Objective
To summarise the associations between antenatal or early‐life blood vitamin D and the development of eczema/food allergy in childhood.
Design
A systematic review and meta‐analyses were ...conducted to synthesize the published literature. Two reviewers independently performed the study selection and data extraction on Covidence. We assessed the risk of bias for observational studies by using the Newcastle‐Ottawa Scale and the Cochrane Risk of Bias tool for clinical trials. The certainty of the evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE).
Data sources
We systematically searched PubMed and Embase from inception and April 2022.
Eligibility criteria
Human studies that investigated prospective associations between antenatal or early‐life blood vitamin D levels, dietary intake or supplementation and childhood eczema/food allergy.
Results
Forty‐three articles including six randomised controlled trials (RCTs) were included. Four RCTs of vitamin D supplementation during pregnancy showed no evidence of an effect on the incidence of eczema (pooled odds ratio OR = 0.85; 0.67–1.08, I2 = 6.7%, n = 2074). Three RCTs reported null associations between supplementation in pregnancy/infancy and food allergy. From six cohort studies, increasing cord blood vitamin D levels were associated with reduced prevalence of eczema at/close to age one (OR per 10 nmol/L increase = 0.89; 0.84–0.94, I2 = 0%, 2025 participants). We found no evidence of an association between maternal antenatal or infant vitamin D level or dietary intake and the development of food allergy or eczema in offspring.
Conclusions
We found an association between higher vitamin D levels in cord blood and reduced risk of eczema in cohort studies. Further trials with maternal and infant supplementation are needed to confirm if vitamin D supplementation can effectively prevent eczema or food allergy in childhood.
Systematic review registration
PROSPERO, No. CRD42013005559.
In this systematic review of prospective studies, we observed an 11% reduction in the prevalence of eczema at approximately 1 year of age per 10 nmol/L increase of vitamin D levels in cord blood (OR = 0.89, 95% CI = 0.84–0.94, six cohort studies, 2025 participants). There was no association between maternal or infant vitamin D levels or vitamin D supplementation during pregnancy and the risk of eczema. A lower level of cord blood vitamin D is a risk factor for developing eczema in childhood.
Background: We aimed to investigate associations between exposure to various trajectories of severe hypoglycemic events and risk of dementia in patients with type 2 diabetes.Methods: In 2002–2003, ...677,618 patients in Taiwan were newly diagnosed as having type 2 diabetes. Among them, 35,720 (5.3%) experienced severe hypoglycemic events during the 3-year baseline period following diagnosis. All patients were followed from the first day after baseline period to the date of dementia diagnosis, death, or the end of 2011. A group-based trajectory model was used to classify individuals with severe hypoglycemic events during the baseline period. Cox proportional hazard models with the competing risk method were used to relate dementia risk to various severe hypoglycemia trajectories.Results: After a median follow-up 6.70 and 6.10 years for patients with and without severe hypoglycemia at baseline, respectively, 1,952 (5.5%) individuals with severe hypoglycemia and 23,492 (3.7%) without developed dementia during follow-up, for incidence rates of 109.80 and 61.88 per 10,000 person-years, respectively. Four groups of severe hypoglycemia trajectory were identified with a proportion of 18.06%, 33.19%, 43.25%, and 5.50%, respectively, for Groups 1 to 4. Groups 3 (early manifestation but with later decrease) and 4 (early and sustained manifestation) were associated with a significantly increased risk of dementia diagnosis, with a covariate-adjusted subdistribution hazard ratio of 1.22 (95% confidence interval, 1.14–1.31) and 1.25 (95% confidence interval, 1.02–1.54), respectively.Conclusion: Our analysis highlighted that early manifestation of severe hypoglycemic events may contribute more than does late manifestation to the risk of dementia among individuals newly diagnosed as having type 2 diabetes.
Introduction and hypothesis
Abdominal sacrocolpopexy is regarded as the gold standard for management of pelvic organ prolapse (POP). Nowadays, minimally invasive surgeries are preferred, and ...sacrocolpopexy can be performed using either a laparoscopic or robotic-assisted approach. The aim of the current study was to compare the efficacy and safety of robotic-assisted sacrocolpopexy (RASC) and laparoscopic sacrocolpopexy (LSC) through an updated systematic review and meta-analysis.
