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Toward Prevention of Adverse Events Using Anticipatory Analytics 使用预期分析预防不良事件
Pub Date : 2020-05-13 DOI: 10.1097/pp9.0000000000000029
J. Norman, A. Akhavan, Chen Shen, D. Aron, Luci K. Leykum, Y. Bar-Yam
Supplemental Digital Content is available in the text. Introduction: Electronic Medical Records provide new opportunities for studying the historical condition and dynamics of individual patients and populations to enable new insights that may lead to improved care and treatment. Diabetes is a prime target for new analyses as it is a chronic condition that affects 1 in 10 of the U.S. adult population and causes substantial disability and loss of life. Methods: We take typical physiological measures from 3 healthcare appointments of 1,711 diabetic patients and extract combined measures that capture the overall conditions of patients and the structure of the population. Further, we examined the dynamics of individual patients across appointments in this combined measure space and examined regions associated with variability in clinical measures. Results: Our results suggest that the dynamics of standard measures may aid evaluation of the risk of adverse events, and their utility should be tested in medical trials. Conclusions: Dynamic variability of vital signs and standard measures may reflect a loss of homeostasis, associated physiological instability, and potential for adverse events that can be estimated using the proposed method.
文本中提供了补充数字内容。简介:电子病历为研究个体患者和人群的历史状况和动态提供了新的机会,从而获得可能改善护理和治疗的新见解。糖尿病是新分析的主要目标,因为它是一种慢性疾病,影响着十分之一的美国成年人口,并导致严重残疾和生命损失。方法:我们从1711名糖尿病患者的3次医疗预约中提取典型的生理指标,并提取反映患者整体状况和人群结构的综合指标。此外,我们在这个组合测量空间中检查了各个预约患者的动态,并检查了与临床测量变异性相关的区域。结果:我们的研究结果表明,标准措施的动态性可能有助于评估不良事件的风险,其效用应在医学试验中进行测试。结论:生命体征和标准测量的动态变异性可能反映了体内平衡的丧失、相关的生理不稳定以及使用所提出的方法可以估计的不良事件的可能性。
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引用次数: 0
Cross-sectional Study on the Knowledge and Prevalence of PCOS at a Multiethnic University 一所多民族大学PCOS知识和患病率的横断面研究
Pub Date : 2020-05-01 DOI: 10.1097/pp9.0000000000000028
Manisha Rao
Introduction: Polycystic ovary syndrome (PCOS) is a complex, poorly understood, and underdiagnosed endocrine disorder in women. Understanding PCOS prevalence and information sources allows for resource development for those with PCOS and their loved ones. The purpose of this study was to identify PCOS prevalence, knowledge, and information sources in a young multiethnic cohort in Texas. Methods: An online survey polled students, faculty, and staff at Texas Woman’s University campuses in Denton, Dallas, and Houston. Seven hundred sixty-nine respondents including 722 females and 47 males completed the survey. Results: Approximately, 28.5% of female respondents indicated a formal diagnosis of PCOS, and 40.5% of those without a formal diagnosis had 2 or more symptoms that align with PCOS. A majority of participants ranked their PCOS knowledge as “Know some” or less (66.3% women and 83% of men). Healthcare professionals were the most common information source in women with a PCOS diagnosis (83.7%). Hispanics were least likely to use healthcare resources (36%) and to seek information from family and friends (17.6%). Differences were also observed by education level. Conclusions: Although women in this study recorded a PCOS prevalence above the national average (6%–12%) and were more likely to seek information from healthcare professionals, these numbers may have been skewed attributable to an increased likelihood of polycystic women to respond to the questionnaire. Ethnicity and education need to be accounted for in designing informative material for polycystic women and their family and friends.
