Junjie, Iannucci, Vincent C., Ibitoye, Segun Emmanuel, Idrisov, Bulat, Ilesanmi, Olayinka Stephen, Ilic, Irena M., Ilic, Milena D., Inbaraj, Leeberk Raja, Irvani, Seyed Sina Naghibi, Islam, Jessica Y., Islam, Rakibul M., Islam, Sheikh Mohammed Shariful, Islami, Farhad, Iso, Hiroyasu, Itumalla, Ramaiah, Iwagami, Masao, Jaafari, Jalil, Jain, Vardhmaan, Jakovljevic, Mihajlo, Jang, Sung-In, Janjani, Hosna, Jayaram, Shubha, Jeemon, Panniyammakal, Jha, Ravi Prakash, Jonas, Jost B., Joo, Tamas, Jürisson, Mikk, Kabir, Ali, Kabir, Zubair, Kalankesh, Leila R., Kanchan, Tanuj, Kandel, Himal, Kapoor, Neeti, Karimi, Salah Eddin, Katikireddi, rinivasa Vittal, Kebede, Hafte Kahsay, Kelkay, Bayew, Kennedy, Ryan David, Khoja, Abdullah T., Khubchandani, Jagdish, Kim, Gyu Ri, Kim, Young-Eun, Kimokoti, Ruth W., Kivimäki, Mika, Kosen, Soewarta, Koulmane Laxminarayana, Sindhura Lakshmi, Koyanagi, Ai, Krishan, Kewal, Kugbey, Nuworza, Kumar, G. Anil, Kumar, Nithin, Kurmi, Om P., Kusuma, Dian, Lacey, Ben, Lam, Jennifer O., Landires, Iván, Lasrado, Savita, Lauriola, Paolo, Lee, Doo Woong, Lee, Yo Han, Leung, Janni, Li, Shanshan, Lin, Hualiang, Linn, Shai, Liu, Wei, Lopez, Alan D., Lopukhov, Platon D., Lorkowski, Stefan, Lugo, Alessandra, Majeed, Azeem, Maleki, Afshin, Malekzadeh, Reza, Malta, Deborah Carvalho, Mamun, Abdullah A., Manjunatha, Narayana, Mansouri, Borhan, Mansournia, Mohammad Ali, Martinez-Raga, Jose, Martini, Santi, Mathur, Manu Raj, Medina-Solís, Carlo Eduardo, Mehata, Suresh, Mendoza, Walter, Menezes, Ritesh G., Meretoja, Atte, Meretoja, Tuomo J., Miazgowski, Bartosz, Michalek, Irmina Maria, Miller, Ted R., Mirrakhimov, Erkin M., Mirzaei, Hamed, Mirzaei-Alavijeh, Mehdi, Misra, Sanjeev, Moghadaszadeh, Masoud, Mohammad, Yousef, Mohammadian-Hafshejani, Abdollah, Mohammed, Shafiu, Mokdad, Ali H., Monasta, Lorenzo, Moni, Mohammad Ali, Moradi, Ghobad, Moradi-Lakeh, Maziar, Moradzadeh, Rahmatollah, Morrison, Shane Douglas, Mossie, Tilahun Belete, Mubarik, Sumaira, Mullany, Erin C., Murray, Christopher J.L., Naghavi, Mohsen, Naghshtabrizi, Behshad, Nair, Sanjeev, Nalini, Mahdi, Nangia, Vinay, Naqvi, Atta Abbas, Narasimha Swamy, Sreenivas, Naveed, Muhammad, Nayak, Smitha, Nayak, Vinod C., Nazari, Javad, Nduaguba, Sabina O., Neupane Kandel, Sandhya, Nguyen, Cuong Tat, Nguyen, Huong Lan Thi, Nguyen, Son Hoang, Nguyen, Trang Huyen, Nixon, Molly R., Nnaji, Chukwudi A., Norrving, Bo, Noubiap, Jean Jacques, Nowak, Christoph, Ogbo, Felix Akpojene, Oguntade, Ayodipupo Sikiru, Oh, In-Hwan, Olagunju, Andrew T., Oren, Eyal, Otstavnov, Nikita, Otstavnov, Stanislav S., Owolabi, Mayowa O., P A, Mahesh, Pakhale, Smita, Pakshir, Keyvan, Palladino, Raffaele, Pan, Liping, Pana, Adrian, Panda-Jonas, Songhomitra, Pandey, Ashok, Parekh, Utsav, Park, Eun-Cheol, Park, Eun-Kee, Pashazadeh Kan, Fatemeh, Patton, George C., Pawar, Shrikant, Pestell, Richard G., Pinheiro, Marina, Piradov, Michael A., Pirouzpanah, Saeed, Pokhrel, Khem Narayan, Polibin, Roman V., Prashant, Akila, Pribadi, Dimas Ria Angga, Radfar, Amir, Rahimi-Movaghar, Vafa, Rahman, Azizur, Rahman, Mohammad Hifz Ur, Rahman, Muhammad Aziz, Rahmani, Amir Masoud, Rajai, Nazanin, Ram, Pradhum, Ranabhat, Chhabi Lal, Rathi, Priya, Rawal, Lal, Renzaho, Andre M.N., Reynales-Shigematsu, Luz Myriam, Rezapour, Aziz, Riahi, Seyed Mohammad, Riaz, Mavra A., Roever, Leonardo, Ronfani, Luca, Roshandel, Gholamreza, Roy, Ambuj, Roy, Bedanta, Sacco, Simona, Saddik, Basema, Sahebkar, Amirhossein, Salehi, Sana, Salimzadeh, Hamideh, Samaei, Mehrnoosh, Samy, Abdallah M., Santos, Itamar S., Santric-Milicevic, Milena M., Sarrafzadegan, Nizal, Sathian, Brijesh, Sawhney, Monika, Saylan, Mete, Schaub, Michael P., Schmidt, Maria Inês, Schneider, Ione Jayce Ceola, Schutte, Aletta Elisabeth, Schwendicke, Falk, Seidu, Abdul-Aziz, Senthil Kumar, Nachimuthu, Sepanlou, Sadaf G., Seylani, Allen, Shafaat, Omid, Shah, Syed Mahboob, Shaikh, Masood Ali, Shalash, Ali S., Shannawaz, Mohammed, Sharafi, Kiomars, Sheikh, Aziz, Sheikhbahaei, Sara, Shigematsu, Mika, Shiri, Rahman, Shishani, Kawkab, Shivakumar, K.M., Shivalli, Siddharudha, Shrestha, Roman, Siabani, Soraya, Sidemo, Negussie Boti, Sigfusdottir, Inga Dora, Sigurvinsdottir, Rannveig, Silva, Diego Augusto Santos, Silva, João Pedro, Singh, Ambrish, Singh, Jasvinder A., Singh, Virendra, Sinha, Dhirendra Narain, Sitas, Freddy, Skryabin, Valentin Yurievich, Skryabina, Anna Aleksandrovna, Soboka, Matiwos, Soriano, Joan B., Soroush, Ali, Soshnikov, Sergey, Soyiri, Ireneous N., Spurlock, Emma Elizabeth, Sreeramareddy, Chandrashekhar T., Stein, Dan J, Steiropoulos, Paschalis, Stortecky, Stefan, Straif, Kurt, Suliankatchi Abdulkader, Rizwan, Sulo, Gerhard, Sundström, Johan, Tabuchi, Takahiro, Tadakamadla, Santosh Kumar, Taddele, Biruk Wogayehu, Tadesse, Eyayou Girma, Tamiru, Animut Tagele, Tareke, Minale, Tareque, Md Ismail, Tarigan, Ingan Ukur, Temsah, Mohamad-Hani, Thankappan, Kavumpurathu Raman, Thapar, Rekha, Tichopad, Ales, Tolani, Musliu Adetola, Topouzis, Fotis, Tovani-Palone, Marcos Roberto, Tran, Bach Xuan, Tripathy, Jaya Prasad, Tsegaye, Gebiyaw Wudie, Tsilimparis, Nikolaos, Tymeson, Hayley D., Ullah, Anayat, Ullah, Saif, Unim, Brigid, Updike, Rachel L., Vacante, Marco, Valdez, Pascual R., Vardavas, Constantine, Varona Pérez, Patricia, Vasankari, Tommi Juhani, Venketasubramanian, Narayanaswamy, Verma, Madhur, Vetrova, Marina V., Vo, Bay, Vu, Giang Thu, Waheed, Yasir, Wang, Yanzhong, Welding, Kevin, Werdecker, Andrea, Whisnant, Joanna L., Wickramasinghe, Nuwan Darshana, Yamagishi, Kazumasa, Yandrapalli, Srikanth, Yatsuya, Hiroshi, Yazdi-Feyzabadi, Vahid, Yeshaw, Yigizie, Yimmer, Mohammed Zewdu, Yonemoto, Naohiro, Yu, Chuanhua, Yunusa, Ismaeel, Yusefzadeh, Hasan, Zahirian Moghadam, Telma, Zaman, Muhammed Shahriar, Zamanian, Maryam, Zandian, Hamed, Zar, Heather J., Zastrozhin, Mikhail Sergeevich, Zastrozhina, Anasthasia, Zavala-Arciniega, Luis, Zhang, Jianrong, Zhang, Zhi-Jiang, Zhong, Chenwen, Zuniga, Yves Miel H., Gakidou, Emmanuela, Reitsma, Marissa B, Kendrick, Parkes J, Ababneh, Emad, Abbafati, Cristiana, Abbasi-Kangevari, Mohsen, Abdoli, Amir, Abedi, Aidin, Abhilash, E S, Abila, Derrick Bary, Aboyans, Victor, Abu-Rmeileh, Niveen ME, Adebayo, Oladimeji M, Advani, Shailesh M, Aghaali, Mohammad, Ahinkorah, Bright Opoku, Ahmad, Sohail, Ahmadi, Keivan, Ahmed, Haroon, Aji, Budi, Akunna, Chisom Joyqueenet, Al-Aly, Ziyad, Alanzi, Turki M, Alhabib, Khalid F, Ali, Liaqat, Alif, Sheikh Mohammad, Alipour, Vahid, Aljunid, Syed Mohamed, Alla, Françoi, Allebeck, Peter, Alvis-Guzman, Nelson, Amin, Tarek Tawfik, Amini, Saeed, Amu, Hubert, Amul, Gianna Gayle Herrera, Ancuceanu, Robert, Anderson, Jason A, Ansari-Moghaddam, Alireza, Antonio, Carl Abelardo T, Antony, Benny, Anvari, Davood, Arabloo, Jalal, Arian, Nicholas D, Arora, Monika, Asaad, Malke, Ausloos, Marcel, Awan, Asma Tahir, Ayano, Getinet, Aynalem, Getie Lake, Azari, Samad, B, Darshan B, Badiye, Ashish D, Baig, Atif Amin, Bakhshaei, Mohammad Hossein, Banach, Maciej, Banik, Palash Chandra, Barker-Collo, Suzanne Lyn, Bärnighausen, Till Winfried, Barqawi, Hiba Jawdat, Basu, Sanjay, Bayati, Mohsen, Bazargan-Hejazi, Shahrzad, Behzadifar, Masoud, Bekuma, Tariku Tesfaye, Bennett, Derrick A, Bensenor, Isabela M, Berfield, Kathleen S Sachiko, Bhagavathula, Akshaya Srikanth, Bhardwaj, Nikha, Bhardwaj, Pankaj, Bhattacharyya, Krittika, Bibi, Sadia, Bijani, Ali, Bintoro, Bagas Suryo, Biondi, Antonio, Birara, Setognal, Braithwaite, Dejana, Brenner, Hermann, Brunoni, Andre R, Burkart, Katrin, Butt, Zahid A, Caetano dos Santos, Florentino Luciano, Cámera, Luis Alberto, Car, Josip, Cárdenas, Rosario, Carreras, Giulia, Carrero, Juan J, Castaldelli-Maia, Joao Mauricio, Cattaruzza, Maria Sofia Sofia, Chang, Jung-Chen, Chen, Simiao, Chu, Dinh-Toi, Chung, Sheng-Chia, Cirillo, Massimo, Costa, Vera Marisa, Couto, Rosa A S, Dadras, Omid, Dai, Xiaochen, Damasceno, Albertino Antonio Moura, Damiani, Giovanni, Dandona, Lalit, Dandona, Rakhi, Daneshpajouhnejad, Parnaz, Darega Gela, Jiregna, Davletov, Kairat, Derbew Molla, Meseret, Dessie, Getenet Ayalew, Desta, Abebaw Alemayehu, Dharmaratne, Samath Dhamminda, Dianatinasab, Mostafa, Diaz, Daniel, Do, Hoa Thi, Douiri, Abdel, Duncan, Bruce B, Duraes, Andre Rodrigue, Eagan, Arielle Wilder, Ebrahimi Kalan, Mohammad, Edvardsson, Kristina, Elbarazi, Iffat, El Tantawi, Maha, Esmaeilnejad, Saman, Fadhil, Ibtihal, Faraon, Emerito Jose A, Farinha, Carla Sofia e Sá, Farwati, Medhat, Farzadfar, Farshad, Fazlzadeh, Mehdi, Feigin, Valery L, Feldman, Rachel, Fernandez Prendes, Carlota, Ferrara, Pietro, Filip, Irina, Filippidis, Filippo, Fischer, Florian, Flor, Luisa Sorio, Foigt, Nataliya A, Folayan, Morenike Oluwatoyin, Foroutan, Masoud, Gad, Mohamed M, Gaidhane, Abhay Motiramji, Gallus, Silvano, Geberemariyam, Biniyam Sahiledengle, Ghafourifard, Mansour, Ghajar, Alireza, Ghashghaee, Ahmad, Giampaoli, Simona, Gill, Paramjit Singh, Glozah, Franklin N, Gnedovskaya, Elena V, Golechha, Mahaveer, Gopalani, Sameer Vali, Gorini, Giuseppe, Goudarzi, Houman, Goulart, Alessandra C, Greaves, Felix, Guha, Avirup, Guo, Yuming, Gupta, Bhawna, Gupta, Rajat Da, Gupta, Rajeev, Gupta, Tarun, Gupta, Vin, Hafezi-Nejad, Nima, Haider, Mohammad Rifat, Hamadeh, Randah R, Hankey, Graeme J, Hargono, Arief, Hartono, Risky Kusuma, Hassankhani, Hadi, Hay, Simon I, Heidari, Golnaz, Herteliu, Claudiu, Hezam, Kamal, Hird, Thomas R, Hole, Michael K, Holla, Ramesh, Hosseinzadeh, Mehdi, Hostiuc, Sorin, Househ, Mowafa, Hsiao, Thoma, Huang, Junjie, Iannucci, Vincent C, Ibitoye, Segun Emmanuel, Idrisov, Bulat, Ilesanmi, Olayinka Stephen, Ilic, Irena M, Ilic, Milena D, Inbaraj, Leeberk Raja, Irvani, Seyed Sina Naghibi, Islam, Jessica Y, Islam, Rakibul M, Islam, Sheikh Mohammed Shariful, Islami, Farhad, Iso, Hiroyasu, Itumalla, Ramaiah, Iwagami, Masao, Jaafari, Jalil, Jain, Vardhmaan, Jakovljevic, Mihajlo, Jang, Sung-In, Janjani, Hosna, Jayaram, Shubha, Jeemon, Panniyammakal, Jha, Ravi Prakash, Jonas, Jost B, Joo, Tama, Jürisson, Mikk, Kabir, Ali, Kabir, Zubair, Kalankesh, Leila R, Kanchan, Tanuj, Kandel, Himal, Kapoor, Neeti, Karimi, Salah Eddin, Katikireddi, Srinivasa Vittal, Kebede, Hafte Kahsay, Kelkay, Bayew, Kennedy, Ryan David, Khoja, Abdullah T, Khubchandani, Jagdish, Kim, Gyu Ri, Kim, Young-Eun, Kimokoti, Ruth W, Kivimäki, Mika, Kosen, Soewarta, Koulmane Laxminarayana, Sindhura Lakshmi, Koyanagi, Ai, Krishan, Kewal, Kugbey, Nuworza, Kumar, G Anil, Kumar, Nithin, Kurmi, Om P, Kusuma, Dian, Lacey, Ben, Lam, Jennifer O, Landires, Iván, Lasrado, Savita, Lauriola, Paolo, Lee, Doo Woong, Lee, Yo Han, Leung, Janni, Li, Shanshan, Lin, Hualiang, Linn, Shai, Liu, Wei, Lopez, Alan D, Lopukhov, Platon