Selective serotonin reuptake inhibitors and selective serotonin and norepinephrine reuptake inhibitors use and risk of fractures in adults: a systematic review and meta-analysis

Objective: to evaluate the association between SSRI and SNRI use and risk of fractures in older adults. Methods: We systematically identified and analyzed observational studies comparing SSRI/SNRI use for depression with non-SSRI/SNRI use with a primary outcome of risk of fractures in older adults. We searched for studies in MEDLINE, PsycINFO, EMBASE, DARE, the Cochrane Library, Web of Science clinical trials research registers from 2011 for SSRIs and 1990 for SNRIs to November 29, 2016. Results: Thirty-three studies met our inclusion criteria, 23 studies were included in meta-analysis: 9 case-control studies and 14 cohort studies. A 1.67-fold increase in the risk of fracture for SSRI users compared to non-users was observed (Relative Risk 1.67, 95% CI 1.56-1.79, p=0.000). The risk of fracture increases with their long-term use: within 1 year the risk is 2.9% or one additional fracture in every 85 users; within 5 years the risk is 13.4% or one additional fracture in every 19 users. In meta-regression we found that the increase in risk did not differ across age groups (OR=1.006; p=0.173). A limited number of studies on SNRIs use and the risk of fractures prevented us from conducting a meta-analysis. Conclusions: Our systematic review showed an association between risk of fracture and the use of SSRIs, especially with increasing use. Age does not increase this risk. No such conclusions can be drawn about the effect of SNRIs on the risk of fracture due to a lack of studies

Pharmaceutical adsorption from the primary and secondary effluents of a wastewater treatment plant by powdered activated carbon

<p>This study investigated the powdered activated carbon (PAC) adsorption of 13 pharmaceuticals from the primary (and secondary) effluents of a wastewater treatment plant. In addition to fresh PAC, PAC that was previously used for pharmaceutical elimination from the secondary effluent was also examined for its reuse potential in the primary effluent. The results showed a comparably negligible pharmaceutical uptake by fresh and used PACs in the primary effluent, in contrast to a substantial uptake by both PACs in the secondary effluent. This result indicated a severe adsorption competition induced from the primary effluent organic matter, i.e. the considerably higher constituents of low molecular and hydrophobic components. Furthermore, the competition effect even resulted in a desorption of the negatively charged pharmaceuticals from the used PAC into the primary effluent. It was concluded that adding fresh PAC to the secondary effluent is preferred and that recycling the used PAC into the activated sludge tank could not offer an additional pharmaceutical adsorption.</p

Image_3_A systematic review and meta-analysis comparing the diagnostic capability of automated breast ultrasound and contrast-enhanced ultrasound in breast cancer.jpeg

ObjectiveTo compare the diagnostic performance of automated breast ultrasound (ABUS) and contrast-enhanced ultrasound (CEUS) in breast cancer.MethodsPublished studies were collected by systematically searching the databases PubMed, Embase, Cochrane Library and Web of Science. The sensitivities, specificities, likelihood ratios and diagnostic odds ratio (DOR) were confirmed. The symmetric receiver operator characteristic curve (SROC) was used to assess the threshold of ABUS and CEUS. Fagan’s nomogram was drawn. Meta-regression and subgroup analyses were applied to search for sources of heterogeneity among the included studies.ResultsA total of 16 studies were included, comprising 4115 participants. The combined sensitivity of ABUS was 0.88 [95% CI (0.73–0.95)], specificity was 0.93 [95% CI (0.82–0.97)], area under the SROC curve (AUC) was 0.96 [95% CI (0.94–0.96)] and DOR was 89. The combined sensitivity of CEUS was 0.88 [95% CI (0.84–0.91)], specificity was 0.76 [95% CI (0.66–0.84)], AUC was 0.89 [95% CI (0.86–0.92)] and DOR was 24. The Deeks’ funnel plot showed no existing publication bias. The prospective design, partial verification bias and blinding contributed to the heterogeneity in specificity, while no sources contributed to the heterogeneity in sensitivity. The post-test probability of ABUS in BC was 75%, and the post-test probability of CEUS in breast cancer was 48%.ConclusionCompared with CEUS, ABUS showed higher specificity and DOR for detecting breast cancer. ABUS is expected to further improve the accuracy of BC diagnosis.</p

Image_1_A systematic review and meta-analysis comparing the diagnostic capability of automated breast ultrasound and contrast-enhanced ultrasound in breast cancer.png

ObjectiveTo compare the diagnostic performance of automated breast ultrasound (ABUS) and contrast-enhanced ultrasound (CEUS) in breast cancer.MethodsPublished studies were collected by systematically searching the databases PubMed, Embase, Cochrane Library and Web of Science. The sensitivities, specificities, likelihood ratios and diagnostic odds ratio (DOR) were confirmed. The symmetric receiver operator characteristic curve (SROC) was used to assess the threshold of ABUS and CEUS. Fagan’s nomogram was drawn. Meta-regression and subgroup analyses were applied to search for sources of heterogeneity among the included studies.ResultsA total of 16 studies were included, comprising 4115 participants. The combined sensitivity of ABUS was 0.88 [95% CI (0.73–0.95)], specificity was 0.93 [95% CI (0.82–0.97)], area under the SROC curve (AUC) was 0.96 [95% CI (0.94–0.96)] and DOR was 89. The combined sensitivity of CEUS was 0.88 [95% CI (0.84–0.91)], specificity was 0.76 [95% CI (0.66–0.84)], AUC was 0.89 [95% CI (0.86–0.92)] and DOR was 24. The Deeks’ funnel plot showed no existing publication bias. The prospective design, partial verification bias and blinding contributed to the heterogeneity in specificity, while no sources contributed to the heterogeneity in sensitivity. The post-test probability of ABUS in BC was 75%, and the post-test probability of CEUS in breast cancer was 48%.ConclusionCompared with CEUS, ABUS showed higher specificity and DOR for detecting breast cancer. ABUS is expected to further improve the accuracy of BC diagnosis.</p

