4,193 research outputs found

    Hospital Mental Health Admissions in Women after Unsuccessful Infertility Treatment and In Vitro Fertilization: An Australian Population-Based Cohort Study

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    Objective - To examine the association between in vitro fertilization (IVF) and later admission to hospital with a mental health diagnosis in women who remained childless after infertility treatment. Methods - This was a population-based cohort study using linked administrative hospital and registry data. The study population included all women commencing hospital treatment for infertility in Western Australia between the years 1982 and 2002 aged 20–44 years at treatment commencement who did not have a recorded birth by the end of follow-up (15 August 2010) and did not have a hospital mental health admission prior to the first infertility admission (n=6,567). Of these, 2,623 women had IVF and 3,944 did not. We used multivariate Cox regression modeling of mental health admissions and compared women undergoing IVF treatment with women having infertility treatment but not IVF. Results - Over an average of 17 years of follow-up, 411 women in the cohort were admitted to hospital with a mental health diagnosis; 93 who had IVF and 318 who did not. The unadjusted hazard ratio (HR) for a hospital mental health admission comparing women who had IVF with those receiving other infertility treatment was 0.50 (95% confidence interval [CI] 0.40–0.63). After adjustment for age, calendar year and socio-economic status the HR was 0.56 (95% CI 0.44–0.71). Conclusions - IVF treatment is associated with a reduced risk of hospital mental health admissions in women after unsuccessful infertility treatment. This may be explained by the healthy cohort effect

    Physical activity and associations with clinical outcome measures in adults with cystic fibrosis; A systematic review

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    Background: Physical activity (PA) is important in the management of Cystic Fibrosis (CF) and is associated with a number of beneficial effects. PA assessment is not commonplace or consistent clinical practice, therefore understanding of PA in adults with CF remains limited. The purpose of this review was to evaluate PA levels in this population and compare PA to global recommendations and non-CF peers. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were utilised to inform the review process. Original research was identified and screened against inclusion/exclusion criteria. Quality was assessed, data extracted and a narrative synthesis undertaken to describe the findings. Results: Adults with CF did not achieve recommended PA guidelines and step count targets in 5/8 studies where assessment was possible. No significant differences in PA were found between CF and non-CF peers in 3/5 studies. Associations between PA and improved lung function were inconsistent with 4/9 studies finding a positive association. Evidence for an association between PA and higher exercise capacity was stronger with all 4 studies reviewed reporting a positive association. Quality ratings were low across all studies. Conclusions: PA in adults with CF is largely comparable to their non-CF peers, despite being insufficiently active to achieve PA recommendations. Assessment tools used and outcomes reported are variable, many of which do not provide sufficient information to assess relevant components of PA. There is a requirement for high quality studies designed specifically to explore PA in adults with CF, ideally employing standardised PA assessment methods

    Comparison of tumour-based (Petersen Index) and inflammation-based (Glasgow Prognostic Score) scoring systems in patients undergoing curative resection for colon cancer

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    After resection, it is important to identify colon cancer patients, who are at a high risk of recurrence and who may benefit from adjuvant treatment. The Petersen Index (PI), a prognostic model based on pathological criteria is validated in Dukes' B and C disease. Similarly, the modified Glasgow Prognostic Score (mGPS) based on biochemical criteria has also been validated. This study compares both the scores in patients undergoing curative resection of colon cancer. A total of 244 patients underwent elective resection between 1997 and 2005. The PI was constructed from pathological reports; the mGPS was measured pre-operatively. The median follow-up was 67 months (minimum 36 months) during which 109 patients died; 68 of them from cancer. On multivariate analysis of age, Dukes' stage, PI and mGPS, age (hazard ratio, HR, 1.74, P=0.001), Dukes' stage (HR, 3.63, P<0.001), PI (HR, 2.05, P=0.010) and mGPS (HR, 2.34, P<0.001) were associated independently with cancer-specific survival. Three-year cancer-specific survival rates for Dukes' B patients with the low-risk PI were 98, 92 and 82% for the mGPS of 0, 1 and 2, respectively (P<0.05). The high-risk PI population is small, in particular for Dukes' B disease (9%). The mGPS further stratifies those patients classified as low risk by the PI. Combining both the scoring systems could identify patients who have undergone curative surgery but are at high-risk of cancer-related death, therefore guiding management and trial stratification

    Altered SMRT levels disrupt vitamin D3 receptor signalling in prostate cancer cells.

