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Investigative Ophthalmology & Visual... Jun 2024To assess the association of age-related macular degeneration (AMD) progression and statins, connected with AMD genetic risk, and if there is an interplay between...
PURPOSE
To assess the association of age-related macular degeneration (AMD) progression and statins, connected with AMD genetic risk, and if there is an interplay between statins and genetics.
METHODS
In this analysis, 682 subjects made two visits (6.5-year follow-up) of the Coimbra Eye Study. Subjects who started taking statins at any time point between the two visits were considered. Progressors were defined as not having AMD at baseline and having any AMD at follow-up. Genetic risk scores (GRSs) were calculated individually with 52 independent variants associated with AMD. Time to progression was estimated using unadjusted Kaplan-Meier curves. An extended Cox model was used for the association between statins and GRS with the risk for AMD progression. Multiplicative and additive interactions were assessed.
RESULTS
Median survival time was 7.50 years for subjects not taking statins and 7.62 for subjects taking statins (P < 0.001). Statin intake reduced the risk for progression to AMD in 48%, adjusting for age, sex, body mass index, smoking, and diabetes (model 1) and GRS (model 2). The combined effects of not taking statins and having high GRS increased the progression risk fourfold compared to taking statins and having low GRS (hazard ratio [HR] = 4.25; 95% confidence interval [CI], 1.62-11.16; P = 0.003). For subjects not taking statins, an increased risk of progression was found for those subjects with high GRS compared to subjects with low GRS (HR = 1.80; 95% CI, 1.13-2.85; P = 0.013). No statistically significant multiplicative or additive interactions were found.
CONCLUSIONS
Statins seem to be protective against AMD progression, and genetics may play a role in treatment response.
Topics: Humans; Male; Female; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Aged; Disease Progression; Macular Degeneration; Follow-Up Studies; Risk Factors; Middle Aged; Aged, 80 and over; Polymorphism, Single Nucleotide; Genetic Predisposition to Disease
PubMed: 38935028
DOI: 10.1167/iovs.65.6.38 -
Journal of Family Psychology : JFP :... Jun 2024Protective parenting, when enacted in contexts that do not require it, predicts child anxiety. Both child (e.g., temperament) and maternal (e.g., physiology and...
Protective parenting, when enacted in contexts that do not require it, predicts child anxiety. Both child (e.g., temperament) and maternal (e.g., physiology and cognition) factors relate to parenting behavior, supporting family systems theory. In order to better understand the development of environmental risk for child anxiety, the present study applied the integrated social information and emotion processing theory to protective parenting, assessing concurrent relations among child temperament, maternal physiology, maternal cognitions, and protective parenting in toddlerhood. The present study also investigated whether the theory could be applied to longitudinal relations, testing cognition as a mechanism by which maternal physiology and child temperament predict maternal protective parenting over time. Study participants included 189 mothers (89.9% White, 2.1% Hispanic, 32.3% with annual household income ≤ $40,000) and children (55.6% male, 81.0% White, 3.7% Hispanic). Results indicated that the theory was partially applicable to both concurrent and prospective mother-child relations implicated in child anxiety development. Namely, child inhibited temperament (IT) related concurrently to maternal beliefs about the harm of child anxiety at child age 1 year, and to maternal protective parenting at child ages 2 and 3 years. Maternal baseline respiratory sinus arrythmia related to protective parenting at child age 3 years. Longitudinally, maternal beliefs at child age 1 year predicted maternal perceptions of child IT at child age 2 years. Maternal beliefs at child age 2 years predicted maternal protective parenting at child age 3 years. Although the mechanistic role of cognition was not supported, child emotion processes and maternal cognitions may uniquely contribute to maternal protective parenting. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
PubMed: 38934913
DOI: 10.1037/fam0001252 -
Polish Archives of Internal Medicine Jun 2024The role of iron homeostasis has become increasingly recognized as a key factor in determining the prognosis of patients with heart failure (HF). Disruptions in iron...
INTRODUCTION
The role of iron homeostasis has become increasingly recognized as a key factor in determining the prognosis of patients with heart failure (HF). Disruptions in iron balance, encompassing deficiency and overload, can affect patient prognosis, therefore, these indicators are considered of significant implications for treatment and management strategies.
OBJECTIVES
The current study intends to delve into the association between iron homeostasis-related indicators and long-term mortality as well as first-admission mortality in individuals with HF.
PATIENTS AND METHODS
Data on 3483 HF patients from the MIMIC IV database were retrospectively analyzed. The relationship between iron homeostasis-related indicators (ferritin, serum iron, transferrin, and total iron binding capacity [TIBC]) and the prognosis of HF patients was discerned utilizing the Cox proportional hazards model and Kaplan-Meier survival analysis. Additionally, the predictive capability of these indicators for patient prognosis was assessed using receiver operating characteristic curve (ROC).
