Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial

Objective To evaluate the impact of telling patients their estimated spirometric lung age as an incentive to quit smoking.Design Randomised controlled trial.Setting Five general practices in Hertfordshire, England.Participants 561 current smokers aged over 35.Intervention All participants were offered spirometric assessment of lung function. Participants in intervention group received their results in terms of "lung age" (the age of the average healthy individual who would perform similar to them on spirometry). Those in the control group received a raw figure for forced expiratory volume at one second (FEV1). Both groups were advised to quit and offered referral to local NHS smoking cessation services.Main outcome measures The primary outcome measure was verified cessation of smoking by salivary cotinine testing 12 months after recruitment. Secondary outcomes were reported changes in daily consumption of cigarettes and identification of new diagnoses of chronic obstructive lung disease.Results Follow-up was 89%. Independently verified quit rates at 12 months in the intervention and control groups, respectively, were 13.6% and 6.4% (difference 7.2%, P=0.005, 95% confidence interval 2.2% to 12.1%; number needed to treat 14). People with worse spirometric lung age were no more likely to have quit than those with normal lung age in either group. Cost per successful quitter was estimated at 280 pound ((euro) 365, $556). A new diagnosis of obstructive lung disease was made in 17% in the intervention group and 14% in the control group; a total of 16% (89/561) of participants.Conclusion Telling smokers their lung age significantly improves the likelihood of them quitting smoking, but the mechanism by which this intervention achieves its effect is unclear.Trial registration National Research Register N0096173751

Smoking assessment and work ability trends in asthma patients – prospective and retrospective study approach

Smoking increases the risk of asthma and impairs the prognosis of the disease and therapeutic response. Smoking cessation is an essential part of the treatment of asthma. The comprehensive treatment of asthma is also important for the patient’s work ability. The prevalence of asthma has grown, and an increasing number of workers have to cope with the disease in their working lives. The present study aimed to evaluate how reliably asthmatics reported their smoking status and the changes in smoking habits over the last 15 years. We investigated how actively physicians discuss and document patient’s smoking status. The study also examined the development of the work ability score (WAS) in asthma patients to find risk factors for poor development of WAS. This study included two cohorts. The Finnish obstructive airway disease (CAD) cohort included 1,329 asthma patients and 959 chronic obstructive pulmonary disease patients. Their smoking habits, work ability, and general health were followed by questionnaires during 10-years. The register-based cohort included 35,650 patients, whose electronic health records (EHR) were analysed with a combination of rule-and deep learning (ULMFiT)-based algorithms. Only 6% of asthmatics had unreliability in the self-reported smoking data. Pack years can be considered only a rough estimate of the comprehensive consumption of tobacco products. Based on the algorithmic analysis, 61% of asthma patients had documented smoking status, and 55% of current smokers had discussed smoking cessation with the clinician during the two-year follow-up. In the future, smoking cessation care should be activated in hospitals. The performance of the ULMFiT-based classifier was good and showed that deep-learning-based models can create efficient tools for utilising the Finnish EHR. Over 90% of the patients’ WAS remained stable throughout the 10-year study period, but 8% of the patients who had more severe asthma, higher BMI, and multiple comorbidities showed significantly poorer outcomes. To support asthma patients’ work ability, comprehensive treatment of asthma and comorbidities, regular controls, and weight management are needed.Tupakoinnin arviointi ja työkyvyn trendit astmapotilailla – prospektiivinen ja retrospektiivinen lähestymistapa Tupakointi lisää astmariskiä, heikentää sairauden ennustetta ja terapeuttista vastetta. Tupakoinnin lopettaminen on tärkeä osa astman hoitoa. Astman kokonaisvaltainen hoito on oleellista myös potilaan työkyvyn kannalta. Astman esiintyvyys on kasvanut ja yhä useamman täytyy selviytyä sairauden kanssa työelämässä. Tutkimuksen tavoitteena oli selvittää kuinka luotettavasti astmaatikot raportoivat tupakointitietojaan ja mitkä ovat tupakointitottumusten muutokset viimeisten 15 v aikana. Tutkimme myös kuinka aktiivisesti lääkärit keskustelevat tupakoinnista ja dokumentoivat potilaan tupakointistatuksen sairaskertomukseen. Lisäksi tavoitteena oli tutkia työkykypisteiden (WAS) kehitystä astmapotilailla, jotta löydettäisiin riskitekijöitä työkyvyn heikolle kehitykselle. Tutkimus sisälsi kaksi kohorttia. Astman ja keuhkoahtaumataudin yksilöllinen hoito -tutkimuskohortti (AST) koostui 1329 astma- ja 959 keuhkoahtauma-tautipotilaasta. Heidän tupakointitapojaan, työkykyään ja yleistä terveyttään seurattiin 10 vuoden ajan kyselylomakkeiden avulla. Rekisteripohjainen kohortti koostui 35 650 aikuispotilaasta, joiden sairauskertomustekstejä analysoitiin sääntöpohjaisten ja syväoppimiseen (ULMFiT) perustuvien algoritmien avulla. Vain 6%:lla astmapotilaista itseraportoidut tupakkatiedot olivat epäluotettavia. Askivuosia voidaan käyttää vain karkeana arviona tupakointitaakasta. Algoritmisten analyysien pohjalta 61%:lla astmapotilaista oli tupakointistatus merkittynä sairauskertomukseen ja 55% nykyisistä tupakoitsijoista oli keskustellut lopetta-misesta lääkärin kanssa. Tulevaisuudessa tupakka- ja nikotiiniriippuvuuden hoitoa tulee aktivoida sairaaloissa. ULMFiT:iin perustuvan tupakointiluokittelijan toimivuus oli hyvä ja osoitti, että syväoppimiseen perustuvat mallit voivat luoda tehokkaita työkaluja suomalaisen sairauskertomuksen hyödyntämiseen. Yli 90%:lla potilaista työkykypistemäärä pysyi vakaana 10 vuoden seuranta-ajan, mutta 8%:lla potilaista, joilla oli vaikeampi astma ja enemmän oheissairauksia, tulokset olivat selkeästi heikommat. Astmapotilaiden työkyvyn tukemiseksi tarvitaan astman ja oheissairauksien kokonaisvaltaista hoitoa sekä ohjausta painonhallinnan

