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Increased number of symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged time to return to full sports performance—AWAREⅧ

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Journal of Sport and health Science 2024年第3期13卷 280-287,I0001页

作者： Carolette Snyders Marlise Dyer Nicola Sewry Esme Jordaan Martin Schwellnus Sport Exercise Medicine and Lifestyle Institute(SEMLI)Faculty of Health SciencesUniversity of PretoriaPretoria 0083South Africa section Sports Medicine Faculty of Health SciencesUniversity of PretoriaPretoria 0083South Africa IOC Research centre of South Africa Pretoria 0083South Africa Biostatistics Unit South African Medical Research CouncilTygerberg 7505South Africa Statistics and population Studies Department University of the Western CapeCape Town 7535South Africa

Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)*** Prospective cohort study with cross sectional analysis.A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a coronavirus disease 2019 recovery clinic gave a history of age,sex,type/level of sport,co-morbidities,pre-infection training hours,and 26 acute SARS-CoV-2 symptoms from 3 categories(“nose and throat”,“chest and neck”,and“whole body”/systemic).Data on days to RTFP were obtained by structured *** associated with RTFP were demographics,sport participation,history of co-morbidities,pre-infection training history,and acute symptoms(type,number).Outcomes were:(a)days to RTFP(median,interquartile range(IQR))in asymptomatic(n=7)and symptomatic athletes(n=77),and(b)hazard ratios(HRs;95%confidence interval)for symptomatic athletes with *** a factor(univariate,multiple models).HR0.05).Factors associated with prolonged RTFP(univariate models)were:females(HR=0.57;p=0.014),endurance athletes(HR=0.41;p<0.0001),co-morbidity number(HR=0.75;p=0.001),and respiratory disease history(HR=0.54;p=0.026).In symptomatic athletes,prolonged RTFP(multiple models)was significantly associated with increased“chest and neck”(HR=0.85;p=0.017)and“nose and throat”(HR=0.84;p=0.013)symptoms,but the association was more profound between prolonged RFTP and increased total number of“all symptoms”(HR=0.91;p=0.001)and“whole body”/systemic(HR=0.82;p=0.007)*** A larger number of total symptoms and specifically“whole body”/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP.

关键词： Athletes COVID-19 Performance Recovery Return to play

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DNA-delivered monoclonal antibodies targeting the p53 R175H mutant epitope inhibit tumor development in mice

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Genes & Diseases 2024年第4期11卷 368-380页

作者： Dafei Chai Xu Wang Praveen Neeli Shan Zhou Xingfang Yu Kanaga Sabapathy Yong Li Department of Medicine Section of Epidemiology and Population SciencesDan L Duncan Comprehensive Cancer CenterBaylor College of MedicineHoustonTX 77030USA Division of Cellular&Molecular Research Humphrey Oei Institute of Cancer ResearchNational Cancer Centre SingaporeSingapore 168583Singapore

tThe tumor suppressor p53 is the most common mutated gene in cancer,with the R175H as the most frequent p53 missense ***,there are currently no approved targeted therapies or immunotherapies against mutant ***,we characterized and inves-tigated a monoclonal antibody(mAb)that recognizes the mutant p53-R175H for its affinity,specificity,and activity against tumor cells in *** then delivered DNA plasmids expres-sing the anti-R175H mAb or a bispecific antibody(BsAb)into mice to evaluate their therapeutic *** results showed that the anti-R175H mAb specifically bound to the p53-R175H an-tigen with a high affinity and recognized the human mutant p53-R175H antigen expressed on HEK293T or MC38 cells,with no cross-reactivity with wild-type *** cultured cells,the anti-R175H mAb showed higher cytotoxicity than the control but did not induce antibody-dependent cellular *** made a recombinant MC38 mouse cell line(MC38-p53-R175H)that overexpressed the human p53-R175H after knocking out the endogenous mutant p53 *** vivo,administration of the anti-R175H mAb plasmid elicited a robust anti-tumor effect against MC38-p53-R175H in *** administration of the anti-R175H BsAb plasmid showed no therapeutic effects,yet potent anti-tumor activity was observed in combination with the anti-PD-1 *** results indicate that targeting specific mutant epitopes using DNA-delivered mAbs or BsAbs presents a form of improved natural immunity derived from tumor-infiltrating B cells and plasma cells against intracellular tumor antigens.