D, Lorkowski, Stefan, Lugo, Alessandra, Majeed, Azeem, Maleki, Afshin, Malekzadeh, Reza, Malta, Deborah Carvalho, Mamun, Abdullah A, Manjunatha, Narayana, Mansouri, Borhan, Mansournia, Mohammad Ali, Martinez-Raga, Jose, Martini, Santi, Mathur, Manu Raj, Medina-Solís, Carlo Eduardo, Mehata, Suresh, Mendoza, Walter, Menezes, Ritesh G, Meretoja, Atte, Meretoja, Tuomo J, Miazgowski, Bartosz, Michalek, Irmina Maria, Miller, Ted R, Mirrakhimov, Erkin M, Mirzaei, Hamed, Mirzaei-Alavijeh, Mehdi, Misra, Sanjeev, Moghadaszadeh, Masoud, Mohammad, Yousef, Mohammadian-Hafshejani, Abdollah, Mohammed, Shafiu, Mokdad, Ali H, Monasta, Lorenzo, Moni, Mohammad Ali, Moradi, Ghobad, Moradi-Lakeh, Maziar, Moradzadeh, Rahmatollah, Morrison, Shane Dougla, Mossie, Tilahun Belete, Mubarik, Sumaira, Mullany, Erin C, Murray, Christopher J L, Naghavi, Mohsen, Naghshtabrizi, Behshad, Nair, Sanjeev, Nalini, Mahdi, Nangia, Vinay, Naqvi, Atta Abba, Narasimha Swamy, Sreeniva, Naveed, Muhammad, Nayak, Smitha, Nayak, Vinod C, Nazari, Javad, Nduaguba, Sabina O, Neupane Kandel, Sandhya, Nguyen, Cuong Tat, Nguyen, Huong Lan Thi, Nguyen, Son Hoang, Nguyen, Trang Huyen, Nixon, Molly R, Nnaji, Chukwudi A, Norrving, Bo, Noubiap, Jean Jacque, Nowak, Christoph, Ogbo, Felix Akpojene, Oguntade, Ayodipupo Sikiru, Oh, In-Hwan, Olagunju, Andrew T, Oren, Eyal, Otstavnov, Nikita, Otstavnov, Stanislav S, Owolabi, Mayowa O, P A, Mahesh, Pakhale, Smita, Pakshir, Keyvan, Palladino, Raffaele, Pan, Liping, Pana, Adrian, Panda-Jonas, Songhomitra, Pandey, Ashok, Parekh, Utsav, Park, Eun-Cheol, Park, Eun-Kee, Pashazadeh Kan, Fatemeh, Patton, George C, Pawar, Shrikant, Pestell, Richard G, Pinheiro, Marina, Piradov, Michael A, Pirouzpanah, Saeed, Pokhrel, Khem Narayan, Polibin, Roman V, Prashant, Akila, Pribadi, Dimas Ria Angga, Radfar, Amir, Rahimi-Movaghar, Vafa, Rahman, Azizur, Rahman, Mohammad Hifz Ur, Rahman, Muhammad Aziz, Rahmani, Amir Masoud, Rajai, Nazanin, Ram, Pradhum, Ranabhat, Chhabi Lal, Rathi, Priya, Rawal, Lal, Renzaho, Andre M N, Reynales-Shigematsu, Luz Myriam, Rezapour, Aziz, Riahi, Seyed Mohammad, Riaz, Mavra A, Roever, Leonardo, Ronfani, Luca, Roshandel, Gholamreza, Roy, Ambuj, Roy, Bedanta, Sacco, Simona, Saddik, Basema, Sahebkar, Amirhossein, Salehi, Sana, Salimzadeh, Hamideh, Samaei, Mehrnoosh, Samy, Abdallah M, Santos, Itamar S, Santric-Milicevic, Milena M, Sarrafzadegan, Nizal, Sathian, Brijesh, Sawhney, Monika, Saylan, Mete, Schaub, Michael P, Schmidt, Maria Inê, Schneider, Ione Jayce Ceola, Schutte, Aletta Elisabeth, Schwendicke, Falk, Seidu, Abdul-Aziz, Senthil Kumar, Nachimuthu, Sepanlou, Sadaf G, Seylani, Allen, Shafaat, Omid, Shah, Syed Mahboob, Shaikh, Masood Ali, Shalash, Ali S, Shannawaz, Mohammed, Sharafi, Kiomar, Sheikh, Aziz, Sheikhbahaei, Sara, Shigematsu, Mika, Shiri, Rahman, Shishani, Kawkab, Shivakumar, K M, Shivalli, Siddharudha, Shrestha, Roman, Siabani, Soraya, Sidemo, Negussie Boti, Sigfusdottir, Inga Dora, Sigurvinsdottir, Rannveig, Silva, Diego Augusto Santo, Silva, João Pedro, Singh, Ambrish, Singh, Jasvinder A, Singh, Virendra, Sinha, Dhirendra Narain, Sitas, Freddy, Skryabin, Valentin Yurievich, Skryabina, Anna Aleksandrovna, Soboka, Matiwo, Soriano, Joan B, Soroush, Ali, Soshnikov, Sergey, Soyiri, Ireneous N, Spurlock, Emma Elizabeth, Sreeramareddy, Chandrashekhar T, Stein, Dan J, Steiropoulos, Paschali, Stortecky, Stefan, Straif, Kurt, Suliankatchi Abdulkader, Rizwan, Sulo, Gerhard, Sundström, Johan, Tabuchi, Takahiro, Tadakamadla, Santosh Kumar, Taddele, Biruk Wogayehu, Tadesse, Eyayou Girma, Tamiru, Animut Tagele, Tareke, Minale, Tareque, Md Ismail, Tarigan, Ingan Ukur, Temsah, Mohamad-Hani, Thankappan, Kavumpurathu Raman, Thapar, Rekha, Tichopad, Ale, Tolani, Musliu Adetola, Topouzis, Foti, Tovani-Palone, Marcos Roberto, Tran, Bach Xuan, Tripathy, Jaya Prasad, Tsegaye, Gebiyaw Wudie, Tsilimparis, Nikolao, Tymeson, Hayley D, Ullah, Anayat, Ullah, Saif, Unim, Brigid, Updike, Rachel L, Vacante, Marco, Valdez, Pascual R, Vardavas, Constantine, Varona Pérez, Patricia, Vasankari, Tommi Juhani, Venketasubramanian, Narayanaswamy, Verma, Madhur, Vetrova, Marina V, Vo, Bay, Vu, Giang Thu, Waheed, Yasir, Wang, Yanzhong, Welding, Kevin, Werdecker, Andrea, Whisnant, Joanna L, Wickramasinghe, Nuwan Darshana, Yamagishi, Kazumasa, Yandrapalli, Srikanth, Yatsuya, Hiroshi, Yazdi-Feyzabadi, Vahid, Yeshaw, Yigizie, Yimmer, Mohammed Zewdu, Yonemoto, Naohiro, Yu, Chuanhua, Yunusa, Ismaeel, Yusefzadeh, Hasan, Zahirian Moghadam, Telma, Zaman, Muhammed Shahriar, Zamanian, Maryam, Zandian, Hamed, Zar, Heather J, Zastrozhin, Mikhail Sergeevich, Zastrozhina, Anasthasia, Zavala-Arciniega, Lui, Zhang, Jianrong, Zhang, Zhi-Jiang, Zhong, Chenwen, Zuniga, Yves Miel H, Gakidou, Emmanuela, Collaborators, GBD 2019 Tobacco, Lacey, B, Lee Kong Chian School of Medicine (LKCMedicine), Department of Public Health, Clinicum, Neurologian yksikkö, HUS Neurocenter, University of Helsinki, HUS Comprehensive Cancer Center, GBD 2019 Tobacco Collaborators, Reitsma, M, Kendrick, P, Ababneh, E, Abbafati, C, Abbasi-Kangevari, M, Abdoli, A, Abedi, A, Abhilash, E, Abila, D, Aboyans, V, Abu-Rmeileh, N, Adebayo, O, Advani, S, Aghaali, M, Ahinkorah, B, Ahmad, S, Ahmadi, K, Ahmed, H, Aji, B, Akunna, C, Al-Aly, Z, Alanzi, T, Alhabib, K, Ali, L, Alif, S, Alipour, V, Aljunid, S, Alla, F, Allebeck, P, Alvis-Guzman, N, Amin, T, Amini, S, Amu, H, Amul, G, Ancuceanu, R, Anderson, J, Ansari-Moghaddam, A, Antonio, C, Antony, B, Anvari, D, Arabloo, J, Arian, N, Arora, M, Asaad, M, Ausloos, M, Awan, A, Ayano, G, Aynalem, G, Azari, S, B, D, Badiye, A, Baig, A, Bakhshaei, M, Banach, M, Banik, P, Barker-Collo, S, Bärnighausen, T, Barqawi, H, Basu, S, Bayati, M, Bazargan-Hejazi, S, Behzadifar, M, Bekuma, T, Bennett, D, Bensenor, I, Berfield, K, Bhagavathula, A, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bibi, S, Bijani, A, Bintoro, B, Biondi, A, Birara, S, Braithwaite, D, Brenner, H, Brunoni, A, Burkart, K, Butt, Z, Caetano dos Santos, F, Cámera, L, Car, J, Cárdenas, R, Carreras, G, Carrero, J, Castaldelli-Maia, J, Cattaruzza, M, Chang, J, Chen, S, Chu, D, Chung, S, Cirillo, M, Costa, V, Couto, R, Dadras, O, Dai, X, Damasceno, A, Damiani, G, Dandona, L, Dandona, R, Daneshpajouhnejad, P, Darega Gela, J, Davletov, K, Derbew Molla, M, Dessie, G, Desta, A, Dharmaratne, S, Dianatinasab, M, Diaz, D, Do, H, Douiri, A, Duncan, B, Duraes, A, Eagan, A, Ebrahimi Kalan, M, Edvardsson, K, Elbarazi, I, El Tantawi, M, Esmaeilnejad, S, Fadhil, I, Faraon, E, Farinha, C, Farwati, M, Farzadfar, F, Fazlzadeh, M, Feigin, V, Feldman, R, Fernandez Prendes, C, Ferrara, P, Filip, I, Filippidis, F, Fischer, F, Flor, L, Foigt, N, Folayan, M, Foroutan, M, Gad, M, Gaidhane, A, Gallus, S, Geberemariyam, B, Ghafourifard, M, Ghajar, A, Ghashghaee, A, Giampaoli, S, Gill, P, Glozah, F, Gnedovskaya, E, Golechha, M, Gopalani, S, Gorini, G, Goudarzi, H, Goulart, A, Greaves, F, Guha, A, Guo, Y, Gupta, B, Gupta, R, Gupta, T, Gupta, V, Hafezi-Nejad, N, Haider, M, Hamadeh, R, Hankey, G, Hargono, A, Hartono, R, Hassankhani, H, Hay, S, Heidari, G, Herteliu, C, Hezam, K, Hird, T, Hole, M, Holla, R, Hosseinzadeh, M, Hostiuc, S, Househ, M, Hsiao, T, Huang, J, Iannucci, V, Ibitoye, S, Idrisov, B, Ilesanmi, O, Ilic, I, Ilic, M, Inbaraj, L, Irvani, S, Islam, J, Islam, R, Islam, S, Islami, F, Iso, H, Itumalla, R, Iwagami, M, Jaafari, J, Jain, V, Jakovljevic, M, Jang, S, Janjani, H, Jayaram, S, Jeemon, P, Jha, R, Jonas, J, Joo, T, Jürisson, M, Kabir, A, Kabir, Z, Kalankesh, L, Kanchan, T, Kandel, H, Kapoor, N, Karimi, S, Katikireddi, S, Kebede, H, Kelkay, B, Kennedy, R, Khoja, A, Khubchandani, J, Kim, G, Kim, Y, Kimokoti, R, Kivimäki, M, Kosen, S, Koulmane Laxminarayana, S, Koyanagi, A, Krishan, K, Kugbey, N, Kumar, G, Kumar, N, Kurmi, O, Kusuma, D, Lam, J, Landires, I, Lasrado, S, Lauriola, P, Lee, D, Lee, Y, Leung, J, Li, S, Lin, H, Linn, S, Liu, W, Lopez, A, Lopukhov, P, Lorkowski, S, Lugo, A, Majeed, A, Maleki, A, Malekzadeh, R, Malta, D, Mamun, A, Manjunatha, N, Mansouri, B, Mansournia, M, Martinez-Raga, J, Martini, S, Mathur, M, Medina-Solís, C, Mehata, S, Mendoza, W, Menezes, R, Meretoja, A, Meretoja, T, Miazgowski, B, Michalek, I, Miller, T, Mirrakhimov, E, Mirzaei, H, Mirzaei-Alavijeh, M, Misra, S, Moghadaszadeh, M, Mohammad, Y, Mohammadian-Hafshejani, A, Mohammed, S, Mokdad, A, Monasta, L, Moni, M, Moradi, G, Moradi-Lakeh, M, Moradzadeh, R, Morrison, S, Mossie, T, Mubarik, S, Mullany, E, Murray, C, Naghavi, M, Naghshtabrizi, B, Nair, S, Nalini, M, Nangia, V, Naqvi, A, Narasimha Swamy, S, Naveed, M, Nayak, S, Nayak, V, Nazari, J, Nduaguba, S, Neupane Kandel, S, Nguyen, C, Nguyen, H, Nguyen, S, Nguyen, T, Nixon, M, Nnaji, C, Norrving, B, Noubiap, J, Nowak, C, Ogbo, F, Oguntade, A, Oh, I, Olagunju, A, Oren, E, Otstavnov, N, Otstavnov, S, Owolabi, M, P A, M, Pakhale, S, Pakshir, K, Palladino, R, Pana, A, Panda-Jonas, S, Pandey, A, Parekh, U, Park, E, Pashazadeh Kan, F, Patton, G, Pawar, S, Pestell, R, Pinheiro, M, Piradov, M, Pirouzpanah, S, Pokhrel, K, Polibin, R, Prashant, A, Pribadi, D, Radfar, A, Rahimi-Movaghar, V, Rahman, A, Rahman, M, Rahmani, A, Rajai, N, Ram, P, Ranabhat, C, Rathi, P, Rawal, L, Renzaho, A, Reynales-Shigematsu, L, Rezapour, A, Riahi, S, Riaz, M, Roever, L, Ronfani, L, Roshandel, G, Roy, A, Roy, B, Sacco, S, Saddik, B, Sahebkar, A, Salehi, S, Salimzadeh, H, Samaei, M, Samy, A, Santos, I, Santric-Milicevic, M, Sarrafzadegan, N, Sathian, B, Sawhney, M, Saylan, M, Schaub, M, Schmidt, M, Schneider, I, Schutte, A, Schwendicke, F, Seidu, A, Senthil Kumar, N, Sepanlou, S, Seylani, A, Shafaat, O, Shah, S, Shaikh, M, Shalash, A, Shannawaz, M, Sharafi, K, Sheikh, A, Sheikhbahaei, S, Shigematsu, M, Shiri, R, Shishani, K, Shivakumar, K, Shivalli, S, Shrestha, R, Siabani, S, Sidemo, N, Sigfusdottir, I, Sigurvinsdottir, R, Silva, D, Silva, J, Singh, A, Singh, J, Singh, V, Sinha, D, Sitas, F, Skryabin, V, Skryabina, A, Soboka, M, Soriano, J, Soroush, A, Soshnikov, S, Soyiri, I, Spurlock, E, Sreeramareddy, C, Stein, D, Steiropoulos, P, Stortecky, S, Straif, K, Suliankatchi Abdulkader, R, Sulo, G, Sundström, J, Tabuchi, T, Tadakamadla, S, Taddele, B, Tadesse, E, Tamiru, A, Tareke, M, Tareque, M, Tarigan, I, Temsah, M, Thankappan, K, Thapar, R, Tichopad, A, Tolani, M, Topouzis, F, Tovani-Palone, M, Tran, B, Tripathy, J, Tsegaye, G, Tsilimparis, N, Tymeson, H, Ullah, A, Ullah, S, Unim, B, Updike, R, Vacante, M, Valdez, P, Vardavas, C, Varona Pérez, P, Vasankari, T, Venketasubramanian, N, Verma, M, Vetrova, M, Vo, B, Vu, G, Waheed, Y, Wang, Y, Welding, K, Werdecker, A, Whisnant, J, Wickramasinghe, N, Yamagishi, K, Yandrapalli, S, Yatsuya, H, Yazdi-Feyzabadi, V, Yeshaw, Y, Yimmer, M, Yonemoto, N, Yu, C, Yunusa, I, Yusefzadeh, H, Zahirian Moghadam, T, Zaman, M, Zamanian, M, Zandian, H, Zar, H, Zastrozhin, M, Zastrozhina, A, Zavala-Arciniega, L, Zhang, J, Zhang, Z, Zhong, C, Zuniga, Y, and Gakidou, E
