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1. Development of omega-3 enriched egg using fish-oil based fowl feed supplement

Author: Benny Antony, Merina Benny, Sunil Jose, Sherina Jacob, Vinod Nedumpilly, Ajimol M S, and Giby Abraham
Subjects: eicosapentaenoic acid, docosahexaenoic acids, omega-3, fatty acids, fish oil, dietary supplements, Animal culture, SF1-1100, Food processing and manufacture, TP368-456
Abstract: SUMMARY: Nutritional content of egg can be manipulated by altering hen feed. Developing an economical fowl feed supplement to produce omega-3 enriched egg from purified fish oil, produced using a proprietary method, leads to a value-added product. The objective of the study was to evaluate the effect of feeding an omega-3 enriched fowl feed supplement on the concentration and/or levels of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and omega-3 content in eggs obtained thereafter. Thirty BV-380 strain hens were divided into 5 groups and fed varying doses of the omega-3 supplement along with their regular feed. Eggs collected over 180 days were analyzed for EPA, DHA, and omega-3 content. Results showed that as the supplement dose increased, so did the EPA, DHA, and omega-3 concentrations in the eggs, with significant differences compared to the control group. Specifically, after 180 days, the EPA, DHA, and omega-3 content in eggs ranged from 11.4 to 28.71 mg/100 g, 116.41 to 206.62 mg/100 g, and 172.03 to 327.78 mg/100 g, respectively, depending on the supplement dose. This research demonstrates the feasibility of enhancing the nutritional value of eggs through dietary manipulation, offering a practical method for producing omega-3 enriched eggs.
Published: 2024
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2. Long-term effects of vitamin D supplementation and maintaining sufficient vitamin D on knee osteoarthritis over 5 years

Author: Zhiqiang Wang, Zhaohua Zhu, Feng Pan, Shuang Zheng, Venkat Parameswaran, Leigh Blizzard, Changhai Ding, and Benny Antony
Subjects: Vitamin D, Osteoarthritis, Knee symptoms, Depression, Knee surgery, Diseases of the musculoskeletal system, RC925-935
Abstract: Abstract Objectives This study aimed to investigate the long-term effect of vitamin D supplementation compared to placebo over 5 years in participants with knee osteoarthritis (OA). We also aimed to describe the effect of maintaining sufficient serum vitamin D levels over five years in knee OA. Methods Participants (n = 173) from the Hobart centre of the Vitamin D Effects on Osteoarthritis (VIDEO) trial were extensively followed up 3 years after the cessation of 2-year investigational treatment. Participants were classified as maintaining sufficient vitamin D (n = 79) and not maintaining sufficient vitamin D (n = 61) groups. Results There was no significant difference in change in the knee symptoms, depression, and serum levels of IL6 and hs-CRP between both comparisons after 3 years of cessation of the clinical trial. However, among participants who reported no knee surgery (KS), there was a significant improvement in WOMAC function (β: − 83.7, 95% CI: − 167.3, 0) and depression scores (β: − 1.3, 95% CI: − 2.3, − 0.2) in vitamin D group compared to the placebo group. Similarly, those who maintained adequate vitamin D levels over 5 years had significantly less WOMAC knee pain (β: − 33.9, 95% CI: − 65.7, − 2) and physical dysfunction (β: − 105.5, 95% CI: − 198.2, − 12.8) than participants with vitamin D deficiency over 5 years. Conclusion Vitamin D supplementation over 2 years or maintaining vitamin D sufficiency for 5 years was not associated with statistically significant differences in change in knee symptom scores over 5 years. However, among participants who did not report KS, 2-year vitamin D supplementation and maintaining sufficient vitamin D was linked to modest improvements in knee symptoms and depression scores in knee OA.
Published: 2023
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3. Pharmacokinetics and bioequivalence of Withania somnifera (Ashwagandha) extracts – A double blind, crossover study in healthy adults

Author: Se-Kwon Kim, Jayachandran Venkatesan, Priyank Rathi, and Benny Antony
Subjects: Ashwagandha, Withania somnifera, Bioavailability, Bioequivalence, Withaferin A, Withanolide A, Science (General), Q1-390, Social sciences (General), H1-99
Abstract: Introduction: Withania somnifera (WS) or ashwagandha is an adaptogenic plant used extensively in traditional medicines and as a food supplement. Despite a long history of use and numerous clinical trials, the human pharmacokinetics of withanolides, the active phytochemicals in WS extracts, have not been fully evaluated. This study evaluated the oral pharmacokinetics and bioequivalence of active withanolides in human plasma after administration of a single dose of two commercial ashwagandha extracts containing equal amounts of total withanolides. Methods: This randomized, double-blind, single-dose crossover study of 16 healthy human volunteers evaluated the acute oral bioavailability of withanolides and the bioequivalence of two WS extracts, WS-35 and WS-2.5. WS-35 was standardized to total withanolides not less than 40% comprising not less than 35% withanolide glycosides and WS-2.5 was standardized to 2.5% withanolides. The clinical dosages were normalized to 185 mg of total withanolide in each extract at the bioequivalent dosages. The pharmacokinetic parameters of withanolide A, withanoside IV, withaferin A, and total withanolides were quantified in the blood plasma using a validated LC-MS/MS method. Results: The half-life, C-max, and mean residence time of the total withanolides were 5.18, 5.62 and 4.13 times significantly higher and had lower systemic clearance with WS-35 than with WS-2.5 extract. Considering the plasma AUC 0-inf of total withanolides per mg of each WS extract administered orally, WS-35 was 280.74 times more bioavailable than WS-2.5. Conclusion: The results of this study highlight the importance of withanolide glycosides in improving the pharmacokinetics of WS extracts. Owing to its superior pharmacokinetic profile, WS-35, with 35% withanolide glycosides, is a promising candidate for further studies on Withania somnifera. Clinical trial registration: CTRI/2020/10/028397 [registered on:13/10/2020] (Trial prospectively registered) http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=42149&EncHid=&userName=CTRI/2020/10/028397.
Published: 2023
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4. Impact of Pain on Activities of Daily Living in Older Adults: A Cross-Sectional Analysis of Korean Longitudinal Study of Aging (KLoSA)

Author: Ambrish Singh, Sreelatha Akkala, Minakshi Nayak, Anirudh Kotlo, Naresh Poondla, Syed Raza, Jim Stankovich, and Benny Antony
Subjects: pain, elderly, activities of daily living, quality of life, musculoskeletal pain, multisite pain, Geriatrics, RC952-954.6
Abstract: Pain, particularly musculoskeletal (MSK) and multi-site pain, significantly impacts activities of daily living (ADL) in the elderly, leading to a decline in overall quality of life (QoL). This study, comprising 7490 participants, (mean age: 69 ± 10; females: 57%) from the sixth wave of the Korean Longitudinal Study of Aging (KLoSA), aimed to assess the association between self-reported pain and ADL impairment among the elderly population. Notably, 62% of participants reported experiencing pain, with back pain being the most prevalent (36%) and stomachache the least (0.39%). A majority (61%) of individuals reported MSK-related pain. Additionally, 20% reported pain at one site and 0.03% experienced pain at 12 sites. ADL impairment was observed in 376 (5.0%) participants. Compared to those without pain, participants reporting moderate and severe pain had higher odds of ADL impairment [2.31 (95% CI, 1.66–3.21) and 2.98 (95% CI, 1.95–4.53), respectively]. Pain experienced in the shoulder, arm, wrist, back, hip, leg, and ankle had a significant association with ADL impairment, with ORs ranging from 2.66 (95% CI, 1.80–3.93; hip pain) to 1.36 (95% CI 1.07–1.72; back pain). Furthermore, multi-site pain was associated with higher ADL impairment [1–6 sites: OR: 1.49 (95% CI, 1.11–2.01); 7–12 sites: OR: 7.16 (95% CI, 3.60–14.26)]. These findings underscore the importance of addressing MSK and multi-site pain through targeted interventions, potentially enhancing ADL and contributing to an improved QoL among the elderly population.
Published: 2024
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5. Study protocol for a randomised controlled trial of diacerein versus placebo to treat knee osteoarthritis with effusion-synovitis (DICKENS)

Author: Guoqi Cai, Graeme Jones, Flavia M. Cicuttini, Anita E. Wluka, Yuanyuan Wang, Catherine Hill, Helen Keen, Benny Antony, Xia Wang, Barbara de Graaff, Michael Thompson, Tania Winzenberg, Kathy Buttigieg, and Dawn Aitken
Subjects: Diacerein, Effusion-synovitis, Knee pain, Magnetic resonance imaging (MRI), Osteoarthritis (OA), Randomised controlled trial, Medicine (General), R5-920
Abstract: Abstract Background There is an unmet need for treatments for knee osteoarthritis (OA). Effusion-synovitis is a common inflammatory phenotype of knee OA and predicts knee pain and structural degradation. Anti-inflammatory therapies, such as diacerein, may be effective for this phenotype. While diacerein is recommended for alleviating pain in OA patients, evidence for its effectiveness is inconsistent, possibly because studies have not targeted patients with an inflammatory phenotype. Therefore, we will conduct a multi-centre, randomised, placebo-controlled double-blind trial to determine the effect of diacerein on changes in knee pain and effusion-synovitis over 24 weeks in patients with knee OA and magnetic resonance imaging (MRI)-defined effusion-synovitis. Methods We will recruit 260 patients with clinical knee OA, significant knee pain, and MRI-detected effusion-synovitis in Hobart, Melbourne, Adelaide, and Perth, Australia. They will be randomly allocated to receive either diacerein (50mg twice daily) or identical placebo for 24 weeks. MRI of the study knee will be performed at screening and after 24 weeks of intervention. The primary outcome is improvement in knee pain at 24 weeks as assessed by a 100-mm visual analogue scale (VAS). Secondary outcomes include improvement in volumetric (ml) and semi-quantitative (Whole-Organ Magnetic Resonance Imaging Score, 0–3) measurements of effusion-synovitis using MRI over 24 weeks, and improvement in knee pain (VAS) at 4, 8, 12, 16, and 20 weeks. Intention-to-treat analyses of primary and secondary outcomes will be performed as the primary analyses. Per protocol analyses will be performed as the secondary analyses. Discussion This study will provide high-quality evidence to determine whether diacerein improves pain, changes disease trajectory, and slows disease progression in OA patients with effusion-synovitis. If diacerein proves effective, this has the potential to significantly benefit the substantial proportion (up to 60%) of knee OA patients with an inflammatory phenotype. Trial registration Australian and New Zealand Clinical Trial Registry ACTRN12618001656224 . Registered on 08 October 2018.
Published: 2022
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6. Efficacy and safety of hydroxychloroquine in osteoarthritis: a systematic review and meta-analysis of randomized controlled trials

Author: Ambrish Singh, Anirudh Kotlo, Zhiqiang Wang, Thusharika Dissanayaka, Siddharth Das, and Benny Antony
Subjects: hydroxychloroquine, osteoarthritis, systematic review, meta-analysis, randomized controlled trial, Medicine
Abstract: Background/Aims Conventional disease-modifying anti-rheumatic drugs have been trialed in osteoarthritis (OA). Hydroxychloroquine (HCQ), which has shown its effectiveness in rheumatoid arthritis, has been trialed for the treatment of OA; however, its efficacy and safety remain unclear. This systematic review and meta-analysis evaluate efficacy and safety of HCQ for the treatment of OA. Methods MEDLINE, EMBASE, and Cochrane Central were searched from inception through June 2020. Two reviewers independently screened for randomized controlled trials (RCTs) comparing HCQ with placebo or other active-comparators for the treatment of knee, hand, or hip OA, extracted data, and performed Cochrane risk of bias assessments. Results Six RCTs, four in hand OA, two in knee OA, consisting of 842 patients (436 in HCQ arm, 406 in control arm) were included. RCTs were conducted between 2012 and 2020, one each at UK, Netherlands, Germany, Italy, Iran, and Egypt; follow-up period ranged 24 to 52 weeks. High-quality evidence showed no clinically important pain reduction with HCQ compared to placebo/active-control in hand OA (standardized mean difference [SMD], 0.14; 95% confidence interval [CI], –0.20 to 0.48). Effect on pain reduction in knee and hand OA was small and non-significant (SMD, –0.09; 95% CI, –0.44 to 0.25). High-quality evidence showed no improvement in dysfunction with HCQ compared to placebo in hand OA patients (SMD, 0.08; 95% CI, –0.23 to 0.40). Effect on dysfunction improvement in knee and hand OA was modest and statistically non-significant (SMD, –0.20; 95% CI,–0.57 to 0.18). No improvement in quality of life was observed in hand OA. Conclusions HCQ has no benefit in reducing pain and improving physical function in hand or knee OA patients.
Published: 2022
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7. Associations between the morphological parameters of proximal tibiofibular joint (PTFJ) and changes in tibiofemoral joint structures in patients with knee osteoarthritis

Author: Jun Chang, Tianyu Chen, Yizhu Yan, Zhaohua Zhu, Weiyu Han, Yi Zhao, Benny Antony, Anita Wluka, Tania Winzenberg, Flavia Cicuttini, and Changhai Ding
Subjects: Diseases of the musculoskeletal system, RC925-935
Abstract: Abstract Background To describe the longitudinal associations between the morphological parameters of proximal tibiofibular joint (PTFJ) and joint structural changes in tibiofemoral compartments in patients with knee osteoarthritis (OA). Methods The participants were selected from the Vitamin D Effects on Osteoarthritis (VIDEO) study. PTFJ morphological parameters were measured on coronal and sagittal MRI. The contacting area (S) of PTFJ and its projection areas onto the horizontal (load-bearing area, Sτ), sagittal (lateral stress-bolstering area, Sφ), and coronal plane (posterior stress-bolstering area, Sυ) were assessed. Knee structural abnormalities, including cartilage defects, bone marrow lesions (BMLs), and cartilage volume, were evaluated at baseline and after 2 years. Log binominal regression models and linear regression models were used to assess the associations between PTFJ morphological parameters and osteoarthritic structural changes. Results In the longitudinal analyses, the S (RR: 1.45) and Sτ (RR: 1.55) of PTFJ were significantly and positively associated with an increase in medial tibial (MT) cartilage defects. The Sτ (β: − 0.07), Sυ (β: − 0.07), and S (β: − 0.06) of PTFJ were significantly and negatively associated with changes in MT cartilage volume. The Sτ (RR: 1.55) of PTFJ was positively associated with an increase in MT BMLs, and Sφ (RR: 0.35) was negatively associated with an increase in medial femoral BMLs. Conclusions This longitudinal study suggests that higher load-bearing area of PTFJ could be a risk factor for structural changes in medial tibiofemoral (MTF) compartment in knee OA. Trial registration Clinicaltrials.gov Identifier: NCT01176344 Anzctr.org.au Identifier: ACTRN12610000495022 Date of registration: 7 May 2010
Published: 2022
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8. Protocol for a systematic review and meta-analysis of minimal important differences for generic multiattribute utility instruments

Author: Andrew J Palmer, Bruce V Taylor, Qing Xia, Benny Antony, Julie A Campbell, Ingrid van der Mei, Ambrish Singh, Steve Simpson-Yap, Suzi B Claflin, and Glen James Henson
Subjects: Medicine
Abstract: Introduction Generic multiattribute utility instruments (MAUIs) are efficient tools for determining and enumerating health-related quality of life. MAUIs accomplish this by generating health state utilities (HSUs) via algorithms. Minimal important differences (MIDs) assist with the interpretation of HSUs by estimating minimum changes that are clinically significant. The overall goal of the proposed systematic review and meta-analysis is the development of comprehensive guidelines for MID estimation.Methods and analysis This protocol defines a systematic review and meta-analysis of MIDs for generic MAUIs. The proposed research will involve a comprehensive investigation of 10 databases (EconLit, IDEAs database, INAHTA database, Medline, PsycINFO, Embase, Emcare, JBIEBP and CINAHL) from 1 June 2022 to 7 June 2022, and will be performed and reported in accordance with several validated guidelines, principally the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of papers, considered for inclusion in the review, will be appraised using the COnsensus-based Standards for the selection of health Measurement INstruments, inter alia.Narrative analysis will involve identifying the characteristics of MIDs including methods of calculation, sources of heterogeneity, and validation. Meta-analysis will also be conducted. The descriptive element of meta-analysis will involve the generation of I2 statistics and Galbraith plots of MID heterogeneity. Together with narrative analysis, this will allow sources of MID heterogeniety to be identified. A multilevel mixed model, estimated via restricted maximum likelihood estimation, will be constructed for the purposes of meta-regression. Meta-regression will attempt to enumerate the effects of sources of heterogeneity on MID estimates. Meta-analysis will be concluded with pooling of MIDs via a linear random-effects model.Ethics and dissemination Ethics approval is not required for this review, as it will aggregate data from published literature. Methods of dissemination will include publication in a peer-reviewed journal, as well as presentation at conferences and seminars.PROSPERO registration number CRD42021261821.
Published: 2022
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9. Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

Author: Shuang Zheng, Liudan Tu, Flavia Cicuttini, Zhaohua Zhu, Weiyu Han, Benny Antony, Anita E. Wluka, Tania Winzenberg, Dawn Aitken, Leigh Blizzard, Graeme Jones, and Changhai Ding
Subjects: Depression, Knee osteoarthritis, Risk factors, Joint symptoms, Diseases of the musculoskeletal system, RC925-935
Abstract: Abstract Background To describe demographic and clinical factors associated with the presence and incidence of depression and explore the temporal relationship between depression and joint symptoms in patients with symptomatic knee osteoarthritis (OA). Methods Three hundred ninety-seven participants were selected from a randomized controlled trial in people with symptomatic knee OA and vitamin D deficiency (age 63.3 ± 7.1 year, 48.6% female). Depression severity and knee joint symptoms were assessed using the patient health questionnaire (PHQ-9) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively, at baseline and 24 months. Results The presence and incidence of depression was 25.4 and 11.2%, respectively. At baseline, having younger age, a higher body mass index (BMI), greater scores of WOMAC pain (PR: 1.05, 95%CI:1.03, 1.07), dysfunction (PR: 1.02, 95%CI:1.01, 1.02) and stiffness (PR: 1.05, 95%CI: 1.02, 1.09), lower education level, having more than one comorbidity and having two or more painful body sites were significantly associated with a higher presence of depression. Over 24 months, being female, having a higher WOMAC pain (RR: 1.05, 95%CI: 1.02, 1.09) and dysfunction score (RR: 1.02, 95%CI: 1.01, 1.03) at baseline and having two or more painful sites were significantly associated with a higher incidence of depression. In contrast, baseline depression was not associated with changes in knee joint symptoms over 24 months. Conclusion Knee OA risk factors and joint symptoms, along with co-existing multi-site pain are associated with the presence and development of depression. This suggests that managing common OA risk factors and joint symptoms may be important for prevention and treatment depression in patients with knee OA. Trial registration ClinicalTrials.gov identifier: NCT01176344 . Anzctr.org.au identifier: ACTRN12610000495022 .
Published: 2021
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10. Efficacy and cost-effectiveness of Stem Cell injections for symptomatic relief and strUctural improvement in people with Tibiofemoral knee OsteoaRthritis: protocol for a randomised placebo-controlled trial (the SCUlpTOR trial)

Author: Leticia A Deveza, Win Min Oo, Xia Wang, Felix Eckstein, Wolfgang Wirth, Anthony Harris, Xiaoqian Liu, Sarah Robbins, Sonika Virk, Benny Antony, David Humphries, Christopher Little, James Linklater, Karen Schuck, and Kirsty Carmichael
Subjects: Medicine
Abstract: Introduction Knee osteoarthritis (KOA) is a highly prevalent disabling joint disease. Intra-articular stem cell therapy is increasingly being used for treating KOA with little high-quality evidence to support its use. The aim of this study is to investigate the efficacy, safety and cost-effectiveness of allogeneic mesenchymal stem cells (Cymerus MSCs) for treating symptomatic tibiofemoral KOA and improving knee structure over 24 months.Methods and analysis The Stem Cell injections for symptomatic relief and strUctural improvement in people with Tibiofemoral knee OsteoaRthritis study is a phase III, multi-centre, parallel, superiority, randomised, double-blind, placebo-controlled trial, which will be conducted in Sydney and Hobart, Australia. 440 participants (220 per arm) aged over 40 years with painful KOA and mild to moderate structural change on X-ray (Kellgren and Lawrence grade 2 or 3) with medial minimum joint space width between 1 and 4 mm in the study knee will be recruited from the community and randomly allocated to receive either intra-articular MSCs or saline at baseline, week 3 and week 52. The coprimary outcomes will be the proportion of participants achieving patient-acceptable symptom state for knee pain at 24 months and quantitative central medial femorotibial compartment cartilage thickness change from baseline to 24 months. Main secondary outcomes include change in knee pain, Patient Global Assessment, physical function, quality of life and other structural changes. Additional data for cost-effectiveness analysis will also be recorded. Adverse events will be monitored throughout the study. The primary analysis will be conducted using modified intention-to-treat.Ethics and dissemination This protocol has been approved by The University of Sydney (USYD) Human Research Ethics Committee (HREC) #: 2020/119 and The University of Tasmania (UTAS) HREC #: H0021868. All participants will be required to provide informed consent. Dissemination will occur through conferences, social media, and scientific publications.Trial registration numbers Australian New Zealand Clinical Trials Registry (ACTRN12620000870954); U1111-1234-4897.
Published: 2021
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11. Association of Pain Phenotypes with Risk of Falls and Incident Fractures

Author: Maxim Devine, Canchen Ma, Jing Tian, Benny Antony, Flavia Cicuttini, Graeme Jones, and Feng Pan
Subjects: falls risk, incident fractures, pain phenotypes, Biology (General), QH301-705.5
Abstract: Objective: To compare whether falls risk score and incident fracture over 10.7 years were different among three previously identified pain phenotypes. Methods: Data on 915 participants (mean age 63 years) from a population-based cohort study were studied at baseline and follow-ups at 2.6, 5.1 and 10.7 years. Three pain phenotypes were previously identified using the latent class analysis: Class 1: high prevalence of emotional problems and low prevalence of structural damage; Class 2: high prevalence of structural damage and low prevalence of emotional problems; Class 3: low prevalence of emotional problems and low prevalence of structural damage. Fractures were self-reported and falls risk score was measured using the Physiological Profile Assessment. Generalized estimating equations model and linear mixed-effects model were used to compare differences in incident fractures and falls risk score over 10.7 years between pain phenotypes, respectively. Results: There were 3 new hip, 19 vertebral, and 121 non-vertebral fractures, and 138 any site fractures during 10.7-year follow-up. Compared with Class 3, Class 1 had a higher risk of vertebral (relative risk (RR) = 2.44, 95% CI: 1.22–4.91), non-vertebral fractures (RR = 1.20, 95% CI: 1.01–1.42), and any site fractures (RR = 1.24, 95% CI: 1.04–1.46) after controlling for covariates, bone mineral density and falls risk score. Class 2 had a higher risk of non-vertebral and any site fracture relative to those in Class 3 (non-vertebral: RR = 1.41, 95% CI: 1.17–1.71; any site: RR = 1.44, 95% CI: 1.20–1.73), but not vertebral fracture. Compared with Class 3, Class 1 had a higher falls risk score at baseline (β = 0.16, 95% CI: 0.09–0.23) and over 10.7-year (β = 0.03, 95% CI: 0.01–0.04). Conclusions: Class 1 and/or Class 2 had a higher risk of incident fractures and falls risk score than Class 3, highlighting that targeted preventive strategies for fractures and falls are needed in pain population.
Published: 2022
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12. A Randomised Controlled Trial of YOGa and Strengthening Exercise for Knee OsteoArthritis: Protocol for a Comparative Effectiveness Trial (YOGA Trial)

Author: Ambrish Singh, Dawn Aitken, Steffany Moonaz, Andrew J. Palmer, Leigh Blizzard, Changhai Ding, Stan Drummen, Graeme Jones, Kim Bennell, and Benny Antony
Subjects: yoga: strengthening exercise, knee osteoarthritis, comparative effectiveness research, randomised controlled trial, Diseases of the musculoskeletal system, RC925-935
Abstract: Osteoarthritis (OA) is a common joint disorder for which there is no cure. Current treatments are suboptimal. Exercise is a core treatment for knee OA, with muscle strengthening exercise commonly recommended. Yoga is a mind-body exercise intervention that can improve flexibility, muscle strength, balance, and fitness and potentially reduce symptoms of OA. However, there is a scarcity of robust, high-quality conclusive evidence on the efficacy of yoga in knee OA. We are currently conducting the first randomised comparative effectiveness and cost-effectiveness trial of a yoga program compared with a strengthening exercise program in patients with symptomatic knee OA. This study protocol describes the design and conduct of this trial. The YOGA study is a phase III, single-centre, parallel, superiority, randomised, active-controlled trial which will be conducted in Hobart, Australia. One hundred and twenty-six participants (63 in each arm) aged over 40 years with symptomatic knee OA will be recruited from the community and randomly allocated to receive either a 24-week yoga program (3×/week) or a strengthening exercise program (3×/week). The primary outcome will be change in knee pain over 12 weeks, assessed using a 100 mm visual analogue scale (VAS). The secondary outcomes include change in knee pain, patient global assessment, physical function, quality of life, gait speed, biomarkers, and others over 12 and 24 weeks. We will also assess whether the presence of neuropathic pain moderates the effects of yoga compared to strengthening exercise. Additional data, such as cost and resource utilization, will be collected for the cost-effectiveness analysis. The primary analysis will be conducted using an intention-to-treat approach. Adverse events will be monitored throughout the study. Once completed, this trial will contribute to the knowledge of whether yoga can be used as a simple, effective, low-cost option for the management of knee OA, thus saving economic costs in the healthcare system.
Published: 2022
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13. Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000–17

