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It has been proposed that night shift work could increase breast cancer incidence. A 2007 World Health Organization review concluded, mainly from animal evidence, that shift work involving circadian disruption is probably carcinogenic to humans. We therefore aimed to generate prospective epidemiological evidence on night shift work and breast cancer incidence.
One of the most challenging objective for clinical cytometry in prospective multicenter immunomonitoring trials is to compare frequencies, absolute numbers of leukocyte populations and further the mean fluorescence intensities of cell markers, especially when the data are generated from different instruments. Here, we describe an innovative standardization workflow to compare all data to carry out any large-scale, prospective multicentric flow cytometry analysis whatever the duration, the number or type of instruments required for the realization of such projects.
Plasma leakage is a precursor to life-threatening complications of dengue, but this group is poorly defined and not often reported in literature. Patients with Dengue haemorrhagic fever (DHF) as defined in the 1997 World Health Organization classification are often reported, and they all have plasma leakage, but some patients with plasma leakage do not meet the definition of DHF. The study aims to estimate the frequency of plasma leakage and DHF (as a surrogate of plasma leakage) in dengue and its variations based on virus serotype, geography, patient gender and pre-existing immunity to dengue. PUBMED, Scopus, EMBASE, CINAHL and Web of Science were searched for prospective observational studies reporting on plasma leakage or DHF. Quality of data was assessed using the NIH quality assessment tool for cohort studies. Forty-three studies that recruited 15,794 confirmed dengue patients were eligible. Cumulative frequency of plasma leakage was 36.8% (15 studies, 1642/4462, 95% CI 35.4-38.2%), but surprisingly the estimated cumulative frequency of DHF was higher (45.7%, 32 studies, 4758/10417, 95% CI 44.7-46.6%), indicating that current medical literature over-reports DHF or under-reports plasma leakage. Therefore, a reliable estimate for the proportion of dengue patients developing plasma leakage cannot be derived from existing medical literature even after applying rigorous inclusion criteria to select homogenous studies. Plasma leakage is an important marker of "at-risk" dengue patients and standardizing its definition, diagnosis and reporting should be a priority in research and global policy.
Background: Consensus is lacking with regard to whether hearing loss is an independent risk factor for dementia. We therefore conducted a meta-analysis to clarify the relationship of hearing loss and dementia. Methods: Prospective cohort studies investigating the association between hearing loss and the incidence of dementia in a community-derived population were included by searching electronic databases that included PubMed, Embase, and Cochrane's Library. A random-effects model was adopted to combine the results. Results: Fourteen cohorts including 726,900 participants were analyzed. It was shown that hearing loss was independently associated with dementia [adjusted hazard ratio (HR): 1.59, 95% confidence interval (CI): 1.37 to 1.86, p < 0.001; I 2 = 86%]. Sensitivity analysis sequentially excluding any of the individual studies included showed similar results. Subgroup analysis according to the diagnostic methods for hearing loss, validation strategy for dementia, follow-up duration, and adjustment of apolipoprotein E genotype also showed consistent results (p-values for subgroup differences all > 0.05). Meta-analysis with five studies showed that hearing loss was also connected to higher risk of Alzheimer's disease (adjusted HR: 2.24, 95% CI: 1.32 to 3.79, p = 0.003; I 2 = 2%). Conclusions: Hearing loss may increase the risk of dementia in the adult population. Whether effective treatment for hearing loss could reduce the incidence of dementia should be explored in the future.
There are approximately 23 million patients with heart failure (HF) worldwide. The prognosis of patients with HF is still poor and a prospective approach for preventing and treating HF is necessary. The number of HF patients in Japan has been increasing since 1950 mainly because of a rapidly aging population. Furthermore, westernized dietary pattern, reduced physical activity, and obesity have become prominent, particularly in younger Japanese men. There is an increasing trend of diabetes and dyslipidemia, and the prevalence of smoking and hypertension continues to remain high. One of the largest HF cohorts in Japan, the CHART Studies, showed that coronary artery disease (CAD) was the most frequent etiology of HF currently. Thus, prospective strategies including accurate risk stratification, effective prevention of disease progression through evidence-based treatments, optimally personalized treatment particularly in elderly individuals, and life-long control of CAD risk factors are required to manage HF in Japan.