RESULTS
Fourth quartile levels of ferritin and serum iron were obviously associated with poor long-term outcomes in HF patients. Conversely, fourth quartile levels of transferrin and TIBC served as protective factors and were associated with a better prognosis. Additionally, iron homeostasis indicators exhibited a certain predictive value for both long-term mortality and first-admission mortality in HF patients.
CONCLUSIONS
This study underscores the significant association between iron homeostasis indicators and the prognosis of HF patients, providing valuable insights for risk stratification and clinical decision-making for this population. Future studies should focus on the dynamic fluctuations in patients' iron homeostasis and explore intervention measures to improve the prognosis of HF patients.
PubMed: 38934851
DOI: 10.20452/pamw.16788 -
Health Promotion International Jun 2024The article examines the experiences of family caregivers engaged in the provision of long-term care for their relatives with complex health needs within the Latvian...
The article examines the experiences of family caregivers engaged in the provision of long-term care for their relatives with complex health needs within the Latvian context. Semi-structured interviews were conducted with seven caregivers who provide care in cases of dementia, depression, schizophrenia, opioid use, Down syndrome and mild cognitive impairment. A thematic analysis of interview transcripts revealed common themes, such as the initial experiences when encountering a family member's disorder and the subsequent reactions, as well as the quest for support and resources. Variations mainly centered around differences in formal aspects and childhood experiences of care. Caregivers reported risk factors such as guilt, lack of support from family and friends, financial difficulties, deficiency of professional care and ignoring the caregiver's own needs. Awareness of personal resources, values and limits, coping with personal stigma and improved overall quality of life were identified as protective factors. The findings underscore several preventive measures that social and mental health services could implement to mitigate the adverse effects of caregiving on caregivers' lives.
Topics: Humans; Caregivers; Latvia; Female; Male; Middle Aged; Aged; Family; Adaptation, Psychological; Social Support; Interviews as Topic; Adult; Quality of Life; Qualitative Research; Social Stigma; Long-Term Care
PubMed: 38934478
DOI: 10.1093/heapro/daae070 -
Immunity, Inflammation and Disease Jun 2024To investigate the prognostic factors of patients with anti-melanoma differentiation-associated gene 5 (MDA5) positive clinically amyopathic dermatomyositis (CADM) and...
OBJECTIVE
To investigate the prognostic factors of patients with anti-melanoma differentiation-associated gene 5 (MDA5) positive clinically amyopathic dermatomyositis (CADM) and interstitial lung disease (ILD).
METHODS
A retrospective analysis was conducted on clinical data of 125 patients with anti-MDA5 + CADM-ILD collected from 10 branches in eastern China between December 2014 and December 2022. Prognostic factors were analyzed using χ test, Log-rank test, COX and logistic regression analysis.
RESULTS
In this cohort, 125 anti-MDA5 + CADM-ILD patients exhibited a rapidly progressive interstitial lung disease (RPILD) incidence of 37.6%, and an overall mortality rate of 24.8%. One patient was lost to follow-up. After diagnosis of RPILD, a mortality rate of 53.2% occurred in patients died within 3 months, and that of 5.6% appeared in those who survived for more than 3 months. Multiple factor analysis revealed that C-reactive protein (CRP) ≥ 10 mg/L (p = 0.01) and recombinant human tripartite motif containing 21 (Ro52) (+) (p = 0.003) were associated with a higher risk of RPILD in anti-MDA5 + CADM-ILD patients; CRP ≥ 10 mg/L (p = 0.018) and the presence of RPILD (p = 0.003) were identified as the factors influencing survival time in these patients, while arthritis was the protective factor (p = 0.016).
CONCLUSION
Patients with anti-MDA5 + CADM-ILD will have a higher mortality rate, and the initial 3 months after diagnosis of RPILD is considered the risk window for the dismal prognosis. Patients with CRP ≥ 10 mg/L, Ro52 (+) and RPILD may be related to a shorter survival time, while patients complicated with arthritis may present with relatively mild conditions.
Topics: Humans; Lung Diseases, Interstitial; Dermatomyositis; Interferon-Induced Helicase, IFIH1; Male; Female; Prognosis; Middle Aged; Retrospective Studies; Adult; Autoantibodies; China; Aged
PubMed: 38934403
DOI: 10.1002/iid3.1332 -
European Journal of Histochemistry : EJH Jun 2024Cardiomyocyte apoptosis is a complex biological process involving the interaction of many factors and signaling pathways. In hypoxic environment, cardiomyocytes may...
