Displaying publications 21 - 40 of 411 in total

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  1. Abdullah N, Fulazzaky MA, Yong EL, Yuzir A, Sallis P
    J Environ Manage, 2016 Mar 1;168:273-9.
    PMID: 26760229 DOI: 10.1016/j.jenvman.2015.12.015
    The treatment of high-strength organic brewery wastewater with added acetaminophen (AAP) by an anaerobic digester was investigated. An anaerobic packed-bed reactor (APBR) was operated as a continuous process with an organic loading rate of 1.5-g COD per litre per day and a hydraulic retention time of three days. The results of steady-state analysis showed that the greatest APBR performances for removing COD and TOC were as high as 98 and 93%, respectively, even though the anaerobic digestibility after adding the different AAP concentrations of 5, 10 and 15 mg L(-1) into brewery wastewater can affect the efficiency of organic matter removal. The average CH4 production decreased from 81 to 72% is counterbalanced by the increased CO2 production from 11 to 20% before and after the injection of AAP, respectively. The empirical kinetic models for substrate utilisation and CH4 production were used to predict that, under unfavourable conditions, the performance of the APBR treatment process is able to remove COD with an efficiency of only 6.8%.
    Matched MeSH terms: Longitudinal Studies
  2. Nuriah Mohamad, Azlin Suhaida Azmi, Fathilah Ali, Mohamad Firdaus Omar
    MyJurnal
    Sulfur has been highly sought by many industries everywhere around the world for various applications. This exceptionally useful element has been largely manufactured especially in powder form each year reflecting its increase in demand in line with technological advancement and uses for various product applications. The manufacturing processes include mining as well as chemical reactions in Claus Process. Rubber industries normally use abundance of sulfur in their latex compound to introduce vulcanization. The geneal concern of sulfur for rubber vulcanization is dispersibility in the rubber matrix due to improper optimization of its preparation process prior to latex compounding. Another crucial issue is crystallization of soluble sulfur from its insoluble origin, either during or post-rubber vulcanization that constitutes to formation of sulfur bloom that grows on the surface of the rubber articles. It is known that both issues are related to the process conditions and compounding recipe that could not be fully solved. Various studies have been conducted to minimize such occurences – from process optimization to sulfur chemistry itself – and of continuous improvement and innovation to solve various threats in sulfur applications. This paper reviews on detailed description on elemental sulfur, of respective industrial applications, and most importantly highlights on sulfur trends and issues normally encountered.
    Matched MeSH terms: Longitudinal Studies
  3. Abd Rahman FA, Ab Kadir MZA, Ungku Amirulddin UA, Osman M
    Materials (Basel), 2021 Mar 29;14(7).
    PMID: 33805583 DOI: 10.3390/ma14071684
    The fourth rail transit is an interesting topic to be shared and accessed by the community within that area of expertise. Several ongoing works are currently being conducted especially in the aspects of system technical performances including the rail bracket component and the sensitivity analyses on the various rail designs. Furthermore, the lightning surge study on railway electrification is significant due to the fact that only a handful of publications are available in this regard, especially on the fourth rail transit. For this reason, this paper presents a study on the electrical performance of a fourth rail Direct Current (DC) urban transit affected by an indirect lightning strike. The indirect lightning strike was modelled by means of the Rusck model and the sum of two Heidler functions. The simulations were carried out using the EMTP-RV software which included the performance comparison of polymer-insulated rail brackets, namely the Cast Epoxy (CE), the Cycloaliphatic Epoxy A (CEA), and the Glass Reinforced Plastic (GRP) together with the station arresters when subjected by 30 kA (5/80 µs) and 90 kA (9/200 µs) lightning currents. The results obtained demonstrated that the GRP material has been able to slightly lower its induced overvoltage as compared to other materials, especially for the case of 90 kA (9/200 µs), and thus serves better coordination with the station arresters. This improvement has also reflected on the recorded residual voltage and energy absorption capacity of the arrester, respectively.
    Matched MeSH terms: Longitudinal Studies
  4. Nadarajah VD, Sow CF, Syed Aznal SS, Montagu A, Boursicot K, Er HM
    J Med Educ Curric Dev, 2020 11 19;7:2382120520970894.
    PMID: 33283046 DOI: 10.1177/2382120520970894
    A preparatory framework called EASI (Evaluate, Align, Student-centred, Implement and Improve) was developed with the aim of creating awareness about interim options and implementation opportunities for online Clinical and Communication Skills (CCS) learning. The framework, when applied requires faculty to evaluate current resources, align sessions to learning outcomes with student-centred approaches and to continuously improve based on implementation experiences. Using the framework, we were able to generate various types of online CCS learning sessions for implementation in a short period of time due to the recent Covid-19 pandemic. Importantly we learnt a few lessons post-implementation from both students and faculty perspective that will be used for planning and delivery of future sessions. In summary, the framework was useful for creating or redesigning CCS sessions which were disrupted during the pandemic, however post-implementation experience suggests the framework can also be used for future solutions in online CCS learning as healthcare systems and delivery are increasingly decentralised and widely distributed.
    Matched MeSH terms: Longitudinal Studies
  5. Effendi-Tenang I, Tan MP, Khaliddin N, Jamaluddin Ahmad M, Amir NN, Kamaruzzaman SB, et al.
    Arch Gerontol Geriatr, 2020 06 26;90:104165.
    PMID: 32650156 DOI: 10.1016/j.archger.2020.104165
    INTRODUCTION: Published literature on vision impairment and cognitive function amongst older Malaysians remains scarce. This study investigates the association between vision impairment and cognitive function in an older Malaysian population.

