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Psychiatric comorbidities in epilepsy:population co-occurrence,genetic correlations and causal effects

General Psychiatry 2024年第1期37卷 103-111页

作者： Viktor H Ahlqvist Christina Dardani Paul Madley-Dowd Harriet Forbes Jessica Rast Caichen Zhong Renee M Gardner Christina Dalman Kristen Lyal cRAIG Newschaffer Torbjorn Tomson Michael Lundberg Daniel Berglind Neil M Davies Brian K Lee Cecilia Magnusson Dheeraj Rai Department of Global Public health Karolinska InstitutetStockholmSweden Medical research Council Integrative Epidemiology Unit Bristol Medical SchoolUniversity of BristolBristolUK centre for Academic Mental health Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK Faculty of Epidemiology and Population health London School of Hygiene and Tropical MedicineLondonUK A.J.Drexel Autism Institute Drexel UniversityPhiladelphiaPAUSA Department of Epidemiology and Biostatistics School of Public HealthDrexel UniversityPhiladelphiaPAUSA College of health and Human Development Pennsylvania State UniversityState CollegePAUSA Department of Clinical Neuroscience Karolinska InstitutetStockholmSweden centre for Epidemiology and Community Medicine Region StockholmStockholmSweden K.G Jebsen Center for Genetic Epidemiology Department of Public Health and NursingNorwegian University of Science and TechnologyTrondheimNorway Division of Psychiatry University Collge LondonLondonUK Department of Statistical Sciences University Cllge LondonLondonK nihr Biomedical research centre University of BristoBristolUK Avon and Wiltshire Partnership NHS Mental Health TrustBristolUK

Background Psychiatric comorbidities are common in patients with *** for the co-occurrence of psychiatric conditions and epilepsy remain poorly *** We aimed to triangulate the relationship between epilepsy and psychiatric conditions to determine the extent and possible origins of these *** Using nationwide Swedish health registries,we quantified the lifetime prevalence of psychiatric disorders in patients with *** then used summarydata from genome-wide association studies to investigate whether the identified observational associations could be attributed to a shared underlying genetic aetiology using cross-trait linkage disequilibrium score ***,we assessed the potential bidirectional relationships using two-sample Mendelian *** In a cohort of 7628495 individuals,we found that almost half of the 94435 individuals diagnosed with epilepsy were also diagnosed with a psychiatric condition in their lifetime(adjusted lifetime prevalence,44.09%;95%confidence interval(Cl)43.78%to 44.39%).We found evidence for a genetic correlation between epilepsy and some neurodevelopmental and psychiatric *** example,we observed a genetic correlation between epilepsy and attention-deficit/hyperactivity disorder(r,=0.18,95%Cl 0.09 to 0.27,p<0.001)—a correlation that was more pronounced in focal epilepsy(r=0.23,95%CI 0.09 to 0.36,p<0.001).Findings from Mendelian randomisation using common genetic variants did not support bidirectional effects between epilepsy and neurodevelopmental or psychiatric *** Psychiatric comorbidities are common in patients with *** correlations may partially explain some comorbidities;however,there is little evidence of a bidirectional relationship between the genetic liability of epilepsy and psychiatric *** findings highlight the need to understand the role of environmental factors or rare genetic variations in the origins of psy

关键词： epilepsy Psychiat lifetime

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Impact of pre-existing cardiometabolic diseases on metastatic cancer stage at diagnosis:a prospective multinational cohort study

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Cancer Communications 2024年第5期44卷 593-597页

