AIM To summarize and compare worldwide colorectal cancer(CRC) screening recommendations in order to identify similarities and disparities.METHODS A systematic literature search was performed using MEDLINE, EMBASE, Sco...AIM To summarize and compare worldwide colorectal cancer(CRC) screening recommendations in order to identify similarities and disparities.METHODS A systematic literature search was performed using MEDLINE, EMBASE, Scopus, CENTRAL and ISI Web of knowledge identifying all average-risk CRC screening guideline publications within the last ten years and/or position statements published in the last 2 years. In addition, a hand-search of the webpages of National Gastroenterology Society websites, the National Guideline Clearinghouse, the BMJ Clinical Evidence website,Google and Google Scholar was performed. RESULTS Fifteen guidelines were identified. Six guidelines were published in North America, four in Europe, four in Asia and one from the World Gastroenterology Organization. The majority of guidelines recommend screening average-risk individuals between ages 50 and 75 using colonoscopy(every 10 years), or flexible sigmoidoscopy(FS, every 5 years) or fecal occult blood test(FOBT, mainly the Fecal Immunochemical Test, annually or biennially). Disparities throughout the different guidelines are found relating to the use of colonoscopy, rank order between test, screening intervals and optimal age ranges for screening. CONCLUSION Average risk individuals between 50 and 75 years should undergo CRC screening. Recommendations for optimal surveillance intervals, preferred tests/test cascade as well as the optimal timing when to start and stop screening differ regionally and should be considered for clinical decision making. Furthermore, local resource availability and patient preferences are important to increase CRC screening uptake, as any screening is better than none.展开更多
Tissue homeostasis requires a carefully-orchestrated balance between cell proliferation, cellular senescence and cell death. Cells proliferate through a cell cycle that is tightly regulated by cyclin-dependent kinase ...Tissue homeostasis requires a carefully-orchestrated balance between cell proliferation, cellular senescence and cell death. Cells proliferate through a cell cycle that is tightly regulated by cyclin-dependent kinase activities. Cellular senescence is a safeguard program limiting the proliferative competence of cells in living organisms. Apoptosis eliminates unwanted cells by the coordinated activity of gene products that regulate and effect cell death. The intimate link between the cell cycle, cellular senes- cence, apoptosis regulation, cancer development and tumor responses to cancer treatment has become eminently apparent. Extensive research on tumor suppressor genes, oncogenes, the cell cycle and apoptosis regulatory genes has revealed how the DNA damage-sensing and -signaling pathways, referred to as the DNA-damage response network, are tied to cell proliferation, cell-cycle arrest, cellular senescence and apoptosis. DNA-damage responses are complex, involving “sensor” proteins that sense the damage, and transmit signals to “transducer” proteins, which, in turn, convey the signals to numerous “effector” proteins implicated in specific cellular pathways, including DNA repair mechanisms, cell-cycle checkpoints, cellular senescence and apoptosis. The Bcl-2 family of proteins stands among the most crucial regulators of apoptosis and performs vital functions in deciding whether a cell will live or die after cancer chemotherapy and irradiation. In addition, several studies have now revealed that members of the Bcl-2 family also interface with the cell cycle, DNA repair/recombination and cellular senescence, effects that are generally distinct from their function in apoptosis. In this review, we report progress in understanding the molecular networks that regulate cell-cycle checkpoints, cellular senescence and apoptosis after DNA damage, and discuss the influence of some Bcl-2 family members on cell-cycle checkpoint regulation.展开更多
AIM To performed a systematic review and meta-analysis to determine any possible differences in terms of effectiveness, safety and tolerability between existing colon-cleansing products in patients with inflammatory b...AIM To performed a systematic review and meta-analysis to determine any possible differences in terms of effectiveness, safety and tolerability between existing colon-cleansing products in patients with inflammatory bowel disease.METHODS Systematic searches were performed( January 1980-September 2016) using MEDLINE, EMBASE, Scopus, CENTRAL and ISI Web of knowledge for randomized trials assessing preparations with or without adjuvants, given in split and non-split dosing, and in high(> 3 L) or low-volume(2 L or less) regimens. Bowel cleansing quality was the primary outcome. Secondary outcomes included patient willingness-torepeat the procedure and side effects/complications.RESULTS Out of 439 citations, 4 trials fulfilled our inclusion criteria(n = 449 patients). One trial assessed the impact of adding simethicone to polyethylene glycol(PEG) 4 L with no effect on bowel cleansing quality, but a better tolerance. Another trial compared senna to castor oil, again without any differences in term of bowel cleansing. Two trials compared the efficacy of PEG high-volume vs PEG low-volume associated to an adjuvant in split-dose regimens: PEG low-dose efficacy was not different to PEG high-dose; OR = 0.84(0.37-1.92). A higher proportion of patients were willing to repeat low-volume preparations vs high-volume; OR = 5.11(1.31-20.0). CONCLUSION In inflammatory bowel disease population, PEG lowvolume regimen seems not inferior to PEG high-volume to clean the colon, and yields improved willingness-torepeat. Further additional research is urgently required to compare contemporary products in this population.展开更多
Recent advances in the proteomic field have allowed high-throughput experiments to be conducted on chloroplast samples. Many proteomic investigations have focused on either whole chloroplast or sub-plastidial fraction...Recent advances in the proteomic field have allowed high-throughput experiments to be conducted on chloroplast samples. Many proteomic investigations have focused on either whole chloroplast or sub-plastidial fractions. To date, the Plant Protein Database （PPDB, Sun et al., 2009） presents the most exhaustive chloroplast proteome available online. However, the accurate localization of many proteins that were identified in different sub-plastidial compartments remains hypothetical. Ferro et al. （2009） went a step further into the knowledge of Arabidopsis thaliana chloroplast proteins with regards to their accurate localization within the chloroplast by using a semi-quantitative proteomic approach known as spectral counting. Their proteomic strategy was based on the accurate mass and time tags （AMT） database approach and they built up AT_CHLORO, a comprehensive chloroplast proteome database with sub-plastidial localization and curated information on envelope proteins. Comparing these two extensive databases, we focus here on about 100 enzymes involved in the synthesis of chloroplast-specific isoprenoids. Well known pathways （i.e. compartmentation of the methyl erythritol phosphate biosynthetic pathway, of tetrapyrroles and chlorophyll biosynthesis and breakdown within chloroplasts） validate the spectral counting-based strategy. The same strategy was then used to identify the precise localization of the biosynthesis of carotenoids and prenylquinones within chloroplasts （i.e. in envelope membranes, stroma, and/or thylakoids） that remains unclear until now.展开更多