    METHODS: Subjects aged 55 years and above from the Malaysian Elders Longitudinal Research (MELoR) study with available information on vision and Montreal Cognitive Assessment (MoCA) scores were included. Data were obtained through a home-based interview and hospital-based health check by trained researchers. Visual acuity (VA) was assessed with logMAR score with vision impairment defined as VA 6/18 or worse in the better-seeing eye. Cognition was evaluated using the MoCA-Blind scoring procedure. Those with a MoCA-Blind score of <19/22 were considered to have cognitive impairment.

    RESULTS: Data was available for 1144 participants, mean (SD) age = 68.57 (±7.23) years. Vision impairment was present in 143 (12.5 %) and 758 (66.3 %) had MoCA-Blind score of <19. Subjects with vision impairment were less likely to have a MoCA-Blind score of ≥19 (16.8 % vs 36.2 %, p < 0.001). Vision impairment was associated with poorer MoCA-Blind scores after adjustments for age, gender, and ethnicity (β = 2.064; 95 % CI, -1.282 to 3.320; P = 0.003). In those who had > 6 years of education attainment, vision impairment was associated with a significant reduction of cognitive function and remained so after adjustment for age and gender (β = 1.863; 95 % CI, 1.081-3.209; P = 0.025).

    CONCLUSION: Our results suggest that vision impairment correlates with cognitive decline. Therefore, maintaining good vision is an important interventional strategy for preventing cognitive decline in older adults.

    Matched MeSH terms: Longitudinal Studies
  6. Mohan D, Teong ZK, Bakir AN, Sajab MS, Kaco H
    Polymers (Basel), 2020 Aug 20;12(9).
    PMID: 32825377 DOI: 10.3390/polym12091876
    The materials for additive manufacturing (AM) technology have grown substantially over the last few years to fulfill industrial needs. Despite that, the use of bio-based composites for improved mechanical properties and biodegradation is still not fully explored. This limits the universal expansion of AM-fabricated products due to the incompatibility of the products made from petroleum-derived resources. The development of naturally-derived polymers for AM materials is promising with the increasing number of studies in recent years owing to their biodegradation and biocompatibility. Cellulose is the most abundant biopolymer that possesses many favorable properties to be incorporated into AM materials, which have been continuously focused on in recent years. This critical review discusses the development of AM technologies and materials, cellulose-based polymers, cellulose-based three-dimensional (3D) printing filaments, liquid deposition modeling of cellulose, and four-dimensional (4D) printing of cellulose-based materials. Cellulose-based AM material applications and the limitations with future developments are also reviewed.
    Matched MeSH terms: Longitudinal Studies
  7. Li Tsu Chong, Deena Clare Thomas, Renie Martha Joanes, Rose A Nain
    MyJurnal
    Introduction: Phlebitis may localise to the insertion site or travel along the vein. The risk of phlebitis is higher in children as they have thin and weak blood vessels and move continuously due to the pain associated with insertion. Therefore, regular assessment of the risk of developing phlebitis is crucial. This review aimed to identify infusion phlebitis assessment tool used in the paediatric setting. Methods: Electronic databases used were Scopus, ProQuest, ScienceDirect, and Google Scholar. A total of ten studies which assess the development of infusion phlebitis on hos- pitalised children included in this reviewed. Study findings were discussed and concluded with a recommendation for clinical practice and future studies. Results: Phlebitis development rate was the primary outcome measures in ten studies. Of ten studies, six provided no actual definition of phlebitis. Eight reported phlebitis incidence and/or severity, eight used a scale and two used a definition alone in assessing the development of phlebitis. This review identified five different phlebitis assessment scales. Conclusion: Although there are applicable phlebitis scales can be used for paediatric setting, Limited studies have been conducted on infusion phlebitis assessment method in chil- dren. Therefore, it is suggested that more studies and vigorous test needed to identify applicable assessment tools in paediatric setting.
    Matched MeSH terms: Longitudinal Studies
  8. Loo JMY, Kraus SW, Potenza MN
    J Behav Addict, 2019 Dec 01;8(4):625-648.
    PMID: 31830810 DOI: 10.1556/2006.8.2019.64
    BACKGROUND AND AIMS: This systematic review analyzes and summarizes gambling-related findings from the nationally representative US National Epidemiological Survey on Alcohol and Related Conditions (NESARC) data.

