Modifiable

可修改
  • 文章类型: Journal Article
    背景:在全球范围内,胃肠炎(GE)显着影响儿童的健康,并有助于社会,经济,和健康负担。先前报告高收入环境中儿童GE风险因素的研究主要依赖于疫情调查,它固有地仅捕获GE发生的整个频谱的分数表示。此外,关于通用电气可修改风险因素的综合信息很少。本范围审查旨在综合有关高收入国家儿童中与GE相关的可修改和行为风险因素的现有证据。
    方法:PubMed,Embase,CINAHL,Scopus是检索文章的数据库。对证据进行了描述性综合,遵循Arksey和O\'Malley范围研究框架,并通过系统审查首选报告项目和范围审查清单(PRISMA-ScR)的Meta分析扩展进行了增强。
    结果:系统搜索确定了13,395篇期刊文章,随后进行了筛查,并删除重复项,导致19篇文章纳入审查。这些研究中的大多数(63.2%)采用了病例对照设计,并且主要在社区环境中进行(68.4%)。父母识字等因素,与表现出胃肠道症状的个体接触,在家庭环境中,尿布穿着被确定为与儿童GE显着相关。儿童保育相关变量,包括入学人数,儿童群体之间的人员混合,中央清洁站的存在,以及卫生和疾病预防政策的实施,与GE显著相关。此外,沙坑的存在,划桨池,儿童保育中心的动物与就诊儿童中GE的发病率增加有关。
    结论:范围审查揭示了高收入国家儿童胃肠炎(GE)影响因素的复杂多样的研究前景。研究结果表明,虽然一些变量与特定病原体密切相关,其他人可能不是,突出GE病因学的变异性。各种家庭水平和儿童保育相关因素与儿童GE之间的显着关联为未来研究和公共卫生干预指明了有价值的方向。
    BACKGROUND: Globally, gastroenteritis (GE) significantly impacts children\'s health and contributes to societal, economic, and health burdens. Previous studies reporting risk factors of GE in children in high-income settings mainly rely on outbreak investigations, which inherently capture only a fractional representation of the overall spectrum of GE occurrences. In addition, there is paucity of comprehensive information pertaining to modifiable risk factors of GE. This scoping review aims to synthesize existing evidence concerning modifiable and behavioural risk factors associated with GE among children in high-income countries.
    METHODS: PubMed, Embase, CINAHL, and Scopus were the databases from which articles were retrieved. A descriptive synthesis of the evidence was performed, following the Arksey and O\'Malley scoping studies framework and enhanced by the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews checklist (PRISMA-ScR).
    RESULTS: The systematic search identified 13,395 journal articles, which were subsequently screened, and duplicates removed, resulting in 19 articles for inclusion in the review. The majority of these studies (63.2%) employed a case-control design and were predominantly conducted in community settings (68.4%). Factors such as parental literacy, contact with individuals exhibiting gastrointestinal symptoms, and nappy-wearing were identified as significantly associated with childhood GE within domestic environments. Childcare-related variables, including enrolment size, mixing of personnel between child groups, the presence of central cleaning stations, and the implementation of hygiene and disease prevention policies, showed significant association with GE. In addition, the presence of sand pits, paddling pools, and animals in childcare centers correlated with increased incidences of GE among attending children.
    CONCLUSIONS: The scoping review reveals a complex and varied research landscape on factors influencing gastroenteritis (GE) for children in high-income countries. The findings suggest that while some variables are closely linked to specific pathogens, others may not be, highlighting variability across GE aetiology. The significant association between various household level and childcare-related factors and childhood GE points to a valuable direction for future research and public health intervention.