Sophora leaves from several areas in Beijing are analysed by femtosecond laser-induced breakdown spectroscopy （femto-LIBS）. Although the used spectral detection system is not time-resolved, the spectral lines of tra...Sophora leaves from several areas in Beijing are analysed by femtosecond laser-induced breakdown spectroscopy （femto-LIBS）. Although the used spectral detection system is not time-resolved, the spectral lines of trace mineral elements are detected and analysed. It is proven that the femto-LIBS can be an efficient method to detect mineral trace elements contained in tree leaves which is a biomonitor for atmospheric pollution assessment or botanic studies. An interesting case of correlation between trace elements detected in tree leaves and the pollution of the concerned area is presented, for the first time to our knowledge.展开更多
Buruli ulcer is the third most common mycobacterial disease worldwide, posing a significant public health burden, especially in impoverished regions of West and Central Africa, such as Benin. The management of Buruli ...Buruli ulcer is the third most common mycobacterial disease worldwide, posing a significant public health burden, especially in impoverished regions of West and Central Africa, such as Benin. The management of Buruli ulcer (BU) in Africa is often hindered by limited resources, delays in treatment, and inadequate medical facilities. Additionally, a portion of the population does not seek hospital care, which facilitates the continued presence of the pathogen in the environment. This paper aims to investigate the role of environmental factors in the transmission of Buruli ulcer. We develop a mathematical model to describe the dynamics of Buruli ulcer transmission, incorporating the presence of the bacterium in the environment. Theoretical results are presented to demonstrate that the model is well-posed. We compute the equilibria, including the disease-free equilibrium and the endemic equilibrium, and study their stability. To achieve this, we derive a threshold parameter called the basic reproduction number ℛ0, which determines whether the disease will persist in a human population. If ℛ0is less than one, the disease will eventually die out;if ℛ0is greater than one, the disease will persist. Sensitivity analysis is performed to understand the impact of various parameters on the dynamics of Buruli ulcer transmission and to identify the parameters that influence the basic reproduction number ℛ0. Finally, numerical simulations are conducted to validate the theoretical results obtained from the mathematical analysis.展开更多
Background: Tuberculous endocarditis is a rare but serious complication of heart valve replacement surgery. We report the case of a 24-year-old patient, who presented with tuberculous endocarditis after mechanical mit...Background: Tuberculous endocarditis is a rare but serious complication of heart valve replacement surgery. We report the case of a 24-year-old patient, who presented with tuberculous endocarditis after mechanical mitral valve replacement, with a favorable clinical course following anti-tuberculosis treatment. Case Presentation: We report a 24-year-old male patient, admitted to the cardiac surgery department of the Fann Hospital (Dakar, Senegal), for the management of severe mixed (rheumatic and endocarditic) mitral insufficiency with associated tricuspid insufficiency. He had a history of recurrent angina and polyarthralgia in childhood, was hospitalized several times for refractory global cardiac decompensation, and for a suspected infective endocarditis a month before his admission. On admission, the clinical examination revealed signs suggestive of mitral and tricuspid insufficiency. Transthoracic echocardiography revealed severe post-endocarditic mitral insufficiency with A3 amputation, highly mobile 15 mm vegetations on the free edge of the large valve, moderate tricuspid insufficiency, and severe pulmonary artery hypertension. Mechanical mitral valve replacement and tricuspid valve annuloplasty using autologous pericardial strip were performed via median sternotomy. After ten days, the patient presented with global cardiac decompensation associated with a clinico-biological infectious syndrome, and tans-oesophageal echography revealed an abscess at the sinotubular junction, communicating with the aorta. A thoraco-abdomino-pelvic CT scan was done, which revealed a bilateral alveolar-interstitial syndrome with mediastinal lymphadenopathy. Anti-tuberculosis treatment with RHZE was initiated for 06 months. The clinical course was favorable. Conclusion: Tuberculous endocarditis in prostheses is a serious complication of heart valve replacement surgery, which may evolve favorably under medical treatment.展开更多
Objective: This study aims to systematically examine the existing evidence regarding the clinical benefits of carbocysteine as an adjunctive treatment in acute bronchopulmonary and otorhinological processes. Design: S...Objective: This study aims to systematically examine the existing evidence regarding the clinical benefits of carbocysteine as an adjunctive treatment in acute bronchopulmonary and otorhinological processes. Design: Systematic review and meta-analysis. Data sources: An electronic search was conducted across PubMed, Cochrane Library, clinicaltrials.gov, and the European Clinical Trial Register, with the search dated to May 2023. Bibliographic references from other literature reviews and meta-analyses were also reviewed. The search was limited to randomized clinical trials published in any language and year. It was completed by cross-checking the references of the located articles. Methods: Inclusion criteria covered studies assessing systemic or inhaled carbocysteine, regardless of dosing regimen. Concomitant medication use was acceptable if balanced between intervention and control groups. Authors independently extracted data, resolving disagreements through consensus. Methodological quality assessment relied on critical reading of each study. Dichotomous variables were analyzed using odds ratio (OR), and a final effect size was calculated. Statistical significance was established when confidence intervals did not cross the neutral value. Heterogeneity was assessed via the X<sup>2</sup> test and I<sup>2</sup> index. Results: Out of 318 initially identified studies, 4 met inclusion criteria. The meta-analysis for poor general condition yielded an OR of 0.45 in favor of intervention, p = 0.013, with non-significant heterogeneity. Cough events showed a percentage of 15.8% for carbocysteine vs. 27.2% for placebo. On the seventh day, expectoration rates were 18.37% for carbocysteinevs 33.3% for placebo. Conclusions: The observed clinical benefits align with carbocysteine’s mucoactive and muco-regulatory properties, complemented by anti-inflammatory and antioxidant actions. Carbocysteine stands out among mucolytic agents. In the context of persistent infectious diseases, the study emphasizes the need for further expl展开更多