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    We hypothesized that key antiproliferative target genes for the vitamin D receptor (VDR) were repressed by an epigenetic mechanism in prostate cancer cells resulting in apparent hormonal insensitivity. To explore this possibility, we examined nuclear receptor corepressor expression in a panel of nonmalignant and malignant cell lines and primary cultures, and found frequently elevated SMRT corepressor mRNA expression often associated with reduced sensitivity to 1alpha,25-dihydroxyvitamin D(3) (1alpha,25(OH)2D3). For example, PC-3 and DU-145 prostate cancer cell lines had 1.8-fold and twofold increases in SMRT mRNA relative to normal PrEC cells (P<0.05). Similarly, 10/15 primary tumour cultures (including three matched to normal cells from the same donors) had elevated SMRT mRNA levels; generally NCoR1 and Alien were not as commonly elevated. Corepressor proteins often have associated histone deacetylases (HDAC) and reflectively the antiproliferative action of 1alpha,25(OH)2D3 can be restored by cotreatment with low doses of HDAC inhibitors such as trichostatin A (TSA, 15 nM) to induce apoptosis in prostate cancer cell lines. To decipher the transcriptional events that lead to these cellular responses, we undertook gene expression studies in PC-3 cells after cotreatment of 1alpha,25(OH)2D3 plus TSA after 6 h. Examination of known VDR target genes and cDNA microarray analyses revealed cotreatment of 1alpha,25(OH)2D3 plus TSA cooperatively upregulated eight (out of 1176) genes, including MAPK-APK2 and GADD45alpha. MRNA and protein time courses and inhibitor studies confirmed these patterns of regulation. Subsequently, we knocked down SMRT levels in PC-3 cells using a small interfering RNA (siRNA) approach and found that GADD45alpha induction by 1alpha,25(OH)2D3 alone became very significantly enhanced. The same distortion of gene responsiveness, with repressed induction of GADD45alpha was found in primary tumour cultures compared and to matched peripheral zone (normal) cultures from the same donor. These data demonstrate that elevated SMRT levels are common in prostate cancer cells, resulting in suppression of target genes associated with antiproliferative action and apparent 1alpha,25(OH)2D3-insensitivity. This can be targeted therapeutically by combination treatments with HDAC inhibitors

    Paid employment and common mental disorders in 50-64-year olds: analysis of three cross-sectional nationally representative survey samples in 1993, 2000 and 2007

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    Aims. Associations between employment status and mental health are well recognised, but evidence is sparse on the relationship between paid employment and mental health in the years running up to statutory retirement ages using robust mental health measures. In addition, there has been no investigation into the stability over time in this relationship: an important consideration if survey findings are used to inform future policy. The aim of this study is to investigate the association between employment status and common mental disorder (CMD) in 50–64-year old residents in England and its stability over time, taking advantage of three national mental health surveys carried out over a 14-year period. / Methods. Data were analysed from the British National Surveys of Psychiatric Morbidity of 1993, 2000 and 2007. Paid employment status was the primary exposure of interest and CMD the primary outcome – both ascertained identically in all three surveys (CMD from the revised Clinical Interview Schedule). Multivariable logistic regression models were used. / Results. The prevalence of CMD was higher in people not in paid employment across all survey years; however, this association was only present for non-employment related to poor health as an outcome and was not apparent in those citing other reasons for non-employment. Odds ratios for the association between non-employment due to ill health and CMD were 3.05 in 1993, 3.56 in 2000, and 2.80 in 2007, after adjustment for age, gender, marital status, education, social class, housing tenure, financial difficulties, smoking status, recent physical health consultation and activities of daily living impairment. / Conclusions. The prevalence of CMD was higher in people not in paid employment for health reasons, but was not associated with non-employment for other reasons. Associations had been relatively stable in strength from 1993 to 2007 in those three cross-sectional nationally representative samples

    A Decision Support Tool for the Selection of Promoting Actions to Encourage Collaboration in Projects for the Agriculture Sector