    METHODS: Systematic literature searches in accordance with PRISMA guidelines found 51 eligible studies that met inclusion criteria. Eight studies utilized both Waves 1 and 2 NESARC data, and selection of sample sizes varied from 185 to 43,093 individuals, consistent with specified research objectives of each study.

    RESULTS: The prevalence of lifetime pathological gambling was 0.42% (0.64% among men, 0.23% among women), while past-year prevalence was 0.16%. Pathological gambling rates were generally higher in populations with substance-use disorders and other psychiatric diagnoses. Rates of adverse childhood experiences and suicidal attempts were higher among individuals with problem or pathological gambling. Early-onset gamblers were more likely to be male, be never married, have incomes below $70,000, belong to younger cohorts and have Cluster B personality disorders, but less likely to be diagnosed with mood disorders. While pathological gambling was related to obesity, increased stress, and poorer physical health among general age groups, recreational gambling was linked with improved physical and mental functioning in older adults.

    CONCLUSIONS: The NESARC has provided important information on the correlates of pathological gambling and subdiagnostic patterns of gambling behaviors. Additional studies should examine these relationships in the current gambling environment and longitudinally with aims of implementing policies to improve the public health.

    Matched MeSH terms: Longitudinal Studies
  9. Asma Alhusna Abang Abdullah, Rohaya Megat Abdul Wahab, Shahrul Hisham Zainal Ariffin
    Sains Malaysiana, 2011;40(10):1147-1151.
    Bone formation has been associated with the presence of an enzyme called alkaline phosphatase (ALP). This longitudinal study was carried out to observe its activity in gingival crevicular fluid (GCF) during leveling and alignment stage of orthodontic fixed appliance treatment. Fourteen patients between the ages of 15 and 27 years old with moderate upper labial segment crowding were recruited from postgraduate orthodontic clinic. GCF from mesial and distal sites of upper canines were collected using endodontic paper point before the fixed appliance placement (week 0). The baseline level of ALP (week 0) acted as a control. Samplings of GCF were repeated at 1st, 2nd and 3rd week during orthodontic treatment. The activities of ALP were measured using spectrophotometer (405 nm). Paired sample t-test was used to assess the significance of difference over the 3 weeks. Although the results showed patterns of ALP activities on the test teeth throughout the 3 weeks of leveling and alignment stage, however the results were not significant (p >0.05) when compared to control. Therefore, it has been shown that there was no significant pattern of ALP activities in GCF in patients undergoing leveling and alignment stage of orthodontic treatment.
    Matched MeSH terms: Longitudinal Studies
  10. Teng KH, Kot P, Muradov M, Shaw A, Hashim K, Gkantou M, et al.
    Sensors (Basel), 2019 Jan 28;19(3).
    PMID: 30696110 DOI: 10.3390/s19030547
    : Concrete failure will lead to serious safety concerns in the performance of a building structure. It is one of the biggest challenges for engineers to inspect and maintain the quality of concrete throughout the service years in order to prevent structural deterioration. To date, a lot of research is ongoing to develop different instruments to inspect concrete quality. Detection of moisture ingress is important in the structural monitoring of concrete. This paper presents a novel sensing technique using a smart antenna for the non-destructive evaluation of moisture content and deterioration inspection in concrete blocks. Two different standard concrete samples (United Kingdom and Malaysia) were investigated in this research. An electromagnetic (EM) sensor was designed and embedded inside the concrete to detect the moisture content within the structure. In addition, CST microwave studio was used to validate the theoretical model of the EM sensor against the test data. The results demonstrated that the EM sensor at 2.45 GHz is capable of detecting the moisture content in the concrete with linear regression of R² = 0.9752. Furthermore, identification of different mix ratios of concrete were successfully demonstrated in this paper. In conclusion, the EM sensor is capable of detecting moisture content non-destructively and could be a potential technique for maintenance and quality control of the building performance.