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030204 cardiovascular system & hematology ,0302 clinical medicine ,HV ,GBD 2019 Tobacco Collaborators ,Prevalence ,Global health ,Medicine ,030212 general & internal medicine ,610 Medicine & health ,11 Medical and Health Sciences ,RISK ,Tobacco control ,1. No poverty ,Public Health, Global Health, Social Medicine and Epidemiology ,General Medicine ,Articles ,Tobacco smoking ,3142 Public health care science, environmental and occupational health ,3. Good health ,A990 Medicine and Dentistry not elsewhere classified ,Life Sciences & Biomedicine ,HAZARDS ,03 medical and health sciences ,Medicine, General & Internal ,Environmental health ,General & Internal Medicine ,Tobacco ,Premature Deaths ,Population growth ,Medicine [Science] ,Global Burden ,Attributable Diseases ,Risk factor ,Mortality ,PROGRESS ,Disease burden ,Estimation ,Science & Technology ,business.industry ,Smoking Tobacco ,MORTALITY ,Former Smoker ,GOAL ,REDUCTION ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,3121 General medicine, internal medicine and other clinical medicine ,PREMATURE DEATHS ,business ,RA ,RC - Abstract
Background Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. Methods We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Findings Globally in 2019, 1·14 billion (95% uncertainty interval 1·13–1·16) individuals were current smokers, who consumed 7·41 trillion (7·11–7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5% [26·5–28·5] reduction) and females (37·7% [35·4–39·9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98–1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16–8·20) deaths and 200 million (185–214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% [19·3–21·1] of male deaths). 6·68 million [86·9%] of 7·69 million deaths attributable to smoking tobacco use were among current smokers. Interpretation In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. Funding Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
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- 2021
16. Antibody to CD137 Activated by Extracellular Adenosine Triphosphate Is Tumor Selective and Broadly EffectiveIn Vivowithout Systemic Immune Activation
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Tatsuhiko Tachibana, Nasa Savory, Otoya Ueda, Sayuri Horikawa, Tetsushi Sakiyama, Tomochika Matsushita, Yuji Hori, Kou-ichi Jishage, Haruka Kuroi, Motohiko Sato, Tetsuya Wakabayashi, Junko Shinozuka, Naoka Hironiwa, Meiri Shida-Kawazoe, Kenji Adachi, Ryo Uchikawa, Taro Miyazaki, Koki Hamada, Masaki Honda, Fumihisa Isomura, Mika Endo, Mika Kamata-Sakurai, Yoshito Nakanishi, Yuki Noguchi, Natsuki Ono, Yasuko Satoh, Yuki Ohte, Tomoyuki Igawa, Ayano Hirako, Hirofumi Mikami, Naoko A. Wada, Noriaki Sawada, Takehisa Kitazawa, Yasushi Tomii, Shun-ichiro Komatsu, Takayuki Nemoto, Yoshinori Narita, Kenji Taniguchi, Shun Shimizu, Naoi Sotaro, Akihisa Sakamoto, Shojiro Kadono, Yoshiki Kawabe, Atsuhiko Kato, Kamimura Masaki, Shoichi Metsugi, and Ami Ito
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0301 basic medicine ,Tumor microenvironment ,biology ,business.industry ,medicine.medical_treatment ,CD137 ,Cancer ,Immunotherapy ,medicine.disease ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Oncology ,Antigen ,In vivo ,030220 oncology & carcinogenesis ,Extracellular ,Cancer research ,biology.protein ,Medicine ,Antibody ,business - Abstract
Agonistic antibodies targeting CD137 have been clinically unsuccessful due to systemic toxicity. Because conferring tumor selectivity through tumor-associated antigen limits its clinical use to cancers that highly express such antigens, we exploited extracellular adenosine triphosphate (exATP), which is a hallmark of the tumor microenvironment and highly elevated in solid tumors, as a broadly tumor-selective switch. We generated a novel anti-CD137 switch antibody, STA551, which exerts agonistic activity only in the presence of exATP. STA551 demonstrated potent and broad antitumor efficacy against all mouse and human tumors tested and a wide therapeutic window without systemic immune activation in mice. STA551 was well tolerated even at 150 mg/kg/week in cynomolgus monkeys. These results provide a strong rationale for the clinical testing of STA551 against a broad variety of cancers regardless of antigen expression, and for the further application of this novel platform to other targets in cancer therapy.Significance:Reported CD137 agonists suffer from either systemic toxicity or limited efficacy against antigen-specific cancers. STA551, an antibody designed to agonize CD137 only in the presence of extracellular ATP, inhibited tumor growth in a broad variety of cancer models without any systemic toxicity or dependence on antigen expression.See related commentary by Keenan and Fong, p. 20.This article is highlighted in the In This Issue feature, p. 1
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- 2021
17. Renal Biopsy-induced Hematoma and Infection in a Patient with Asymptomatic May-Hegglin Anomaly
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Tae, Matsumoto, Takeshi, Yanagihara, Kaoru, Yoshizaki, Masami, Tsuchiya, Mika, Terasaki, Kiyotaka, Nagahama, Akira, Shimizu, Shinji, Kunishima, Miho, Maeda, Matsumoto, Tae, Yanagihara, Takeshi, Yoshizaki, Kaoru, Tsuchiya, Masami, Terasaki, Mika, Nagahama, Kiyotaka, Shimizu, Akira, Kunishima, Shinji, and Maeda, Miho
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Male ,medicine.medical_specialty ,Biopsy ,Hearing Loss, Sensorineural ,Gastroenterology ,Asymptomatic ,03 medical and health sciences ,0302 clinical medicine ,Focal segmental glomerulosclerosis ,Internal medicine ,medicine ,Humans ,Child ,Hematuria ,Hematoma ,Purpura, Thrombocytopenic, Idiopathic ,medicine.diagnostic_test ,Myosin Heavy Chains ,business.industry ,Glomerulosclerosis, Focal Segmental ,General Medicine ,medicine.disease ,Thrombocytopenic purpura ,Thrombocytopenia ,Transplantation ,Proteinuria ,Platelet transfusion ,030220 oncology & carcinogenesis ,May–Hegglin anomaly ,030211 gastroenterology & hepatology ,Renal biopsy ,medicine.symptom ,business ,Nephritis - Abstract
The May-Hegglin anomaly is characterized by inherited thrombocytopenia, giant platelets, and leukocyte cytoplasmic inclusion bodies. The Fechtner, Sebastian, and Epstein syndromes are associated with mutations of the MYH9-coding nonmuscle myosin heavy chain ⅡA, similar to the May-Hegglin anomaly, and are together classified as MYH9 disorders. MYH9 disorders may include symptoms of Alport syndrome, including nephritis and auditory and ocular disorders. A 6-year-old boy was diagnosed with an MYH9 disorder after incidental discovery of hematuria and proteinuria. Focal segmental glomerulosclerosis was detected on renal biopsy. However, despite no prior bleeding diatheses, he developed a large post-biopsy hematoma despite a preprocedural platelet transfusion calculated to increase the platelet count from 54,000/μL to >150,000/μL. Idiopathic thrombocytopenic purpura is a major cause of pediatric thrombocytopenia following acute infection or vaccination, and patients with MYH9 disorders may be misdiagnosed with idiopathic thrombocytopenic purpura and inappropriately treated with corticosteroids. Careful differential diagnosis is important in thrombocytopenic patients with hematuria and proteinuria for the early detection of thrombocytopenia. Patients with MYH9 disorders require close follow-up and treatment with angiotensin Ⅱ receptor blockers to prevent the onset of progressive nephritis, which may necessitate hemodialysis or renal transplantation. The need for renal biopsy in patients with MYH9 disorders should be carefully considered because there could be adverse outcomes even after platelet transfusion.
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- 2021
18. The effect of simulation‐based education before a cadaver dissection course
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Munekazu Naito, Nobutaro Ban, Shuichi Hirai, Tomiko Yakura, Chikako Kawahara, Naoyuki Hatayama, Mika Ohmichi, Takashi Nakano, and Yusuke Ohmichi
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Embryology ,medicine.medical_specialty ,Students, Medical ,Histology ,Educational method ,Self-efficacy score ,business.industry ,General Medicine ,Course (navigation) ,Dissection ,Accidental ,Anatomical knowledge ,Cadaver ,medicine ,Humans ,Cadaver dissection ,Medical physics ,Curriculum ,Educational Measurement ,Anatomy ,business ,Simulation based ,Education, Medical, Undergraduate - Abstract
Although the methods for medical education continue to evolve due to the development of medicines, the cadaver dissection course still plays a fundamental role. The cadaver dissection course allows students to learn to handle instruments correctly while actively exploring three-dimensional anatomy. However, dissection comes with the risk of accidental injury. In recent years, the number of classes offered for the cadaver dissection course has decreased while the amount of knowledge required in clinical medicine has increased. Simulation-based education has been proven to be an effective educational method that enhances the development of practical skills by integrating learners' knowledge and skills. This study aimed to investigate the effect of SBE as a preparatory education course when taken prior to a medical student's enrollment in the cadaver dissection course. In the present study, an SBE assuming practical cadaver dissection course was performed in the Clinical Simulation Center. The frequency of injury rates per 1,000 hours of cadaver dissection course was significantly less in 2017 and 2018 compared to that in 2016. Two years after the implementation of the simulation-based education, average student self-efficacy scores and written examination scores significantly increased, whereas self-contentment scores were relatively unchanged. The results showed that the implementation of simulation-based education decreased the incidence of injuries and improved students' overall self-efficacy scores and increased acquisition of knowledge evident on written examination score. Therefore, simulation-based education as a preparatory education course may effectively promote the combined development of dissection skills and anatomical knowledge in the subsequent fundamental cadaver dissection course.