Author: Aniruddha Deshpande, Molly K Miller-Petrie, Paulina A Lindstedt, Mathew M Baumann, Kimberly B Johnson, Brigette F Blacker, Hedayat Abbastabar, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R.M. Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Abdu A Adamu, Oladimeji M Adebayo, Isaac Akinkunmi Adedeji, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Tara Ballav Adhikari, Mohsen Afarideh, Marcela Agudelo-Botero, Mehdi Ahmadi, Keivan Ahmadi, Muktar Beshir Ahmed, Anwar E Ahmed, Temesgen Yihunie Akalu, Ali S Akanda, Fares Alahdab, Ziyad Al-Aly, Samiah Alam, Noore Alam, Genet Melak Alamene, Turki M Alanzi, James Albright, Ammar Albujeer, Jacqueline Elizabeth Alcalde-Rabanal, Animut Alebel, Zewdie Aderaw Alemu, Muhammad Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Saeed Amini, Arianna Maever L. Amit, Gianna Gayle Herrera Amul, Catalina Liliana Andrei, Mina Anjomshoa, Ansariadi Ansariadi, Carl Abelardo T. Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Olatunde Aremu, Bahram Armoon, Amit Arora, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Daniel Asmelash, Hagos Tasew Atalay, Seyyede Masoume Athari, Seyyed Shamsadin Athari, Sachin R Atre, Marcel Ausloos, Shally Awasthi, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Yared Asmare Aynalem, Samad Azari, Andrew S Azman, Ebrahim Babaee, Alaa Badawi, Mojtaba Bagherzadeh, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Maciej Banach, Joseph Adel Mattar Banoub, Aleksandra Barac, Miguel A Barboza, Till Winfried Bärnighausen, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Neeraj Bedi, Mahya Beheshti, Meysam Behzadifar, Masoud Behzadifar, Diana Fernanda Bejarano Ramirez, Michelle L Bell, Derrick A. Bennett, Habib Benzian, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Krittika Bhattacharyya, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Muhammad Shahdaat Bin Sayeed, Raaj Kishore Biswas, Somayeh Bohlouli, Soufiane Boufous, Oliver J Brady, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Alexandria Brown, Sharath Burugina Nagaraja, Zahid A Butt, Luis Alberto Cámera, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Carlos A Castañeda-Orjuela, Franz Castro, Ester Cerin, Binaya Chalise, Vijay Kumar Chattu, Ken Lee Chin, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Elizabeth A Cromwell, Abel Fekadu Fekadu Dadi, Tukur Dahiru, Saad M A Dahlawi, Rakhi Dandona, Lalit Dandona, Anh Kim Dang, Farah Daoud, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Claudio Alberto Dávila-Cervantes, Nicole Davis Weaver, Fernando Pio De la Hoz, Jan-Walter De Neve, Dereje Bayissa Demissie, Gebre Teklemariam Demoz, Edgar Denova-Gutiérrez, Kebede Deribe, Assefa Desalew, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Isaac Oluwafemi Dipeolu, Hoa Thi Do, Christiane Dolecek, Kerrie E Doyle, Eleonora Dubljanin, Andre Rodrigues Duraes, Hisham Atan Edinur, Andem Effiong, Aziz Eftekhari, Nevine El Nahas, Maysaa El Sayed Zaki, Maha El Tantawi, Hala Rashad Elhabashy, Shaimaa I. 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Foigt, Morenike Oluwatoyin Folayan, Masoud Foroutan, Richard Charles Franklin, Joseph Jon Frostad, Takeshi Fukumoto, Mohamed M Gad, Gregory M Garcia, Augustine Mwangi Gatotoh, Reta Tsegaye Gayesa, Ketema Bizuwork Gebremedhin, Yilma Chisha Dea Geramo, Hailay Abrha Gesesew, Kebede Embaye Gezae, Ahmad Ghashghaee, Farzaneh Ghazi Sherbaf, Tiffany K Gill, Paramjit Singh Gill, Themba G Ginindza, Alem Girmay, Zemichael Gizaw, Amador Goodridge, Sameer Vali Gopalani, Bárbara Niegia Garcia Goulart, Alessandra C Goulart, Ayman Grada, Manfred S Green, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Rajeev Gupta, Rahul Gupta, Giang Hai Ha, Juanita A. Haagsma, Nima Hafezi-Nejad, Dessalegn H Haile, Michael Tamene Haile, Brian J. Hall, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Ninuk Hariyani, Ahmed I. Hasaballah, Md. Mehedi Hasan, Amir Hasanzadeh, Hamid Yimam Hassen, Desta Haftu Hayelom, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Andualem Henok, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru, Thomas R Hird, Chi Linh Hoang, Gillian I Hollerich, Praveen Hoogar, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Guoqing Hu, Ayesha Humayun, Syed Ather Hussain, Mamusha Aman A Hussen, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Milena D. Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Rebecca Q Ivers, Chinwe Juliana Iwu, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ensiyeh Jenabi, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Jost B. Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Tanuj Kanchan, André Karch, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A. Kayode, Mihiretu M Kebede, Peter Njenga Keiyoro, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Junaid Khan, Md Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Amir M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Sezer Kisa, Adnan Kisa, Sonali Kochhar, Tufa Kolola, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, Nuworza Kugbey, Pushpendra Kumar, G Anil Kumar, Manasi Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Aparna Lal, Dharmesh Kumar Lal, Hilton Lam, Faris Hasan Lami, Van Charles Lansingh, Savita Lasrado, Georgy Lebedev, Paul H Lee, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Aubrey J Levine, Sonia Lewycka, Shanshan Li, Shai Linn, Shiwei Liu, Jaifred Christian F Lopez, Platon D Lopukhov, Muhammed Magdy Abd El Razek, D.R. 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Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Shafiu Mohammed, Jemal Abdu Mohammed, Hassen Mohammed, Farnam Mohebi, Ali H Mokdad, Yoshan Moodley, Masoud Moradi, Ghobad Moradi, Mohammad Moradi-Joo, Paula Moraga, Linda Morales, Abbas Mosapour, Jonathan F. Mosser, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor, Sandra B Munro, Moses K. Muriithi, Christopher J L Murray, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Gurudatta Naik, Vinay Nangia, Bruno Ramos Nascimento, Javad Nazari, Duduzile Edith Ndwandwe, Ionut Negoi, Henok Biresaw Netsere, Josephine W. 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Singh, Ambrish Singh, Dhirendra Narain Sinha, Malede Mequanent Sisay, Eirini Skiadaresi, David L Smith, Adauto Martins Soares Filho, Mohammad Reza Sobhiyeh, Anton Sokhan, Joan B Soriano, Muluken Bekele Sorrie, Ireneous N Soyiri, Emma Elizabeth Spurlock, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Hafiz Ansar Rasul Suleria, Bryan L. Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Ingan Ukur Tarigan, Bineyam Taye, Yonatal Mesfin Tefera, Arash Tehrani-Banihashemi, Shishay Wahdey Tekelemedhin, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay, Fisaha Haile Tesfay, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Akhil Soman ThekkePurakkal, Nihal Thomas, Robert L Thompson, Alan J Thomson, Roman Topor-Madry, Marcos Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Olalekan A Uthman, Benjamin S. Chudi Uzochukwu, Pascual R Valdez, Santosh Varughese, Yousef Veisani, Francesco S Violante, Sebastian Vollmer, Feleke Gebremeskel W/hawariat, Yasir Waheed, Mitchell Taylor Wallin, Yuan-Pang Wang, Yafeng Wang, Kinley Wangdi, Daniel J Weiss, Girmay Teklay Weldesamuel, Adhena Ayaliew Werkneh, Ronny Westerman, Taweewat Wiangkham, Kirsten E Wiens, Tissa Wijeratne, Charles Shey Wiysonge, Haileab Fekadu Wolde, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Getasew Taddesse Worku, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Mehdi Yaseri, Hiroshi Yatsuya, Alex Yeshaneh, Mekdes Tigistu Yilma, Paul Yip, Engida Yisma, Naohiro Yonemoto, Mustafa Z Younis, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Telma Zahirian Moghadam, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Heather J Zar, Taddese Alemu Zerfu, Yunquan Zhang, Arash Ziapour, Sanjay Zodpey, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. Funding: Bill & Melinda Gates Foundation.
Published: 2020
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14. The global distribution of lymphatic filariasis, 2000–18: a geospatial analysis

Author: Aniruddha Deshpande, Molly K Miller-Petrie, Paulina A Lindstedt, Mathew M Baumann, Kimberly B Johnson, Brigette F Blacker, Hedayat Abbastabar, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R.M. Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Abdu A Adamu, Oladimeji M Adebayo, Isaac Akinkunmi Adedeji, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Tara Ballav Adhikari, Mohsen Afarideh, Marcela Agudelo-Botero, Mehdi Ahmadi, Keivan Ahmadi, Muktar Beshir Ahmed, Anwar E Ahmed, Temesgen Yihunie Akalu, Ali S Akanda, Fares Alahdab, Ziyad Al-Aly, Samiah Alam, Noore Alam, Genet Melak Alamene, Turki M Alanzi, James Albright, Ammar Albujeer, Jacqueline Elizabeth Alcalde-Rabanal, Animut Alebel, Zewdie Aderaw Alemu, Muhammad Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Saeed Amini, Arianna Maever L. Amit, Gianna Gayle Herrera Amul, Catalina Liliana Andrei, Mina Anjomshoa, Ansariadi Ansariadi, Carl Abelardo T. Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Olatunde Aremu, Bahram Armoon, Amit Arora, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Daniel Asmelash, Hagos Tasew Atalay, Seyyede Masoume Athari, Seyyed Shamsadin Athari, Sachin R Atre, Marcel Ausloos, Shally Awasthi, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Yared Asmare Aynalem, Samad Azari, Andrew S Azman, Ebrahim Babaee, Alaa Badawi, Mojtaba Bagherzadeh, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Maciej Banach, Joseph Adel Mattar Banoub, Aleksandra Barac, Miguel A Barboza, Till Winfried Bärnighausen, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Neeraj Bedi, Mahya Beheshti, Meysam Behzadifar, Masoud Behzadifar, Diana Fernanda Bejarano Ramirez, Michelle L Bell, Derrick A. Bennett, Habib Benzian, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Krittika Bhattacharyya, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Muhammad Shahdaat Bin Sayeed, Raaj Kishore Biswas, Somayeh Bohlouli, Soufiane Boufous, Oliver J Brady, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Alexandria Brown, Sharath Burugina Nagaraja, Zahid A Butt, Luis Alberto Cámera, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Carlos A Castañeda-Orjuela, Franz Castro, Ester Cerin, Binaya Chalise, Vijay Kumar Chattu, Ken Lee Chin, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Elizabeth A Cromwell, Abel Fekadu Fekadu Dadi, Tukur Dahiru, Saad M A Dahlawi, Rakhi Dandona, Lalit Dandona, Anh Kim Dang, Farah Daoud, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Claudio Alberto Dávila-Cervantes, Nicole Davis Weaver, Fernando Pio De la Hoz, Jan-Walter De Neve, Dereje Bayissa Demissie, Gebre Teklemariam Demoz, Edgar Denova-Gutiérrez, Kebede Deribe, Assefa Desalew, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Isaac Oluwafemi Dipeolu, Hoa Thi Do, Christiane Dolecek, Kerrie E Doyle, Eleonora Dubljanin, Andre Rodrigues Duraes, Hisham Atan Edinur, Andem Effiong, Aziz Eftekhari, Nevine El Nahas, Maysaa El Sayed Zaki, Maha El Tantawi, Hala Rashad Elhabashy, Shaimaa I. El-Jaafary, Ziad El-Khatib, Hajer Elkout, Aisha Elsharkawy, Shymaa Enany, Daniel Adane Endalew, Babak Eshrati, Sharareh Eskandarieh, Arash Etemadi, Oluchi Ezekannagha, Emerito Jose A. Faraon, Mohammad Fareed, Andre Faro, Farshad Farzadfar, Alebachew Fasil Fasil, Mehdi Fazlzadeh, Valery L. Feigin, Wubalem Fekadu, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Carsten Flohr, Nataliya A. Foigt, Morenike Oluwatoyin Folayan, Masoud Foroutan, Richard Charles Franklin, Joseph Jon Frostad, Takeshi Fukumoto, Mohamed M Gad, Gregory M Garcia, Augustine Mwangi Gatotoh, Reta Tsegaye Gayesa, Ketema Bizuwork Gebremedhin, Yilma Chisha Dea Geramo, Hailay Abrha Gesesew, Kebede Embaye Gezae, Ahmad Ghashghaee, Farzaneh Ghazi Sherbaf, Tiffany K Gill, Paramjit Singh Gill, Themba G Ginindza, Alem Girmay, Zemichael Gizaw, Amador Goodridge, Sameer Vali Gopalani, Bárbara Niegia Garcia Goulart, Alessandra C Goulart, Ayman Grada, Manfred S Green, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Rajeev Gupta, Rahul Gupta, Giang Hai Ha, Juanita A. Haagsma, Nima Hafezi-Nejad, Dessalegn H Haile, Michael Tamene Haile, Brian J. Hall, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Ninuk Hariyani, Ahmed I. Hasaballah, Md. Mehedi Hasan, Amir Hasanzadeh, Hamid Yimam Hassen, Desta Haftu Hayelom, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Andualem Henok, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru, Thomas R Hird, Chi Linh Hoang, Gillian I Hollerich, Praveen Hoogar, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Guoqing Hu, Ayesha Humayun, Syed Ather Hussain, Mamusha Aman A Hussen, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Milena D. Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Rebecca Q Ivers, Chinwe Juliana Iwu, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ensiyeh Jenabi, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Jost B. Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Tanuj Kanchan, André Karch, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A. Kayode, Mihiretu M Kebede, Peter Njenga Keiyoro, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Junaid Khan, Md Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Amir M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Sezer Kisa, Adnan Kisa, Sonali Kochhar, Tufa Kolola, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, Nuworza Kugbey, Pushpendra Kumar, G Anil Kumar, Manasi Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Aparna Lal, Dharmesh Kumar Lal, Hilton Lam, Faris Hasan Lami, Van Charles Lansingh, Savita Lasrado, Georgy Lebedev, Paul H Lee, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Aubrey J Levine, Sonia Lewycka, Shanshan Li, Shai Linn, Shiwei Liu, Jaifred Christian F Lopez, Platon D Lopukhov, Muhammed Magdy Abd El Razek, D.R. Mahadeshwara Prasad, Phetole Walter Mahasha, Narayan B. Mahotra, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Abdullah A Mamun, Navid Manafi, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Gabriel Martinez, Santi Martini, Francisco Rogerlândio Martins-Melo, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Entezar Mehrabi Nasab, Kala M Mehta, Teferi Mekonnen, Tefera Chane Mekonnen, Gebrekiros Gebremichael Meles, Hagazi Gebre Meles, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Tomislav Mestrovic, Workua Mekonnen Metekiya, Bartosz Miazgowski, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Yousef Mohammad, Dara K. Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Shafiu Mohammed, Jemal Abdu Mohammed, Hassen Mohammed, Farnam Mohebi, Ali H Mokdad, Yoshan Moodley, Masoud Moradi, Ghobad Moradi, Mohammad Moradi-Joo, Paula Moraga, Linda Morales, Abbas Mosapour, Jonathan F. Mosser, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor, Sandra B Munro, Moses K. Muriithi, Christopher J L Murray, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Gurudatta Naik, Vinay Nangia, Bruno Ramos Nascimento, Javad Nazari, Duduzile Edith Ndwandwe, Ionut Negoi, Henok Biresaw Netsere, Josephine W. Ngunjiri, Cuong Tat Nguyen, Huong Lan Thi Nguyen, QuynhAnh P Nguyen, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Ole F Norheim, Jean Jacques Noubiap, Bogdan Oancea, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Jacob Olusegun Olusanya, Bolajoko Olubukunola Olusanya, Obinna E Onwujekwe, Doris V. Ortega-Altamirano, Osayomwanbo Osarenotor, Frank B Osei, Mayowa O Owolabi, Mahesh P A, Jagadish Rao. 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Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Nizal Sarrafzadegan, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Maheswar Satpathy, Monika Sawhney, Mehdi Sayyah, Alyssa N Sbarra, Lauren E Schaeffer, David C Schwebel, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Azadeh Shafieesabet, Amira A Shaheen, Izza Shahid, Masood Ali Shaikh, Ali S Shalash, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Rajesh Sharma, Aziz Sheikh, B Suresh Kumar Shetty, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Reza Shirkoohi, K M Shivakumar, Si Si, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Virendra Singh, Narinder Pal Singh, Balbir Bagicha Singh Singh, Jasvinder A. Singh, Ambrish Singh, Dhirendra Narain Sinha, Malede Mequanent Sisay, Eirini Skiadaresi, David L Smith, Adauto Martins Soares Filho, Mohammad Reza Sobhiyeh, Anton Sokhan, Joan B Soriano, Muluken Bekele Sorrie, Ireneous N Soyiri, Emma Elizabeth Spurlock, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Hafiz Ansar Rasul Suleria, Bryan L. Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Ingan Ukur Tarigan, Bineyam Taye, Yonatal Mesfin Tefera, Arash Tehrani-Banihashemi, Shishay Wahdey Tekelemedhin, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay, Fisaha Haile Tesfay, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Akhil Soman ThekkePurakkal, Nihal Thomas, Robert L Thompson, Alan J Thomson, Roman Topor-Madry, Marcos Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Olalekan A Uthman, Benjamin S. Chudi Uzochukwu, Pascual R Valdez, Santosh Varughese, Yousef Veisani, Francesco S Violante, Sebastian Vollmer, Feleke Gebremeskel W/hawariat, Yasir Waheed, Mitchell Taylor Wallin, Yuan-Pang Wang, Yafeng Wang, Kinley Wangdi, Daniel J Weiss, Girmay Teklay Weldesamuel, Adhena Ayaliew Werkneh, Ronny Westerman, Taweewat Wiangkham, Kirsten E Wiens, Tissa Wijeratne, Charles Shey Wiysonge, Haileab Fekadu Wolde, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Getasew Taddesse Worku, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Mehdi Yaseri, Hiroshi Yatsuya, Alex Yeshaneh, Mekdes Tigistu Yilma, Paul Yip, Engida Yisma, Naohiro Yonemoto, Mustafa Z Younis, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Telma Zahirian Moghadam, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Heather J Zar, Taddese Alemu Zerfu, Yunquan Zhang, Arash Ziapour, Sanjay Zodpey, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection. Methods: A global dataset of georeferenced surveyed locations was used to model annual 2000–18 lymphatic filariasis prevalence for 73 current or previously endemic countries. We applied Bayesian model-based geostatistics and time series methods to generate spatially continuous estimates of global all-age 2000–18 prevalence of lymphatic filariasis infection mapped at a resolution of 5 km2 and aggregated to estimate total number of individuals infected. Findings: We used 14 927 datapoints to fit the geospatial models. An estimated 199 million total individuals (95% uncertainty interval 174–234 million) worldwide were infected with lymphatic filariasis in 2000, with totals for WHO regions ranging from 3·1 million (1·6–5·7 million) in the region of the Americas to 107 million (91–134 million) in the South-East Asia region. By 2018, an estimated 51 million individuals (43–63 million) were infected. Broad declines in prevalence are observed globally, but focal areas in Africa and southeast Asia remain less likely to have attained infection prevalence thresholds proposed to achieve local elimination. Interpretation: Although the prevalence of lymphatic filariasis infection has declined since 2000, MDA is still necessary across large populations in Africa and Asia. Our mapped estimates can be used to identify areas where the probability of meeting infection thresholds is low, and when coupled with large uncertainty in the predictions, indicate additional data collection or intervention might be warranted before MDA programmes cease. Funding: Bill & Melinda Gates Foundation.
Published: 2020
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15. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

Author: Kirsten E Wiens, Paulina A Lindstedt, Brigette F Blacker, Kimberly B Johnson, Mathew M Baumann, Lauren E Schaeffer, Hedayat Abbastabar, Sr, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R M Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Maryam Adabi, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Sr, Victor Adekanmbi, Olatunji O Adetokunboh, Sr, Beyene Meressa Adhena, Mohsen Afarideh, Sohail Ahmad, Keivan Ahmadi, Anwar E Ahmed, Muktar Beshir Ahmed, Rushdia Ahmed, Temesgen Yihunie Akalu, Fares Alahdab, Ziyad Al-Aly, Noore Alam, Sr, Samiah Alam, Genet Melak Alamene, Turki M Alanzi, Jacqueline Elizabeth Alcalde-Rabanal, Beriwan Abdulqadir Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Sr, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Saeed Amini, Sr, Arianna Maever L 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Elias Merdassa Roro, Sr, Jennifer M Ross, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Yogesh Damodar Sabde, Siamak Sabour, Ehsan Sadeghi, Sr, Yahya Safari, Roya Safari-Faramani, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, S Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Sr, Payman Salamati, Hosni Salem, Marwa R Rashad Salem I, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Sr, Milena M Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Kaushik Sarkar, Sr, Abdur Razzaque Sarker, Nizal Sarrafzadegan I, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Monika Sawhney, Sonia Saxena, Sr, David C Schwebel, Sr, Anbissa Muleta Senbeta IV, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Sr, Hosein Shabaninejad, Azadeh Shafieesabet, Sr, Masood Ali Shaikh, Ali S Shalash, Sr, Seifadin Ahmed Shallo, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Hamid Sharifi, Hatem Samir Shehata, Sr, Aziz Sheikh, B Suresh Kumar Shetty, Sr, Kenji Shibuya, Sr, Wondimeneh Shibabaw Shiferaw, Sr, Desalegn Markos Shifti, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Sr, Reza Shirkoohi, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Ambrish Singh, Jasvinder A Singh, Narinder Pal Singh, Virendra Singh, Malede Mequanent Sisay, Eirini Skiadaresi, Mohammad Reza Sobhiyeh, Sr, Anton Sokhan, Shahin Soltani, Ranjani Somayaji, Moslem Soofi, Muluken Bekele Sorrie, Sr, Ireneous N Soyiri, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Sr, Hafiz Ansar Rasul Suleria, Marufa Sultana, Bruno Fokas Sunguya, Bryan L Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Jr, Ingan Ukur Tarigan, Aberash Abay Tasew, Yonatal Mesfin Tefera, Sr, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay I, Fisaha Haile Haile Tesfay, Belay Tessema, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Nihal Thomas, Alemayehu Toma Toma, Sr, Roman Topor-Madry, Marcos Roberto Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Sr, Benjamin S Chudi Uzochukwu, Sr, Pascual R Valdez, Santosh Varughese, Sr, Francesco S Violante, Sr, Sebastian Vollmer, Sr, Feleke Gebremeskel W/hawariat, Sr, Yasir Waheed, Mitchell Taylor Wallin, Yafeng Wang, Yuan-Pang Wang, Marcia Weaver, Bedilu Girma Weji, Girmay Teklay Weldesamuel, Catherine A Welgan, Andrea Werdecker, Ronny Westerman, Sr, Taweewat Wiangkham, Charles Shey Wiysonge, Sr, Haileab Fekadu Wolde, Sr, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Sr, Getasew Taddesse Worku, Sr, Ai-Min Wu, Gelin Xu, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Sr, Hiroshi Yatsuya, Alex Yeshaneh, Christopher Sabo Yilgwan, Mekdes Tigistu Yilma, Paul Yip, Sr, Engida Yisma, Naohiro Yonemoto, Sr, Seok-Jun Yoon, Mustafa Z Younis, Mahmoud Yousefifard, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Nejimu Biza Zepro, Taddese Alemu Zerfu, Yunquan Zhang, Xiu-Ju George Zhao, Arash Ziapour, Sanjay Zodpey, Sr, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation.
Published: 2020
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16. Global Prevalence of COVID-19-Associated Mucormycosis (CAM): Living Systematic Review and Meta-Analysis

Author: Salman Hussain, Abanoub Riad, Ambrish Singh, Jitka Klugarová, Benny Antony, Hasanul Banna, and Miloslav Klugar
Subjects: coinfection, COVID-19, epidemiology, meta-analysis, mucormycosis, mycoses, Biology (General), QH301-705.5
Abstract: Mucormycosis, a secondary fungal infection, gained much attention in the ongoing COVID-19 pandemic. This deadly infection has a high all-cause mortality rate and imposes a significant economic, epidemiological, and humanistic burden on the patients and healthcare system. Evidence from the published epidemiological studies showed the varying prevalence of COVID-19-associated mucormycosis (CAM). This study aims to compute the pooled prevalence of CAM and other associated clinical outcomes. MEDLINE, Embase, Cochrane COVID-19 Study Register, and WHO COVID-19 databases were scanned to retrieve the relevant articles until August 2021. All studies reporting the prevalence of mucormycosis among COVID-19 patients were eligible for inclusion. Two investigators independently screened the articles against the selection criteria, extracted the data, and performed the quality assessment using the JBI tool. The pooled prevalence of CAM was the primary outcome, and the pooled prevalence of diabetes, steroid exposure, and the mortality rate were the secondary outcomes of interest. Comprehensive Meta-Analysis software version 2 was used for performing the meta-analysis. This meta-analysis comprised six studies with a pooled sample size of 52,916 COVID-19 patients with a mean age of 62.12 ± 9.69 years. The mean duration of mucormycosis onset was 14.59 ± 6.88 days after the COVID-19 diagnosis. The pooled prevalence of CAM (seven cases per 1000 patients) was 50 times higher than the highest recorded background of mucormycosis (0.14 cases per 1000 patients). A high mortality rate was found among CAM patients with a pooled prevalence rate of 29.6% (95% CI: 17.2–45.9%). Optimal glycemic control and the judicious use of steroids should be the approach for tackling rising CAM cases.
Published: 2021
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17. Prevalence and Clinical Significance of Residual or Reconverted Red Bone Marrow on Knee MRI