关键词： BsAb Cytotoxicity mAb Mutant p53 PD-1 R175H

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Incidence of respiratory infections and SARS-CoV-2 is higher during contact phases in student rugby players–Lessons learnt from COVID-19 risk mitigation strategies–AWARE V

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Sports Medicine and health Science 2024年第3期6卷 252-259页

作者： Carolette Snyders Nicola Sewry Wayne Derman Maaike Eken Esme Jordaan Sonja Swanevelder Martin Schwellnus Sport Exercise Medicine and Lifestyle Institute(SEMLI)Faculty of Health SciencesUniversity of PretoriaSouth Africa section Sports Medicine Faculty of Health SciencesUniversity of PretoriaSouth Africa IOC Research centre of South Africa South Africa Institute of Sport and Exercise Medicine Department of ExerciseSport and Lifestyle MedicineFaculty of Medicine and Health SciencesStellenbosch UniversitySouth Africa Biostatistics Unit South African Medical Research CouncilSouth Africa Statistics and population Studies Department University of the Western CapeSouth Africa

The incidence of acute respiratory infections(ARinf),including SARS-CoV-2,in unvaccinated student rugby players during phases from complete lockdown during the COVID-19 pandemic to returning to competition is *** aim of the study was to determine the incidence of ARinf(including SARS-CoV-2)during noncontact and contact phases during the COVID-19 pandemic to evaluate risk mitigation *** this retrospective cohort study,319 top tier rugby players from 17 universities completed an online *** was reported during 4 phases over 14 months(April 2020–May 2021):phase 1(individual training),phase 2(non-contact team training),phase 3(contact team training)and phase 4(competition).Incidence(per 1000 player days)and Incidence Ratio(IR)for‘All ARinf’,and subgroups(SARS-CoV-2;‘Other ARinf’)are *** factors associated with ARinf were also *** incidence of‘All ARinf’(0.31)was significantly higher for SARS-CoV-2(0.23)vs.‘Other ARinf’(0.08)(p<0.01).The incidence of‘All ARinf’(IR¼3.6;p<0.01)and SARS-CoV-2(IR¼4.2;p<0.01)infection was significantly higher during contact(phases 3þ4)compared with non-contact(phases 1þ2).Demographics,level of sport,co-morbidities,allergies,influenza vaccination,injuries and lifestyle habits were not associated with ARinf *** student rugby,contact phases are associated with a 3–4 times higher incidence of ARinf/SARS-CoV-2 compared to non-contact *** risk mitigation strategies in the contact sport setting are *** from this study serve as a platform to which future research on incidence of ARinf in athletes within contact team sports,can be compared.

关键词： COVID-19 Athletes Risk Prevention Epidemiology

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Reducing strain on primary healthcare systems through innovative models of care:the impact of direct access physiotherapy for musculoskeletal conditions—an interrupted time series analysis

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Family Medicine and Community health 2024年第3期12卷 1-12页

作者： James Henry Zouch Bjørnar Berg Are Hugo Pripp Kjersti Storheim Claire E Ashton-James Manuela L Ferreira Margreth Grotle Paulo H Ferreira Sydney Musculoskeletal health Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia centre for Intelligent Musculoskeletal health Oslo Metropolitan University Faculty of Health SciencesOsloNorway Oslo Metropolitan University Faculty of health sciences OsloNorway Oslo centre of Biostatistics and Epidemiology Oslo University HospitalOsloNorway Department of Rehabilitation Science and health Technology Oslo Metropolitan University Faculty of Health SciencesOsloNorway Department of Research and Innovation Oslo University Hospital Division of Clinical NeuroscienceOsloNorway Sydney Medical School Kolling InstituteThe University of Sydney Faculty of Medicine and HealthSydneyNew South WalesAustralia The George Institute for Global health SydneyNew South WalesAustralia Department of Research and Innovation Oslo University HospitalOsloNorway Department of Rehabilitation and Technology Oslo Metropolitan University Faculty of Health SciencesOsloNorway Charles Perkins centre Sydney Musculoskeletal HealthThe University of Sydney Faculty of Medicine and HealthSydneyNew South WalesAustralia