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- 2021
19. Burden of Migraine in Japan: Results of the ObserVational Survey of the Epidemiology, tReatment, and Care Of MigrainE (OVERCOME [Japan]) Study
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Kaname Ueda, Dena H Jaffe, Mika Komori, Yongin Kim, Koichi Hirata, Yasuhiko Matsumori, Anthony Zagar, and Takao Takeshima
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education.field_of_study ,medicine.medical_specialty ,business.industry ,Population ,medicine.disease ,Quality of life (healthcare) ,Neurology ,Migraine ,Family medicine ,Presenteeism ,Epidemiology ,medicine ,Observational study ,International Classification of Headache Disorders ,Neurology (clinical) ,Headaches ,medicine.symptom ,education ,business - Abstract
INTRODUCTION The ObserVational survey of the Epidemiology, tReatment, and Care Of MigrainE study in Japan (OVERCOME [Japan]) assessed the impact and burden of migraine in Japan. METHODS OVERCOME (Japan) was a cross-sectional, observational, population-based web survey of Japanese people with migraine conducted between July and September 2020. The burden and impact of migraine were assessed using the Migraine Disability Assessment (MIDAS), Migraine-Specific Quality-of-Life Questionnaire (MSQ), Migraine Interictal Burden Scale (MIBS-4), and Work Productivity and Activity Impairment-Migraine scale. Results were stratified by average number of monthly headache days (0-3, 4-7, 8-14, ≥ 15). RESULTS In total, 17,071 Japanese people with migraine completed the survey. Of these, 14,033 (82.2%) met International Classification of Headache Disorders, 3rd edition criteria for migraine and 9667 (56.6%) reported a physician diagnosis of migraine. Overall, 20.7% of respondents experienced moderate-to-severe disability (MIDAS). Moderate-to-severe interictal burden (MIBS-4) was experienced by 41.5% of respondents. MSQ scores in all domains were lowest in respondents with the most frequent headaches (≥ 15 monthly headache days) and highest in those with the lowest frequency headaches (≤ 3 monthly headache days), indicating poorer quality of life in those with more frequent headaches. Work time missed due to migraine (absenteeism) increased with increasing headache frequency, from 3.8 to 6.2%; presenteeism affected 29.8-49.9% of work time. Although migraine burden was greatest in people with the most frequent headaches, those with the lowest headache frequency still experienced substantial disability, interictal burden, and impacts on productivity and quality of life. There was also substantial unmet need for migraine care: 36.5% of respondents had ever hesitated to seek medical care for their headaches, and 89.8% had never used preventive medication. CONCLUSION In Japan, the burden of migraine and barriers to migraine care are substantial. Improving patient awareness and healthcare provider vigilance may help improve patient outcomes.
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- 2021
20. Alveolar soft part sarcoma of the orbit: A case report
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Osamu Togao, Akio Hiwatashi, Mamoru Ito, Shingo Baba, Kousei Ishigami, Hidetaka Yamamoto, Takeshi Oda, Mika Tanabe, Kazufumi Kikuchi, and Masahiro Mizoguchi
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medicine.medical_specialty ,Soft Tissue Neoplasm ,medicine.diagnostic_test ,business.industry ,Apparent Diffusion Coefficient ,R895-920 ,Intraorbital Tumor ,Case Report ,Magnetic resonance imaging ,Computed tomography ,Extraocular muscles ,medicine.disease ,Alveolar Soft Part Sarcoma ,Magnetic Resonance Imaging ,Medical physics. Medical radiology. Nuclear medicine ,medicine.anatomical_structure ,Flow Voids ,Alveolar soft part sarcoma ,Fluorodeoxyglucose-Position Emission Tomography/Computed Tomography ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,Orbit (anatomy) - Abstract
Alveolar soft part sarcoma is a rare soft tissue neoplasm that accounts for approximately 1% of all sarcomas and is usually identified in the extremities in adults. The occurrence of alveolar soft part sarcoma in the orbit is extremely rare, estimated at approximately 5% – 15% among all cases of alveolar soft part sarcoma . Here, we present a case of 29-year-old woman with orbital alveolar soft part sarcoma. We describe the magnetic resonance and F-18 2-fluoro-2-deoxy-D-glucose-position emission tomography/computed tomography findings of this case. This young woman had a spindle-shaped mass. A higher signal compared to the extraocular muscle on T1-weighted images, numerous flow voids on T2-weighted images, and intense enhancement could be key findings of this disease.
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- 2021
21. Antimicrobial Efficacy of Titanium Dioxide Coating in Operating Theaters at A Tertiary Care Hospital in Arunachal Pradesh
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Tumbi Lollen, Jyothinath Kothapalli, Mika Umpo, and Moji Jini
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business.industry ,titanium dioxide ,Antimicrobial efficacy ,Dentistry ,engineering.material ,Tertiary care hospital ,relative light units ,Applied Microbiology and Biotechnology ,Microbiology ,operation theatre ,QR1-502 ,sepsis ,chemistry.chemical_compound ,chemistry ,Coating ,Titanium dioxide ,engineering ,nosocomial infections ,Medicine ,smartcoat ,nanoparticles ,business ,Biotechnology - Abstract
SmartCoat is a novel technology with titanium dioxide (TiO2) nanoparticles, isopropyl alcohol, and distilled water as the active ingredients. TiO2, along with water and oxygen, generates highly reactive OH radicals that can neutralize bacteria and other microorganisms and remove volatile organic compounds (VOCs). Smart coat requires air circulation and a light source for its catalytic activity. The efficacy of TiO2 in industrial setups and dental devices has been documented. The present study aimed to evaluate the efficacy of TiO2 in preventing microbial growth in an operating theater (OT) where maximum sterility is desired to prevent sepsis and nosocomial infections. Among the four operating theaters, two were selected. Periodic swab samples taken over a period of nine months from OT 3 (Smart coated) and OT 4 (Control) showed minimal variations in terms of microbial growth in the processed swabs. The findings were statistically analyzed using a paired-sample t-test. The computed value of ‘t’ i.e., 2.084 was lower than the critical value of 3.18 at 3 deg of freedom (df) and hence was not significant. The null hypothesis cannot be rejected (p=0.129>0.05) at the 5% level of significance. SmartCoat with TiO2 was not effective in preventing microbial growth on biomedical devices in the OT. The product may not be suitable for operating theaters unless it is supplemented by other sterilization procedures. However, it can be used in other healthcare settings and in public places.
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- 2021
22. Profile of referrals to an intensive care unit from a regional hospital emergency centre in KwaZulu-Natal
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Robert A. Wise, Nikki Allorto, Mika Singh, and Roshen Chathram Maharaj
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Medicine (General) ,Original article ,medicine.medical_specialty ,Emergency centre ,Referral ,Population ,law.invention ,R5-920 ,Geochemistry and Petrology ,law ,medicine ,Intensive care unit ,education ,education.field_of_study ,business.industry ,Workload ,Triage ,Mews ,Regional hospital ,Critical care ,Emergency medicine ,Emergency Medicine ,Medicine ,business ,Gerontology ,Decision-making - Abstract
Introduction The objective was to describe the clinical characteristics, disease profile and outcome of patients referred from a regional hospital Emergency Centre (EC) to the Intensive Care Unit (ICU). Methods A retrospective review was performed using data extracted from the Integrated Critical Care Electronic Database (iCED). Data were extracted from the database with respect to patient characteristics, Society of Critical Care Medicine (SCCM) grading, and outcome of the ICU referral. Modified early warning scores (MEWS) were calculated from EC referral data. Results There were a total of 2187 referrals. Of these, 56.3% (1231/2187) were male. The mean age of referrals was 36 years. Of the referred patients, 41.5% (907/2187) were initially accepted for admission. A further 378 patients were accepted for admission after a follow up ICU review. Medical conditions accounted for the majority of patient referrals, followed by general surgery and trauma. Most patients initially accepted to ICU were classified as SCCM I and II and had a mean MEWS of 4. Almost half of the patients experienced a delay in admission, most commonly due to a lack of ICU bed availability. ICU mortality was 13.6% for patients admitted from the EC. Discussion The EC population referred to the ICU was young with a high burden of medical and trauma conditions. Decisions to accept patients to ICU are limited by available resources, and there was a need to apply ICU triage criteria. Delays in the transfer of ICU patients from the EC increase the workload and contribute to EC crowding.
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- 2021
23. Quantification of cell-free DNAfor the analysis of CD19-CAR-T cells during lymphoma treatment
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Julia Thomson, Thomas Mika, Verena Nilius-Eliliwi, Susanne Klein-Scory, Gerald Wulf, Roland Schroers, Alexander Baraniskin, and Deepak Vangala
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CAR-T cells ,medicine.medical_treatment ,Cell ,lymphoma ,QH426-470 ,CD19-directed chimeric antigen receptor T cells ,CD19 ,Flow cytometry ,cell-free DNA ,03 medical and health sciences ,0302 clinical medicine ,Cancer immunotherapy ,axi-cel ,medicine ,digital-droplet PCR (ddPCR) ,Genetics ,Liquid biopsy ,Molecular Biology ,030304 developmental biology ,0303 health sciences ,cancer immunotherapy ,biology ,medicine.diagnostic_test ,liquid biopsy ,QH573-671 ,business.industry ,medicine.disease ,Chimeric antigen receptor ,3. Good health ,Lymphoma ,medicine.anatomical_structure ,Cell-free fetal DNA ,030220 oncology & carcinogenesis ,biology.protein ,Cancer research ,Molecular Medicine ,Original Article ,business ,Cytology - Abstract
Chimeric antigen receptor (CAR)-T cells are increasingly used for the treatment of hematologic malignancies. Treatment success relies highly upon sufficient expansion of CAR-T effector cells. Accordingly, longitudinal quantification of CAR-T cells during therapy is clinically important. Techniques to quantify CAR-T cells in patient blood samples are based on flow cytometry and PCR. However, cellular kinetics of CAR-T cells are very complex and under current investigation. In this study, feasibility of CAR-T cell quantification by cell-free DNA (cfDNA) was analyzed. cfDNA isolated from 74 blood samples of 12 patients during lymphoma treatment with the anti-CD19 CAR-T cell product axicabtagene ciloleucel (axi-cel) were analyzed. Concentrations of cfDNA specific for the CAR-T gene construct (cfCAR-DNA) and a reference gene were quantified by a newly designed digital-droplet PCR (ddPCR) assay. Detection and quantification of cfCAR-DNA was feasible and reliable for all patients included. Relative quantification of cfCAR-DNA compared to a reference gene, suitable for genomic DNA analysis, was heterogeneous in treatment responders and non-responders. In contrast, parallel analyses of cfCAR-DNA and reference cfDNA in a patient-specific approach gave insight into active lymphoma killing and treatment responses. In summary, plasma cfDNA determination in lymphoma patients is a promising tool for future clinical decision making., Graphical abstract, The study proves the feasibility to quantify cell-free CAR-DNA in lymphoma patients during CAR-T cell treatment by a novel digital-droplet PCR assay. Combined analysis of cell-free CAR-DNA and reference cell-free DNA displays CAR-T cell-mediated lymphoma killing in individual patients.