Methods
We performed a systematic literature review of different databases and related references from their inception until July 2020 without language restrictions. All randomized control trials and comparative studies that compared RASC and LSC for the management of POP were included.
Results
A total of 13 studies including 2115 participants were included for the pooled analysis. The pooled results revealed that RASC was associated with a significantly longer operative time (weighted mean difference, 29.53 min; 95% confidence interval CI, 12.88 to 46.18 min,
P
= 0.0005), significantly less estimated blood loss (weighted mean difference, −86.52 ml; 95% CI −130.26 to −42.79 ml,
P
= 0.0001), significantly fewer overall intraoperative complications (odds ratio OR 0.6; 95% CI 0.40 to 0.91;
P
= 0.01) and significantly lower conversion rate (OR 0.39; 95% CI 0.19 to 0.82;
P
= 0.01) compared with LSC. There were no significant differences between the length of hospital stays, overall postoperative complications, postoperative stress incontinence, mesh erosion and effectiveness between the two groups.
Conclusion
The current study showed comparable efficacy between RASC and LSC. Though RASC was associated with less blood loss and a lower conversion rate, the differences were not clinically significant. The choice of surgical procedure with either RASC or LSC is according to surgeon discretion and patient preferences.
Background
Previous systematic reviews have focused on associations between single time point measures of Body Mass Index (BMI) and asthma and allergic diseases. As BMI changes dynamically during ...childhood, examination of associations between longitudinal trajectories in BMI and allergic diseases is needed to fully understand the nature of these relationships.
Objective
To systematically synthesise the association between BMI trajectories in childhood (0–18 years) and allergic diseases (asthma, eczema, allergic rhinitis, or food allergies outcomes).
Design
We conducted a systematic review following the PRISMA guidelines, and two independent reviewers assessed the study quality using the ROBINS‐E and GRADE tools. A narrative synthesis was performed as the statistical heterogeneity did not allow a meta‐analysis.
Data Sources
A search was performed on PubMed and EMBASE databases on 4th January 2023.
Eligibility Criteria
Longitudinal cohort studies assessing the associations between childhood BMI trajectories and allergic diseases were included.
Results
Eleven studies met the inclusion criteria with a total of 37,690 participants between 0 and 53 years of age. Ten studies examined asthma outcomes, three assessed association with allergic rhinitis, two assessed eczema, and one assessed food allergy. High heterogeneity and high risk of bias were observed. Overall, the quality of evidence was very low. Nevertheless, two consistent findings were identified: (1) a persistently high BMI between 6 and 10 years of age may be associated with an increased risk of asthma at 18 years and (2) a rapid increase in BMI in the first 2 years of life may be associated with subsequent asthma.
Conclusions
Maintaining a normal BMI trajectory during childhood may reduce the risk of asthma. Future research that adequately addresses confounding and includes longer‐term follow‐up is needed. Moreover, additional studies examining potential associations with eczema, food allergies, and allergic rhinitis outcomes are needed.
We observed that catch‐up growth in the first 2 years or a persistently high BMI trajectory between 6 and 10 years of age may be associated with subsequent asthma. The risk of bias (assessed using ROBINS E) was high among all studies. The overall quality of evidence (determined by GRADE) was very low. There was insufficient evidence to draw conclusions for eczema, allergic rhinitis, and food allergy outcomes. Well‐designed prospective studies examining the association between BMI trajectories and allergic diseases are needed.
Warm-up is an essential component for optimizing performance before an exercise session. This study investigated that the immediate effects of vibration rolling (VR), nonvibration rolling (NVR), and ...static stretching as a part of a warm-up regimen on the flexibility, knee joint proprioception, muscle strength, and dynamic balance of the lower extremity in young adults. Compared with the preintervention, VR induced the range of motion of knee flexion and extension significantly increased by 2.5% and 6%, respectively, and isokinetic peak torque and dynamic balance for muscle strength and dynamic balance increased by 33%-35% and 1.5%, respectively. In the three conditions, most outcomes between VR and NVR were comparable; however, the participants had a significantly higher knee joint reposition error after NVR than after VR, indicating that NVR would have a hampering knee joint proprioception effect. In particular, compared with static stretching, VR significantly increased the quadriceps muscle strength by 2-fold and dynamic balance by 1.8-fold. These findings suggest that athletic professionals may take VR into account for designing more efficient and effective preperformance routine to improve exercise performances. VR has high potential to translate into an on-field practical application.