Objectives To evaluate the longitudinal impact of introducing a national,direct access physiotherapy model of care on the rates of primary and secondary care consultations for musculoskeletal(MSK)*** Interrupted time series analysis using segmented linear *** Norway primary care Participants A cohort of 82072 participants was derived from 3 population-based health surveys conducted across separate geographical regions in *** participants surveyed were eligible for inclusion as a national representative sample of the Norwegian *** MSK consultations were linked to the Norwegian Control and Payment of health Reimbursement database and the Norwegian Patient Register using the International Classification of Primary Care diagnostic medical codes L-chapter for MSK conditions and spine related International Classification of Diseases,10th Revision,*** Direct access to physiotherapy model of care introduced nationally in Norway in *** model allowed Norwegians to consult directly with qualified physiotherapists for MSK conditions(eg,back pain,knee osteoarthritis)without the need for a medical referral in order to claim a social security *** outcomes measured Rates of primary care consultations per 10000 population(general practitioner(GP)and physiotherapist consultations)and secondary care(specialist consultations and surgical procedures)measured from 2014 to *** The introduction of the direct access physiotherapy model was associated with an immediate stepped reduction of 391 general practice consultations per 10000 population,(95%CI:−564 to−216),without an associated change in physiotherapy *** analyses suggested there was an associated reduction in physiotherapy consultations for those in the lowest education group of 150 consultations per quarter(95%CI:−203 to−97),70 consultations per quarter in the intermediate education group(95%CI:−115 to−27)and a step

关键词： impact analysis strain

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Temporal trends and practice variation of paediatric diagnostic tests in primary care:retrospective analysis of 14 million tests

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Family Medicine and Community health 2024年第4期12卷 1-8页

作者： Elizabeth T Thomas Diana R Withrow Cynthia Wright Drakesmith Peter J Gill Rafael Perera-Salazar Carl Heneghan centre for Evidence-Based Medicine Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK Nuffield Department of Primary Care health sciences University of OxfordOxfordUK Department of Pediatrics University of TorontoTorontoOntarioCanada Hospital for Sick Children TorontoOntarioCanada

Objective The primary objective was to investigate temporal trends and between-practice variability of paediatric test use in primary *** and analysis This was a descriptive study of population-based data from Clinical practice Research Datalink Aurum primary care consultation records from 1 January 2007 to 31 December *** aged 0–15 who were registered to one of the eligible 1464 general practices and had a diagnostic test code in their clinical record were *** primary outcome measures were(1)temporal changes in test rates measured by the average annual percent change,stratified by test type,gender,age group and deprivation level and(2)practice variability in test use,measured by the coefficient of *** 14299598 diagnostic tests were requested over 27.8 million child-years of observation for 2542101 *** test use increased by 3.6%/year(95%CI 3.4 to 3.8%)from 399/1000 child-years to 608/1000 child-years,driven by increases in blood tests(8.0%/year,95%CI 7.7 to 8.4),females aged 11–15(4.0%/year,95%CI 3.7 to 4.3),and children from the most socioeconomically deprived group(4.4%/year,95%CI 4.1 to 4.8).Tests subject to the greatest temporal increases were faecal calprotectin,fractional exhaled nitric oxide and vitamin *** classified as high-use and high-practice variability were iron studies,coeliac testing,vitamin B12,folate,and vitamin *** In this first nationwide study of paediatric test use in primary care,we observed significant temporal increases and practice variability in *** reflects inconsistency in practice and diagnosis rates and a scarcity of evidence-based *** test use generates more clinical activity with significant resource implications but conversely may improve clinical *** research should evaluate whether increased test use and variability are warranted by exploring test indications and test results and directly examine how increased test use impacts