引言:多囊卵巢综合征(PCOS)是一种复杂的、鲜为人知的、诊断不足的女性内分泌疾病。了解多囊卵巢综合征的患病率和信息来源可以为多囊卵巢综合症患者及其亲人开发资源。本研究的目的是确定德克萨斯州一个年轻的多民族队列中多囊卵巢综合征的患病率、知识和信息来源。方法:一项在线调查对位于丹顿、达拉斯和休斯顿的得克萨斯女子大学校园的学生、教职员工进行了调查。包括722名女性和47名男性在内的七百六十九名受访者完成了这项调查。结果:约28.5%的女性受访者表示正式诊断为多囊卵巢综合征,40.5%的未经正式诊断的女性受访者有2种或2种以上与多囊卵巢综合症相关的症状。大多数参与者将他们的多囊卵巢综合征知识列为“了解一些”或更少(66.3%的女性和83%的男性)。在被诊断为多囊卵巢综合征的女性中,医疗保健专业人员是最常见的信息来源(83.7%)。西班牙裔最不可能使用医疗保健资源(36%)和向家人和朋友寻求信息(17.6%)。教育水平也存在差异。结论:尽管本研究中的女性多囊卵巢综合征患病率高于全国平均水平(6%-12%),并且更有可能向医疗保健专业人员寻求信息,但这些数字可能存在偏差,原因是多囊女性对问卷做出回应的可能性增加。在为多囊女性及其家人和朋友设计信息材料时,需要考虑到种族和教育。
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引用次数: 29
How Much Sodium Should We Eat? 我们应该摄入多少钠?
Pub Date : 2019-12-26 DOI: 10.1097/pp9.0000000000000026
Chen Shen, P. J. Bowers, Y. Bar-Yam
Introduction: Sodium, an important dietary requirement, is essential to many physiologic processes. High sodium intake affects serious health issues such as hypertension and cardiovascular disease, the largest cause of death globally. Consequently, many health organizations have recommended substantial reductions in sodium intake, to as little as 1,500 mg/d. Yet limited understanding exists for the entire range of the effect of sodium between high intake and the recommendations. Methods: We built a simulation using equations from the Uttamsingh model of the renal system to simulate the long-term mean arterial pressure (MAP) across sodium intake ranges. We used another existing physiology simulation platform, HumMod-3.0.4, for comparison. We compared the simulation results with empirical studies done on the global population. Results: We find a linear increase in MAP for consumption above 4,000 mg/d, but nearly constant MAP between 1,200 and 4,000 mg/d. Below 1,200 mg/d, the system cannot maintain homeostasis. Conclusion: Supporting the U-shape theory of sodium intake, which posits that too-high and too-low sodium intake rates increase cardiovascular disease risks, our results suggest that the homeostatic regulation by antidiuretic hormone and aldosterone transitions from sodium retention to sodium excretion at around 4,000 mg/d (a value that varies across individuals and conditions), indicating sodium saturation and evolutionary optimality. Our findings are consistent with recent empirical studies on large populations globally. We suggest that the current low-level recommendations are not supported by this physiologic model analysis and would require more compelling evidence.
钠是一种重要的膳食需求,对许多生理过程至关重要。高钠摄入会影响严重的健康问题,如高血压和心血管疾病,这是全球最大的死亡原因。因此,许多卫生组织建议大量减少钠的摄入量,少至每天1 500毫克。然而,人们对高摄入量和建议摄入量之间钠的整个影响范围的了解有限。方法:利用Uttamsingh肾系统模型的方程,模拟钠摄入量范围内的长期平均动脉压(MAP)。我们使用另一个现有的生理模拟平台HumMod-3.0.4进行比较。我们将模拟结果与全球人口的实证研究进行了比较。结果:我们发现,在摄入量超过4000 mg/d时,MAP呈线性增长,但在1200至4000 mg/d之间,MAP几乎不变。低于1200mg /d,系统无法维持体内平衡。结论:我们的研究结果支持钠摄入量的u型理论,该理论认为钠摄入量过高和过低会增加心血管疾病的风险,我们的研究结果表明,抗利尿激素和醛固酮的体内平衡调节在约4,000 mg/d时从钠潴留转变为钠排泄(该值因个体和条件而异),表明钠饱和和进化最优。我们的发现与最近对全球大量人口的实证研究是一致的。我们认为目前的低剂量建议不受生理模型分析的支持,需要更有说服力的证据。
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引用次数: 0
Family Functioning and Psychosocial Factors in a Weight Loss Randomized Controlled Pilot for Black Men 黑人男性减肥随机对照试验中的家庭功能和心理社会因素
Pub Date : 2019-12-20 DOI: 10.1097/pp9.0000000000000025
C. Alick, C. Samuel-Hodge, D. Ward, A. Ammerman, C. Rini, C. Edwards, D. Tate
The aim of this study was to explore whether the Together Eating & Activity Matters trial, a spousal support-enhanced randomized control pilot for weight loss among Black men, changed the intended theoretical constructs of family functioning, social support, self-regulation, and self-efficacy. In Together Eating & Activity Matters, 40 Black men were randomized to 2 experimental groups (standard [n = 19]; enhanced [n = 21]). Among the enhanced group, communication and incendiary communication increased and family cohesion and emotional involvement decreased. There were no significant differences between groups on other measures. These results may help explain and document the process of change associated with couples-based interventions in Black men. Lastly, and with this pilot study, we highlight a potentially significant intervention for future research and weight loss in Black men.