2022 Summer Experience Program Abstracts

The mission of the MD Anderson Summer Experience Program is to eliminate cancer, through training of high School, undergraduates and first year medical students to make a lasting impact on training the next generation of scientist and physicians through research and education. The MD Anderson Summer Experience is an umbrella program that comprises 18 summer academic programs at MD Anderson. The summer research program is an 8-10 week program that offers hands-on experience in biomedical, translational or clinical research. In this program, students are matched with a mentor from MD Anderson’s research or clinical faculty. Participants work alongside the mentor in a lab or clinic, on projects designed by faculty to reflect current research. Workshops and lectures provide opportunities to connect with faculty, residents, postdoctoral and clinical fellows, and other participants. Through the program, students assess goals related to careers in oncology research and patient care. The program culminates with a symposium in which participants present talks and posters on their research projects to peers and faculty.https://openworks.mdanderson.org/sumexp22/1061/thumbnail.jp

Diagnóstico no invasivo de patologías humanas combinando análisis de aliento y modelización con redes neuronales

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Ciencias Químicas, leída el 09-09-2016It is currently known that there is a direct relation between the moment a disease is detected or diagnosed and the consequences it will have on the patient, as an early detection is generally linked to a more favorable outcome. This concept is the basis of the present research, due to the fact that its main goal is the development of mathematical tools based on computational artificial intelligence to safely and non-invasively attain the detection of multiple diseases. To reach these devices, this research has focused on the breath analysis of patients with diverse diseases, using several analytical methodologies to extract the information contained in these samples, and multiple feature selection algorithms and neural networks for data analysis. In the past, it has been shown that there is a correlation between the molecular composition of breath and the clinical status of a human being, proving the existence of volatile biomarkers that can aid in disease detection depending on their presence or amount. During this research, two main types of analytical approaches have been employed to study the gaseous samples, and these were cross-reactive sensor arrays (based on organically functionalized silicon nanowire field-effect transistors (SiNW FETs) or gold nanoparticles (GNPs)) and proton transfer reaction-mass spectrometry (PTR-MS). The cross-reactive sensors analyze the bulk of the breath samples, offering global, fingerprint-like information, whereas PTR-MS quantifies the volatile molecules present in the samples. All of the analytical equipment employed leads to the generation of large amounts of data per sample, forcing the need of a meticulous mathematical analysis to adequately interpret the results. In this work, two fundamental types of mathematical tools were utilized. In first place, a set of five filter-based feature selection algorithms (χ2 (chi2) score, Fisher’s discriminant ratio, Kruskal-Wallis test, Relief-F algorithm, and information gain test) were employed to reduce the amount of independent in the large databases to the ones which contain the greatest discriminative power for a further modeling task. On the other hand, and in relation to mathematical modeling, artificial neural networks (ANNs), algorithms that are categorized as computational artificial intelligence, have been employed. These non-linear tools have been used to locate the relations between the independent variables of a system and the dependent ones to fulfill estimations or classifications. The type of ANN that has been used in this thesis coincides with the one that is more commonly employed in research, which is the supervised multilayer perceptron (MLP), due to its proven ability to create reliable models for many different applications...Actualmente es sabido que existe una relación directa entre el momento en el cual se detecta o diagnostica una enfermedad y las consecuencias que tendrá sobre el paciente, ya que una detección temprana va generalmente ligada a un desarrollo más favorable. Este concepto es el cimiento de la presente investigación, cuyo objetivo fundamental es el desarrollo de herramientas basadas en inteligencia artificial computacional que