AIM:To compare efficacy and complications of par-tially covered self-expandable metal stent(pcSEMS)to plastic stent(PS)in patients treated for malignant,infrahilar biliary obstruction.METHODS:Multicenter prospective r...AIM:To compare efficacy and complications of par-tially covered self-expandable metal stent(pcSEMS)to plastic stent(PS)in patients treated for malignant,infrahilar biliary obstruction.METHODS:Multicenter prospective randomized clinical trial with treatment allocation to a pcWallstent(SEMS)or a 10 French PS.Palliative patients aged≥18,for infrahilar malignant biliary obstruction and a Karnofsky performance scale index>60%from 6 participating North American university centers.Primary endpoint was time to stent failure,with secondary outcomes of death,adverse events,Karnofsky performance score and short-form-36 scale administered on a three-monthly basis for up to 2 years.Survival analyses were performed for stent failure and death,with Cox proportional hazards regression models to determine significant predictive characteristics.RESULTS:Eighty-five patients were accrued over 37mo,42 were randomized to the SEMS group and 83patients were available for analyses.Time to stent failure was 385.3±52.5 d in the SEMS and 153.3±19.8 d in the PS group,P=0.006.Time to death did not differ between groups(192.3±23.4 d for SEMS vs211.5±28.0 d for PS,P=0.70).The only significant predictor was treatment allocation,relating to the time to stent failure(P=0.01).Amongst other measured outcomes,only cholangitis differed,being more common in the PS group(4.9%vs 24.5%,P=0.029).The small number of patients in follow-up limits longitudinal assessments of performance and quality of life.From an initially planned 120 patients,only 85 patients were recruited.CONCLUSION:Partially covered SEMS result in a longer duration till stent failure without increased complication rates,yet without accompanying measurable benefits in survival,performance,or quality of life.展开更多
Introduction: Tuberculosis is a chronic infectious disease that remains a global public health problem. Children, accounting for 10% of cases, are particularly vulnerable to this disease. Based on a case of multifocal...Introduction: Tuberculosis is a chronic infectious disease that remains a global public health problem. Children, accounting for 10% of cases, are particularly vulnerable to this disease. Based on a case of multifocal tuberculosis in a 14-month-old infant, the authors conducted a literature review on this condition. Observation: The case involved a 14-month-old infant referred from a health center for persistent symptoms including anemia, fever, and lateral deviation of the mouth during crying. Clinical examination revealed an infectious and meningeal syndrome, as well as facial paralysis. The results of brain imaging, cerebrospinal fluid examination, fundus examination, and gastric lavage fluid examination led to the conclusion of multifocal tuberculosis in the infant without association with HIV. Improvement was observed one week after the start of antituberculosis treatment, with complete recovery without sequelae after 12 months. Conclusion: Although rare, multifocal tuberculosis does exists and its diagnosis remains challenging in infants. Early treatment generally leads to favorable outcomes, especially in the absence of HIV coinfection.展开更多
Introduction: Undernutrition is a public health problem in the world and especially in developing countries. According to the demographic and health survey with multiple indicators of Benin IV (DHS-MICS-IV), the preva...Introduction: Undernutrition is a public health problem in the world and especially in developing countries. According to the demographic and health survey with multiple indicators of Benin IV (DHS-MICS-IV), the prevalence of acute undernutrition (AU), chronic undernutrition (CU) and that of underweight (UW) was 16%, 45% and 21%, respectively. The objective of this work was to determine the prevalence of undernutrition in children aged 6 to 59 months in the municipality of Toucountouna in 2017. Materials and Methods: This was a descriptive cross-sectional study with two-stage cluster random sampling, composed of 390 children aged 6 to 59 months, living in the municipality of Toucountouna for at least six months. The study variables were: socio-demographic, economic, behavioral, socio-sanitary and anthropometric. Data were entered and analyzed using Epi-info 7.2 software. Results: 203 out of 390 children included, were boys (sex ratio of 1.08). The mean age of the children was 28.70 ± 11.79 months. The prevalence of AU, CU and UW was 10.26%, 31.54% and 11.79%, respectively. Conclusion: The results of this study showed that efforts remain to be made in terms of undernutrition and other surveys could identify the determinants linked to this situation in the locality for the effective implementation of prevention.展开更多
Background: Neonatal mortality is a real public health problem in the world and particularly in countries with limited resources. Essential care remains an effective means of reducing this mortality. Objective: To eva...Background: Neonatal mortality is a real public health problem in the world and particularly in countries with limited resources. Essential care remains an effective means of reducing this mortality. Objective: To evaluate the practice of administering of vitamin K1, ocular and cord care in maternity wards in the Kozah 1 municipality. Method: This is a cross-sectional study conducted from March 1st to June 30th, 2022 in all maternity wards in the Kozah 1 municipality. Socioprofessional aspects of providers and those related to the administration of vitamin K1, ocular and cord care were studied. Results: Eighty-five (85) maternity providers were included in this study. The average age of the providers was 36.2 years with extremes of 21 and 55 years. Providers were midwives (51.8%), childbirth attendants (35.3%), and matrons (12.9%). The average length of practice was 9.5 years with extremes of 1 and 28 years. For three out of four providers (75.3%), the postpartum period was defined as a period of 02 hours following delivery. The importance of cord, ocular care, and administration of vitamin K1 in postpartum was known respectively by 84.7%, 98.8%, and 92.9% of the providers. Chlorhexidine gel was used by 81.2% of providers for umbilical cord care. For ocular disinfection, more than half of the providers (52.9%) reported using half-diluted povidone iodine. No center had displayed care protocol. Conclusion: This study highlighted the level of knowledge and practice of three essential postpartum care practices. The products used for the different care practices are consistent with recommendations but vary according to the care providers.展开更多
Background: Renal stone (RS) is a highly prevalent disease in our societies and is mostly secondary to lifestyle habits. HIV<sub>1</sub> patients often experience RS, although specific risk factors are not...Background: Renal stone (RS) is a highly prevalent disease in our societies and is mostly secondary to lifestyle habits. HIV<sub>1</sub> patients often experience RS, although specific risk factors are not known. Despite other priorities, comprehensive work-up should be offered to avoid recurrences (50% risk in 5 years). Purpose and Methods: The aim of the study is to describe how to handle RS in persons living with HIV<sub>1</sub> and to suggest how the understanding of mechanisms involved in stone composition helps customize therapy and prevent recurrences. We prospectively performed a complete work-up in a cohort of 23 prevalent HIV<sub>1</sub> patients referred to our highly-specialized center by HIV physicians. Results: Inclusion was secondary to a colic episode with spontaneous elimination of the stone (74%), bilateral (67%), not obstructive (67%);53% underwent urologic interventions. Mean age was 34 ± 16 years old and BMI was 22.5 ± 3 (one-third with metabolic syndrome). History of RS showed only one episode (22%), >one (74%) or >4 (4%). Estimated GFR was 78 ± 24 ml/min/1.73m<sup>2</sup> (mean Cr 101 ± 24 μmol/L), and 5 were classified CKD stage 3. Stone analysis was only available for 7 patients and in 6/7 patients, and calcium metabolism was fully explored (2 absorptive hypercalciuria, 4 renal primitive hypercalciuria). Retained mechanism for RS was uric acid dependent for one, oxalic acid dependent for three and calcium dependent for three. Very few patients were exposed to known environmental risk factors for RS, 3 were/had been exposed to darunavir and 3 to atazanavir, 1 to efavirenz, 1 to acetazolamide, 2 to allopurinol. Conclusion: RS in HIV<sub>1</sub> patients is mostly not related to ARV. Understanding of renal stone composition is critical to prevent recurrences by offering specific dietetic counselling and therapy. The role of HIV physicians is important due to the high prevalence of RS in the context of HIV disease.展开更多
