Nowadays the system of public health is constructed in such a manner so that its main objective is the recovery of an already sick person, while prediction and prevention receive little attention. Meanwhile the develo...Nowadays the system of public health is constructed in such a manner so that its main objective is the recovery of an already sick person, while prediction and prevention receive little attention. Meanwhile the development of these aspects of medicine can lead to the ability to control morbidity among the population, to identify chronic and genetic diseases in the early stages of development, and thus to prevent their further progression. This will reduce traditionally high costs of sick people treatment and the number of disabled population, and improve the quality and duration of life. The elaboration of new fields of science that are working on the study and interpretation of data obtained during laboratory and clinical research, creation of new methods for diagnosis, prognosis and treatment, provides an opportunity now to implement a new strategy, called PPPM, and gets promising results, which should lead to further development of an existing medicine.展开更多
Background Little is known about the association between stressors(especially positive stressors)during pregnancy and postpartum depression and anxiety.Aims We investigated the association between positive and negativ...Background Little is known about the association between stressors(especially positive stressors)during pregnancy and postpartum depression and anxiety.Aims We investigated the association between positive and negative stress events during different stages of pregnancy and postpartum mental health outcomes among low-income pregnant women with symptoms of anxiety in Pakistan and evaluated whether an intervention based on cognitive behavioural therapy(CBT)had a regulatory effect.Methods Participants were 621 pregnant Pakistani women with mild anxiety.Using the Pregnancy Experience Scale-Brief Version,six scores were created to assess positive and negative stressors.We performed a multivariate linear regression to examine whether these six scores,measured both at baseline and in the third trimester,were associated with postpartum anxiety and depressive symptoms.The effect of the intervention on this relationship was examined by adding an interaction term to the regression model.Results Hassles frequency measured in the third trimester was positively associated with depression(B=0.22,95%confidence interval(Cl):0.09 to 0.36)and anxiety(B=0.19,95%Cl:0.08to 0.30).At the same timepoint,uplifts intensity was negatively associated with symptoms of depression(B=-0.82,95%Cl:1.46 to-0.18)and anxiety(B=-0.70,95%Cl:-1.25 to-0.15),whereas hassles intensity was positively related to symptoms of depression(B=1.02,95%Cl:0.36 to 1.67)and anxiety(B=0.90,95%Cl:0.34 to 1.47).The intensity ratio of hassles to uplifts reported in the third trimester was positively related to both depression(B=1.40,95%Cl:0.59 to 2.20)and anxiety(B=1.26,95%Cl:0.57 to 1.96).The intervention strengthened the overall positive effects of uplfts and the negative effects of hassles.Pregnancy experiences at baseline during early pregnancy to mid-pregnancy were not associated with mental health outcomes.Conclusions Stressors in the third trimester but not earlier in pregnancy were associated with postpartum symptoms of anxiety and depression.The CBT intervention modified the association between pregnancy stressors and postpartum mental health outcomes.Programmes that promote positive experiences and reduce negative experiences,especially in late pregnancy,may mitigate postpartum mental health consequences.展开更多
BACKGROUND There is little research investigating how human immunodeficiency virus(HIV)affects outcomes in orthopaedic surgery.With advances in treatment,HIV has become a chronic health problem and the chance of ortho...BACKGROUND There is little research investigating how human immunodeficiency virus(HIV)affects outcomes in orthopaedic surgery.With advances in treatment,HIV has become a chronic health problem and the chance of orthopaedic surgeons encountering it in clinical practice is increasing.AIM To ascertain the quantity and quality of peer-reviewed publications in orthopaedic journals about HIV.METHODS A search of the Web of Science database was carried out,identifying any articles relating to HIV published in orthopaedic journals.These were assessed for geographic origin and level of evidence.RESULTS Of 48.7%of orthopaedic journals listed on the Web of Science database had published articles relating to HIV.There were 168 articles about HIV in orthopaedic journals with only 40.5%(n=68)published in the time frame we analysed(January 2007 to September 2017).Very few articles came from lowincome countries and any articles published from that setting were collaborations.All of the articles were low level of evidence.CONCLUSION There is a need for more high level orthopaedic and trauma research investigating the effects of HIV,particularly research from low-income countries,where higher level research will help to guide improvements in their treatment of its musculoskeletal manifestations and complications.展开更多
