Abstract
Context
Predicting the onset of menopause is important for family planning and to ensure prompt intervention in women at risk of developing menopause-related diseases.
Objective
We aimed to ...summarize risk prediction models of natural menopause onset and their performance.
Methods
Five bibliographic databases were searched up to March 2022. We included prospective studies on perimenopausal women or women in menopausal transition that reported either a univariable or multivariable model for risk prediction of natural menopause onset. Two authors independently extracted data according to the CHARMS (critical appraisal and data extraction for systematic reviews of prediction modelling studies) checklist. Risk of bias was assessed using a prediction model risk of bias assessment tool (PROBAST).
Results
Of 8132 references identified, we included 14 articles based on 8 unique studies comprising 9588 women (mainly Caucasian) and 3289 natural menopause events. All included studies used onset of natural menopause (ONM) as outcome, while 4 studies also predicted early ONM. Overall, there were 180 risk prediction models investigated, with age, anti-Müllerian hormone, and follicle-stimulating hormone being the most investigated predictors. Estimated C-statistic for the prediction models ranged from 0.62 to 0.95. Although all studies were rated at high risk of bias mainly due to the methodological concerns related to the statistical analysis, their applicability was satisfactory.
Conclusion
Predictive performance and generalizability of current prediction models on ONM is limited given that these models were generated from studies at high risk of bias and from specific populations/ethnicities. Although in certain settings such models may be useful, efforts to improve their performance are needed as use becomes more widespread.
Systematic review and meta-analysis.
To determine the difference in cardiovascular risk factors (blood pressure, lipid profile, and markers of glucose metabolism and inflammation) according to the ...neurological level of spinal cord injury (SCI).
We searched 5 electronic databases from inception until July 4, 2020. Data were extracted by two independent reviewers using a pre-defined data collection form. The pooled effect estimate was computed using random-effects models, and heterogeneity was calculated using I
statistic and chi-squared test (CRD42020166162).
We screened 4863 abstracts, of which 47 studies with 3878 participants (3280 males, 526 females, 72 sex unknown) were included in the meta-analysis. Compared to paraplegia, individuals with tetraplegia had lower systolic and diastolic blood pressure (unadjusted weighted mean difference, -14.5 mmHg, 95% CI -19.2, -9.9; -7.0 mmHg 95% CI -9.2, -4.8, respectively), lower triglycerides (-10.9 mg/dL, 95% CI -19.7, -2.1), total cholesterol (-9.9 mg/dL, 95% CI -14.5, -5.4), high-density lipoprotein (-1.7 mg/dL, 95% CI -3.3, -0.2) and low-density lipoprotein (-5.8 mg/dL, 95% CI -9.0, -2.5). Comparing individuals with high- vs. low-thoracic SCI, persons with higher injury had lower systolic and diastolic blood pressure (-10.3 mmHg, 95% CI -13.4, -7.1; -5.3 mmHg 95% CI -7.5, -3.2, respectively), while no differences were found for low-density lipoprotein, serum glucose, insulin, and inflammation markers. High heterogeneity was partially explained by age, prevalent cardiovascular diseases and medication use, body mass index, sample size, and quality of studies.
In SCI individuals, the level of injury may be an additional non-modifiable cardiovascular risk factor. Future well-designed longitudinal studies with sufficient follow-up and providing sex-stratified analyses should confirm our findings and explore the role of SCI level in cardiovascular health and overall prognosis and survival.
Timeliness of vaccinations is rarely part of monitoring in a routine immunization program. We reviewed infant immunization and conducted caregiver interviews in three regions in the Philippines from ...January to October 2016. We randomly selected thirty public health centers, one for each region. We defined timeliness of the receipt of antigen as within 4 weeks after the recommended age at vaccination. We assessed a total of 986 infants for timeliness of vaccination. The median age of receipt of vaccine was at 2.7 weeks (BCG), 10.1 weeks (Penta 1), and 21.7 weeks (Penta 3) compared to the recommended 0, 6, and 14 weeks of age, respectively. We found timely receipt only in 74.4% for BCG, 70.3% for Penta 1, and 39.1% for Penta 3 recipients. Thus, alongside declining immunization coverage, the infants in the Philippines had substantial delays in vaccine receipt.
