Risk Factors for the Development of Psoriasis Kamiya, Koji; Kishimoto, Megumi; Sugai, Junichi ...
International journal of molecular sciences,
09/2019, Letnik:
20, Številka:
18
Journal Article
Recenzirano
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Psoriasis is an immune-mediated genetic skin disease. The underlying pathomechanisms involve complex interaction between the innate and adaptive immune system. T cells interact with dendritic cells, ...macrophages, and keratinocytes, which can be mediated by their secreted cytokines. In the past decade, biologics targeting tumor necrosis factor-α, interleukin (IL)-23, and IL-17 have been developed and approved for the treatment of psoriasis. These biologics have dramatically changed the treatment and management of psoriasis. In contrast, various triggering factors can elicit the disease in genetically predisposed individuals. Recent studies suggest that the exacerbation of psoriasis can lead to systemic inflammation and cardiovascular comorbidity. In addition, psoriasis may be associated with other auto-inflammatory and auto-immune diseases. In this review, we summarize the risk factors, which can be divided into two groups (namely, extrinsic and intrinsic risk factors), responsible for the onset and exacerbation of psoriasis in order to facilitate its prevention.
Underdiagnosis and underreporting of scrub typhus has increasingly affected public health in Bhutan since its initial detection in 2008. Identifying scrub typhus risk factors would support early ...diagnosis and treatment for this nonspecific febrile disease, reducing the incidence of potentially fatal complications. We conducted a hospital-based, case‒control study during October‒December 2015 in 11 scrub typhus‒prone districts. We identified harvesting cardamom as the major risk factor (odds ratio 1,519; p<0.001); other factors were traditional housing, largely caused by an outside toilet location, as well as owning a goat and frequently sitting on grass. Harvesting vegetables, herding cattle in the forest, and female sex were protective. Age had a nonlinear effect; children and the elderly were more likely to seek treatment for clinical scrub typhus. This study has informed public health policies and awareness programs for healthcare workers through development of National Guidelines for Prevention, Treatment and Control of Scrub Typhus in Bhutan.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•A safety risk assessment model is developed to evaluate site layout quantitatively.•Risk factors of interaction flows and safety/environmental concerns are analyzed.•Safety risks are assessed by ...rules of risk factors decayed with distance.•The intensity scale and closeness scale are adopted to normalize risk factors.•Reducing resources transportation frequency and distance can improve site safety.
A good site layout is necessary to provide a safe construction site environment. Previous studies treated construction site layout planning as an optimization problem to achieve high safety performance. However, the optimization problem does not contain holistic risk factor analysis. Risk factors such as the dangers of falling objects, noise pollution and hazardous chemicals tend to be neglected. Moreover, when site managers face different site layout scenarios, no safety risk assessment models are currently available to help them make decisions. Therefore, this paper aims to develop a quantitative safety risk assessment model, including factor identification and classification, factor analysis, and assessment function development, to help site managers evaluate different site layout scenarios more accurately and holistically. In factor identification and classification, the interaction flows between facilities are initially considered as risk factors. Safety/environmental concerns which were not deeply probed into by previous studies are also considered. For the above two risk factor categories, safety risk assessment functions are developed according to the likelihood of accident occurrence and the linear attenuation law respectively. Finally, a case study is used to verify the proposed model. This study interprets how to implement site safety management by means of site facility layout improvement. It enriches occupational safety research by providing a systematic model for assessing site layout plans in a quantitative and more valid manner. The findings help conduct effective site safety management by proper facilities displacement during the preconstruction stage and in turn guarantee construction safety in later stages.