Knowledge of student smoking behaviors and attitudes was sought to inform a proposal to implement a smoke-free university campus. This study assessed prevalence of student smoking and quitting behaviors and associated...Knowledge of student smoking behaviors and attitudes was sought to inform a proposal to implement a smoke-free university campus. This study assessed prevalence of student smoking and quitting behaviors and associated demographic, contextual and attitudinal factors. A cross-sectional design using a convenience sample on a single university site was utilized. Data were collected by anonymous self-administered questionnaires and analyzed using bivariate and multivariable logistic models comparing smokers and non-smokers (Model 1) and daily with occasional smokers Model 2. Of 739 respondents, 19% of students smoked;12% occasional (non-daily) and 7% daily smokers. Smokers were more likely to be ≥22 years and to allow smoking inside their accommodation (Model 1). They were less likely to agree that tobacco was addictive and to consider those who smoked at parties and weekends to be regular smokers. In Model 2, daily smokers were older and nine times more likely to report increased difficulty in handling stress if they quit smoking. Forty-four percent of all smokers had attempted to quit in the past year, 35% of smokers intended to quit in the next 30 days and 53% in the next six months. Forty percent did not use quitting supports. Occasional rather than daily smoking was more prevalent in university students. Smokers differed from non-smokers in their perception of smoking-related health risks. Increasing age was the best predictor of regular and occasional smoking. Intentions to quit smoking and quit attempts were high among all smokers although use of on-site cessation supports was less than the optimal. These combined factors indicate a need for better targeting of our prevention strategies and the need to promote greater awareness of cessation supports for successful implementation of a smoke-free campus.展开更多
Background Changing health care providers frequently breaks the continuity of care,which is associated with many health care problems.The purpose of this study was to examine the association between a change of health...Background Changing health care providers frequently breaks the continuity of care,which is associated with many health care problems.The purpose of this study was to examine the association between a change of health care providers and pregnancy exposure to FDA category C,D and X drugs.Methods A 50% random sample of women who gave a birth in Saskatchewan between January 1,1997 and December 31,2000 were chosen for this study.The association between the number of changes in health care providers and with pregnancy exposure to category C,D,and X drugs for those women with and without chronic diseases were evaluated using multiple logistical regression,with adjusted odds ratios （ORs） and its 95% confidence intervals （C/s） as the association measures.Results A total of 18 568 women were included in this study.Rates of FDA C,D,and X drug uses were 14.35%,17.07%,21.72%,and 31.14%,in women with no change of provider,1-2 changes,3-5 changes,and more than 5 changes of health care providers.An association between the number of changes of health care providers and pregnancy exposure to FDA C,D,and X drugs existed in women without chronic diseases but not in women with chronic disease.Conclusion Change of health care providers is associated with pregnancy exposure to FDA category C,D and X drugs in women without chronic diseases.展开更多
The coronavirus epidemic may affect us far beyond the virus itself.Previously,there was a considerable body of evidence that maternal stress or other limitations caused by adverse events or emergencies,such as natural...The coronavirus epidemic may affect us far beyond the virus itself.Previously,there was a considerable body of evidence that maternal stress or other limitations caused by adverse events or emergencies,such as natural disasters,did indeed have long-term effects on offspring prenatally exposed to the events[1–2].However,we did not find any study that evaluated the long-term impact of a severe infectious disease epidemic as a public health emergency on offspring at the population level.We will have to wait to determine these issues regarding coronavirus disease2019(COVID-19),but we have a natural experiment from the last important coronavirus epidemic.展开更多
BACKGROUND Breast cancer(BC)is the most common cancer among women globally.The WHO estimates 416,000 women are diagnosed to have BC annually in China,and the numbers of BC cases and deaths in China are predicted to ri...BACKGROUND Breast cancer(BC)is the most common cancer among women globally.The WHO estimates 416,000 women are diagnosed to have BC annually in China,and the numbers of BC cases and deaths in China are predicted to rise by 16%and 48%,respectively,over the next 20 years(1).BC can be hereditary,and the most common cause of hereditary BC is an inherited pathogenic or likely pathogenic variant(henceforth called‘pathogenic variant’or‘PV’)in the BRCA1 or BRCA2 genes.BRCA1/BRCA2 PV carriers have a 17%–44%risk of developing ovarian cancer(OC)and a 69%–72%risk of developing BC up to the age of 80(2).PALB2 is a more recently established,highpenetrance BC gene:testing for which is now more widely advocated.PALB2 carriers have a 53%risk of BC up to the age of 80(3).In addition,PALB2 has recently been shown to be a moderate-risk OC gene with a 5%lifetime risk of OC(3).PV in these three genes accounts for around 4%of BC.Most of these cancers are preventable or can be better mitigated if they are detected earlier.展开更多