A self-assembled nanocomposite is prepared from an aqueous mixture of aptamer-modified gold nanoparticles (Apt–Au NPs), bismuth ions and chloride ions. The Apt–Au NPs are immobilized on bismuth ...oxychloride (BiOCl) nanosheets in situ to form Apt–Au NPs/BiOCl nanocomposites. The as-prepared nanocomposites exhibit high peroxidase-like activity for the catalytic conversion of Amplex Red (AR) to fluorescent resorufin in the presence of H2O2. The catalytic activity of Apt–Au NPs/BiOCl nanocomposites is at least 90-fold higher than that of Apt–Au NPs or BiOCl nanosheets, revealing synergistic effects on their activity. The catalytic activity of Apt–Au NPs/BiOCl nanocomposites is suppressed by vascular endothelial growth factor-A165 (VEGF-A165) molecules that specifically interact with the aptamer units (Del-5-1 and v7t-1) on the nanocomposite surface. The AR/H2O2–Apt–Au NPs/BiOCl nanocomposites probe shows high selectivity (>1000-fold over other proteins) and sensitivity (detection limit ~0.5nM) for the detection of VEGF-A165. Furthermore, the probe is employed for the detection of VEGF isoforms and for the study of interactions between VEGF and VEGF receptors. The practicality of this simple, rapid, cost-effective probe is validated by the analysis of VEGF-A165 in cell culture media, showing its great potential for the analysis of VEGF in biological samples.
Aptamer-modified gold nanoparticles (Apt–Au NPs) are immobilized onto bismuth oxychloride (BiOCl) nanosheets in situ to form Apt–Au NPs/BiOCl nanocomposites. The peroxidase-like activity of Apt–Au NPs/BiOCl nanocomposites is suppressed by vascular endothelial growth factor-A165 (VEGF-A165) molecules that specifically interact with the aptamer units on the nanocomposite surface.
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•Aptamer-modified gold nanoparticles are immobilized on BiOCl nanosheets.•The nanocomposites exhibit high peroxidase-like activity.•Catalytic activity of the nanocomposites is suppressed by VEGF.•Analysis of VEGF isoforms and their interaction to receptors.
The impact of opioid analgesic use before cancer diagnosis on survival in patients with chronic pain is unclear. Therefore, we designed a propensity score-matched population-based cohort study to ...compare overall and cancer-related survival of patients with chronic pain who received long-term opioid analgesic treatment with that of those who did not receive such treatment.
We included patients with chronic pain and categorised them into the following two groups according to their analgesic use: patients with cancer and chronic pain who were prescribed ≥180 defined daily doses of opioid analgesics per year >3 months before cancer diagnosis comprised the case group, and those who were prescribed <28 defined daily doses of opioid analgesics per year before cancer diagnosis comprised the control group. Patients in both groups were matched at a ratio of 1:5. The primary outcome was overall long-term survival.
The matching process yielded a final cohort of 1716 patients (286 and 1430 in the case and control groups, respectively) who were eligible for further analysis. The adjusted hazard ratio for overall survival in patients receiving long-term opioids was 3.53 (95% confidence interval: 3.03–4.11; P<0.001).
Long-term opioid analgesic use before cancer diagnosis might be associated with poor overall survival in patients with chronic pain compared with such patients who did not receive long-term opioid analgesics.
No studies have investigated the effects of irradiation-dose escalation intensity-modulated radiotherapy (IMRT)-based concurrent chemoradiotherapy (CCRT) in patients with thoracic esophageal squamous ...cell carcinoma (TESCC).
We analyzed data from patients with TESCC who were enrolled in the Taiwan Cancer Registry database. To compare treatment outcomes, the patients were categorized into two groups according to their radiotherapy doses: group 1, who received CCRT<60Gy with IMRT, and group 2, who received CCRT≥60Gy with IMRT. Group 1 was used as the control for investigating posttreatment mortality risk.