Among the impacts of climate change,there is the intensification of phenomena such as the El Niño South-ern Oscillation(ENSO)responsible for El Niño and La Niña.However,understanding their effects on th...Among the impacts of climate change,there is the intensification of phenomena such as the El Niño South-ern Oscillation(ENSO)responsible for El Niño and La Niña.However,understanding their effects on the functional pro-cesses of forests is limited.Therefore,this study evaluated the effects of ENSO on litter stock and water holding capac-ity(WHC)in a successional forest in eastern Amazonia.Evaluations occurred in periods with the most rainfall in El Niño(2019)and least in La Niña(2021)years.Twelve permanent plots were used to sample litter.ENSO effects were evident for WHC,higher during El Niño.However,this influence was not clear for litter,as only in the rainy season effects were found.There was a positive correlation of WHC with precipitation and humidity,while litter stocks were negatively correlated with temperature and wind speed.Although the subject of this study requires long-term assessments,preliminary results suggests that,depending on the intensity of ENSO,forest functional processes can be strongly impacted and altered.The conclusion reinforces warnings by the scientific community about the impacts of climate change on the maintenance of litter stocks,decomposition and,consequently,the biogeochemical cycle and essential ecosystem services for the maintenance of Amazonia biodiversity.The need to develop long-term research to understand the effects of climatic change on litter stocks and water holding capacity is highlighted,especially in Amazonia.展开更多
BACKGROUND Violence against healthcare workers(HCWs)in the Caribbean continues to prevail yet remains underreported.Our aim is to determine the cause,traits,and consequences of violence on HCWs in the Caribbean.AIM To...BACKGROUND Violence against healthcare workers(HCWs)in the Caribbean continues to prevail yet remains underreported.Our aim is to determine the cause,traits,and consequences of violence on HCWs in the Caribbean.AIM To determine the cause,traits,and consequences of violence on HCWs in the Caribbean.METHODS This research adopted an online cross-sectional survey approach,spanning over eight weeks(between June 6th and August 9th,2022).The survey was generated using Research Electronic Data Capture forms and followed a snowballing strategy to contact individuals using emails,social media,text messages,etc.Logistic regression analysis was performed to evaluate the variables that influence violence,including gender,age,years of experience,institution type,and night shift frequency.RESULTS The survey was completed by 225 HCWs.Females comprised 61%.Over 51%of respondents belonged to the 21 to 35 age group.Dominica(n=61),Haiti(n=50),and Grenada(n=31)had the most responses.Most HCWs(49%)worked for government academic institutions,followed by community hospitals(23%).Medical students(32%),followed by attending physicians(22%),and others(16%)comprised the most common cadre of respondents.About 39%of the participants reported experiencing violence themselves,and 18%reported violence against colleague(s).Verbal violence(48%),emotional abuse(24%),and physical misconduct(14%)were the most common types of violence.Nearly 63%of respondents identified patients or their relatives as the most frequent aggressors.Univariate logistic regression analyses demonstrated that female gender(OR=2.08;95%CI:1.16-3.76,P=0.014)and higher frequency of night shifts(OR=2.22;95%CI:1.08-4.58,P=0.030)were associated with significantly higher odds of experiencing violence.More than 50%of HCWs felt less motivated and had decreased job satisfaction post-violent conduct.CONCLUSION A large proportion of HCWS in the Caribbean are exposed to violence,yet the phenomenon remains underreported.As a result,HCWs’job satisfaction has diminished.展开更多
EMBRYONIC FLOWER （EMF） genes are required to maintain vegetative development via repression of flower homeotic genes in Arabidopsis. Removal of EMF gene function caused plants to flower upon germination, producing a...EMBRYONIC FLOWER （EMF） genes are required to maintain vegetative development via repression of flower homeotic genes in Arabidopsis. Removal of EMF gene function caused plants to flower upon germination, producing abnormal and sterile flowers. The pleiotropic effect of ernfl mutation suggests its requirement for gene programs involved in diverse developmental processes. Transgenic plants harboring EMF1 promoter：：glucuronidase （GUS） reporter gene were generated to investigate the temporal and spatial expression pattern of EMF1. These plants displayed differential GUS activity in vegetative and flower tissues, consistent with the role of EMF1 in regulating multiple gene programs. EMFI：：GUS expression pattern in emf mutants suggests organ-specific auto-regulation. Sense- and antisense （as） EMF1 cDNA were expressed under the control of stage- and tissue-specific promoters in transgenic plants. Characterization of these transgenic plants showed that EMF1 activity is required in meristematic as well as differentiating tissues to rescue emf mutant phenotype. Temporal removal or reduction of EMF1 activity in the embryo or shoot apex of wild-type seedlings was sufficient to cause early flowering and terminal flower formation in adult plants. Such reproductive cell memory is reflected in the flower MADS-box gene activity expressed prior to flowering in these early flowering plants. However, temporal removal of EMF1 activity in flower meristem did not affect flower development. Our results are consistent with EMF1＇s primary role in repressing flowering in order to allow for vegetative growth.展开更多
Background:Newly diagnosed breast cancer patients experience symptoms that may affect their quality of life,treatment outcomes,and survival.Preventing and managing breast cancer-related symptoms soon after diagnosis i...Background:Newly diagnosed breast cancer patients experience symptoms that may affect their quality of life,treatment outcomes,and survival.Preventing and managing breast cancer-related symptoms soon after diagnosis is essential.The purpose of this study was to investigate the associations between health-related fitness(HRF)and patient-reported symptoms in newly diagnosed breast cancer patients.Methods:This study utilized baseline data from the Alberta Moving Beyond Breast Cancer Cohort Study that were collected within 90 days of diagnosis.HRF measures included peak cardiopulmonary fitness(peak volume of oxygen consumption(VO_(2peak))),maximal muscular strength and endurance,flexibility,and body composition.Symptom measures included depression,sleep quality,and fatigue.Adjusted multivariable logistic regression was performed for analyses.Results:Of 1458 participants,51.5%reported poor sleep quality,26.5%reported significant fatigue,and 10.4%reported moderate depression.In multivariable-adjusted models,lower relative VO_(2peak)was independently associated with a greater likelihood of all symptom measures,including moderate depression(p<0.001),poor sleep quality(p=0.009),significant fatigue(p=0.008),any symptom(p<0.001),and multiple symptoms(p<0.001).VO_(2peak)demonstrated threshold associations with all symptom measures such that all 3 lower quartiles exhibited similar elevated risk compared to the highest quartile.The strength of the threshold associations varied by the symptom measure with odds ratios ranging from-1.5 for poor sleep quality to-3.0 for moderate depression and multiple symptoms.Moreover,lower relative upper body muscular endurance was also independently associated with fatigue in a dose-response manner(p=0.001),and higher body weight was independently associated with poor sleep quality in an inverted U pattern(p=0.021).Conclusion:Relative VO_(2peak)appears to be a critical HRF component associated with multiple patient-reported symptoms in newly diagnosed breast cancer patients.Other HRF parameter展开更多