Author: Minh Tu Vo, Ambrish Singh, Tao Meng, Jasveen Kaur, Alison Venn, Flavia Cicuttini, Lyn March, Marita Cross, Terence Dwyer, Andrew Halliday, Graeme Jones, Changhai Ding, and Benny Antony
Subjects: residual/reconverted red bone marrow, young adults, knee pain, magnetic resonance imaging, Medicine (General), R5-920
Abstract: Background: Residual/reconverted red bone marrow (RBM) in adult knees is occasionally observed on routine knee magnetic resonance imaging (MRI). We aimed to identify its prevalence, distribution, and associations with lifestyle factors, knee structural abnormalities, and knee symptoms in young adults. Methods: Participants (n = 327; aged = 31–41 years) were selected from the Childhood Determinants of Adult Health (CDAH) knee study. They underwent T1-weighted and proton-density-weighted fat-suppressed MRI scans of knees. Residual/reconverted RBM in distal femur and proximal tibia were graded semi-quantitatively (grades: 0–3) based on the percentage area occupied. Knee structural abnormalities were graded semi-quantitatively using previously published MRI scoring systems. Knee symptoms (pain, stiffness, and dysfunction) were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale during CDAH knee study (year: 2008–2010) and at 6–9-year follow-up during the CDAH-3 study (year: 2014–2019). Associations between definite RBM (grade ≥ 2) and lifestyle factors, knee symptoms, and structural abnormalities were described using log-binomial regressions. Results: Definite RBM was seen in females only, in 29 out of 154 cases (18.8%), with femoral involvement preceding tibial involvement. Definite RBM was associated with increased BMI (PR = 1.09/kg/m2; 95% CI: 1.03, 1.16), overweight status (PR = 2.19; 95% CI: 1.07, 4.51), and WOMAC knee pain (PR = 1.75; 95% CI: 1.11, 2.74) in cross-section analysis. However, there was no association between RBM and knee-pain after seven years (PR = 1.15; 95% CI: 0.66, 2.00). There were no associations between RBM and knee structural abnormalities. Conclusion: Presence of definite RBM in young adult knees was observed in females only. Definite RBM was associated with overweight measures, and the modest association with knee pain may not be causally related.
Published: 2021
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18. Imaging and Biochemical Markers for Osteoarthritis

Author: Benny Antony and Ambrish Singh
Subjects: n/a, Medicine (General), R5-920
Abstract: Osteoarthritis (OA) is the most common form of arthritis in adults that affects more than 500 million people globally [...]
Published: 2021
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19. IoT driven framework based efficient green energy management in smart cities using multi-objective distributed dispatching algorithm

Author: Xiaoyi, Zhang, Dongling, Wang, Yuming, Zhang, Manokaran, Karthik Bala, and Benny Antony, A.
Published: 2021
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20. Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050

Author: Manuela L Ferreira, Katie de Luca, Lydia M Haile, Jaimie D Steinmetz, Garland T Culbreth, Marita Cross, Jacek A Kopec, Paulo H Ferreira, Fiona M Blyth, Rachelle Buchbinder, Jan Hartvigsen, Ai-Min Wu, Saeid Safiri, Anthony D Woolf, Gary S Collins, Kanyin Liane Ong, Stein Emil Vollset, Amanda E Smith, Jessica A Cruz, Kai Glenn Fukutaki, Semagn Mekonnen Abate, Mitra Abbasifard, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Ahmed Abdelalim, Aidin Abedi, Hassan Abidi, Qorinah Estiningtyas Sakilah Adnani, Ali Ahmadi, Rufus Olusola Akinyemi, Abayneh Tadesse Alamer, Adugnaw Zeleke Alem, Yousef Alimohamadi, Mansour Abdullah Alshehri, Mohammed Mansour Alshehri, Hosam Alzahrani, Saeed Amini, Sohrab Amiri, Hubert Amu, Catalina Liliana Andrei, Tudorel Andrei, Benny Antony, Jalal Arabloo, Judie Arulappan, Ashokan Arumugam, Tahira Ashraf, Seyyed Shamsadin Athari, Nefsu Awoke, Sina Azadnajafabad, Till Winfried Bärnighausen, Lope H Barrero, Amadou Barrow, Akbar Barzegar, Lindsay M Bearne, Isabela M Bensenor, Alemshet Yirga Berhie, Bharti Bhandari Bhandari, Vijayalakshmi S Bhojaraja, Ali Bijani, Belay Boda Abule Bodicha, Srinivasa Rao Bolla, Javier Brazo-Sayavera, Andrew M Briggs, Chao Cao, Periklis Charalampous, Vijay Kumar Chattu, Flavia M Cicuttini, Benjamin Clarsen, Sarah Cuschieri, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Azizallah Dehghan, Takele Gezahegn G Demie, Edgar Denova-Gutiérrez, Syed Masudur Rahman Dewan, Samath Dhamminda Dharmaratne, Mandira Lamichhane Dhimal, Meghnath Dhimal, Daniel Diaz, Mojtaba Didehdar, Lankamo Ena Digesa, Mengistie Diress, Hoa Thi Do, Linh Phuong Doan, Michael Ekholuenetale, Muhammed Elhadi, Sharareh Eskandarieh, Shahriar Faghani, Jawad Fares, Ali Fatehizadeh, Getahun Fetensa, Irina Filip, Florian Fischer, Richard Charles Franklin, Balasankar Ganesan, Belete Negese Belete Gemeda, Motuma Erena Getachew, Ahmad Ghashghaee, Tiffany K Gill, Mahaveer Golechha, Pouya Goleij, Bhawna Gupta, Nima Hafezi-Nejad, Arvin Haj-Mirzaian, Pawan Kumar Hamal, Asif Hanif, Netanja I Harlianto, Hamidreza Hasani, Simon I Hay, Jeffrey J Hebert, Golnaz Heidari, Mohammad Heidari, Reza Heidari-Soureshjani, Mbuzeleni Mbuzeleni Hlongwa, Mohammad-Salar Hosseini, Alexander Kevin Hsiao, Ivo Iavicoli, Segun Emmanuel Ibitoye, Irena M Ilic, Milena D Ilic, Sheikh Mohammed Shariful Islam, Manthan Dilipkumar Janodia, Ravi Prakash Jha, Har Ashish Jindal, Jost B Jonas, Gebisa Guyasa Kabito, Himal Kandel, Rimple Jeet Kaur, Vikash Ranjan Keshri, Yousef Saleh Khader, Ejaz Ahmad Khan, Md Jobair Khan, Moien AB Khan, Hamid Reza Khayat Kashani, Jagdish Khubchandani, Yun Jin Kim, Adnan Kisa, Jitka Klugarová, Ali-Asghar Kolahi, Hamid Reza Koohestani, Ai Koyanagi, G Anil Kumar, Narinder Kumar, Tea Lallukka, Savita Lasrado, Wei-Chen Lee, Yo Han Lee, Ata Mahmoodpoor, Jeadran N Malagón-Rojas, Mohammad-Reza Malekpour, Reza Malekzadeh, Narges Malih, Man Mohan Mehndiratta, Entezar Mehrabi Nasab, Ritesh G Menezes, Alexios-Fotios A Mentis, Mohamed Kamal Mesregah, Ted R Miller, Mohammad Mirza-Aghazadeh-Attari, Maryam Mobarakabadi, Yousef Mohammad, Esmaeil Mohammadi, Shafiu Mohammed, Ali H Mokdad, Sara Momtazmanesh, Lorenzo Monasta, Mohammad Ali Moni, Ebrahim Mostafavi, Christopher J L Murray, Tapas Sadasivan Nair, Javad Nazari, Seyed Aria Nejadghaderi, Subas Neupane, Sandhya Neupane Kandel, Cuong Tat Nguyen, Ali Nowroozi, Hassan Okati-Aliabad, Emad Omer, Abderrahim Oulhaj, Mayowa O Owolabi, Songhomitra Panda-Jonas, Anamika Pandey, Eun-Kee Park, Shrikant Pawar, Paolo Pedersini, Jeevan Pereira, Mario F P Peres, Ionela-Roxana Petcu, Mohammadreza Pourahmadi, Amir Radfar, Shahram Rahimi-Dehgolan, Vafa Rahimi-Movaghar, Mosiur Rahman, Amir Masoud Rahmani, Nazanin Rajai, Chythra R Rao, Vahid Rashedi, Mohammad-Mahdi Rashidi, Zubair Ahmed Ratan, David Laith Rawaf, Salman Rawaf, Andre M N Renzaho, Negar Rezaei, Zahed Rezaei, Leonardo Roever, Guilherme de Andrade Ruela, Basema Saddik, Amirhossein Sahebkar, Sana Salehi, Francesco Sanmarchi, Sadaf G Sepanlou, Saeed Shahabi, Shayan Shahrokhi, Elaheh Shaker, MohammadBagher Shamsi, Mohammed Shannawaz, Saurab Sharma, Maryam Shaygan, Rahim Ali Sheikhi, Jeevan K Shetty, Rahman Shiri, Siddharudha Shivalli, Parnian Shobeiri, Migbar Mekonnen Sibhat, Ambrish Singh, Jasvinder A Singh, Helen Slater, Marco Solmi, Ranjani Somayaji, Ker-Kan Tan, Rekha Thapar, Seyed Abolfazl Tohidast, Sahel Valadan Tahbaz, Rohollah Valizadeh, Tommi Juhani Vasankari, Narayanaswamy Venketasubramanian, Vasily Vlassov, Bay Vo, Yuan-Pang Wang, Taweewat Wiangkham, Lalit Yadav, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Lin Yang, Fereshteh Yazdanpanah, Naohiro Yonemoto, Mustafa Z Younis, Iman Zare, Armin Zarrintan, Mohammad Zoladl, Theo Vos, Lyn M March, Surgery, Erasmus MC other, Public Health, and Pharmacy
Subjects: Rheumatology, Immunology, Immunology and Allergy
Abstract: Background: Low back pain is highly prevalent and the main cause of years lived with disability (YLDs). We present the most up-to-date global, regional, and national data on prevalence and YLDs for low back pain from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021. Methods: Population-based studies from 1980 to 2019 identified in a systematic review, international surveys, US medical claims data, and dataset contributions by collaborators were used to estimate the prevalence and YLDs for low back pain from 1990 to 2020, for 204 countries and territories. Low back pain was defined as pain between the 12th ribs and the gluteal folds that lasted a day or more; input data using alternative definitions were adjusted in a network meta-regression analysis. Nested Bayesian meta-regression models were used to estimate prevalence and YLDs by age, sex, year, and location. Prevalence was projected to 2050 by running a regression on prevalence rates using Socio-demographic Index as a predictor, then multiplying them by projected population estimates. Findings: In 2020, low back pain affected 619 million (95% uncertainty interval 554–694) people globally, with a projection of 843 million (759–933) prevalent cases by 2050. In 2020, the global age-standardised rate of YLDs was 832 per 100 000 (578–1070). Between 1990 and 2020, age-standardised rates of prevalence and YLDs decreased by 10·4% (10·9–10·0) and 10·5% (11·1–10·0), respectively. A total of 38·8% (28·7–47·0) of YLDs were attributed to occupational factors, smoking, and high BMI. Interpretation: Low back pain remains the leading cause of YLDs globally, and in 2020, there were more than half a billion prevalent cases of low back pain worldwide. While age-standardised rates have decreased modestly over the past three decades, it is projected that globally in 2050, more than 800 million people will have low back pain. Challenges persist in obtaining primary country-level data on low back pain, and there is an urgent need for more high-quality, primary, country-level data on both prevalence and severity distributions to improve accuracy and monitor change. Funding: Bill and Melinda Gates Foundation.
Published: 2023

21. Association between knee magnetic resonance imaging markers and knee symptoms over 6–9 years in young adults

Author: Ambrish Singh, Alison Venn, Leigh Blizzard, Lyn March, Felix Eckstein, Graeme Jones, Wolfgang Wirth, Flavia Cicuttini, Changhai Ding, and Benny Antony
Subjects: Rheumatology, Pharmacology (medical)
Abstract: Objectives Describe associations between MRI markers with knee symptoms in young adults. Methods Knee symptoms assessed using WOMAC scale during Childhood Determinants of Adult Health (CDAH)-knee study (year : 2008–10) and 6–9 year follow-up (CDAH-3; year : 2014–2019). Knee MRI scans, obtained at baseline, assessed for morphological markers (cartilage volume, cartilage thickness, subchondral bone area) and structural abnormalities (cartilage defects and bone marrow lesions (BMLs)). Univariable and multivariable (age, sex, BMI adjusted) zero-inflated Poisson (ZIP) regression models were used for analysis. Result Participants' mean age±SD in CDAH-knee and CDAH-3 were 34.95 ± 2.72 and 43.27 ± 3.28 years, with 49% and 48% females, respectively. Cross-sectionally, there was a weak but significant negative association between medial femorotibial compartment (MFTC) [ratio of mean (RoM)=0.99971084; 95%CI : 0.9995525–0.99986921; p< 0.001], lateral femorotibial compartment (LFTC) [RoM = 0.99982602; 95%CI : 0.99969915–0.9999529; p= 0.007], and patellar cartilage volume [RoM = 0.99981722; 95%CI : 0.99965326–0.9999811; p= 0.029] with knee symptoms. Similarly, there was a negative association between patellar cartilage volume (RoM = 0.99975523; 95%CI : 0.99961427–0.99989621; p= 0.014), MFTC cartilage thickness (RoM = 0.72090775; 95%CI : 0.59481806–0.87372596; p= 0.001) and knee symptoms assessed after 6–9 years. The total bone area was negatively associated with knee symptoms at baseline [RoM = 0.9210485; 95%CI : 0.8939677–0.9489496; p< 0.001] and 6–9 years (RoM = 0.9588811; 95%CI : 0.9313379–0.9872388; p= 0.005). The cartilage defects and BMLs were associated with higher knee symptoms at baseline and 6–9 years. Conclusion BMLs and cartilage defects were positively associated with knee symptoms, whereas cartilage volume and thickness at MFTC and total bone area were weakly and negatively associated with knee symptoms. These results suggest that the quantitative and semi-quantitative MRI markers can be explored as a marker of clinical progression of OA in young adults.
Published: 2023

22. Quantitatively Measured Infrapatellar Fat Pad Signal Intensity Alteration is Associated with Joint Effusion-synovitis in Knee Osteoarthritis

Author: Changhai Ding, Guangfeng Ruan, Shilong Lu, Yan Zhang, Zhaohua Zhu, Peihua Cao, Xiaoshuai Wang, Jia Li, Su’an Tang, Tianyu Chen, Weiyu Han, Jianwei Zhu, Di Chen, Benny Antony, Tania Winzenberg, Anita E Wluka, and Flavia Cicuttini
Subjects: Radiology, Nuclear Medicine and imaging
Abstract: Objective: The objective of this study is to investigate whether quantitatively measured infrapatellar fat pad (IPFP) signal intensity alteration is associated with joint effusion-synovitis in people with knee osteoarthritis (OA) over two years. Methods: Among 255 knee OA patients, IPFP signal intensity alteration represented by four measurement parameters [standard deviation of IPFP signal intensity (IPFP sDev), upper quartile value of IPFP high signal intensity region (IPFP UQ (H)), ratio of IPFP high signal intensity region volume to whole IPFP volume (IPFP percentage (H)), and clustering factor of IPFP high signal intensity (IPFP clustering factor (H))] was measured quantitatively at baseline and two-year follow-up using magnetic resonance imaging (MRI). Effusion-synovitis of the suprapatellar pouch and other cavities were measured both quantitatively and semi-quantitatively as effusion-synovitis volume and effusion-synovitis score at baseline and two-year follow-up using MRI. Mixed effects models assessed the associations between IPFP signal intensity alteration and effusion-synovitis over two years. Results: In multivariable analyses, all four parameters of IPFP signal intensity alteration were positively associated with total effusion-synovitis volume and effusion-synovitis volumes of the suprapatellar pouch and of other cavities over two years (all P＜0.05). They were also associated with the semi-quantitative measure of effusion-synovitis except for IPFP percentage (H) with effusion-synovitis in other cavities. Conclusion: Quantitatively measured IPFP signal intensity alteration is positively associated with joint effusion-synovitis in people with knee OA, suggesting that IPFP signal intensity alteration may contribute to effusion-synovitis and a coexistent pattern of these two imaging biomarkers could exist in knee OA patients.
Published: 2023

23. Efficacy and safety of hydroxychloroquine in osteoarthritis: a systematic review and meta-analysis of randomized controlled trials

Author: Zhiqiang Wang, Benny Antony, Anirudh Kotlo, Thusharika Dissanayaka, Siddharth Das, and Ambrish Singh
Subjects: medicine.medical_specialty, hydroxychloroquine, Pain, Osteoarthritis, Placebo, Osteoarthritis, Hip, law.invention, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Quality of life, Randomized controlled trial, systematic review, law, Internal medicine, Humans, Medicine, Randomized Controlled Trials as Topic, business.industry, Hydroxychloroquine, Osteoarthritis, Knee, medicine.disease, meta-analysis, osteoarthritis, Editorial, Strictly standardized mean difference, Antirheumatic Agents, Rheumatoid arthritis, Meta-analysis, randomized controlled trial, Original Article, 030211 gastroenterology & hepatology, business, medicine.drug
Abstract: Background/Aims: Conventional disease-modifying anti-rheumatic drugs have been trialed in osteoarthritis (OA). Hydroxychloroquine (HCQ), which has shown its effectiveness in rheumatoid arthritis, has been trialed for the treatment of OA; however, its efficacy and safety remain unclear. This systematic review and meta-analysis evaluate efficacy and safety of HCQ for the treatment of OA.Methods: MEDLINE, EMBASE, and Cochrane Central were searched from inception through June 2020. Two reviewers independently screened for randomized controlled trials (RCTs) comparing HCQ with placebo or other active-comparators for the treatment of knee, hand, or hip OA, extracted data, and performed Cochrane risk of bias assessments.Results: Six RCTs, four in hand OA, two in knee OA, consisting of 842 patients (436 in HCQ arm, 406 in control arm) were included. RCTs were conducted between 2012 and 2020, one each at UK, Netherlands, Germany, Italy, Iran, and Egypt; follow-up period ranged 24 to 52 weeks. High-quality evidence showed no clinically important pain reduction with HCQ compared to placebo/active-control in hand OA (standardized mean difference [SMD], 0.14; 95% confidence interval [CI], –0.20 to 0.48). Effect on pain reduction in knee and hand OA was small and non-significant (SMD, –0.09; 95% CI, –0.44 to 0.25). High-quality evidence showed no improvement in dysfunction with HCQ compared to placebo in hand OA patients (SMD, 0.08; 95% CI, –0.23 to 0.40). Effect on dysfunction improvement in knee and hand OA was modest and statistically non-significant (SMD, –0.20; 95% CI,–0.57 to 0.18). No improvement in quality of life was observed in hand OA.Conclusions: HCQ has no benefit in reducing pain and improving physical function in hand or knee OA patients.
Published: 2022

24. Effect of Curcuma longa extract on serum inflammatory markers and MRI-based synovitis in knee osteoarthritis

Author: Zhiqiang Wang, Tania Winzenberg, Ambrish Singh, Dawn Aitken, Leigh Blizzard, Mikael Boesen, Edwin H.G. Oei, Tijmen A. van Zadelhoff, Venkat Parameswaran, Changhai Ding, Robert Jones, Benny Antony, and Radiology & Nuclear Medicine
Subjects: Pharmacology, Complementary and alternative medicine, Drug Discovery, Pharmaceutical Science, Molecular Medicine
Abstract: Background: Curcuma longa (CL) extract is modestly effective for relieving knee symptoms in knee osteoarthritis (OA) patients; however, its mechanism of action is unclear. Purpose: We aimed to determine the effects of CL treatment on serum inflammatory markers over 12 weeks and to explore its potential effects on synovitis assessed by contrast-enhanced magnetic resonance imaging (CE-MRI) of the knee. Methods: Secondary analyses were conducted on the CL for knee OA (CurKOA) trial, which compared CL (n = 36) and placebo (n = 34) over 12 weeks for the treatment of knee OA. Systemic inflammatory markers (TNFα, IL6, and hsCRP) and a cartilage extracellular matrix degradative enzyme (MMP-3) were measured. A subgroup of participants (CL, n = 7; placebo, n = 5) underwent CE-MRI at baseline and a 12-week follow-up. Results: Over 12 weeks, there were no between-group differences in change in hsCRP, IL-6, and TNFα levels. MMP-3 levels decreased in both CL (-1.31 ng/ml [95%CI: -1.89 to -0.73]) and placebo (-2.34 ng/ml [95%CI: -2.95 to -1.73]) groups, with the placebo group having a slightly greater decrease (1.03 ng/ml [95%CI: 0.19 to 1.88]). Most (10 of 12) sub-study participants had normal synovial thickness scores at baseline. One participant had mild synovitis in each of the placebo and CL groups. Synovitis status was stable for all except two participants, one each in the CL and placebo group, whose synovitis score increased. Conclusion: This is the first study that explored the effect of CL treatment on local and systemic inflammation using biochemical markers and CE-MRI outcomes on knee OA patients. Secondary analyses from this pilot study suggest that CL is unlikely to have clinically significant effects on systemic (inflammatory and cartilage) or local synovitis (CE-MRI) biomarkers compared to placebo. The mechanism of action for CL effect on pain remains unclear.
Published: 2023

25. Boswellia for osteoarthritis

Author: Zhiqiang Wang, Ambrish Singh, Graeme Jones, Dawn Aitken, Laura L Laslett, Salman Hussain, Pablo García-Molina, Changhai Ding, and Benny Antony
Subjects: Pharmacology (medical)
Published: 2022

26. Efficacy and safety of colchicine for the treatment of osteoarthritis: a systematic review and meta‑analysis of intervention trials

Author: Ambrish Singh, Pablo Molina-Garcia, Salman Hussain, Alok Paul, Siddharth Kumar Das, Ying-Ying Leung, Catherine L. Hill, Debashish Danda, Jonathan Samuels, and Benny Antony
Subjects: Rheumatology, Calcium pyrophosphate, Osteoarthritis, Chondrocalcinosis, General Medicine, Colchicine, Osteoarthritis knee
Abstract: Objective Colchicine, an approved treatment for gout, has been trialed in many diseases including osteoarthritis (OA) due to its anti-inflammatory effects. However, its efficacy and safety remain unclear in OA. This systematic review and metaanalysis evaluated the efficacy and safety of colchicine for the treatment of OA. Methods PubMed, Web of Science, Scopus, and Cochrane Central were searched from inception through September 2022. Two reviewers independently screened for randomized controlled trials (RCTs) comparing colchicine with placebo or other active comparators for the treatment of OA (knee, hand, or hip OA), extracted data, and performed Cochrane risk of bias assessments. Result Nine RCTs for the knee OA and one for the hand OA were identified, consisting of 847 patients (429 in colchicine arms, 409 in control arms). The studies were conducted between 2002 and 2021 with follow-up periods ranging from 2 to 12 months, in India, Iran, Turkey, Australia, Singapore, and Iraq. Moderate-quality evidence showed no clinically important pain reduction with colchicine compared to control (standardized mean difference [SMD], 0.17; 95% confidence interval [CI], − 0.55, 0.22). Moderate-quality evidence showed no improvement in function with colchicine compared to control in knee OA patients (SMD, − 0.37; 95% CI, − 0.87, 0.13). Colchicine showed an acceptable safety profile with AEs/SAEs comparable to control. Conclusion Current evidence does not suggest a benefit of colchicine in reducing pain and improving physical function in the overall cohort of hand/knee OA patients. Future trials should focus on the subgroups of OA patients with local or systemic inflammation and/or mineralization who might benefit from colchicine., International Graduate Research Scholarship, University of Tasmania, National Health and Medical Research Council (NHMRC) of Australia 2017-20, Operational Programme Research, Development, and Education CZ.02.2.69/0.0/0.0/18_053/0016952 CAUL
Published: 2022