作者： Anna Jansana Aviane Auguste Marina Kvaskoff Agnès Fournier Emma Fontvieille Laia Peruchet-Noray Carine Biessy Reynalda Cordova Kristina Elin Nielsen Petersen Anne Tjoneland Verena Katzke Rudolf Kaaks Fulvio Ricceri Salvatore Panico Paolo Contiero Maria-Jose Sánchez Jesus Castilla Marta Crous-Bou Alicia Heath Elom Kouassivi Aglago Elisabete Weiderpass Marc James Gunter Pietro Ferrari Elio Riboli Vivian Viallon Heinz Freisling International Agency for research on Cancer(Iarc-WHO) LyonFrance Paris-Saclay University University of Versailles-Saint-Quentin-en-YvelineUniversity Paris-SudFrench National Institute for Health and Medical Research(Inserm)Gustave Roussy“Exposome and Heredity”TeamCESPVillejuifFrance Department of Nutritional Sciences University of ViennaViennaAustria Danish Cancer society research Center CopenhagenDenmark Department of Public health University of CopenhagenCopenhagenDenmark Division of Cancer Epidemiology German Cancer Research CentreHeidelbergGermany Department of Clinical and Biological Sciences University of TurinTurinItaly Unit of Epidemiology Regional Health Service ASL TO3GrugliascoTurinItaly Department of Clinical Medicine and Surgery Federico II UniversityNaplesItaly Environmental Epidemiology Unit Istituto di Ricovero e Cura a Carattere Scientifico(IRCCS)-Istituto Nazionale dei TumoriMilanItaly Cancer Registry of Granada Institute for Biosanitary Research of Granada(ibs.GRANADA)GranadaSpain Epidemiology and Control of Chronic Diseases Group Epidemiology and Public Health Networking Biomedical Research CentreMadridSpain Navarra Public health Institute PamplonaSpain Unit of Nutrition and Cancer Cancer Epidemiology Research ProgramCatalan Institute of Oncology(ICO)-Bellvitge Biomedical Research Institute(IDIBELL)L’Hospitalet de LlobregatBarcelonaSpain Department of Epidemiology Harvard Tseng-Hsi Chan School of Public HealthBostonMassachusettsUSA Department of Epidemiology and Biostatistics School of Public HealthImperial College LondonSt Mary’s CampusNorfolk PlaceLondonUK

Owing to shared risk factors between cardiometabolic diseases(CMDs)and cancer,coupled with population aging,the lifetime risk of an individual developing cancer after a CMD is ***,biological mechanisms such as insulin resistance or inflammation may not only predispose individuals withCMDto an elevated risk of certain types of cancer but also to a diagnosis of cancer at an advanced stage[1,2].

关键词： diagnosis diseases cancer

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Barriers and Facilitators to Implementation of Digital Solutions

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health 2021年第11期13卷 1330-1345页

作者： Elaine Bidmead Catherine McShane nihr arc nenc and centre for research in health and society Institute of Health University of Cumbria Carlisle Cumbria County Durham and Darlington NHS Foundation Trust Darlington Memorial Hospital Darlington UK

Intro/background: The NHS Long term plan calls for “digital-first” solutions, however, many good innovations fail. Barriers to digital innovation in healthcare are well-rehearsed and often predictable. This paper aims to highlight issues to be considered in implementation. Methods: It is a qualitative study of experiences of telehealth implementation. Findings: Staff engagement is crucial to acceptance;compatibility with existing practises helps but where impossible, pathway redesign is necessary. There is a notion that staff of any grade can become digital champions, yet the role is challenging for staff without power. Funding systems can restrict adoption due to associated savings impacting elsewhere in the system. Organisational support for innovation is often apparent but does not trickle down to service level sufficiently. Conclusions: Senior management needs to lead on and support at a micro level the implementation of digitally enabled health care. Funders and commissioners need to recognise that innovation takes time and that measured approaches are more successful.

关键词： Telehealth Telemonitoring Digital health Digital health Adoption Qualitative research

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Preoperative immunonutrition in patients undergoing liver resection:A prospective randomized trial

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World Journal of Hepatology 2019年第3期11卷 305-317页

作者： Kylie Russell Han-Guang Zhang Lyn K GillANDers Adam SJR Bartlett Helena L Fisk Philip C Calder Peter J Swan Lindsay D Plank Nutrition Services Auckland City Hospital Department of Surgery University of Auckland New Zealand Liver Transplant Unit Auckland City Hospital Human Development and health Faculty of Medicine University of Southampton nihr Southampton Biomedical research centre University Hospital Southampton NHS Foundation Trust and University of Southampton

BACKGROUND Preoperative supplementation with immunonutrients, including arginine and n-3 fatty acids, has been shown in a number of systematic reviews to reduce infectious complications in patients who have undergone gastrointestinal surgery. Limited information, however, is available on the benefits of nutritional supplementation enriched with arginine and n-3 fatty acids in patients undergoing liver *** To evaluate the effects of preoperative nutritional supplementation enriched with arginine and n-3 fatty acids on inflammatory and immunologic markers and clinical outcome in patients undergoing liver *** Thirty-four patients undergoing liver resection were randomized to either five days of preoperative Impact? [1020 kcal/d, immunonutrition(IMN) group], or standard care [no supplementation, standard care(STD) group]. Nutritional status was measured at study entry by subjective global assessment(SGA).Functional assessments(grip strength, fatigue and performance status) were carried out at study entry, on the day prior to surgery, and on postoperative day(POD) 7 and 30. Inflammatory and immune markers were measured at study entry, on the day prior to surgery, and POD 1, 3, 5, 7, 10 and 30. Postoperative complications were recorded prospectively until *** A total of 32 patients(17 IMN and 15 STD) were analysed. All except four patients were SGA class A. The plasma ratio of(eicosapentaenoic acid plus docosahexaenoic acid) to arachidonic acid was higher in IMN patients on the day prior to surgery and POD 1, 3, 5 and 7(P < 0.05). Plasma interleukin(IL)-6 concentrations were elevated in the IMN group(P = 0.017 for POD7). No treatment effect was detected for functional measures, immune response(white cell count and total lymphocytes) or markers of inflammation(C-reactive protein,tumour necrosis factor-α, IL-8, IL-10). There were 10 patients with infectious complications in the IMN group and 4 in the STD group(P = 0.087). Median hospital st