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  • 文章类型: Journal Article
    目的:体重减轻是胃癌幸存者(GCS)的一个关键问题,与预后和生活质量较差有关。然而,与GCS体重减轻相关的可改变因素似乎有限。我们调查了体重显着下降的因素,包括GCS的饮食模式变化。
    方法:在这项横断面研究中,从2014年到2017年,韩国癌症幸存者从两家大学附属医院招募。总的来说,通过术前体重指数水平分析591例GCSs。显著和严重的体重减轻定义为体重减少超过5%和10%,分别。
    结果:大约68.7%和35.0%的GCS报告了显著和严重的体重减轻,分别。年龄和手术类型是与总体上明显体重减轻相关的重要因素。在术前超重或肥胖的受试者中,性别和手术类型是体重减轻的危险因素.总摄食量减少是体重显著减轻的唯一可改变的因素(调整后的比值比(aOR)1.78,95%置信区间(CI)1.19-2.64),特别是术前正常或体重不足的GCS(aOR2.62,95%CI1.44-4.78)。发现增加蔬菜和盐的减少与显著体重减轻的较低风险有关。减少加工肉对体重减轻的影响因体重减轻程度和术前BMI水平而异。
    结论:改变食物消耗是与显著体重减轻相关的重要可改变因素,这在术前体重不足或正常GCS中更为明显。因此,他们需要进一步的特定饮食建议,以防止体重明显下降。
    结论:为了防止体重明显下降,应向GCS提供饮食调整,以确保总食物摄入量不会减少。
    OBJECTIVE: Weight loss is a critical problem in gastric cancer survivor (GCS) associated with worse prognosis and quality of life. Nevertheless, modifiable factors related to weight loss of GCS seem limited. We investigated the factors with significant weight loss including dietary pattern change in GCS.
    METHODS: In this cross-sectional study, Korean cancer survivors were recruited from two university-affiliated hospitals from 2014 to 2017. Overall, 591 GCSs were analyzed by preoperative body mass index levels. Significant and severe weight loss was defined as a weight reduction of more than 5% and 10%, respectively.
    RESULTS: Around 68.7% and 35.0% of GCS reported significant and severe weight loss, respectively. Age and surgery type were the important factors related to significant weight loss in total. In preoperative overweight or obese subjects, sex and surgery type were the risk factors for weight loss. Total food intake reduction was the only modifiable factor of significant weight loss (adjusted odds ratio (aOR) 1.78, 95% confidence interval (CI) 1.19-2.64), particularly in preoperative normal or underweight GCS (aOR 2.62, 95% CI 1.44-4.78). Increasing vegetable and salt reduction was found to be related to a lower risk of significant weight loss. The impact of reducing processed meat on weight loss differed by degree of weight loss and preoperative BMI level.
    CONCLUSIONS: Changing food consumption was the important modifiable factor related to significant weight loss which was more evident in preoperative underweight or normal GCS. Thus, further specific dietary recommendation is necessary for them to prevent significant weight loss.
    CONCLUSIONS: In order to prevent significant weight loss, dietary modification should be provided to GCS to ensure that total food intake does not decrease.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    在术前确定可改变的共病条件对于优化结局很重要。我们使用国家数据库评估这些危险因素与上肢手术后结果之间的关系。
    国家外科质量改进计划(NSQIP)2006-2016年数据库用于使用CPT代码识别接受上肢原则外科手术的患者。可改变的危险因素被定义为吸烟状况,使用酒精,肥胖,最近体重下降了10%以上,营养不良,和贫血。结果包括出院目的地,主要并发症,出血并发症,计划外的重新手术,脓毒症,并延长逗留时间。卡方和多变量逻辑回归用于确定结果的重要预测因子。显著性定义为P<0.01。
    应用排除标准后,最终分析包括53,780名患者。术前营养不良与非常规出院显著相关(OR=4.75),主要并发症(OR=7.27),出血并发症(OR=7.43),计划外再操作(OR=2.44),脓毒症(OR=10.22),并延长住院时间(OR=5.27)。贫血与非常规出院相关(OR=2.67),出血并发症(OR=13.27),并延长住院时间(OR=3.26)。在体重减轻超过10%的患者中,非常规放电增加(OR=2.77),主要并发症(OR=2.93),和脓毒症(OR=3.7)。吸烟,酒精使用,肥胖与这些并发症无关.