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- 2021
24. RESEARCH ON ACCEPTABLE LUMINANCE CONTRAST BETWEEN THE WINDOW AND THE SURROUNDING WALL (Part 1) : EXAMINATION OF WINDOWS INSTALLED AT WAIST HEIGHT INCLUDING BLINDS
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Nozomu Yoshizawa, Mika Kato, Yasuhiro Miki, and Hideki Yamaguchi
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Environmental Engineering ,Waist ,Optics ,business.industry ,media_common.quotation_subject ,Window (computing) ,Contrast (vision) ,business ,Luminance ,Geology ,media_common - Published
- 2021
25. Carbon footprint of different recovery options for the repulping reject from liquid packaging board waste treatment process
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Mika Horttanainen, Jouni Havukainen, Md.Musharof Hussain Khan, Vilma Laitinen, Lappeenrannan-Lahden teknillinen yliopisto LUT, Lappeenranta-Lahti University of Technology LUT, and fi=School of Energy Systems|en=School of Energy Systems
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Waste management ,business.industry ,Biomass ,Incineration ,Refuse Disposal ,Liquid packaging board ,Greenhouse Gases ,Waste treatment ,Waste Management ,Natural gas ,Greenhouse gas ,Carbon footprint ,Environmental science ,Repulping reject ,Mechanical recycling ,business ,Waste Management and Disposal ,Life-cycle assessment ,Pyrolysis ,Beverage food packaging ,Carbon Footprint - Abstract
Liquid packaging board (LPB) is an integral part of storing and transporting liquid food. In addition to its significant advantages, LPB has been challenging the existing waste management sector since its introduction into the market. In most European countries, LPB waste is either incinerated or recycled in the recycling facilities where fibre is recycled, and the repulping reject is separated for incineration. Mechanical recycling and chemical recycling processes are other options for repulping reject treatment. This study used life cycle assessment (LCA) to compare the environmental impacts of three treatment processes, incineration, mechanical recycling and chemical recycling; each was considered with the functional unit of 1 tonne of repulping reject. Furthermore, two sub-scenarios based on the substituted heat produced by energy from the treatment processes were considered. In substituting biomass-based heat sources, chemical recycling generated the lowest greenhouse gas (GHG) emissions, about 560 kg CO2 eq. tonne-1 repulping rejects, followed by the mechanical recycling process (approximately 740 kg CO2 eq. tonne-1 repulping reject). The maximum amount of GHG was emitted from the incineration scenario, which was about 1900 kg CO2 eq. tonne-1 repulping rejects. By substituting natural gas-based heat sources, chemical recycling generated about 290 kg CO2 eq. tonne-1 repulping rejects. On the contrary, the mechanical recycling process generated about 430 kg CO2 eq. tonne-1 repulping rejects and incineration process generated 960 kg CO2 eq. tonne-1 repulping rejects. Uncertainty analysis showed that some assumptions significantly impact the results; however, the chemical recycling process had the lowest environmental impact in almost all uncertainty analysis. Publishers version
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- 2021
26. The prevalence of artificially administered nutrition and hydration in different age groups among patients with advanced cancer admitted to palliative care units
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Jiro Miyamoto, Hiroto Ishiki, Kaoru Nishijima, Masayuki Ikenaga, Kazuki Kitade, Natsuki Kawashima, Keiji Shimizu, Akira Inoue, Takeshi Hirohashi, Shuji Hiramoto, Hoshu Hashimoto, Yoichi Matsuda, Junko Nozato, Keisuke Kaneishi, Kosuke Kuwahara, Takashi Ohmori, Junichi Shimoinaba, Kengo Imai, Takehiro Nakai, Satoshi Inoue, Yosuke Matsuda, Toshihiro Yamauchi, Ritsuko Yabuki, Takahiro Higashibata, Rena Kamura, Satoru Tsuneto, Tetsuya Ito, Masaya Ehara, Eri Matsumoto, Ryo Matsunuma, Yoshihisa Matsumoto, Keiko Tanaka, Masanori Mori, Yuko Uehara, Toru Terabayashi, Yutaka Hatano, Yuki Sumazaki Watanabe, Teruaki Uno, Hirofumi Katayama, Yuto Unoki, Takayuki Hisanaga, Tomohiro Nishi, Akemi Shirado Naito, Hiroaki Tsukuura, Ayumi Okizaki, Koji Amano, Shingo Hagiwara, Tetsuo Hori, Tomonao Okamura, Satoko Ito, Yusuke Hiratsuka, Ko Sato, Takeya Yamaguchi, Tatsuya Morita, Hiromi Funaki, Yukari Azuma, Akihiro Sakashita, Hana Takatsu, Takuhiro Yamaguchi, Satoshi Miyake, Sayaka Maeda, Hideyuki Kashiwagi, Ryoichi Nakahori, Jun Nakagawa, Takashi Yamaguchi, Keita Tagami, Nanao Ishibashi, Yaichiro Matsumoto, Naosuke Yokomichi, Kiyofumi Oya, Shu Koito, Miho Shimokawa, Eriko Satomi, Kazuhiro Kosugi, Megumi Uchida, Yasuhiro Shibata, Tina Kamei, Jun Hamano, Akira Hayakawa, Takashi Ikee, Tetsuji Iriyama, Takuya Odagiri, Yu Uneno, Shunsuke Nakashima, Mitsunori Miyashita, Nao Ikuta, Takashi Kawaguchi, Yoshiyuki Kizawa, Mika Baba, Saran Yoshida, Tetsuya Yamagiwa, Isseki Maeda, Akira Yoshioka, Shohei Ueno, Yuta Ishiyama, Hiroyuki Kohara, Shunsuke Oyamada, Ayako Kikuchi, Hiroyuki Otani, Kozue Suzuki, Hiroaki Watanabe, Shunsuke Kosugi, Takeru Okoshi, and Tomofumi Miura
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medicine.medical_specialty ,Nutrition and Dietetics ,Palliative care ,Calorie ,Younger age ,business.industry ,Parenteral hydration ,Nutrition. Foods and food supply ,Endocrinology, Diabetes and Metabolism ,Parenteral nutrition ,Advanced cancer ,Artificially administered nutrition ,Age groups ,Internal medicine ,medicine ,Parenteral route ,TX341-641 ,Enteral tube feeding ,Prospective cohort study ,business ,Artificially administered hydration - Abstract
Summary: Background & Aims: The prevalence of artificially administered nutrition and hydration (AANH) in different age groups among patients with advanced cancer remains unknown. The present study investigated the current utilization of AANH according to age groups in palliative care units. Methods: This was a secondary analysis of a prospective cohort study. We obtained information on primary nutritional administration routes during the first week of admission and data on the averaged calorie sufficiency rate or total calorie intake on the 7th day of admission. Patients were divided into five age groups (18–39, 40–59, 60–74, 75–89, and 90- years). Among patients receiving AANH, the proportions of higher-calorie AANH were compared between the five age groups. Results: A total of 1453 patients were included. The proportion of patients categorized as receiving nutrition and hydration via the parenteral route was the highest in the 18–39 and 40–59 groups (52.4 and 41.1%, respectively). Among patients receiving AANH (n = 534), the proportions of patients categorized into the
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- 2021
27. Risk of Recurrent Stillbirth in Subsequent Pregnancies
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Neil W Scott, Mika Gissler, Kathleen Lamont, Miriam Gatt, and Sohinee Bhattacharya
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Pregnancy ,medicine.medical_specialty ,Placental abruption ,Obstetrics ,business.industry ,Hazard ratio ,Absolute risk reduction ,Obstetrics and Gynecology ,medicine.disease ,female genital diseases and pregnancy complications ,Preeclampsia ,Relative risk ,medicine ,population characteristics ,business ,Live birth ,reproductive and urinary physiology ,Cohort study - Abstract
OBJECTIVE To compare the prospective risk of stillbirth between women with and without a stillbirth in their first pregnancy. METHODS We conducted a cohort study using perinatal data from Finland, Malta, and Scotland. Women who had at least two singleton deliveries were included. The exposed and unexposed cohorts comprised women with a stillbirth and live birth in their first pregnancy, respectively. The risk of stillbirth in any subsequent pregnancy was assessed using a Cox proportional hazards model. Time-to-event analyses were conducted to investigate whether first pregnancy outcome had an effect on time to or the number of pregnancies preceding subsequent stillbirth. RESULTS The pooled data set included 1,064,564 women, 6,288 (0.59%) with a stillbirth and 1,058,276 with a live birth in a first pregnancy. Compared with women with a live birth, women with a stillbirth in the first pregnancy were more likely to have a subsequent stillbirth (adjusted hazard ratio [aHR] 2.25, 95% CI 1.86-2.72). For women with more than two pregnancies, the difference in risk of subsequent stillbirth between the two groups increased with the number of subsequent pregnancies. Maternal age younger than 25 years or 40 years and older, smoking, low socioeconomic status, not having a partner, pre-existing diabetes, preeclampsia, placental abruption, or delivery of a growth-restricted neonate in a first pregnancy were independently associated with subsequent stillbirth. Compared with women with a live birth in the first pregnancy, women with a stillbirth were more likely to have another pregnancy within 1 year. The absolute risk of stillbirth in a subsequent pregnancy for women with stillbirth and live birth in a first pregnancy were 2.5% and 0.5%, respectively. CONCLUSION Compared with women with a live birth in a first pregnancy, women with a stillbirth have a higher risk of subsequent stillbirth irrespective of the number and sequence of the pregnancies. Despite high relative risk, the absolute risk of recurrence was low.
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- 2021
28. UV-Sensing Cellulose Fibers Manufactured by Direct Incorporation of Photochromic Minerals
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Marja Rissanen, Mika Lastusaari, Sami Vuori, Herbert Sixta, Emma Sairanen, Wenwen Fang, Isabella Norrbo, School common, CHEM, Department of Bioproducts and Biosystems, University of Turku, Biorefineries, Aalto-yliopisto, and Aalto University
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Textile ,Materials science ,Renewable Energy, Sustainability and the Environment ,business.industry ,General Chemical Engineering ,Regenerated cellulose ,General Chemistry ,Daily wear ,regenerated cellulose ,smart textiles ,Photochromism ,Cellulose fiber ,chemistry.chemical_compound ,hackmanite ,chemistry ,Chemical engineering ,Ionic liquid ,dry jet wet spinning ,Environmental Chemistry ,business ,ionic liquid - Abstract
Funding Information: This project is funded by the Academy of Finland Project WTF-Click-Nano. We would like to thank Simone Haslinger (Reima Oy) for providing knowledge of the textile market and fruitful discussions, Kaniz Moriam (Aalto University) for her support in fiber spinning, and Sami Rantasalo for technical support in the lab. We acknowledge the provision of facilities and technical support by Aalto University at the OtaNano–Nanomicroscopy Center (Aalto-NMC). Publisher Copyright: © 2021 The Authors. Published by American Chemical Society. Textile-based wearable sensors integrated into daily wear offer opportunities for on-demand, real-time self-diagnosis to monitor health conditions with changing environmental surroundings and hazards. One still underrated environmental hazard is accumulated UV irradiation, causing skin burns, accelerated aging, and skin cancers. Here, we have demonstrated a sustainable fiber manufacture process to integrate photochromic hackmanite micro-particles directly into a cellulose body to achieve UV-sensing functionality in daily-life textiles. The hackmanite particles were dispersed into an ionic liquid cellulose dope using ultrasonication and nanofibrillated cellulose as a dispersant, resulting in good spinnability. The obtained fibers possess high mechanical strength with up to 10% photochromic hackmanite loading. To demonstrate its application in wearable UV sensors, the fibers were spun into yarn and then knitted into a piece of jersey fabric. The coloration of hackmanite-incorporated textiles under UV irradiation is readily quantified by image analysis using red-green-blue ratios, which was further utilized for UV dosimetry with a smartphone application showcasing the practical use of the UV sensor. The UV-sensing functionality remained the same after intensive washing and abrasion tests, further demonstrating the feasibility of its application in everyday garments.
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- 2021
29. Decreasing the incidence of anal sphincter tears in instrumental delivery in Hudiksvall, Sweden
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Kristina Holmsten, Jouko Pirhonen, Tiina Pirhonen, Jenny Puranen, and Mika Gissler
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medicine.medical_specialty ,Soft Tissue Injuries ,Anal Canal ,Perineum ,Lacerations ,Instrumental delivery ,Pregnancy ,Risk Factors ,Humans ,Medicine ,skin and connective tissue diseases ,Sweden ,Anal sphincter tear ,business.industry ,Incidence ,Incidence (epidemiology) ,Obstetrics and Gynecology ,Delivery, Obstetric ,Obstetric Labor Complications ,Surgery ,Episiotomy ,Pediatrics, Perinatology and Child Health ,Tears ,Female ,sense organs ,business ,Anal sphincter - Abstract
The primary aim of this study was to observe the change in obstetric anal sphincter tear rates in instrumental deliveries during one decade. Secondly, the changes in non-instrumental deliveries were followed.Data from all deliveries at Hudiksvall Hospital, Sweden 2010-2011 and 2016-2017 were collected. The change of OASIS rate during instrumental deliveries was the most important. Statistical significances were calculated by using chi-square test, test for relative proportions, and Students t-test, where appropriate.The total incidence of OASIS decreased significantly (from 2.54% to 0.73%,Based on the results of our study the manual protection of the perineum reduces the risk of OASIS in instrumental delivery significantly.
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- 2021
30. Antipsychotic use in pregnancy and risk of attention/deficit-hyperactivity disorder and autism spectrum disorder: a Nordic cohort study
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Johan Reutfors, Øystein Karlstad, Siri E. Håberg, Helle Kieler, Sinna Pilgaard Ulrichsen, Maarit K. Leinonen, Kari Furu, Oskar Halfdanarson, Helga Zoega, Kristjana Einarsdóttir, Jacqueline M. Cohen, Vidar Hjellvik, Carolyn E. Cesta, Buket Ozturk Essen, Mika Gissler, Marte-Helene Bjork, and Mette Nørgaard
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Male ,Pediatrics ,medicine.medical_specialty ,Autism Spectrum Disorder ,medicine.medical_treatment ,schizophrenia & psychotic disorders ,Population ,child & adolescent psychiatry ,Cohort Studies ,Pregnancy ,mental disorders ,medicine ,Humans ,Attention deficit hyperactivity disorder ,Attention ,Child ,education ,Antipsychotic ,education.field_of_study ,business.industry ,Hazard ratio ,medicine.disease ,psychiatry ,Psychiatry and Mental health ,Attention Deficit Disorder with Hyperactivity ,Autism spectrum disorder ,Prenatal Exposure Delayed Effects ,Cohort ,Female ,adult psychiatry ,business ,Antipsychotic Agents ,Cohort study - Abstract
BackgroundAntipsychotics are increasingly used among women of childbearing age and during pregnancy.ObjectiveTo determine whether children exposed to antipsychotics in utero are at increased risk of attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD), accounting for maternal diagnoses of bipolar, psychotic and other psychiatric disorders.DesignPopulation-based cohort study, including a sibling analysis.SettingNationwide data on all pregnant women and their live-born singletons in Denmark (1997-2017), Finland (1996-2016), Iceland (2004-2017), Norway (2004-2017), and Sweden (2006-2016).Participants4 324 086 children were eligible for inclusion to the study cohort.InterventionAntipsychotic exposure in utero, assessed by pregnancy trimester, type of antipsychotic, and varying patterns of use.Main outcome measuresNon-mutually exclusive diagnoses of ADHD and ASD. We used Cox proportional hazard models to calculate hazard ratios (HRs) controlling for maternal psychiatric disorders and other potential confounding factors.FindingsAmong 4 324 086 singleton births, 15 466 (0.4%) were exposed to antipsychotics in utero. During a median follow-up of 10 years, we identified 72 257 children with ADHD and 38 674 children with ASD. Unadjusted HRs were raised for both outcomes but shifted substantially towards the null after adjustment; 1.10 (95%CI 1.00 to 1.27) for ADHD and 1.12 (0.97 to 1.29) for ASD. Adjusted HRs remained consistent by trimester of exposure and type of antipsychotic. Comparing in utero exposure with pre-pregnancy use yielded HRs of 0.74 (0.62 to 0.87) for ADHD and 0.88 (0.70 to 1.10) for ASD. Sibling analyses yielded HRs of 1.14 (0.79 to 1.64) for ADHD and 1.34 (0.75 to 2.39) for ASD.DiscussionOur findings suggest little or no increased risk of child ADHD or ASD after in utero exposure to antipsychotics.Clinical implicationsResults regarding child neurodevelopment are reassuring for women who need antipsychotics during pregnancy.
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- 2021
31. A Māori reflection on Spinoza’s primordial
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Carl Mika
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Optics ,business.industry ,Philosophy ,Reflection (computer graphics) ,business - Abstract
Māori philosophy is at an exciting point as it looks to other sources for inspiration. In this paper, I refer to some key Māori concepts and terms with Spinoza’s notion of primordial substance in mind. Some Māori terms such as ira (the manifestation and persistence of a thing), whakaaro (indebtedness to a primordial substance) and Papatūānuku (primordial substance) are relevant here. I do not seek to compare Spinoza and Māori thought as such but instead to work with Māori concepts and terms with Spinoza in the background.