关键词： Liver cancer Partial hepatectomy Fish oil Arginine Nutritional status Inflammation

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Using statistics and mathematical modelling to understand infectious disease outbreaks:COVID-19 as an example

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Infectious Disease Modelling 2020年第1期5卷 409-441页

作者： Christopher E.Overton Helena B.Stage Shazaad Ahmad Jacob Curran-Sebastian Paul Dark Rajenki Das Elizabeth Fearon Timothy Felton Martyn Fyles Nick Gent Ian Hall Thomas House Hugo Lewkowicz Xiaoxi Pang Lorenzo Pellis Robert Sawko Andrew Ustianowski Bindu Vekaria Luke Webb Department of Mathematics University of ManchesterUK IBM research Hartree CentreSciTech DaresburyUK Department of Global health and Development London School of Hygiene and Tropical MedicineUK Emergency Response Department Public Health EnglandUK Division of Infection Immunity and Respiratory MedicineNIHR Biomedical Research CentreUniversity of ManchesterUK Department of Virology Manchester Medical Microbiology PartnershipManchester Foundation TrustUK Regional Infectious Diseases Unit North Manchester General HospitalUK School of Medical Sciences University of ManchesterUK Intensive Care Unit Wythenshawe HospitalManchester University NHS Foundation TrustUK Department of health Sciences University of ManchesterUK Department of Mathematical Sciences University of LiverpoolUK The Alan Turing Institute UK Manchester Academic health Sciences centre UK Critical Care Unit Salford Royal HospitalNorthern Care Alliance NHS GroupUK

During an infectious disease outbreak,biases in the data and complexities of the underlying dynamics pose significant challenges in mathematically modelling the outbreak and designing *** by the ongoing response to COVID-19,we provide a toolkit of statistical and mathematical models beyond the simple SIR-type differential equation models for analysing the early stages of an outbreak and assessing *** particular,we focus on parameter estimation in the presence of known biases in the data,and the effect of non-pharmaceutical interventions in enclosed subpopulations,such as households and care *** illustrate these methods by applying them to the COVID-19 pandemic.

关键词： COVID-19 Epidemic modelling Parameter estimation Outbreak Bias Intervention

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Cilostazol and isosorbide mononitrate for the prevention of progression of cerebral small vessel disease:baseline data and statistical analysis plan for the Lacunar Intervention Trial-2(LACI-2)(ISRCTN14911850)

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Stroke & Vascular Neurology 2023年第2期8卷 134-143页

作者： Philip M Bath Iris Mhlanga Lisa J Woodhouse Fergus Doubal Katherine Oatey Alan A Montgomery Joanna M Wardlaw LACI-Trial Investigators Stroke Trials Unit University of NottinghamNottinghamUK centre for Clinical Brain Sciences UK Dementia Research Institute CentreUniversity of EdinburghEdinburghUK Edinburgh Clinical Trials Unit University of EdinburghEdinburghUK Nottingham Clinical Trials Unit University of NottinghamNottinghamUK

Background Cerebral small vessel disease(SVD)causes lacunar strokes(25%of all ischaemic strokes),physical frailty and cognitive impairment and vascular and mixed *** is no specific treatment to prevent progression of *** The LACunar Intervention Trial-2 is an investigator-initiated prospective randomised open-label blinded-endpoint phase II feasibility study assessing cilostazol and isosorbide mononitrate for preventing SVD *** aimed to recruit 400 patients with clinically evident lacunar ischaemic stroke and randomised to cilostazol,isosorbide mononitrate,both or neither,in addition to guideline secondary ischaemic stroke prevention,in a partial factorial *** primary outcome is feasibility of recruitment and adherence to medication;key secondary outcomes include:drug tolerability;recurrent vascular events,cognition and function at 1 year after randomisation;and safety(bleeding,falls,death).Data are number(%)and median(IQR).Results The trial commenced on 5 February 2018 and ceased recruitment on 31 May 2021 with 363 patients randomised,with the following baseline characteristics:average age 64(56.0,72.0)years,female 112(30.9%),stroke onset to randomisation 79.0(27.0,244.0)days,hypertension 267(73.6%),median blood pressures 143.0(130.0,157.0)/83.0(75.0,90.0)mm Hg,current smokers 67(18.5%),educationally achieved end of school examinations(A-level)or higher 118(32.5%),modified Rankin scale 1.0(0.0,1.0),National Institutes health stroke scale 1.0(1.4),Montreal Cognitive Assessment 26.0(23.0,28.0)and total SVD score on brain imaging 1.0(0.0,2.0).This publication summarises the baseline data and presents the statistical analysis *** The trial is currently in follow-up which will complete on 31 May 2022 with results expected in October *** registration number ISRCTN14911850.

