To assess associations among outdoor activity, ocular biometric parameters, and myopia among grade 1 and grade 4 primary students in Beijing.
School-based, cross-sectional study.
A total of 382 grade ...1 and 299 grade 4 children participated in the study.
The children underwent a comprehensive eye examination, including ocular biometry by optical low-coherence reflectometry and noncycloplegic refractometry. Parents and children participated in a detailed interview, including questions on time spent indoors and outdoors.
Factors associated with myopia.
The study included 681 children, with 382 (56.1%) students from grade 1 (mean age, 6.3 ± 0.5 years; range, 5-8 years) and 299 students from grade 4 (mean age, 9.4 ± 0.7 years; range, 8-13 years); 370 students (54.3%) lived in the urban region. The mean daily time spent outdoors was 1.6 ± 0.8 hours (range, 0.5-5.1 hours). In multivariate analysis, axial length was significantly associated with older age (P<0.001; standardized β coefficient, 0.28), taller body height (P = 0.001; β, 0.18), maternal myopia (P = 0.03; β, 0.09), and urban region of habitation (P<0.001; β, -0.21), or alternatively to the region of habitation, with less time spent outdoors (P = 0.001; β, -0.16) and more time spent indoors studying (P = 0.02; β, 0.10). The axial length-to-corneal curvature radius ratio was associated with older age, urban region of habitation, maternal and paternal myopia, and paternal level of education. Presence of myopia (defined as refractive error ≤-1 diopters in the right eye) was associated with older age (P<0.001; odds ratio OR, 1.45; 95% confidence interval CI, 1.24-1.69), maternal myopia (P<0.001; OR, 2.99; 95% CI, 1.94-5.35), and urban region of habitation (P<0.001; OR, 0.17; 95% CI, 0.11-0.26), or alternatively to the region of habitation, with less time spent outdoors (P<0.001; OR, 0.32; 95% CI, 0.21-0.48) and more time spent indoors studying (P<0.001; OR, 1.38; 95% CI, 1.09-1.75).
Less outdoor activity, more indoor studying, older age, maternal myopia, and urban region of habitation were associated with longer ocular axial length and myopia in grade 1 and grade 4 primary school children in Greater Beijing. Remaining outdoors more (e.g., during school) may reduce the high prevalence of myopia in the young generation in Beijing.
Highlights of this study • MiR-187-3p is significantly down-regulated in HCC, and is correlated with adverse clinical features and poor prognosis of HCC patients. • MiR-187-3p can inhibit the ...metastasis of HCC cells by regulating EMT phenotype. • S100A4 is a direct downstream target of miR-187-3p, and mediated the biological function of miR-187-3p in HCC. • MiR-187-3p can be down-regulated by hypoxia, and is involved in the promoting effects of hypoxia on the metastasis and EMT of HCC cells
Men who have sex with men (MSM) are disproportionately affected by HIV and other sexually transmitted infections (STIs) worldwide. Previous reviews investigating the role of circumcision in ...preventing HIV and other STIs among MSM were inconclusive. Many new studies have emerged in the past decade. To inform global prevention strategies for HIV and other STIs among MSM, we reviewed all available evidence on the associations between circumcision and HIV and other STIs among MSM.
In this systematic review and meta-analysis, we searched PubMed, Web of Science, BioMed Central, Scopus, ResearchGate, Cochrane Library, Embase, PsycINFO, Google Scholar, and websites of international HIV and STI conferences for studies published before March 8, 2018. Interventional or observational studies containing original quantitative data describing associations between circumcision and incident or prevalent infection of HIV and other STIs among MSM were included. Studies were excluded if MSM could not be distinguished from men who have sex with women only. We calculated pooled odds ratios (ORs) and their 95% CIs using random-effect models. We assessed risk of bias using the Newcastle-Ottawa scale.
We identified 62 observational studies including 119 248 MSM. Circumcision was associated with 23% reduced odds of HIV infection among MSM overall (OR 0·77, 95% CI 0·67–0·89; number of estimates k=45; heterogeneity I2=77%). Circumcision was protective against HIV infection among MSM in countries of low and middle income (0·58, 0·41–0·83; k=23; I2=77%) but not among MSM in high-income countries (0·99, 0·90–1·09; k=20; I2=40%). Circumcision was associated with reduced odds of herpes simplex virus (HSV) infection among MSM overall (0·84, 0·75–0·95; k=5; I2=0%) and penile human papillomavirus (HPV) infection among HIV-infected MSM (0·71, 0·51–0·99; k=3; I2=0%).
