Macrovascular and microvascular disease in obese patients with type 2 diabetes attending structured diabetes education program: a population-based propensity-matched cohort analysis of Patient Empowerment Programme (PEP)

Patient Empowerment Programme (PEP) in primary care was effective in preventing diabetes-related complications in patients with diabetes. Nevertheless, the effect of PEP on glycaemic control, weight control, and complications was unclear in obese type 2 diabetic patients. We aimed to assess whether PEP reduced all-cause mortality, first macrovascular and microvascular disease events. A cohort of 6372 obese type 2 diabetic patients without prior occurrence of macrovascular or microvascular disease events on or before baseline study recruitment date was linked to the administrative database from 2008 to 2013. Non-PEP participants were matched one-to-one with the PEP participants using propensity score method with respect to their baseline covariates. Cox proportional hazard regressions were performed to estimate the associations of the PEP intervention with the occurrence of first macrovascular or microvascular disease events and death from any cause, controlling for demographic and clinical characteristics. During a median 31.5 months of follow-up, 350 (PEP/non-PEP: 151/199) patients suffered from a first macrovascular or microvascular disease event while 95 patients (PEP/non-PEP: 34/61) died from any cause. After adjusting for confounding variables, PEP participants had lower incidence rates of all-cause mortality [hazard ratio (HR): 0.589, 95 % confidence interval (CI) 0.380–0.915, P = 0.018] and first macrovascular or microvascular disease events (HR: 0.782, 95 % CI 0.632–0.968, P = 0.024) than those with PEP. Enrolment to PEP was an effective approach in reducing all-cause mortality and first macrovascular or microvascular disease events in obese patients with type 2 diabetes.postprin

Patient Empowerment Programme in primary care reduced all-cause mortality and cardiovascular diseases in patients with type 2 diabetes mellitus: a population-based propensity-matched cohort study

Aims: To assess whether a structured diabetes education programme, Patient Empowerment Programme (PEP), was associated with a lower risk of first cardiovascular disease (CVD) event and all-cause mortality in a population-based cohort of type 2 diabetes mellitus (T2DM) patients in primary care. Materials and Methods: A Chinese cohort of 27,278 T2DM patients without prior occurrence of CVD events on or before baseline study recruitment date was linked to the Hong Kong administrative database from 2008 to 2013. PEP was provided to T2DM patients treated at primary care outpatient clinics through community trained professional educators. Non-PEP participants were matched one-to-one with the PEP participants using propensity score method with respect to their baseline covariates. Cox proportional hazard regressions were performed to estimate the associations of PEP with the occurrence of first CVD event, coronary heart disease, stroke, heart failure and death from any cause, controlling for baseline characteristics. Results: During a median of 21.5 months follow-up, 795 (352 PEP participants and 443 non-PEP participants) patients suffered a first CVD event. After adjusting for confounding variables, PEP participants had a lower incidence of all-cause mortality (hazard ratio: 0.564; 95%CI:0.445-0.715; P < 0.001), first CVD (hazard ratio: 0.807; 95%CI:0.696-0.935; P = 0.004) and stroke (hazard ratio: 0.702; 95%CI:0.569-0.867; P = 0.001) events than those without PEP. Conclusions: Enrolment in PEP was associated with reduced all-cause mortality and first CVD events among T2DM patients. The CVD benefit of PEP might be attributable to improving metabolic control through empowerment of self-care and enhancement of quality of diabetes care in primary care.postprin

Evaluation of the outcomes of care of nurse-led continence care clinics for Chinese patients with lower urinary tract symptoms, a 2-year prospective longitudinal study