本研究的目的是探讨共同饮食与活动是否重要试验,配偶支持增强黑人男性减肥的随机对照试验,改变了家庭功能,社会支持,自我调节和自我效能的预期理论结构。在《饮食与活动问题》中,40名黑人男性随机分为2个实验组(标准[n = 19];增强[n = 21])。在增强组中,沟通和煽动性沟通增加,家庭凝聚力和情感投入减少。两组在其他指标上没有显著差异。这些结果可能有助于解释和记录黑人男性夫妻干预相关的变化过程。最后,通过这项初步研究,我们强调了未来研究和黑人减肥的潜在重要干预措施。
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引用次数: 1
The 3 Curcuminoid Analogs Comprising the Curcumin Extract Comparably Inhibit Nuclear Factor kappa-light-chain-enhancer Activation 含有姜黄素提取物的3种姜黄素类类似物可以抑制核因子κ轻链增强剂的激活
Pub Date : 2019-08-01 DOI: 10.1097/PP9.0000000000000023
Franco Cavaleri
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引用次数: 1
Curcuminoid Analogs Differentially Modulate Nuclear Factor Kappa-Light-Chain-Enhancer, P65 Serine276, Mitogen- and Stress-activated Protein Kinase 1 And MicroRNA 148a Status 姜黄素类似物差异调节核因子Kappa轻链增强子、P65丝氨酸276、有丝分裂原和应激激活蛋白激酶1和MicroRNA 148a状态
Pub Date : 2019-08-01 DOI: 10.1097/PP9.0000000000000024
Franco Cavaleri
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引用次数: 2
Use of Geographic Information Systems in Physical Activity Interventions: a Systematic Review. 地理信息系统在体育活动干预中的应用:系统综述。
Pub Date : 2019-06-14 eCollection Date: 2019-06-01 DOI: 10.1097/pp9.0000000000000022
Liliana Aguayo, Mariha Khan, Reynaldo De Leon, Andiara Schwingel

Introduction: The promotion of physical activity is inextricably dependent on the environment. This systematic review summarizes studies that used geographic information systems to account for the role of geographic features in the design, implementation, or evaluation of interventions that promoted physical activity.

Methods: Pubmed, ProQuest/PsycInfo, and Cochrane Library were searched for physical activity interventions that employed geographic information systems. The search was conducted with an algorithm that included 10 geographic, 28 intervention, and 9 physical activity search terms. Data were systematically reviewed using a standardized form based on the PICOS framework (participants, interventions, comparison, outcomes, and study design). Quality of the studies included was independently rated on 14 criteria (Registration number CRD42016046011).

Results: Search yield 12,518 published articles, of which, 19 studies satisfied our inclusion criteria. Proximity to recreational areas and neighborhood walkability were the most common geographic factors measured in studies of physical activity interventions. Interventions focused on supporting physical activity by providing recreational spaces and adequate infrastructure to participants. Fifteen intervention studies assessed socioeconomic environmental factors along with physical environmental factors. Support groups were introduced by 4 of the interventions to offset social environmental barriers in the geographical environment. Given the lack of consistency in measurements of physical activity, and long-term assessments, it was not possible to determine if findings are attributable to the geographic environment or a novelty effect.

Conclusion: More research is needed to better understand the physical and social factors within the geographic environment that work as barriers or facilitators of physical activity changes.

