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- Tran, K. B., et al.
(författare)
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The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019
- 2022
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Ingår i: Lancet. - 0140-6736. ; 400:10352, s. 563-591
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Tidskriftsartikel (refereegranskat)abstract
- Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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| 4. |
- Novak, R., et al.
(författare)
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Robotic fluidic coupling and interrogation of multiple vascularized organ chips
- 2020
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Ingår i: Nature Biomedical Engineering. - : Nature Research. - 2157-846X.
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Tidskriftsartikel (refereegranskat)abstract
- Organ chips can recapitulate organ-level (patho)physiology, yet pharmacokinetic and pharmacodynamic analyses require multi-organ systems linked by vascular perfusion. Here, we describe an ‘interrogator’ that employs liquid-handling robotics, custom software and an integrated mobile microscope for the automated culture, perfusion, medium addition, fluidic linking, sample collection and in situ microscopy imaging of up to ten organ chips inside a standard tissue-culture incubator. The robotic interrogator maintained the viability and organ-specific functions of eight vascularized, two-channel organ chips (intestine, liver, kidney, heart, lung, skin, blood–brain barrier and brain) for 3 weeks in culture when intermittently fluidically coupled via a common blood substitute through their reservoirs of medium and endothelium-lined vascular channels. We used the robotic interrogator and a physiological multicompartmental reduced-order model of the experimental system to quantitatively predict the distribution of an inulin tracer perfused through the multi-organ human-body-on-chips. The automated culture system enables the imaging of cells in the organ chips and the repeated sampling of both the vascular and interstitial compartments without compromising fluidic coupling.
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| 5. |
- Herland, Anna, et al.
(författare)
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Quantitative prediction of human pharmacokinetic responses to drugs via fluidically coupled vascularized organ chips
- 2020
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Ingår i: Nature Biomedical Engineering. - : Springer Science and Business Media LLC. - 2157-846X. ; 4:4, s. 421-436
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Tidskriftsartikel (refereegranskat)abstract
- Analyses of drug pharmacokinetics (PKs) and pharmacodynamics (PDs) performed in animals are often not predictive of drug PKs and PDs in humans, and in vitro PK and PD modelling does not provide quantitative PK parameters. Here, we show that physiological PK modelling of first-pass drug absorption, metabolism and excretion in humans—using computationally scaled data from multiple fluidically linked two-channel organ chips—predicts PK parameters for orally administered nicotine (using gut, liver and kidney chips) and for intravenously injected cisplatin (using coupled bone marrow, liver and kidney chips). The chips are linked through sequential robotic liquid transfers of a common blood substitute by their endothelium-lined channels (as reported by Novak et al. in an associated Article) and share an arteriovenous fluid-mixing reservoir. We also show that predictions of cisplatin PDs match previously reported patient data. The quantitative in-vitro-to-in-vivo translation of PK and PD parameters and the prediction of drug absorption, distribution, metabolism, excretion and toxicity through fluidically coupled organ chips may improve the design of drug-administration regimens for phase-I clinical trials.
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| 7. |
- Shirazi, M., et al.
(författare)
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Assessing Medical Students' Communication Skills by the Use of Standardized Patients : Emphasizing Standardized Patients' Quality Assurance
- 2014
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Ingår i: Academic Psychiatry. - : Springer. - 1042-9670 .- 1545-7230. ; 38:3, s. 354-360
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Tidskriftsartikel (refereegranskat)abstract
- The objective structured examination is one of the most valid, reliable, and effective tools for assessing clinical and communication skills, often by use of standard patients (SPs). SPs can also be assessors of those skills. One of the crucial areas when utilizing SP-based assessment is the quality and consistency assurance of their portrayal of the case and their ability to fill in checklists in an adequate way. The aim of this study was to assess the validity and reliability of SPs' ability to assess students' communication skill via a Calgary-Cambridge checklist. This cross-sectional and correlational study was conducted at the Tehran University of Medical Science. We first analyzed validity; the criterion validity of the SPs' filling in the checklists was assessed through determining the correlation between the SPs' completed checklists and the checklists filled in by three physician raters individually and then reproducibility: it was assessed by a test-retest approach inter-rater reliability. The mean correlation for assessing the validity of SPs' completed checklists by individual SPs was 0.81. The inter-rater reliability was calculated by kappa coefficient, and the total correlation among the three raters was 0.85. The reliability of the test-retest approach showed no significant differences between the test and re-test results. The increased number of medical students and different faculties' responsibilities such as doing educational, research, and health services duties assessing medical student communication skills is a complex issue. The results of our study showed that trained SPs can be used as a valid tool to assess medical students' communication skills, which is also more cost effective and reduces work load of medical faculties.