Humans and other animals have always been battling viruses,especially those that cause emerging and re-emerging infectious diseases.Along with the ongoing COVID-19 pandemic,highly pathogenic avian influenza(HPAI)virus...Humans and other animals have always been battling viruses,especially those that cause emerging and re-emerging infectious diseases.Along with the ongoing COVID-19 pandemic,highly pathogenic avian influenza(HPAI)viruses of the H5 subtype are attacking silently as a re-emerging disease,thus seriously impairing poultry and human health.Recently,there have been outbreaks of the H5N8 subtype of HPAI virus in many regions around the world.According to data available through the Global Animal Disease Information System(http://empres-i.fao.org/)of the Food and Agriculture Organization of the United Nations,a total of 412 HPAI H5N8 outbreaks were reported worldwide from August 31 to December 1,2020,with 353,851 animals confirmed to be infected in 26 countries around the world.Only sporadic cases of this strain were found during the same period in the previous year.展开更多
Virus-induced asthma is prevalent among children,but its underlying mechanisms are unclear.Accumulated evidence indicates that early-life respiratory virus infection increases susceptibility to allergic asthma.Nonethe...Virus-induced asthma is prevalent among children,but its underlying mechanisms are unclear.Accumulated evidence indicates that early-life respiratory virus infection increases susceptibility to allergic asthma.Nonetheless,the relationship between systemic virus infections,such as enterovirus infection,and the ensuing effects on allergic asthma development is unknown.Early-life enterovirus infection was correlated with higher risks of allergic diseases in children.Adult mice exhibited exacerbated mite allergen-induced airway inflammation following recovery from EV-A71 infection in the neonatal period.Bone marrow-derived macrophages(BMDMs)from recovered EV-A71-infected mice showed sustained innate immune memory(trained immunity)that could drive naïve T helper cells toward Th2 and Th17 cell differentiation when in contact with mites.Adoptive transfer of EV-A71-trained BMDMs induced augmented allergic inflammation in naïve recipient mice,which was inhibited by 2-deoxy-D-glucose(2-DG)pretreatment,suggesting that trained macrophages following enterovirus infection are crucial in the progression of allergic asthma later in life.展开更多
文摘Nowadays the system of public health is constructed in such a manner so that its main objective is the recovery of an already sick person, while prediction and prevention receive little attention. Meanwhile the development of these aspects of medicine can lead to the ability to control morbidity among the population, to identify chronic and genetic diseases in the early stages of development, and thus to prevent their further progression. This will reduce traditionally high costs of sick people treatment and the number of disabled population, and improve the quality and duration of life. The elaboration of new fields of science that are working on the study and interpretation of data obtained during laboratory and clinical research, creation of new methods for diagnosis, prognosis and treatment, provides an opportunity now to implement a new strategy, called PPPM, and gets promising results, which should lead to further development of an existing medicine.
基金the National Institute of Mental Health at the US National Institutes of Health(grant number:R01 MH111859).
文摘Background Little is known about the association between stressors(especially positive stressors)during pregnancy and postpartum depression and anxiety.Aims We investigated the association between positive and negative stress events during different stages of pregnancy and postpartum mental health outcomes among low-income pregnant women with symptoms of anxiety in Pakistan and evaluated whether an intervention based on cognitive behavioural therapy(CBT)had a regulatory effect.Methods Participants were 621 pregnant Pakistani women with mild anxiety.Using the Pregnancy Experience Scale-Brief Version,six scores were created to assess positive and negative stressors.We performed a multivariate linear regression to examine whether these six scores,measured both at baseline and in the third trimester,were associated with postpartum anxiety and depressive symptoms.The effect of the intervention on this relationship was examined by adding an interaction term to the regression model.Results Hassles frequency measured in the third trimester was positively associated with depression(B=0.22,95%confidence interval(Cl):0.09 to 0.36)and anxiety(B=0.19,95%Cl:0.08to 0.30).At the same timepoint,uplifts intensity was negatively associated with symptoms of depression(B=-0.82,95%Cl:1.46 to-0.18)and anxiety(B=-0.70,95%Cl:-1.25 to-0.15),whereas hassles intensity was positively related to symptoms of depression(B=1.02,95%Cl:0.36 to 1.67)and anxiety(B=0.90,95%Cl:0.34 to 1.47).The intensity ratio of hassles to uplifts reported in the third trimester was positively related to both depression(B=1.40,95%Cl:0.59 to 2.20)and anxiety(B=1.26,95%Cl:0.57 to 1.96).The intervention strengthened the overall positive effects of uplfts and the negative effects of hassles.Pregnancy experiences at baseline during early pregnancy to mid-pregnancy were not associated with mental health outcomes.Conclusions Stressors in the third trimester but not earlier in pregnancy were associated with postpartum symptoms of anxiety and depression.The CBT intervention modified the association between pregnancy stressors and postpartum mental health outcomes.Programmes that promote positive experiences and reduce negative experiences,especially in late pregnancy,may mitigate postpartum mental health consequences.