引言:体育活动的促进与环境密不可分。本系统综述总结了使用地理信息系统来说明地理特征在促进体育活动的干预措施的设计、实施或评估中的作用的研究。方法:检索Pubmed、ProQuest/PsycInfo和Cochrane图书馆中使用地理信息系统的体育活动干预措施。搜索使用的算法包括10个地理搜索项、28个干预搜索项和9个身体活动搜索项。使用基于PICOS框架的标准化表格(参与者、干预措施、比较、结果和研究设计)对数据进行系统审查。纳入研究的质量根据14项标准(注册号CRD42016046011)进行了独立评分。结果:搜索产生12518篇发表文章,其中19项研究符合我们的纳入标准。在体育活动干预研究中,接近娱乐区和社区可步行性是最常见的地理因素。干预措施的重点是通过为参与者提供娱乐空间和充足的基础设施来支持体育活动。15项干预研究评估了社会经济环境因素和物理环境因素。其中4项干预措施引入了支持小组,以抵消地理环境中的社会环境障碍。鉴于对体力活动的测量和长期评估缺乏一致性,无法确定这些发现是由于地理环境还是新颖性影响。结论:需要更多的研究来更好地了解地理环境中的身体和社会因素,这些因素是身体活动变化的障碍或促进因素。
{"title":"Use of Geographic Information Systems in Physical Activity Interventions: a Systematic Review.","authors":"Liliana Aguayo,&nbsp;Mariha Khan,&nbsp;Reynaldo De Leon,&nbsp;Andiara Schwingel","doi":"10.1097/pp9.0000000000000022","DOIUrl":"https://doi.org/10.1097/pp9.0000000000000022","url":null,"abstract":"<p><strong>Introduction: </strong>The promotion of physical activity is inextricably dependent on the environment. This systematic review summarizes studies that used geographic information systems to account for the role of geographic features in the design, implementation, or evaluation of interventions that promoted physical activity.</p><p><strong>Methods: </strong>Pubmed, ProQuest/PsycInfo, and Cochrane Library were searched for physical activity interventions that employed geographic information systems. The search was conducted with an algorithm that included 10 geographic, 28 intervention, and 9 physical activity search terms. Data were systematically reviewed using a standardized form based on the PICOS framework (participants, interventions, comparison, outcomes, and study design). Quality of the studies included was independently rated on 14 criteria (Registration number CRD42016046011).</p><p><strong>Results: </strong>Search yield 12,518 published articles, of which, 19 studies satisfied our inclusion criteria. Proximity to recreational areas and neighborhood walkability were the most common geographic factors measured in studies of physical activity interventions. Interventions focused on supporting physical activity by providing recreational spaces and adequate infrastructure to participants. Fifteen intervention studies assessed socioeconomic environmental factors along with physical environmental factors. Support groups were introduced by 4 of the interventions to offset social environmental barriers in the geographical environment. Given the lack of consistency in measurements of physical activity, and long-term assessments, it was not possible to determine if findings are attributable to the geographic environment or a novelty effect.</p><p><strong>Conclusion: </strong>More research is needed to better understand the physical and social factors within the geographic environment that work as barriers or facilitators of physical activity changes.</p>","PeriodicalId":92284,"journal":{"name":"Progress in preventive medicine (New York, N.Y.)","volume":"4 2","pages":"e0022"},"PeriodicalIF":0.0,"publicationDate":"2019-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/pp9.0000000000000022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41223264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Genomics and Big Data Analytics in Ayurvedic Medicine 阿育吠陀医学中的基因组学和大数据分析
Pub Date : 2019-04-01 DOI: 10.1097/PP9.0000000000000021
M. Mukerji, M. Sagner
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引用次数: 2
Big Data Analysis of Traditional Knowledge-based Ayurveda Medicine 传统阿育吠陀医学知识大数据分析
Pub Date : 2018-10-01 DOI: 10.1097/pp9.0000000000000020
Harpreet Singh, S. Bhargava, Sailesh Ganeshan, R. Kaur, Tavpritesh Sethi, Mukesh K Sharma, Madhusudan Chauhan, Neerja Chauhan, Rishipal Chauhan, P. Chauhan, S. Brahmachari
Introduction: Modern medicine has embraced data-driven understanding of health, principally through electronic medical records. However, Ayurveda, which is the dominant traditional medicine system in India, much of it is still practiced without digital records. Methods: In this study, 353,000 patients’ data were captured digitally by ~300 Ayurveda doctors over teleconsultation and in-person consultations. The entire dataset was analyzed based on age, sex, region, chronicity, Vikriti, disease morbidity, and comorbitidy and reported effectiveness of the treatment. Results: Younger patients were found to use more Ayurveda telemedicine, but all age groups were well represented. It was found that 82% patients had disease chronicity greater than 1 year. About 85% of the diseases were related to 6 organ systems, digestive (30.6%), endocrine (14.6%), skeleton (13.5%), skin (11.2%), nervous (7.6%), and respiratory (7.4%). The network analysis of the data revealed difference in sex and age-based patterns. Disease of endocrine and cardiovascular systems become comorbid for patient population at older age-groups as also observed in case of modern medicines. Conclusion: Within the limitations of using practice data from a single large group of Ayurveda practitioners, this represents the first data-driven view of Ayurveda practice in India. In spite of 82% of all the patients having chronic diseases, Ayurveda treatment offered complete or partial relief in more than 76% of cases, and only 0.9% reported aggravation in symptoms.