文摘AIM To summarize and compare worldwide colorectal cancer(CRC) screening recommendations in order to identify similarities and disparities.METHODS A systematic literature search was performed using MEDLINE, EMBASE, Scopus, CENTRAL and ISI Web of knowledge identifying all average-risk CRC screening guideline publications within the last ten years and/or position statements published in the last 2 years. In addition, a hand-search of the webpages of National Gastroenterology Society websites, the National Guideline Clearinghouse, the BMJ Clinical Evidence website,Google and Google Scholar was performed. RESULTS Fifteen guidelines were identified. Six guidelines were published in North America, four in Europe, four in Asia and one from the World Gastroenterology Organization. The majority of guidelines recommend screening average-risk individuals between ages 50 and 75 using colonoscopy(every 10 years), or flexible sigmoidoscopy(FS, every 5 years) or fecal occult blood test(FOBT, mainly the Fecal Immunochemical Test, annually or biennially). Disparities throughout the different guidelines are found relating to the use of colonoscopy, rank order between test, screening intervals and optimal age ranges for screening. CONCLUSION Average risk individuals between 50 and 75 years should undergo CRC screening. Recommendations for optimal surveillance intervals, preferred tests/test cascade as well as the optimal timing when to start and stop screening differ regionally and should be considered for clinical decision making. Furthermore, local resource availability and patient preferences are important to increase CRC screening uptake, as any screening is better than none.
基金the Canadian Institutes of Health Research and the Cancer Research Society, and fellowships by the Health Research Funds of Quebec, Canada
文摘Tissue homeostasis requires a carefully-orchestrated balance between cell proliferation, cellular senescence and cell death. Cells proliferate through a cell cycle that is tightly regulated by cyclin-dependent kinase activities. Cellular senescence is a safeguard program limiting the proliferative competence of cells in living organisms. Apoptosis eliminates unwanted cells by the coordinated activity of gene products that regulate and effect cell death. The intimate link between the cell cycle, cellular senes- cence, apoptosis regulation, cancer development and tumor responses to cancer treatment has become eminently apparent. Extensive research on tumor suppressor genes, oncogenes, the cell cycle and apoptosis regulatory genes has revealed how the DNA damage-sensing and -signaling pathways, referred to as the DNA-damage response network, are tied to cell proliferation, cell-cycle arrest, cellular senescence and apoptosis. DNA-damage responses are complex, involving “sensor” proteins that sense the damage, and transmit signals to “transducer” proteins, which, in turn, convey the signals to numerous “effector” proteins implicated in specific cellular pathways, including DNA repair mechanisms, cell-cycle checkpoints, cellular senescence and apoptosis. The Bcl-2 family of proteins stands among the most crucial regulators of apoptosis and performs vital functions in deciding whether a cell will live or die after cancer chemotherapy and irradiation. In addition, several studies have now revealed that members of the Bcl-2 family also interface with the cell cycle, DNA repair/recombination and cellular senescence, effects that are generally distinct from their function in apoptosis. In this review, we report progress in understanding the molecular networks that regulate cell-cycle checkpoints, cellular senescence and apoptosis after DNA damage, and discuss the influence of some Bcl-2 family members on cell-cycle checkpoint regulation.
文摘AIM To performed a systematic review and meta-analysis to determine any possible differences in terms of effectiveness, safety and tolerability between existing colon-cleansing products in patients with inflammatory bowel disease.METHODS Systematic searches were performed( January 1980-September 2016) using MEDLINE, EMBASE, Scopus, CENTRAL and ISI Web of knowledge for randomized trials assessing preparations with or without adjuvants, given in split and non-split dosing, and in high(> 3 L) or low-volume(2 L or less) regimens. Bowel cleansing quality was the primary outcome. Secondary outcomes included patient willingness-torepeat the procedure and side effects/complications.RESULTS Out of 439 citations, 4 trials fulfilled our inclusion criteria(n = 449 patients). One trial assessed the impact of adding simethicone to polyethylene glycol(PEG) 4 L with no effect on bowel cleansing quality, but a better tolerance. Another trial compared senna to castor oil, again without any differences in term of bowel cleansing. Two trials compared the efficacy of PEG high-volume vs PEG low-volume associated to an adjuvant in split-dose regimens: PEG low-dose efficacy was not different to PEG high-dose; OR = 0.84(0.37-1.92). A higher proportion of patients were willing to repeat low-volume preparations vs high-volume; OR = 5.11(1.31-20.0). CONCLUSION In inflammatory bowel disease population, PEG lowvolume regimen seems not inferior to PEG high-volume to clean the colon, and yields improved willingness-torepeat. Further additional research is urgently required to compare contemporary products in this population.
文摘Recent advances in the proteomic field have allowed high-throughput experiments to be conducted on chloroplast samples. Many proteomic investigations have focused on either whole chloroplast or sub-plastidial fractions. To date, the Plant Protein Database （PPDB, Sun et al., 2009） presents the most exhaustive chloroplast proteome available online. However, the accurate localization of many proteins that were identified in different sub-plastidial compartments remains hypothetical. Ferro et al. （2009） went a step further into the knowledge of Arabidopsis thaliana chloroplast proteins with regards to their accurate localization within the chloroplast by using a semi-quantitative proteomic approach known as spectral counting. Their proteomic strategy was based on the accurate mass and time tags （AMT） database approach and they built up AT_CHLORO, a comprehensive chloroplast proteome database with sub-plastidial localization and curated information on envelope proteins. Comparing these two extensive databases, we focus here on about 100 enzymes involved in the synthesis of chloroplast-specific isoprenoids. Well known pathways （i.e. compartmentation of the methyl erythritol phosphate biosynthetic pathway, of tetrapyrroles and chlorophyll biosynthesis and breakdown within chloroplasts） validate the spectral counting-based strategy. The same strategy was then used to identify the precise localization of the biosynthesis of carotenoids and prenylquinones within chloroplasts （i.e. in envelope membranes, stroma, and/or thylakoids） that remains unclear until now.
