Sextonbyrd4629

Several studies have previously assessed the association between interleukin (IL)-10 gene polymorphisms and the risk of asthma, leading to conflicting results. To resolve the incongruent outcomes yielded from different single studies, we conducted the most up-to-date meta-analysis of the IL-10 gene rs1800896, rs1800871, and rs1800872 single-nucleotide polymorphisms (SNPs) and susceptibility to asthma. A systematic literature search performed until April 2020, and the pooled odds ratio (OR) and their corresponding 95% confidence interval (CI) were calculated to determine the association strength. Thirty articles comprising 5678 asthmatic patients and 6079 controls met the inclusion criteria. No significant association was found between rs1800872 SNP and susceptibility to asthma across all genetic models in the overall and subgroup analyses. The rs1800871 SNP had only significant association with a decreased risk of asthma in Europeans (OR 0.66, CI 0.53-0.82, P  less then  0.001). However, rs1800896 SNP was significantly associated with a decreased risk of asthma by dominant (OR 0.67, CI 0.50-0.90, P  less then  0.001) and heterozygote (OR 0.66, CI 0.49-0.88, P  less then  0.001) models in the overall analysis. Subgroup analyses indicated significant association of rs1800896 SNP by dominant (OR 0.45, CI 0.28-0.72, P  less then  0.001) and heterozygote (OR 0.43, CI 0.26-0.70, P  less then  0.001) models in the African population. selleck inhibitor The IL-10 rs1800896 SNP confers protection against the risk of asthma, especially in Africans. Additionally, rs1800871 SNP has a protective role against asthma in Europeans.Transdiagnostic models of psychopathology suggest that disorders may share common features that could influence their severity. Attention problems and psychomotor restlessness are included in the diagnostic criteria for several disorders, including disorders on the internalizing spectrum, but their transdiagnostic significance has received little attention. The present study identifies patterns of attention problems and restlessness among youth with internalizing problems, in order to understand their clinical significance in terms of internalizing symptom severity and response to cognitive behavioral therapy (CBT). Participants were 142 adolescents age 11-18 clinically referred for mood and/or anxiety problems. Latent class analysis was used to identify patterns of self-reported attention problems and psychomotor restlessness, and classes were compared on internalizing, depression, and anxiety severity. Differences in treatment response were examined in a subset of youth (n = 82; age 14-18) who participated in group CBT. Youth in the Attention Problems class (42% of sample) and youth in the Restless class (15% of sample) endorsed significantly more internalizing, depression, and anxiety problems than youth with Low Symptoms of attention problems or psychomotor restlessness (43% of sample). Youth in the Restless class responded significantly better to CBT than youth in the Low Symptoms of attention problems or psychomotor restlessness class in terms of decrease in overall internalizing problems. Attention problems and psychomotor restlessness appear to be important transdiagnostic markers of severity across the internalizing spectrum; however, they do not limit the effectiveness of CBT and, in the case of psychomotor restlessness, may forecast a good treatment response.Sluggish cognitive tempo (SCT) is marked by impairments across social, emotional, and academic functioning, but few studies have examined the association between SCT and neuropsychological functioning. The present study examined the associations between SCT and measures of processing speed, executive function, attention, and reaction time. From a larger sample of 8,238 children and adolescents, a subsample of 928 children were overselected for symptoms of SCT or attention-deficit/hyperactivity disorder (ADHD) and compared to a matched control sample of 652 individuals without elevations of ADHD or SCT (age range = 5.9-15.4 years). Multiple regression analyses revealed that symptoms of SCT were independently associated with deficits in nearly all domains assessed by a battery of neuropsychological assessments, including slower processing speed, poorer working memory, decreased inhibition, poorer vigilance, and increased reaction time. Further, weaknesses in all five of these domains remained significant even after symptoms of ADHD-inattention, anxiety, and depression were controlled. These findings add to literature that supports the validity of SCT as a symptom profile separate from ADHD-inattention symptoms.The process of introducing a new health technology into a healthcare system is characterized by uncertainty and risk for those involved-pharmaceutical companies, payers, patients and the government. In view of the accelerated introduction of new technologies in recent years, mechanisms to reduce uncertainty are of growing interest. One example is the Managed Entry Agreement (MEA), which we explore using a mechanism design approach. We make use of the Israeli experience, in which pharmaceutical companies and health plans (i.e., payers) negotiate over the introduction of new technologies into the national Health Services Basket (HSB) with the Ministry of Health acting as a mediator. We use the framework of bargaining within a mechanism design framework to show that in the process of negotiation the parties, the pharmaceutical company (PC) and the health plan (HP), have independent private valuations and that a situation of common knowledge that gains from MEA exists is rare. Adding a mediator (i.e., the MEA team) to the mechanism, as in a direct-revelation mechanism, reduces the level of uncertainty for both sides (i.e., the PC and the HP), thus making it