consigan, mediante medios seguros y no invasivos, la detección de diversas enfermedades. Para alcanzar dichos sistemas, los estudios han sido enfocados en el análisis de muestras de aliento de pacientes de diversas enfermedades, empleando varias técnicas para extraer información, y diversos algoritmos de selección de variables y redes neuronales para el procesamiento matemático. En el pasado, se ha comprobado que hay una correlación entre la composición molecular del aliento y el estado clínico de una persona, evidenciando la existencia de biomarcadores volátiles que pueden ayudar a detectar enfermedades, ya sea por su presencia o por su cantidad. Durante el transcurso de esta investigación, se han empleado esencialmente dos tipos de técnicas analíticas para estudiar las muestras gaseosas, y estas son conjuntos de sensores de reactividad cruzada (basados en transistores de efecto de campo con nanocables de silicio (SiNW FETs) o en nanopartículas de oro (GNPs), ambos funcionalizados con cadenas orgánicas) y equipos de reacción de transferencia de protones con espectrometría de masas (PTR-MS). Los sensores de reactividad cruzada analizan el aliento en su conjunto, extrayéndose información de la muestra global, mientras que usando PTR-MS, se cuantifican las moléculas volátiles presentes en las muestras analizadas. Todas las técnicas empleadas desembocan en la generación de grandes cantidades de datos por muestra, por lo que un análisis matemático exhaustivo es necesario para poder sacar el máximo rendimiento de los estudios. En este trabajo, se emplearon principalmente dos tipos de herramientas matemáticas. Las primeras son un grupo de cinco algoritmos de selección de variables, concretamente, filtros de variables (cálculos basados en estadística de χ2 (chi2), ratio discriminante de Fisher, análisis de Kruskal-Wallis, algoritmo relief-F y test de ganancia de información), que se han empleado en las bases de datos con grandes cantidades de variables independientes para localizar aquellas con mayor importancia o poder discriminativo para una tarea de modelización matemática posterior. Por otro lado, en cuando a dicha modelización, se ha empleado un tipo de algoritmo que se cataloga dentro del área de la inteligencia artificial computacional: las redes neuronales artificiales (ANNs). Estas herramientas matemáticas de naturaleza no lineal se han utilizado para localizar las relaciones existentes entre las variables independientes de un sistema y las variables dependientes o parámetros a estimar o clasificar. Se ha empleado el tipo de ANN supervisada más extensamente usado en investigación, que son los perceptrones multicapa (MLPs), debido a su habilidad contrastada para originar modelos fiables para numerosas aplicaciones...Fac. de Ciencias QuímicasTRUEunpu

Evaluation of aspects of screening for oral cancer

Evidence suggests that early detection of oral cancer or precancer decreases both mortality and morbidity. Screening for oral cancer may be an effective health care intervention in view of the annual increase in new registrations of oral cancer and rising mortality rates. Oral cancer meets many of the criteria for a disease suitable for screening, however a need exists for research into the design of a screening programme and the validity of a screening test. Visual examination of the oral mucosa would appear to be a valid instrument for detecting oral cancer and precancer; in this study a selection of qualified dentists achieved this with a sensitivity and specificity of 0.74 and 0.99 respectively. Compliance from an invitational screening programme was disappointingly low (25.7%) compared to other similar programmes suggesting that targeting of high risk individuals may be more effective in detecting lesions. Data from the screened population was modified and used to train a computerised neural network, this was shown to be a useful tool for the identification of people at high risk from oral cancer and could detect lesions with sensitivity (0.80) and specificity (0.77), values comparable to dentists. Health care interventions such as screening programmes are assessed in terms of costs and benefits to the patient and public. Quality of life was compared in terms of utility values between patients treated for small oral cancers and those treated for more major cancers. Utility values for various stages of oral cancer were also obtained from a sample of the public since it is argued that they should play a part in health care decision making. Finally, the potential value of screening was determined using a decision model based on the results obtained from this study

