Search

The pharmacokinetic (PK) characteristics of drugs were altered under high‐altitude hypoxia. We aim to describe the population PK of atorvastatin (ATV) to identify patient characteristics that are predictive of variability in the PK parameters of the ATV and investigate the effects of high‐altitude hypoxia on the blood concentration of ATV in patients with hyperlipidemia. A total of 160 plasma concentrations were collected from 40 patients with hyperlipidemia in plateau areas and 40 in plain areas. The population pharmacokinetic model of patients with hyperlipidemia in plateau and plain areas of China was established by a nonlinear mixed‐effects model. The PK of ATV were described by a 1‐compartment model with first‐order elimination. The main PK parameters of ATV were the first‐order absorption rate (0.76 hour−1 fixed); clearance (174.22 L/h) and apparent volume of distribution (1119.62 L). The values of area and age were identified as significant covariates for the clearance, area, age, and urea for the volume of distribution. The steady‐state peak concentration in the plateau area was higher than that in the plain area. This study may suggest dose reduction is necessary for patients with hyperlipidemia in high altitudes. [ABSTRACT FROM AUTHOR]

Background: Radiomics is increasingly utilized to distinguish pulmonary nodules between lung adenocarcinoma (LUAD) and tuberculosis (TB). However, it remains unclear whether different segmentation criteria, such as the inclusion or exclusion of the cavity region within nodules, affect the results. Methods: A total of 525 patients from two medical centers were retrospectively enrolled. The radiomics features were extracted according to two regions of interest (ROI) segmentation criteria. Multiple logistic regression models were trained to predict the pathology: (1) The clinical model relied on clinical‐radiological semantic features; (2) The radiomics models (radiomics+ and radiomics−) utilized radiomics features from different ROIs (including or excluding cavities); (3) the composite models (composite+ and composite−) incorporated both above. Results: In the testing set, the radiomics+/− models and the composite+/− models still possessed efficient prediction performance (AUC ≥ 0.94), while the AUC of the clinical model was 0.881. In the validation set, the AUC of the clinical model was only 0.717, while that of the radiomics+/− models and the composite+/− models ranged from 0.801 to 0.825. The prediction performance of all the radiomics+/− and composite+/− models were significantly superior to that of the clinical model (p < 0.05). Whether the ROI segmentation included or excluded the cavity had no significant effect on these models (radiomics+ vs. radiomics−, composite+ model vs. composite−) (p > 0.05). Conclusions: The present study established a machine learning‐based radiomics strategy for differentiating LUAD from TB lesions. The ROI segmentation including or excluding the cavity region may exert no significant effect on the predictive ability. [ABSTRACT FROM AUTHOR]

Loving‐kindness and compassion meditation (LKCM) have been well applied among employees to improve their health and well‐being. Existing studies on LKCM have also provided supportive evidence of its benefits and effectiveness under organizational contexts. The current meta‐analytical study aimed to systematically summarise the effects of LKCM in the workplace and to outline directions for future research and practice. Among 327 empirical studies on LKCM published until March 2022, 21 trials focussed on employees and provided sufficient information, which were included in the following meta‐analysis. The results showed that LKCM benefited eight categories of workplace outcomes. Specifically, LKCM effectively decreased employees' burnout (g = 0.395, k = 10) and stress (g = 0.544, k = 10) and facilitated their mindfulness (g = 0.558, k = 14), self‐compassion (g = 0.646, k = 12), personal mental health (g = 0.308, k = 13), job attitudes (g = 0.283, k = 4), interpersonal relationships (g = 0.381, k = 12), and psychological resources (g = 0.406, k = 6). The results of moderation analyses further indicated that the participants' job type, gender, and the focus of LKCM might differentially fluctuate the magnitude of LKCM effects. To advance research and best practice, we finally pointed out several issues that deserve attention, such as long‐term effects, underlying mechanisms, potential moderators, and outcomes or influential factors at the organizational level. [ABSTRACT FROM AUTHOR]

