Abstract Purpose Many dietary factors have either proinflammatory or anti-inflammatory properties. We previously developed a dietary inflammatory index (DII) to assess the inflammatory potential of ...diet. In this study, we conducted a construct validation of the DII based on data from a food frequency questionnaire and three inflammatory biomarkers in a subsample of 2567 postmenopausal women in the Women's Health Initiative Observational Study. Methods We used multiple linear and logistic regression models, controlling for potential confounders, to test whether baseline DII predicted concentrations of interleukin-6, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha receptor 2, or an overall biomarker score combining all three inflammatory biomarkers. Results The DII was associated with the four biomarkers with beta estimates (95% confidence interval) comparing the highest with lowest DII quintiles as follows: interleukin-6: 1.26 (1.15–1.38), Ptrend < .0001; tumor necrosis factor alpha receptor 2: 81.43 (19.15–143.71), Ptrend = .004; dichotomized hs-CRP (odds ratio for higher vs. lower hs-CRP): 1.30 (0.97–1.67), Ptrend = .34; and the combined inflammatory biomarker score: 0.26 (0.12–0.40), Ptrend = .0001. Conclusions The DII was significantly associated with inflammatory biomarkers. Construct validity of the DII indicates its utility for assessing the inflammatory potential of diet and for expanding its use to include associations with common chronic diseases in future studies.
Culturing of human embryos in optimal conditions is crucial for a successful in vitro fertilisation (IVF) programme. In addition, the capacity to assess and rank embryos correctly for quality will ...allow for transfer of the potentially 'best' embryo first, thereby shortening the time to pregnancy, although not improving cumulative pregnancy and live birth rates. It will also encourage and facilitate the implementation of single embryo transfers, thereby increasing safety for mother and offspring. Time-lapse technology introduces the concept of stable culture conditions, in connection with the possibility of continuous viewing and documenting of the embryo throughout development. However, so far, even when embryo quality scoring is based on large datasets, or when using the time-lapse technology, the morphokinetic scores are still mainly based on subjective and intermittent annotations of morphology and timings. Also, the construction of powerful algorithms for widespread use is hampered by large variations in culture conditions between individual IVF laboratories. New methodology, involving machine learning, where every image from the time-lapse documentation is analysed by a computer programme, looking for patterns that link to outcome, may in the future provide a more accurate and non-biased embryo selection.
Due to the rapid increase in chronic diseases in South Korea, the Korean government has expanded chronic disease management to primary care. Thus, the role of primary care nurses is critical. ...However, the fee for chronic disease management services provided by primary care nurses has not been set, and few studies have evaluated the value of nursing services. This study aimed to estimate the willingness to pay (WTP) for chronic disease management services provided by primary care nurses and to identify the factors that affect WTP. This study adopted a descriptive research design and conducted a cross-sectional online survey from January 16 to 18, 2023. The inclusion criteria were community residents aged greater than or equal to 20 years living in South Korea and capable of participating in online surveys. A total of 520 people participated in this study. A contingent valuation method (CVM) was used with double-bound dichotomous choice questions along with open-ended questions. The mean WTP was calculated using a Tobit model. The mean WTP of the 520 study participants for one chronic disease management service provided by primary care nurses was 15,390.71 Korean won ($11.90). Factors affecting WTP were having a chronic disease, recognition of primary care nurses, and the first-bid price. Community residents with fewer chronic diseases, high awareness of primary care nurses, and a higher first-bid price showed higher WTP for chronic disease management services provided by primary care nurses. Primary care is important worldwide due to the increasing number of chronic diseases, and Korea is no exception. However, payment for services by primary care nurses is undervalued compared to their critical role and skills. This has led to problems such as a primary care nurse shortage and burnout. This study estimated individuals' WTP for chronic disease management services provided by primary care nurses. The results can be used as a basic resource for setting the fee for services provided by primary care nurses. It is also a good starting point to understand the benefits of primary care nurse services.