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- 2021
32. Nivolumab Versus Gemcitabine or Pegylated Liposomal Doxorubicin for Patients With Platinum-Resistant Ovarian Cancer: Open-Label, Randomized Trial in Japan (NINJA)
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Hisamori Kato, Nobuhiro Takeshima, Noriyuki Katsumata, Takayuki Enomoto, Hidemichi Watari, Yusuke Takahashi, Junzo Hamanishi, Takashi Matsumoto, Koji Matsumoto, Kimio Ushijima, Kazuhiro Takehara, Hidekatsu Nakai, Ikuo Konishi, Takashi Sawasaki, Toru Sugiyama, Masaki Mandai, Satoshi Takeuchi, Akira Takazawa, Kimihiko Ito, Eiji Kondo, Yoichi Aoki, Noriaki Sakuragi, Satomi Aihara, Hiroshi Kobayashi, Toshiaki Saito, Aikou Okamoto, Daisuke Aoki, Nobutaka Takahashi, Kosei Hasegawa, Satoru Nagase, Yoshinobu Namba, Tadashi Kimura, Mika Mizuno, Kan Yonemori, Yoshito Terai, Keiichi Fujiwara, Hitoshi Niikura, Kenzo Sonoda, Nao Suzuki, Hirokuni Takano, Sari Nakao, and Hidenori Kato
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Oncology ,Cancer Research ,medicine.medical_specialty ,Chemotherapy ,business.industry ,medicine.medical_treatment ,medicine.disease ,Gemcitabine ,law.invention ,Pegylated Liposomal Doxorubicin ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Open label ,Nivolumab ,Ovarian cancer ,business ,medicine.drug ,Platinum resistant - Abstract
PURPOSE This phase III, multicenter, randomized, open-label study investigated the efficacy and safety of nivolumab versus chemotherapy (gemcitabine [GEM] or pegylated liposomal doxorubicin [PLD]) in patients with platinum-resistant ovarian cancer. MATERIALS AND METHODS Eligible patients had platinum-resistant epithelial ovarian cancer, received ≤ 1 regimen after diagnosis of resistance, and had an Eastern Cooperative Oncology Group performance score of ≤ 1. Patients were randomly assigned 1:1 to nivolumab (240 mg once every 2 weeks [as one cycle]) or chemotherapy (GEM 1000 mg/m2 for 30 minutes [once on days 1, 8, and 15] followed by a week's rest [as one cycle], or PLD 50 mg/m2 once every 4 weeks [as one cycle]). The primary outcome was overall survival (OS). Secondary outcomes included progression-free survival (PFS), overall response rate, duration of response, and safety. RESULTS Patients (n = 316) were randomly assigned to nivolumab (n = 157) or GEM or PLD (n = 159) between October 2015 and December 2017. Median OS was 10.1 (95% CI, 8.3 to 14.1) and 12.1 (95% CI, 9.3 to 15.3) months with nivolumab and GEM or PLD, respectively (hazard ratio, 1.0; 95% CI, 0.8 to 1.3; P = .808). Median PFS was 2.0 (95% CI, 1.9 to 2.2) and 3.8 (95% CI, 3.6 to 4.2) months with nivolumab and GEM or PLD, respectively (hazard ratio, 1.5; 95% CI, 1.2 to 1.9; P = .002). There was no statistical difference in overall response rate between groups (7.6% v 13.2%; odds ratio, 0.6; 95% CI, 0.2 to 1.3; P = .191). Median duration of response was numerically longer with nivolumab than GEM or PLD (18.7 v 7.4 months). Fewer treatment-related adverse events were observed with nivolumab versus GEM or PLD (61.5% v 98.1%), with no additional or new safety risks. CONCLUSION Although well-tolerated, nivolumab did not improve OS and showed worse PFS compared with GEM or PLD in patients with platinum-resistant ovarian cancer.
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- 2021
33. Artificial Intelligence (AI): Hidden Rules of our Society
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Mika-Petri Laakkonen
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German ,Katsaukset ,Entscheidungsproblem ,business.industry ,Field (Bourdieu) ,Research community ,language ,Katsauksia ,Contemporary society ,Sociology ,Artificial intelligence ,business ,language.human_language - Abstract
AI explanatory research community has become vital in AI, because explanatory analysis of AI opens up and explains the operating principles of the hidden rules of AI. Explanatory AI community expounds the construction role between human-machine in AI modelling, and breaks the gap in understanding the hidden layers of AI. Instead of Alan Turning’s (1936) well-known problem of decidability (Entscheidungsproblem) the review approaches the AI hidden rules of our society from them knowledge interest (Erkenntnisinteresse) premises coined by German social theorist Jürgen Habermas (1970; 1978). This review illuminates how our contemporary society is constructed with AI models and hidden rules of artificial intelligence. It shall enlighten the Artificial Intelligence (AI) modelling complexity and illustrate AI hidden rules functionality in our society. AI explanatory research community opens field of wider discursion for socio-technological scholars, where aim is to understand AI's role in our society.
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- 2021
34. Mobile Alert and Warning in the United States and Japan: Confronting the Challenges of International Harmonization
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Bean, Hamilton, Cruz, Ana Maria, Shimizu, Mika, Stephens, Keri K., McGlone, Matthew, and Strover, Sharon
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Sustainable development ,Global and Planetary Change ,Alerts ,Warning ,Disaster risk reduction ,Warning system ,business.industry ,Geography, Planning and Development ,Conference Report ,Management, Monitoring, Policy and Law ,Public relations ,United States ,Disasters ,Japan ,Natural hazard ,Political science ,Mobile technology ,Global partnership ,International harmonization ,business ,Safety Research ,Mobile device - Abstract
A U.S.-Japan expert workshop on mobile alert and warning was held online 8–10 September 2021. Funded by the Japan Foundation’s Center for Global Partnership (CGP) and responding to the Sendai Framework for Disaster Risk Reduction 2015–2030, the workshop compared U.S. and Japanese mobile alert and warning contexts, systems, policies, and messages to investigate possibilities for international harmonization of mobile device-based early warning. The workshop’s sessions revealed two interrelated issues that repeatedly surfaced among workshop participants: culture and policy. The workshop illuminated several possibilities and problems confronting U.S., Japanese, and global stakeholders as they develop, deploy, and seek to improve the effectiveness of mobile alert and warning systems and messages.
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- 2021
35. One-anastomosis gastric bypass modulates the serum levels of pro- and anti-inflammatory oxylipins, which may contribute to the resolution of inflammation
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Justyna Korczynska, Lukasz Kaska, Agata Janczy, Tomasz Sledzinski, Adriana Mika, Ivan Liakh, Alicja Pakiet, and Monika Proczko-Stepaniak
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Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Gastric Bypass ,Medicine (miscellaneous) ,Adipose tissue ,Inflammation ,Polymerase Chain Reaction ,Statistics, Nonparametric ,Insulin resistance ,Internal medicine ,medicine ,Humans ,Maresin ,Oxylipins ,chemistry.chemical_classification ,Nutrition and Dietetics ,business.industry ,Fatty acid ,Middle Aged ,Oxylipin ,medicine.disease ,Endocrinology ,chemistry ,Female ,Steatosis ,medicine.symptom ,business ,Polyunsaturated fatty acid - Abstract
Background/objectives Oxylipins are polyunsaturated fatty acid derivatives involved in the regulation of various processes, including chronic inflammation, insulin resistance and hepatic steatosis. They can be synthesized in various tissues, including adipose tissue. There is some evidence that obesity is associated with the deregulation of serum oxylipin levels. The aim of this study was to evaluate the effect of bariatric surgery (one-anastomosis gastric bypass) on the serum levels of selected oxylipins and their fatty acid precursors and to verify the hypothesis that their changes after surgery can contribute to the resolution of inflammation. Moreover, we compared the oxylipin levels (prostaglandin E2, 13-HODE, maresin 1 and resolvin E1), fatty acids and the expression of enzymes that synthesize oxylipins in adipose tissue of lean controls and subjects with severe obesity. Subjects/methods The study included 50 patients with severe obesity that underwent bariatric surgery and 41 subjects in lean, control group. Fatty acid content was analyzed by GC-MS, oxylipin concentrations were measured with immunoenzymatic assay kits and real-time PCR analysis was used to assess mRNA levels in adipose tissue. Results Our results show increased expression of some enzymes that synthesize oxylipins in adipose tissue and alterations in the levels of oxylipins in both adipose tissue and serum of subjects with obesity. After bariatric surgery, the levels of anti-inflammatory oxylipins increased, whereas pro-inflammatory oxylipins decreased. Conclusions In patients with obesity, the metabolism of oxylipins is deregulated in adipose tissue, and their concentrations in serum are altered. Bariatric surgery modulates the serum levels of pro- and anti-inflammatory oxylipins, which may contribute to the resolution of inflammation.
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- 2021
36. MODELING OPTIMAL CONTROL OF AFRICAN TRYPANOSOMIASIS DISEASE WITH COST-EFFECTIVE STRATEGIES
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Yustina A. Liana, Nyimvua Shaban, and Goodluck Mika Mlay
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Ecology ,Risk analysis (engineering) ,business.industry ,Cost effectiveness ,Applied Mathematics ,Medicine ,African trypanosomiasis ,General Medicine ,Disease ,business ,medicine.disease ,Optimal control ,Agricultural and Biological Sciences (miscellaneous) - Abstract
An optimal control model of African trypanosomiasis to minimize the cost of implementing control efforts and the number of infected humans, cattle, and tsetse-fly populations in their respective communities was formulated. Time-dependent controls such as public health education, human and cattle treatments, and tsetse-fly trapping were considered. Using Pontryagin’s maximum principle, the necessary conditions and the existence of an optimal control solution of an optimal control problem were analyzed. Using forward and backward in time fourth-order Runge–Kutta scheme, numerical simulations of the optimal control problem were performed. The results showed that the strategy involving public health education, treatment of humans, cattle treatment, and trapping of tsetse-flies was the most effective in reducing the number of infected individuals in their respective populations. Furthermore, the incremental cost-effectiveness analysis was performed, which showed that the tsetse-fly trapping was the most cost-effective strategy to implement in source limited settings.
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- 2021
37. Hospital Presentation for Self-Harm in Youth as a Risk Marker for Later Psychotic and Bipolar Disorders
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David Gyllenberg, Mika Gissler, Ulla Lång, Ian Kelleher, Juha Veijola, Koen Bolhuis, Antti Kääriälä, Child and Adolescent Psychiatry / Psychology, Nuorisopsykiatria, University of Helsinki, and HUS Psychiatry
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Adult ,Male ,Psychosis ,medicine.medical_specialty ,Bipolar Disorder ,Adolescent ,AcademicSubjects/MED00810 ,3124 Neurology and psychiatry ,Young Adult ,03 medical and health sciences ,mania ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Risk Factors ,medicine ,Humans ,Longitudinal Studies ,Registries ,bidirectional ,Bipolar disorder ,Psychiatry ,Finland ,mania/epidemiology ,suicide ,register ,Proportional hazards model ,business.industry ,Hazard ratio ,medicine.disease ,Mental illness ,030227 psychiatry ,3. Good health ,schizophrenia ,Psychiatry and Mental health ,Psychotic Disorders ,Schizophrenia ,Cohort ,Female ,epidemiology ,Emergency Service, Hospital ,business ,Self-Injurious Behavior ,030217 neurology & neurosurgery ,Regular Articles ,Cohort study - Abstract
Publisher Copyright: © 2021 The Author(s). Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. Expanding clinical strategies to identify high risk groups for psychotic and bipolar disorders is a research priority. Considering that individuals diagnosed with psychotic and bipolar disorder are at high risk of self-harm, we hypothesised the reverse order relationship would also be true (ie, self-harm would predict psychotic/bipolar disorder). Specifically, we hypothesised that hospital presentation for self-harm would be a marker of high risk for subsequent development of psychotic/bipolar disorder and sought to test this hypothesis in a large population sample. This prospective register-based study included everyone born in Finland in 1987, followed until age 28 years (N = 59 476). We identified all hospital records of self-harm presentations, as well as all ICD-10 healthcare registrations of first diagnoses of psychotic and bipolar disorders. Cox proportional hazards models were used to assess the relationship between self-harm and psychotic/bipolar disorders. Of all individuals who presented to hospital with self-harm (n = 481), 12.8% went on to receive a diagnosis of psychosis (hazard ratio [HR] = 6.03, 95% confidence interval [CI] 4.56-7.98) and 9.4% a diagnosis of bipolar disorder (HR = 7.85, 95% CI 5.73-10.76) by age 28 years. Younger age of first self-harm presentation was associated with higher risk-for individuals who presented before age 18 years, 29.1% developed a psychotic or bipolar disorder by age 28 years. Young people who present to hospital with self-harm are at high risk of future psychotic and bipolar disorders. They represent an important cohort for the prevention of serious mental illness.