    Matched MeSH terms: Longitudinal Studies
  11. Mat Nawi NI, Abd Halim NS, Lee LC, Wirzal MDH, Bilad MR, Nordin NAH, et al.
    Polymers (Basel), 2020 Jan 21;12(2).
    PMID: 31973178 DOI: 10.3390/polym12020252
    The competitiveness of algae as biofuel feedstock leads to the growth of membrane filtration as one of promising technologies for algae harvesting. Nanofiber membrane (NFM) was found to be efficient for microalgae harvesting via membrane filtration, but it is highly limited by its weak mechanical strength. The main objective of this study is to enhance the applicability of nylon 6,6 NFM for microalgae filtration by optimizing the operational parameters and applying solvent vapor treatment to improve its mechanical strength. The relaxation period and filtration cycle could be optimized to improve the hydraulic performance. For a cycle of 5 min., relaxation period of ≤2 min shows the highest steady-state permeability of 365 ± 14.14 L m-2 h-1 bar-1, while for 10 min cycle, 3 min. of relaxation period was found optimum that yields permeability of 402 ± 34.47 L m-2 h-1 bar-1. The treated nylon 6,6 NFM was also used to study the effect of aeration rate. It is confirmed that the aeration rate enhances the steady-state performance for both intermittent and continuous mode of aeration. Remarkably, intermittent aeration shows 7% better permeability than the full aeration for all tested condition, which is beneficial for reducing the total energy consumption.
    Matched MeSH terms: Longitudinal Studies
  12. Foong HF, Ibrahim R, Hamid TA, Haron SA
    BMC Geriatr, 2021 12 07;21(1):679.
    PMID: 34876024 DOI: 10.1186/s12877-021-02617-9
    BACKGROUND: Physical fitness declines with age. Low levels of physical fitness appear to be a risk factor of cognitive impairment. Literature elucidates social networking as a potential moderator for the relationship between physical fitness and cognitive impairment. Present study aimed to examine the relationship between physical fitness and cognitive function among community-dwelling older Malaysians, and if social network moderates said relationship.

    METHODS: Data of 2322 representative community-dwelling older adults were obtained from the first wave of the "Longitudinal Study on Neuroprotective Model for Healthy Longevity" national survey. Cognitive function, physical fitness and social network was assessed through Malay-version of Mini-Mental State Examination, 2-min step test and Lubben Social Network Scale-6 respectively. Moderated hierarchical multiple regression was employed to investigate if social networks moderate the relationship between physical fitness and cognitive function.

    RESULTS: A positive association between physical fitness and cognitive function were found upon controlling for covariates. Moderated hierarchical multiple regression revealed social networks to be a moderator of the association between physical fitness and cognitive function. When physical fitness was low, those with small social network revealed lowest cognitive function.

    CONCLUSIONS: Social networks moderated the relationship between physical fitness and cognitive function as older adults with low levels of physical fitness and small social networks revealed lowest cognitive function. Therefore, community support or peer-based interventions among physically unfit older adults should be implemented to promote cognitive function.

    Matched MeSH terms: Longitudinal Studies
  13. Szczuka Z, Siwa M, Abraham C, Baban A, Brooks S, Cipolletta S, et al.
    Soc Sci Med, 2023 Jan;317:115569.
    PMID: 36436259 DOI: 10.1016/j.socscimed.2022.115569
    RATIONALE: The associations between the number of COVID-19 cases/deaths and subsequent uptake of protective behaviors may reflect cognitive and behavioral responses to threat-relevant information.

