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  • 1
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 80, No. 6 ( 2023-06), p. 1311-1320
    Abstract: Data from the US National Health and Nutrition Examination Survey are freely available and can be analyzed to produce hypertension statistics for the noninstitutionalized US population. The analysis of these data requires statistical programming expertise and knowledge of National Health and Nutrition Examination Survey methodology. Methods: We developed a web-based application that provides hypertension statistics for US adults using 10 cycles of National Health and Nutrition Examination Survey data, 1999 to 2000 through 2017 to 2020. We validated the application by reproducing results from prior publications. The application’s interface allows users to estimate crude and age-adjusted means, quantiles, and proportions. Population counts can also be estimated. To demonstrate the application’s capabilities, we estimated hypertension statistics for noninstitutionalized US adults. Results: The estimated mean systolic blood pressure (BP) declined from 123 mm Hg in 1999 to 2000 to 120 mm Hg in 2009 to 2010 and increased to 123 mm Hg in 2017 to 2020. The age-adjusted prevalence of hypertension (ie, systolic BP≥130 mm Hg, diastolic BP≥80 mm Hg or self-reported antihypertensive medication use) was 47.9% in 1999 to 2000, 43.0% in 2009 to 2010, and 44.7% in 2017 to 2020. In 2017 to 2020, an estimated 115.3 million US adults had hypertension. The age-adjusted prevalence of controlled BP, defined by the 2017 American College of Cardiology/American Heart Association BP guideline, among nonpregnant US adults with hypertension was 9.7% in 1999 to 2000, 25.0% in 2013 to 2014, and 21.9% in 2017 to 2020. After age adjustment and among nonpregnant US adults who self-reported taking antihypertensive medication, 27.5%, 48.5%, and 43.0% had controlled BP in 1999 to 2000, 2013 to 2014, and 2017 to 2020, respectively. Conclusions: The application developed in the current study is publicly available at https://bcjaeger.shinyapps.io/nhanesShinyBP/ and produced valid, transparent and reproducible results.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2094210-2
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  • 2
    Online Resource
    Online Resource
    Nepal Journals Online (JOL) ; 2011
    In:  Nepal Journal of Epidemiology Vol. 1, No. 5 ( 2011-12-31), p. 160-167
    In: Nepal Journal of Epidemiology, Nepal Journals Online (JOL), Vol. 1, No. 5 ( 2011-12-31), p. 160-167
    Abstract: Background: Chronic Kidney Disease (CKD) is a worldwide growing issue and a public health problem. It is associated with significant morbidity and mortality. The prevalence of CKD has been described in several studies. High prevalence of CKD has also reported in the different studies from different part of world. The prevalence of reduced glomerular filtration rate (GFR) in Australia was 11.2%. Singapore, a South-East Asian country, reported a CKD prevalence of 10.1%, while the prevalence of CKD in Japanese general population was reported to be 18.7%. Reduced kidney function is associated with a variety of biochemical abnormalities such as electrolytes. However, the extent of the changes and their magnitude in relation to different stages of CKD is not well defined especially in the early stages of CKD. Thus, the main objective of our study was to assess the variations in the serum levels of sodium, potassium, calcium and phosphorus in different stages of CKD. Materials and methods: It was a hospital based cross-sectional study conducted in the Department of Clinical Biochemistry in collaboration with the Department of Internal Medicine (nephrology unit), Kathmandu, Nepal between 1st February, 2008 to 1st January, 2010. CKD was defined as per National Kidney Foundation Guidelines. The variables collected were age, gender, blood pressure, serum level of urea, creatinine , sodium, potassium, calcium, phosphorus, urinary albumin, urinary total protein (UTP), urinary protein creatinine ratio (PCR). The One way ANOVA was used to examine the statistical significant difference between groups. Correlation of different parameters with markers of CKD was done by Pearson‘s correlation for quantitative data. A p-value of 〈 0.05 (two-tailed) was used to establish statistical significance. Results: Increased values of systolic and diastolic blood pressure found up to the level of stage IV CKD. However, in stage V CKD a slight decrement of blood pressure from stage IV CKD was seen. With the progression of stages of CKD, sodium levels were found to be decreased (p 〈 0.001). In contrast to that potassium and phosphorus levels were found to be increased with the stages of CKD and (p 〈 0.001). Serum level of calcium was found to be declined with the augment in stages of CKD (p 〈 0.001). Positive and negative correlation of different parameters with kidney damage markers was assessed by Pearson’s correlation coefficient. Conclusion: The elevation in serum level of potassium, phosphorus and decrease in serum level of calcium were obvious even among the patients with early stages CKD.DOI: http://dx.doi.org/10.3126/nje.v1i5.6154 Nepal Journal of Epidemiology 2011;1 (5):160-167 
