Pancreatic cystic lesions(PCLs)are becoming more prevalent due to more frequent abdominal imaging and the increasing age of the general population.It has become crucial to identify these PCLs and subsequently risk str...Pancreatic cystic lesions(PCLs)are becoming more prevalent due to more frequent abdominal imaging and the increasing age of the general population.It has become crucial to identify these PCLs and subsequently risk stratify them to guide management.Given the high morbidity associated with pancreatic surgery,only those PCLs at high risk for malignancy should undergo such treatment.However,current diagnostic testing is suboptimal at accurately diagnosing and risk stratifying PCLs.Therefore,research has focused on developing new techniques for differentiating mucinous from non-mucinous PCLs and identifying high risk lesions for malignancy.Cross sectional imaging radiomics can potentially improve the predictive accuracy of primary risk stratification of PCLs at the time of detection to guide invasive testing.While cyst fluid glucose has reemerged as a potential biomarker,cyst fluid molecular markers have improved accuracy for identifying specific types of PCLs.Endoscopic ultrasound guided approaches such as confocal laser endomicroscopy and through the needle microforceps biopsy have shown a good correlation with histopathological findings and are evolving techniques for identifying and risk stratifying PCLs.While most of these recent diagnostics are only practiced at selective tertiary care centers,they hold a promise that management of PCLs will only get better in the future.展开更多
Background:Physical activity(PA)in the early years is associated with a range of positive health outcomes.Fundamental motor skill(FMS)competence is associated with PA and is theorized to be driven by PA in the early y...Background:Physical activity(PA)in the early years is associated with a range of positive health outcomes.Fundamental motor skill(FMS)competence is associated with PA and is theorized to be driven by PA in the early years and vice versa in mid to late childhood.However,to date,no studies have meta-analyzed the association between PA and FMS in the early years.Methods:Six electronic databases were searched for articles published up to April 2019.Cross-sectional and longitudinal studies were included if they targeted children(ages 3-6 year)as the population of the study and assessed the association between objectively measured PA and FMS.Total FMS,total physical activity(TPA),and moderate-to-vigorous physical activity(MVPA)data were meta-analyzed using a random effects model.Results:We identified 24,815 titles and abstracts.In total,19 studies met the inclusion criteria,including 14 cross-sectional and 4 longitudinal studies,as well as 1 study with cross-sectional and longitudinal analysis.There was a significant but small positive association between FMS and MVPA(r=0.20,95%confidence interval(CI):0.13-0.26)and TPA(r=0.20,95%CI:0.12-0.28).Findings from longitudinal studies revealed that PA drives FMS in early childhood.Mediation was explored in 1 study,which found that perceived motor competence did not mediate the association between FMS and PA.Conclusion:Using a meta-analysis,this study is the first to show a positive association between FMS,MVPA,and TPA in the early years of childhood,suggesting that the association begins at an early age.Limited evidence from longitudinal studies supports the theory that PA drives FMS in the early years of childhood.More evidence is needed from large studies to track PA and FMS until mid to late childhood and to explore the mediators of this association.展开更多
文摘Pancreatic cystic lesions(PCLs)are becoming more prevalent due to more frequent abdominal imaging and the increasing age of the general population.It has become crucial to identify these PCLs and subsequently risk stratify them to guide management.Given the high morbidity associated with pancreatic surgery,only those PCLs at high risk for malignancy should undergo such treatment.However,current diagnostic testing is suboptimal at accurately diagnosing and risk stratifying PCLs.Therefore,research has focused on developing new techniques for differentiating mucinous from non-mucinous PCLs and identifying high risk lesions for malignancy.Cross sectional imaging radiomics can potentially improve the predictive accuracy of primary risk stratification of PCLs at the time of detection to guide invasive testing.While cyst fluid glucose has reemerged as a potential biomarker,cyst fluid molecular markers have improved accuracy for identifying specific types of PCLs.Endoscopic ultrasound guided approaches such as confocal laser endomicroscopy and through the needle microforceps biopsy have shown a good correlation with histopathological findings and are evolving techniques for identifying and risk stratifying PCLs.While most of these recent diagnostics are only practiced at selective tertiary care centers,they hold a promise that management of PCLs will only get better in the future.
文摘Background:Physical activity(PA)in the early years is associated with a range of positive health outcomes.Fundamental motor skill(FMS)competence is associated with PA and is theorized to be driven by PA in the early years and vice versa in mid to late childhood.However,to date,no studies have meta-analyzed the association between PA and FMS in the early years.Methods:Six electronic databases were searched for articles published up to April 2019.Cross-sectional and longitudinal studies were included if they targeted children(ages 3-6 year)as the population of the study and assessed the association between objectively measured PA and FMS.Total FMS,total physical activity(TPA),and moderate-to-vigorous physical activity(MVPA)data were meta-analyzed using a random effects model.Results:We identified 24,815 titles and abstracts.In total,19 studies met the inclusion criteria,including 14 cross-sectional and 4 longitudinal studies,as well as 1 study with cross-sectional and longitudinal analysis.There was a significant but small positive association between FMS and MVPA(r=0.20,95%confidence interval(CI):0.13-0.26)and TPA(r=0.20,95%CI:0.12-0.28).Findings from longitudinal studies revealed that PA drives FMS in early childhood.Mediation was explored in 1 study,which found that perceived motor competence did not mediate the association between FMS and PA.Conclusion:Using a meta-analysis,this study is the first to show a positive association between FMS,MVPA,and TPA in the early years of childhood,suggesting that the association begins at an early age.Limited evidence from longitudinal studies supports the theory that PA drives FMS in the early years of childhood.More evidence is needed from large studies to track PA and FMS until mid to late childhood and to explore the mediators of this association.
