Щоб переглянути інші типи публікацій з цієї теми, перейдіть за посиланням: Sécurité de la CI/CD.
Статті в журналах з теми "Sécurité de la CI/CD"
Оформте джерело за APA, MLA, Chicago, Harvard та іншими стилями
Ознайомтеся з топ-50 статей у журналах для дослідження на тему "Sécurité de la CI/CD".
Біля кожної праці в переліку літератури доступна кнопка «Додати до бібліографії». Скористайтеся нею – і ми автоматично оформимо бібліографічне посилання на обрану працю в потрібному вам стилі цитування: APA, MLA, «Гарвард», «Чикаго», «Ванкувер» тощо.
Також ви можете завантажити повний текст наукової публікації у форматі «.pdf» та прочитати онлайн анотацію до роботи, якщо відповідні параметри наявні в метаданих.
Переглядайте статті в журналах для різних дисциплін та оформлюйте правильно вашу бібліографію.
1
Chauvenet, Antoinette, Georges Benguigui, and Françoise Orlic. "Sécurité, insécurité et prisons." IV. Ceux qui contrôlent, no. 30 (October 16, 2015): 135–43. http://dx.doi.org/10.7202/1033672ar.
Повний текст джерелаАнотація:
Plus que dans toute organisation, la finalité, les objectifs, les moyens et les règles de fonctionnement de la prison sont définis à l’extérieur de celle-ci. Aussi le rapport entre sécurité, insécurité et prisons est-il directement relié à celui que la société entretient à sa propre sécurité ou insécurité. La prison en tant que lieu d’expulsion du corps social de ceux de ses membres qui mettent en cause sa sécurité est un objet de méconnaissance, un impensé. Pour cette raison même cet impensé favorise la production d’insécurité tant à l’intérieur qu’à l’extérieur, et partant alimente les discours et les pratiques d’exclusion. L’article se fonde sur les résultats d’une recherche effectuée auprès de 300 surveillants de prisons françaises.
2
Roy, Martin, Charles-Philippe David, and Jean-Philippe Racicot. "Discours multilatéraliste, leadership réaliste : l'évolution de la conduite institutionnelle de sécurité des États-Unis sous Clinton." Études internationales 30, no. 2 (April 12, 2005): 233–56. http://dx.doi.org/10.7202/704027ar.
Повний текст джерелаАнотація:
Cet article analyse le rôle et l'influence des institutions internationales de sécurité à travers l'étude du comportement des États-Unis envers la réforme du Conseil de sécurité des Nations Unies, la consolidation de la paix en Bosnie, et l'élargissement de I'OTAN. L'analyse des trois cas démontre que l'administration Clinton a graduellement diminué l'importance accordée aux institutions internationales dans le maintien de la sécurité internationale. Les États-Unis ont accentué leur leadership au sein des institutions afin de définir l'agenda de sécurité en fonction de leurs intérêts. La poursuite des objectifs américains a été davantage influencée par les débats au sein du gouvernement et les demandes des acteurs extérieurs que par les institutions internationales. Celles-ci ont généralement servi de complément aux pratiques souhaitées par les États-Unis et ne se sont pas substituées au rôle que la superpuissance s'attribuait en sécurité internationale
3
Mulone1, Massimiliano. "Directeurs de sécurité en entreprise et consommation de la sécurité. Étude exploratoire canadienne." Criminologie 46, no. 2 (December 13, 2013): 149–70. http://dx.doi.org/10.7202/1020991ar.
Повний текст джерелаАнотація:
Cette étude exploratoire traite de certaines logiques de consommation sur le marché de la sécurité, et plus précisément du rôle qu’y jouent les directeurs de sécurité en entreprise. En effet, alors qu’indubitablement la sécurité est aujourd’hui en partie produite sous la forme d’un bien de consommation, force est de constater que le savoir cumulé sur les dynamiques du marché au travers duquel cette sécurité est produite présente un déséquilibre certain : les producteurs de sécurité marchandée ont ainsi été largement plus étudiés que les consommateurs. Or, comprendre le fonctionnement du marché nécessite autant de se pencher sur les mécanismes de l’offre que sur ceux de la demande, objet du présent article. À partir d’une dizaine d’entretiens semi-directifs avec les responsables des départements de sécurité auprès de grandes entreprises (celles-ci faisant partie, avec l’État, des deux plus importants clients de l’industrie), il a été possible d’apporter un certain éclairage sur les dynamiques qui sous-tendent la demande dans le marché de la sécurité. Comparant leur fonction à celle de consultant, les directeurs de sécurité en entreprise se présentent ainsi comme des producteurs de la demande. Les données mettent aussi de l’avant le rôle crucial joué par le capital social. Enfin, il apparaît que la sécurité consommée par l’entreprise s’apparenterait plus à une pratique qu’à une fin en soi.