27. Association between diet quality in adolescence and adulthood and knee symptoms in adulthood: a 25-year cohort study

Author: Leigh Blizzard, Johanna E. Wilson, Benny Antony, Graeme Jones, Changhai Ding, Flavia M. Cicuttini, Laura L Laslett, Alison Venn, Terence Dwyer, Lyn March, Tao Meng, and Marita Cross
Subjects: musculoskeletal diseases, medicine.medical_specialty, Nutrition and Dietetics, WOMAC, business.industry, Saturated fat, Medicine (miscellaneous), Osteoarthritis, Limiting, medicine.disease, Affect (psychology), Diet quality, Internal medicine, medicine, Fruit intake, business, Cohort study
Abstract: We aimed to describe associations between diet quality in adolescence and adulthood and knee symptoms in adulthood. Two hundred seventy-five participants had adolescent diet measurements, 399 had adult diet measurements and 240 had diet measurements in both time points. Diet quality was assessed by Dietary Guidelines Index (DGI), reflecting adherence to Australian Dietary Guidelines. Knee symptoms were collected using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Data were analysed using zero-inflated negative binomial regressions. The overall adolescent DGI was not associated with adult knee symptoms, although lower intake of discretionary foods (e.g. cream, alcohol, bacon and cake) in adolescence was associated with lower pain (mean ratio (MR) 0·96) and dysfunction (MR 0·94). The overall adult DGI was not associated with knee symptoms; however, limiting saturated fat was associated with lower WOMAC (Pain: MR 0·93; stiffness: MR 0·93; dysfunction: MR 0·91), drinking water was associated with lower stiffness (MR 0·90) and fruit intake was associated with lower dysfunction (MR 0·90). Higher DGI for dairy products in adulthood was associated with higher WOMAC (Pain: MR 1·07; stiffness: MR 1·13; dysfunction: MR 1·11). Additionally, the score increases from adolescence to adulthood were not associated with adult knee symptoms, except for associations between score increase in limiting saturated fat and lower stiffness (MR 0·89) and between score increase in fruit intake and lower dysfunction (MR 0·92). In conclusion, the overall diet quality in adolescence and adulthood was not associated with knee symptoms in adulthood. However, some diet components may affect later knee symptoms.
Published: 2021

28. Effects of Vitamin D Supplementation on Disabling Foot Pain in Patients With Symptomatic Knee Osteoarthritis

Author: Changhai Ding, Weiyu Han, Jieruo Gu, Benny Antony, Anita E. Wluka, Shuang Zheng, Graeme Jones, L. Tu, Xingzhong Jin, Flavia M. Cicuttini, Tania Winzenberg, and Zhaohua Zhu
Subjects: Male, Vitamin, medicine.medical_specialty, Time Factors, Osteoarthritis, Disability Evaluation, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Double-Blind Method, Rheumatology, Foot Joints, Internal medicine, medicine, Vitamin D and neurology, Humans, In patient, Vitamin D, Aged, Cholecalciferol, Pain Measurement, 030203 arthritis & rheumatology, Vitamin d supplementation, business.industry, Confounding, Liter, Middle Aged, Osteoarthritis, Knee, medicine.disease, Arthralgia, Treatment Outcome, chemistry, Dietary Supplements, Female, business, Biomarkers, Foot (unit)
Abstract: Objective The present study was undertaken to determine whether vitamin D supplementation or maintaining sufficient vitamin D level reduces foot pain over 2 years in patients with symptomatic knee osteoarthritis (OA). Methods A post hoc study was conducted from a randomized, double-blind, placebo-controlled trial named the Vitamin D Effect on Osteoarthritis (VIDEO) study. Symptomatic knee OA patients with serum 25-hydroxyvitamin D levels between 12.5 nmoles/liter and 60 nmoles/liter were included and randomly allocated to either monthly vitamin D3 or placebo treatment (1:1) for 2 years. Manchester Foot Pain and Disability Index (MFPDI) was used to evaluate foot pain and disabling foot pain was defined as at least 1 of the 10 functional limitation items (items 1-9 and 11) being documented as on "most/every day(s)" in the last month. A repeated-measures, mixed-effects model was used to analyze the change of MFPDI scores between groups adjusting for potential confounders. Results A total of 413 patients with a mean age of 63.2 years (49.7% males) were enrolled and 340 completed the study. The mean MFPDI score was 22.8 ± 7.3, with 23.7% of participants having disabling foot pain at baseline. There were significant differences in MFPDI scores change between groups over 2 years, with more improvements in the vitamin D group than in the placebo group (-0.03 versus 1.30; P = 0.013) and more improvement in those maintaining sufficient vitamin D levels (n = 226) than those who did not (n = 114) (-0.09 versus 2.19; P = 0.001). Conclusion Vitamin D supplementation and maintenance of sufficient vitamin D levels may improve foot pain in those with knee OA.
Published: 2021

29. Association between knee symptoms, change in knee symptoms over 6–9 years, and SF-6D health state utility among middle-aged Australians

Author: Graeme Jones, Benny Antony, Terence Dwyer, Changhai Ding, Julie A Campbell, Andrew J. Palmer, Flavia M. Cicuttini, Alison Venn, Ambrish Singh, and Leigh Blizzard
Subjects: musculoskeletal diseases, education.field_of_study, medicine.medical_specialty, WOMAC, business.industry, 030503 health policy & services, Minimal clinically important difference, Public health, Population, Public Health, Environmental and Occupational Health, Psychological intervention, Negative association, Osteoarthritis, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Knee pain, 030220 oncology & carcinogenesis, medicine, Physical therapy, medicine.symptom, 0305 other medical science, education, business
Abstract: Health state utilities (HSUs) are an input metric for estimating quality-adjusted life-years (QALY) in cost–utility analyses. Currently, there is a paucity of data on association of knee symptoms with HSUs for middle-aged populations. We aimed to describe the association of knee symptoms and change in knee symptoms with SF-6D HSUs and described the distribution of HSUs against knee symptoms’ severity. Participants (36–49-years) were selected from the third follow-up (completed 2019) of Australian Childhood Determinants of Adult Health study. SF-6D HSUs were generated from the participant-reported SF-12. Association between participant-reported WOMAC knee symptoms’ severity, change in knee symptoms over 6–9 years, and HSUs were evaluated using linear regression models. For the cross-sectional analysis, 1,567 participants were included; mean age 43.5 years, female 54%, BMI ± SD 27.18 ± 5.31 kg/m2. Mean ± SD HSUs for normal, moderate, and severe WOMAC scores were 0.820 ± 0.120, 0.800 ± 0.120, and 0.740 ± 0.130, respectively. A significant association was observed between worsening knee symptoms and HSUs in univariable and multivariable analyses after adjustment (age and sex). HSU decrement for normal-to-severe total-WOMAC and WOMAC-pain was − 0.080 (95% CI − 0.100 to − 0.060, p
Published: 2021

30. A systematic review of cost-effectiveness analyses of continuous versus intermittent renal replacement therapy in acute kidney injury

Author: Andrew J. Palmer, Kher, M Jose, Benny Antony, Salman Hussain, and Ambrish Singh
Subjects: medicine.medical_specialty, Continuous Renal Replacement Therapy, Cost effectiveness, Cost-Benefit Analysis, medicine.medical_treatment, Intermittent Renal Replacement Therapy, 03 medical and health sciences, Indirect costs, 0302 clinical medicine, Renal Dialysis, medicine, Risk of mortality, Humans, Pharmacology (medical), 030212 general & internal medicine, Renal replacement therapy, Dialysis, business.industry, 030503 health policy & services, Health Policy, Incidence (epidemiology), Acute kidney injury, General Medicine, Cost-effectiveness analysis, Acute Kidney Injury, medicine.disease, 3. Good health, Emergency medicine, 0305 other medical science, business
Abstract: Introduction Though cost-effectiveness analyses (CEAs) have evaluated continuous renal replacement therapy (RRTs) and intermittent RRTs in acute kidney injury (AKI) patients; it is yet to establish which RRT technique is most cost-effective. We systematically reviewed the current evidence from CEAs of CRRT versus IRRT in patients with AKI. Areas covered PubMed, EMBASE, and Cochrane databases searched for CEAs comparing two RRTs. Overall, seven CEAs, two from Brazil and one from US, Canada, Colombia, Belgium, and Argentina were included. Five CEAs used Markov model, three reported following CHEERS, none accounted indirect costs. Time horizon varied from 1-year-lifetime. Marginal QALY gain with CRRT compared to IRRT was reported across CEAs. Older CEAs found CRRT to be costlier and not cost-effective than IRRT (ICER 2019 US$: 152,671$/QALY); latest CEAs (industry-sponsored) reported CRRT to be cost-saving versus IRRT (-117,614$/QALY). Risk of mortality, dialysis dependence, and incidence of renal recovery were the key drivers of cost-effectiveness. Expert opinion CEAs of RRTs for AKI show conflicting findings with secular trends. Latest CEAs suggested CRRT to be cost-effective versus IRRT with dialysis dependence rate as major driver of cost-effectiveness. Future CEAs, preferably non-industry sponsored, may account for indirect costs to improve the generalizability of CEAs.
Published: 2021

31. Associations of blood pressure and arterial stiffness with knee cartilage volume in patients with knee osteoarthritis

Author: Changhai Ding, Shuang Zheng, Johanne Martel-Pelletier, Flavia M. Cicuttini, Jean-Pierre Pelletier, Yuanyuan Wang, Tania Winzenberg, Anita E. Wluka, Benny Antony, Han Cen, Guangfeng Ruan, Tao Meng, and Jimin Zhu
Subjects: Cartilage, Articular, Male, musculoskeletal diseases, medicine.medical_specialty, Supine position, Knee Joint, Blood Pressure, Osteoarthritis, Pulse Wave Analysis, 030204 cardiovascular system & hematology, 03 medical and health sciences, Vascular Stiffness, 0302 clinical medicine, Double-Blind Method, Rheumatology, Internal medicine, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Tibia, Pulse wave velocity, Randomized Controlled Trials as Topic, business.industry, Cartilage, Middle Aged, Osteoarthritis, Knee, medicine.disease, Pulse pressure, medicine.anatomical_structure, Blood pressure, Disease Progression, Cardiology, Arterial stiffness, Female, business
Abstract: Objective To describe the associations of blood pressure and arterial stiffness with knee cartilage volume in patients with knee OA. Methods A secondary analysis was performed on the data from participants in a randomized controlled trial that identified the effects of vitamin D supplementation on knee structures and symptoms among patients with symptomatic knee OA. Brachial and central blood pressure, arterial stiffness indicators and knee cartilage volume were measured at baseline and the 2 year follow-up. Associations were assessed using generalized estimating equations. Results Among 231 participants (average age 63.2 years), 48.9% were females. Higher supine systolic and diastolic pressures were significantly associated with lower tibial cartilage volume (systolic: lateral β −6.23, medial β −5.14, total β −11.35 mm3/mmHg; diastolic: lateral β −10.25, medial β −11.29, total β −21.50 mm3/mmHg). Higher supine systolic pressure was associated with lower femoral cartilage volume (lateral β −17.35, total β −28.31 mm3/mmHg). Central systolic pressure and arterial stiffness indicators (including pulse wave velocity, central pulse pressure and peripheral pulse pressure) were largely not associated with knee cartilage volume; however, higher augmentation index was associated with lower tibial and femoral cartilage volume (tibial: medial β −8.24, total β −19.13 mm3/%; femoral: lateral β −23.70, medial β −26.42, total β −50.12 mm3/%). Conclusions Blood pressure and arterial stiffness are associated with knee cartilage volume at several sites in knee OA patients. This supports that blood pressure and arterial stiffness may involve in the progression of knee OA.
Published: 2021

32. Effectiveness of Curcuma longa Extract for the Treatment of Symptoms and Effusion–Synovitis of Knee Osteoarthritis

Author: Jurgen Fripp, Benny Antony, Tania Winzenberg, Robert D. Jones, Ambrish Singh, Guoqi Cai, Dawn Aitken, Zhiqiang Wang, Graeme Jones, Changhai Ding, Laura L Laslett, and Ingrid Hopper
Subjects: medicine.medical_specialty, WOMAC, Visual analogue scale, business.industry, 010102 general mathematics, General Medicine, Osteoarthritis, Placebo, medicine.disease, 01 natural sciences, law.invention, Clinical trial, 03 medical and health sciences, 0302 clinical medicine, Knee pain, Randomized controlled trial, law, Internal medicine, Internal Medicine, medicine, 030212 general & internal medicine, 0101 mathematics, medicine.symptom, Adverse effect, business
Abstract: Background Current pharmacologic therapies for patients with osteoarthritis are suboptimal. Objective To determine the efficacy of Curcuma longa extract (CL) for reducing knee symptoms and effusion-synovitis in patients with symptomatic knee osteoarthritis and knee effusion-synovitis. Design Randomized, double-blind, placebo-controlled trial. (Australian New Zealand Clinical Trials Registry: ACTRN12618000080224). Setting Single-center study with patients from southern Tasmania, Australia. Participants 70 participants with symptomatic knee osteoarthritis and ultrasonography-defined effusion-synovitis. Intervention 2 capsules of CL (n = 36) or matched placebo (n = 34) per day for 12 weeks. Measurements The 2 primary outcomes were changes in knee pain on a visual analogue scale (VAS) and effusion-synovitis volume on magnetic resonance imaging (MRI). The key secondary outcomes were change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and cartilage composition values. Outcomes were assessed over 12 weeks. Results CL improved VAS pain compared with placebo by -9.1 mm (95% CI, -17.8 to -0.4 mm [P = 0.039]) but did not change effusion-synovitis volume (3.2 mL [CI, -0.3 to 6.8 mL]). CL also improved WOMAC knee pain (-47.2 mm [CI, -81.2 to -13.2 mm]; P = 0.006) but not lateral femoral cartilage T2 relaxation time (-0.4 ms [CI, -1.1 to 0.3 ms]). The incidence of adverse events was similar in the CL (n = 14 [39%]) and placebo (n = 18 [53%]) groups (P = 0.16); 2 events in the CL group and 5 in the placebo group may have been treatment related. Limitation Modest sample size and short duration. Conclusion CL was more effective than placebo for knee pain but did not affect knee effusion-synovitis or cartilage composition. Multicenter trials with larger sample sizes are needed to assess the clinical significance of these findings. Primary funding source University of Tasmania and Natural Remedies Private Limited.
Published: 2020

33. Associations between dietary intake of vitamin K and changes in symptomatic and structural changes in patients with knee osteoarthritis

Author: Zetao Liao, Jun Chang, Zhaohua Zhu, Weiyu Han, Tao Meng, Shuang Zheng, Liudan Tu, Benny Antony, Tania Winzenberg, Anita E. Wluka, Flavia Cicuttini, and Changhai Ding
Subjects: Rheumatology
Abstract: To investigate associations of dietary vitamin K intake with changes in knee symptoms and structures in patients with knee OA.Participants with symptomatic knee OA were enrolled (n=259) and followed up for 2 years (n=212). Baseline dietary vitamin K intake was calculated from a validated food frequency questionnaire. Knee symptoms were assessed by using the Western Ontario and McMaster University Index of osteoarthritis (WOMAC) scores. Knee cartilage defects, bone marrow lesions and effusion-synovitis volume were measured from MRI scans. Univariable and multivariable linear regressions were used for analyses.Higher vitamin K intake quartile was significantly associated with greater decrease in total WOMAC score and dysfunction score over 24 months. The subgroup analyses showed in patients with severe baseline VAS pain, higher vitamin K intake quartile was associated with more improvement in all WOMAC scores. There were no overall significant associations between vitamin K intake and changes in MRI features. In sub-group analysis, vitamin K intake was negatively associated with changes in tibiofemoral, patellar and total cartilage defects in participants with severe baseline radiographic grade, and was negatively associated with change in total and patellar cartilage defects in participants with severe baseline VAS pain and in female patients.The association of higher vitamin K intake with decreased knee symptoms over 24 months in patients with knee OA suggests that clinical trials examining the effect of vitamin K supplementation for knee OA symptoms are warranted. Whether there is an effect on knee structure is unclear. This article is protected by copyright. All rights reserved.
Published: 2022

34. Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019

Author: Ewerton Cousin, Bruce B Duncan, Caroline Stein, Kanyin Liane Ong, Theo Vos, Cristiana Abbafati, Mohsen Abbasi-Kangevari, Michael Abdelmasseh, Amir Abdoli, Rami Abd-Rabu, Hassan Abolhassani, Eman Abu-Gharbieh, Manfred Mario Kokou Accrombessi, Qorinah Estiningtyas Sakilah Adnani, Muhammad Sohail Afzal, Gina Agarwal, Krishna K Agrawaal, Marcela Agudelo-Botero, Bright Opoku Ahinkorah, Sajjad Ahmad, Tauseef Ahmad, Keivan Ahmadi, Sepideh Ahmadi, Ali Ahmadi, Ali Ahmed, Yusra Ahmed Salih, Wuraola Akande-Sholabi, Tayyaba Akram, Hanadi Al Hamad, Ziyad Al-Aly, Jacqueline Elizabeth Alcalde-Rabanal, Vahid Alipour, Syed Mohamed Aljunid, Rajaa M Al-Raddadi, Nelson Alvis-Guzman, Saeed Amini, Robert Ancuceanu, Tudorel Andrei, Catalina Liliana Andrei, Ranjit Mohan Anjana, Adnan Ansar, Ippazio Cosimo Antonazzo, Benny Antony, Anayochukwu Edward Anyasodor, Jalal Arabloo, Damian Arizmendi, Benedetta Armocida, Anton A Artamonov, Judie Arulappan, Zahra Aryan, Samaneh Asgari, Tahira Ashraf, Thomas Astell-Burt, Prince Atorkey, Maha Moh'd Wahbi Atout, Martin Amogre Ayanore, Ashish D Badiye, Atif Amin Baig, Mohan Bairwa, Jennifer L Baker, Ovidiu Constantin Baltatu, Palash Chandra Banik, Anthony Barnett, Mark Thomaz Ugliara Barone, Francesco Barone-Adesi, Amadou Barrow, Neeraj Bedi, Rebuma Belete, Uzma Iqbal Belgaumi, Arielle Wilder Bell, Derrick A Bennett, Isabela M Bensenor, David Beran, Akshaya Srikanth Bhagavathula, Sonu Bhaskar, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Ali Bijani, Boris Bikbov, Setognal Birara, Virginia Bodolica, Aime Bonny, Hermann Brenner, Nikolay Ivanovich Briko, Zahid A Butt, Florentino Luciano Caetano dos Santos, Luis Alberto Cámera, Ismael R Campos-Nonato, Yin Cao, Chao Cao, Ester Cerin, Promit Ananyo Chakraborty, Joht Singh Chandan, Vijay Kumar Chattu, Simiao Chen, Jee-Young Jasmine Choi, Sonali Gajanan Choudhari, Enayet Karim Chowdhury, Dinh-Toi Chu, Barbara Corso, Omid Dadras, Xiaochen Dai, Albertino Antonio Moura Damasceno, Lalit Dandona, Rakhi Dandona, Claudio Alberto Dávila-Cervantes, Jan-Walter De Neve, Edgar Denova-Gutiérrez, Deepak Dhamnetiya, Daniel Diaz, Sanam Ebtehaj, Hisham Atan Edinur, Sahar Eftekharzadeh, Iman El Sayed, Islam Y Elgendy, Muhammed Elhadi, Mohamed A Elmonem, Mohammed Faisaluddin, Umar Farooque, Xiaoqi Feng, Eduarda Fernandes, Florian Fischer, David Flood, Marisa Freitas, Peter Andras Gaal, Mohamed M Gad, Piyada Gaewkhiew, Lemma Getacher, Mansour Ghafourifard, Reza Ghanei Gheshlagh, Ahmad Ghashghaee, Nermin Ghith, Ghozali Ghozali, Paramjit Singh Gill, Ibrahim Abdelmageed Ginawi, Ekaterina Vladimirovna Glushkova, Mahaveer Golechha, Sameer Vali Gopalani, Rafael Alves Guimarães, Rajat Das Gupta, Rajeev Gupta, Vivek Kumar Gupta, Veer Bala Gupta, Sapna Gupta, Tesfa Dejenie Habtewold, Nima Hafezi-Nejad, Rabih Halwani, Asif Hanif, Graeme J Hankey, Shafiul Haque, Ahmed I Hasaballah, Syed Shahzad Hasan, Abdiwahab Hashi, Soheil Hassanipour, Simon I Hay, Khezar Hayat, Mohammad Heidari, Mohammad Bellal Hossain Hossain, Sahadat Hossain, Mostafa Hosseini, Soodabeh Hoveidamanesh, Junjie Huang, Ayesha Humayun, Rabia Hussain, Bing-Fang Hwang, Segun Emmanuel Ibitoye, Kevin S Ikuta, Leeberk Raja Inbaraj, Usman Iqbal, Md Shariful Islam, Sheikh Mohammed Shariful Islam, Rakibul M Islam, Nahlah Elkudssiah Ismail, Gaetano Isola, Ramaiah Itumalla, Masao Iwagami, Ihoghosa Osamuyi Iyamu, Mohammad Ali Jahani, Mihajlo Jakovljevic, Ranil Jayawardena, Ravi Prakash Jha, Oommen John, Jost B Jonas, Tamas Joo, Ali Kabir, Rohollah Kalhor, Ashwin Kamath, Tanuj Kanchan, Himal Kandel, Neeti Kapoor, Gbenga A Kayode, Sewnet Adem Kebede, Pedram Keshavarz, Mohammad Keykhaei, Yousef Saleh Khader, Himanshu Khajuria, Moien AB Khan, Md Nuruzzaman Khan, Maseer Khan, Amir M Khater, Tawfik Ahmed Muthafer Khoja, Jagdish Khubchandani, Min Seo Kim, Yun Jin Kim, Ruth W Kimokoti, Sezer Kisa, Adnan Kisa, Mika Kivimäki, Vladimir Andreevich Korshunov, Oleksii Korzh, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, G Anil Kumar, Nithin Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Anders O Larsson, Savita Lasrado, Wei-Chen Lee, Chiachi Bonnie Lee, Paul H Lee, Shaun Wen Huey Lee, Ming-Chieh Li, Stephen S Lim, Lee-Ling Lim, Giancarlo Lucchetti, Azeem Majeed, Ahmad Azam Malik, Borhan Mansouri, Lorenzo Giovanni Mantovani, Santi Martini, Prashant Mathur, Colm McAlinden, Nafiul Mehedi, Teferi Mekonnen, Ritesh G Menezes, Amanual Getnet Mersha, Junmei Miao Jonasson, Tomasz Miazgowski, Irmina Maria Michalek, Andreea Mirica, Erkin M Mirrakhimov, Agha Zeeshan Mirza, Prasanna Mithra, Abdollah Mohammadian-Hafshejani, Reza Mohammadpourhodki, Arif Mohammed, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Mohammad Ali Moni, Farhad Moradpour, Rahmatollah Moradzadeh, Ebrahim Mostafavi, Ulrich Otto Mueller, Christopher J L Murray, Ahmad Mustafa, Gabriele Nagel, Vinay Nangia, Atta Abbas Naqvi, Biswa Prakash Nayak, Javad Nazari, Rawlance Ndejjo, Ruxandra Irina Negoi, Sandhya Neupane Kandel, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Jean Jacques Noubiap, Christoph Nowak, Bogdan Oancea, Oluwakemi Ololade Odukoya, Ayodipupo Sikiru Oguntade, Temitope T Ojo, Andrew T Olagunju, Obinna E Onwujekwe, Alberto Ortiz, Mayowa O Owolabi, Raffaele Palladino, Songhomitra Panda-Jonas, Seithikurippu R Pandi-Perumal, Shahina Pardhan, Tarang Parekh, Mojtaba Parvizi, Veincent Christian Filipino Pepito, Arokiasamy Perianayagam, Ionela-Roxana Petcu, Manju Pilania, Vivek Podder, Roman V Polibin, Maarten J Postma, Akila Prashant, Navid Rabiee, Mohammad Rabiee, Vafa Rahimi-Movaghar, Muhammad Aziz Rahman, Md. Mosfequr Rahman, Mosiur Rahman, Setyaningrum Rahmawaty, Nazanin Rajai, Pradhum Ram, Juwel Rana, Kamal Ranabhat, Priyanga Ranasinghe, Chythra R Rao, Satish Rao, Salman Rawaf, David Laith Rawaf, Lal Rawal, Andre M N Renzaho, Nima Rezaei, Aziz Rezapour, Seyed Mohammad Riahi, Daniela Ribeiro, Jefferson Antonio Buendia Rodriguez, Leonardo Roever, Peter Rohloff, Godfrey M Rwegerera, Paul MacDaragh Ryan, Maha Mohamed Saber-Ayad, Siamak Sabour, Basema Saddik, Sahar Saeedi Moghaddam, Amirhossein Sahebkar, Harihar Sahoo, KM Saif-Ur-Rahman, Hamideh Salimzadeh, Mehrnoosh Samaei, Juan Sanabria, Milena M Santric-Milicevic, Brijesh Sathian, Thirunavukkarasu Sathish, Markus P Schlaich, Abdul-Aziz Seidu, Mario Šekerija, Nachimuthu Senthil Kumar, Allen Seylani, Masood Ali Shaikh, Hina Shamshad, Md Shajedur Rahman Shawon, Sara Sheikhbahaei, Jeevan K Shetty, Rahman Shiri, K M Shivakumar, Kerem Shuval, Jasvinder A Singh, Ambrish Singh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Ahmad Sofi-Mahmudi, Amin Soheili, Jing Sun, Viktória Szerencsés, Miklós Szócska, Rafael Tabarés-Seisdedos, Hooman Tadbiri, Eyayou Girma Tadesse, Md. Tariqujjaman, Kavumpurathu Raman Thankappan, Rekha Thapar, Nihal Thomas, Binod Timalsina, Ruoyan Tobe-Gai, Marcello Tonelli, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Jaya Prasad Tripathy, Lorainne Tudor Car, Biruk Shalmeno Tusa, Riaz Uddin, Era Upadhyay, Sahel Valadan Tahbaz, Pascual R Valdez, Tommi Juhani Vasankari, Madhur Verma, Victor E Villalobos-Daniel, Sergey Konstantinovitch Vladimirov, Bay Vo, Giang Thu Vu, Rade Vukovic, Yasir Waheed, Richard G Wamai, Andrea Werdecker, Nuwan Darshana Wickramasinghe, Andrea Sylvia Winkler, Befikadu Legesse Wubishet, Xiaoyue Xu, Suowen Xu, Seyed Hossein Yahyazadeh Jabbari, Hiroshi Yatsuya, Sanni Yaya, Taklo Simeneh Yazie Yazie, Siyan Yi, Naohiro Yonemoto, Ismaeel Yunusa, Siddhesh Zadey, Sojib Bin Zaman, Maryam Zamanian, Nelson Zamora, Mikhail Sergeevich Zastrozhin, Anasthasia Zastrozhina, Zhi-Jiang Zhang, Chenwen Zhong, Mohammad Zmaili, Alimuddin Zumla, Mohsen Naghavi, Maria Inês Schmidt, Tampere University, Clinical Medicine, QE Econometrics, RS: GSBE other - not theme-related research, Department of Public Health, University of Helsinki, Cousin, E, Duncan, B, Stein, C, Ong, K, Vos, T, Abbafati, C, Abbasi-Kangevari, M, Abdelmasseh, M, Abdoli, A, Abd-Rabu, R, Abolhassani, H, Abu-Gharbieh, E, Accrombessi, M, Adnani, Q, Afzal, M, Agarwal, G, Agrawaal, K, Agudelo-Botero, M, Ahinkorah, B, Ahmad, S, Ahmad, T, Ahmadi, K, Ahmadi, S, Ahmadi, A, Ahmed, A, Ahmed Salih, Y, Akande-Sholabi, W, Akram, T, Al Hamad, H, Al-Aly, Z, Alcalde-Rabanal, J, Alipour, V, Aljunid, S, Al-Raddadi, R, Alvis-Guzman, N, Amini, S, Ancuceanu, R, Andrei, T, Andrei, C, Anjana, R, Ansar, A, Antonazzo, I, Antony, B, Anyasodor, A, Arabloo, J, Arizmendi, D, Armocida, B, Artamonov, A, Arulappan, J, Aryan, Z, Asgari, S, Ashraf, T, Astell-Burt, T, Atorkey, P, Atout, M, Ayanore, M, Badiye, A, Baig, A, Bairwa, M, Baker, J, Baltatu, O, Banik, P, Barnett, A, Barone, M, Barone-Adesi, F, Barrow, A, Bedi, N, Belete, R, Belgaumi, U, Bell, A, Bennett, D, Bensenor, I, Beran, D, Bhagavathula, A, Bhaskar, S, Bhattacharyya, K, Bhojaraja, V, Bijani, A, Bikbov, B, Birara, S, Bodolica, V, Bonny, A, Brenner, H, Briko, N, Butt, Z, Caetano dos Santos, F, Camera, L, Campos-Nonato, I, Cao, Y, Cao, C, Cerin, E, Chakraborty, P, Chandan, J, Chattu, V, Chen, S, Choi, J, Choudhari, S, Chowdhury, E, Chu, D, Corso, B, Dadras, O, Dai, X, Damasceno, A, Dandona, L, Dandona, R, Davila-Cervantes, C, De Neve, J, Denova-Gutierrez, E, Dhamnetiya, D, Diaz, D, Ebtehaj, S, Edinur, H, Eftekharzadeh, S, El Sayed, I, Elgendy, I, Elhadi, M, Elmonem, M, Faisaluddin, M, Farooque, U, Feng, X, Fernandes, E, Fischer, F, Flood, D, Freitas, M, Gaal, P, Gad, M, Gaewkhiew, P, Getacher, L, Ghafourifard, M, Ghanei Gheshlagh, R, Ghashghaee, A, Ghith, N, Ghozali, G, Gill, P, Ginawi, I, Glushkova, E, Golechha, M, Gopalani, S, Guimaraes, R, Gupta, R, Gupta, V, Gupta, S, Habtewold, T, Hafezi-Nejad, N, Halwani, R, Hanif, A, Hankey, G, Haque, S, Hasaballah, A, Hasan, S, Hashi, A, Hassanipour, S, Hay, S, Hayat, K, Heidari, M, Hossain, M, Hossain, S, Hosseini, M, Hoveidamanesh, S, Huang, J, Humayun, A, Hussain, R, Hwang, B, Ibitoye, S, Ikuta, K, Inbaraj, L, Iqbal, U, Islam, M, Islam, S, Islam, R, Ismail, N, Isola, G, Itumalla, R, Iwagami, M, Iyamu, I, Jahani, M, Jakovljevic, M, Jayawardena, R, Jha, R, John, O, Jonas, J, Joo, T, Kabir, A, Kalhor, R, Kamath, A, Kanchan, T, Kandel, H, Kapoor, N, Kayode, G, Kebede, S, Keshavarz, P, Keykhaei, M, Khader, Y, Khajuria, H, Khan, M, Khater, A, Khoja, T, Khubchandani, J, Kim, M, Kim, Y, Kimokoti, R, Kisa, S, Kisa, A, Kivimaki, M, Korshunov, V, Korzh, O, Koyanagi, A, Krishan, K, Kuate Defo, B, Kumar, G, Kumar, N, Kusuma, D, La Vecchia, C, Lacey, B, Larsson, A, Lasrado, S, Lee, W, Lee, C, Lee, P, Lee, S, Li, M, Lim, S, Lim, L, Lucchetti, G, Majeed, A, Malik, A, Mansouri, B, Mantovani, L, Martini, S, Mathur, P, Mcalinden, C, Mehedi, N, Mekonnen, T, Menezes, R, Mersha, A, Miao Jonasson, J, Miazgowski, T, Michalek, I, Mirica, A, Mirrakhimov, E, Mirza, A, Mithra, P, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mohammed, A, Mokdad, A, Molokhia, M, Monasta, L, Moni, M, Moradpour, F, Moradzadeh, R, Mostafavi, E, Mueller, U, Murray, C, Mustafa, A, Nagel, G, Nangia, V, Naqvi, A, Nayak, B, Nazari, J, Ndejjo, R, Negoi, R, Neupane Kandel, S, Nguyen, C, Nguyen, H, Noubiap, J, Nowak, C, Oancea, B, Odukoya, O, Oguntade, A, Ojo, T, Olagunju, A, Onwujekwe, O, Ortiz, A, Owolabi, M, Palladino, R, Panda-Jonas, S, Pandi-Perumal, S, Pardhan, S, Parekh, T, Parvizi, M, Pepito, V, Perianayagam, A, Petcu, I, Pilania, M, Podder, V, Polibin, R, Postma, M, Prashant, A, Rabiee, N, Rabiee, M, Rahimi-Movaghar, V, Rahman, M, Rahmawaty, S, Rajai, N, Ram, P, Rana, J, Ranabhat, K, Ranasinghe, P, Rao, C, Rao, S, Rawaf, S, Rawaf, D, Rawal, L, Renzaho, A, Rezaei, N, Rezapour, A, Riahi, S, Ribeiro, D, Rodriguez, J, Roever, L, Rohloff, P, Rwegerera, G, Ryan, P, Saber-Ayad, M, Sabour, S, Saddik, B, Saeedi Moghaddam, S, Sahebkar, A, Sahoo, H, Saif-Ur-Rahman, K, Salimzadeh, H, Samaei, M, Sanabria, J, Santric-Milicevic, M, Sathian, B, Sathish, T, Schlaich, M, Seidu, A, Sekerija, M, Senthil Kumar, N, Seylani, A, Shaikh, M, Shamshad, H, Shawon, M, Sheikhbahaei, S, Shetty, J, Shiri, R, Shivakumar, K, Shuval, K, Singh, J, Singh, A, Skryabin, V, Skryabina, A, Sofi-Mahmudi, A, Soheili, A, Sun, J, Szerencses, V, Szocska, M, Tabares-Seisdedos, R, Tadbiri, H, Tadesse, E, Tariqujjaman, M, Thankappan, K, Thapar, R, Thomas, N, Timalsina, B, Tobe-Gai, R, Tonelli, M, Tovani-Palone, M, Tran, B, Tripathy, J, Tudor Car, L, Tusa, B, Uddin, R, Upadhyay, E, Valadan Tahbaz, S, Valdez, P, Vasankari, T, Verma, M, Villalobos-Daniel, V, Vladimirov, S, Vo, B, Vu, G, Vukovic, R, Waheed, Y, Wamai, R, Werdecker, A, Wickramasinghe, N, Winkler, A, Wubishet, B, Xu, X, Xu, S, Yahyazadeh Jabbari, S, Yatsuya, H, Yaya, S, Yazie, T, Yi, S, Yonemoto, N, Yunusa, I, Zadey, S, Zaman, S, Zamanian, M, Zamora, N, Zastrozhin, M, Zastrozhina, A, Zhang, Z, Zhong, C, Zmaili, M, Zumla, A, Naghavi, M, Schmidt, M, GBD 2019 Diabetes Mortality Collaborators, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Cousin, E., Duncan, B. B., Stein, C., Ong, K. L., Vos, T., Abbafati, C., Abbasi-Kangevari, M., Abdelmasseh, M., Abdoli, A., Abd-Rabu, R., Abolhassani, H., Abu-Gharbieh, E., Accrombessi, M. M. K., Adnani, Q. E. S., Afzal, M. S., Agarwal, G., Agrawaal, K. K., Agudelo-Botero, M., Ahinkorah, B. O., Ahmad, S., Ahmad, T., Ahmadi, K., Ahmadi, S., Ahmadi, A., Ahmed, A., Ahmed Salih, Y., Akande-Sholabi, W., Akram, T., Al Hamad, H., Al-Aly, Z., Alcalde-Rabanal, J. E., Alipour, V., Aljunid, S. M., Al-Raddadi, R. M., Alvis-Guzman, N., Amini, S., Ancuceanu, R., Andrei, T., Andrei, C. L., Anjana, R. M., Ansar, A., Antonazzo, I. C., Antony, B., Anyasodor, A. E., Arabloo, J., Arizmendi, D., Armocida, B., Artamonov, A. A., Arulappan, J., Aryan, Z., Asgari, S., Ashraf, T., Astell-Burt, T., Atorkey, P., Atout, M. M. W., Ayanore, M. A., Badiye, A. D., Baig, A. A., Bairwa, M., Baker, J. L., Baltatu, O. C., Banik, P. C., Barnett, A., Barone, M. T. U., Barone-Adesi, F., Barrow, A., Bedi, N., Belete, R., Belgaumi, U. I., Bell, A. W., Bennett, D. A., Bensenor, I. M., Beran, D., Bhagavathula, A. S., Bhaskar, S., Bhattacharyya, K., Bhojaraja, V. S., Bijani, A., Bikbov, B., Birara, S., Bodolica, V., Bonny, A., Brenner, H., Briko, N. I., Butt, Z. A., Caetano dos Santos, F. L., Camera, L. A., Campos-Nonato, I. R., Cao, Y., Cao, C., Cerin, E., Chakraborty, P. A., Chandan, J. S., Chattu, V. K., Chen, S., Choi, J. -Y. J., Choudhari, S. G., Chowdhury, E. K., Chu, D. -T., Corso, B., Dadras, O., Dai, X., Damasceno, A. A. M., Dandona, L., Dandona, R., Davila-Cervantes, C. A., De Neve, J. -W., Denova-Gutierrez, E., Dhamnetiya, D., Diaz, D., Ebtehaj, S., Edinur, H. A., Eftekharzadeh, S., El Sayed, I., Elgendy, I. Y., Elhadi, M., Elmonem, M. A., Faisaluddin, M., Farooque, U., Feng, X., Fernandes, E., Fischer, F., Flood, D., Freitas, M., Gaal, P. A., Gad, M. M., Gaewkhiew, P., Getacher, L., Ghafourifard, M., Ghanei Gheshlagh, R., Ghashghaee, A., Ghith, N., Ghozali, G., Gill, P. S., Ginawi, I. A., Glushkova, E. V., Golechha, M., Gopalani, S. V., Guimaraes, R. A., Gupta, R. D., Gupta, R., Gupta, V. K., Gupta, V. B., Gupta, S., Habtewold, T. D., Hafezi-Nejad, N., Halwani, R., Hanif, A., Hankey, G. J., Haque, S., Hasaballah, A. I., Hasan, S. S., Hashi, A., Hassanipour, S., Hay, S. I., Hayat, K., Heidari, M., Hossain, M. B. H., Hossain, S., Hosseini, M., Hoveidamanesh, S., Huang, J., Humayun, A., Hussain, R., Hwang, B. -F., Ibitoye, S. E., Ikuta, K. S., Inbaraj, L. R., Iqbal, U., Islam, M. S., Islam, S. M. S., Islam, R. M., Ismail, N. E., Isola, G., Itumalla, R., Iwagami, M., Iyamu, I. O., Jahani, M. A., Jakovljevic, M., Jayawardena, R., Jha, R. P., John, O., Jonas, J. B., Joo, T., Kabir, A., Kalhor, R., Kamath, A., Kanchan, T., Kandel, H., Kapoor, N., Kayode, G. A., Kebede, S. A., Keshavarz, P., Keykhaei, M., Khader, Y. S., Khajuria, H., Khan, M. A., Khan, M. N., Khan, M., Khater, A. M., Khoja, T. A. M., Khubchandani, J., Kim, M. S., Kim, Y. J., Kimokoti, R. W., Kisa, S., Kisa, A., Kivimaki, M., Korshunov, V. A., Korzh, O., Koyanagi, A., Krishan, K., Kuate Defo, B., Kumar, G. A., Kumar, N., Kusuma, D., La Vecchia, C., Lacey, B., Larsson, A. O., Lasrado, S., Lee, W. -C., Lee, C. B., Lee, P. H., Lee, S. W. H., Li, M. -C., Lim, S. S., Lim, L. -L., Lucchetti, G., Majeed, A., Malik, A. A., Mansouri, B., Mantovani, L. G., Martini, S., Mathur, P., Mcalinden, C., Mehedi, N., Mekonnen, T., Menezes, R. G., Mersha, A. G., Miao Jonasson, J., Miazgowski, T., Michalek, I. M., Mirica, A., Mirrakhimov, E. M., Mirza, A. Z., Mithra, P., Mohammadian-Hafshejani, A., Mohammadpourhodki, R., Mohammed, A., Mokdad, A. H., Molokhia, M., Monasta, L., Moni, M. A., Moradpour, F., Moradzadeh, R., Mostafavi, E., Mueller, U. O., Murray, C. J. L., Mustafa, A., Nagel, G., Nangia, V., Naqvi, A. A., Nayak, B. P., Nazari, J., Ndejjo, R., Negoi, R. I., Neupane Kandel, S., Nguyen, C. T., Nguyen, H. L. T., Noubiap, J. J., Nowak, C., Oancea, B., Odukoya, O. O., Oguntade, A. S., Ojo, T. T., Olagunju, A. T., Onwujekwe, O. E., Ortiz, A., Owolabi, M. O., Palladino, R., Panda-Jonas, S., Pandi-Perumal, S. R., Pardhan, S., Parekh, T., Parvizi, M., Pepito, V. C. F., Perianayagam, A., Petcu, I. -R., Pilania, M., Podder, V., Polibin, R. V., Postma, M. J., Prashant, A., Rabiee, N., Rabiee, M., Rahimi-Movaghar, V., Rahman, M. A., Rahman, M. M., Rahman, M., Rahmawaty, S., Rajai, N., Ram, P., Rana, J., Ranabhat, K., Ranasinghe, P., Rao, C. R., Rao, S., Rawaf, S., Rawaf, D. L., Rawal, L., Renzaho, A. M. N., Rezaei, N., Rezapour, A., Riahi, S. M., Ribeiro, D., Rodriguez, J. A. B., Roever, L., Rohloff, P., Rwegerera, G. M., Ryan, P. M., Saber-Ayad, M. M., Sabour, S., Saddik, B., Saeedi Moghaddam, S., Sahebkar, A., Sahoo, H., Saif-Ur-Rahman, K. M., Salimzadeh, H., Samaei, M., Sanabria, J., Santric-Milicevic, M. M., Sathian, B., Sathish, T., Schlaich, M. P., Seidu, A. -A., Sekerija, M., Senthil Kumar, N., Seylani, A., Shaikh, M. A., Shamshad, H., Shawon, M. S. R., Sheikhbahaei, S., Shetty, J. K., Shiri, R., Shivakumar, K. M., Shuval, K., Singh, J. A., Singh, A., Skryabin, V. Y., Skryabina, A. A., Sofi-Mahmudi, A., Soheili, A., Sun, J., Szerencses, V., Szocska, M., Tabares-Seisdedos, R., Tadbiri, H., Tadesse, E. G., Tariqujjaman, M., Thankappan, K. R., Thapar, R., Thomas, N., Timalsina, B., Tobe-Gai, R., Tonelli, M., Tovani-Palone, M. R., Tran, B. X., Tripathy, J. P., Tudor Car, L., Tusa, B. S., Uddin, R., Upadhyay, E., Valadan Tahbaz, S., Valdez, P. R., Vasankari, T. J., Verma, M., Villalobos-Daniel, V. E., Vladimirov, S. K., Vo, B., Vu, G. T., Vukovic, R., Waheed, Y., Wamai, R. G., Werdecker, A., Wickramasinghe, N. D., Winkler, A. S., Wubishet, B. L., Xu, X., Xu, S., Yahyazadeh Jabbari, S. H., Yatsuya, H., Yaya, S., Yazie, T. S. Y., Yi, S., Yonemoto, N., Yunusa, I., Zadey, S., Zaman, S. B., Zamanian, M., Zamora, N., Zastrozhin, M. S., Zastrozhina, A., Zhang, Z. -J., Zhong, C., Zmaili, M., Zumla, A., Naghavi, M., Schmidt, M. I., Collaborators, GBD 2019 Diabetes Mortality, and Lacey, BWH
Subjects: Adult, Endocrinology, Diabetes and Metabolism, CHILDHOOD, universal health coverage, Global Health, 3121 Internal medicine, Global Burden of Disease, 1117 Public Health and Health Services, Endocrinology, SDG 3 - Good Health and Well-being, Risk Factors, RA0421, Internal Medicine, Humans, Diabetes mortality, diabetes, mortality, global burden of disease, under 25 years, COHORT, health care services, COMPLICATIONS, CHALLENGES, Diabetes, Mortality trends, Age-specific diabetes, 1103 Clinical Sciences, Public Health, Global Health, Social Medicine and Epidemiology, BRAZIL, Type I Diabetes, INSULIN, 3142 Public health care science, environmental and occupational health, the Socio-demographic Index, Treatment, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, 1101 Medical Biochemistry and Metabolomics, diabete, 3121 General medicine, internal medicine and other clinical medicine, ACCESS, RA, RC
Abstract: Background:Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods:We used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990–2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals. Findings:In 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73·7% (68·3 to 77·4) were classified as due to type 1 diabetes. The age-standardised death rate was 0·50 (0·44 to 0·58) per 100 000 population, and 15 900 (97·5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0·13 (0·12 to 0·14) per 100 000 population in the high SDI quintile, 0·60 (0·51 to 0·70) per 100 000 population in the low-middle SDI quintile, and 0·71 (0·60 to 0·86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r2=0·62). From 1990 to 2019, age-standardised death rates decreased globally by 17·0% (−28·4 to −2·9) for all diabetes, and by 21·0% (–33·0 to −5·9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (−13·6% [–28·4 to 3·4]) and for type 1 diabetes (−13·6% [–29·3 to 8·9]). Interpretation:Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN's Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations. Funding: Bill & Melinda Gates Foundation.
Published: 2022

35. Bioactivity Guided Fractionation and Purification of Anti-Depressant Molecule from Ashwagandha (Withania somnifera)

Author: Anu Sebastian, A. P. Anu Aravind, Benny Antony, Merina Benny, Biji Joseph, and Nishant Kumar Gupta
Subjects: 0301 basic medicine, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Traditional medicine, biology, Chemistry, Anti depressant, General Pharmacology, Toxicology and Pharmaceutics, Withania somnifera, biology.organism_classification, 030217 neurology & neurosurgery, Bioactivity guided fractionation
Abstract: Background: Ashwagandha (Withania somnifera) is an important herb in the Indian traditional system of medicine for neurological disorders. However, the efforts for isolation and characterisation of a molecule with anti-depressant activity and development as a potent dosage form are limited. Objective: The objective of the present study was to characterize the Ashwagandha extract for its antidepressant fraction or constituent and to improve biological benefits at low doses. Methods: Aqueous methanol extract of Ashwagandha was prepared and fractionated into withanolides and flavonoids rich fractions. Withanolide rich fraction was subjected to phytochemical analysis to identify the active molecule/s. The compound was purified by using a semi-preparative HPLC system; identified using various spectroscopic techniques and anti-depressant activity was evaluated in rats. Enteric coating was performed on the extract and fractions after granulation and anti-depressant activity of coated samples were evaluated in rats. Results: Aqueous methanol extract of Ashwagandha and withanolide rich fraction showed prominent dose-dependent anti-depressant activity in forced swim test in rats. Phytochemical analysis of active fraction resulted in the isolation and characterization of a major withanolide glycoside present, namely withanoside X. Enteric coated aqueous methanol extract, withanolide rich fraction and withanoside X showed significant antidepressant activity at low doses as compared to the uncoated forms. Conclusion: The active fraction/isolated compound is sensitive to low pH of the stomach, thus enteric coating might be beneficial to protect the actives in the stomach, facilitating the sustainable release into the intestine and in turn reduce the dosage.
Published: 2020

36. Thiazolidinedione use is associated with reduced risk of Parkinson’s disease in patients with diabetes: a meta-analysis of real-world evidence

Author: Benny Antony, Ambrish Singh, Bruce V. Taylor, Harveen Baxi, John Burgess, and Salman Hussain
Subjects: medicine.medical_specialty, endocrine system diseases, medicine.drug_class, Population, Dermatology, Disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diabetes mellitus, medicine, 030212 general & internal medicine, Thiazolidinedione, education, education.field_of_study, business.industry, Hazard ratio, nutritional and metabolic diseases, Type 2 Diabetes Mellitus, General Medicine, medicine.disease, Psychiatry and Mental health, Meta-analysis, Neurology (clinical), business, Pioglitazone, 030217 neurology & neurosurgery, medicine.drug
Abstract: The thiazolidinedione (TZD) class of oral antidiabetic agents are used to treat type 2 diabetes mellitus (DM). This meta-analysis aimed to understand the protective effect of TZD on Parkinson’s disease (PD) in people with diabetes. A literature search was performed in PubMed, Embase, and Cochrane central from inception to until 30 September 2019. We included all real-world evidence studies assessing the use of TZD class of drugs and the risk of PD in people with diabetes. Quality of the studies was evaluated using the Newcastle-Ottawa scale. The primary outcome was the pooled hazard ratio (HR) of PD among type 2 DM TZD users as compared with TZD non-users in people with diabetes. The secondary outcome was the HR of PD among type 2 DM TZD users as compared with non-users (include both diabetic and nondiabetic population). Meta-analysis was performed using RevMan software. Out of five studies selected for inclusion, four studies fulfilled the criteria for primary outcomes. The participants’ mean age and follow-up duration were 66.23 ± 9.59 years and 5.25 years (2.97–7.9 years), respectively. There was a significant reduction in the risk of PD (pooled adjusted HR of 0.81 [95% CI 0.70–0.93, p = 0.004]) in TZD users compared with non-TZD users in people with diabetes. A significant protective effect of TZD was observed in Caucasian population (3 studies) (HR 0.78 (95% CI 0.66–0.92), p = 0.003). This meta-analysis demonstrates a potential neuroprotective effect of TZD for PD risk in the population with DM.
Published: 2020

37. VALIDATION OF REVERSED-PHASE HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY METHOD FOR SIMULTANEOUS DETERMINATION OF 6-, 8-, 10-GINGEROLS AND 6-SHOGAOL FROM GINGER EXTRACTS