关键词： vitamin nationwide stratified

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A cross-sectional study to assess medication safety,knowledge,attitude,and practices regarding nutrition and medication among pregnant women

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Asian pacific Journal of Reproduction 2024年第3期13卷 115-119页

作者： Gauthami R Bipin Shaji Twinkle MJS Krishnapriya Radhakrishnan Reshma Kolar Juno Jerold Joel Nitte(Deemed to be University) NGSM Institute of Pharmaceutical Sciences(NGSMIPS)Department of Pharmacy PracticeDeralakatteMangaluruIndia Nitte(Deemed to be University) KS Hegde Medical Academy(KSHEMA)Department of Obstetrics and GynaecologyDeralakatteMangaluruIndia AJ Institute of Medical sciences and Research centre Department of Community MedicineMangaluruKarnatakaIndia

Objective:To assess pregnant women's knowledge,attitude,and practice regarding nutrition and medication usage,analyse the prescribing pattern,and categorize them based on the Food and Drug Administration(FDA)***:A cross-sectional study was conducted with 264 pregnant women in the obstetrics and gynaecology department of a tertiary care hospital from October 2022 to August 2023.A knowledge,attitude,and practice(KAP)questionnaire was prepared in English language by the researchers and validated by an expert panel consisting of 12 *** validated questionnaire was then translated into regional languages,Kannada and *** reliability of the questionnaire was assessed with test-retest method with a representative sample population of 30 subjects(10 subjects for each language).The subjects'knowledge,attitude,and practice were evaluated using the validated KAP *** safety of the medication was assessed using the FDA drug safety classification for ***:The mean scores for nutritional and medication usage knowledge,attitude,and practice were 4.14±1.15,4.50±1.09,and 3.00±1.47,*** 30 prescribed medications,3 belong to category A(no risk in human studies),8 belong to category B(no risk in animal studies),18 belong to category C(risk cannot be ruled out)and 1 drug is not classified.A significant association was observed between medication knowledge and practice(r=0.159,P=0.010).Conclusions:Most of the study population knows the need to maintain good dietary and medication practices during *** pregnant women regarding diet and medication usage is crucial in maternal care.

关键词： Pregnancy Nutrition Medication Knowledge practice Safe medication

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The meta-analyses on effectiveness and safety of colorectal cancer screening

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Chinese Medical Journal 2024年第12期137卷 1471-1473页

作者： Pei Li Xueyang Zeng Zuoxiang Liu Jichun Yang Yueying Li Le Gao Hongmei Zeng Lin Zhang Feng Sun Department of Epidemiology and Biostatistics School of Public HealthPeking UniversityBeijing 100191China Peking Union Medical College Beijing 100005China centre for Safe Medication practice and Research Department of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina Department of Cancer Registry National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China School of population Medicine and Public health Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

To the Editor:The colorectal cancer(CRC)is the fourthmost common cause of cancer deaths in China that was treated as a public health threat,accounting for approximately 10%of all the cancer-caused mortalities each year.[1]It usually takes decades to develop from a polyp to full CRC,[2]which allows a time window for detecting precancerous lesions and taking early steps for preventions and treatments.

关键词： colorectal prevention cancer

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Genome Analysis of Plasmodium falciparum:A Preliminary Observation-Sierra Leone,2022-2023

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China CDC weekly 2024年第17期6卷 368-373页

作者： Tianyu Wang Haimo Shen Bin Xu Wanxuan Yang Shenbo Chen Junhu Chen National Institute of Parasitic Diseases Chinese Center for Disease Control and Prevention(Chinese Center for Tropical Diseases Research)NHC Key Laboratory of Parasite and Vector BiologyWHO Collaborating Centre for Tropical DiseasesNational Centre for International Research on Tropical DiseasesShanghaiChina School of Basic Medical sciences and Forensic Medicine Hangzhou Medical CollegeHangzhou CityZhejiang ProvinceChina School of Global health Chinese Centre for Tropical Diseases ResearchShanghai Jiao Tong University School of MedicineShanghaiChina Hainan Tropical Diseases Research Center(Hainan Sub-Center Chinese Center for Tropical Diseases Research)Haikou CityHainan ProvinceChina.

