The rs9340799 polymorphism of the estrogen receptor alpha (ESR1) gene and its association with breast cancer susceptibility

The ESR1 rs9340799 polymorphism has been frequently investigated with regard to its association with breast cancer (BC) susceptibility, but the findings have been inconclusive. In this work, we aimed to address the inconsistencies in study findings by performing a systematic review and meta-analysis. Eligible studies were identified from the Web of Science, PubMed, Scopus, China National Knowledge Infrastructure, VIP and Wanfang databases based on the predefined inclusion and exclusion criteria. The pooled odds ratio (OR) was then calculated under five genetic models: homozygous (GG vs. AA), heterozygous (AG vs. AA), dominant (AG + GG vs. AA), recessive (GG vs. AA + AG) and allele (G vs. A). Combined results from 23 studies involving 34,721 subjects indicated a lack of significant association between the polymorphism and BC susceptibility (homozygous model, OR = 1.045, 95% CI 0.887–1.231, P = 0.601; heterozygous model, OR = 0.941, 95% CI 0.861–1.030, P = 0.186; dominant model, OR = 0.957, 95% CI 0.875–1.045, P = 0.327; recessive model, OR = 1.053, 95% CI 0.908–1.222, P = 0.495; allele model, OR = 0.987, 95% CI 0.919–1.059, P = 0.709). Subgroup analyses by ethnicity, menopausal status and study quality also revealed no statistically significant association (P > 0.05). In conclusion, our results showed that the ESR1 rs9340799 polymorphism was not associated with BC susceptibility, suggesting its limited potential as a genetic marker for BC

Association between XRCC3 p.Thr241Met polymorphism and risk of glioma:a systematic review and meta-analysis

BACKGROUND: The XRCC3 p.Thr241Met (rs861539) polymorphism has been extensively studied for its association with glioma risk, but results remain conflicting. Therefore, we performed a systematic review and meta-analysis to resolve this inconsistency. METHODS: Studies published up to June 10, 2022, were searched in PubMed, Web of Science, Scopus, VIP, Wanfang, and China National Knowledge Infrastructure databases and screened for eligibility. Then, the combined odds ratio (OR) of the included studies was estimated based on five genetic models, i.e., homozygous (Met/Met vs. Thr/Thr), heterozygous (Thr/Met vs. Thr/Thr), dominant (Thr/Met + Met/Met vs. Thr/Thr), recessive (Met/Met vs. Thr/Thr + Thr/Met) and allele (Met vs. Thr). The study protocol was preregistered at PROSPERO (registration number: CRD42021235704). RESULTS: Overall, our meta-analysis of 14 eligible studies involving 12,905 subjects showed that the p.Thr241Met polymorphism was significantly associated with increased glioma risk in both homozygous and recessive models (homozygous, OR = 1.381, 95% CI = 1.081–1.764, P = 0.010; recessive, OR = 1.305, 95% CI = 1.140–1.493, P0.05). CONCLUSION: We demonstrated that the XRCC3 p.Thr241Met polymorphism is associated with an increased risk of glioma only in the homozygous and recessive models

A qualitative study on healthcare professionals’ perceived barriers to insulin initiation in a multi-ethnic population

Background: Nationwide surveys have shown that the prevalence of diabetes rates in Malaysia have almost doubled in the past ten years; yet diabetes control remains poor and insulin therapy is underutilized. This study aimed to explore healthcare professionals’ views on barriers to starting insulin therapy in people with type 2 diabetes. Methods: Healthcare professionals consisting of general practitioners (n = 11), family medicine specialists (n = 10), medical officers (n = 8), government policy makers (n = 4), diabetes educators (n = 3) and endocrinologists (n = 2) were interviewed. A semi-structured topic guide was used to guide the interviews by trained facilitators. The interviews were transcribed verbatim and analysed using a thematic analysis approach. Results: Insulin initiation was found to be affected by patient, healthcare professional and system factors. Patients’ barriers include culture-specific barriers such as the religious purity of insulin, preferred use of complementary medication and perceived lethality of insulin therapy. Healthcare professionals’ barriers include negative attitudes towards insulin therapy and the ‘legacy effect’ of old insulin guidelines; whilst system barriers highlight the lack of resources, language and communication challenges. Conclusions: Tackling the issue of insulin initiation should not only happen during clinical consultations. It requires health education to emphasise the progressive nature of diabetes and the eventuality of insulin therapy at early stage of the illness. Healthcare professionals should be trained how to initiate insulin and communicate effectively with patients from various cultural and religious backgrounds