We found evidence that circumcision is likely to protect MSM from HIV infection, particularly in countries of low and middle income. Circumcision might also protect MSM from HSV and penile HPV infection. MSM should be included in campaigns promoting circumcision among men in countries of low and middle income. In view of the substantial proportion of MSM in countries of low and middle income who also have sex with women, well designed longitudinal studies differentiating MSM only and bisexual men are needed to clarify the effect of circumcision on male-to-male transmission of HIV and other STIs.
National Natural Science Foundation of China, National Science and Technology Major Project of China, Australian National Health and Medical Research Council Early Career Fellowship, Sanming Project of Medicine in Shenzhen, National Institutes of Health, Mega Projects of National Science Research for the 13th Five-Year Plan, Doris Duke Charitable Foundation.
Background Peroral endoscopic myotomy (POEM) has been developed to provide a less-invasive myotomy for achalasia in adults but seldom has been used in pediatric patients. Objective To evaluate the ...feasibility, safety, and efficacy of POEM for pediatric patients with achalasia. Design Single-center, prospective study. Setting Academic medical center. Patients A total of 27 pediatric patients (mean age 13.8 years, range 6-17 years) with achalasia. Interventions POEM. Main Outcome Measurements The primary outcome was symptom relief during follow-up, defined as an Eckardt score of ≤3. Secondary outcomes were procedure-related adverse events, clinical reflux adverse events, and lower esophageal sphincter (LES) pressure on manometry before and after POEM. Results A total of 26 cases (96.3%) underwent successful POEM. A submucosal tunnelling attempt failed in 1 case because of serious inflammation and adhesion. No serious adverse events related to POEM were encountered. During a mean follow-up period of 24.6 months (range 15-38 months), treatment success was achieved in all patients (mean score before vs after treatment 8.3 vs 0.7; P < .001). Mean LES pressure also decreased from a mean of 31.6 mm Hg to 12.9 mm Hg after POEM ( P < .001). Five patients developed clinical reflux adverse events (19.2%). Limitations Single center and lack of some objective evaluations. Conclusion This relatively long-term follow-up study adds to the evidence that POEM seems to be a promising new treatment for pediatric patients with achalasia, resulting in long-term symptom relief in all cases and without serious adverse events.
Objective Extracorporeal membrane oxygenation (ECMO) is used to support postcardiotomy cardiogenic shock patients. Elevated serum lactate levels might reflect hypoxia in the tissues, which is ...associated with mortality in critically ill patients. This study examined the association between the early dynamic behavior of lactate and mortality after ECMO support. Methods We included 123 adult patients who had undergone cardiac surgery and received venous-arterial ECMO implantation to treat refractory postcardiotomy cardiogenic shock. The dynamic behaviors of lactate within 6 hours and 12 hours after the beginning of the ECMO support were incorporated into 2 regression models. Results A total of 56% of the patients were successfully weaned from ECMO support. The in-hospital mortality was 65.9% overall. Univariate and multivariate analyses indicated that age (odds ratio OR: 1.1 in the 6-hour model; 1.1 in the 12-hour model), gender (female; OR: 5.6 in the 6-hour model; 7.7 in the 12-hour model), mean lactate concentration (OR: 1.1 in the 6-hour model; 1.2 in the 12-hour model) and lactate clearance (OR: 0.5 in the 6-hour model; 0.1 in the 12-hour model) were reliable predictors ( P < .05) of in-hospital mortality. The mean lactate concentration (C statistic: 0.71) and lactate clearance (C statistic: 0.72) 12 hours after the initiation of ECMO support provided better prognostic guidance. The mean lactate concentration (OR: 1.2) and lactate clearance (OR: 0.3) were able to predict successful weaning from ECMO in the 12-hour model only. Conclusions In addition to age and gender (female), early lactate behaviors, particularly lactate clearance, after ECMO support are highly associated with in-hospital mortality in postcardiotomy patients. Additionally, early lactate behavior is also predictive of successful weaning from ECMO.