基金Supported by the National Natural Science Foundation of China under Grant Nos 10634020, 10390161, 60621063, and 60478047, the National Basic Research Programme of China Grant No 2007CB815101, the National Hi-Tech ICF Project, and the Internship Scholarship from French Rahone-Alps Region.
文摘Sophora leaves from several areas in Beijing are analysed by femtosecond laser-induced breakdown spectroscopy （femto-LIBS）. Although the used spectral detection system is not time-resolved, the spectral lines of trace mineral elements are detected and analysed. It is proven that the femto-LIBS can be an efficient method to detect mineral trace elements contained in tree leaves which is a biomonitor for atmospheric pollution assessment or botanic studies. An interesting case of correlation between trace elements detected in tree leaves and the pollution of the concerned area is presented, for the first time to our knowledge.
文摘Buruli ulcer is the third most common mycobacterial disease worldwide, posing a significant public health burden, especially in impoverished regions of West and Central Africa, such as Benin. The management of Buruli ulcer (BU) in Africa is often hindered by limited resources, delays in treatment, and inadequate medical facilities. Additionally, a portion of the population does not seek hospital care, which facilitates the continued presence of the pathogen in the environment. This paper aims to investigate the role of environmental factors in the transmission of Buruli ulcer. We develop a mathematical model to describe the dynamics of Buruli ulcer transmission, incorporating the presence of the bacterium in the environment. Theoretical results are presented to demonstrate that the model is well-posed. We compute the equilibria, including the disease-free equilibrium and the endemic equilibrium, and study their stability. To achieve this, we derive a threshold parameter called the basic reproduction number ℛ0, which determines whether the disease will persist in a human population. If ℛ0is less than one, the disease will eventually die out;if ℛ0is greater than one, the disease will persist. Sensitivity analysis is performed to understand the impact of various parameters on the dynamics of Buruli ulcer transmission and to identify the parameters that influence the basic reproduction number ℛ0. Finally, numerical simulations are conducted to validate the theoretical results obtained from the mathematical analysis.
文摘Background: Tuberculous endocarditis is a rare but serious complication of heart valve replacement surgery. We report the case of a 24-year-old patient, who presented with tuberculous endocarditis after mechanical mitral valve replacement, with a favorable clinical course following anti-tuberculosis treatment. Case Presentation: We report a 24-year-old male patient, admitted to the cardiac surgery department of the Fann Hospital (Dakar, Senegal), for the management of severe mixed (rheumatic and endocarditic) mitral insufficiency with associated tricuspid insufficiency. He had a history of recurrent angina and polyarthralgia in childhood, was hospitalized several times for refractory global cardiac decompensation, and for a suspected infective endocarditis a month before his admission. On admission, the clinical examination revealed signs suggestive of mitral and tricuspid insufficiency. Transthoracic echocardiography revealed severe post-endocarditic mitral insufficiency with A3 amputation, highly mobile 15 mm vegetations on the free edge of the large valve, moderate tricuspid insufficiency, and severe pulmonary artery hypertension. Mechanical mitral valve replacement and tricuspid valve annuloplasty using autologous pericardial strip were performed via median sternotomy. After ten days, the patient presented with global cardiac decompensation associated with a clinico-biological infectious syndrome, and tans-oesophageal echography revealed an abscess at the sinotubular junction, communicating with the aorta. A thoraco-abdomino-pelvic CT scan was done, which revealed a bilateral alveolar-interstitial syndrome with mediastinal lymphadenopathy. Anti-tuberculosis treatment with RHZE was initiated for 06 months. The clinical course was favorable. Conclusion: Tuberculous endocarditis in prostheses is a serious complication of heart valve replacement surgery, which may evolve favorably under medical treatment.
文摘Objective: This study aims to systematically examine the existing evidence regarding the clinical benefits of carbocysteine as an adjunctive treatment in acute bronchopulmonary and otorhinological processes. Design: Systematic review and meta-analysis. Data sources: An electronic search was conducted across PubMed, Cochrane Library, clinicaltrials.gov, and the European Clinical Trial Register, with the search dated to May 2023. Bibliographic references from other literature reviews and meta-analyses were also reviewed. The search was limited to randomized clinical trials published in any language and year. It was completed by cross-checking the references of the located articles. Methods: Inclusion criteria covered studies assessing systemic or inhaled carbocysteine, regardless of dosing regimen. Concomitant medication use was acceptable if balanced between intervention and control groups. Authors independently extracted data, resolving disagreements through consensus. Methodological quality assessment relied on critical reading of each study. Dichotomous variables were analyzed using odds ratio (OR), and a final effect size was calculated. Statistical significance was established when confidence intervals did not cross the neutral value. Heterogeneity was assessed via the X<sup>2</sup> test and I<sup>2</sup> index. Results: Out of 318 initially identified studies, 4 met inclusion criteria. The meta-analysis for poor general condition yielded an OR of 0.45 in favor of intervention, p = 0.013, with non-significant heterogeneity. Cough events showed a percentage of 15.8% for carbocysteine vs. 27.2% for placebo. On the seventh day, expectoration rates were 18.37% for carbocysteinevs 33.3% for placebo. Conclusions: The observed clinical benefits align with carbocysteine’s mucoactive and muco-regulatory properties, complemented by anti-inflammatory and antioxidant actions. Carbocysteine stands out among mucolytic agents. In the context of persistent infectious diseases, the study emphasizes the need for further expl
基金Supported by Research Funding from Boston Scientific Inc to Barkun ANResearch Funding from Cook Endoscopy to Branch MSResearch Funding from Pentax Corp to Kowalski TE
文摘AIM:To compare efficacy and complications of par-tially covered self-expandable metal stent(pcSEMS)to plastic stent(PS)in patients treated for malignant,infrahilar biliary obstruction.METHODS:Multicenter prospective randomized clinical trial with treatment allocation to a pcWallstent(SEMS)or a 10 French PS.Palliative patients aged≥18,for infrahilar malignant biliary obstruction and a Karnofsky performance scale index>60%from 6 participating North American university centers.Primary endpoint was time to stent failure,with secondary outcomes of death,adverse events,Karnofsky performance score and short-form-36 scale administered on a three-monthly basis for up to 2 years.Survival analyses were performed for stent failure and death,with Cox proportional hazards regression models to determine significant predictive characteristics.RESULTS:Eighty-five patients were accrued over 37mo,42 were randomized to the SEMS group and 83patients were available for analyses.Time to stent failure was 385.3±52.5 d in the SEMS and 153.3±19.8 d in the PS group,P=0.006.Time to death did not differ between groups(192.3±23.4 d for SEMS vs211.5±28.0 d for PS,P=0.70).The only significant predictor was treatment allocation,relating to the time to stent failure(P=0.01).Amongst other measured outcomes,only cholangitis differed,being more common in the PS group(4.9%vs 24.5%,P=0.029).The small number of patients in follow-up limits longitudinal assessments of performance and quality of life.From an initially planned 120 patients,only 85 patients were recruited.CONCLUSION:Partially covered SEMS result in a longer duration till stent failure without increased complication rates,yet without accompanying measurable benefits in survival,performance,or quality of life.