Cardiomyocyte apoptosis is a complex biological process involving the interaction of many factors and signaling pathways. In hypoxic environment, cardiomyocytes may trigger apoptosis due to insufficient energy supply, increased production of oxygen free radicals, and disturbance of intracellular calcium ion balance. The present research aimed to investigate the role of microRNA-29b1 (miR-29b1) in hypoxia-treated cardiomyocytes and its potential mechanism involved. We established an in vitro ischemia model using AC16 and H9C2 cardiomyocytes through hypoxia treatment (1% O2, 48 h). Cell apoptosis was evaluated by flow cytometry using Annexin V FITC-PI staining assay. Moreover, we used Western blot and immunofluorescence analysis to determine the expression of Bcl-2, Bax caspase-3 and Cx43 proteins. We found that miR-29b1 protected AC16 and H9C2 cells from hypoxia-induced injury as evidence that miR-29b1 attenuated the effects of hypoxia treatment on AC16 and H9C2 cell apoptosis after hypoxia treatment. In conclusion, our findings suggest that miR-29b1 may have potential cardiovascular protective effects during ischemia-related myocardial injury.
Topics: Myocytes, Cardiac; Apoptosis; MicroRNAs; Animals; Rats; Cell Hypoxia; Cell Line; Connexin 43; Proto-Oncogene Proteins c-bcl-2
PubMed: 38934067
DOI: 10.4081/ejh.2024.4021 -
Frontiers in Nutrition 2024Epidemiological studies show dietary habits can have an impact on the risk of cholelithiasis, but the relationship is still unclear. We used a comprehensive Mendelian...
BACKGROUND
Epidemiological studies show dietary habits can have an impact on the risk of cholelithiasis, but the relationship is still unclear. We used a comprehensive Mendelian randomization (MR) study to explore the relationship between dietary habits and cholelithiasis.
METHODS
The 18 dietary habits were divided into six categories: meat foods, cereals, vegetables, fruits, dairy products, beverages, and condiments. Cholelithiasis data came from a GWAS meta-analysis and the FinnGen consortium. The inverse variance weighted (IVW), the weighted median (WM), and MR-Egger approaches were used as the main MR analysis methods. In addition, multiple sensitivity analysis and meta-analysis were performed to verify the robustness of the results.
RESULTS
Dried fruit intake [odds ratio (OR) = 0.568; 95% confidence interval (CI), 0.405-0.797; = 0.001] was discovered to reduce the risk of cholelithiasis. The sensitivity analysis and meta-analysis showed reliable results for the relationship between dried fruit intake and cholelithiasis.
CONCLUSION
Our study found that dried fruit intake is a protective factor in the development of cholelithiasis. However, the mechanisms of action need to be further explored.
PubMed: 38933877
DOI: 10.3389/fnut.2024.1377631 -
Trauma Surgery & Acute Care Open 2024The decision to undertake a surgical intervention for an emergency general surgery (EGS) condition (appendicitis, diverticulitis, cholecystitis, hernia, peptic ulcer,...
BACKGROUND
The decision to undertake a surgical intervention for an emergency general surgery (EGS) condition (appendicitis, diverticulitis, cholecystitis, hernia, peptic ulcer, bowel obstruction, ischemic bowel) involves a complex consideration of factors, particularly in older adults. We hypothesized that identifying variability in the application of operative management could highlight a potential pathway to improve patient survival and outcomes.
METHODS
We included adults aged 65+ years with an EGS condition from the 2016-2017 National Inpatient Sample. Operative management was determined from procedure codes. Each patient was assigned a propensity score (PS) for the likelihood of undergoing an operation, modeled from patient and hospital factors: EGS diagnosis, age, gender, race, presence of shock, comorbidities, and hospital EGS volumes. Low and high probability for surgery was defined using a PS cut-off of 0.5. We identified two model-concordant groups (no surgery-low probability, surgery-high probability) and two model-discordant groups (no surgery-high probability, surgery-low probability). Logistic regression estimated the adjusted OR (AOR) of in-hospital mortality for each group.
RESULTS
Of 375 546 admissions, 21.2% underwent surgery. Model-discordant care occurred in 14.6%; 5.9% had no surgery despite a high PS and 8.7% received surgery with low PS. In the adjusted regression, model-discordant care was associated with significantly increased mortality: no surgery-high probability AOR 2.06 (1.86 to 2.27), surgery-low probability AOR 1.57 (1.49 to 1.65). Model-concordant care showed a protective effect against mortality (AOR 0.83, 0.74 to 0.92).