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| 8. |
- Moghaddam, AK, et al.
(författare)
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Educational impact of assessment on medical students' learning at Tehran University of Medical Sciences: a qualitative study
- 2019
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 9:7, s. e031014-
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Tidskriftsartikel (refereegranskat)abstract
- It has been shown that assessment strongly affects students’ performance. A deeper insight needs to be gained into the interplay of assessment and learning. The aim of the current study was to develop a model to explain the educational impact of assessments on students’ learning, before, during and after the test.DesignThis study used semistructured interviews, focus group discussions and observation and collection of field notes. A qualitative methodology using the grounded theory data analysis approach was then used to generate an explanation of the process of how assessment impacts students’ learning.SettingSchool of Medicine, Tehran University of Medical Sciences.ParticipantsParticipants were medical students and teachers with first-hand experience or expertise in assessment as well as their willingness to participate in the study. Fifteen people (eight medical students, seven faculty members) were interviewed. One focus group discussion (with five students) was held.ResultsThe extracted concepts from our study were classified into four main categories. These categories include elements of the assessment programme which affect learning, the mechanism through which they exert their effects, contextual factors and the impact they have on learning. These elements and their interplay occur within an environment with its antecedent characteristics.ConclusionsThis study suggested a model for understanding the elements of the assessment which, within the context, affect learning, the mechanisms through which they impart their effects and the final outcomes obtained.
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| 9. |
- Abdollahi, Abbas, et al.
(författare)
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Effect of exercise augmentation of cognitive behavioural therapy for the treatment of suicidal ideation and depression
- 2017
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 219, s. 58-63
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Tidskriftsartikel (refereegranskat)abstract
- Background: Suicidal ideation and depression are prevalent and costly conditions that reduce quality of life. This study was designed to determine the efficacy of exercise as an adjunct to cognitive behavioural therapy (CBT) for suicidal ideation and depression among depressed individuals.Methods: In a randomized clinical trial, 54 mildly to moderately depressed patients (54% female, mean age=48.25) were assigned to a combined CBT and exercise group or to a CBT only group. Both groups received one weekly session of therapy for 12 weeks, while the combined group also completed exercise three times weekly over the same period. Self-reported suicidal ideation, depression, and activities of daily living were measured at the beginning and the end of treatment.Results: Multilevel modelling revealed greater improvements in suicidal ideation, depression, and activities of daily living in the combined CBT and exercise group, compared to the CBT only group.Limitations: No follow-up data were collected, so the long-term effects (i.e., maintenance of gains) is unclear.Conclusions: The findings revealed that exercise adjunct to CBT effectively decreases both depressive symptoms and suicidal ideation in mildly to moderately depressed individuals.
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| 10. |
- Etbaeitabari, Amir, et al.
(författare)
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An analytical heat transfer assessment and modeling in a natural convection between two infinite vertical parallel flat plates
- 2013
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Ingår i: Journal of Molecular Liquids. - : Elsevier. - 0167-7322 .- 1873-3166. ; 188, s. 252-257
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Tidskriftsartikel (refereegranskat)abstract
- Heat transfer by natural convection occurs in many physical problems and engineering applications such as geo-thermal systems, heat exchangers, petroleum reservoirs and nuclear waste repositories. These problems and phenomena are modeled by ordinary or partial differential equations. In most cases, experimental solutions cannot be applied to these problems, so these equations should be solved using special techniques. Recently, much attention has been devoted to these methods to construct analytic solutions; such as the perturbation method. Perturbation techniques are dependent upon small parameter. Thus, it is worthwhile developing a new technique independent of small parameter. The Reconstruction of Variational Iteration Method technique is a powerful and convenient algorithm in finding the solutions for the equations. While this method is capable of reducing the size of calculation, it overcomes the difficulty of the perturbation technique or Adomian polynomials by applying Laplace Transform. In this paper an analysis has been performed to study the natural convection of a non-Newtonian fluid between two infinite parallel vertical flat plates and the effects of the non-Newtonian nature of fluid on the heat transfer are studied. In order to compare with exact solution, velocity and temperature profiles are shown graphically. The obtained results are valid with significant accuracy. (C) 2013 Elsevier B.V. All rights reserved.
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