文摘Introduction: Tuberculosis is a chronic infectious disease that remains a global public health problem. Children, accounting for 10% of cases, are particularly vulnerable to this disease. Based on a case of multifocal tuberculosis in a 14-month-old infant, the authors conducted a literature review on this condition. Observation: The case involved a 14-month-old infant referred from a health center for persistent symptoms including anemia, fever, and lateral deviation of the mouth during crying. Clinical examination revealed an infectious and meningeal syndrome, as well as facial paralysis. The results of brain imaging, cerebrospinal fluid examination, fundus examination, and gastric lavage fluid examination led to the conclusion of multifocal tuberculosis in the infant without association with HIV. Improvement was observed one week after the start of antituberculosis treatment, with complete recovery without sequelae after 12 months. Conclusion: Although rare, multifocal tuberculosis does exists and its diagnosis remains challenging in infants. Early treatment generally leads to favorable outcomes, especially in the absence of HIV coinfection.
文摘Introduction: Undernutrition is a public health problem in the world and especially in developing countries. According to the demographic and health survey with multiple indicators of Benin IV (DHS-MICS-IV), the prevalence of acute undernutrition (AU), chronic undernutrition (CU) and that of underweight (UW) was 16%, 45% and 21%, respectively. The objective of this work was to determine the prevalence of undernutrition in children aged 6 to 59 months in the municipality of Toucountouna in 2017. Materials and Methods: This was a descriptive cross-sectional study with two-stage cluster random sampling, composed of 390 children aged 6 to 59 months, living in the municipality of Toucountouna for at least six months. The study variables were: socio-demographic, economic, behavioral, socio-sanitary and anthropometric. Data were entered and analyzed using Epi-info 7.2 software. Results: 203 out of 390 children included, were boys (sex ratio of 1.08). The mean age of the children was 28.70 ± 11.79 months. The prevalence of AU, CU and UW was 10.26%, 31.54% and 11.79%, respectively. Conclusion: The results of this study showed that efforts remain to be made in terms of undernutrition and other surveys could identify the determinants linked to this situation in the locality for the effective implementation of prevention.
文摘Background: Neonatal mortality is a real public health problem in the world and particularly in countries with limited resources. Essential care remains an effective means of reducing this mortality. Objective: To evaluate the practice of administering of vitamin K1, ocular and cord care in maternity wards in the Kozah 1 municipality. Method: This is a cross-sectional study conducted from March 1st to June 30th, 2022 in all maternity wards in the Kozah 1 municipality. Socioprofessional aspects of providers and those related to the administration of vitamin K1, ocular and cord care were studied. Results: Eighty-five (85) maternity providers were included in this study. The average age of the providers was 36.2 years with extremes of 21 and 55 years. Providers were midwives (51.8%), childbirth attendants (35.3%), and matrons (12.9%). The average length of practice was 9.5 years with extremes of 1 and 28 years. For three out of four providers (75.3%), the postpartum period was defined as a period of 02 hours following delivery. The importance of cord, ocular care, and administration of vitamin K1 in postpartum was known respectively by 84.7%, 98.8%, and 92.9% of the providers. Chlorhexidine gel was used by 81.2% of providers for umbilical cord care. For ocular disinfection, more than half of the providers (52.9%) reported using half-diluted povidone iodine. No center had displayed care protocol. Conclusion: This study highlighted the level of knowledge and practice of three essential postpartum care practices. The products used for the different care practices are consistent with recommendations but vary according to the care providers.
文摘Background: Renal stone (RS) is a highly prevalent disease in our societies and is mostly secondary to lifestyle habits. HIV<sub>1</sub> patients often experience RS, although specific risk factors are not known. Despite other priorities, comprehensive work-up should be offered to avoid recurrences (50% risk in 5 years). Purpose and Methods: The aim of the study is to describe how to handle RS in persons living with HIV<sub>1</sub> and to suggest how the understanding of mechanisms involved in stone composition helps customize therapy and prevent recurrences. We prospectively performed a complete work-up in a cohort of 23 prevalent HIV<sub>1</sub> patients referred to our highly-specialized center by HIV physicians. Results: Inclusion was secondary to a colic episode with spontaneous elimination of the stone (74%), bilateral (67%), not obstructive (67%);53% underwent urologic interventions. Mean age was 34 ± 16 years old and BMI was 22.5 ± 3 (one-third with metabolic syndrome). History of RS showed only one episode (22%), >one (74%) or >4 (4%). Estimated GFR was 78 ± 24 ml/min/1.73m<sup>2</sup> (mean Cr 101 ± 24 μmol/L), and 5 were classified CKD stage 3. Stone analysis was only available for 7 patients and in 6/7 patients, and calcium metabolism was fully explored (2 absorptive hypercalciuria, 4 renal primitive hypercalciuria). Retained mechanism for RS was uric acid dependent for one, oxalic acid dependent for three and calcium dependent for three. Very few patients were exposed to known environmental risk factors for RS, 3 were/had been exposed to darunavir and 3 to atazanavir, 1 to efavirenz, 1 to acetazolamide, 2 to allopurinol. Conclusion: RS in HIV<sub>1</sub> patients is mostly not related to ARV. Understanding of renal stone composition is critical to prevent recurrences by offering specific dietetic counselling and therapy. The role of HIV physicians is important due to the high prevalence of RS in the context of HIV disease.
基金This study was funded in part by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Brazil(CAPES)Finance Code 001.A master’s scholarship was granted by CAPES to JIMR(Process 88887.716287/2022-00)a doctoral scholarship to VPO(Process 88887.644953/2021-00).