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- 2021
38. Meta-analysis of epigenome-wide association studies of carotid intima-media thickness
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Shih-Jen Hwang, Jordana T. Bell, Olli T. Raitakari, Mikko Hurme, Joanna M. Wardlaw, W. David Hill, Joshua C. Bis, Traci M. Bartz, Anton J.M. Roks, John M. Starr, Wolfgang Koenig, M. Arfan Ikram, Eliana Portilla-Fernandez, Alexander Teumer, Annette Peters, Mika Kähönen, Ian J. Deary, Maryam Kavousi, Nona Sotoodehnia, Joachim Thiery, Jennifer A. Brody, Melanie Waldenberger, Ulf Schminke, Abbas Dehghan, Hans J. Grabe, Roby Joehanes, Symen Ligthart, Daniel Levy, Bruce M. Psaty, A.H. Jan Danser, Wolfgang Rathmann, Henry Völzke, Andrew Wong, Mohsen Ghanbari, Jochen Seissler, Terho Lehtimäki, Ken K. Ong, Jane Maddock, Rory P. Wilson, Christopher J. O'Donnell, Cornelia Then, Christine Meisinger, Pashupati P. Mishra, Sahar Ghasemi, Marcus Dörr, Portilla-Fernández, Eliana [0000-0003-4105-8586], Ong, Kenneth [0000-0003-4689-7530], Apollo - University of Cambridge Repository, Tampere University, Department of Clinical Chemistry, Clinical Medicine, Department of Clinical Physiology and Nuclear Medicine, BioMediTech, Epidemiology, and Internal Medicine
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0301 basic medicine ,Oncology ,medicine.medical_specialty ,Epidemiology ,Differentially methylated regions ,Aryl hydrocarbon receptor repressor ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Carotid Intima-Media Thickness ,Coronary artery disease ,03 medical and health sciences ,Epigenome ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Risk Factors ,Internal medicine ,Mendelian randomization ,Medicine ,Vascular outcomes ,Humans ,ddc:610 ,cardiovascular diseases ,Stroke ,Cardiovascular risk factors ,Epigenome-wide association studies ,DNA methylation ,business.industry ,medicine.disease ,humanities ,3142 Public health care science, environmental and occupational health ,ddc ,030104 developmental biology ,Cross-Sectional Studies ,CpG site ,Intima-media thickness ,cardiovascular system ,Common carotid intima-media thickness ,business ,Meta-Analysis - Abstract
Funder: Nederlandse Organisatie voor Wetenschappelijk Onderzoek; doi: http://dx.doi.org/10.13039/501100003246, Funder: ZonMw; doi: http://dx.doi.org/10.13039/501100001826, Funder: Research Institute for Diseases in the Elderly, Funder: Ministerie van Onderwijs, Cultuur en Wetenschap; doi: http://dx.doi.org/10.13039/501100003245, Funder: Health Promotion Administration, Ministry of Health and Welfare; doi: http://dx.doi.org/10.13039/100013227, Funder: Municipality of Rotterdam, Common carotid intima-media thickness (cIMT) is an index of subclinical atherosclerosis that is associated with ischemic stroke and coronary artery disease (CAD). We undertook a cross-sectional epigenome-wide association study (EWAS) of measures of cIMT in 6400 individuals. Mendelian randomization analysis was applied to investigate the potential causal role of DNA methylation in the link between atherosclerotic cardiovascular risk factors and cIMT or clinical cardiovascular disease. The CpG site cg05575921 was associated with cIMT (beta = -0.0264, p value = 3.5 × 10-8) in the discovery panel and was replicated in replication panel (beta = -0.07, p value = 0.005). This CpG is located at chr5:81649347 in the intron 3 of the aryl hydrocarbon receptor repressor gene (AHRR). Our results indicate that DNA methylation at cg05575921 might be in the pathway between smoking, cIMT and stroke. Moreover, in a region-based analysis, 34 differentially methylated regions (DMRs) were identified of which a DMR upstream of ALOX12 showed the strongest association with cIMT (p value = 1.4 × 10-13). In conclusion, our study suggests that DNA methylation may play a role in the link between cardiovascular risk factors, cIMT and clinical cardiovascular disease.
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- 2021
39. Involvement of the Peripheral μ-Opioid Receptor in Tramadol-Induced Constipation in Rodents
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Tsutomu Suzuki, Hirokazu Mishima, Mika Kobayashi, Masahide Fujita, Yasuhide Morioka, Motoji Kitaura, Katsumi Koike, Kana Yasufuku, Shino Takenouchi, Hiroki Chiba, and Minoru Hasegawa
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Male ,Nociception ,Constipation ,Side effect ,medicine.drug_class ,Receptors, Opioid, mu ,Pharmaceutical Science ,Pharmacology ,Rats, Sprague-Dawley ,Naldemedine ,Opioid receptor ,Intestine, Small ,Animals ,Medicine ,Rats, Wistar ,Receptor ,Tramadol ,business.industry ,Antagonist ,General Medicine ,Naltrexone ,Rats ,Analgesics, Opioid ,Opioid ,medicine.symptom ,business ,Opioid-Induced Constipation ,medicine.drug - Abstract
Tramadol is a weak opioid that produces analgesic effect via both the μ-opioid receptor (MOR) and non-opioid targets. Constipation is the most common opioid-related side effect in patients with cancer and non-cancer pain. However, the contribution of MOR to tramadol-induced constipation is unclear. Therefore, we used naldemedine, a peripherally acting MOR antagonist, and MOR-knockout mice to investigate the involvement of peripheral MOR in tramadol-induced constipation using a small intestinal transit model. A single dose of tramadol (3-100 mg/kg, per os (p.o.)) inhibited small intestinal transit dose-dependently in rats. Naldemedine (0.01-10 mg/kg, p.o.) blocked the inhibition of small intestinal transit induced by tramadol (30 mg/kg, p.o.) in rats. The transition rate increased dose-dependently over the range of naldemedine 0.01-0.3 mg/kg, and complete recovery was observed at 0.3-10 m/kg. Additionally, tramadol (30 and 100 mg/kg, subcutaneously (s.c.)) inhibited small intestinal transit in wild-type mice but not in MOR-knockout mice. These results suggest that peripheral MOR participates in tramadol-induced constipation.
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- 2021
40. Association of working hour characteristics and on-call work with risk of short sickness absence among hospital physicians: A longitudinal cohort study
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Kati Karhula, Tuula Oksanen, Sampsa Puttonen, Aki Koskinen, Jenni Ervasti, Mika Kivimäki, Mikko Härmä, Annina Ropponen, University of Helsinki, and Clinicum
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Male ,STRESS ,Shift work ,Physiology ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Physicians ,Work Schedule Tolerance ,Physiology (medical) ,on-call work ,Humans ,Medicine ,SLEEPINESS ,Longitudinal Studies ,030212 general & internal medicine ,Longitudinal cohort ,Sickness absence ,physician ,Cross-Over Studies ,business.industry ,1184 Genetics, developmental biology, physiology ,Odds ratio ,CARE ,030210 environmental & occupational health ,Hospitals ,Confidence interval ,Circadian Rhythm ,Increased risk ,Sick leave ,Female ,HEALTH ,3111 Biomedicine ,Sick Leave ,business ,Demography ,Cohort study - Abstract
Publisher Copyright: © 2021 The Author(s). Published with license by Taylor & Francis Group, LLC. Physicians often work long hours and on-call shifts, which may expose them to circadian misalignment and negative health outcomes. However, few studies have examined whether these working hour characteristics, ascertained using objective working hour records, are associated with the physicians’ risk of sickness absence. We investigated the associations of 14 characteristics of payroll-based working hours and on-call work with the risk of short sickness absence among hospital physicians. In this cohort study, 2845 physicians from six Finnish hospital districts were linked to electronic payroll-based records of daily working hours, on-call duty and short (1–3 days) sickness absence between 2005 and 2019. A case-crossover design was applied using conditional logistic regression with the 28 day case and control windows to estimate odds ratios (ORs) and 95% confidence intervals (CI) for short sickness absence. After controlling for weekly working hours and the number of normal (≤12 h) shifts, a higher number of long (>12 h) shifts (ORs for ≥5 versus none: 2.54, 95% CI 1.68–3.84), very long (>24 h) shifts (ORs for ≥5 versus none: 2.62, 95%CI 1.61–4.27), and on-call shifts (OR for ≥5 versus none: 2.15, 95% CI 1.44–3.21) and a higher number of short (
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- 2021
41. Core body temperature changes in school-age children with circadian rhythm sleep–wake disorder
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Shigemi Kimura, Shinji Kohira, Makiko Toyoura, Yutaka Takaoka, and Mika Ohta
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Male ,Core (anatomy) ,Pediatrics ,medicine.medical_specialty ,Sleep disorder ,Schools ,business.industry ,Light Exercise ,Therapeutic effect ,General Medicine ,medicine.disease ,Sleep in non-human animals ,Body Temperature ,Circadian Rhythm ,Sleep Disorders, Circadian Rhythm ,Body Temperature Changes ,medicine ,Humans ,Female ,Circadian rhythm ,Sleep onset ,Child ,Sleep ,business - Abstract
Core body temperature (CBT) is considered a valuable marker for circadian rhythm. This study aimed to investigate the changes in CBT that are associated with the symptoms of circadian rhythm sleep-wake disorder (CRSWD) post-treatment in children.Twenty-eight school-age children [10 boys and 18 girls; mean age (±standard deviation), 13.68 ± 0.93 years] who were admitted to our hospital with CRSWD underwent treatment for 6-8 weeks according to the following protocol: lights-out for sleep at 21:00; phototherapy for waking at 6:00 or 7:00; light exercise everyday (eg, a 20- to 30-min walk). CBT was continuously measured for 24 h on the first day of admission and on the first day after treatment.The mean time of sleep onset/offset (±standard deviation; in hours:minutes) 1 week before admission and 1 week after treatment were 23:53 ± 2:26/9:58 ± 2:15 and 21:17 ± 0:19/6:46 ± 0:32, respectively. The mean times of sleep onset and offset measured post-treatment were significantly earlier than those measured pre-treatment (p 0.001). The mean CBT and mean minimum CBT during sleep were significantly lower on the first day post-treatment than on the first day of admission (p = 0.011 and p 0.001, respectively).Symptom improvements in patients with CRSWD were associated with a decrease in CBT during sleep, suggesting that CBT may be a biomarker for improvements in CRSWD. These results help elucidate the cause of this sleep disorder.
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- 2021
42. Persistent intrathecal interleukin-8 production in a patient with SARS-CoV-2-related encephalopathy presenting aphasia: a case report
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Nobuaki Yoshikura, Kenjiro Kunieda, Akio Kimura, Takuya Kudo, Mika Otsuki, Takayoshi Shimohata, and Yuichi Hayashi
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Male ,medicine.medical_specialty ,Neurology ,Encephalopathy ,Systemic inflammation ,Gastroenterology ,Cerebrospinal fluid ,Aphasia ,Internal medicine ,Case report ,medicine ,Humans ,RC346-429 ,Aged, 80 and over ,Brain Diseases ,IL-8 ,business.industry ,SARS-CoV-2 ,Interleukin-8 ,Interleukin ,COVID-19 ,General Medicine ,medicine.disease ,Methylprednisolone ,Agraphia ,Neurology (clinical) ,Neurology. Diseases of the nervous system ,medicine.symptom ,business ,medicine.drug - Abstract
BackgroundNeurological manifestations of coronavirus disease 2019 (COVID-19) are increasingly recognized and include encephalopathy, although direct infection of the brain by SARS-CoV-2 remains controversial. We herein report the clinical course and cytokine profiles of a patient with severe SARS-CoV-2-related encephalopathy presenting aphasia.Case presentationAn 81-year-old man developed acute consciousness disturbance and status epileptics several days after SARS-CoV-2 infection. Following treatment with remdesivir and dexamethasone, his consciousness and epileptic seizures improved; however, amnestic aphasia and agraphia remained. Two months after methylprednisolone pulse and intravenous immunoglobulin, his neurological deficits improved. We found increased levels of interleukin (IL)-6, IL-8, and monocyte chemoattractant protein-1 (MCP-1), but not IL-2 and IL-10 in the serum and cerebrospinal fluid (CSF), and the levels of serum IL-6 and MCP-1 were much higher than those in the CSF. The level of IL-8 in the CSF after immunotherapy was four times higher than that before immunotherapy.ConclusionThe cytokine profile of our patient was similar to that seen in severe SARS-CoV-2-related encephalopathy. We demonstrated (i) that the characteristic aphasia can occur as a focal neurological deficit associated with SARS-CoV-2-related encephalopathy, and (ii) that IL8-mediated central nervous system inflammation follows systemic inflammation in SARS-CoV-2-related encephalopathy and can persist and worsen even after immunotherapy. Monitoring IL-8 in CSF, and long-term corticosteroids may be required for treating SARS-CoV-2-related encephalopathy.
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- 2021
43. Prediction of bleb formation in intracranial aneurysms using machine learning models based on aneurysm hemodynamics, geometry, location, and patient population
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Matthew J Koch, Fady T. Charbel, Juhana Frösen, Timothy G White, Timo Koivisto, Seyedeh Fatemeh Salimi Ashkezari, Behnam Rezai Jahromi, Spandan Maiti, Henry H. Woo, Yasutaka Tobe, Mika Niemelä, Anne M. Robertson, Martin Slawski, Juan R. Cebral, Alexander Yu, Fernando Mut, Sepideh Amin-Hanjani, and Boyle C. Cheng
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Geometry ,Aneurysm, Ruptured ,Logistic regression ,Machine learning ,computer.software_genre ,Article ,030218 nuclear medicine & medical imaging ,Machine Learning ,03 medical and health sciences ,Blister ,0302 clinical medicine ,Aneurysm ,Humans ,Medicine ,Bleb (cell biology) ,Time point ,business.industry ,Hemodynamics ,Intracranial Aneurysm ,General Medicine ,Blood flow ,medicine.disease ,Random forest ,Support vector machine ,Cross-Sectional Studies ,Hydrodynamics ,Surgery ,Neurology (clinical) ,False positive rate ,Artificial intelligence ,business ,computer ,030217 neurology & neurosurgery - Abstract
BackgroundBleb presence in intracranial aneurysms (IAs) is a known indication of instability and vulnerability.ObjectiveTo develop and evaluate predictive models of bleb development in IAs based on hemodynamics, geometry, anatomical location, and patient population.MethodsCross-sectional data (one time point) of 2395 IAs were used for training bleb formation models using machine learning (random forest, support vector machine, logistic regression, k-nearest neighbor, and bagging). Aneurysm hemodynamics and geometry were characterized using image-based computational fluid dynamics. A separate dataset with 266 aneurysms was used for model evaluation. Model performance was quantified by the area under the receiving operating characteristic curve (AUC), true positive rate (TPR), false positive rate (FPR), precision, and balanced accuracy.ResultsThe final model retained 18 variables, including hemodynamic, geometrical, location, multiplicity, and morphology parameters, and patient population. Generally, strong and concentrated inflow jets, high speed, complex and unstable flow patterns, and concentrated, oscillatory, and heterogeneous wall shear stress patterns together with larger, more elongated, and more distorted shapes were associated with bleb formation. The best performance on the validation set was achieved by the random forest model (AUC=0.82, TPR=91%, FPR=36%, misclassification error=27%).ConclusionsBased on the premise that aneurysm characteristics prior to bleb formation resemble those derived from vascular reconstructions with their blebs virtually removed, machine learning models can identify aneurysms prone to bleb development with good accuracy. Pending further validation with longitudinal data, these models may prove valuable for assessing the propensity of IAs to progress to vulnerable states and potentially rupturing.