Aim: The aim of this study was to evaluate the 24-month outcomes of a nurse-led continence care service for Chinese primary care patients with lower urinary tract symptoms. Background: Most studies evaluating the outcomes of continence care services have had short follow-up durations with limited knowledge on whether benefits are sustained beyond 12Â months. Design: Twenty-four month cohort study. Methods: Two comparison groups were recruited: (1) Patients with lower urinary tract symptoms attending a nurse-led community-based continence care programme; (2) Primary care patients with lower urinary tract symptoms identified by screening, receiving usual medical care. Self-reported symptom severity, health-related quality of life, patient enablement and general health perception were measured at baseline and 24Â months. Data collection occurred from March 2013â August 2015. Results: Baseline and 24-month data were available for 170 continence care and 158 usual care subjects. After controlling for baseline characteristics, the continence care group was observed to have greater reductions in symptom severity and larger improvements in disease-specific health-related quality of life, patient enablement and general health perception than the usual care group. Deterioration in the mental components of generic health-related quality of life was observed in the usual care group, but not in the continence care group. Conclusion: Over 24Â months, when compared with usual medical care, nurse-led continence care services were effective in reducing symptom severity and improving health-related quality of life, patient enablement and general health perception and provided protection against deterioration in the mental components of health-related quality of life in patients with lower urinary tract symptoms.postprin

Association of Excessive Use of Electronic Devices with Musculoskeletal Symptoms, Vision, Psychosocial Health, and Activities of Children and Adolescents in Hong Kong

Health and Medical Research Fund, Health Bureau of Hong Kong (project number.: 02180348)

TP53-induced glycolysis and apoptosis regulator promotes proliferation and invasiveness of nasopharyngeal carcinoma cells

The TP53induced glycolysis and apoptosis regulator (TIGAR) is the protein product of the p53 target gene, C12orf5. TIGAR blocks glycolysis and promotes cellular metabolism via the pentose phosphate pathway; it promotes the production of cellular nicotinamide adenine dinucleotide phosphate (NADPH), which leads to enhanced scavenging of intracellular reactive oxygen species, and inhibition of oxidative stressinduced apoptosis in normal cells. Our previous study identified a novel nucleoside analog that inhibited cellular growth and induced apoptosis in nasopharyngeal carcinoma (NPC) cell lines via downregulation of TIGAR expression. Furthermore, the growth inhibitory effects of cMet tyrosine kinase inhibitors were ameliorated by the overexpression of TIGAR in the NPC cell lines. These results indicate a significant role for TIGAR expression in the survival of NPCs. The present study aimed to further define the function of TIGAR expression in NPC cells. In total, 36 formalinfixed, paraffinembedded NPC tissue samples were obtained for the immunohistochemical determination of TIGAR expression. The effects of TIGAR expression on cell proliferation, NADPH production and cellular invasiveness were also assessed in NPC cell lines. Overall, TIGAR was overexpressed in 27/36 (75%) of the NPC tissues compared with the adjacent noncancer epithelial cells. Similarly, TIGAR overexpression was also observed in a panel of six NPC cell lines compared with normal NP460 hTert and Het1A cell lines. TIGAR overexpression led to increased cellular growth, NADPH production and invasiveness of the NPC cell lines, whereas a knockdown of TIGAR expression resulted in significant inhibition of cellular growth and invasiveness. The expression of the two mesenchymal markers, fibronectin and vimentin, was increased by TIGAR overexpression, but reduced following TIGARknockdown. The present study revealed that TIGAR overexpression led to increased cellular growth, NADPH production and invasiveness, and the maintenance of a mesenchymal phenotype, in NPC tissues.published_or_final_versio

Do we need a Patient-centred Target for Systolic Blood Pressure in Hypertensive Patients With Type 2 Diabetes Mellitus?

postprin

Excessive use of electronic devices among children and adolescents is associated with musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life: a cross-sectional study