    Type of Medium: Online Resource
    ISSN: 2091-0800
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2011
    detail.hit.zdb_id: 2589539-4
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  • 3
    Online Resource
    Online Resource
    Institute of Geographic Science and Natural Resources Research, Chinese Academy of Sciences ; 2021
    In:  Journal of Resources and Ecology Vol. 12, No. 5 ( 2021-9-1)
    In: Journal of Resources and Ecology, Institute of Geographic Science and Natural Resources Research, Chinese Academy of Sciences, Vol. 12, No. 5 ( 2021-9-1)
    Type of Medium: Online Resource
    ISSN: 1674-764X
    Language: Unknown
    Publisher: Institute of Geographic Science and Natural Resources Research, Chinese Academy of Sciences
    Publication Date: 2021
    detail.hit.zdb_id: 2630108-8
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  • 4
    Online Resource
    Online Resource
    Institute of Geographic Science and Natural Resources Research, Chinese Academy of Sciences ; 2022
    In:  Journal of Resources and Ecology Vol. 13, No. 6 ( 2022-10-14)
    In: Journal of Resources and Ecology, Institute of Geographic Science and Natural Resources Research, Chinese Academy of Sciences, Vol. 13, No. 6 ( 2022-10-14)
    Type of Medium: Online Resource
    ISSN: 1674-764X
    Language: Unknown
    Publisher: Institute of Geographic Science and Natural Resources Research, Chinese Academy of Sciences
    Publication Date: 2022
    detail.hit.zdb_id: 2630108-8
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  • 5
    Online Resource
    Online Resource
    Elsevier BV ; 2020
    In:  Biophysical Journal Vol. 118, No. 3 ( 2020-02), p. 192a-
    In: Biophysical Journal, Elsevier BV, Vol. 118, No. 3 ( 2020-02), p. 192a-
    Type of Medium: Online Resource
    ISSN: 0006-3495
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 1477214-0
    SSG: 12
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  • 6
    Online Resource
    Online Resource
    Nepal Journals Online (JOL) ; 2006
    In:  Nepalese Heart Journal Vol. 4, No. 1 ( 2006-11-30), p. 27-31
    In: Nepalese Heart Journal, Nepal Journals Online (JOL), Vol. 4, No. 1 ( 2006-11-30), p. 27-31
    Abstract: Twenty-five years ago, a young German physician, Andreas Gruentzig, inserted a catheter into a 38-year-old man's coronary artery, inflated a tiny balloon the doctor had fashioned in his own kitchen, successfully opening a blockage and restoring blood flow to a human heart. This event set a cascade of newer invention.
    Type of Medium: Online Resource
    ISSN: 2382-5464 , 2091-2978
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2006
    detail.hit.zdb_id: 2901174-7
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  • 7
    In: Toxicological Sciences, Oxford University Press (OUP), Vol. 184, No. 2 ( 2021-11-24), p. 276-285
    Abstract: Overdose of acetaminophen (APAP) is the major cause of acute liver failure (ALF) in the Western world with very limited treatment options. Previous studies from our groups and others have shown that timely activation of liver regeneration is a critical determinant of transplant-free survival of APAP-induced ALF patients. Here, we report that hepatocyte-specific deletion of Yes-associated protein (Yap), the downstream mediator of the Hippo Kinase signaling pathway results in faster recovery from APAP-induced acute liver injury. Initial studies performed with male C57BL/6J mice showed a rapid activation of Yap and its target genes within first 24 h after APAP administration. Treatment of hepatocyte-specific Yap knockout (Yap-KO) mice with 300 mg/kg APAP resulted in equal initial liver injury but a significantly accelerated recovery in Yap-KO mice. The recovery was accompanied by significantly rapid hepatocyte proliferation supported by faster activation of Wnt/β-catenin pathway. Furthermore, Yap-KO mice had significantly earlier and higher pro-regenerative inflammatory response following APAP overdose. Global gene expression analysis indicated that Yap-KO mice had a robust activation of transcription factors involved in response to endoplasmic reticulum stress (XBP1) and maintaining hepatocyte differentiation (HNF4α). In conclusion, these data indicate that inhibition of Yap in hepatocytes results in rapid recovery from APAP overdose due to an earlier activation of liver regeneration.