European polygenic risk score for prediction of breast cancer shows similar performance in Asian women

Abstract: Polygenic risk scores (PRS) have been shown to predict breast cancer risk in European women, but their utility in Asian women is unclear. Here we evaluate the best performing PRSs for European-ancestry women using data from 17,262 breast cancer cases and 17,695 controls of Asian ancestry from 13 case-control studies, and 10,255 Chinese women from a prospective cohort (413 incident breast cancers). Compared to women in the middle quintile of the risk distribution, women in the highest 1% of PRS distribution have a ~2.7-fold risk and women in the lowest 1% of PRS distribution has ~0.4-fold risk of developing breast cancer. There is no evidence of heterogeneity in PRS performance in Chinese, Malay and Indian women. A PRS developed for European-ancestry women is also predictive of breast cancer risk in Asian women and can help in developing risk-stratified screening programmes in Asia

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Active participant identification and tracking using depth sensing technology for video conferencing

Video conferencing represents an effective method of point-to-point or multipoint real-time communication between two or more participants. However, persistent manual adjustments of the video capture device to focus on an active participant represent a challenge, especially if the conference participant moves out of the video capture window. As such, this paper proposes an active-based participant identification and tracking system, which continuously tracks and automatically adjusts the video capture device to maintain focus of the active conference participant. The proposed system first applies a haarcascade face detection algorithm to register and store a set of facial images of the active participant. By leveraging on the depth sensing technology of Microsoft Kinect, this system compares the captured skeletal head position images of participants within the Kinect camera viewpoint, which is then compared against the aforementioned stored face detection images using the principle component analysis face recognition algorithm. The recognized user by the system is then continuously tracked as a skeletal object via a custom designed vertical and horizontal servo controlled motorized system. The custom motorized system sits under the Kinect sensor and is able to achieve 180 degrees in horizontal panning and 22.7 degrees in vertical tilting in line with tracking the movement of the active conference participant

Knowledge management performance measurement: measures, approaches, trends and future directions

This paper presents a review on Knowledge Management (KM) performance measurement in the past two decades. Various tools and techniques that have been developed are discussed and presented chronologically to show how KM performance measurement has changed during this period. Each tool and technique is evaluated and classified based on the types of measures and approaches used. This paper also proposes six new categories: traditional, advanced, deterministic, stochastic, general result oriented, and specific result oriented, to complement the previous classification schemes. Future research directions for KM performance measurement are identified and presented in a holistic framework to act as a guideline for new researchers who wish to embark on this fiel

Thermoelectric Properties of Alumina-Doped Bi0.4Sb1.6Te3 Nanocomposites Prepared through Mechanical Alloying and Vacuum Hot Pressing

In this study, γ-Al2O3 particles were dispersed in p-type Bi0.4Sb1.6Te3 through mechanical alloying to form γ-Al2O3/Bi0.4Sb1.6Te3 composite powders. The composite powders were consolidated using vacuum hot pressing to produce nano- and microstructured composites. Thermoelectric (TE) measurements indicated that adding an optimal amount of γ-Al2O3 nanoparticles improves the TE performance of the fabricated composites. High TE performances with figure of merit (ZT) values as high as 1.22 and 1.21 were achieved at 373 and 398 K for samples containing 1 and 3 wt % γ-Al2O3 nanoparticles, respectively. These ZT values are higher than those of monolithic Bi0.4Sb1.6Te3 samples. The ZT values of the fabricated samples at 298–423 K are 1.0–1.22; these ZT characteristics make γ-Al2O3/Bi0.4Sb1.6Te3 composites suitable for power generation applications because no other material with a similarly high ZT value has been reported at this temperature range. The achieved high ZT value may be attributable to the unique nano- and microstructures in which γ-Al2O3 nanoparticles are dispersed among the grain boundary or in the matrix grain, as revealed by high-resolution transmission electron microscopy. The dispersed γ-Al2O3 nanoparticles thus increase phonon scattering sites and reduce thermal conductivity. The results indicated that the nano- and microstructured γ-Al2O3/Bi0.4Sb1.6Te3 alloy can serve as a high-performance material for application in TE devices