Ionizing radiation (IR)-induced pulmonary fibrosis (PF) is an irreversible and severe late effect of thoracic radiation therapy. The goal of this study was to determine whether clearance of senescent ...cells with ABT-263, a senolytic drug that can selectively kill senescent cells, can reverse PF.
C57BL/6J mice were exposed to a single dose of 17 Gy on the right side of the thorax. Sixteen weeks after IR, they were treated with 2 cycles of vehicle or ABT-263 (50 mg/kg per day for 5 days per cycle) by gavage. The effects of ABT-263 on IR-induced increases in senescent cells; elevation in the expression of selective inflammatory cytokines, matrix metalloproteinases, and tissue inhibitors of matrix metalloproteinases; and the severity of the tissue injury and fibrosis in the irradiated lungs were evaluated 3 weeks after the last treatment, in comparison with the changes observed in the irradiated lungs before treatment or after vehicle treatment.
At 16 weeks after exposure of C57BL/6 mice to a single dose of 17 Gy, thoracic irradiation resulted in persistent PF associated with a significant increase in senescent cells. Treatment of the irradiated mice with ABT-263 after persistent PF had developed reduced senescent cells and reversed the disease.
To our knowledge, this is the first study to demonstrate that PF can be reversed by a senolytic drug such as ABT-263 after it becomes a progressive disease. Therefore, ABT-263 has the potential to be developed as a new treatment for PF.
Objective To compare the differences of immunological characteristics between newborn and adults, we performed high-throughput sequencing to reveal the diversity of umbilical cord blood and adult ...peripheral blood at both T-cell receptor beta chain (TRB) and immunoglobulin heavy chain (IGH) levels. Study design High-throughput sequencing was performed to analyze the expression of TRB-CDR3 and IGH-CDR3 in circulating T and B cells isolated from 20 healthy adults, 56 pregnant women, and 40 newborns. Results Our results revealed different immunological characteristics between newborn and adults, such as distinctive complementarity determining region 3 (CDR3) lengths, usage bias of variable and joining segments, random nucleotide addition, a large number of unique CDR3 peptides, and a greater repertoire diversity. Moreover, each newborn had a distinctive TRB-/IGH-CDR3 repertoire that was independent of the maternal immune status. Conclusions This study presents comprehensive, unrestricted profiles of the TRB/IGH-CDR3 repertoire of newborns, pregnant women, and healthy adults at a sequence-level resolution. Our data may contribute to a better understanding of the immune system of newborns and benefit the efficient application of umbilical cord blood transplantation in future.
Abstract Background Pathogenesis and diagnostic biomarkers for diseases can be discovered by metabolomic profiling of human fluids. If the various types of coronary artery disease (CAD) can be ...accurately characterized by metabolomics, effective treatment may be targeted without using unnecessary therapies and resources. Objectives The authors studied disturbed metabolic pathways to assess the diagnostic value of metabolomics-based biomarkers in different types of CAD. Methods A cohort of 2,324 patients from 4 independent centers was studied. Patients underwent coronary angiography for suspected CAD. Groups were divided as follows: normal coronary artery (NCA), nonobstructive coronary atherosclerosis (NOCA), stable angina (SA), unstable angina (UA), and acute myocardial infarction (AMI). Plasma metabolomic profiles were determined by liquid chromatography–quadrupole time-of-flight mass spectrometry and were analyzed by multivariate statistics. Results We made 12 cross-comparisons to and within CAD to characterize metabolic disturbances. We focused on comparisons of NOCA versus NCA, SA versus NOCA, UA versus SA, and AMI versus UA. Other comparisons were made, including SA versus NCA, UA versus NCA, AMI versus NCA, UA versus NOCA, AMI versus NOCA, AMI versus SA, significant CAD (SA/UA/AMI) versus nonsignificant CAD (NCA/NOCA), and acute coronary syndrome (UA/AMI) versus SA. A total of 89 differential metabolites were identified. The altered metabolic pathways included reduced phospholipid catabolism, increased amino acid metabolism, increased short-chain acylcarnitines, decrease in tricarboxylic acid cycle, and less biosynthesis of primary bile acid. For differential diagnosis, 12 panels of specific metabolomics-based biomarkers provided areas under the curve of 0.938 to 0.996 in the discovery phase (n = 1,086), predictive values of 89.2% to 96.0% in the test phase (n = 933), and 85.3% to 96.4% in the 3-center external sets (n = 305). Conclusions Plasma metabolomics are powerful for characterizing metabolic disturbances. Differences in small-molecule metabolites may reflect underlying CAD and serve as biomarkers for CAD progression.