Author: Mary Reshma, Merina Benny, and Benny Antony
Subjects: Pharmacology, Detection limit, 0303 health sciences, Analyte, Chromatography, 030309 nutrition & dietetics, Chemistry, Calibration curve, Ginger Extract, Relative standard deviation, Pharmaceutical Science, 04 agricultural and veterinary sciences, Shogaol, 040401 food science, High-performance liquid chromatography, 03 medical and health sciences, chemistry.chemical_compound, 0404 agricultural biotechnology, Phase (matter)
Abstract: Objective: Development and validation of a High-Performance Liquid Chromatography (HPLC) method for the simultaneous estimation of 6-, 8-, 10-Gingerols and 6-Shogaol in ginger extract using authentic standards. Methods: The chromatographic separation was achieved by using a C18 column and a mobile phase composed of acetonitrile, ortho-phospohoric acid in water and methanol. The proposed method was validated in terms of the analytical parameters such as specificity, accuracy, precision, linearity, range, the limit of detection (LOD) and limit of quantification (LOQ) according to ICH guidelines. Results: Linear calibration curves were obtained over concentration ranges of 10-250 µg/ml for 6-, 8-, 10-gingerols and 6-shogaol with determination coefficients more than 0.99 for each analyte. Intra and inter-day precisions of the method were found to be below 2% for each analyte, with relative standard deviation (% RSD) values in the range of 0.47 to 1.55% for 6-gingerol, 0.44 to 1.51% for 8-gingerol, 0.24 to 1.90% for 10-gingerol and 0.25 to 1.67% for 6-shogaol. The percentage recovery of gingerols and shogaol was obtained with an average of 99.53%, 99.97%, 100.13% and 100.53% respectively, which was well within acceptance range. Conclusion: Simple, accurate, precise and rapid HPLC method was developed for the simultaneous analysis of 6-, 8-, 10-gingerols and 6-shogaol and validated in accordance with ICH guidelines. The developed method was found to be suitable for the standardization of herbal extracts and polyherbal formulations for the content of 6-, 8-, 10-gingerols and 6-shogaol.
Published: 2020

38. Acute and sub chronic toxicity studies with herbal pain relieving formula (Rhuleave-K™) in rats

Author: Benny Antony, Merina Benny, Binu T. Kuruvilla, Nishant Kumar Gupta, and Sherina Jacob
Subjects: No-Observed-Adverse-Effect Level, Plant Extracts, Toxicity Tests, Acute, Animals, Pain, Female, General Medicine, Toxicology, Rats
Abstract: Rhuleave-K™ is a proprietary combination of Curcuma longa extract, Boswellia serrata extract and black sesame seed oil. Acute toxicity was evaluated as per OECD guidelines 423. Rhuleave-K™ was fed at 2000 mg/kg to overnight fasted female rats. Clinical signs of abnormality and mortality was observed daily for 14 days. Sub-chronic toxicity was studied by feeding Rhuleave-K™ at 100, 500 and 1000 mg/kg/day to rats as per OECD guidelines 408. After 90 days feeding, hematological and biochemical parameters were analyzed. Histopathology of all the major organs was also studied. In the acute toxicity study, there was no clinical sign of toxicity in any of the rats at maximum dose of 2000 mg/kg. The LD50 was computed as2000 mg/kg in rats. The repeated dosing of Rhuleave-K™ at the maximum dose level of 1000 mg/kg for 90 days did not induce any observable toxic effects in rats, when compared to its corresponding control. The hematology and biochemistry profiles of treated rats were similar to control animals and difference was non-significant (p 0.05). The histopathology of major organs of all the control and treated animals was normal. In this study the NOAEL for Rhuleave-K™ was calculated as 1000 mg/kg daily in rats.
Published: 2022

39. The global burden of cancer attributable to risk factors, 2010–19 : A systematic analysis for the Global Burden of Disease Study 2019

Author: Khanh Bao Tran, Justin J Lang, Kelly Compton, Rixing Xu, Alistair R Acheson, Hannah Jacqueline Henrikson, Jonathan M Kocarnik, Louise Penberthy, Amirali Aali, Qamar Abbas, Behzad Abbasi, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Hedayat Abbastabar, Michael Abdelmasseh, Sherief Abd-Elsalam, Ahmed Abdelwahab Abdelwahab, Gholamreza Abdoli, Hanan Abdulkadir Abdulkadir, Aidin Abedi, Kedir Hussein Abegaz, Hassan Abidi, Richard Gyan Aboagye, Hassan Abolhassani, Abdorrahim Absalan, Yonas Derso Abtew, Hiwa Abubaker Ali, Eman Abu-Gharbieh, Basavaprabhu Achappa, Juan Manuel Acuna, Daniel Addison, Isaac Yeboah Addo, Oyelola A Adegboye, Miracle Ayomikun Adesina, Mohammad Adnan, Qorinah Estiningtyas Sakilah Adnani, Shailesh M Advani, Sumia Afrin, Muhammad Sohail Afzal, Manik Aggarwal, Bright Opoku Ahinkorah, Araz Ramazan Ahmad, Rizwan Ahmad, Sajjad Ahmad, Sohail Ahmad, Sepideh Ahmadi, Haroon Ahmed, Luai A Ahmed, Muktar Beshir Ahmed, Tarik Ahmed Rashid, Wajeeha Aiman, Marjan Ajami, Gizachew Taddesse Akalu, Mostafa Akbarzadeh-Khiavi, Addis Aklilu, Maxwell Akonde, Chisom Joyqueenet Akunna, Hanadi Al Hamad, Fares Alahdab, Fahad Mashhour Alanezi, Turki M Alanzi, Saleh Ali Alessy, Abdelazeem M Algammal, Mohammed Khaled Al-Hanawi, Robert Kaba Alhassan, Beriwan Abdulqadir Ali, Liaqat Ali, Syed Shujait Ali, Yousef Alimohamadi, Vahid Alipour, Syed Mohamed Aljunid, Motasem Alkhayyat, Sadeq Ali Ali Al-Maweri, Sami Almustanyir, Nivaldo Alonso, Shehabaldin Alqalyoobi, Rajaa M Al-Raddadi, Rami H Hani Al-Rifai, Salman Khalifah Al-Sabah, Ala'a B Al-Tammemi, Haya Altawalah, Nelson Alvis-Guzman, Firehiwot Amare, Edward Kwabena Ameyaw, Javad Javad Aminian Dehkordi, Mohammad Hosein Amirzade-Iranaq, Hubert Amu, Ganiyu Adeniyi Amusa, Robert Ancuceanu, Jason A Anderson, Yaregal Animut Animut, Amir Anoushiravani, Ali Arash Anoushirvani, Alireza Ansari-Moghaddam, Mustafa Geleto Ansha, Benny Antony, Maxwell Hubert Antwi, Sumadi Lukman Anwar, Razique Anwer, Anayochukwu Edward Anyasodor, Jalal Arabloo, Morteza Arab-Zozani, Olatunde Aremu, Ayele Mamo Argaw, Hany Ariffin, Timur Aripov, Muhammad Arshad, Al Artaman, Judie Arulappan, Raphael Taiwo Aruleba, Armin Aryannejad, Malke Asaad, Mulusew A Asemahagn, Zatollah Asemi, Mohammad Asghari-Jafarabadi, Tahira Ashraf, Reza Assadi, Mohammad Athar, Seyyed Shamsadin Athari, Maha Moh'd Wahbi Atout, Sameh Attia, Avinash Aujayeb, Marcel Ausloos, Leticia Avila-Burgos, Atalel Fentahun Awedew, Mamaru Ayenew Awoke, Tewachew Awoke, Beatriz Paulina Ayala Quintanilla, Tegegn Mulatu Ayana, Solomon Shitu Ayen, Davood Azadi, Sina Azadnajafabad, Saber Azami-Aghdash, Melkalem Mamuye Azanaw, Mohammadreza Azangou-Khyavy, Amirhossein Azari Jafari, Hosein Azizi, Ahmed Y Y Azzam, Amirhesam Babajani, Muhammad Badar, Ashish D Badiye, Nayereh Baghcheghi, Nader Bagheri, Sara Bagherieh, Saeed Bahadory, Atif Amin Baig, Jennifer L Baker, Ahad Bakhtiari, Ravleen Kaur Bakshi, Maciej Banach, Indrajit Banerjee, Mainak Bardhan, Francesco Barone-Adesi, Fabio Barra, Amadou Barrow, Nasir Z Bashir, Azadeh Bashiri, Saurav Basu, Abdul-Monim Mohammad Batiha, Aeysha Begum, Alehegn Bekele Bekele, Alemayehu Sayih Belay, Melaku Ashagrie Belete, Uzma Iqbal Belgaumi, Arielle Wilder Bell, Luis Belo, Habib Benzian, Alemshet Yirga Berhie, Amiel Nazer C Bermudez, Eduardo Bernabe, Akshaya Srikanth Bhagavathula, Neeraj Bhala, Bharti Bhandari Bhandari, Nikha Bhardwaj, Pankaj Bhardwaj, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Soumitra S Bhuyan, Sadia Bibi, Awraris Hailu Bilchut, Bagas Suryo Bintoro, Antonio Biondi, Mesfin Geremaw Birega Birega, Habitu Eshetu Birhan, Tone Bjørge, Oleg Blyuss, Belay Boda Abule Bodicha, Srinivasa Rao Bolla, Archith Boloor, Cristina Bosetti, Dejana Braithwaite, Michael Brauer, Hermann Brenner, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Christina Maree Buchanan, Norma B Bulamu, Maria Teresa Bustamante-Teixeira, Muhammad Hammad Butt, Nadeem Shafique Butt, Zahid A Butt, Florentino Luciano Caetano dos Santos, Luis Alberto Cámera, Chao Cao, Yin Cao, Giulia Carreras, Márcia Carvalho, Francieli Cembranel, Ester Cerin, Promit Ananyo Chakraborty, Periklis Charalampous, Vijay Kumar Chattu, Odgerel Chimed-Ochir, Jesus Lorenzo Chirinos-Caceres, Daniel Youngwhan Cho, William C S Cho, Devasahayam J Christopher, Dinh-Toi Chu, Isaac Sunday Chukwu, Aaron J Cohen, Joao Conde, Sandra Cortés, Vera Marisa Costa, Natália Cruz-Martins, Garland T Culbreth, Omid Dadras, Fentaw Teshome Dagnaw, Saad M A Dahlawi, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Parnaz Daneshpajouhnejad, Anna Danielewicz, An Thi Minh Dao, Reza Darvishi Cheshmeh Soltani, Aso Mohammad Darwesh, Saswati Das, Dragos Virgil Davitoiu, Elham Davtalab Esmaeili, Fernando Pio De la Hoz, Sisay Abebe Debela, Azizallah Dehghan, Biniyam Demisse, Fitsum Wolde Demisse, Edgar Denova-Gutiérrez, Afshin Derakhshani, Meseret Derbew Molla, Diriba Dereje, Kalkidan Solomon Deribe, Rupak Desai, Markos Desalegn Desalegn, Fikadu Nugusu Dessalegn, Samuel Abebe A 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Abbas Farmany, Umar Farooque, Hossein Farrokhpour, Abidemi Omolara Fasanmi, Ali Fatehizadeh, Wafa Fatima, Hamed Fattahi, Ginenus Fekadu, Berhanu Elfu Feleke, Allegra Allegra Ferrari, Simone Ferrero, Lorenzo Ferro Desideri, Irina Filip, Florian Fischer, Roham Foroumadi, Masoud Foroutan, Takeshi Fukumoto, Peter Andras Gaal, Mohamed M Gad, Muktar A Gadanya, Abduzhappar Gaipov, Nasrin Galehdar, Silvano Gallus, Tushar Garg, Mariana Gaspar Fonseca, Yosef Haile Gebremariam, Teferi Gebru Gebremeskel, Mathewos Alemu Gebremichael, Yohannes Fikadu Geda, Yibeltal Yismaw Gela, Belete Negese Belete Gemeda, Melaku Getachew, Motuma Erena Getachew, Kazem Ghaffari, Mansour Ghafourifard, Seyyed-Hadi Ghamari, Mohammad Ghasemi Nour, Fariba Ghassemi, Ajnish Ghimire, Nermin Ghith, Maryam Gholamalizadeh, Jamshid Gholizadeh Navashenaq, Sherief Ghozy, Syed Amir Gilani, Paramjit Singh Gill, Themba G Ginindza, Abraham Tamirat T Gizaw, James C Glasbey, Justyna Godos, Amit Goel, Mahaveer Golechha, Pouya Goleij, 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Hossain Hossain, Mohammad-Salar Hosseini, Ali Hosseinzadeh, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Mowafa Househ, Junjie Huang, Fernando N Hugo, Ayesha Humayun, Salman Hussain, Nawfal R Hussein, Bing-Fang Hwang, Segun Emmanuel Ibitoye, Pulwasha Maria Iftikhar, Kevin S Ikuta, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Mustapha Immurana, Kaire Innos, Pooya Iranpour, Lalu Muhammad Irham, Md Shariful Islam, Rakibul M Islam, Farhad Islami, Nahlah Elkudssiah Ismail, Gaetano Isola, Masao Iwagami, Linda Merin J, Abhishek Jaiswal, Mihajlo Jakovljevic, Mahsa Jalili, Shahram Jalilian, Elham Jamshidi, Sung-In Jang, Chinmay T Jani, Tahereh Javaheri, Umesh Umesh Jayarajah, Shubha Jayaram, Seyed Behzad Jazayeri, Rime Jebai, Bedru Jemal, Wonjeong Jeong, Ravi Prakash Jha, Har Ashish Jindal, Yetunde O John-Akinola, Jost B Jonas, Tamas Joo, Nitin Joseph, Farahnaz Joukar, Jacek Jerzy Jozwiak, Mikk Jürisson, Ali Kabir, Salah Eddine Oussama Kacimi, Vidya Kadashetti, Farima Kahe, Pradnya Vishal Kakodkar, Laleh R Kalankesh, Leila R Kalankesh, Rohollah Kalhor, Vineet Kumar Kamal, Farin Kamangar, Ashwin Kamath, Tanuj Kanchan, Eswar Kandaswamy, Himal Kandel, HyeJung Kang, Girum Gebremeskel Kanno, Neeti Kapoor, Sitanshu Sekhar Kar, Shama D Karanth, Ibraheem M Karaye, André Karch, Amirali Karimi, Bekalu Getnet Kassa, Patrick DMC Katoto, Joonas H Kauppila, Harkiran Kaur, Abinet Gebremickael Kebede, Leila Keikavoosi-Arani, Gemechu Gemechu Kejela, Phillip M Kemp Bohan, Maryam Keramati, Mohammad Keykhaei, Himanshu Khajuria, Abbas Khan, Abdul Aziz Khan Khan, Ejaz Ahmad Khan, Gulfaraz Khan, Md Nuruzzaman Khan, Moien AB Khan, Javad Khanali, Khaled Khatab, Moawiah Mohammad Khatatbeh, Mahalaqua Nazli Khatib, Maryam Khayamzadeh, Hamid Reza Khayat Kashani, Mohammad Amin Khazeei Tabari, Mehdi Khezeli, Mahmoud Khodadost, Min Seo Kim, Yun Jin Kim, Adnan Kisa, Sezer Kisa, Miloslav Klugar, Jitka Klugarová, Ali-Asghar Kolahi, Pavel Kolkhir, Farzad Kompani, Parvaiz A Koul, Sindhura 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Mokhtar Mohammadi, Abdollah Mohammadian-Hafshejani, Reza Mohammadpourhodki, Arif Mohammed, Shafiu Mohammed, Syam Mohan, Mohammad Mohseni, Nagabhishek Moka, Ali H Mokdad, Alex Molassiotis, Mariam Molokhia, Kaveh Momenzadeh, Sara Momtazmanesh, Lorenzo Monasta, Ute Mons, Ahmed Al Montasir, Fateme Montazeri, Arnulfo Montero, Mohammad Amin Moosavi, Abdolvahab Moradi, Yousef Moradi, Mostafa Moradi Sarabi, Paula Moraga, Lidia Morawska, Shane Douglas Morrison, Jakub Morze, Abbas Mosapour, Ebrahim Mostafavi, Seyyed Meysam Mousavi, Haleh Mousavi Isfahani, Amin Mousavi Khaneghah, Christine Mpundu-Kaambwa, Sumaira Mubarik, Francesk Mulita, Daniel Munblit, Sandra B Munro, Efrén Murillo-Zamora, Jonah Musa, Ashraf F Nabhan, Ahamarshan Jayaraman Nagarajan, Shankar Prasad Nagaraju, Gabriele Nagel, Mohammadreza Naghipour, Mukhammad David Naimzada, Tapas Sadasivan Nair, Atta Abbas Naqvi, Sreenivas Narasimha Swamy, Aparna Ichalangod Narayana, Hasan Nassereldine, Zuhair S Natto, Biswa Prakash Nayak, Rawlance Ndejjo, Sabina Onyinye Nduaguba, Wogene Wogene Negash, Seyed Aria Nejadghaderi, Kazem Nejati, Sandhya Neupane Kandel, Huy Van Nguyen Nguyen, Robina Khan Niazi, Nurulamin M Noor, Maryam Noori, Nafise Noroozi, Hasti Nouraei, Ali Nowroozi, Virginia Nuñez-Samudio, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Nzoputam, Bogdan Oancea, Oluwakemi Ololade Odukoya, Onome Bright Oghenetega, Ropo Ebenezer Ogunsakin, Ayodipupo Sikiru Oguntade, In-Hwan Oh, Hassan Okati-Aliabad, Akinkunmi Paul Okekunle, Andrew T Olagunju, Tinuke O Olagunju, Babayemi Oluwaseun Olakunde, Isaac Iyinoluwa Olufadewa, Emad Omer, Abidemi E Emmanuel Omonisi, Sokking Ong, Obinna E Onwujekwe, Hans Orru, Stanislav S Otstavnov, Abderrahim Oulhaj, Bilcha Oumer, Oluwatomi Funbi Owopetu, Babatunji Emmanuel Oyinloye, Mahesh P A, Alicia Padron-Monedero, Jagadish Rao Padubidri, Babak Pakbin, Keyvan Pakshir, Reza Pakzad, Tamás Palicz, Adrian Pana, Anamika Pandey, Ashok Pandey, Suman Pant, Shahina Pardhan, Eun-Cheol Park, Eun-Kee 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Thomas, N, Ticoalu, J, Tiyuri, A, Tollosa, D, Topor-Madry, R, Touvier, M, Tovani-Palone, M, Traini, E, Tran, M, Tripathy, J, Ukke, G, Ullah, I, Ullah, S, Unnikrishnan, B, Vacante, M, Vaezi, M, Valadan Tahbaz, S, Valdez, P, Vardavas, C, Varthya, S, Vaziri, S, Velazquez, D, Veroux, M, Villeneuve, P, Violante, F, Vladimirov, S, Vlassov, V, Vo, B, Vu, L, Wadood, A, Waheed, Y, Walde, M, Wamai, R, Wang, C, Wang, F, Wang, N, Wang, Y, Ward, P, Waris, A, Westerman, R, Wickramasinghe, N, Woldemariam, M, Woldu, B, Xiao, H, Xu, S, Xu, X, Yadav, L, Yahyazadeh Jabbari, S, Yang, L, Yazdanpanah, F, Yeshaw, Y, Yismaw, Y, Yonemoto, N, Younis, M, Yousefi, Z, Yousefian, F, Yu, C, Yu, Y, Yunusa, I, Zahir, M, Zaki, N, Zaman, B, Zangiabadian, M, Zare, F, Zare, I, Zareshahrabadi, Z, Zarrintan, A, Zastrozhin, M, Zeineddine, M, Zhang, D, Zhang, J, Zhang, Y, Zhang, Z, Zhou, L, Zodpey, S, Zoladl, M, Vos, T, Hay, S, Force, L, Murray, C, Epidemiologie, RS: NUTRIM - R3 - Respiratory & Age-related Health, Bill & Melinda Gates Foundation, Kuwait University (Kuwait), Ministry of Higher Education (Malasia), Lega Italiana per la Lotta ai Tumori, Health Effects Institute (Estados Unidos), Unión Europea. Comisión Europea. European Research Council (ERC), Unión Europea. Comisión Europea. H2020, Fundação para a Ciência e Tecnologia (Portugal), African-German Network of Excellence in Science (AGNES), Federal Ministry of Education & Research (Alemania), Alexander von Humboldt Foundation, Novo Nordisk Foundation, National Institute for Health Research (Reino Unido), National Health and Medical Research Council (Australia), Romanian National Authority for Scientific Research and Innovation, Romanian Ministry of Research Innovation and Digitalization, Ministry of Education, Science and Technological Development (Serbia), Sigrid Jusélius Foundation, Finnish Cancer Foundation, Datta Meghe Institute of Medical Sciences (India), Xiamen University (Malasia), Manipal Academy of Higher Education (India), Panjab University (India), Sistema Nacional de Investigación (Panamá), Secretaría Nacional de Ciencia, Tecnología e Innovación (Panamá), Ministry of Science and Technology (Taiwan), Lung Foundation Australia, National Natural Science Foundation of China, Wellcome Trust, UNSW Sydney (Australia), ICMR - National Institute of Epidemiology (India), University of Tasmania (Australia), National Council for Scientific and Technological Development (Brasil), Coordenação de Aperfeicoamento de Pessoal de Nível Superior (Brasil), Institute for Advanced Studies in Basic Sciences (Irán), Ain Shams University (Egipto), International Center of Medical Sciences Research (Islamabad), National Institutes of Health (Estados Unidos), University of Oxford (Reino Unido), National Institute of Genetic Engineering and Biotechnology (Irán), Marga und Walter Boll - Stiftung, Ministero della Salute (Italia), IRCCS Materno Infantile Burlo Garofolo (Italia), King College London, Wellcome Trust/DBT India Alliance (India), Public Health, University of St Andrews. School of Medicine, and University of St Andrews. Population and Behavioural Science Division
Subjects: Male, DEATHS, DALY, cancer, risk factors, Medizin, systematic analysis, Global Health, Risk Assessment, Cancer prevention, Global Burden of Disease, RC0254, Risk-attributable cancer deaths, SDG 3 - Good Health and Well-being, RA0421, Risk Factors, RA0421 Public health. Hygiene. Preventive Medicine, Quality-Adjusted Life Year, Neoplasms, cancer, Humans, Global Burden of Disease Study, UK, Medicine(all), MCC, RC0254 Neoplasms. Tumors. Oncology (including Cancer), Risk Factor, Smoking, COVID-19, 3rd-DAS, General Medicine, Disability-adjusted life-years, SOCIAL DETERMINANTS, Risk assessments, risk factor, Cardiovascular and Metabolic Diseases, 3121 General medicine, internal medicine and other clinical medicine, OBESITY, Cancer burden, Neoplasm, Female, LIFE-STYLE, Quality-Adjusted Life Years, HEALTH, RA, Human, RC
Abstract: Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01-4·94) deaths and 105 million (95·0-116) DALYs for both sexes combined, representing 44·4% (41·3-48·4) of all cancer deaths and 42·0% (39·1-45·6) of all DALYs. There were 2·88 million (2·60-3·18) risk-attributable cancer deaths in males (50·6% [47·8-54·1] of all male cancer deaths) and 1·58 million (1·36-1·84) risk-attributable cancer deaths in females (36·3% [32·5-41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6-28·4) and DALYs by 16·8% (8·8-25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9-42·8] and 33·3% [25·8-42·0]). Interpretation: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. We are grateful to the surveillance systems, including cancer registries, that generated and shared observed cancer burden data. S M Aljunid acknowledges the Department of Health Policy and Management, College of Public Health, Kuwait University for the approval and support to participate in this research project. H Ariffin acknowledges support from the Ministry of Higher Education, Malaysia (grant FRGS/1/2021/SKK0/UM/01/1). F Barra acknowledges support from Lega Italiana per la Lotta contro i Tumori - LILT - Bando 5 x 1000 anno 2019. L Belo and M Carvalho acknowledge the support from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB. A J Cohen was supported by the Health Effects Institute, Boston, MA, USA. J Conde acknowledges financial support from the European Research Council - ERC Starting Grant 848325. V M Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. T C Ekundayo was supported by the African-German Network of Excellence in Science (AGNES), the Federal Ministry of Education and Research (BMBF) and the Alexander von Humboldt Foundation (AvH). N Ghith acknowledges support from a grant from Novo Nordisk Foundation (NNF16OC0021856). J C Glasbey is support by a Doctoral Research Fellowship from the National Institute of Health Research (NIHR300175). V K Gupta and V B Gupta acknowledge funding support from National Health and Medical Research Council (NHMRC), Australia. C Herteliu, A Pana, and M Ausloos acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. C Herteliu is also partially supported by a grant of the Romanian Ministry of Research Innovation and Digitalization, MCID, project number ID-585-CTR-42-PFE-2021. S Hussain was supported from Operational Programme Research, Development and Education–Project, Postdoc2MUNI (number CZ.02.2. 69/0.0/0.0/18_053/0016952). M Jakovljevic acknowledges partial support through the grant OI 175 014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. J H Kauppila acknowledges research grants from Sigrid Jusélius Foundation and the Finnish Cancer Foundation. M N Khatib acknowledges support from Datta Meghe Institute of Medical Sciences (deemed-to-be-university). Y J Kim was supported by the Research Management Centre, Xiamen University Malaysia [XMUMRF/2020-C6/ITCM/0004]. S L Koulmane Laxminarayana acknowledges institutional assistance by Manipal Academy of Higher Education, Manipal. K Krishan is supported by the UGC Centre of Advanced Study (Phase II), awarded to the Department of Anthropology, Panjab University, Chandigarh, India. I Landires is a member of the Sistema Nacional de Investigación (SNI), which is supported by Panama’s Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). M-C Li was supported by the Ministry of Science and Technology, Taiwan (MOST 110-2314-B-003-001). G Liu acknowledges support from the CREATE Hope scientific fellowship from Lung Foundation Australia. J Liu acknowledges support from the National Natural Science Foundation (72122001). J A Loureiro was supported by Scientific Employment Stimulus (FCT; CEECINST/00049/2018). E Mathews is supported by a Clinical and Public Health Early Career Fellowship (grant number IA/CPHE/17/1/503345) from the DBT India Alliance/Wellcome Trust Department of Biotechnology, India Alliance (2018–2023). T J Meretoja was supported by an unrestricted grant from Cancer Foundation Finland sr. S Mohammed acknowledges a fellowship grant from Alexander von Humboldt Foundation, outside the submitted work. M Molokhia is supported by the National Institute for Health Research Biomedical Research Center at Guy’s and St Thomas’ National Health Service Foundation Trust and King’s College London. L Monasta received support from the Italian Ministry of Health at the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste - Italy (RC 34/2017). U Mons is supported by the Marga and Walter Boll Foundation, Kerpen, Germany. M A Moosavi acknowledges the financial support of National Institute of Genetics Engineering and Biotechnology (NIGEB). J Musa acknowledges support from the NIH/FICK43TW011416 for research-protected time for cervical cancer research and career development at University of Jos. V Nuñez-Samudio is a member of the Sistema Nacional de Investigación (SNI), which is supported by Panama’s Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). O O Odukoya acknowledges support by the Fogarty International Center of the National Institutes of Health under the award number K43TW010704 for research-protected time. The content is solely the responsibility of all the authors and does not necessarily represent the official views of the National Institutes of Health. A S Oguntade acknowledges funding by a doctoral scholarship from the Nuffield Department of Population Health, University of Oxford (Oxford Population Health). J R Padubidri acknowledges Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal for their constant support in research collaborations. R G Pestell acknowledges support from NIH grant W81XWH1810605 Breast Cancer Research, Breakthrough Grant R21 CA235139-01. Z Z Piracha acknowledges the International Center of Medical Sciences Research (ICMSR), Islamabad (44000), Pakistan. R A Radhakrishnan acknowledges support from Wellcome Trust/DBT India Alliance - IA/CPHI/18/1/503927. U Saeed acknowledges the International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan. A M Samy acknowledges the support from Ain Shams University and the Egyptian Fulbright Mission Program. F Sha was supported by the Shenzhen Science and Technology Program (grant number KQTD20190929172835662). H R Shahsavari acknowledges the Institute for Advanced Studies in Basic Sciences (IASBS) Research Council. A Shetty acknowledges Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal for all the academic support. D A S Silva acknowledges financing in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES)—Finance Code 001 and D A S Silva is supported in part by CNPq-Brazil (309589/2021-5). L M L R Silva was supported by project CENTRO-04-3559-FSE-000162, Fundo Social Europeu (FSE). Am Singh is supported by the International Graduate Research Scholarship, University of Tasmania. R Suliankatchi Abdulkader acknowledges support from ICMR—National Institute of Epidemiology. B Unnikrishnan acknowledges Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. H Xiao acknowledges support from the Public Health Sciences Division of the Fred Hutchinson Cancer Research Center. X Xu is supported by the University of New South Wales (Australia) Scientia Program. C Yu was supported by the National Natural Science Foundation of China (grant number 82173626) and Wuhan Medical Research Program of Joint Fund of Hubei Health Committee (grant number WJ2019H304). Sí
Published: 2022