关键词： nitrate initiated prevention

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Emerging artificial intelligence applications in liver magnetic resonance imaging

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World Journal of Gastroenterology 2021年第40期27卷 6825-6843页

作者： Charles E Hill Luca Biasiolli Matthew D Robson Vicente Grau Michael Pavlides Department of Engineering Science University of OxfordOxford OX37DQUnited Kingdom Radcliffe Department of Medicine University of OxfordOxford OX39DUUnited Kingdom MR Physics Perspectum LtdOxford OX42LLUnited Kingdom Department of Engineering University of OxfordOxford OX37DQUnited Kingdom Oxford centre for Clinical Magnetic Resonance research Division of Cardiovascular MedicineRadcliffe Department of MedicineUniversity of OxfordOxford OX39DUUnited Kingdom Translational Gastroenterology Unit University of OxfordOxford OX39DUUnited Kingdom Oxford nihr Biomedical research centre University of OxfordOxford OX39DUUnited Kingdom

Chronic liver diseases(CLDs)are becoming increasingly more prevalent in modern *** use of imaging techniques for early detection,such as magnetic resonance imaging(MRI),is crucial in reducing the impact of these diseases on healthcare *** intelligence(AI)algorithms have been shown over the past decade to excel at image-based analysis tasks such as detection and *** applied to liver MRI,they have the potential to improve clinical decision making,and increase throughput by automating *** Liver diseases becoming more prevalent in society,the need to implement these techniques to utilize liver MRI to its full potential,is *** this review,we report on the current methods and applications of AI methods in liver MRI,with a focus on machine learning and deep learning *** assess four main themes of segmentation,classification,image synthesis and artefact detection,and their respective potential in liver MRI and the wider *** provide a brief explanation of some of the algorithms used and explore the current challenges affecting the *** there are many hurdles to overcome in implementing AI methods in the clinic,we conclude that AI methods have the potential to positively aid healthcare professionals for years to come.

关键词： Liver diseases Magnetic resonance imaging Machine learning Deep learning Artificial intelligence Computer vision

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Clinical outcome measures in dementia with Lewy bodies trials: critique and recommendations

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Translational Neurodegeneration 2022年第1期11卷 514-531页

作者： Federico Rodriguez-Porcel Kathryn A.Wyman-Chick Carla Abdelnour Ruiz Jon B.Toledo Daniel Ferreira Prabitha Urwyler Rimona S.Weil Joseph Kane Andrea Pilotto Arvid Rongve Bradley Boeve John-Paul Taylor Ian McKeith Dag Aarsland Simon J.G.Lewis the Lewy Body Dementias Clinical Trials Workgroup from the Lewy Body Dementias Professional Interest Area-Alzheimer’s Association International society to Advance Alzheimer’s research and Treatment(ISTAART) Department of Neurology Medical University of South Carolina208b Rutledge Av.CharlestonSC 29403USA Department of Neurology Center for Memory and AgingHealthPartnersSaint PaulMNUSA Autonomous University of Barcelona BarcelonaSpain Fixel Institute for Neurological Diseases University of FloridaGainesvilleFLUSA Division of Clinical Geriatrics Department of NeurobiologyCare Sciencesand SocietyCenter for Alzheimer’s ResearchKarolinska InstitutetStockholmSweden Department of Radiology Mayo ClinicRochesterMNUSA ARTORG Center for Biomedical Engineering research University of BernBernSwitzerland Dementia research centre University College LondonLondonUK centre for Public health Queen’s UniversityBelfastUK Neurology Unit Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly Department of research and Innovation Helse FonnaHaugesund HospitalHaugesundNorway Institute of Clinical Medicine(K1) The University of Ber-genBergenNorway Department of Neurology Center for Sleep MedicineMayo ClinicRochesterMNUSA Translational and Clinical research Institute Newcastle UniversityNewcastle upon TyneUK Department of Old Age Psychiatry Institute of Psychiatry Psychology and Neuroscience King’s College LondonLondonUK ForeFront Parkinson’s Disease research Clinic Brain and Mind CentreSchool of Medical SciencesUniversity of Sydney100 Mallett StreetCamperdownNSW 2050Australia. 不详