文摘Among the impacts of climate change,there is the intensification of phenomena such as the El Niño South-ern Oscillation(ENSO)responsible for El Niño and La Niña.However,understanding their effects on the functional pro-cesses of forests is limited.Therefore,this study evaluated the effects of ENSO on litter stock and water holding capac-ity(WHC)in a successional forest in eastern Amazonia.Evaluations occurred in periods with the most rainfall in El Niño(2019)and least in La Niña(2021)years.Twelve permanent plots were used to sample litter.ENSO effects were evident for WHC,higher during El Niño.However,this influence was not clear for litter,as only in the rainy season effects were found.There was a positive correlation of WHC with precipitation and humidity,while litter stocks were negatively correlated with temperature and wind speed.Although the subject of this study requires long-term assessments,preliminary results suggests that,depending on the intensity of ENSO,forest functional processes can be strongly impacted and altered.The conclusion reinforces warnings by the scientific community about the impacts of climate change on the maintenance of litter stocks,decomposition and,consequently,the biogeochemical cycle and essential ecosystem services for the maintenance of Amazonia biodiversity.The need to develop long-term research to understand the effects of climatic change on litter stocks and water holding capacity is highlighted,especially in Amazonia.
文摘BACKGROUND Violence against healthcare workers(HCWs)in the Caribbean continues to prevail yet remains underreported.Our aim is to determine the cause,traits,and consequences of violence on HCWs in the Caribbean.AIM To determine the cause,traits,and consequences of violence on HCWs in the Caribbean.METHODS This research adopted an online cross-sectional survey approach,spanning over eight weeks(between June 6th and August 9th,2022).The survey was generated using Research Electronic Data Capture forms and followed a snowballing strategy to contact individuals using emails,social media,text messages,etc.Logistic regression analysis was performed to evaluate the variables that influence violence,including gender,age,years of experience,institution type,and night shift frequency.RESULTS The survey was completed by 225 HCWs.Females comprised 61%.Over 51%of respondents belonged to the 21 to 35 age group.Dominica(n=61),Haiti(n=50),and Grenada(n=31)had the most responses.Most HCWs(49%)worked for government academic institutions,followed by community hospitals(23%).Medical students(32%),followed by attending physicians(22%),and others(16%)comprised the most common cadre of respondents.About 39%of the participants reported experiencing violence themselves,and 18%reported violence against colleague(s).Verbal violence(48%),emotional abuse(24%),and physical misconduct(14%)were the most common types of violence.Nearly 63%of respondents identified patients or their relatives as the most frequent aggressors.Univariate logistic regression analyses demonstrated that female gender(OR=2.08;95%CI:1.16-3.76,P=0.014)and higher frequency of night shifts(OR=2.22;95%CI:1.08-4.58,P=0.030)were associated with significantly higher odds of experiencing violence.More than 50%of HCWs felt less motivated and had decreased job satisfaction post-violent conduct.CONCLUSION A large proportion of HCWS in the Caribbean are exposed to violence,yet the phenomenon remains underreported.As a result,HCWs’job satisfaction has diminished.
文摘EMBRYONIC FLOWER （EMF） genes are required to maintain vegetative development via repression of flower homeotic genes in Arabidopsis. Removal of EMF gene function caused plants to flower upon germination, producing abnormal and sterile flowers. The pleiotropic effect of ernfl mutation suggests its requirement for gene programs involved in diverse developmental processes. Transgenic plants harboring EMF1 promoter：：glucuronidase （GUS） reporter gene were generated to investigate the temporal and spatial expression pattern of EMF1. These plants displayed differential GUS activity in vegetative and flower tissues, consistent with the role of EMF1 in regulating multiple gene programs. EMFI：：GUS expression pattern in emf mutants suggests organ-specific auto-regulation. Sense- and antisense （as） EMF1 cDNA were expressed under the control of stage- and tissue-specific promoters in transgenic plants. Characterization of these transgenic plants showed that EMF1 activity is required in meristematic as well as differentiating tissues to rescue emf mutant phenotype. Temporal removal or reduction of EMF1 activity in the embryo or shoot apex of wild-type seedlings was sufficient to cause early flowering and terminal flower formation in adult plants. Such reproductive cell memory is reflected in the flower MADS-box gene activity expressed prior to flowering in these early flowering plants. However, temporal removal of EMF1 activity in flower meristem did not affect flower development. Our results are consistent with EMF1＇s primary role in repressing flowering in order to allow for vegetative growth.
基金funded by a Team Grant(#107534)to KSC,CMF,SNCR,MLM,JKV,GJB,and JRMa Project Grant(#155952)to CMF,KSC,SNCR,MLM,JKV,and JRM+1 种基金a Foundation Grant(#159927)to KSC,CMF,SNCR,MLM,and JKV from the Canadian Institutes of Health Research.KSC and JKV are supported by the Canada Research Chairs ProgramCMF was supported by an Alberta Innovates Health Senior Scholar Award and by the Alberta Cancer Foundation Weekend to End Women’s Cancers Breast Cancer Chair.
文摘Background:Newly diagnosed breast cancer patients experience symptoms that may affect their quality of life,treatment outcomes,and survival.Preventing and managing breast cancer-related symptoms soon after diagnosis is essential.The purpose of this study was to investigate the associations between health-related fitness(HRF)and patient-reported symptoms in newly diagnosed breast cancer patients.Methods:This study utilized baseline data from the Alberta Moving Beyond Breast Cancer Cohort Study that were collected within 90 days of diagnosis.HRF measures included peak cardiopulmonary fitness(peak volume of oxygen consumption(VO_(2peak))),maximal muscular strength and endurance,flexibility,and body composition.Symptom measures included depression,sleep quality,and fatigue.Adjusted multivariable logistic regression was performed for analyses.Results:Of 1458 participants,51.5%reported poor sleep quality,26.5%reported significant fatigue,and 10.4%reported moderate depression.In multivariable-adjusted models,lower relative VO_(2peak)was independently associated with a greater likelihood of all symptom measures,including moderate depression(p<0.001),poor sleep quality(p=0.009),significant fatigue(p=0.008),any symptom(p<0.001),and multiple symptoms(p<0.001).VO_(2peak)demonstrated threshold associations with all symptom measures such that all 3 lower quartiles exhibited similar elevated risk compared to the highest quartile.The strength of the threshold associations varied by the symptom measure with odds ratios ranging from-1.5 for poor sleep quality to-3.0 for moderate depression and multiple symptoms.Moreover,lower relative upper body muscular endurance was also independently associated with fatigue in a dose-response manner(p=0.001),and higher body weight was independently associated with poor sleep quality in an inverted U pattern(p=0.021).Conclusion:Relative VO_(2peak)appears to be a critical HRF component associated with multiple patient-reported symptoms in newly diagnosed breast cancer patients.Other HRF parameter