Meta-analyses on coffee and cancer incidence mainly restricted to limited cancers. We carried out a more comprehensive meta-analysis of cohort studies to explore association between coffee and most cancer types. We conducted comprehensive search and summarized relative risk (RR) and 95% confidence intervals for the highest versus lowest coffee intake and cancer using STATA12. We conducted dose-analysis if result suggested significant association. The publication bias was evaluated with begg's and egger's test. Finally, 105 individual prospective studies were included. Inverse associations were observed on oral, pharyngeal, colon, liver, prostate, endometrial cancer and melanoma, with RR 0.69 (95% CI = 0.48-0.99, I2 = 73.4%, P = 0.044), 0.87 (95% CI = 0.78-0.96, I2 = 28.4%, P = 0.007), 0.46 (95% CI = 0.37-0.57, I2 = 0%, P = 0), 0.89 (95% CI = 0.84-0.93, I2 = 30.3%, P = 0.003), 0.73 (95% CI = 0.67-0.80, I2 = 0%, P = 0) and 0.89 (95% CI = 0.80-0.99, I2 = 0%, P = 0.031) respectively. However, the relative risk for lung cancer is 2.18 (95% CI = 1.26-3.75, I2 = 63.3%, P = 0.005). The summary relative risk for increment of 2 cups of coffee were RR = 0.73, 95% CI = 0.67-0.79 for liver cancer, RR = 0.97, 95% CI = 0.96-0.98 for prostate cancer and RR = 0.88, 95% CI = 0.85-0.92 for endometrial cancer. Accordingly, coffee intake was associated with reduced risk of oral, pharynx, liver, colon, prostate, endometrial cancer and melanoma and increased lung cancer risk.
Reirradiation is a potentially useful option for many patients with recurrent cancer, aiming at cure or symptom palliation, depending on disease/recurrence type and stage. The purpose of this follow-up study to a previous review from 2016 was to summarize all recently published randomized trials. Points of interest again included identifcation of methodological strengths and weaknesses, practice-changing results, and open questions.
Epidemiological evidence on the association between sedentary behaviors and the risk of depression is inconsistent. We conducted a meta-analysis of prospective studies to identify the impact of sedentary behaviors on the risk of depression. We systematically searched in the PubMed and Embase databases to June 2019 for prospective cohort studies investigating sedentary behaviors in relation to the risk of depression. The pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated with random-effect meta-analysis. In addition, meta-regression analyses, subgroup analyses, and sensitivity analyses were performed to explore the potential sources of heterogeneity. Twelve prospective studies involving 128,553 participants were identified. A significantly positive association between sedentary behavior and the risk of depression was observed (RR = 1.10, 95% CI 1.03-1.19, I2 = 60.6%, P < 0.01). Subgroup analyses revealed that watching television was positively associated with the risk of depression (RR = 1.18, 95% CI 1.07-1.30), whereas using a computer was not (RR = 0.99, 95% CI 0.79-1.23). Mentally passive sedentary behaviors could increase the risk of depression (RR = 1.17, 95% CI 1.08-1.27), whereas the effect of mentally active sedentary behaviors were non-significant (RR = 0.98, 95% CI 0.83-1.15). Sedentary behaviors were positively related to depression defined by clinical diagnosis (RR = 1.08, 95% CI 1.03, 1.14), whereas the associations were statistically non-significant when depression was evaluated by the CES-D and the Prime-MD screening. The present study suggests that mentally passive sedentary behaviors, such as watching television, could increase the risk of depression. Interventions that reduce mentally passive sedentary behaviors may prevent depression.
The relationship between comorbidity and ovarian cancer survival has been controversial so far. Therefore, we conducted a meta-analysis to summarize the existing evidence from prospective studies on this issue. Relevant studies were identified by searching the PubMed, EMBASE, and ISI Web of Science databases through the end of January 2015. Two authors independently performed the eligibility evaluation and data abstraction. Random-effects models were used to estimate summary hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival. Eight prospective studies involving 12,681 ovarian cancer cases were included in the present study. The summarized HR for presence versus absence of comorbidity was 1.20 (95% CI = 1.11-1.30, n = 8), with moderate heterogeneity (I(2) = 31.2%, P = 0.179). In addition, the summarized HR for the highest compared with the lowest category of the Charlson's comorbidity index was 1.68 (95% CI = 1.50-1.87, n = 2), without heterogeneity (I(2) = 0%, P = 0.476). Notably, a significant negative impact of comorbidity on ovarian cancer survival was observed in most subgroup analyses stratified by the study characteristics and whether there was adjustment for potential confounders. In conclusion, the findings of this meta-analysis suggest that underlying comorbidity is consistently associated with decreased survival in patients with ovarian cancer. Comorbidity should be taken into account when managing these patients.