    行为危险因素(吸烟,酒精使用,和肥胖)与并发症发生率增加无关。营养不良,减肥,贫血与上肢矫形外科手术患者术后并发症发生率增加有关,应在手术前解决。建议营养实验室应该是最初血液工作的一部分。
    UNASSIGNED: Identification of modifiable comorbid conditions in the preoperative period is important in optimizing outcomes. We evaluate the association between such risk factors and postoperative outcomes after upper extremity surgery using a national database.
    UNASSIGNED: The National Surgical Quality Improvement Program (NSQIP) 2006-2016 database was used to identify patients undergoing an upper extremity principle surgical procedure using CPT codes. Modifiable risk factors were defined as smoking status, use of alcohol, obesity, recent loss of >10% body weight, malnutrition, and anemia. Outcomes included discharge destination, major complications, bleeding complications, unplanned re-operation, sepsis, and prolonged length of stay. Chi square and multivariable logistic regressions were used to identify significant predictors of outcomes. Significance was defined as P<0.01.
    UNASSIGNED: After applying exclusion criteria, 53,780 patients were included in the final analysis. Preoperative malnutrition was significantly associated with non-routine discharge (OR=4.75), major complications (OR=7.27), bleeding complications (OR=7.43), unplanned re-operation (OR=2.44), sepsis (OR=10.22), and prolonged length of stay (OR=5.27). Anemia was associated with non-routine discharge (OR=2.67), bleeding complications (OR=13.27), and prolonged length of stay (OR=3.26). In patients who had a weight loss of greater than 10%, there was an increase of non-routine discharge (OR=2.77), major complications (OR=2.93), and sepsis (OR=3.7). Smoking, alcohol use, and obesity were not associated with these complications.
    UNASSIGNED: Behavioral risk factors (smoking, alcohol use, and obesity) were not associated with increased complication rates. Malnutrition, weight loss, and anemia were associated with an increase in postoperative complication rates in patients undergoing upper limb orthopaedic procedures and should be addressed prior to surgery, suggesting nutrition labs should be part of the initial blood work.
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  • 文章类型: Review
    肥胖研究进展迅速,但是肥胖患病率的增加更快。在过去的三十年里,研究人员发现,生物心理社会因素决定体重增加的程度远远超过个人选择和责任。已经发现各种基因通过与我们的肥胖环境相互作用而使人们容易患肥胖症。在这次审查中,我们讨论了缺乏体力活动的影响,摄入过多的热量,宫内环境,产后影响,睡眠不足,毒品,医疗条件,社会经济地位,种族,心理社会压力,内分泌干扰化学物质和胃肠道微生物组,关于肥胖的发生。
    Obesity research is advancing swiftly, but the increase in obesity prevalence is faster. Over the past three decades, researchers have found that biopsychosocial factors determine weight gain much more than personal choices and responsibility. Various genes have found to predispose people to obesity by interacting with our obesogenic environment. In this review, we discuss the impact of physical inactivity, excessive caloric intake, intrauterine environment, postnatal influences, insufficient sleep, drugs, medical conditions, socioeconomic status, ethnicity, psychosocial stress, endocrine disrupting chemicals and the gastrointestinal microbiome, on the occurrence of obesity.
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  • 文章类型: Journal Article
    控制印度尼西亚的结核病(TB)决定因素是控制社区结核病的一种方法。需要进行审查,以探索印度尼西亚结核病的危险因素,作为加快结核病预防计划的关键策略。这项审查的目的是确定印度尼西亚成年人中结核病的可修改和不可修改的危险因素。
    进行了一项荟萃分析,以回顾印度尼西亚成年人中与可改变和不可改变的结核病危险因素有关的当前研究。搜索PubMed,ProQuest,和谷歌学者发表的相关文章(2000年1月至2023年12月)。用95%CI计算来自获得的数据的汇集赔率比(POR)。进行了固定效应和随机效应分析。结果显示为森林地块,Begg检验和Egger检验用于检查研究偏倚。使用审查经理(RevMan)5.4和Stata14.2处理和分析所有数据。
    这项研究结果表明,印度尼西亚成年人结核病的不可改变危险因素(结核病家族史)的POR为6.08(95%CI2.99-12.34)。基于可修改的风险因素,众所周知,家庭接触的POR最高(6.01,2.57-14.04),其次是营养不良(5.86,2.50-13.69),不适当的通风(5.57,1.74-17.86),糖尿病(4.92,3.04-7.96),吸烟行为(3.24,2.22-4.72),和低收入水平(2.34,1.42-3.87)。
    基于与结核病发病率相关的重要因素,本综述的结果可能对政府确定成人结核病预防的最佳策略有价值.