简介:现代医学主要通过电子医疗记录接受了数据驱动的健康理解。然而,在印度占主导地位的传统医学体系阿育吠陀,大部分仍然没有数字记录。方法:在本研究中,约300名阿育吠陀医生通过远程会诊和面对面会诊,以数字方式捕获35.3万例患者的数据。整个数据集基于年龄、性别、地区、慢性、Vikriti、疾病发病率、合并症和报告的治疗有效性进行分析。结果:年轻患者更多地使用阿育吠陀远程医疗,但所有年龄组都有很好的代表性。发现82%的患者疾病慢性期大于1年。85%的疾病与消化系统(30.6%)、内分泌系统(14.6%)、骨骼系统(13.5%)、皮肤系统(11.2%)、神经系统(7.6%)和呼吸系统(7.4%)有关。对数据的网络分析揭示了基于性别和年龄的模式差异。内分泌和心血管系统疾病成为老年患者群体的合并症,在现代药物的情况下也观察到。结论:在使用来自单一大阿育吠陀从业者群体的实践数据的局限性内,这代表了印度阿育吠陀实践的第一个数据驱动视图。尽管82%的患者患有慢性疾病,但阿育吠陀治疗在超过76%的病例中提供了完全或部分缓解,只有0.9%的病例报告症状加重。
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引用次数: 10
Theoretical Rationale for How Slimming Garments May Motivate Physical Activity in People with Obesity 瘦身服装如何激励肥胖人群进行体育锻炼的理论依据
Pub Date : 2018-06-01 DOI: 10.1097/pp9.0000000000000017
M. Binks, Shao-Hua Chin
Obesity and inactivity contribute to disease burden and increased mortality worldwide. Consistency in initiating and maintaining adequate physical activity continues to be a major challenge. The majority of the weight loss and exercise science literature focuses on enhancing personal responsibility. For people with obesity, perceptions of others, a history of negative self-judgment and consequent low exercise self-efficacy influence the likelihood that they will engage in physical activity. We provide a theoretical rationale for the utility of slimming garments in enhancing exercise adherence. We reviewed and compiled relevant literature related to motivational theory and body image to develop a theoretical basis for the use of slimming garments to promote exercise adherence. Our review provides theoretical support for the potential for slimming garments to improve exercise adherence. Reductions in exercise avoidance may be achieved through the use of slimming garments during and following exercise.
肥胖和不活动导致了世界范围内的疾病负担和死亡率增加。坚持开展和保持适当的体育活动仍然是一项重大挑战。大多数减肥和锻炼科学文献都集中在增强个人责任感上。对于肥胖者来说,对他人的看法、负面自我判断的历史以及随之而来的低运动自我效能感会影响他们进行体育活动的可能性。我们为减肥服在增强运动依从性方面的实用性提供了理论依据。我们回顾并汇编了与动机理论和身体形象相关的相关文献,为使用减肥服促进运动坚持性奠定了理论基础。我们的综述为减肥服装提高运动依从性的潜力提供了理论支持。通过在运动期间和运动后使用减肥服,可以减少运动回避。
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引用次数: 0
期刊
Progress in preventive medicine (New York, N.Y.)
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