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    [EN] Development and innovation agencies promote consortiums of agricultural stakeholders to collaborate in the proposal of projects for public calls. To achieve this partnerships, these agencies should select between different promoting actions to be performed with two objectives: maximize the number of project proposals presented and minimize the resources invested. To support agencies with these decisions, a computer tool based on a multi-objective integer linear programming model is proposed. To deal with the two objectives the weighting sum method is implemented. The model is validated in different scenarios by means a realistic case of an agency in Brittany (France). The results show the conflict between the two objectives considered and the dependency of the solutions on the scenarios defined. As a conclusion it can be stated that: 1) decision-makers should be careful in defining the weights of each objective and 2) the impact of the different promoting actions on the level of stakeholders¿ participation should be precisely estimated.The authors acknowledge the support of the project 691249, RUCAPS: "Enhancing and implementing knowledge based ICT solutions within high risk and uncertain conditions for agriculture production systems", funded by the European Union¿s research and innovation programme under the H2020 Marie Sk¿odowska-Curie Actions.Alemany Díaz, MDM.; Alarcón Valero, F.; Pérez Perales, D.; Guyon, C. (2020). A Decision Support Tool for the Selection of Promoting Actions to Encourage Collaboration in Projects for the Agriculture Sector. IFIP Advances in Information and Communication Technology. 598:534-545. https://doi.org/10.1007/978-3-030-62412-5_44S534545598European Comission Funded Programs. https://ec.europa.eu/programmes/horizon2020Zoie, C., Radulescu, M.: Decision analysis for the project selection problem under risk. IFAC Proc. 34(8), 445–450 (2001)Sadi-Nezhad, S.: A state-of-art survey on project selection using MCDM techniques. J. Project Manage. 2, 1–10 (2017)Caballero, H.C., Chopra, S., Schmidt, E.K.: Project portfolio selection using mathematical programming and optimization methods. In: Paper presented at PMI® Global Congress 2012–North America, Vancouver, British Columbia, Canada, Newtown Square, PA, Project Management Institute (2012)Ahmad, B., Haq, I.: Project selection techniques, relevance and applications in Pakistan. Int. J. Technol. Res. 4, 52–60 (2016)Inuiguchi, M., Ramı́k, J.: Possibilistic linear programming: a brief review of fuzzy mathematical programming and a comparison with stochastic programming in portfolio selection problem. Fuzzy Sets Syst. 111(1), 3–28 (2000)Stewart, R., Mohamed, S.: IT/IS projects selection using multi-criteria utility theory. Log. Inf. Manage. 15(4), 254–270 (2002)Alzober, W., Yaakub, A.R.: Integrated model for MCDM: selection contractor in Malaysian construction industry. In: Applied Mechanics and Materials 548, pp. 1587–1595. Trans Tech Publications (2014)Adhikary, P., Roy, P.K., Mazumdar, A.: Optimal renewable energy project selection: a multi-criteria optimization technique approach. Global J. Pure Appl. Math. 11(5), 3319–3329 (2015)Strang, K.D.: Portfolio selection methodology for a nuclear project. Project Manage. J. 42(2), 81–93 (2011)Benjamin, C.O.: A linear goal-programming model for public-sector project selection. J. Oper. Res. Soc. 36(1), 13–23 (1985)Coronado, J.R., Pardo-Mora, E.M., Valero, M.: A multi-objective model for selection of projects to finance new enterprise SMEs in Colombia. J. Ind. Eng. Manage. 4(3), 407–417 (2011)Mat, N.A.C., Cheung, Y.: Partner selection: criteria for successful collaborative network. In: 20th Australian Conference on Information Systems, pp. 631–641 (2009)Camarinha-Matos, L.M., Afsarmanesh, H.: Collaborative Networks. In: Wang, K., Kovacs, G.L., Wozny, M., Fang, M. (eds.) PROLAMAT 2006. IIFIP, vol. 207, pp. 26–40. Springer, Boston, MA (2006). https://doi.org/10.1007/0-387-34403-9_4Paixão, M., Sbragia, R., Kruglianskas, I.: Factors for selecting partners in innovation projects–evidences from alliances in the Brazilian petrochemical leader. Rev. Admin. Innov. São Paulo 11(2), 241–272 (2014)Duisters, D., Duysters, G., de Man, A.P.: The partner selection process: steps, effectiveness, governance. Ann. Hematol. 2, 7–25 (2011)Zhang, X.: Criteria for selecting the private-sector partner in public-private partnerships. J. Constr. Eng. Manage. 131(6), 631–644 (2005

    The relationship between the systemic inflammatory response, tumour proliferative activity, T-lymphocytic and macrophage infiltration, microvessel density and survival in patients with primary operable breast cancer