4
Mayens, Paul. "Assurer le développement ou développer l’assurance : les discours experts sur la sécurité sociale dans les pays du Sud (1950-1975)." Monde(s) N° 25, no. 1 (May 28, 2024): 69–90. http://dx.doi.org/10.3917/mond1.225.0069.
Повний текст джерелаАнотація:
Entre le début des années 1950 et les années 1970 l’aide au développement fournie par les organisations internationales croît rapidement. Celle-ci se concentre sur l’accroissement de la productivité et la formation de la main-d’œuvre. Au sein du Bureau international du travail et de l’Association internationale de sécurité sociale des voix se font entendre pour que la sécurité sociale ne reste pas en marge de ces politiques. Un débat s’engage sur la pertinence de la mise en place de programmes de protection sociale dans des pays où le salariat reste minoritaire. Contre un discours dominant qui ferait de la sécurité sociale un coût trop lourd à supporter pour des économies fragiles, les experts gravitant autour du BIT et de l’AISS tentent d’articuler le développement de la protection sociale avec les impératifs du développement économique. Selon eux, celle-ci pourrait s’avérer être davantage un levier de développement qu’un coût.
5
Setyoko, Andreas Dimas, and Amalia Zahra. "Perbandingan Efisiensi Proses CI/CD Multi-Lingkungan melalui Implementasi Paralel dan Berurutan." MALCOM: Indonesian Journal of Machine Learning and Computer Science 4, no. 3 (May 25, 2024): 911–25. http://dx.doi.org/10.57152/malcom.v4i3.1334.
Повний текст джерелаАнотація:
Penelitian ini mengatasi masalah pengembangan aplikasi di PT. Astra International Tbk. dengan menggunakan sistem otomatis Continuous Integration/Continuous Deployment (CI/CD). Astra saat ini menghadapi masalah kompilasi dan distribusi yang dilakukan secara manual dimana proses yang dilakukan memakan waktu yang lama dan seringkali terjadi kesalahan konfigurasi terlebih terdapat berbagai macam environment dalam tiap aplikasi. Solusi yang diusulkan adalah implementasi CI/CD untuk otomatisasi proses kompilasi dan distribusi untuk setiap environment aplikasi. CI/CD adalah salah satu praktik DevOps yang digunakan untuk pengembangan perangkat lunak menjadi lebih terorganisir. Dengan memanfaatkan CI/CD, tim pengembang dapat merasakan manfaat dari proses kompilasi dan distribusi aplikasi yang lebih cepat. Penelitian ini membandingkan implementasi CI/CD berurutan dengan CI/CD paralel. Hasil penelitian menunjukkan bahwa CI/CD berurutan dapat mengurangi waktu yang diperlukan sebesar 33% dari proses manual, sedangkan CI/CD paralel dapat mengurangi waktu yang diperlukan sebesar 79% dari proses manual.
6
Singh, Nikhil. "CI/CD Pipeline for Web Applications." International Journal for Research in Applied Science and Engineering Technology 11, no. 5 (May 31, 2023): 5218–26. http://dx.doi.org/10.22214/ijraset.2023.52867.