    UNASSIGNED: Controlling tuberculosis (TB) determinant factors in Indonesia is one way to control TB in the community. A review is needed to explore risk factors for TB in Indonesia as the key strategies for accelerating the TB preventive program.The purpose of this review was to determine modifiable and non-modifiable risk factors for TB among adults in Indonesia.
    UNASSIGNED: A meta-analysis was undertaken to review current studies related to modifiable and non-modifiable risk factors for TB among adults in Indonesia. A search of PubMed, ProQuest, and Google Scholar for related articles published (January 2000 until December 2023). The Pooled Odds Ratio (POR) from the acquired data were calculated with a 95% CI. The fixed and random effects analysis was performed. The results were presented as forest plots, and Begg\'s test and Egger\'s test were used to examine study bias. Review Manager (RevMan) 5.4 and Stata 14.2 were used to process and analyze all of the data.
    UNASSIGNED: This study results revealed the POR of non-modifiable risk factor (family history of TB) for TB among adults in Indonesia was 6.08 (95% CI 2.99-12.34). Based on modifiable risk factors, it is known that household contact have the highest POR (6.01, 2.57-14.04), followed by malnutrition (5.86, 2.50-13.69), inappropriate ventilation (5.57, 1.74-17.86), diabetes mellitus (4.92, 3.04-7.96), smoking behavior (3.24, 2.22-4.72), and low-income level (2.34, 1.42-3.87).
    UNASSIGNED: Based on significant factors that are related to TB incidence, the results of this review may be valuable to the government in identifying the optimal strategy for TB prevention among adults.
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  • 文章类型: Review
    痴呆症的许多危险因素,从观察性研究中确定,可能是可修改的。这增加了一种可能性,即针对关键的可改变的痴呆风险因素可能会降低痴呆的患病率。这导致了降低痴呆症风险和预防策略的发展,如干预试验或痴呆预防指南。然而,在告知这些策略的研究中很少考虑的是,可改变的痴呆危险因素在多大程度上可以(1)被个体识别,(2)容易被个人修改。可改变的痴呆危险因素的特征,如识别和靶向准备,以及何时应该成为目标,可以影响设计,或降低痴呆症风险的策略的成功。这篇综述旨在开发一个框架,用于对痴呆症危险因素的可修饰程度进行分类,以进行研究。确定这些可改变的痴呆危险因素可以通过寻求降低其痴呆风险的个体来改变的程度。以及风险因素识别和修改可能需要的资源,以及在生命早期(年龄<45岁)中修改是否最佳,中年(年龄45-65岁)或晚年(年龄>65岁)。最后,可能影响个人参与风险因素修改的能力的障碍,最终,讨论了降低痴呆风险的问题。
    Many risk factors for dementia, identified from observational studies, are potentially modifiable. This raises the possibility that targeting key modifiable dementia risk factors may reduce the prevalence of dementia, which has led to the development of dementia risk reduction and prevention strategies, such as intervention trials or dementia prevention guidelines. However, what has rarely been considered in the studies that inform these strategies is the extent to which modifiable dementia risk factors can (1) be identified by individuals, and (2) be readily modified by individuals. Characteristics of modifiable dementia risk factors such as readiness of identification and targeting, as well as when they should be targeted, can influence the design, or success of strategies for reducing dementia risk. This review aims to develop a framework for classifying the degree of modifiability of dementia risk factors for research studies. The extent to which these modifiable dementia risk factors could be modified by an individual seeking to reduce their dementia risk is determined, as well as the resources that might be needed for both risk factor identification and modification, and whether modification may be optimal in early-life (aged <45 years), midlife (aged 45-65 years) or late-life (aged >65 years). Finally, barriers that could influence the ability of an individual to engage in risk factor modification and, ultimately, dementia risk reduction are discussed.