Autoimmune disease heritability is enriched in T cell-specific regulatory regions of the genome. Modern-day T cell datasets now enable association studies between single nucleotide polymorphisms ...(SNPs) and a myriad of molecular phenotypes, including chromatin accessibility, gene expression, transcriptional programs, T cell antigen receptor (TCR) amino acid usage, and cell state abundances. Such studies have identified hundreds of quantitative trait loci (QTLs) in T cells that colocalize with genetic risk for autoimmune disease. The key challenge facing immunologists today lies in synthesizing these results toward a unified understanding of the autoimmune T cell: which genes, cell states, and antigens drive tissue destruction?
Abstract Objectives This study sought to determine whether racial and ethnic differences exist among patients with similar access to care. We examined outcomes after heart failure hospitalization ...within a large municipal health system. Background Racial and ethnic disparities in heart failure outcomes are present in administrative data, and one explanation is differential access to care. Methods We performed a retrospective cohort study of 8,532 hospitalizations of adults with heart failure at 11 hospitals in New York City from 2007 to 2010. Primary exposure was ethnicity and race, and outcomes were 30- and 90-day readmission and 30-day and 1-year mortality rates. Generalized estimating equations were used to test for associations between ethnicity and race and outcomes with covariate adjustment. Results Of the number of hospitalizations included, 4,305 (51%) were for blacks, 2,449 (29%) were for Hispanics, 1,494 (18%) were for whites, and 284 (3%) were for Asians. Compared to whites, blacks and Asians had lower 1-year mortality, with adjusted odds ratios (aORs) of 0.75 (95% confidence interval CI: 0.59 to 0.94) and 0.57 (95% CI: 0.38 to 0.85), respectively, and rates for Hispanics were not significantly different (aOR: 0.81; 95% CI: 0.64 to 1.03). Hispanics had higher odds of readmission than whites (aOR: 1.27; 95% CI: 1.03 to 1.57) at 30 (aOR: 1.40; 95% CI: 1.15 to 1.70) and 90 days. Blacks had higher odds of readmission than whites at 90 days (aOR:1.21; 95% CI: 1.01 to 1.47). Conclusions Racial and ethnic differences in outcomes after heart failure hospitalization were present within a large municipal health system. Access to a municipal health system may not be sufficient to eliminate disparities in heart failure outcomes.
Background: Organophosphate pesticides (OPs) are one of the most commonly used classes of insecticides in the U.S., and metabolites of OPs have been detected in the urine of >75% of the U.S. ...population. While studies have shown that OP exposure is associated with risk of neurological diseases and some cancers, the relationship between OP exposure and breast cancer risk is not well understood. Methods: The aim of this rapid review was to systematically evaluate published literature on the relationship between OP exposure and breast cancer risk, including both epidemiologic and laboratory studies. Twenty-seven full-text articles were reviewed by searching on Pubmed, EMBASE, and Cochrane databases. Results: Some human studies showed that malathion, terbufos, and chlorpyrifos were positively associated with human breast cancer risk, and some laboratory studies demonstrated that malathion and chlorpyrifos have estrogenic potential and other cancer-promoting properties. However, the human studies were limited in number, mostly included agricultural settings in several geographical areas in the U.S., and did not address cumulative exposure. Conclusions: Given the mixed results found in both human and laboratory studies, more research is needed to further examine the relationship between OP exposure and breast cancer risk, especially in humans in non-agricultural settings.
Abstract Congenital heart disease affects 1% of infants and is associated with impaired neurodevelopment. Right- or left-sided sulcal features correlate with executive function among people with ...Tetralogy of Fallot or single ventricle congenital heart disease. Studies of multiple congenital heart disease types are needed to understand regional differences. Further, sulcal pattern has not been studied in people with d-transposition of the great arteries. Therefore, we assessed the relationship between sulcal pattern and executive function, general memory, and processing speed in a meta-regression of 247 participants with three congenital heart disease types (114 single ventricle, 92 d-transposition of the great arteries, and 41 Tetralogy of Fallot) and 94 participants without congenital heart disease. Higher right hemisphere sulcal pattern similarity was associated with improved executive function (Pearson r = 0.19, false discovery rate-adjusted P = 0.005), general memory (r = 0.15, false discovery rate P = 0.02), and processing speed (r = 0.17, false discovery rate P = 0.01) scores. These positive associations remained significant in for the d-transposition of the great arteries and Tetralogy of Fallot cohorts only in multivariable linear regression (estimated change β = 0.7, false discovery rate P = 0.004; β = 4.1, false discovery rate P = 0.03; and β = 5.4, false discovery rate P = 0.003, respectively). Duration of deep hypothermic circulatory arrest was also associated with outcomes in the multivariate model and regression tree analysis. This suggests that sulcal pattern may provide an early biomarker for prediction of later neurocognitive challenges among people with congenital heart disease.