    OBJECTIVE: Applying protection motivation theory (PMT), this study explored whether the number of total COVID-19 cases/deaths and general anxiety were associated with cross-situational handwashing adherence and whether these associations were mediated by PMT-specific self-regulatory cognitions (threat appraisal: perceived vulnerability, perceived illness severity; coping appraisal: self-efficacy, response efficacy, response costs).

    METHOD: The study (#NCT04367337) was conducted in March-September 2020 among 1256 adults residing in 14 countries. Self-reports on baseline general anxiety levels, handwashing adherence across 12 situations, and PMT-related constructs were collected using an online survey at two points in time, four weeks apart. Values of COVID-19 cases and deaths were retrieved twice for each country (one week prior to the individual data collection).

    RESULTS: Across countries and time, levels of adherence to handwashing guidelines were high. Path analysis indicated that smaller numbers of COVID-19 cases/deaths (Time 0; T0) were related to stronger self-efficacy (T1), which in turn was associated with higher handwashing adherence (T3). Lower general anxiety (T1) was related to better adherence (T3), with this effect mediated by higher response efficacy (T1, T3) and lower response cost (T3). However, higher general anxiety (T1) was related to better adherence via higher illness severity (T1, T3). General anxiety was unrelated to COVID-19 indicators.

    CONCLUSIONS: We found a complex pattern of associations between the numbers of COVID-19 cases/deaths, general anxiety, PMT variables, and handwashing adherence at the early stages of the pandemic. Higher general anxiety may enable threat appraisal (perceived illness severity), but it may hinder coping appraisal (response efficacy and response costs). The indicators of the trajectory of the pandemic (i.e., the smaller number of COVID-19 cases) may be indirectly associated with higher handwashing adherence via stronger self-efficacy.

    Matched MeSH terms: Longitudinal Studies
  14. Low LS, Wong JHD, Tan LK, Chan WY, Jalaludin MY, Anuar Zaini A, et al.
    J Neuroradiol, 2023 Mar;50(2):271-277.
    PMID: 34800564 DOI: 10.1016/j.neurad.2021.11.004
    BACKGROUND: In subjects with isolated growth hormone deficiency (IGHD), recombinant human growth hormone (rhGH) is an approved method to achieve potential mid-parental height. However, data reporting rhGH treatment response in terms of brain structure volumes were scarce. We report the volumetric changes of the pituitary gland, basal ganglia, corpus callosum, thalamus, hippocampus and amygdala in these subjects post rhGH treatment.

    MATERIALS AND METHODS: This was a longitudinal study of eight IGHD subjects (2 males, 6 females) with a mean age of 11.1 ± 0.8 years and age-matched control groups. The pituitary gland, basal ganglia and limbic structures volumes were obtained using 3T MRI voxel-based morphology. The left-hand bone age was assessed using the Tanner-Whitehouse method. Follow-up imaging was performed after an average of 1.8 ± 0.4 years on rhGH.

    RESULTS: Subjects with IGHD had a smaller mean volume of the pituitary gland, right thalamus, hippocampus, and amygdala than the controls. After rhGH therapy, these volumes normalized to the age-matched controls. Corpus callosum of IGHD subjects had a larger mean volume than the controls and did not show much volume changes in response to rhGH therapy. There were changes towards normalization of bone age deficit of IGHD in response to rhGH therapy.

    CONCLUSION: The pituitary gland, hippocampus, and amygdala volumes in IGHD subjects were smaller than age-matched controls and showed the most response to rhGH therapy. Semi-automated volumetric assessment of pituitary gland, hippocampus, and amygdala using MRI may provide an objective assessment of response to rhGH therapy.

    Matched MeSH terms: Longitudinal Studies
  15. Salway R, Su TT, Ismail R, Glynis Armstrong ME, Foster C, Johnson L
    J Glob Health, 2021;11:05029.
    PMID: 35003716 DOI: 10.7189/jogh.11.05029
    BACKGROUND: The COVID-19 pandemic prompted movement restrictions in countries worldwide, impacting on physical activity (PA), a major non-communicable disease risk factor, and thus may have unintentional long-term health implications. In semi-rural areas of low-middle-income-countries (LMICs), where occupational activity is the main source of PA, changes in PA associated with COVID-19 restrictions are unknown. We investigated the impact of Movement Control Order (MCO) restrictions in a semi-rural region of Malaysia.