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    The significance of the inter-relationship between tumour and host local/systemic inflammatory responses in primary operable invasive breast cancer is limited. The inter-relationship between the systemic inflammatory response (pre-operative white cell count, C-reactive protein and albumin concentrations), standard clinicopathological factors, tumour T-lymphocytic (CD4+ and CD8+) and macrophage (CD68+) infiltration, proliferative (Ki-67) index and microvessel density (CD34+) was examined using immunohistochemistry and slide-counting techniques, and their prognostic values were examined in 168 patients with potentially curative resection of early-stage invasive breast cancer. Increased tumour grade and proliferative activity were associated with greater tumour T-lymphocyte (P&lt;0.05) and macrophage (P&lt;0.05) infiltration and microvessel density (P&lt;0.01). The median follow-up of survivors was 72 months. During this period, 31 patients died; 18 died of their cancer. On univariate analysis, increased lymph-node involvement (P&lt;0.01), negative hormonal receptor (P&lt;0.10), lower albumin concentrations (P&lt;0.01), increased tumour proliferation (P&lt;0.05), increased tumour microvessel density (P&lt;0.05), the extent of locoregional control (P&lt;0.0001) and limited systemic treatment (Pless than or equal to0.01) were associated with cancer-specific survival. On multivariate analysis of these significant covariates, albumin (HR 4.77, 95% CI 1.35–16.85, P=0.015), locoregional treatment (HR 3.64, 95% CI 1.04–12.72, P=0.043) and systemic treatment (HR 2.29, 95% CI 1.23–4.27, P=0.009) were significant independent predictors of cancer-specific survival. Among tumour-based inflammatory factors, only tumour microvessel density (P&lt;0.05) was independently associated with poorer cancer-specific survival. The host inflammatory responses are closely associated with poor tumour differentiation, proliferation and malignant disease progression in breast cancer

    J/Psi and Psi' total cross sections and formation times from data for charmonium suppression in pApA collisions

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    The recent data for E866 experiment on the x_F dependence for charmonium suppression in pA collisions at 800 GeV are analyzed using a time- and energy-dependent preformed charmonium absorption cross section \sigma_{abs}^\psi(\tau,\sqrt{s}). For \sqrt{s}=10 GeV the initially (\tau=0) produced premeson has an absorption cross section of \sigma_{pr}~3mb. At the same energy but for \tau -> \infty one deduces for the total cross sections \sigma_{tot}^{J/Psi N}=(2.8\pm 0.3)mb, \sigma_{tot}^{J/Psi N}= (10.5\pm 3.6)mb. The date are compatible with a formation time \tau_{1/2}=0.6 fm/c.Comment: 13 pages of Latex including 2 figures; typos in the abstract are correcte

    Multimorbidity in bipolar disorder and under-treatment of cardiovascular disease: a cross sectional study

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    Background: Individuals with serious mental disorders experience poor physical health, especially increased rates of cardiometabolic morbidity and premature morbidity. Recent evidence suggests that individuals with schizophrenia have numerous comorbid physical conditions which may be under-recorded and under-treated but to date very few studies have explored this issue for bipolar disorder. Methods:We conducted a cross-sectional analysis of a dataset of 1,751,841 registered patients within 314 primary-care practices in Scotland, U.K. Bipolar disorder was identified using Read Codes recorded within electronic medical records. Data on 32 common chronic physical conditions were also assessed. Potential prescribing inequalities were evaluated by analyzing prescribing data for coronary heart disease (CHD) and hypertension. Results: Compared to controls, individuals with bipolar disorder were significantly less likely to have no recorded physical conditions (OR 0.59, 95% CI 0.54-0.63) and significantly more likely to have one physical condition (OR 1.27, 95% CI 1.16-1.39), two physical conditions (OR 1.45, 95% CI 1.30-1.62) and three or more physical conditions (OR 1.44, 95% CI 1.30-1.64). People with bipolar disorder also had higher rates of thyroid disorders, chronic kidney disease, chronic pain, chronic obstructive airways disease and diabetes but, surprisingly, lower recorded rates of hypertension and atrial fibrillation. People with bipolar disorder and comorbid CHD or hypertension were significantly more likely to be prescribed no antihypertensive or cholesterol-lowering medications compared to controls, and bipolar individuals with CHD or hypertension were significantly less likely to be on 2 or more antihypertensive agents. Conclusions: Individuals with bipolar disorder are similar to individuals with schizophrenia in having a wide range of comorbid and multiple physical health conditions. They are also less likely than controls to have a primary-care record of cardiovascular conditions such as hypertension and atrial fibrillation. Those with a recorded diagnosis of CHD or hypertension were less likely to be treated with cardiovascular medications and were treated less intensively. This study highlights the high physical healthcare needs of people with bipolar disorder, and provides evidence for a systematic under-recognition and under-treatment of cardiovascular disease in this group
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