文摘BACKGROUND There is little research investigating how human immunodeficiency virus(HIV)affects outcomes in orthopaedic surgery.With advances in treatment,HIV has become a chronic health problem and the chance of orthopaedic surgeons encountering it in clinical practice is increasing.AIM To ascertain the quantity and quality of peer-reviewed publications in orthopaedic journals about HIV.METHODS A search of the Web of Science database was carried out,identifying any articles relating to HIV published in orthopaedic journals.These were assessed for geographic origin and level of evidence.RESULTS Of 48.7%of orthopaedic journals listed on the Web of Science database had published articles relating to HIV.There were 168 articles about HIV in orthopaedic journals with only 40.5%(n=68)published in the time frame we analysed(January 2007 to September 2017).Very few articles came from lowincome countries and any articles published from that setting were collaborations.All of the articles were low level of evidence.CONCLUSION There is a need for more high level orthopaedic and trauma research investigating the effects of HIV,particularly research from low-income countries,where higher level research will help to guide improvements in their treatment of its musculoskeletal manifestations and complications.
文摘Knowledge of student smoking behaviors and attitudes was sought to inform a proposal to implement a smoke-free university campus. This study assessed prevalence of student smoking and quitting behaviors and associated demographic, contextual and attitudinal factors. A cross-sectional design using a convenience sample on a single university site was utilized. Data were collected by anonymous self-administered questionnaires and analyzed using bivariate and multivariable logistic models comparing smokers and non-smokers (Model 1) and daily with occasional smokers Model 2. Of 739 respondents, 19% of students smoked;12% occasional (non-daily) and 7% daily smokers. Smokers were more likely to be ≥22 years and to allow smoking inside their accommodation (Model 1). They were less likely to agree that tobacco was addictive and to consider those who smoked at parties and weekends to be regular smokers. In Model 2, daily smokers were older and nine times more likely to report increased difficulty in handling stress if they quit smoking. Forty-four percent of all smokers had attempted to quit in the past year, 35% of smokers intended to quit in the next 30 days and 53% in the next six months. Forty percent did not use quitting supports. Occasional rather than daily smoking was more prevalent in university students. Smokers differed from non-smokers in their perception of smoking-related health risks. Increasing age was the best predictor of regular and occasional smoking. Intentions to quit smoking and quit attempts were high among all smokers although use of on-site cessation supports was less than the optimal. These combined factors indicate a need for better targeting of our prevention strategies and the need to promote greater awareness of cessation supports for successful implementation of a smoke-free campus.
文摘Background Changing health care providers frequently breaks the continuity of care,which is associated with many health care problems.The purpose of this study was to examine the association between a change of health care providers and pregnancy exposure to FDA category C,D and X drugs.Methods A 50% random sample of women who gave a birth in Saskatchewan between January 1,1997 and December 31,2000 were chosen for this study.The association between the number of changes in health care providers and with pregnancy exposure to category C,D,and X drugs for those women with and without chronic diseases were evaluated using multiple logistical regression,with adjusted odds ratios （ORs） and its 95% confidence intervals （C/s） as the association measures.Results A total of 18 568 women were included in this study.Rates of FDA C,D,and X drug uses were 14.35%,17.07%,21.72%,and 31.14%,in women with no change of provider,1-2 changes,3-5 changes,and more than 5 changes of health care providers.An association between the number of changes of health care providers and pregnancy exposure to FDA C,D,and X drugs existed in women without chronic diseases but not in women with chronic disease.Conclusion Change of health care providers is associated with pregnancy exposure to FDA category C,D and X drugs in women without chronic diseases.