    METHODS: The South East Asia Community Observatory (SEACO) is a dynamic prospective community cohort. We contacted a random sample of 1007 adults (18+) who had previously provided PA data in 2018. We asked about PA during the MCO (March-May 2020) and at the time of interview (June 2020).

    RESULTS: During the MCO, PA reduced by a mean of 6.7 hours/week (95% confidence interval (CI) = 5.3, 8.0) compared to 2018, with the largest reductions among those in employment. By June, PA was 3.4 hours/week (95% CI = 2.0, 4.8) less than 2018, leaving 34% of adults currently inactive (20% in 2018). Reductions in occupational PA were not replaced with active travel or activity at home. Despite these observed reductions, most participants did not think the MCO had affected their PA.

    CONCLUSIONS: Movement restrictions are associated with lower PA lasting beyond the period of strict restrictions; such longer-term reductions in PA may have a detrimental impact on health. Future MCOs should encourage people to be active, but may additionally need targeted messaging for those who don't necessarily realise they are at risk. In particular, policies developed in more affluent countries may not easily translate to LMICs.

    Matched MeSH terms: Longitudinal Studies
  16. Liu H, Zhang X, Liu H, Chong ST
    Int J Public Health, 2023;68:1605322.
    PMID: 36798738 DOI: 10.3389/ijph.2023.1605322
    Objective: To explore the predictive value of machine learning in cognitive impairment, and identify important factors for cognitive impairment. Methods: A total of 2,326 middle-aged and elderly people completed questionnaire, and physical examination evaluation at baseline, Year 2, and Year 4 follow-ups. A random forest machine learning (ML) model was used to predict the cognitive impairment at Year 2 and Year 4 longitudinally. Based on Year 4 cross-sectional data, the same method was applied to establish a prediction model and verify its longitudinal prediction accuracy for cognitive impairment. Meanwhile, the ability of random forest and traditional logistic regression model to longitudinally predict 2-year and 4-year cognitive impairment was compared. Results: Random forest models showed high accuracy for all outcomes at Year 2, Year 4, and cross-sectional Year 4 [AUC = 0.81, 0.79, 0.80] compared with logistic regression [AUC = 0.61, 0.62, 0.70]. Baseline physical examination (e.g., BMI, Blood pressure), biomarkers (e.g., cholesterol), functioning (e.g., functional limitations), demography (e.g., age), and emotional status (e.g., depression) characteristics were identified as the top ten important predictors of cognitive impairment. Conclusion: ML algorithms could enhance the prediction of cognitive impairment among the middle-aged and older Chinese for 4 years and identify essential risk markers.
    Matched MeSH terms: Longitudinal Studies
  17. Thomas AG, Armstrong SL, Stewart-Williams S, Jones BC
    Evol Psychol, 2021;19(1):1474704920976318.
    PMID: 33412934 DOI: 10.1177/1474704920976318
    Previous research has found that women at peak fertility show greater interest in extra-pair sex. However, recent replications have failed to detect this effect. In this study, we add to this ongoing debate by testing whether sociosexuality (the willingness to have sex in the absence of commitment) is higher in women who are at peak fertility. A sample of normally ovulating women (N = 773) completed a measure of sociosexuality and had their current fertility status estimated using the backward counting method. Contrary to our hypothesis, current fertility was unrelated to sociosexual attitudes and desires, even when relationship status was included as a moderator. These findings raise further doubts about the association between fertility and desire for extra-pair sex.
    Matched MeSH terms: Longitudinal Studies
  18. Connelly K, Kandane-Rathnayake R, Hoi A, Louthrenoo W, Hamijoyo L, Cho J, et al.
    Lancet Rheumatol, 2022 Dec;4(12):e831-e841.
    PMID: 38261391 DOI: 10.1016/S2665-9913(22)00307-1
    BACKGROUND: The selection and categorisation of laboratory tests in disease activity measures used within systemic lupus erythematosus (SLE) trial endpoints lack strong evidence. We aimed to determine whether longitudinal improvements in routinely measured laboratory tests are associated with measures of clinical improvement in patients with baseline active SLE.

    METHODS: We included patients from a multicentre longitudinal cohort (recruited between May 1, 2013, and Dec 31, 2019) with active SLE (SLEDAI-2K ≥6) coinciding with an abnormality in at least one of 13 routine laboratory tests, at a visit designated as baseline. At 12 months, we analysed associations between thresholds of improvement in individual laboratory test results, measured as continuous variables, and five clinical outcomes using logistic regression. Primary outcomes were damage accrual and lupus low disease activity state (LLDAS), and secondary outcomes were modified SLE responder index (mSRI), physician global assessment (PGA) improvement of at least 0·3, and flare.