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  • 文章类型: Systematic Review
    已经确定了子宫肌瘤发展中的许多危险因素,但是女性和她们的医生很少意识到生活方式对子宫肌瘤发育的影响。本系统综述的目的是研究和总结与子宫肌瘤发展相关的可改变的预后因素。
    根据PRISMA指南搜索Pubmed和Embase的相关文章。筛选来自所包括的文章的参考文献,并且在相关时还包括。包括对肌瘤发育中可改变因子的人体体内研究。关于不可改变因素和治疗的研究,体外研究和动物研究被排除.共筛选了607篇,共纳入33篇。两名独立调查人员从报告中收集数据。
    肌瘤发展的最大危险因素是高BMI,而最强的保护因素是高水果和蔬菜摄入量和高维生素D摄入量。
    需要更多高质量的研究来更好地了解上述因素的影响以及它们在已经存在的肌瘤生长中的作用。
    子宫肌瘤的发展是多因素的。各种不可改变和可改变的因素与子宫肌瘤的发展有关。可改变的因素可由患者自己控制。我们进行了系统评价以调查这些可改变的因素。我们从2个数据库(PubMed和Embase)中筛选了607篇文章,其中33篇被纳入综述。我们只包括对人类的临床研究。发现高体重指数(BMI)是子宫肌瘤发展的可改变的危险因素。保护子宫肌瘤的发展是高水果和蔬菜的摄入量和高维生素D的摄入量或阳光暴晒。需要更多的研究来研究这些发现在临床实践中的适用性,并研究对已经存在的子宫肌瘤生长的影响。
    UNASSIGNED: Many risk factors in uterine fibroid development have been identified, but women and their physicians are less aware of the influence of lifestyle on uterine fibroid development. The objective of this systematic review is to investigate and summarize modifiable prognostic factors associated with uterine fibroid development.
    UNASSIGNED: Pubmed and Embase were searched for relevant articles according to PRISMA guidelines. References from included articles were screened and when relevant also included. Human in vivo studies on modifiable factors in fibroid development were included. Studies on non-modifiable factors and treatment, in vitro studies and animal studies were excluded. 607 articles were screened and 33 articles were included. Two independent investigators collected data from the report.
    UNASSIGNED: The strongest risk factor for fibroid development was a high BMI, while the strongest protective factors were a high fruit and vegetable intake and high vitamin D intake.
    UNASSIGNED: More high-quality studies are necessary to better understand the impact of the abovementioned factors as well as the role they play in the growth of already existing fibroids.
    Uterine fibroid development is multifactorial. Various non-modifiable and modifiable factors have been linked to uterine fibroid development. Modifiable factors are controllable by patients themselves. We performed a systematic review to investigate these modifiable factors. We screened 607 articles from 2 databases (PubMed and Embase) of which 33 were included in the review. We only included clinical studies on humans. A high body mass index (BMI) is found to be a modifiable risk factor for uterine fibroid development. Protective of uterine fibroid development are high fruit and vegetable intake and high vitamin D intake or sun exposure. More research is needed to investigate the applicability of these findings in clinical practice and to investigate the influence on the growth of already existing uterine fibroids.
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  • 文章类型: Meta-Analysis
    背景:静脉血栓栓塞症(VTE)与几种可改变的因素(MFs)和心血管合并症有关。然而,机制在很大程度上是未知的。我们旨在破译VTE与MFs和心血管合并症相关的蛋白质组学通路。
    方法:采用包括81,190例VTE的全基因组荟萃分析数据,进行了两阶段网络孟德尔随机化(MR)分析,以探讨15例MF和1,151例血液蛋白与VTE之间的关联。我们使用来自35,559名个体的蛋白质数据作为发现分析,以及来自两个独立研究的蛋白质数据,包括分别为10,708和54,219名参与者作为复制分析。基于鉴定的蛋白质,我们评估了药物可服用性,并检查了心血管多效性.