IMPORTANCE: Early adversity is associated with leading causes of adult morbidity and mortality and effects on life opportunities. OBJECTIVE: To provide an updated prevalence estimate of adverse ...childhood experiences (ACEs) in the United States using a large, diverse, and representative sample of adults in 23 states. DESIGN, SETTING, AND PARTICIPANTS: Data were collected through the Behavioral Risk Factor Surveillance System (BRFSS), an annual, nationally representative telephone survey on health-related behaviors, health conditions, and use of preventive services, from January 1, 2011, through December 31, 2014. Twenty-three states included the ACE assessment in their BRFSS. Respondents included 248 934 noninstitutionalized adults older than 18 years. Data were analyzed from March 15 to April 25, 2017. MAIN OUTCOMES AND MEASURES: The ACE module consists of 11 questions collapsed into the following 8 categories: physical abuse, emotional abuse, sexual abuse, household mental illness, household substance use, household domestic violence, incarcerated household member, and parental separation or divorce. Lifetime ACE prevalence estimates within each subdomain were calculated (range, 1.00-8.00, with higher scores indicating greater exposure) and stratified by sex, age group, race/ethnicity, annual household income, educational attainment, employment status, sexual orientation, and geographic region. RESULTS: Of the 214 157 respondents included in the sample (51.51% female), 61.55% had at least 1 and 24.64% reported 3 or more ACEs. Significantly higher ACE exposures were reported by participants who identified as black (mean score, 1.69; 95% CI, 1.62-1.76), Hispanic (mean score, 1.80; 95% CI, 1.70-1.91), or multiracial (mean score, 2.52; 95% CI, 2.36-2.67), those with less than a high school education (mean score, 1.97; 95% CI, 1.88-2.05), those with income of less than $15 000 per year (mean score, 2.16; 95% CI, 2.09-2.23), those who were unemployed (mean score, 2.30; 95% CI, 2.21-2.38) or unable to work (mean score, 2.33; 95% CI, 2.25-2.42), and those identifying as gay/lesbian (mean score 2.19; 95% CI, 1.95-2.43) or bisexual (mean score, 3.14; 95% CI, 2.82-3.46) compared with those identifying as white, those completing high school or more education, those in all other income brackets, those who were employed, and those identifying as straight, respectively. Emotional abuse was the most prevalent ACE (34.42%; 95% CI, 33.81%-35.03%), followed by parental separation or divorce (27.63%; 95% CI, 27.02%-28.24%) and household substance abuse (27.56%; 95% CI, 27.00%-28.14%). CONCLUSIONS AND RELEVANCE: This report demonstrates the burden of ACEs among the US adult population using the largest and most diverse sample to date. These findings highlight that childhood adversity is common across sociodemographic characteristics, but some individuals are at higher risk of experiencing ACEs than others. Although identifying and treating ACE exposure is important, prioritizing primary prevention of ACEs is critical to improve health and life outcomes throughout the lifespan and across generations.
Police kill more than 300 black Americans—at least a quarter of them unarmed—each year in the USA. These events might have spillover effects on the mental health of people not directly affected.
In ...this population-based, quasi-experimental study, we combined novel data on police killings with individual-level data from the nationally representative 2013–15 US Behavioral Risk Factor Surveillance System (BRFSS) to estimate the causal impact of police killings of unarmed black Americans on self-reported mental health of other black American adults in the US general population. The primary exposure was the number of police killings of unarmed black Americans occurring in the 3 months prior to the BRFSS interview within the same state. The primary outcome was the number of days in the previous month in which the respondent's mental health was reported as “not good”. We estimated difference-in-differences regression models—adjusting for state-month, month-year, and interview-day fixed effects, as well as age, sex, and educational attainment. We additionally assessed the timing of effects, the specificity of the effects to black Americans, and the robustness of our findings.
38 993 (weighted sample share 49%) of 103 710 black American respondents were exposed to one or more police killings of unarmed black Americans in their state of residence in the 3 months prior to the survey. Each additional police killing of an unarmed black American was associated with 0·14 additional poor mental health days (95% CI 0·07–0·22; p=0·00047) among black American respondents. The largest effects on mental health occurred in the 1–2 months after exposure, with no significant effects estimated for respondents interviewed before police killings (falsification test). Mental health impacts were not observed among white respondents and resulted only from police killings of unarmed black Americans (not unarmed white Americans or armed black Americans).
Police killings of unarmed black Americans have adverse effects on mental health among black American adults in the general population. Programmes should be implemented to decrease the frequency of police killings and to mitigate adverse mental health effects within communities when such killings do occur.
Robert Wood Johnson Foundation and National Institutes of Health.
•Radiomics signature was a prognostic biomarker and stratified patients for HGG.•Age and IDH were important supplements to radiomics signature for low-risk HGG.•Nomogram combining radiomic signature, ...IDH and age improved the predictive performance.
To develop a radiomic signature to predict overall survival (OS) for high-grade glioma (HGG), and construct a nomogram by combining selected radiomic, genetic and clinical risk factors to further improve the performance of the risk model.
147 cases of HGG with MRI images, genetic data, clinical data were studied, wherein 112 patients were used as training cohort, and 35 patients were as independent test cohort. Radiomics features were extracted from tumor area and peritumoral edema area on CE-T1WI and T2FLAIR images. Association between radiomics signature, genetic, clinical risk factors and OS was explored by Kaplan-Meier survival analysis and log rank test. The multivariate Cox regression analysis was trained with radiomic features along with selected genetic and clinical risk factors, which was presented as a nomogram.
The radiomic signature constructed by 11 radiomics features stratified patients into low- and high-risk groups, and the C-Index for OS prediction was 0.707 and 0.711 in training and test cohorts, respectively. The multivariable Cox regression analysis identified radiomics signature (hazard ratio (HR): 2.18, P = 0.005), IDH (HR: 0.490, P = 0.007) and age (HR: 1.039, P = 0.005) as independent risk factors. A nomogram combining these independent risk factors further improved the performance for OS estimation (C-index = 0.764 and 0.758 in training and test cohorts, respectively).
The radiomics signature is a new prognostic biomarker for HGG. A nomogram incorporating radiomics signature, IDH and age improved the performance of OS estimation, which might be a new complement to the treatment guidelines of glioma.
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