    Type of Medium: Online Resource
    ISSN: 1096-6080 , 1096-0929
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 1471974-5
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  • 8
    In: BMJ Open, BMJ, Vol. 11, No. 8 ( 2021-08), p. e048481-
    Abstract: Despite carrying a disproportionately high burden of depression, patients in low-income countries lack access to effective care. The collaborative care model (CoCM) has robust evidence for clinical effectiveness in improving mental health outcomes. However, evidence from real-world implementation of CoCM is necessary to inform its expansion in low-resource settings. Methods We conducted a 2-year mixed-methods study to assess the implementation and clinical impact of CoCM using the WHO Mental Health Gap Action Programme protocols in a primary care clinic in rural Nepal. We used the Capability Opportunity Motivation-Behaviour (COM-B) implementation research framework to adapt and study the intervention. To assess implementation factors, we qualitatively studied the impact on providers’ behaviour to screen, diagnose and treat mental illness. To assess clinical impact, we followed a cohort of 201 patients with moderate to severe depression and determined the proportion of patients who had a substantial clinical response (defined as ≥50% decrease from baseline scores of Patient Health Questionnaire (PHQ) to measure depression) by the end of the study period. Results Providers experienced improved capability (enhanced self-efficacy and knowledge), greater opportunity (via access to counsellors, psychiatrist, medications and diagnostic tests) and increased motivation (developing positive attitudes towards people with mental illness and seeing patients improve) to provide mental healthcare. We observed substantial clinical response in 99 (49%; 95% CI: 42% to 56%) of the 201 cohort patients, with a median seven point (Q1:−9, Q3:−2) decrease in PHQ-9 scores (p 〈 0.0001). Conclusion Using the COM-B framework, we successfully adapted and implemented CoCM in rural Nepal, and found that it enhanced providers’ positive perceptions of and engagement in delivering mental healthcare. We observed clinical improvement of depression comparable to controlled trials in high-resource settings. We recommend using implementation research to adapt and evaluate CoCM in other resource-constrained settings to help expand access to high-quality mental healthcare.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2599832-8
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  • 9
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 10, No. 8 ( 2021-04-20)
    Abstract: Few adults at high risk for atherosclerotic cardiovascular disease events use a PCSK9i (proprotein convertase subtilisin/kexin type 9 inhibitor). Methods and Results Using data from the US Veterans Health Administration, we identified veterans who initiated a PCSK9i between January 2018 and December 2019, matched 1:4 to veterans who did not initiate this medication over this time period (case‐cohort study). Two cohorts of veterans were analyzed: (1) atherosclerotic cardiovascular disease, with a most recent low‐density lipoprotein cholesterol (LDL‐C) ≥70 mg/dL; and (2) severe hypercholesterolemia (ie, familial hypercholesterolemia or any prior LDL‐C ≥190 mg/dL, with most recent LDL‐C ≥100 mg/dL). Conditional logistic regression was used to analyze factors associated with PCSK9i initiation, adjusting for all factors, simultaneously. There were 2394 initiators and 9576 noninitiators in the atherosclerotic cardiovascular disease cohort (median LDL‐C, 141 and 96 mg/dL, respectively; P 〈 0.001). Factors associated with a higher likelihood of PCSK9i initiation included age 65 to 〈 75 versus 〈 65 years, highest versus lowest quartile of median area‐level income, familial hypercholesterolemia, former statin use, and current ezetimibe use. PCSK9i initiation was lower among veterans of a race/ethnicity other than non‐Hispanic White. There were 245 initiators and 980 noninitiators in the severe hypercholesterolemia cohort (median LDL‐C, 183 and 151 mg/dL, respectively; P 〈 0.001). Age ≥75 versus 〈 65 years, history of chronic kidney disease, former statin use, and current ezetimibe use were associated with a higher likelihood of PCSK9i initiation. Conclusions Several patient‐level factors, including age, sex, and race/ethnicity, were significantly associated with PCSK9i initiation, suggesting an unmet treatment need in several patient groups.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2653953-6
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  • 10
    In: Humanities and Social Sciences Communications, Springer Science and Business Media LLC, Vol. 9, No. 1 ( 2022-06-15)
    Abstract: The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, has devastated every sphere of human society. Governments around the world implemented unprecedented policies designed to slow the spread of the disease and assistance to cope with its impacts. Such policies, however, are short-term and debates have ensued about what broader policies are needed in the post-COVID-19 era to ensure societies are better prepared for future pandemics. Public opinion concerning COVID-19 and the post-COVID-19 era is diverse, and the patterns in opinion are not well documented. Here we synthesized the opinions of 3731 research scholars throughout the world based on a survey. The highest consensus among respondents concerned the need for improving public health infrastructure and delivering economic support, whereas agreement concerning ecological aspects was low. The survey revealed three dimensions of thinking about COVID-19. The first dimension relates to public health and has widespread support. The second dimension relates to science-led policy development focusing on social justice and environmental governance, covering components of both ecology and economy. The third dimension covers the role of nature conservation in reducing the risk of pandemics. Although opinions differed with age, country of citizenship, and level of education, there is strong agreement on the need for global health equity and science-led public policy.
    Type of Medium: Online Resource
    ISSN: 2662-9992
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 3033393-3
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