We enrolled 2061 patients with TESCC without distant metastasis who received CCRT with IMRT. Multivariate Cox regression analysis indicated that advanced clinical American Joint Committee on Cancer (AJCC) stage (≥IIIA), alcohol consumption, and cigarette smoking were significant, poor independent predictors in patients with TESCC receiving IMRT-based CCRT. IMRT-based CCRT (≥60Gy; adjusted hazard ratio aHR: 0.75; 95% confidence interval CI: 0.63–0.83) was a significant independent prognostic factor for overall survival (P<0.0001). After adjustment for confounders, the aHRs (95% CIs) for overall mortality at all clinical stages were 0.75 (0.68–0.83, P<0.0001) in group 2. In group 2, the aHRs (95% CIs) for overall mortality at early (IA–IIB) and advanced (IIIA–IIIC) AJCC clinical stages were 0.89 (0.70–1.04, P=0.1905) and 0.75 (0.67–0.83, P<0.0001), respectively.
Compared with standard-dose IMRT-based CCRT, high-dose IMRT-based CCRT yields more favorable survival outcomes in patients with advanced-stage TESCC.
Purpose: Whether preexisting sarcopenia is an independent risk factor for cancer incidence remains unclear. Therefore, we performed this propensity score (PS)-matched (PSM) population-based cohort ...study to compare the incidence rate ratios (IRRs) of specific cancers between patients with and without sarcopenia. Patients and Methods: The patients were categorized into two groups according to the presence or absence of sarcopenia, matched at a 4:1 ratio. Results: PS matching yielded a final cohort of 77,608 patients (15,527 in the sarcopenia and 62,081 nonsarcopenia groups) eligible for further analysis. In our multivariate Cox regression analysis, compared with the nonsarcopenia group, the adjusted hazard ratio (aHR; 95% confidence interval (CI)) for cancer risk in the sarcopenia group was 1.277 (1.10 to 1.36; p < 0.001). Furthermore, the adjusted IRRs (95% CIs) for sarcopenia patients were pancreatic cancer 3.77 (1.79 to 4.01), esophageal cancer 3.38 (1.87 to 4.11), lung cancer 2.66 (1.15 to 2.90), gastric cancer 2.25 (1.54 to 3.23), head and neck cancer 2.15 (1.44 to 2.53), colorectal cancer 2.04 (1.77 to 2.30), hepatocellular carcinoma 1.84 (1.30 to 2.36), breast cancer 1.56 (1.12 to 1.95), and ovarian cancer 1.43 (1.10 to 2.29), respectively. Conclusions: Sarcopenia might be a significant cancer risk factor for lung, colorectal, breast, head and neck, pancreas, gastric, esophageal, and ovarian cancer, as well as hepatocellular carcinoma.
We examined locoregional recurrence (LRR) in patients with breast invasive ductal carcinoma (IDC) receiving breast conservative surgery (BCS) under propofol-based paravertebral block-regional ...anesthesia (PB-RA) versus sevoflurane-based inhalational general anesthesia (INHA-GA) without propofol. All-cause death and distant metastasis were secondary endpoints.
Patients with breast IDC receiving BCS were recruited through propensity score matching and categorized into INHA-GA with sevoflurane and PB-RA with propofol groups. Cox regression analysis was performed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).
In the multivariate Cox regression analysis, the adjusted HR (aHR; 95% CI) of LRR for the PB-RA with propofol group was 0.67 (0.46–0.99) compared with the INHA-GA with sevoflurane group. The aHRs of LRR for differentiation grade II, grade III, the American Joint Committee on Cancer clinical stage II, stage III, pathological tumor (pT) stage 2, pT stage 3–4, pathological nodal (pN) stage 2–3, and Her-2 positivity were 1.87 (1.03–3.42), 2.31 (1.20–4.44), 1.67 (1.09–2.56), 2.43 (1.18–4.97), 1.17 (1.03–1.19), 1.28 (1.13–2.24), 1.20 (1.05–2.22), and 1.59 (1.01–2.51), respectively, compared with those for differentiation grade I, clinical stage I, pT1, pN0, and HER-2 negativity. The aHR of LRR for adjuvant radiotherapy was 0.60 (0.38–0.97) compared with that for no adjuvant radiotherapy.
PB-RA with propofol might be beneficial for reducing LRR in women with breast IDC receiving BCS compared with INHA-GA without propofol.
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