What is already known about this topic?Sierra Leone,with a gross domestic product(GDP)per capita below$300 and significant poverty,ranks among the world’s least developed countries(LDCs).Despite its modest population of 8.6 million,the nation reports approximately 2.6 million malaria cases ***,there has been no reporting on the malaria genome data from this *** is added by this report?In this study,we present the first reported wholegenome sequence analysis of 19 high parasite-density Plasmodium falciparum isolates from Sierra Leone,providing insights into the genomic epidemiology of this high-prevalence *** found a high degree of relatedness among infections and substantial genetic diversity,consistent with the gradual reduction in overall case ***,our whole-genome analysis revealed that,beyond drug-resistance genes,gene families related to blood cell invasion,immune evasion,and others are undergoing directional *** suggests that the population in Sierra Leone has developed a relatively strong acquired *** are the implications for public health practice?The genomic data not only facilitate the creation of single nucleotide polymorphism barcodes for case tracking but also enable the analysis of evolving transmission dynamics and selection ***,the samples from Sierra Leone exhibited higher selective pressures on resistance genes compared to those from Asia,a trend not commonly observed in other African *** suggests that less stringent healthcare systems and inconsistent treatment strategies can subject parasites to increased drug pressure,thereby accelerating the development of resistant strains.

关键词： epidemiology invasion Observation

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Correlation between non-alcoholic fatty liver disease and metabolic parameters in persons with newly diagnosed type 2 diabetes mellitus

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World Journal of Hepatology 2024年第8期16卷 1120-1130页

作者： Supriyo Mukherjee Sushmita Mukherjee Chun Shing Kwok Anne Phillips Department of Medicine Research Centre for Diabetes Hypertension and ObesitySamastipur 848101India Department of Clinical Ultrasonography Research Centre for Diabetes Hypertension and ObesitySamastipur 848101India Cardiology Registrar University Hospitals of North Midlands NHS Trust United KingdomStaffordshire ST46QGUnited Kingdom Faculty of health Education and Life sciences Department of Post-Qualifying Healthcare PracticeBirmingham City UniversityBirmingham B47APUnited Kingdom

BACKGROUND There are limited studies investigating the association between type 2 diabetes mellitus(T2DM)and non-alcoholic fatty liver disease(NAFLD)in the region of Bihar,*** To estimate the prevalence of NAFLD in persons with newly diagnosed T2DM in the population of North Bihar,*** This single centre cross-sectional study was undertaken in the Research centre for Diabetes Hypertension and Obesity,Samastipur,Bihar,*** were collected from persons newly diagnosed with T2DM or those diagnosed within 6 months of when the study was conducted between December 2022 to May *** A total of 148 people with newly diagnosed T2DM were included(median age 47 years,46.6%female)and 109 patients with liver disease on ultrasound *** persons with liver disease consumed more fats and oils(88.1%vs 74.4%,P=0.042)and they had significantly greater body mass index(27.4 vs 23.0,P<0.001),waist circumference(37 vs 33,P<0.001),and waist-to-hip ratio(1.00 vs 0.70,P=0.025).Females were associated with greater liver disease[odds ratio(OR):3.09,95%confidence interval(CI):1.09-8.80,P=0.32].Waist circumference(OR:1.42,95%CI:1.22-1.66,P<0.001)and low-density lipoprotein cholesterol(OR:1.01,95%CI:1.01-1.02,P=0.048)were associated with any liver *** factors most associated with grade 2/3 liver disease was right upper quadrant pain or heaviness(OR:5.22,95%CI:1.40-19.41,P=0.14),greater income(OR:3.58,95%CI:1.28-10.04,P=0.015)and waist circumference(OR:1.31,95%CI:1.02-1.69,P=0.036).CONCLUSION NAFLD is common in new/recently diagnosed T2DM and disease burden is high and common among patients who are either high consumers of fats and oils or have obesity-associated markers.