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- 2021
44. Allergic sensitisation did not affect bronchial hyper‐responsiveness in children without respiratory tract symptoms
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Mika J. Mäkelä, Sami Remes, and Janne Burman
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Male ,medicine.medical_specialty ,Respiratory System ,Bronchial Provocation Tests ,Atopy ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Respiratory system ,Child ,Methacholine Chloride ,Skin Tests ,030304 developmental biology ,Asthma ,0303 health sciences ,Cumulative dose ,business.industry ,Incidence (epidemiology) ,General Medicine ,medicine.disease ,3. Good health ,medicine.anatomical_structure ,030228 respiratory system ,Bronchial hyperresponsiveness ,Pediatrics, Perinatology and Child Health ,Female ,Methacholine ,Bronchial Hyperreactivity ,business ,medicine.drug ,Respiratory tract - Abstract
AIM The potential for immunotherapy to prevent asthma development has become a hot topic. This prompted us to revisit data from an early study that examined allergic sensitisation on bronchial hyperresponsiveness (BHR) in children with and without respiratory symptoms. Unlike previous studies, it used both indirect and direct test methods. METHODS The study was conducted in Kuopio, Finland, in 1994 and 247 children (55.1% boys) with a mean age 10.5 ± 1.7 years were recruited using a school survey: 165 with lower respiratory symptoms and 82 healthy controls. Each child underwent a 6-min free-running test and a methacholine test with a cumulative dose of 4900 µg. All participants underwent skin-prick tests: 127were sensitised and 120 were non-sensitised. RESULTS There were no significant differences in lung function between the sensitised and non-sensitised children. However, sensitisation was associated with BHR which was measured by both the methacholine test (2400 µg versus >4900 µg, p
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- 2021
45. Evaluation of ultrastructural alterations of glomerular basement membrane and podocytes in glomeruli by low-vacuum scanning electron microscopy
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Lan Ping, Xiaoyang Yu, Akiko Mii, Dedong Kang, Lyu Jia, Masako Tagawa, Liyi Xie, Mika Terasaki, Akira Shimizu, and Yoko Endo
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medicine.medical_specialty ,Pathology ,Vacuum ,Physiology ,Kidney ,Immunofluorescence ,Heymann Nephritis ,Membranous nephropathy ,Physiology (medical) ,Internal medicine ,Glomerular Basement Membrane ,medicine ,Animals ,Humans ,Frozen section procedure ,medicine.diagnostic_test ,Podocytes ,business.industry ,Glomerular basement membrane ,medicine.disease ,Rats ,Staining ,medicine.anatomical_structure ,Renal pathology ,Nephrology ,Microscopy, Electron, Scanning ,Ultrastructure ,business - Abstract
BackgroundLow-vacuum scanning electron microscopy (LV-SEM) is applied to diagnostic renal pathology.MethodsTo demonstrate the usefulness of LV-SEM and to clarify the optimal conditions of pathology samples, we investigated the alterations of glomerular basement membrane (GBM) and podocytes in control and experimental active Heymann nephritis (AHN) rats by LV-SEM.ResultsOn week 15 following induction of AHN, spike formation on GBM with diffuse deposition of IgG and C3 developed. Using LV-SEM, diffuse crater-like protrusions were clearly noted three-dimensionally (3D) on surface of GBM in the same specimens of light microscopy (LM) and immunofluorescence (IF) studies only after removal coverslips or further adding periodic acid-silver methenamine (PAM) staining. These 3D ultrastructural findings of GBM surface could be detected in PAM-stained specimens by LV-SEM, although true GBM surface findings could not be obtained in acellular glomeruli, because some subepithelial deposits remained on surface of GBM. Adequate thickness was 1.5–5 μm for 10% formalin-fixed paraffin-embedded (FFPE) and 5–10 μm for the unfixed frozen sections. The foot processes and their effacement of podocytes could be observed by LV-SEM using 10%FFPE specimens with platinum blue (Pt-blue) staining or double staining of PAM and Pt-blue. These findings were obtained more large areas in 2.5% glutaraldehyde-fixed paraffin-embedded (2.5%GFPE) specimens.ConclusionOur findings suggest that LV-SEM is a useful assessment tool for evaluating the alterations of GBM and podocytes in renal pathology using routine LM and IF specimens, as well as 2.5%GFPE specimens.
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- 2021
46. Long-term safety and effectiveness of mycophenolate mofetil in adults with lupus nephritis: a real-world study in Japan
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Hideyuki Hashimoto, Tsutomu Takeuchi, and Mika Matsumoto
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Adult ,Pediatrics ,medicine.medical_specialty ,business.industry ,Remission Induction ,Lupus nephritis ,Mycophenolic Acid ,medicine.disease ,Mycophenolate ,Herpes Zoster ,Lupus Nephritis ,Treatment Outcome ,Japan ,Rheumatology ,Humans ,Medicine ,Prospective Studies ,Long term safety ,business ,Cyclophosphamide ,Immunosuppressive Agents - Abstract
Objectives To assess the safety and effectiveness of mycophenolate mofetil (MMF) in Japanese adults with lupus nephritis (LN) in real-world clinical practice. Methods This multicentre, prospective, post-marketing surveillance study investigated the effectiveness and safety of MMF, as induction or maintenance therapy, in LN patients. Primary endpoints were adverse drug reactions (ADRs), changes in renal function from baseline, and relapse rate (RR) after 6 months in the maintenance group, estimated using the Kaplan–Meier method. Complete remission (CR) and partial remission (PR) were estimated by renal measurements. Results Overall, 112 patients were enrolled in the induction group and 340 in the maintenance group. Of these 452 patients, 418 were evaluable for safety and 396 for effectiveness. Eighty-three patients (19.85%) experienced ADRs, most commonly herpes zoster (3.34%) and diarrhoea (3.11%). Serious ADRs occurring in more than three patients were cytomegalovirus infections (1.43%), acute pyelonephritis (0.71%), and herpes zoster (0.71%). One patient died from herpes zoster disseminated. CR and PR were 19.54% and 44.82%, respectively, in the induction group, and 40.62% and 66.16%, respectively, in the maintenance group. RR in the maintenance group was 0.70%. Conclusions The tolerability of MMF is in line with that reported in other studies. Since the average dose of MMF was
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- 2021
47. Self-Powered, Ultrathin, and Transparent Printed Pressure Sensor for Biosignal Monitoring
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Mikko Peltokangas, Karem Lozano Montero, Jarmo Verho, Mika-Matti Laurila, Mira Haapala, Antti Vehkaoja, Niku Oksala, Matti Mäntysalo, Tampere University, Electrical Engineering, BioMediTech, Verisuoni- ja toimenpideradiologinen keskus, and Clinical Medicine
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318 Medical biotechnology ,Materials science ,business.industry ,213 Electronic, automation and communications engineering, electronics ,02 engineering and technology ,3121 Internal medicine ,010402 general chemistry ,021001 nanoscience & nanotechnology ,01 natural sciences ,Pressure sensor ,0104 chemical sciences ,Electronic, Optical and Magnetic Materials ,Materials Chemistry ,Electrochemistry ,Optoelectronics ,Biosignal ,0210 nano-technology ,business - Abstract
Ultrathin sensing devices utilizing piezoelectric materials have emerged as potential candidates to develop highly skin-conformable and energy-efficient continuous biosignal monitoring systems. However, biocompatible, cost-efficient, and simple fabrication processes still need to be investigated to enable wider adoption of such devices. This study proposes a simple two-step printing process for the fabrication of a piezoelectric biosignal sensor that utilizes readily available and biocompatible polymer-based materials for the substrate (i.e., Parylene-C), electroactive layer (i.e., poly(vinylidene fluoride-trifluoroethylene) (PVDF-TrFE)), and interdigitated electrodes (i.e., poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS)). The proposed interdigitated electrode architecture improves upon the conventional metal–insulator–metal architecture by (1) increasing the thickness-normalized output voltage and (2) enabling the detection of bending orientation. The performance of the proposed sensor structure is demonstrated with the measurement of the arterial pulse waveform signal and limb movement detection. The presented results pave the way for cost-effective and continuous unobtrusive on-skin biosignal monitoring. publishedVersion
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- 2021
48. Psychiatric disorders diagnosed in adolescence and subsequent long-term exclusion from education, employment or training: longitudinal national birth cohort study
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Antti Kääriälä, Ida Ringbom, Mika Gissler, Jaana Suvisaari, David Gyllenberg, Andre Sourander, and Tiina Ristikari
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Adult ,Employment ,medicine.medical_specialty ,Adolescent ,Autism Spectrum Disorder ,business.industry ,Mental Disorders ,030227 psychiatry ,Term (time) ,Cohort Studies ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Child, Preschool ,Humans ,Medicine ,Birth Cohort ,030212 general & internal medicine ,10. No inequality ,business ,Birth cohort ,Psychiatry - Abstract
BackgroundLong-term ‘not in education, employment or training’ (NEET) status is an important indicator of youth marginalisation.AimsTo carry out a comprehensive overview of the associations between different psychiatric illnesses and long-term NEET status.MethodWe used the register-based 1987 Finnish Birth Cohort study, which includes all live births in Finland during that year. The analyses comprised 55 273 individuals after exclusions for intellectual disability, death or emigration. We predicted that psychiatric disorders, diagnosed by specialist services between 1998 and 2007 when the cohort were 10–20 years of age, would be associated with subsequent long-term NEET (defined as NEET for at least 5 years between 2008 and 2015, when they were 20–28 years of age).ResultsIn total, 1438 individuals (2.6%) were long-term NEET during follow-up and the associations between long-term NEET and the 11 diagnostic categories we studied were statistically significant (P < 0.001). In multivariate models we included sociodemographic characteristics and upper secondary education as covariates, and the highest effect sizes, measured by odds ratios (OR) with 95% confidence intervals (CI), were found for psychosis (OR = 12.0, 95% CI 9.5–15.2) and autism spectrum disorder (OR = 17.3, 95% CI 11.5–26.0). If individuals had not successfully completed this education, 70.6% of those with autism spectrum disorder and 48.4% of those with psychosis were later long-term NEET.ConclusionsAdolescents who receive treatment for psychiatric disorders, particularly autism spectrum disorder or psychosis, need support to access education and employment. This could help to prevent marginalisation in early adulthood.
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- 2021
49. The clinical significance of tertiary lymphoid structure and its relationship with peripheral blood characteristics in patients with surgically resected non-small cell lung cancer: a single-center, retrospective study
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Hironori Takagi, Jun Osugi, Mika Hoshino, Yuki Matsumura, Hiroyuki Suzuki, Hikaru Yamaguchi, Hayato Mine, Mitsuro Fukuhara, Masayuki Watanabe, Yutaka Shio, Takuya Inoue, Mitsunori Higuchi, Sho Inomata, Yuki Ozaki, Takumi Yamaura, Takeo Hasegawa, Satoshi Muto, and Naoyuki Okabe
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Oncology ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Immunology ,Single Center ,Peripheral blood mononuclear cell ,Lymphocytes, Tumor-Infiltrating ,Carcinoma, Non-Small-Cell Lung ,Internal medicine ,Tumor Microenvironment ,medicine ,Humans ,Immunology and Allergy ,Clinical significance ,Mass cytometry ,Neutrophil to lymphocyte ratio ,Lung cancer ,Retrospective Studies ,Tumor microenvironment ,business.industry ,Retrospective cohort study ,Prognosis ,medicine.disease ,Tertiary Lymphoid Structures ,business - Abstract
The presence of tertiary lymphoid structure (TLS) in tumor tissues has been reported to be a factor associated with a good prognosis in several types of cancers. However, the relationship between TLS formation and peripheral blood findings remains unclear. The purposes of the study were to evaluate the effect of the presence of TLS on survival and determine the peripheral blood characteristics associated with TLS formation in non-small cell lung cancer (NSCLC) patients. A total of 147 consecutive NSCLC patients who underwent lung resection at Fukushima Medical University Hospital between 2013 and 2017 were enrolled. TLS expression was evaluated, and the relationships between clinical parameters and outcomes were analyzed. Peripheral blood mononuclear cells (PBMCs) were further analyzed by mass cytometry to characterize the TLS-positive microenvironment. Forty-six patients had high TLS expression, and the remaining 101 patients had low TLS expression. In stage II to IV patients (n = 35), disease-free survival was longer in the high TLS expression group (p = 0.027). A low neutrophil to lymphocyte ratio (NLR)
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- 2021
50. The Association of Lumbosacral Transitional Vertebrae with Low Back Pain and Lumbar Degenerative Findings in MRI
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Juhani H Määttä, Jaro Karppinen, Jaakko Niinimäki, Jaakko Hanhivaara, and Mika T. Nevalainen
- Subjects
medicine.medical_specialty ,Disc protrusion ,Cohort Studies ,Lumbar ,Internal medicine ,medicine ,Chi-square test ,Humans ,Orthopedics and Sports Medicine ,Retrospective Studies ,Lumbar Vertebrae ,business.industry ,Modic changes ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Low back pain ,Large cohort ,Cross-Sectional Studies ,Birth Cohort ,Neurology (clinical) ,medicine.symptom ,business ,Birth cohort ,Low Back Pain ,Lumbosacral joint - Abstract
Study design A cross-sectional study of the Northern Finland Birth Cohort 1966 (NFBC1966). Objective To evaluate the association of lumbosacral transitional vertebrae (LSTV) with low back pain (LBP) and associated degenerative findings using MR imaging. Summary of background data LSTV is a common finding with a prevalence of 10% to 29%. LSTV causes biomechanical alterations leading to accelerated lumbar degeneration. However, its association with degenerative findings on MRI and LBP is unclear. Methods 1468 lumbar spine MRI scans from the NFBC1966 acquired at a mean age of 47 years were assessed for the presence of LSTV and degenerative changes. Castellvi classification was utilized to identify LSTV anatomy. Additionally, 100 controls without LSTV were collected. Self-reported LBP with a duration of >30 days in the past year was deemed clinically relevant. For the statistical analyses, chi square test, independent samples t-test and multinomial logistic regression analyses were used. Results LSTV was found in 310 (21.1%) subjects. After adjusting for age, sex and disc degeneration (DD) sum, subjects with Castellvi type III reported prolonged LBP significantly more frequently than the controls (OR = 8.9, p = 0.001). We observed a higher prevalence of facet degeneration (FD) at all levels from L3/L4 to L5/S1 in type I, and L3/L4 to L4/L5 in types II-IV. DD was more prevalent at L4/L5 in types II-IV. Disc protrusion/extrusion occurred more frequently at L3/L4 and L4/L5 in type II, and at L3/L4 in type III. Castellvi type II had a higher prevalence of type 1 Modic changes at all levels from L3/L4 to L5/S1, and type IV had a higher prevalence of any Modic changes at L4/L5. Conclusion LSTVs were a common finding within this study, and Castellvi type III LSTVs were associated with LBP. Degenerative findings were associated with LSTV anatomy and occurred more commonly above the transitional level.Level of Evidence: 3.
- Published
- 2021
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