    FINDINGS: We included 1525 patients (1415 [93%] women and 110 [7%] men, 1328 [87%] Asian ethnicity) in separate subsets for each laboratory test. The strongest associations with LLDAS and damage protection were seen with improvements in proteinuria (complete response: adjusted odds ratio [OR] 62·48, 95% CI 18·79-208·31 for LLDAS, OR 0·22, 95% CI 0·10-0·49 for damage accrual), albumin (complete response: adjusted OR 6·46, 95% CI 2·20-18·98 for LLDAS, OR 0·42, 95% CI 0·20-1·22 for damage accrual), haemoglobin (complete response: adjusted OR 1·97, 95% CI 1·09-3·53 for LLDAS, OR 0·33, 95% CI 0·15-0·71 for damage accrual), erythrocyte sedimentation rate (complete response: adjusted OR 1·71, 95% CI 1·10-2·67 for LLDAS, OR 0·53, 95% CI 0·30-0·94 for damage accrual), and platelets (complete response: adjusted OR 4·82, 95% CI 1·54-15·07 for LLDAS, OR 0·49, 95% CI 0·20-1·19 for damage accrual). Improvement in serological tests were mainly associated with PGA and mSRI. White cell and lymphocyte count improvements were least predictive.

    INTERPRETATION: Improvements in several routine laboratory tests correspond with clinical outcomes in SLE over 12 months. Tests with the strongest associations were discrepant with laboratory tests included in current trial endpoints, and associations were observed across a range of improvement thresholds including incomplete resolution. These findings suggest the need to revise the use of laboratory test results in SLE trial endpoints.

    FUNDING: Abbvie.

    Matched MeSH terms: Longitudinal Studies
  19. Tan MMC, Barbosa MG, Pinho PJMR, Assefa E, Keinert AÁM, Hanlon C, et al.
    Obes Rev, 2024 Feb;25(2):e13661.
    PMID: 38105610 DOI: 10.1111/obr.13661
    Multimorbidity-the coexistence of at least two chronic health conditions within the same individual-is an important global health challenge. In high-income countries (HICs), multimorbidity is dominated by non-communicable diseases (NCDs); whereas, the situation may be different in low- and middle-income countries (LMICs), where chronic communicable diseases remain prominent. The aim of this systematic review was to identify determinants (including risk and protective factors) and potential mechanisms underlying multimorbidity from published longitudinal studies across diverse population-based or community-dwelling populations in LMICs. We systematically searched three electronic databases (Medline, Embase, and Global Health) using pre-defined search terms and selection criteria, complemented by hand-searching. All titles, abstracts, and full texts were independently screened by two reviewers from a pool of four researchers. Data extraction and reporting were according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methodological quality and risk of bias assessment was performed using the Newcastle-Ottawa Scale for cohort studies. Data were summarized using narrative synthesis. The search yielded 1782 records. Of the 52 full-text articles included for review, 8 longitudinal population-based studies were included for final data synthesis. Almost all studies were conducted in Asia, with only one from South America and none from Africa. All studies were published in the last decade, with half published in the year 2021. The definitions used for multimorbidity were heterogeneous, including 3-16 chronic conditions per study. The leading chronic conditions were heart disease, stroke, and diabetes, and there was a lack of consideration of mental health conditions (MHCs), infectious diseases, and undernutrition. Prospectively evaluated determinants included socio-economic status, markers of social inequities, childhood adversity, lifestyle behaviors, obesity, dyslipidemia, and disability. This review revealed a paucity of evidence from LMICs and a geographical bias in the distribution of multimorbidity research. Longitudinal research into epidemiological aspects of multimorbidity is warranted to build up scientific evidence in regions beyond Asia. Such evidence can provide a detailed picture of disease development, with important implications for community, clinical, and interventions in LMICs. The heterogeneity in study designs, exposures, outcomes, and statistical methods observed in the present review calls for greater methodological standardisation while conducting epidemiological studies on multimorbidity. The limited evidence for MHCs, infectious diseases, and undernutrition as components of multimorbidity calls for a more comprehensive definition of multimorbidity globally.
    Matched MeSH terms: Longitudinal Studies
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