基金the National Social Science Foundation of China(18CRK005)。
文摘The coronavirus epidemic may affect us far beyond the virus itself.Previously,there was a considerable body of evidence that maternal stress or other limitations caused by adverse events or emergencies,such as natural disasters,did indeed have long-term effects on offspring prenatally exposed to the events[1–2].However,we did not find any study that evaluated the long-term impact of a severe infectious disease epidemic as a public health emergency on offspring at the population level.We will have to wait to determine these issues regarding coronavirus disease2019(COVID-19),but we have a natural experiment from the last important coronavirus epidemic.
基金China Medical Board(Grant No.19-336)the National Natural Science Foundation of China(Grant No.71911530221 and 72174010)the National Key Research and Development Program of China(Grant No.2021YFC2500405).
文摘BACKGROUND Breast cancer(BC)is the most common cancer among women globally.The WHO estimates 416,000 women are diagnosed to have BC annually in China,and the numbers of BC cases and deaths in China are predicted to rise by 16%and 48%,respectively,over the next 20 years(1).BC can be hereditary,and the most common cause of hereditary BC is an inherited pathogenic or likely pathogenic variant(henceforth called‘pathogenic variant’or‘PV’)in the BRCA1 or BRCA2 genes.BRCA1/BRCA2 PV carriers have a 17%–44%risk of developing ovarian cancer(OC)and a 69%–72%risk of developing BC up to the age of 80(2).PALB2 is a more recently established,highpenetrance BC gene:testing for which is now more widely advocated.PALB2 carriers have a 53%risk of BC up to the age of 80(3).In addition,PALB2 has recently been shown to be a moderate-risk OC gene with a 5%lifetime risk of OC(3).PV in these three genes accounts for around 4%of BC.Most of these cancers are preventable or can be better mitigated if they are detected earlier.
基金The National Natural Science Foundation of China(3191101787,31970153)Strategic Priority Research Program of the Chinese Academy of Sciences(XDB29010000))+1 种基金National Key R&D Program of China(2016YFD0500206)Biotechnology and Biosciences Research Council(BBSRC)Institute Strategic Programme Grant:Control of Infectious Diseases BBS/E/D/20002173,Scottish Government Rural and Environment Science and Analytical Services Division as part of the Centre of Expertise on Animal Disease Outbreaks(EPIC),and Youth Innovation Promotion Association of CAS(2019091)provided funding for this work.
文摘Humans and other animals have always been battling viruses,especially those that cause emerging and re-emerging infectious diseases.Along with the ongoing COVID-19 pandemic,highly pathogenic avian influenza(HPAI)viruses of the H5 subtype are attacking silently as a re-emerging disease,thus seriously impairing poultry and human health.Recently,there have been outbreaks of the H5N8 subtype of HPAI virus in many regions around the world.According to data available through the Global Animal Disease Information System(http://empres-i.fao.org/)of the Food and Agriculture Organization of the United Nations,a total of 412 HPAI H5N8 outbreaks were reported worldwide from August 31 to December 1,2020,with 353,851 animals confirmed to be infected in 26 countries around the world.Only sporadic cases of this strain were found during the same period in the previous year.
基金This study was,in part,supported by the Centre of Allergy and Mucosal Immunity,Headquarters of University Advancement at the National Cheng Kung University,Ministry of Education,Taiwan.H.J.T is supported in part by a grant from the National Health Research Institutes(PI:Tsai,PH-101-PP-14,PH-101-SP-14,and PH-108-PP-08).
文摘Virus-induced asthma is prevalent among children,but its underlying mechanisms are unclear.Accumulated evidence indicates that early-life respiratory virus infection increases susceptibility to allergic asthma.Nonetheless,the relationship between systemic virus infections,such as enterovirus infection,and the ensuing effects on allergic asthma development is unknown.Early-life enterovirus infection was correlated with higher risks of allergic diseases in children.Adult mice exhibited exacerbated mite allergen-induced airway inflammation following recovery from EV-A71 infection in the neonatal period.Bone marrow-derived macrophages(BMDMs)from recovered EV-A71-infected mice showed sustained innate immune memory(trained immunity)that could drive naïve T helper cells toward Th2 and Th17 cell differentiation when in contact with mites.Adoptive transfer of EV-A71-trained BMDMs induced augmented allergic inflammation in naïve recipient mice,which was inhibited by 2-deoxy-D-glucose(2-DG)pretreatment,suggesting that trained macrophages following enterovirus infection are crucial in the progression of allergic asthma later in life.