关键词： Type 2 diabetes mellitus Non-alcoholic fatty liver disease Prevalence Waist circumference Obesity

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将WHO《心理健康差距干预指南》应用于中国全科医学服务:一项德尔菲研究

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中国全科医学 2024年第1期27卷 15-26页

作者： Kendall Searle Grant Blashki Ritsuko Kakuma 杨辉吕淑荣李宝琪肖莹莹 Harry Minas VIC 3010 Global and Cultural Mental health Unit Centre for Mental HealthSchool of Population and Global HealthUniversity of MelbourneParkvilleAustralia VIC 3010 Nossal Institute for Global health University of MelbourneMelbourneAustralia WC1E 7HTE London School of Hygiene and Tropical Medicine LondonEnglandUK VIC 3168 Monash Institute for health and Clinical Education School of Primary Health CareMonash UniversityNotting HillAustralia 中国科学院大学深圳医院(光明) 广东省深圳市518107

背景中国全科医生越来越期望能够识别和预防抑郁障碍,但其接受的心理健康培训有限,社区卫生服务中心(CHCs)也缺乏针对抑郁障碍的诊断和服务规范。WHO《心理健康差距干预指南》第2版(mhGAP-IG.v2)是为非心理健康专业人员提供的决策支持工... 详细信息

背景中国全科医生越来越期望能够识别和预防抑郁障碍,但其接受的心理健康培训有限,社区卫生服务中心(CHCs)也缺乏针对抑郁障碍的诊断和服务规范。WHO《心理健康差距干预指南》第2版(mhGAP-IG.v2)是为非心理健康专业人员提供的决策支持工具,可用于评估、管理、随访精神障碍、神经疾病及物质使用障碍患者。鉴于mhGAP-IG.v2的通用性,其在中国的应用应根据抑郁障碍在不同文化下的差异性和中国心理健康系统特点进行调整。方法开展两轮基于网络的德尔菲(Delphi)调查。邀请来自深圳市的全科医生小组对mhGAP-IG.v2中涉及抑郁障碍的199条表述进行五分制的赞同程度打分,即“如要把该表述用在深圳市,是否赞同调整其内容和结构”。如果>80%的全科医生“有些/肯定赞同”调整某表述,则视为全科医生对调整该表述达成共识;如果>80%的全科医生“有些/肯定不赞同”调整某表述,则视为全科医生对不调整该表述达成共识。结果全科医生对79%的表述达成了需要调整的共识,平均得分为4.26分,即全科医生“有些赞同”对mh GAP-IG.v2中涉及抑郁障碍的相关表述进行调整。具体调整建议包括:抑郁评估方法应考虑更广泛的抑郁症状,并考虑病情的发展阶段;增加抑郁筛查工具的使用指南;明确全科医生的作用,以及家庭参与和跨部门服务的转诊途径;药物治疗建议应与中国用药规范保持一致;指南所有章节要强调预防自杀;情境化健康教育;强调“以人为本”的服务方法。全科医生认为,应维持mhGAP-IG.v2中对经历抑郁发作的双相障碍患者的诊断和治疗建议。结论对mhGAP-IG.v2抑郁部分的调整研究反映出对指南的评估应考虑文化和国情背景,包括中国特色的初级卫生保健系统、健康优先领域、治疗可得性,以及多样化的社会心理教育需要。调整后的mhGAP-IG.v2可以给中国全科医学教育和全科医疗服务提供参考,也可以为其他国家的非精神病学专业人员开展心理健康服务提供有益借鉴。

关键词：抑郁障碍心理健康差距干预指南德尔菲调整概念化初级保健跨部门服务世界卫生组织中国深圳

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