sj-pdf-4-imr-10.1177_03000605231184046 - Supplemental material for Association with controlling nutritional status score and disease activity of ulcerative colitis

Supplemental material, sj-pdf-4-imr-10.1177_03000605231184046 for Association with controlling nutritional status score and disease activity of ulcerative colitis by Ziyu Lian, Jingyi Hu, Cheng Cheng, Yajun Liu, Lei Zhu and Hong Shen in Journal of International Medical Research</p

Gene conversion outcomes are unaffected in N-terminal chimeric Rad54 and Rdh54.

(A) Graph representing the red/white/sectored colony outcomes for all strains used in this paper. Strains are labeled in the figure. The bars and error bars represent the mean and standard deviation of at least three independent experiments. (TIF)</p

Image_6_A systematic review and meta-analysis comparing the diagnostic capability of automated breast ultrasound and contrast-enhanced ultrasound in breast cancer.png

ObjectiveTo compare the diagnostic performance of automated breast ultrasound (ABUS) and contrast-enhanced ultrasound (CEUS) in breast cancer.MethodsPublished studies were collected by systematically searching the databases PubMed, Embase, Cochrane Library and Web of Science. The sensitivities, specificities, likelihood ratios and diagnostic odds ratio (DOR) were confirmed. The symmetric receiver operator characteristic curve (SROC) was used to assess the threshold of ABUS and CEUS. Fagan’s nomogram was drawn. Meta-regression and subgroup analyses were applied to search for sources of heterogeneity among the included studies.ResultsA total of 16 studies were included, comprising 4115 participants. The combined sensitivity of ABUS was 0.88 [95% CI (0.73–0.95)], specificity was 0.93 [95% CI (0.82–0.97)], area under the SROC curve (AUC) was 0.96 [95% CI (0.94–0.96)] and DOR was 89. The combined sensitivity of CEUS was 0.88 [95% CI (0.84–0.91)], specificity was 0.76 [95% CI (0.66–0.84)], AUC was 0.89 [95% CI (0.86–0.92)] and DOR was 24. The Deeks’ funnel plot showed no existing publication bias. The prospective design, partial verification bias and blinding contributed to the heterogeneity in specificity, while no sources contributed to the heterogeneity in sensitivity. The post-test probability of ABUS in BC was 75%, and the post-test probability of CEUS in breast cancer was 48%.ConclusionCompared with CEUS, ABUS showed higher specificity and DOR for detecting breast cancer. ABUS is expected to further improve the accuracy of BC diagnosis.</p

DataSheet1_Synthesis of N-Heteroarenemethyl Esters via C–C Bond Cleavage of Acyl Cyanides Under Transition Metal-Free Conditions.PDF

A practical method to synthesize N-heteroaryl esters from N-heteroaryl methanols with acyl cyanides via C–C bond cleavage without using any transition metal is demonstrated here. The use of Na2CO3/15-crown-5 couple enables access to a series of N-heteroaryl esters in high efficiency. This protocol is operationally simple and highly environmentally benign producing only cyanides as byproducts.</p

sj-pdf-1-imr-10.1177_03000605231184046 - Supplemental material for Association with controlling nutritional status score and disease activity of ulcerative colitis

Supplemental material, sj-pdf-1-imr-10.1177_03000605231184046 for Association with controlling nutritional status score and disease activity of ulcerative colitis by Ziyu Lian, Jingyi Hu, Cheng Cheng, Yajun Liu, Lei Zhu and Hong Shen in Journal of International Medical Research</p

Comparison of N-terminal Chimeras for solid red and solid white colonies.

(A). Quantification of sectored red colonies in which both sister chromatids have undergone STGC for BIR or BIR like, CO, and NCO for WT, rdh54Δ/rdh54Δ, rad54Nrdh54/ rad54Nrdh54, and rdh54Nrad54/ rdh54Nrad54 strains. The WT and rdh54Δ strains are reproduced from S1 Fig. The columns represent the mean, and the error bars represent the standard deviation of at least 3 independent experiments. (B). Quantification of sectored white colonies in which both sister chromatid has undergone LTGC for BIR or BIR like, CO, and NCO for WT, rdh54Δ/rdh54Δ, rad54Nrdh54/ rad54Nrdh54, and rdh54Nrad54/ rdh54Nrad54 strains. The WT and rdh54Δ strains are reproduced from S1 Fig. The columns represent the mean, and the error bars represent the standard deviation of at least 3 independent experiments. (TIF)</p