Data availability statement: The original contributions presented in the study are included in the article/Supplementary material, further inquiries can be directed to the corresponding author.Supplementary material: The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh.2023.1178769/full#supplementary-materialCopyright © 2023 Tsang, Cheing, Lam, Siu, Pang, Yip, Chan and Jensen. Objective: Electronic devices have become an indispensable part of our daily lives. The frequency and duration of device use in children and adolescents have increased drastically over the years and the study of its negative musculoskeletal, visual and psychosocial health impacts is necessary. Materials and methods: This cross-sectional study aimed to evaluate the associations between electronic device use and the prevalence and severity of musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life in children and adolescents studying at primary and secondary schools. Data were collected through confidential online and paper-and-pencil questionnaires. Primary 4–5 and Secondary 1–4 students were recruited from 3 schools in Hong Kong. Demographics, frequency and duration of electronic device use, frequencies of musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life outcomes were measured. Results: 1,058 children and adolescents aged 9–17  years participated. Sixty-one percent and 78% of all students spent more than 2  h per day using electronic devices during school days and weekend/holidays, respectively. Extended electronic device use was associated with increased prevalence and severity of musculoskeletal symptoms (ρ’s = 0.28–0.33, P’s < 0.001), visual symptoms (ρ’s = 0.33–0.35, P’s < 0.001), and poorer device use-related psychosocial health (ρ’s = 0.38–0.47, P’s < 0.001). Secondary school students reported greater device use and severity of symptoms than primary school students. Conclusion: Excessive electronic device use was associated with increased prevalence and severity of physical and psychosocial symptoms, and such use is more prevalent in adolescents when compared to the children. The findings have important health implications for children and adolescents, suggesting that early intervention is needed to reduce the risk of developing device use-related disorders.This research was supported by Health and Medical Research Fund, Health Bureau of Hong Kong (project number.: 02180348)

The effects of ocular magnification on Spectralis spectral domain optical coherence tomography scan length

Purpose The purpose of this study was to assess the effects of incorporating individual ocular biometry measures of corneal curvature, refractive error, and axial length on scan length obtained using Spectralis spectral domain optical coherence tomography (SD-OCT). Methods Two SD-OCT scans were acquired for 50 eyes of 50 healthy participants, first using the Spectralis default keratometry (K) setting followed by incorporating individual mean-K values. Resulting scan lengths were compared to predicted scan lengths produced by image simulation software, based on individual ocular biometry measures including axial length. Results Axial length varied from 21.41 to 29.04 mm. Spectralis SD-OCT scan lengths obtained with default-K ranged from 5.7 to 7.3 mm, and with mean-K from 5.6 to 7.6 mm. We report a stronger correlation of simulated scan lengths incorporating the subject’s mean-K value (ρ = 0.926, P < 0.0005) compared to Spectralis default settings (ρ = 0.663, P < 0.0005). Conclusions Ocular magnification appears to be better accounted for when individual mean-K values are incorporated into Spectralis SD-OCT scan acquisition versus using the device’s default-K setting. This must be considered when taking area measurements and lateral measurements parallel to the retinal surface

Plasticity of BRCA2 Function in Homologous Recombination: Genetic Interactions of the PALB2 and DNA Binding Domains

The breast cancer suppressor BRCA2 is essential for the maintenance of genomic integrity in mammalian cells through its role in DNA repair by homologous recombination (HR). Human BRCA2 is 3,418 amino acids and is comprised of multiple domains that interact with the RAD51 recombinase and other proteins as well as with DNA. To gain insight into the cellular function of BRCA2 in HR, we created fusions consisting of various BRCA2 domains and also introduced mutations into these domains to disrupt specific protein and DNA interactions. We find that a BRCA2 fusion peptide deleted for the DNA binding domain and active in HR is completely dependent on interaction with the PALB2 tumor suppressor for activity. Conversely, a BRCA2 fusion peptide deleted for the PALB2 binding domain is dependent on an intact DNA binding domain, providing a role for this conserved domain in vivo; mutagenesis suggests that both single-stranded and double-stranded DNA binding activities in the DNA binding domain are required for its activity. Given that PALB2 itself binds DNA, these results suggest alternative mechanisms to deliver RAD51 to DNA. In addition, the BRCA2 C terminus contains both RAD51-dependent and -independent activities which are essential to HR in some contexts. Finally, binding the small peptide DSS1 is essential for activity when its binding domain is present, but not when it is absent. Our results reveal functional redundancy within the BRCA2 protein and emphasize the plasticity of this large protein built for optimal HR function in mammalian cells. The occurrence of disease-causing mutations throughout BRCA2 suggests sub-optimal HR from a variety of domain modulations

Intraocular pressure variation from ocular compression in low and high myopia

202304 bcwwNot applicableSelf-fundedEarly release12 month