Objectives: The proportion of older people with dementia in China is gradually increasing with the increase in the aging population over recent years. Hypertension and diabetes are common non‐communicable diseases among rural populations in China. However, it remains unclear whether these conditions affect the occurrence and development of cognitive impairment as there is limited research on cognitive status and its risk factors among residents of rural areas. Methods: A multi‐stage stratified cluster random sampling method was used to select 5400 participants from rural permanent residents. A self‐designed structured questionnaire was used to investigate demographic data of the participants. Cognitive function was assessed using the Montreal Cognitive Function Assessment Scale (MoCA). The results were analyzed using chi‐square test, ANOVA and multiple linear regression analysis. Results: A total of 5028 participants returned the survey, giving a response rate of 93.1%. Higher education (odds ratio (OR) = 3.2, 95% confidence interval (CI) 2.87–3.54, p < 0.001), higher income (OR = 1.61, 95% CI 1.16–2.07, p < 0.001), and dietary control (OR = 0.66, 95%CI 0.34–0.98, p < 0.001) were protective factors. A visual representation of the relationship between annual income and MoCA score showed an inverted U‐curve, the group with an annual income of 6000–7999 RMB had a maximum OR of 1.93 (95%CI 0.12–2.74, p < 0.001). While difficulty in maintaining sleep were risk factors for cognitive impairment (OR = −2.28, 95% CI–4.18–0.39, p = 0.018). Conclusions: Participants with middle incomes had better cognitive status than those with the highest incomes. Higher education, proper diet control and good sleep are beneficial to the cognitive status of residents in rural areas. Key points: Higher education level, higher income level and diet control are protective factors for the development of cognitive dysfunction.Cognitive dysfunction is more likely to occur in women and in people who have difficulty maintaining sleep.There were no significant differences in the demographic characteristics of patients with hypertension, diabetes, the combination of hypertension and diabetes, and healthy residents in low‐income rural areas.The cognitive status of middle‐income people is better than that of high‐income people than that of low‐income people, a visual representation of the relationship between annual income and MoCA score showed an inverted U‐curve. [ABSTRACT FROM AUTHOR]

Aim: To estimate the incidence and identify risk factors of postpartum hemorrhage (PPH) after vaginal delivery. Methods: A systematic review and meta‐analysis was conducted. PubMed, Cochrane Library, CINAHL, Web of Science, EMBASE, and ClinicalTrials.gov databases were systematically searched from inception to April 30th, 2022. Cross‐sectional, cohort, case–control, and secondary analysis of randomized controlled studies that reported the incidence of PPH and the related risk factors in vaginal delivery were eligible through screening of 2343 articles. The incidence, associated standard error, adjusted odds ratios, relative risks and associated 95% confidence intervals were combined in the meta‐analysis. Results: Thirty‐six articles were included in the descriptive review. The incidence of PPH (blood loss ≥500 mL and blood loss ≥1000 mL) was 17% and 6%, respectively. Forty‐one identified risk factors were divided into five categories under two criteria: history and demographics; maternal comorbidity; pregnancy‐related factors; labor‐related factors; delivery‐related factors. Conclusions: With the increasing incidence of PPH globally, obstetric health care providers need to improve their awareness of these multi‐factorial risks to optimize obstetric care and reduce maternal morbidity. This systematic review and meta‐analysis have raised important questions about the nature of vaginal delivery, such as the duration of prolonged labor, details on the use of oxytocin, and the presence of genital tract trauma. There should be highlighted by obstetric personnel on these factors during a patients' labor process. [ABSTRACT FROM AUTHOR]

Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis. An extended-release (XR) formulation has been designed to provide a once-daily (QD) dosing option to patients to achieve comparable pharmacokinetic (PK) parameters to the twice-daily immediate-release (IR) formulation. We conducted 2 randomized, open-label, phase 1 studies in healthy volunteers. Study A characterized single-dose and steady-state PK of tofacitinib XR 11 mg QD and intended to demonstrate equivalence of exposure under single-dose and steady-state conditions to tofacitinib IR 5 mg twice daily. Study B assessed the effect of a high-fat meal on the bioavailability of tofacitinib from the XR formulation. Safety and tolerability were monitored in both studies. In study A (N = 24), the XR and IR formulations achieved time to maximum plasma concentration at 4 hours and 0.5 hours postdose, respectively; terminal half-life was 5.9 hours and 3.2 hours, respectively. Area under plasma concentration-time curve (AUC) and maximum plasma concentration (Cmax) after single- and multiple-dose administration were equivalent between the XR and IR formulations. In study B (N = 24), no difference in AUC was observed for fed vs fasted conditions. Cmax increased by 27% under the fed state. On repeat administration, negligible accumulation (<20%) of systemic exposures was observed for both formulations. Steady state was achieved within 48 hours of dosing with the XR formulation. Tofacitinib administration as an XR or IR formulation was generally well tolerated in these studies. [ABSTRACT FROM AUTHOR]