40. Efficacy and safety of hydroxychloroquine for the treatment of osteoarthritis a systematic review and meta-analysis of randomized controlled trials

Author: Zhiqiang Wang, Thusharika Dissanayaka, Siddharth Das, Ambrish Singh, Anirudh Kotlo, and Benny Antony
Subjects: medicine.medical_specialty, business.industry, Biomedical Engineering, Hydroxychloroquine, Osteoarthritis, medicine.disease, law.invention, Rheumatology, Randomized controlled trial, law, Internal medicine, Meta-analysis, medicine, Orthopedics and Sports Medicine, business, medicine.drug
Published: 2021

41. Global Prevalence of COVID-19-Associated Mucormycosis (CAM): Living Systematic Review and Meta-Analysis

Author: Abanoub Riad, Benny Antony, Ambrish Singh, Miloslav Klugar, Jitka Klugarová, Salman Hussain, and Hasanul Banna
Subjects: Microbiology (medical), medicine.medical_specialty, QH301-705.5, prevalence, Prevalence, MEDLINE, Plant Science, mucormycosis, Article, 03 medical and health sciences, 0302 clinical medicine, systematic review, Internal medicine, Epidemiology, medicine, risk factors, 030212 general & internal medicine, mycoses, Biology (General), Ecology, Evolution, Behavior and Systematics, Glycemic, 0303 health sciences, 030306 microbiology, business.industry, Mortality rate, Mucormycosis, COVID-19, medicine.disease, coinfection, 3. Good health, meta-analysis, Meta-analysis, Coinfection, epidemiology, business
Abstract: Mucormycosis, a secondary fungal infection, gained much attention in the ongoing COVID-19 pandemic. This deadly infection has a high all-cause mortality rate and imposes a significant economic, epidemiological, and humanistic burden on the patients and healthcare system. Evidence from the published epidemiological studies showed the varying prevalence of COVID-19-associated mucormycosis (CAM). This study aims to compute the pooled prevalence of CAM and other associated clinical outcomes. MEDLINE, Embase, Cochrane COVID-19 Study Register, and WHO COVID-19 databases were scanned to retrieve the relevant articles until August 2021. All studies reporting the prevalence of mucormycosis among COVID-19 patients were eligible for inclusion. Two investigators independently screened the articles against the selection criteria, extracted the data, and performed the quality assessment using the JBI tool. The pooled prevalence of CAM was the primary outcome, and the pooled prevalence of diabetes, steroid exposure, and the mortality rate were the secondary outcomes of interest. Comprehensive Meta-Analysis software version 2 was used for performing the meta-analysis. This meta-analysis comprised six studies with a pooled sample size of 52,916 COVID-19 patients with a mean age of 62.12 ± 9.69 years. The mean duration of mucormycosis onset was 14.59 ± 6.88 days after the COVID-19 diagnosis. The pooled prevalence of CAM (seven cases per 1000 patients) was 50 times higher than the highest recorded background of mucormycosis (0.14 cases per 1000 patients). A high mortality rate was found among CAM patients with a pooled prevalence rate of 29.6% (95% CI: 17.2–45.9%). Optimal glycemic control and the judicious use of steroids should be the approach for tackling rising CAM cases.
Published: 2021

42. Efficacy and cost-effectiveness of Stem Cell injections for symptomatic relief and strUctural improvement in people with Tibiofemoral knee OsteoaRthritis: protocol for a randomised placebo-controlled trial (the SCUlpTOR trial)

Author: Rachel O'Connell, Karen Schuck, Win Min Oo, Christopher B. Little, Sarah R Robbins, Kirsty Carmichael, David Humphries, David J. Hunter, Changhai Ding, Felix Eckstein, Gillian Z. Heller, Thomas Buttel, Xiaoqian Liu, Anthony Harris, Stefan Lohmander, Benny Antony, Leticia A Deveza, Sonika Virk, Xia Wang, Wolfgang Wirth, and James M. Linklater
Subjects: medicine.medical_specialty, Cost effectiveness, Cost-Benefit Analysis, Placebo-controlled study, knee, Osteoarthritis, Quality of life, Rheumatology, Double-Blind Method, Informed consent, medicine, Humans, Multicenter Studies as Topic, Aged, Randomized Controlled Trials as Topic, clinical trials, business.industry, Stem Cells, Australia, General Medicine, Osteoarthritis, Knee, medicine.disease, Symptomatic relief, Clinical trial, Knee pain, Treatment Outcome, Physical therapy, Quality of Life, Medicine, medicine.symptom, business
Abstract: IntroductionKnee osteoarthritis (KOA) is a highly prevalent disabling joint disease. Intra-articular stem cell therapy is increasingly being used for treating KOA with little high-quality evidence to support its use. The aim of this study is to investigate the efficacy, safety and cost-effectiveness of allogeneic mesenchymal stem cells (Cymerus MSCs) for treating symptomatic tibiofemoral KOA and improving knee structure over 24 months.Methods and analysisThe Stem Cell injections for symptomatic relief and strUctural improvement in people with Tibiofemoral knee OsteoaRthritis study is a phase III, multi-centre, parallel, superiority, randomised, double-blind, placebo-controlled trial, which will be conducted in Sydney and Hobart, Australia. 440 participants (220 per arm) aged over 40 years with painful KOA and mild to moderate structural change on X-ray (Kellgren and Lawrence grade 2 or 3) with medial minimum joint space width between 1 and 4 mm in the study knee will be recruited from the community and randomly allocated to receive either intra-articular MSCs or saline at baseline, week 3 and week 52. The coprimary outcomes will be the proportion of participants achieving patient-acceptable symptom state for knee pain at 24 months and quantitative central medial femorotibial compartment cartilage thickness change from baseline to 24 months. Main secondary outcomes include change in knee pain, Patient Global Assessment, physical function, quality of life and other structural changes. Additional data for cost-effectiveness analysis will also be recorded. Adverse events will be monitored throughout the study. The primary analysis will be conducted using modified intention-to-treat.Ethics and disseminationThis protocol has been approved by The University of Sydney (USYD) Human Research Ethics Committee (HREC) #: 2020/119 and The University of Tasmania (UTAS) HREC #: H0021868. All participants will be required to provide informed consent. Dissemination will occur through conferences, social media, and scientific publications.Trial registration numbersAustralian New Zealand Clinical Trials Registry (ACTRN12620000870954); U1111-1234-4897.
Published: 2021

43. Protocol for a systematic review and meta-analysis of minimal important differences for generic multiattribute utility instruments

Author: Glen James Henson, Bruce V Taylor, Ingrid van der Mei, Suzi B Claflin, Steve Simpson-Yap, Andrew J Palmer, Qing Xia, Benny Antony, Ambrish Singh, and Julie A Campbell
Subjects: Review Literature as Topic, Meta-Analysis as Topic, Research Design, Quality of Life, Humans, General Medicine, Systematic Reviews as Topic
Abstract: IntroductionGeneric multiattribute utility instruments (MAUIs) are efficient tools for determining and enumerating health-related quality of life. MAUIs accomplish this by generating health state utilities (HSUs) via algorithms. Minimal important differences (MIDs) assist with the interpretation of HSUs by estimating minimum changes that are clinically significant. The overall goal of the proposed systematic review and meta-analysis is the development of comprehensive guidelines for MID estimation.Methods and analysisThis protocol defines a systematic review and meta-analysis of MIDs for generic MAUIs. The proposed research will involve a comprehensive investigation of 10 databases (EconLit, IDEAs database, INAHTA database, Medline, PsycINFO, Embase, Emcare, JBIEBP and CINAHL) from 1 June 2022 to 7 June 2022, and will be performed and reported in accordance with several validated guidelines, principally the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of papers, considered for inclusion in the review, will be appraised using the COnsensus-based Standards for the selection of health Measurement INstruments, inter alia.Narrative analysis will involve identifying the characteristics of MIDs including methods of calculation, sources of heterogeneity, and validation. Meta-analysis will also be conducted. The descriptive element of meta-analysis will involve the generation of I2statistics and Galbraith plots of MID heterogeneity. Together with narrative analysis, this will allow sources of MID heterogeniety to be identified. A multilevel mixed model, estimated via restricted maximum likelihood estimation, will be constructed for the purposes of meta-regression. Meta-regression will attempt to enumerate the effects of sources of heterogeneity on MID estimates. Meta-analysis will be concluded with pooling of MIDs via a linear random-effects model.Ethics and disseminationEthics approval is not required for this review, as it will aggregate data from published literature. Methods of dissemination will include publication in a peer-reviewed journal, as well as presentation at conferences and seminars.PROSPERO registration numberCRD42021261821.
Published: 2022

44. Beta-adrenergic drugs and risk of Parkinson’s disease: A systematic review and meta-analysis

Author: Ambrish Singh, Salman Hussain, Sreelatha Akkala, Jitka Klugarová, Andrea Pokorná, Miloslav Klugar, E. Haydn Walters, Ingrid Hopper, Julie A. Campbell, Bruce Taylor, and Benny Antony
Subjects: Cohort Studies, Aging, Adrenergic Agents, Neurology, Case-Control Studies, Humans, Parkinson Disease, Molecular Biology, Biochemistry, Biotechnology
Abstract: Parkinson's Disease (PD) is a neurodegenerative disorder manifested by rest tremor, rigidity, bradykinesia, and postural instability. Recent pharmaco-epidemiological studies evaluating beta-adrenergic drug use and risk of PD have reported conflicting findings.This systematic review and meta-analyses evaluate the association between beta-adrenergic (agonists and antagonists) drugs' use and PD.An electronic literature search of eight databases was performed from inception to July 2021 to identify pharmaco-epidemiological studies (case-control and cohort) reporting the risk of PD in beta-adrenergic users compared to non-users. We used the generic inverse variance method and RevMan (5.3.5) to estimate pooled adjusted risk ratios (aRRs) of PD using a random-effects model.Of 3168 records, 15 studies (10 case-control; five cohort) with 6508,877 participants, including 87,011 PD cases, were included. In the pooled analysis (n = 10) including any beta-antagonist users, compared with non-users, the aRR for PD was 1.19 (CI: 1.05,1.35); for any beta-agonist users (n = 8) aRR for PD was 0.87 (CI: 0.78,0.97). Propranolol users had a significantly increased risk of PD (aRR:1.91; CI:1.20,3.06), whereas salbutamol use was associated with reduced risk of PD (aRR:0.95; CI:0.92,0.99). Significant heterogeneity (IBeta-antagonist use was associated with a modestly increased risk of PD, whereas beta-agonist use was associated with a modest decreased risk of PD. Future epidemiological studies should address the issues of protopathic bias and indirect association using appropriate epidemiological methods.
Published: 2022

45. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update From the GBD 2019 Study