possible to meet the budget constraint while increasing value for patients and enhancing ex-post efficiency.Hereditary angioedema (HAE) is an autosomal dominant disease mostly due to the deficiency of C1 inhibitor (C1-INH). HAE with normal C1-INH was first described in 2000 and associated with mutations in the coagulation factor XII in 2006. Both diseases are associated with high bradykinin production, resulting in increased vascular permeability. Gastrointestinal edema due to HAE can be misdiagnosed as acute abdomen and unnecessary surgical procedures may be performed. The present study evaluates the prevalence of surgical procedures and/or acute abdomen in HAE patients with the coagulation factor XII mutation. It is a retrospective study where patients were diagnosed with recurrent angioedema without urticaria, normal C1-INH levels, and positive family history of angioedema. All patients were evaluated for the known mutations located at exon 9 of the F12 gene. Medical records were evaluated and questionnaires were applied to 52 patients with normal C1-INH levels (age range 13-76 years; 47/52, 90.38% women; 5/52, 9.61% men). F12 mutation was present in 32/52 patients (61.5%). Acute abdominal pain was diagnosed in 16/52 (30.76%) patients, appendicitis in 9/16 (56.2%), and undetermined diagnosis in 7/16 (43.7%). Among patients diagnosed with acute abdominal pain, 13/16 (81.2%) underwent surgery and 3/16 (18.7%) improved without surgical intervention. We conclude that many HAE patients with coagulation factor XII mutation were misdiagnosed with acute abdomen and subjected to unnecessary invasive procedures. It is critical to disseminate information about this rare mutation in patients with otherwise normal C1-INH activity, in order to speed up diagnosis and avoid misconduct.The essays in this special issue of HEC Forum provide reflections that make explicit the implicit anthropology that our current pandemic has brought but which in the medical ethics literature around COVID-19 has to a great extent ignored. Three of the essays are clearly "journalistic" as a literary genre one by a hospital chaplain, one by a medical student in her pre-clinical years, and one by a fourth-year medical student who reports her experience as she completed her undergraduate clerkships and applied for positions in graduate medical education. Other essays explore the pandemic from historical, sociological, and economic perspectives, particularly how triage policies have been found to be largely blind to structural healthcare disparities, while simultaneously unable to appropriately address those disparities. link2 Central issues that need to be addressed in triage are not just whether a utilitarian response is the most just response, but what exactly is the greatest good for the greatest number? Together, the essays in this special issue of HEC Forum create a call for a more anthropological approach to understanding health and healthcare. The narrow approach of viewing health as resulting primarily from healthcare will continue to hinder advances and perpetuate disparities. Health outcomes result from a complex interaction of various social, economic, cultural, historical, and political factors. Advancing healthcare requires contextualizing the health of populations amongst these factors. The COVID-19 pandemic has made us keenly aware of how interdependent our health as a society can be.Breast cancer is one of the leading causes of mortality in the world and it occurs in high frequency among women that carries away many lives. To detect cancer, extraction or segmentation of lesions/tumors is required. Segmentation process is very crucial if the mammogram images are blurred or low contrast. This paper suggests a novel clustering approach for segmenting lesions/tumors in the mammogram images using Atanassov's intuitionistic fuzzy set theory. The algorithm initially converts an image to an intuitionistic fuzzy image using a novel intuitionistic fuzzy generator. From the intuitionistic fuzzy image, two membership intervals are computed. Then, using Zadeh's min t-conorm, a new membership function is computed. Using the new membership function, an interval type 2 fuzzy image is constructed. Two types of distance functions are used in clustering-intuitionistic fuzzy divergence and a fuzzy exponential type distance function. Further, in each iteration, membership matrix is updated using a hesitation degree and a clustered image is obtained. Tumors/lesions are then segmented from the clustered image. The proposed method is compared with existing methods both quantitatively and qualitatively and it is observed that the proposed method performs better than the existing methods.

Despite the increasing use of adjuvant bone-modifying agents (BMAs) such as zoledronate and clodronate in the treatment of patients with early stage breast cancer (EBC), little is known about real world practice patterns. A physician survey was performed to address this deficit and determine interest in clinical trials of alternative strategies for BMA administration.

Canadian oncologists treating patients with EBC were surveyed via an anonymized online survey. The survey collected information on physician demographics, knowledge and interpretation of adjuvant bisphosphonate guidelines, and real world prescribing practices. Questions also determined thoughts around the design of future adjuvant BMA trials.

Of 127 surveyed physicians, 53 eligible invitees responded (response rate 42%). The majority of physicians are offering high-risk postmenopausal patients adjuvant BMAs. link3 The most common BMA regimen was adjuvant zoledronate (45/53, 85%) every 6 months for 3 years. Concerns around toxicities and repeated visits to the cancer centre were perceived as the greatest barriers to adjuvant bisphosphonate use.