Dietary phytochemical intake associations with cardiovascular health and mortality remain unknown. We studied the relations between total dietary phytochemical intake and cardiovascular health ...outcomes in a middle-aged Swiss population. We analyzed data spanning 2009 to 2021 from a prospective cohort study in Lausanne, Switzerland, including 3721 participants (54.8% women, 57.2 ± 10.3 years) without cardiovascular disease (CVD) history. Dietary intake was assessed using a validated self-reported food frequency questionnaire. The Dietary Phytochemical Index (DPI) and the healthy Dietary Phytochemical Index (hDPI) were calculated as the total energy intake percentage obtained from phytochemical-rich food consumption. The Healthy Plant-Based Diet Index (hPBD) was estimated by scoring healthy plant foods positively and less-healthy plant foods negatively. Indices tertiles and cardiometabolic outcome associations were determined using Cox proportional hazard models. Over 30,217 person-years of follow-up, 262 CVD events, and 178 deaths occurred. Unadjusted analyses found 36%, 33%, and 32% lower CVD risk for the highest hDPI, DPI, and hPBD tertiles, respectively. After adjustment, only the second hDPI tertile showed a 30% lower CVD risk (HR 0.70, 95% CI 0.51–0.95; P for trend 0.362). No other associations emerged. In this middle-aged Swiss cohort, no associations between dietary indices reflecting a phytochemical-rich dietary pattern and incident CVD, all-cause, or CVD mortality were observed.
Bioactive compounds in Raphanus sativus (radish) have been used to treat several diseases; therefore, radish has attracted increasing scientific attention due to its nutritional and phytochemical ...composition.
The available evidence on the nutrient and bioactive composition of radish was systematically assessed. Four databases (PubMed, Embase, Web of Science, and Cochrane trials) were searched, up to September 26th, 2020, for key articles assessing the chemical composition of radish. Two independent reviewers carried out screening, selection of articles, and data extraction.
Of 1214 references, 63 met our inclusion criteria. We found 609 chemical compounds within 23 categories. Red (30% of all studied varieties), white (13%), and black (6%) radish were the most studied varieties. Nutrients and phytochemicals were reported mainly in roots and leaves. The largest categories were flavonoids (38.8% of the reported data), non-flavonoid polyphenols (8.4%), terpenes and derivatives (8.2%), fat and fatty related compounds (6.4%), and glucosinolates and breakdown products (5.6%). Leaves have high concentrations of macronutrients, calcium, potassium, sodium, fiber, fatty acids, and non-flavonoid polyphenols while sprouts are a major source of flavonoids, specifically anthocyanins, β-carotene and vitamin C. Roots are rich in non-flavonoid polyphenols together with terpenes and derivatives, and glucosinolates, the latter also highly concentrated in seeds. Raphanus sativus is a rich source of nutrients and phytochemicals. Leaves and sprouts could be considered part of a healthy diet, and together with roots, they could be explored as raw material for the development of nutraceuticals.
•Raphanus sativus (radish) has high nutritional and phytochemical potential.•Flavonoids, especially anthocyanins, are the most studied and reported compounds.•Leaves and sprouts have the highest amount of several nutrients and phytochemicals.•The identified compounds exert health benefits through various possible mechanisms.•Leaves and sprouts could be recommended as part of a healthy diet.
•The incidence of Japanese encephalitis in the Philippines was found to be a minimum of 0.7/100,000 in children aged <15 years.•Cases peaked annually from July to October, but occurred all year ...round.•Most confirmed cases were of children aged 2–4 years (n = 194, 23.0%).•Annual minimum incidences were found to be higher in the northern regions of the Philippines.
Findings were published in 2015 that highlighted the endemicity of Japanese Encephalitis (JE) in the Philippines. The policymakers responded by conducting an immunization campaign and strengthening the surveillance system. Using data on the revitalized surveillance system, the epidemiology of JE in the country was updated.