Noncommunicable Diseases

Noncommunicable Diseases: A Compendium introduces readers to noncommunicable diseases (NCDs) – what they are, their burden, their determinants and how they can be prevented and controlled. Focusing on cardiovascular disease, diabetes, cancer and chronic respiratory disease and their five shared main risk factors (tobacco use, harmful use of alcohol, unhealthy diet, physical inactivity and air pollution) as defined by the United Nations, this book provides a synopsis of one of the world’s biggest challenges of the 21st century. NCDs prematurely claim the lives of millions of people across the world every year, with untold suffering to hundreds of millions more, trapping many people in poverty and curtailing economic growth and sustainable development. While resources between and within countries largely differ, the key principles of surveillance, prevention and management apply to all countries, as does the need to focus resources on the most cost-effective and affordable interventions and the need for strong political will, sufficient resources, and sustained and broad partnerships. This compendium consists of 59 short and accessible chapters in six sections: (i) describing and measuring the burden and impact of NCDs; (ii) the burden, epidemiology and priority interventions for individual NCDs; (iii) social determinants and risk factors for NCDs and priority interventions; (iv) global policy; (v) cross-cutting issues; and (vi) stakeholder action. Drawing on the expertise of a large and diverse team of internationally renowned policy and academic experts, the book describes the key epidemiologic features of NCDs and evidence-based interventions in a concise manner that will be useful for policymakers across all parts of society, as well as for public health and clinical practitioners

Advancing health equity, eliminating health disparities, and improving population health