The incidences of both T1D and T2D are increasing in the U.S., and CVD is the leading cause of death among both cohorts. Despite differences in the underlying pathophysiology of T1D and T2D, CVD ...prevention approaches for T1D have been widely extrapolated from T2D studies. A few prior studies have compared CVD incidence and mortality rates between patients with T1D and T2D; however, a comparison of CVD risk factors between T1D and T2D within the same study cohort, as a measure of differences in progression to CVD events, has not been done. We thus compared CVD risk factors between patients with T1D and T2D, among U.S. adults (≥age 20) with self-reported diabetes from NHANES 1999-2016. First, we classified diabetes cases (n=5347) into T1D (n=230) and T2D (n=4677) using a treatment-based approach we developed, regardless of age at diagnosis (n=440 excluded as unassigned). Next, we compared the demographics, classical CVD risk factors and diabetes-related risk factors by diabetes type using bivariate analysis, and stepwise model selection. The final model comprised race, age, education, diabetes duration, triglycerides, CKD, BMI, and HbA1c Table. The similarity between the final model and the bivariate association results, suggests that differences in CVD risk factors between T1D and T2D are mainly due to the underlying pathophysiology and cannot merely be explained by demographic and diabetes-related differences between the two types.
Disclosure
M. Mosslemi: None. H.L. Park: None. C.E. McLaren: None. N.D. Wong: Advisory Panel; Self; Novartis Pharmaceuticals Corporation. Consultant; Self; Akcea Therapeutics, AstraZeneca. Research Support; Self; Amarin Corporation, Amgen Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk Inc.
Virtual reality (VR) technology provides an immersive environment that enables users to have modified experiences of reality. VR is increasingly used to manage patients with pain, disability, ...obesity, neurologic dysfunction, anxiety, and depression. However, public opinion regarding the use of VR in health care has not been explored. Understanding public opinion of VR is critical to ensuring effective implementation of this emerging technology.
This study aimed to examine public opinion about health care VR using social listening, a method that allows for the exploration of unfiltered views of topics discussed on social media and online forums.
In March 2016, NBC News produced a video depicting the use of VR for patient care. The video was repackaged by NowThis, a social media news website, and distributed on Facebook by Upworthy, a news aggregator, yielding 4.3 million views and 2401 comments. We used Microsoft Excel Power Query and ATLAS.ti software (version 7.5, Scientific Software Development) to analyze the comments using content analysis and categorized the comments around first-, second-, and third-order concepts. We determined self-identified gender from the user's Facebook page and performed sentiment analysis of the language to analyze whether the perception of VR differed by gender using a Pearson's chi-square test.
Out of the 1614 analyzable comments, 1021 (63.26%) were attributed to female Facebook users, 572 (35.44%) to male users, and 21 (1.30%) to users of unknown gender. There were 1197 comments coded as expressing a positive perception about VR (74.16%), 251 coded as expressing a negative perception and/or concern (15.56%), and 560 coded as neutral (34.70%). Informants identified 20 use cases for VR in health care, including the use of VR for pain and stress reduction; bed-bound individuals; women during labor; and patients undergoing chemotherapy, dialysis, radiation, or imaging procedures. Negative comments expressed concerns about radiation, infection risk, motion sickness, and the ubiquity of and overall dependence on technology. There was a statistically significant association between the language valence of the Facebook post and the gender of the Facebook user; men were more likely to post negative perceptions about the use of VR for health care, whereas women were more likely to post positive perceptions (P<.001).
Most informants expressed positive perceptions about the use of VR in a wide range of health care settings. However, many expressed concerns that should be acknowledged and addressed as health care VR continues to evolve. Our results provide guidance in determining where further research on the use of VR in patient care is needed, and offer a formal opportunity for public opinion to shape the VR research agenda.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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