Electronic databases were searched, and conference proceedings related to JE in the Philippines were identified until 31 December 2018. Surveillance data from 01 January 2014 to 31 December 2017 were used. The 2015 population census was used to estimate the national and regional incidence for children aged <15 years.
Four studies reported the seroprevalence of JE in the Philippines, which showed increasing seroprevalence with increasing age. Seroprevalence rates were from 0% for infants (aged <1 year) to 65.7% in adolescents (12–18 years) before the immunization campaign. Among five studies on the clinical profile of JE, case fatality ranged from 0 to 21.1% and neurologic sequelae ranged from 5.2 to 81.8% of diagnosed cases. In the surveillance data, JE cases peaked annually from July to October, coinciding with the wet season. The national incidence was estimated at a minimum of 0.7 JE cases/100,000 among children aged <15 years, but higher rates were seen in the northern regions of the country.
Improved surveillance affirmed the burden of JE in the Philippines. A subnational immunization campaign in April 2019 was conducted in the northern regions of the country. This paper highlights the importance of including the JE vaccine in the immunization program and sustained high-quality surveillance to monitor its impact on JE control.
•Starting in 2012, RVV was introduced in public health clinics of Agusan del Sur province.•Declines in diarrheal hospitalizations and consults were seen following RVV introduction.•No declines in ...diarrheal admissions were observed in a province where RVV was not introduced.•This is the first evidence of the public health impact of RVV in a middle income country Asia.
Monovalent rotavirus (RV) vaccine was introduced in the Philippines in a phased manner beginning in 2012. To assess the impact of RV vaccine, we conducted a retrospective review of diarrheal admissions in two hospitals.
Records of physician-diagnosed diarrheal admissions were reviewed in D.O. Plaza Hospital (DOPH) from 2009 to 2016 in Agusan del Sur where RV vaccine was introduced in the immunization program; and in Cotabato Regional Medical Center (CRMC) from 2011 to 2016 in a region where the vaccine was not introduced. Reports from consultations in public health clinics in Agusan Del Sur and RV vaccine coverage were obtained.
All-cause diarrheal admissions among children <5 years old in DOPH declined from 2013 to 2016 following RV vaccine introduction in 2012. Using the 2009–2011 mean number of hospitalizations as baseline (X‾ = 1,141), the reductions were 28% (n = 821), 56% (n = 507), 63% (n = 417) and 59% (n = 466) in 2013, 2014, 2015 and 2016, respectively. In comparison, no substantial declines in diarrheal hospitalizations were seen in CRMC from 2011 to 2016. A declining trend was also seen in outpatient consultations in Agusan del Sur following RV vaccine introduction with declines of 27% (n = 2,333), 33% (n = 2,143), 45% (n = 1,764) and 67% (n = 1,059) in 2013, 2014, 2015 and 2016. From September 2012 to December 2016, the 1 and 2-dose RV vaccine coverage gradually increased from 5% and 4% in 2012 to 92% and 88% in 2015, but decreased in 2016 to 53% and 52%, respectively.
RV vaccine introduction was associated with a substantial decline in diarrheal hospitalizations and outpatient consultations for diarrhea in Agusan del Sur, Philippines.
Rotavirus (RV) diarrhea is one of the most common cause of childhood morbidity and mortality in the world. The World Health Organization has recommended RV vaccines' use in national immunization ...programs since 2009. However, access to vaccines remain limited, particularly for most low- and middle-income countries where the burden of the disease is high. The Philippines is a lower-middle income country in Asia where RV vaccination remains limited. Recent studies in the Philippines indicate an estimated vaccine effectiveness of 60% against RV hospitalization, and a 50-60% reduction of all cause diarrhea among children aged under 5 within the population. Furthermore, we estimate that 225 rotavirus cases can be prevented per 1000 children vaccinated against RV. This information will be crucial as policymakers decide on expanding RV vaccination nationwide.
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