Glaucoma is a common blinding disease; while there is no cure, effective treatments include medications, laser, and incisional surgery. There is significant interest from patients and doctors to develop safer surgical options throughout the spectrum of disease, to minimize treatment burden in mild glaucoma patients and to minimize risk of complications in patients needing more aggressive treatment. Surgical procedures called Minimally or Micro-Invasive Glaucoma Surgery (MIGS) are growing in popularity. Eighty-seven prospective studies on MIGS were identified and assessed for quality. Most (74%) did not have a control group. Twelve of the highest quality were reviewed. MIGS procedures appeared to have fewer complications, and lowered intraocular pressure, and reduced medication use. Studies were limited by small sample size, narrow spectrum of glaucomatous disease, and/or conflicts of interest. There is a need for high quality, independently funded and performed, comparative studies on the MIGS to help make treatment decisions.
ehaviour change is a key to addressing many health and healthcare problems and interventions have been designed to improve health outcomes. These behaviour change interventions have been evaluated in many ways, including randomised controlled trials, and over recent decades there has been considerable progress in the conduct and reporting these studies. This paper is a personal retrospection on the changes occurring that have resulted in our current improved methods and their potential for future advancement.
The association between height and risk of hip fracture has been investigated in several studies, but the evidence is inconclusive. We therefore conducted this meta-analysis of prospective cohort studies to explore whether an association exists between height and risk of hip fracture. We searched PubMed and EMBASE, Web of Science, and the Cochrane Library for studies of height and risk of hip fracture up to February 16, 2016. The random-effects model was used to combine results from individual studies. Seven prospective cohort studies, with 7,478 incident hip fracture cases and 907,913 participants, were included for analysis. The pooled relative risk (RR) was 1.65 (95% confidence interval (CI): 1.26-2.16) comparing the highest with the lowest category of height. Result from dose-response analysis suggested a linear association between height and hip fracture risk (P-nonlinearity = 0.0378). The present evidence suggests that height is positively associated with increased risk of hip fracture. Further well-designed cohort studies are needed to confirm the present findings in other ethnicities.
A comprehensive overview of the evidence for factors derived from leading psychological theories of the onset of major depressive disorder (MDD) that underpin psychological interventions is scarce . We aimed to systematically investigate the prospective evidence for factors derived from the behavioural, cognitive, diathesis-stress, psychodynamic and personality-based theories for the first onset of MDD.
Epidemiological studies have shown inconsistent findings on the association between chocolate consumption and risk of heart failure (HF). We, therefore, performed a meta-analysis of prospective studies to determine the role of chocolate intake in the prevention of HF. We searched databases of PubMed, Web of Science, and Scopus through December 2016 and scrutinized the reference lists of relevant literatures to identify eligible studies. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were aggregated using random effect models. The dose-response relationship between chocolate consumption and incident HF was also assessed. This meta-analysis is registered with PROSPERO, number CRD42017054230. Five prospective studies with 106,109 participants were finally included. Compared to no consumption of chocolate, the pooled HRs (95% CIs) of HF were 0.86 (0.82-0.91) for low-to-moderate consumption (<7 servings/week) and 0.94 (0.80-1.09) for high consumption (≥7 servings/week). In dose-response meta-analysis, we detected a curve linear relationship between chocolate consumption and risk of HF (p for nonlinearity = 0.005). Compared with non-consumption, the HRs (95% CIs) of HF across chocolate consumption levels were 0.92 (0.88-0.97), 0.86 (0.78-0.94), 0.93 (0.85-1.03), and 1.07 (0.92-1.23) for 1, 3, 7, and 10 servings/week, respectively. In conclusion, chocolate consumption in moderation may be associated with a decreased risk of HF.
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