The spread of new coronavirus (SARS-Cov-2) follows a different pattern than previous respiratory viruses, posing a serious public health risk worldwide. World Health Organization (WHO) named the ...disease as COVID-19 and declared it a pandemic. COVID-19 is characterized by highly contagious nature, rapid transmission, swift clinical course, profound worldwide impact, and high mortality among critically ill patients. Chest X-ray, computerized tomography (CT), and ultrasound are commonly used imaging modalities. Among them, ultrasound, due to its portability and non-invasiveness, can be easily moved to the bedside for examination at any time. In addition, with use of 4G or 5G networks, remote ultrasound consultation can also be performed, which allows ultrasound to be used in isolated medial areas. Besides, the contact surface of ultrasound probe with patients is small and easy to be disinfected. Therefore, ultrasound has gotten lots of positive feedbacks from the frontline healthcare workers, and it has played an indispensable role in the course of COVID-19 diagnosis and follow up.
Summary Approximately 27–37% of the people experienced prolonged sleep duration and 12–16% reported shortened sleep duration. However, prolonged or shortened sleep duration may be associated with ...serious health problems. A comprehensive, flexible, non-linear meta-regression with restricted cubic spline (RCS) was used to investigate the dose–response relationship between sleep duration and all-cause mortality in adults. Medline (Ovid), Embase, EBSCOhost—PsycINFO, and EBSCOhost—CINAHL Plus databases, reference lists of relevant review articles, and included studies were searched up to Nov. 29, 2015. Prospective cohort studies investigating the association between sleep duration and all-cause mortality in adults with at least three categories of sleep duration were eligible for inclusion. We eventually included in our study 40 cohort studies enrolling 2,200,425 participants with 271,507 deaths. A J-shaped association between sleep duration and all-cause mortality was present: compared with 7 hours of sleep (reference for 24-hour sleep duration), both shorted and prolonged sleep durations were associated with increased risk of all-cause mortality (4 hours: relative risk RR = 1.05; 95% confidence interval CI = 1.02–1.07; 5 hours: RR = 1.06; 95% CI = 1.03–1.09; 6 hours: RR =1.04; 95% CI = 1.03–1.06; 8 hours: RR = 1.03; 95% CI = 1.02–1.05; 9 hours: RR = 1.13; 95% CI = 1.10–1.16; 10 hours: RR = 1.25; 95% CI = 1.22–1.29; 11 hours: RR = 1.38; 95% CI = 1.33–1.44; n = 29; P < 0.01 for non-linear test). With regard to the night-sleep duration, prolonged night-sleep duration was associated with increased all-cause mortality (8 hours: RR = 1.01; 95% CI = 0.99–1.02; 9 hours: RR = 1.08; 95% CI = 1.04–1.11; 10 hours: RR = 1.24; 95% CI = 1.21–1.28; n = 13; P < 0.01 for non-linear test). Subgroup analysis showed females with short sleep duration a day (<7 h) were at high risk of all-cause mortality (4 hours: RR = 1.07; 95% CI = 1.02–1.13; 5 hours: RR = 1.08; 95% CI = 1.03–1.14; 6 hours: RR = 1.05; 95% CI = 1.02–1.09), but males were not (4 hours: RR = 1.01; 95% CI = 0.96–1.06; 5 hours: RR = 1.02; 95% CI = 0.97–1.08; 6 hours: RR = 1.02; 95% CI = 0.98–1.06). The current evidence suggests that insufficient or prolonged sleep may increase all-cause mortality. Women may be more susceptible to short sleep duration on all-cause mortality. Glossary of terms Restricted cubic spline: A smoothly joined piecewise polynomial with third-order polynomials fitted within each piecewise, which the left and (or) right tail of the curve are (is) restricted to linear. The joints of polynomials refer to knots. This function is usually used to fit the non-linear relationship.
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