Publication date from document properties.Health-Disparities-Collection_508.pdf01. Advancing Health Equity, Eliminating Health Disparities, and Improving Population Health Jack L Jr. Advancing Health Equity, Eliminating Health Disparities, and Improving Population Health. Prev Chronic Dis 2021;18:210264. / 02. PCD\u2019s Commitment to Advancing Diversity, Equity, and Inclusion in Its Scientific Leadership, Peer-Review Process, Research Focus, Training, and Continuing Education / Jack L Jr. PCD\u2019s Commitment to Advancing Diversity, Equity, and Inclusion in Its Scientific Leadership, Peer-Review Process, Research Focus, Training, and Continuing Education. Prev Chronic Dis 2021;18:210269. -- 03. Engaging With Communities \u2014 Lessons (Re)Learned From COVID-19 / Michener L, Aguilar-Gaxiola S, Alberti PM, Castaneda MJ, Castrucci BC, Harrison LM, et al. Engaging With Communities \u2014 Lessons (Re)Learned From COVID-19. Prev Chronic Dis 2020;17:200250. -- 04. Culture Matters in Communicating the Global Response to COVID-19 / Airhihenbuwa C, Iwelunmor J, Munodawafa D, Ford C, Oni T, Agyemang C, et al. Culture Matters in Communicating the Global Response to COVID-19. Prev Chronic Dis 2020;17:200245. -- 05. Reaching the Hispanic Community About COVID-19 Through Existing Chronic Disease Prevention Programs / Calo WA, Murray A, Francis E, Bermudez M, Kraschnewski J. Reaching the Hispanic Community About COVID-19 Through Existing Chronic Disease Prevention Programs. Prev Chronic Dis 2020;17:200165. -- 06. Community Engagement of African Americans in the Era of COVID-19: Considerations, Challenges, Implications, and Recommendations for Public Health / Henry Akintobi T, Jacobs T, Sabbs D, Holden K, Braithwaite R, Johnson LN, et al. Community Engagement of African Americans in the Era of COVID-19: Considerations, Challenges, Implications, and Recommendations for Public Health. Prev Chronic Dis 2020;17:200255. -- 07. Addressing Racial and Ethnic Disparities in COVID-19 Among School-Aged Children: Are We Doing Enough? -- White A, Liburd LC, Coronado F. Addressing Racial and Ethnic Disparities in COVID-19 Among School-Aged Children: Are We Doing Enough? Prev Chronic Dis 2021;18:210084. -- 08. A Framework for Mobilizing Health Care to Respond to the Community Within the COVID-19 Pandemic / Epps F, Wiley Z, Teunis LJ, Johnson TM II, Patzer RE, Ofotokun I, et al. A Framework for Mobilizing Health Care to Respond to the Community Within the COVID-19 Pandemic. Prev Chronic Dis 2021;18:200572. -- 09. Addressing Emotional Wellness During the COVID-19 Pandemic: the Role of Promotores in Delivering Integrated Mental Health Care and Social Services / Moon KJ, Montiel GI, Cantero PJ, Nawaz S. Addressing Emotional Wellness During the COVID-19 Pandemic: the Role of Promotores in Delivering Integrated Mental Health Care and Social Services. Prev Chronic Dis 2021;18:200656. -- 10. COVID-19 and Chronic Disease: The Impact Now and in the Future / Hacker KA, Briss PA, Richardson L, Wright J, Petersen R. COVID-19 and Chronic Disease: The Impact Now and in the Future. Prev Chronic Dis 2021;18:210086. -- 11. Screening and Referral Care Delivery Services and Unmet Health-Related Social Needs: A Systematic Review / Ruiz Escobar E, Pathak S, Blanchard CM. Screening and Referral Care Delivery Services and Unmet Health-Related Social Needs: A Systematic Review. Prev Chronic Dis 2021;18:200569. -- 12. Community and Research Perspectives on Cancer Disparities in Wisconsin -- Olson J, Cawthra T, Beyer K, Frazer D, Ignace L, Maurana C, et al. Community and Research Perspectives on Cancer Disparities in Wisconsin. Prev Chronic Dis 2020;17:200183. -- 13. Urban\u2013Rural Disparities in Access to Low-Dose Computed Tomography Lung Cancer Screening in Missouri and Illinois / Rohatgi KW, Marx CM, Lewis-Thames MW, Liu J, Colditz GA, James AS. Urban\u2013Rural Disparities in Access to Low-Dose Computed Tomography Lung Cancer Screening in Missouri and Illinois. Prev Chronic Dis 2020;17:200202. -- 14. Quantification of Potential Inequities in Breast Cancer Incidence in New Mexico Through Bayesian Disease Mapping / Zahrieh D, Golafshar MA, Patel SH, DeWees TA. Quantification of Potential Inequities in Breast Cancer Incidence in New Mexico Through Bayesian Disease Mapping. Prev Chronic Dis 2021;18:200468. -- 15. HbA1c Performance in African Descent Populations in the United States With Normal Glucose Tolerance, Prediabetes, or Diabetes: A Scoping Review / Khosla L, Bhat S, Fullington LA, Horlyck-Romanovsky MF. HbA1c Performance in African Descent Populations in the United States With Normal Glucose Tolerance, Prediabetes, or Diabetes: A Scoping Review. Prev Chronic Dis 2021;18:200365. -- 16. Reducing Tobacco Use in Oregon Through Multisector Collaboration: Aligning Medicaid and Public Health Programs / Livingston CJ, Bartelmann SE, Goff NM, Aird KG. Reducing Tobacco Use in Oregon Through Multisector Collaboration: Aligning Medicaid and Public Health Programs. Prev Chronic Dis 2020;17:200220. -- 17. \u201cWe\u2019re, Like, the Most Unhealthy People in the Country\u201c: Using an Equity Lens to Reduce Barriers to Healthy Food Access in Rural Appalachia / Cardarelli K, DeWitt E, Gillespie R, Norman-Burgdolf H, Jones N, Mullins JT. \u201cWe\u2019re, Like, the Most Unhealthy People in the Country\u201d: Using an Equity Lens to Reduce Barriers to Healthy Food Access in Rural Appalachia. Prev Chronic Dis 2020;17:200340. -- 18. Oral Health Behaviors in Very Young Children in Low-Income Urban Areas in Chicago, Illinois, 2018\u20132019 / Martin M, Pugach O, Avenetti D, Lee H, Salazar S, Rosales G, et al. Oral Health Behaviors in -- Very Young Children in Low-Income Urban Areas in Chicago, Illinois, 2018\u20132019. Prev Chronic Dis 2020;17:200213. -- 19. A Randomized Trial to Improve Adherence to Follow-up Eye Examinations Among People With Glaucoma / Leiby BE, Hegarty SE, Zhan T, Myers JS, Katz LJ, Haller JA, et al. A Randomized Trial to Improve Adherence to Follow-up Eye Examinations Among People With Glaucoma. Prev Chronic Dis 2021;18:200567.20211055