    结果:网络MR分析确定了10个MF-VTE,86MF-蛋白,和34种蛋白质-VTE关联。这些关联在复制分析中总体上是一致的。鉴定了在MF-蛋白-VTE途径中具有方向一致的直接和间接作用的38条途径。低密度脂蛋白受体相关蛋白12(LRP12,34.3%-58.1%)和凝血因子XI(20.6%-39.6%)介导了三个肥胖指标与VTE之间的大多数关联。同样,凝血因子XI介导了大多数吸烟-VTE关联(40%;95%置信区间20%-60%)和失眠-VTE关联(27%;95%置信区间5%-49%)。许多VTE相关蛋白对于血栓形成病症是高度可药用的。五种蛋白质(白介素6受体亚基α,LRP12,凝血酶原,血管生成素-1和低密度脂蛋白受体相关蛋白4)与VTE及其心血管合并症相关。
    结论:本研究提示凝血因子XI,一个下药的目标,是肥胖关联的重要媒介,吸烟,和失眠与VTE风险。
    BACKGROUND: Venous thromboembolism (VTE) has been associated with several modifiable factors (MFs) and cardiovascular comorbidities. However, the mechanisms are largely unknown.
    OBJECTIVE: We aimed to decipher proteomic pathways underlying the associations of VTE with MFs and cardiovascular comorbidities.
    METHODS: A 2-stage network Mendelian randomization analysis was conducted to explore the associations between 15 MFs, 1151 blood proteins, and VTE using data from a genome-wide meta-analysis including 81 190 cases of VTE. We used protein data from 35 559 individuals as the discovery analysis, and from 2 independent studies including 10 708 and 54 219 participants as the replication analyses. Based on the identified proteins, we assessed the druggability and examined the cardiovascular pleiotropy.
    RESULTS: The network Mendelian randomization analyses identified 10 MF-VTE, 86 MF-protein, and 34 protein-VTE associations. These associations were overall consistent in the replication analyses. Thirty-eight pathways with directionally consistent direct and indirect effects in the MF-protein-VTE pathway were identified. Low-density lipoprotein receptor-related protein 12 (LRP12: 34.3%-58.1%) and coagulation factor (F)XI (20.6%-39.6%) mediated most of the associations between 3 obesity indicators and VTE. Likewise, coagulation FXI mediated most of the smoking-VTE association (40%; 95% CI, 20%-60%) and insomnia-VTE association (27%; 95% CI, 5%-49%). Many VTE-associated proteins were highly druggable for thrombotic conditions. Five proteins (interleukin-6 receptor subunit alpha, LRP12, prothrombin, angiopoietin-1, and low-density lipoprotein receptor-related protein 4) were associated with VTE and its cardiovascular comorbidities.
    CONCLUSIONS: This study suggests that coagulation FXI, a druggable target, is an important mediator of the associations of obesity, smoking, and insomnia with VTE risk.
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  • 文章类型: Journal Article
    痴呆症是一个总称,用于描述一组以行为变化为特征的症状,进行性神经系统疾病导致的认知和社会功能丧失。据估计,英国有944,000人患有痴呆症,到2051年,这一数字将增加到200万。我们正在更多地了解在一生中发展为痴呆症的风险因素。本文讨论了痴呆症的可修改和不可修改的危险因素,并考虑了可在初级保健环境中使用的健康促进和健康教育活动。
    Dementia is an umbrella term used to describe a group of symptoms characterised by behavioural changes, loss of cognitive and social functioning brought about by progressive neurological disorders. There are estimated to be 944 000 people living with dementia in the UK and it is indicated that this will increase to 2 million by 2051. We are learning more about the risk factors for developing dementia over the life course. This paper discusses the modifiable and non-modifiable risk factors for dementia and considers health promotion and health education activities that can be used in a primary care setting.
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