CONCLUSIONS
Nearly one in seven EGS patients received model-discordant care, which was associated with higher mortality. Our study suggests that streamlined treatment protocols can be applied in EGS patients as a means to save lives.
LEVEL OF EVIDENCE
III.
PubMed: 38933602
DOI: 10.1136/tsaco-2023-001288 -
Frontiers in Oncology 2024Multiple myeloma (MM), a malignant disease of plasma cells originating in the bone marrow, is influenced significantly by genetic factors. Although plasma liposomes have...
BACKGROUND
Multiple myeloma (MM), a malignant disease of plasma cells originating in the bone marrow, is influenced significantly by genetic factors. Although plasma liposomes have been linked to MM, the nature of their potential causal relationship remains to be elucidated. This study aims to explore this relationship using Mendelian randomization (MR) analysis.
METHODS
Liposome-associated genetic instrumental variables (IVs) were identified from plasma lipidomics data of 7,174 Finnish individuals within a Genome-Wide Association Study (GWAS) pooled database. A MM pooled dataset was sourced from a GWAS meta-analysis encompassing 150,797 individuals, including 598 MM patients and 218,194 controls. These IVs underwent MR analysis, adhering to strict criteria for correlation, independence, and the exclusion of confounders. The inverse variance weighted (IVW) method, MR-Egger method, weighted median (WM) method, and simple median were utilized for MR analysis assessment, alongside Cochran's Q test, MR-Egger intercept, MR-Pleiotropy Residual Sum and Outlier (MR-RESSO) method, and leave-one-out analysis for evaluating heterogeneity, multiplicity, and instrumental bias.
RESULTS
The study identified 88 significant, independent single nucleotide polymorphisms (SNPs) as IVs for MR analysis, each with an F-statistic value above 10, indicating robustness against weak instrument bias. IVW analysis revealed associations between six plasma liposome components and MM risk (p < 0.05). Phosphatidylinositol (16:0_18:1) serum levels (odds ratio [OR] = 1.769, 95% confidence interval [CI]: 1.132-2.763, p = 0.012) and triacylglycerol (56:4) levels (p = 0.026, OR = 1.417, 95% CI: 1.042-1.926) were positively correlated with the risk of multiple myeloma development. Phosphatidylethanolamine (18:0_20:4) (p = 0.004, 95% CI: 0.621-0.916, OR = 0.754), phosphatidylcholine (18:2_20:4) (p = 0.004, OR = 0.680, 95% CI: 0.519-0.889), sterol ester (27:1/18:3) levels (p = 0.013, OR = 0.677, 95% CI: 0.498-0.922), and phosphatidylcholine (O-18:2_20:4) levels (OR = 0.710, 95% CI: 0.517-0.913, p = 0.033) were negatively associated with the risk of developing multiple myeloma. The Cochran's Q test did not detect statistical method heterogeneity, nor did the MR-RESSO test or the MR-Egger intercept detect horizontal pleiotropy; leave-one-out analyses confirmed the absence of bias from individual SNPs.
CONCLUSIONS
Our findings suggest a complex relationship between plasma liposome components and MM risk. Elevated serum levels of triacylglycerol and phosphatidylinositol are positively associated with MM risk, while certain phospholipids and sterol esters offer a protective effect. This study provides valuable insights into the clinical relevance of liposomes in the pathology of multiple myeloma.
PubMed: 38933448
DOI: 10.3389/fonc.2024.1404744 -
Acta Endocrinologica (Bucharest,... 2023This study aims to investigate the effect of job characteristics and protective factors on burnout, one of the common medical staff issues. So far, little attention has...
OBJECTIVE
This study aims to investigate the effect of job characteristics and protective factors on burnout, one of the common medical staff issues. So far, little attention has been paid to testing protective factors' role on medical staff exhaustion.
DESIGN
Using a correlation design, these constructs were tested on a sample of 221 participants, doctors, and nurses.
MAIN OUTCOME
The present study revealed protective factors power in predicting burnout, over job characteristics, and the moderation effect of role-playing in the medical care unit and clinical department.
MEASURES
For assessing burnout were used a Romanian translated version of the Maslach Burnout Inventory - General Survey (MBI).
RESULTS
Protective factors like physical activities, vacation, and hours spent with family introduced an explanatory model and had a predictive validity over job characteristics in predicting medical staff's burnout. Finally, the effect of physical activities on burnout was moderated both by the role played in the medical care unit and clinical department, while the effect of time served in other medical institutions was moderated only by the role played in the medical care unit.
CONCLUSION
These results provide guidance for better burnout programs interventions, which are addressed to medical healthcare experts.
PubMed: 38933250
DOI: 10.4183/aeb.2023.523