The selection of appropriate outcome measures is fundamental to the design of any successful clinical trial. Although dementia with Lewy bodies (DLB) is one of the most common neurodegenerative conditions, assessment of therapeutic benefit in clinical trials often relies on tools developed for other conditions, such as Alzheimer’s or Parkinson’s disease. These may not be sufficiently valid or sensitive to treatment changes in DLB, decreasing their utility. In this review, we discuss the limitations and strengths of selected available tools used to measure DLB-associated outcomes in clinical trials and highlight the potential roles for more specific objective measures. We emphasize that the existing outcome measures require validation in the DLB population and that DLB-specific outcomes need to be developed. Finally, we highlight how the selection of outcome measures may vary between symptomatic and disease-modifying therapy trials.

关键词： Dementia with Lewy bodies Clinical trials Outcomes Measurement properties

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Polypharmacy Among People Living with Dementia — Israel and 24 Countries in European Union, 2015–2019

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China CDC weekly 2022年第45期4卷 1007-1012页

作者： Shanquan Chen Xi Chen Huanyu Zhang Department of Psychiatry University of CambridgeCambridgeUnited Kingdom School of Public health Yale UniversityNew HavenConnecticutUnited States Shenzhen research Institute the Chinese University of Hong KongShenzhenChina.

What is already known about this topic?With a growing number of people living with dementia(PLWD),the practice of taking multiple medications to manage symptoms or comorbidities,i.e.,polypharmacy,among PLWD has become a global health *** is added by this report?In 2015–2019,polypharmacy for PLWD varied substantially among 25 studied countries,with approximately 1 in 5 Estonian PLWD and 4 in 5 Cypriot PLWD having *** addition,Switzerland,Poland,Austria,and the Czech Republic have experienced a significantly increasing trend in polypharmacy for *** are the implications for public health practice?Countries should pay special attention to polypharmacy and make efforts to control polypharmacy among PLWD,especially in countries where the trend of polypharmacy among PLWD has been increasing.

关键词： medication Israel pharmacy

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Associations of blood biomarkers with glomerular filtration rate in patients with TIA and stroke: population-based study

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Stroke & Vascular Neurology 2021年第1期6卷 48-56页

作者： Dearbhla M.Kelly Linxin Li Annette I Burgess Deborah L Poole Julia M Duerden Peter M.Rothwell Wolfson centre for the Prevention of Stroke and Dementia Nuffield Department of Clinical NeurosciencesOxford UniversityOxfordUK

Background and purpose Non-traditional risk factors such as chronic inflammation,oxidative stress and thrombogenic factors are believed to contribute to the excess stroke risk in chronic kidney disease(CKD)by triggering vascular injury and endothelial *** aimed to determine how well a panel of biomarkers representative of these factors would correlate with estimated glomerular filtration rate(eGFR)in patients with recent transient ischaemic attack(TIA)or *** also investigated whether eGFR would confound previously reported associations between biomarkers and *** We studied a panel of 16 blood biomarkers related to inflammation,thrombosis,atherogenesis and cardiac or neuronal cell damage in TIA or ischaemic stroke in a population-based study(Oxford Vascular Study).Biomarker levels were log-transformed and correlated with eGFR,adjusted for *** proportional hazard models were used for survival *** Among 1297 patients with TIA or stroke,52.7%(n=684)of patients had CKD(eGFR<60 mL/min/1.73 m^(2)).There was a moderate correlation between log-eGFR and the log-transformed soluble tumour necrosis factor receptor-1(R^(2)=0.21),attenuating with adjustment for age(R^(2)=0.12).There were moderate-to strong correlations with markers of cardiac injury,N-terminal pro-brain natriuretic peptide and heart-type fatty acid binding protein(hFABP,R2=0.14 and 0.34,respectively).The strongest correlation after adjustment for age was between hFABP and eGFR(R^(2)=0.20).Adjusting for eGFR did not impact any biomarker associations with *** Correlations between biomarkers related to inflammation and thrombosis with renal dysfunction in the setting of cerebrovascular events were generally modest after adjustment for age,suggesting that putative risk factors such as chronic inflammation or coagulopathy are unlikely to be important stroke mechanisms in patients with CKD.

关键词： inflammation patients mortality

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