Author: Roth, Gregory A, Mensah, George A, Johnson, Catherine O, Addolorato, Giovanni, Ammirati, Enrico, Baddour, Larry M, Barengo, Noël C, Beaton, Andrea Z, Benjamin, Emelia J, Benziger, Catherine P, Bonny, Aimé, Brauer, Michael, Brodmann, Marianne, Cahill, Thomas J, Carapetis, Jonathan, Catapano, Alberico L, Chugh, Sumeet S, Cooper, Leslie T, Coresh, Josef, Criqui, Michael, DeCleene, Nicole, Eagle, Kim A, Emmons-Bell, Sophia, Feigin, Valery L, Fernández-Solà, Joaquim, Fowkes, Gerry, Gakidou, Emmanuela, Grundy, Scott M, He, Feng J, Howard, George, Hu, Frank, Inker, Lesley, Karthikeyan, Ganesan, Kassebaum, Nicholas, Koroshetz, Walter, Lavie, Carl, Lloyd-Jones, Donald, Lu, Hong S, Mirijello, Antonio, Temesgen, Awoke Misganaw, Mokdad, Ali, Moran, Andrew E, Muntner, Paul, Narula, Jagat, Neal, Bruce, Ntsekhe, Mpiko, Moraes de Oliveira, Glaucia, Otto, Catherine, Owolabi, Mayowa, Pratt, Michael, Rajagopalan, Sanjay, Reitsma, Marissa, Ribeiro, Antonio Luiz P, Rigotti, Nancy, Rodgers, Anthony, Sable, Craig, Shakil, Saate, Sliwa-Hahnle, Karen, Stark, Benjamin, Sundström, Johan, Timpel, Patrick, Tleyjeh, Imad M, Valgimigli, Marco, Vos, Theo, Whelton, Paul K, Yacoub, Magdi, Zuhlke, Liesl, Murray, Christopher, Fuster, Valentin, GBD-NHLBI-JACC Global, Burden of, Cardiovascular Diseases, Writing Group, Gregory A, Roth George, A Mensah, Catherine O, Johnson, Giovanni, Addolorato, Enrico, Ammirati, Larry M, Baddour Noel, C Barengo, Andrea, Beaton, Emelia J, Benjamin Catherine, P Benziger, Aime, Bonny, Michael, Brauer, Marianne, Brodmann, Thomas J, Cahill Jonathan, R Carapetis, Alberico L, Catapano, Sumeet, Chugh, Leslie T, Cooper, Josef, Coresh, Michael H, Criqui Nicole, K DeCleene, Kim A, Eagle, Sophia, Emmons-Bell, Valery L, Feigin, Joaquim, Fernández-Sola, F Gerry, R Fowkes, Emmanuela, Gakidou, Scott M, Grundy Feng, J He, George, Howard, Frank, Hu, Lesley, Inker, Ganesan, Karthikeyan, Nicholas J, Kassebaum Walter, J Koroshetz, Carl, Lavie, Donald, Lloyd-Jones, Hong S, Antonio, Mirijello, Awoke T, Misganaw Ali, H Mokdad, Andrew E, Moran, Paul, Muntner, Jagat, Narula, Bruce, Neal, Mpiko, Ntsekhe, Gláucia M, M Oliveira, Catherine M, Otto Mayowa, O Owolabi, Michael, Pratt, Sanjay, Rajagopalan, Marissa B, Reitsma Antonio, Luiz P, Ribeiro Nancy, A Rigotti, Anthony, Rodgers, Craig A, Sable Saate, S Shakil, Karen, Sliwa, Benjamin A, Stark, Johan, Sundström, Patrick, Timpel, Imad I, Tleyjeh, Marco, Valgimigli, Theo, Vos, Paul K, Whelton, Magdi, Yacoub, Liesl J, Zuhlke, Mohsen, Abbasi-Kangevari, Alireza, Abdi, Aidin, Abedi, Victor, Aboyans, Woldu A, Abrha, Eman, Abu-Gharbieh, Abdelrahman I, Abushouk, Dilaram, Acharya, Tim, Adair, Oladimeji M, Adebayo, Zanfina, Ademi, Shailesh M, Advani, Khashayar, Afshari, Ashkan, Afshin, Gina, Agarwal, Pradyumna, Agasthi, Sohail, Ahmad, Sepideh, Ahmadi, Muktar B, Ahmed, Budi, Aji, Yonas, Akalu, Wuraola, Akande-Sholabi, Addis, Aklilu, Chisom J, Akunna, Fares, Alahdab, Ayman, Al-Eyadhy, Khalid F, Alhabib Sheikh, M Alif, Vahid, Alipour, Syed M, Aljunid, François, Alla, Amir, Almasi-Hashiani, Sami, Almustanyir, Rajaa M, Al-Raddadi Adeladza, K Amegah, Saeed, Amini, Arya, Aminorroaya, Hubert, Amu, Dickson A, Amugsi, Robert, Ancuceanu, Deanna, Anderlini, Tudorel, Andrei, Catalina Liliana, Andrei, Alireza, Ansari-Moghaddam, Zelalem A, Anteneh Ippazio, Cosimo Antonazzo, Benny, Antony, Razique, Anwer, Lambert T, Appiah, Jalal, Arabloo, Johan, Ärnlöv, Kurnia D, Artanti, Zerihun, Ataro, Marcel, Ausloos, Leticia, Avila-Burgos, Asma T, Awan Mamaru, A Awoke, Henok T, Ayele Muluken, A Ayza, Samad, Azari, Darshan B, B, Nafiseh, Baheiraei, Atif A, Baig, Ahad, Bakhtiari, Maciej, Banach, Palash C, Banik Emerson, A Baptista, Miguel A, Barboza, Lingkan, Barua, Sanjay, Basu, Neeraj, Bedi, Yannick, Béjot, Derrick A, Bennett Isabela, M Bensenor, Adam E, Berman Yihienew, M Bezabih, Akshaya S, Bhagavathula, Sonu, Bhaskar, Krittika, Bhattacharyya, Ali, Bijani, Boris, Bikbov, Mulugeta M, Birhanu, Archith, Boloor, Luisa C, Brant, Hermann, Brenner, Nikolay I, Briko Zahid, A Butt, Florentino Luciano, Caetano Dos, Santos Leah, E Cahill, Lucero, Cahuana-Hurtado, Luis A, Cámera Ismael, R Campos-Nonato, Carlos, Cantu-Brito, Josip, Car, Juan J, Carrero, Felix, Carvalho, Carlos A, Castañeda-Orjuela, Ferrán, Catalá-López, Ester, Cerin, Jaykaran, Charan, Vijay Kumar, Chattu, Simiao, Chen, Ken L, Chin Jee-Young, J Choi, Dinh-Toi, Chu, Sheng-Chia, Chung, Cirillo, Massimo, Sean, Coffey, Sara, Conti, Vera M, Costa David, K Cundiff, Omid, Dadras, Baye, Dagnew, Xiaochen, Dai, Albertino A, M Damasceno, Lalit, Dandona, Rakhi, Dandona, Kairat, Davletov, Vanessa De, la Cruz-Góngora, Fernando P, De la, Hoz Jan-Walter, De Neve, Edgar, Denova-Gutiérrez, Meseret Derbew, Molla Behailu, T Derseh, Rupak, Desai, Günther, Deuschl, Samath D, Dharmaratne, Meghnath, Dhimal, Raja Ram, Dhungana, Mostafa, Dianatinasab, Daniel, Diaz, Shirin, Djalalinia, Klara, Dokova, Abdel, Douiri, Bruce B, Duncan Andre, R Duraes, Arielle W, Eagan, Sanam, Ebtehaj, Aziz, Eftekhari, Sahar, Eftekharzadeh, Michael, Ekholuenetale, Nevine El, Nahas Islam, Y Elgendy, Muhammed, Elhadi, Shaimaa I, El-Jaafary, Sadaf, Esteghamati, Atkilt E, Etisso, Oghenowede, Eyawo, Ibtihal, Fadhil, Emerito Jose, A Faraon, Pawan S, Faris, Medhat, Farwati, Farshad, Farzadfar, Eduarda, Fernandes, Carlota Fernandez, Prendes, Pietro, Ferrara, Irina, Filip, Florian, Fischer, David, Flood, Takeshi, Fukumoto, Mohamed M, Gad, Shilpa, Gaidhane, Morsaleh, Ganji, Jalaj, Garg, Abadi K, Gebre Birhan, G Gebregiorgis, Kidane Z, Gebregzabiher Gebreamlak, G Gebremeskel, Lemma, Getacher, Abera Getachew, Obsa, Alireza, Ghajar, Ahmad, Ghashghaee, Nermin, Ghith, Simona, Giampaoli, Syed Amir, Gilani Paramjit, S Gill, Richard F, Gillum Ekaterina, V Glushkova, Elena V, Gnedovskaya, Mahaveer, Golechha, Kebebe B, Gonfa Amir, Hossein Goudarzian, Alessandra C, Goulart Jenny, S Guadamuz, Avirup, Guha, Yuming, Guo, Rajeev, Gupta, Vladimir, Hachinski, Nima, Hafezi-Nejad, Teklehaimanot G, Haile Randah, R Hamadeh, Samer, Hamidi, Graeme J, Hankey, Arief, Hargono, Risky K, Hartono, Maryam, Hashemian, Abdiwahab, Hashi, Shoaib, Hassan, Hamid Y, Hassen Rasmus, J Havmoeller, Simon I, Hay, Khezar, Hayat, Golnaz, Heidari, Claudiu, Herteliu, Ramesh, Holla, Mostafa, Hosseini, Mehdi, Hosseinzadeh, Mihaela, Hostiuc, Sorin, Hostiuc, Mowafa, Househ, Junjie, Huang, Ayesha, Humayun, Ivo, Iavicoli, Charles U, Ibeneme Segun, E Ibitoye, Olayinka S, Ilesanmi Irena, M Ilic, Milena D, Ilic, Usman, Iqbal, Seyed Sina, N Irvani, Sheikh Mohammed, Shariful Islam, Rakibul M, Islam, Hiroyasu, Iso, Masao, Iwagami, Vardhmaan, Jain, Tahereh, Javaheri, Sathish Kumar, Jayapal, Shubha, Jayaram, Ranil, Jayawardena, Panniyammakal, Jeemon, Ravi P, Jha Jost, B Jonas, Jitendra, Jonnagaddala, Farahnaz, Joukar, Jacek J, Jozwiak, Mikk, Jürisson, Ali, Kabir, Tanvir, Kahlon, Rizwan, Kalani, Rohollah, Kalhor, Ashwin, Kamath, Ibrahim, Kamel, Himal, Kandel, Amit, Kandel, André, Karch, Ayele Semachew, Kasa Patrick, D M, C Katoto, 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Amegah, K, Saeed, Amini, Arya, Aminorroaya, Hubert, Amu, Dickson, A, Amugsi, Robert, Ancuceanu, Deanna, Anderlini, Tudorel, Andrei, Catalina, Liliana, Andrei, Alireza, Ansari-Moghaddam, Zelalem, A, Anteneh, Ippazio, Cosimo, Antonazzo, Benny, Antony, Razique, Anwer, Lambert, T, Appiah, Jalal, Arabloo, Johan, Ärnlöv, Kurnia, D, Artanti, Zerihun, Ataro, Marcel, Ausloo, Leticia, Avila-Burgo, Asma, T, Awan, Mamaru, Awoke, A, Henok, T, Ayele, Muluken, Ayza, A, Samad, Azari, Darshan, B, B, Nafiseh, Baheiraei, Atif, A, Baig, Ahad, Bakhtiari, Maciej, Banach, Palash, C, Banik, Emerson, Baptista, A, Miguel, A, Barboza, Lingkan, Barua, Sanjay, Basu, Neeraj, Bedi, Yannick, Béjot, Derrick, A, Bennett, Isabela, Bensenor, M, Adam, E, Berman, Yihienew, Bezabih, M, Akshaya, S, Bhagavathula, Sonu, Bhaskar, Krittika, Bhattacharyya, Ali, Bijani, Boris, Bikbov, Mulugeta, M, Birhanu, Archith, Boloor, Luisa, C, Brant, Hermann, Brenner, Nikolay, I, Briko, Zahid, Butt, A, Florentino, Luciano, Caetano, Do, Santos, Leah, Cahill, E, Lucero, Cahuana-Hurtado, Luis, A, Cámera, Ismael, Campos-Nonato, R, Carlos, Cantu-Brito, Josip, Car, Juan, J, Carrero, Felix, Carvalho, Carlos, A, Castañeda-Orjuela, Ferrán, Catalá-López, Ester, Cerin, Jaykaran, Charan, Vijay, Kumar, Chattu, Simiao, Chen, Ken, L, Chin, Jee-Young, Dinh-Toi, Chu, Sheng-Chia, Chung, Cirillo, Massimo, Sean, Coffey, Sara, Conti, Vera, M, Costa, David, Cundiff, K, Omid, Dadra, Baye, Dagnew, Xiaochen, Dai, Albertino, A, Damasceno, M, Lalit, Dandona, Rakhi, Dandona, Kairat, Davletov, Vanessa, De, Cruz-Góngora, La, Fernando, P, De, La, Hoz, Jan-Walter, Neve, De, Edgar, Denova-Gutiérrez, Meseret, Derbew, Molla, Behailu, Derseh, T, Rupak, Desai, Günther, Deuschl, Samath, D, Dharmaratne, Meghnath, Dhimal, Raja, Ram, Dhungana, Mostafa, Dianatinasab, Daniel, Diaz, Shirin, Djalalinia, Klara, Dokova, Abdel, Douiri, Bruce, B, Duncan, Andre, Duraes, R, Arielle, W, Eagan, Sanam, Ebtehaj, Aziz, Eftekhari, Sahar, Eftekharzadeh, Michael, Ekholuenetale, Nevine, El, Nahas, Islam, Elgendy, Y, Muhammed, Elhadi, Shaimaa, I, El-Jaafary, Sadaf, Esteghamati, Atkilt, E, Etisso, Oghenowede, Eyawo, Ibtihal, Fadhil, Emerito, Jose, Faraon, A, Pawan, S, Faris, Medhat, Farwati, Farshad, Farzadfar, Eduarda, Fernande, Carlota, Fernandez, Prendes, Pietro, Ferrara, Irina, Filip, Florian, Fischer, David, Flood, Takeshi, Fukumoto, Mohamed, M, Gad, Shilpa, Gaidhane, Morsaleh, Ganji, Jalaj, Garg, Abadi, K, Gebre, Birhan, Gebregiorgis, G, Kidane, Z, Gebregzabiher, Gebreamlak, Lemma, Getacher, Abera, Getachew, Obsa, Alireza, Ghajar, Ahmad, Ghashghaee, Nermin, Ghith, Simona, Giampaoli, Syed, Amir, Gilani, Paramjit, Gill, S, Richard, F, Gillum, Ekaterina, Glushkova, V, Elena, V, Gnedovskaya, Mahaveer, Golechha, Kebebe, B, Gonfa, Amir, Hossein, Goudarzian, Alessandra, C, Goulart, Jenny, Guadamuz, S, Avirup, Guha, Yuming, Guo, Rajeev, Gupta, Vladimir, Hachinski, Nima, Hafezi-Nejad, Teklehaimanot, G, Haile, Randah, Samer, Hamidi, Graeme, J, Hankey, Arief, Hargono, Risky, K, Hartono, Maryam, Hashemian, Abdiwahab, Hashi, Shoaib, Hassan, Hamid, Y, Hassen, Rasmu, Havmoeller, J, Simon, I, Hay, Khezar, Hayat, Golnaz, Heidari, Claudiu, Herteliu, Ramesh, Holla, Mostafa, Hosseini, Mehdi, Hosseinzadeh, Mihaela, Hostiuc, Sorin, Hostiuc, Mowafa, Househ, Junjie, Huang, Ayesha, Humayun, Iavicoli, Ivo, Charles, U, Ibeneme, Segun, Ibitoye, E, Olayinka, S, Ilesanmi, Irena, Milena, D, Ilic, Usman, Iqbal, Seyed, Sina, Irvani, N, Sheikh, Mohammed, Shariful, Islam, Rakibul, M, Islam, Hiroyasu, Iso, Masao, Iwagami, Vardhmaan, Jain, Tahereh, Javaheri, Sathish, Kumar, Jayapal, Shubha, Jayaram, Ranil, Jayawardena, Panniyammakal, Jeemon, Ravi, P, Jha, Jost, Jonas, B, Jitendra, Jonnagaddala, Farahnaz, Joukar, Jacek, J, Jozwiak, Mikk, Jürisson, Ali, Kabir, Tanvir, Kahlon, Rizwan, Kalani, Rohollah, Kalhor, Ashwin, Kamath, Ibrahim, Kamel, Himal, Kandel, Amit, Kandel, André, Karch, Ayele, Semachew, Kasa, Patrick, D, M, Katoto, C, Gbenga, A, Kayode, Yousef, Khader, S, Mohammad, Khammarnia, Muhammad, S, Khan, Md, Nuruzzaman, Khan, Maseer, Khan, Ejaz, A, Khan, Khaled, Khatab, Gulam, M, Kibria, A, Yun, Jin, Kim, Gyu, Kim, Ri, Ruth, W, Kimokoti, Sezer, Kisa, Adnan, Kisa, Mika, Kivimäki, Dhaval, Kolte, Ali, Koolivand, Vladimir, A, Korshunov, Sindhura, Lakshmi, Koulmane, Laxminarayana, Koyanagi, Ai, Kewal, Krishan, Vijay, Krishnamoorthy, Barthelemy, Kuate, Defo, Burcu, Kucuk, Bicer, Vaman, Kulkarni, Anil, G, Kumar, Nithin, Kumar, Om, P, Kurmi, Dian, Kusuma, Gene, F, Kwan, Carlo, Vecchia, La, Ben, Lacey, Tea, Lallukka, Qing, Lan, Savita, Lasrado, Zohra, S, Lassi, Paolo, Lauriola, Wayne, R, Lawrence, Avula, Laxmaiah, Kate, E, Legrand, Ming-Chieh, Li, Bingyu, Li, Shanshan, Li, Stephen, S, Lim, Lee-Ling, Lim, Hualiang, Lin, Ziqiang, Lin, Ro-Ting, Lin, Xuefeng, Liu, Alan, D, Lopez, Stefan, Lorkowski, Paulo, A, Lotufo, Alessandra, Lugo, Nirmal, K, M, Fabiana, Madotto, Morteza, Mahmoudi, Azeem, Majeed, Reza, Malekzadeh, Ahmad, A, Malik, Abdullah, Navid, Manafi, Mohammad, Ali, Mansournia, Lorenzo, Mantovani, G, Santi, Martini, Manu, R, Mathur, Giampiero, Mazzaglia, Suresh, Mehata, Man, Mohan, Mehndiratta, Toni, Meier, Ritesh, G, Menezes, Atte, Meretoja, Tomislav, Mestrovic, Bartosz, Miazgowski, Tomasz, Miazgowski, Irmina, Maria, Michalek, Ted, Miller, R, Erkin, M, Mirrakhimov, Hamed, Mirzaei, Babak, Moazen, Masoud, Moghadaszadeh, Yousef, Mohammad, Dara, K, Mohammad, Shafiu, Mohammed, Mohammed, A, Mohammed, Yaser, Mokhayeri, Mariam, Molokhia, Ahmed, A, Montasir, Ghobad, Moradi, Rahmatollah, Moradzadeh, Paula, Moraga, Lidia, Morawska, Ilais, Moreno, Velásquez, Jakub, Morze, Sumaira, Mubarik, Walter, Muruet, Kamarul, Imran, Musa, Ahamarshan, Nagarajan, J, Mahdi, Nalini, Vinay, Nangia, Atta, Abba, Naqvi, Sreeniva, Narasimha, Swamy, Bruno, R, Nascimento, Vinod, Nayak, C, Javad, Nazari, Milad, Nazarzadeh, Ruxandra, I, Negoi, Sandhya, Neupane, Kandel, Huong, L, Nguyen, T, Molly, R, Nixon, Norrving, Bo, Jean, Jacque, Noubiap, Brice, Nouthe, E, Christoph, Nowak, Oluwakemi, O, Odukoya, Felix, Ogbo, A, Andrew, T, Olagunju, Hans, Orru, Alberto, Ortiz, Samuel, M, Ostroff, Jagadish, Rao, Padubidri, Palladino, Raffaele, Adrian, Pana, Songhomitra, Panda-Jona, Utsav, Parekh, Eun-Cheol, Park, Mojtaba, Parvizi, Fatemeh, Pashazadeh, Kan, Urvish, Patel, K, Mona, Pathak, Rajan, Paudel, Veincent, Christian, Pepito, F, Arokiasamy, Perianayagam, Norberto, Perico, Hai, Q, Pham, Thomas, Pilgrim, Michael, A, Piradov, Farhad, Pishgar, Vivek, Podder, Roman, V, Polibin, Akram, Poursham, Dimas, R, Pribadi, A, Navid, Rabiee, Mohammad, Rabiee, Amir, Radfar, Alireza, Rafiei, Fakher, Rahim, Vafa, Rahimi-Movaghar, Mohammad, Hifz, Rahman, Ur, Muhammad, Aziz, Rahman, Amir, Masoud, Rahmani, Ivo, Rakovac, Pradhum, Ram, Sudha, Ramalingam, Juwel, Rana, Priyanga, Ranasinghe, Sowmya, J, Rao, Priya, Rathi, Lal, Rawal, Wasiq, F, Rawasia, Reza, Rawassizadeh, Giuseppe, Remuzzi, Andre, M, Renzaho, N, Aziz, Rezapour, Seyed, Mohammad, Riahi, Ro, Roberts-Thomson, L, Leonardo, Roever, Peter, Rohloff, Michele, Romoli, Gholamreza, Roshandel, Godfrey, M, Rwegerera, Seyedmohammad, Saadatagah, Maha, M, Saber-Ayad, Siamak, Sabour, Simona, Sacco, Masoumeh, Sadeghi, Sahar, Saeedi, Moghaddam, Saeed, Safari, Amirhossein, Sahebkar, Sana, Salehi, Hamideh, Salimzadeh, Mehrnoosh, Samaei, Abdallah, M, Samy, Itamar, Santos, S, Milena, M, Santric-Milicevic, Nizal, Sarrafzadegan, Arash, Sarveazad, Thirunavukkarasu, Sathish, Monika, Sawhney, Mete, Saylan, Maria, I, Schmidt, Aletta, Schutte, E, Subramanian, Senthilkumaran, Sadaf, G, Sepanlou, Feng, Sha, Saeed, Shahabi, Izza, Shahid, Masood, A, Shaikh, Mahdi, Shamali, Morteza, Shamsizadeh, Shajedur, Md, Rahman, Shawon, Aziz, Sheikh, Mika, Shigematsu, Min-Jeong, Shin, Jae, Il, Shin, Rahman, Shiri, Ivy, Shiue, Kerem, Shuval, Soraya, Siabani, Tariq, J, Siddiqi, Diego, A, S, Silva, Jasvinder, Singh, A, Ambrish, Singh, Mtech, Valentin, Skryabin, Y, Anna, A, Skryabina, Amin, Soheili, Emma, E, Spurlock, Leo, Stockfelt, Stefan, Stortecky, Saverio, Strange, Rizwan, Suliankatchi, Abdulkader, Hooman, Tadbiri, Eyayou, G, Tadesse, Degena, Tadesse, B, Masih, Tajdini, Tariqujjaman, Md, Berhane, F, Teklehaimanot, Mohamad-Hani, Temsah, Ayenew, K, Tesema, Bhaskar, Thakur, Kavumpurathu, R, Thankappan, Rekha, Thapar, Amanda, G, Thrift, Binod, Timalsina, Marcello, Tonelli, Mathilde, Touvier, Marcos, R, Tovani-Palone, Avnish, Tripathi, Jaya, P, Tripathy, Thoma, Truelsen, C, Guesh, M, Tsegay, Gebiyaw, Tsegaye, W, Nikolaos, Tsilimpari, Biruk, S, Tusa, Stefanos, Tyrovola, Krishna, Kishore, Umapathi, Brigid, Unim, Bhaskaran, Unnikrishnan, Usman, Muthiah, Vaduganathan, Pascual, R, Valdez, Tommi, Vasankari, J, Diana, Z, Velazquez, Narayanaswamy, Venketasubramanian, Giang, T, Isidora, Vu, Vujcic, S, Yasir, Waheed, Yanzhong, Wang, Fang, Wang, Jingkai, Wei, Robert, G, Weintraub, Abrha, Weldemariam, H, Ronny, Westerman, Andrea, S, Winkler, Charle, Wiysonge, S, Charles, D, Wolfe, A, Befikadu, Legesse, Wubishet, Gelin, Xu, Ali, Yadollahpour, Kazumasa, Yamagishi, Lijing, L, Yan, Srikanth, Yandrapalli, Yuichiro, Yano, Hiroshi, Yatsuya, Tomas, Y, Yeheyis, Yigizie, Yeshaw, Christopher, S, Yilgwan, Naohiro, Yonemoto, Chuanhua, Yu, Hasan, Yusefzadeh, Geevar, Zachariah, Sojib, Bin, Zaman, Muhammed, Maryam, Zamanian, Ramin, Zand, Alireza, Zandifar, Afshin, Zarghi, Mikhail, S, Zastrozhin, Anasthasia, Zastrozhina, Zhi-Jiang, Zhang, Yunquan, Zhang, Wangjian, Zhang, Chenwen, Zhong, Zhiyong, Zou, Yves, Miel, Zuniga, H, Christopher, J, Murray, L, and Valentin, Fuster
Subjects: cardiovascular disease, global health, health policy, population health
Abstract: Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases.
Published: 2020

46. Prevalence and Clinical Significance of Residual or Reconverted Red Bone Marrow on Knee MRI

Author: Ambrish Singh, Terence Dwyer, Changhai Ding, Graeme Jones, Benny Antony, Alison Venn, Marita Cross, Flavia M. Cicuttini, A. Halliday, Jasveen Kaur, Minh Tu Vo, Tao Meng, and Lyn March
Subjects: young adults, musculoskeletal diseases, medicine.medical_specialty, Medicine (General), WOMAC, Clinical Biochemistry, Osteoarthritis, residual/reconverted red bone marrow, Overweight, Article, Red bone marrow, R5-920, knee pain, magnetic resonance imaging, Internal medicine, medicine, Clinical significance, Young adult, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, medicine.disease, musculoskeletal system, Knee pain, medicine.symptom, business, human activities
Abstract: Background: Residual/reconverted red bone marrow (RBM) in adult knees is occasionally observed on routine knee magnetic resonance imaging (MRI). We aimed to identify its prevalence, distribution, and associations with lifestyle factors, knee structural abnormalities, and knee symptoms in young adults. Methods: Participants (n = 327; aged = 31–41 years) were selected from the Childhood Determinants of Adult Health (CDAH) knee study. They underwent T1-weighted and proton-density-weighted fat-suppressed MRI scans of knees. Residual/reconverted RBM in distal femur and proximal tibia were graded semi-quantitatively (grades: 0–3) based on the percentage area occupied. Knee structural abnormalities were graded semi-quantitatively using previously published MRI scoring systems. Knee symptoms (pain, stiffness, and dysfunction) were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale during CDAH knee study (year: 2008–2010) and at 6–9-year follow-up during the CDAH-3 study (year: 2014–2019). Associations between definite RBM (grade ≥ 2) and lifestyle factors, knee symptoms, and structural abnormalities were described using log-binomial regressions. Results: Definite RBM was seen in females only, in 29 out of 154 cases (18.8%), with femoral involvement preceding tibial involvement. Definite RBM was associated with increased BMI (PR = 1.09/kg/m2; 95% CI: 1.03, 1.16), overweight status (PR = 2.19; 95% CI: 1.07, 4.51), and WOMAC knee pain (PR = 1.75; 95% CI: 1.11, 2.74) in cross-section analysis. However, there was no association between RBM and knee-pain after seven years (PR = 1.15; 95% CI: 0.66, 2.00). There were no associations between RBM and knee structural abnormalities. Conclusion: Presence of definite RBM in young adult knees was observed in females only. Definite RBM was associated with overweight measures, and the modest association with knee pain may not be causally related.
Published: 2021
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47. Association of acute kidney injury with the risk of dementia: A meta-analysis protocol

Author: Radim Líčeník, Ambrish Singh, Miloslav Klugar, Salman Hussain, Jitka Klugarová, and Benny Antony
Subjects: Protocol (science), medicine.medical_specialty, urogenital system, business.industry, Acute kidney injury, MEDLINE, Renal function, Subgroup analysis, urologic and male genital diseases, medicine.disease, female genital diseases and pregnancy complications, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Meta-analysis, Internal medicine, Epidemiology, medicine, Dementia, 030212 general & internal medicine, business, 030217 neurology & neurosurgery
Abstract: Acute kidney injury (AKI) is a complex disorder characterized by an abrupt decline in kidney function over a short period of time. Published epidemiological studies linked AKI with the development of dementia. This meta-analysis aims to understand the pooled risk of dementia in AKI patients compared to non-AKI patients. MEDLINE and Embase databases, and the grey literature in five sources were searched to identify the studies assessing the association of AKI with dementia. The Newcastle-Ottawa scale (NOS) will be used to determine the quality of included studies. The primary outcome of this study will be the risk of dementia among AKI patients compared to non-AKI patients. Subgroup analysis and sensitivity analysis will also be performed. Review Manager version 5.4.1 will be used to perform the meta-analysis.
Published: 2021

48. Burden of diabetes and hyperglycaemia in adults in the Americas, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Ewerton Cousin, Maria Inês Schmidt, Kanyin Liane Ong, Rafael Lozano, Ashkan Afshin, Abdelrahman I Abushouk, Gina Agarwal, Marcela Agudelo-Botero, Ziyad Al-Aly, Jacqueline Elizabeth Alcalde-Rabanal, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Benny Antony, Malke Asaad, Till Winfried Bärnighausen, Sanjay Basu, Isabela M Bensenor, Zahid A Butt, Ismael R Campos-Nonato, Vijay Kumar Chattu, Michael H Criqui, Parnaz Daneshpajouhnejad, Claudio Alberto Dávila-Cervantes, Edgar Denova-Gutiérrez, Samath Dhamminda Dharmaratne, Daniel Diaz, Irina Filip, Mohamed M Gad, MA Garcia-Gordillo, Shakiba Ghasemi Assl, Sameer Vali Gopalani, Rafael Alves Guimarães, Rajat Das Gupta, Nima Hafezi-Nejad, Maryam Hashemian, Simon I Hay, Tanvir Kahlon, Jagdish Khubchandani, Ruth W Kimokoti, Adnan Kisa, Barthelemy Kuate Defo, Iván Landires, Ted R Miller, Ali H Mokdad, Linda Morales, Shane Douglas Morrison, Yeshambel T Nigatu, Virginia Nuñez-Samudio, Andrew T Olagunju, Seithikurippu R Pandi-Perumal, Urvish K Patel, Amir Radfar, Maria Rios-Blancas, Leonardo Roever, Seyedmohammad Saadatagah, Juan Sanabria, Itamar S Santos, Thirunavukkarasu Sathish, Mahsima Shabani, Omid Shafaat, Sara Sheikhbahaei, Diego Augusto Santos Silva, Ambrish Singh, Jasvinder A Singh, Marcos Roberto Tovani-Palone, Diana Zuleika Velazquez, Siddhesh Zadey, Mohsen Naghavi, Theo Vos, and Bruce B Duncan
Subjects: Adult, Blood Glucose, Endocrinology, Diabetes and Metabolism, Global Health, Global Burden of Disease, Endocrinology, Life Expectancy, Diabetes Mellitus, Type 2, Socioeconomic Factors, Risk Factors, Cause of Death, Hyperglycemia, Internal Medicine, Humans, Quality-Adjusted Life Years, Renal Insufficiency, Chronic
Abstract: High prevalence of diabetes has been reported in the Americas, but no comprehensive analysis of diabetes burden and related factors for the region is available. We aimed to describe the burden of type 1 and type 2 diabetes and that of hyperglycaemia in the Americas from 1990 to 2019.We used estimates from GBD 2019 to evaluate the burden of diabetes in adults aged 20 years or older and high fasting plasma glucose in adults aged 25 years or older in the 39 countries and territories of the six regions in the Americas from 1990 to 2019. The main source to estimate the mortality attributable to diabetes and to chronic kidney disease due to diabetes was vital registration. Mortality due to overall diabetes (ie, diabetes and diabetes due to chronic kidney disease) was estimated using the Cause of Death Ensemble model. Years of life lost (YLLs) were calculated as the number of deaths multiplied by standard life expectancy at the age that the death occurred, years lived with disability (YLDs) were estimated based on the prevalence and severity of complications of diabetes. Disability-adjusted life-years (DALYs) were estimated as a sum of YLDs and YLLs. We assessed the association of diabetes burden with the level of development of a country (according to the Socio-demographic Index), health-care access and quality (estimated with the Healthcare Access and Quality Index), and diabetes prevalence. We also calculated the population attributable fraction (PAF) of diabetes burden due to each of its risk factors. We report the 95% uncertainty intervals for all estimates.In 2019, an estimated total of 409 000 (95% uncertainty interval 373 000-443 000) adults aged 20 years or older in the Americas died from diabetes, which represented 5·9% of all deaths. Diabetes was responsible for 2266 (1930-2649) crude DALYs per 100 000 adults in the Americas, and high fasting plasma glucose for 4401 DALYs (3685-5265) per 100 000 adults, with large variation across regions. DALYs were mostly due to type 2 diabetes and distribution was heterogeneous, being highest in central Latin America and the Caribbean and lowest in high-income North America and southern Latin America. Between 1990 and 2019, age-standardised DALYs due to type 2 diabetes increased 27·4% (22·0-32·5). This increase was particularly high in Andean Latin America and high-income North America. Burden for both type 1 and type 2 diabetes across countries increased with higher diabetes prevalence and decreased with greater Socio-demographic and Healthcare Access and Quality Indices. Main risk factors for the burden were high BMI, with a PAF of 63·2% and dietary risks, with a PAF of 27·5%. The fraction of burden due to disability has increased since 1990 and now represents nearly half of the overall burden in 2019.The burden of diabetes in the Americas is large, increasing, heterogeneous, and expanding. To confront the rising burden, population-based interventions aimed to reduce type 2 diabetes risk and strengthening health systems to provide effective and cost-efficient care for those affected are mandatory.BillMelinda Gates Foundation.
Published: 2021

49. Systematic Review and Meta-Analysis Protocol: Beta adrenoreceptor drugs and risk of Parkinson’s disease

Author: Benny Antony, Akkala S, Ambrish Singh, Miloslav Klugar, Andrea Pokorná, Jitka Klugarová, and Salman Hussain
Subjects: Protocol (science), medicine.medical_specialty, business.industry, Dopaminergic, Antagonist, Disease, Bioinformatics, 3. Good health, 03 medical and health sciences, Critical appraisal, 0302 clinical medicine, Meta-analysis, Epidemiology, medicine, 030212 general & internal medicine, Beta (finance), business, 030217 neurology & neurosurgery
Abstract: Parkinson’s disease (PD) is a progressive nervous system disorder characterised by the loss of dopaminergic neurons leading to motor and non-motor symptoms. Accumulation of α-synuclein protein (SNCA) in the form of Lewy bodies has been observed in dopaminergic neurons of PD patients. Potential relationships between β-adrenergic drugs (agonists and antagonist) and SNCA synthesis in PD have been recently suggested. This study aims to systematically review the evidence from various epidemiological studies that analysed the association between beta-adrenoceptors (agonists and antagonists) and the risk of PD. Biomedical databases such as PubMed and Embase will be searched to identify the individual studies that reported the relationship between beta-adrenoceptors and the risk of PD. JBI critical appraisal tool scale will be used to assess the quality of included studies. The primary outcome will be to compute the pooled risk of PD among beta-agonist and antagonist users. Furthermore, we will consider the pooled risk of PD based on study design, types of beta-agonist or antagonist exposure under secondary outcomes. RevMan 5, STATA 16, and ProMeta 3.0 will be used to conduct the statistical analysis.
Published: 2021

50. Proton pump inhibitor use and the risk of hepatocellular carcinoma: A systematic review of pharmacoepidemiological data

Author: Benny Antony, Salman Hussain, Ambrish Singh, Miloslav Klugar, Robin Jha, and Aarthi S Jayraj
Subjects: Oncology, medicine.medical_specialty, Carcinoma, Hepatocellular, medicine.drug_class, business.industry, Health Policy, Liver Neoplasms, Proton-pump inhibitor, Proton Pump Inhibitors, General Medicine, medicine.disease, Real world evidence, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Hepatocellular carcinoma, Meta-analysis, medicine, Humans, 030211 gastroenterology & hepatology, business, 030217 neurology & neurosurgery
Published: 2021

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