Повний текст джерелаАнотація:
Abstract: Modern organisation’s rapid pace of software development necessitates teams delivering high-quality software products faster than ever before. In order to accomplish this, software development teams are incorporating continuous integration and continuous deployment (CI/CD) methodologies into their software development processes. CI/CD pipelines are a set of practises and tools that allow teams to efficiently and reliably automate the development, testing, and deployment of software products. CI/CD pipelines have become an essential tool for teams delivering web applications at a faster pace while ensuring scalability, security, and performance in the context of web applications. This paper provides an overview of the best practises and tools for constructing a successful CI/CD pipeline for web applications. Version control, continuous integration, automated testing, deployment automation, monitoring, and logging are among the key steps covered in the paper. The paper also discusses the advantages and disadvantages of CI/CD pipelines, such as increased productivity, shorter time-to-market, fewer manual errors, and better collaboration between development and operations teams. Several case studies are included in the paperto demonstrate the effectiveness of CI/CD pipelines in web application development. The case studies cover a variety of web applications, such as e-commerce websites, social media platforms, and healthcare apps. Each case study provides practical insights into CI/CD pipeline implementation, including the tools and technologies used, the benefits realised, and the challenges encountered. The case studies also emphasise the importance of culture and collaboration in CI/CD pipeline implementation success. The paper also discusses the key tools and technologies used in web application CI/CD pipelines, such as Git, Jenkins, Docker, Kubernetes, and AWS. The paper provides an overview of these tools as well as their role in various stages of the CI/CD pipeline. The paper also discusses the importance ofsecurity in CI/CD pipelines, as well as an overview of the key security practices that must be implemented
7
Kiss, Áron. "An explorative analysis of managed CI/CD usage among open-source C/C++ projects." Production Systems and Information Engineering 10, no. 3 (2022): 16–25. http://dx.doi.org/10.32968/psaie.2022.3.2.
Повний текст джерелаАнотація:
CI/CD is a common practice in software projects today, because it provides a higher level of reliability and safety, especially in the case of dynamically typed script languages. Several studies have examined questions about the effects of using CI/CD pipelines in general. This paper presents, how projects are written primarily in one of the mature C and C++ programming languages adapt to the emerging CI/CD trend. What proportion of these projects are using a CI/CD pipeline? Which managed CI/CD services are typically used in these projects? How early are the CI/CD approach adopted? Is project popularity related to CI/CD adoption rate? Data about 6,000 open-source C/C++ repositories were collected and analysed in this study to answer the aforementioned questions.
8
Roberge, Marie-Claude. "Compétence des Tribunaux ad hoc pour l'ex-Yougoslavie et le Rwanda concernant les crimes contre l'humanité et le crime de génocide." Revue Internationale de la Croix-Rouge 79, no. 828 (December 1997): 695–710. http://dx.doi.org/10.1017/s0035336100057191.
Повний текст джерелаАнотація:
Le Tribunal pénal international pour l'ex-Yougoslavie (ci-après le TPIY) et le Tribunal pénal international pour le Rwanda (ci-après le TPIR) ont été respectivement créés le 11 février 1993 et le 8 novembre 1994 par le Conseil de sécurité des Nations Unies pour poursuivre les personnes responsables de violations graves du droit international humanitaire. Le but du Conseil de sécurité était de faire cesser ces violations et de contribuer au rétablissement et au maintien de la paix. L'établissement de ces tribunaux ad hoc constitue indubitablement un pas important dans cette direction. De plus, il envoie — aux auteurs de ces crimes et aux victimes — un signal dépourvu de toute ambiguïté: un tel comportement ne sera plus toléré.
9
Le, P. H., C. H. Chiu, and C. T. Chiu. "P174 Clostridium innocuum Infection in Inpatients with Inflammatory Bowel Disease." Journal of Crohn's and Colitis 16, Supplement_1 (January 1, 2022): i243. http://dx.doi.org/10.1093/ecco-jcc/jjab232.302.
Повний текст джерелаАнотація:
Abstract Background Clostridium innocuum (CI) infection can lead to creeping fat in Crohn’s disease and is associated with intestinal strictures. At present, no clinical study ever has evaluated the role of CI infection in inflammatory bowel disease (IBD). Methods In this retrospective cohort study, we enrolled hospitalized IBD patients with culture results for both CI and Clostridioides difficile (CD) in a medical center between October 2019 and April 2021. They were divided into the CI (CI+/CD−), control (CI−/CD−), coinfection (CI+/CD+), and CD (CI−/CD+) groups. We analyzed the risk factors, clinical presentations, and outcomes by comparing the CI and control groups. Results We enrolled a total of 90 patients, including 22, 39, 13, and 16 patients in the CI, control, coinfection, and CD groups. The incidence rates of CI (CI+) and CD (CD+) were 39% (35/90) and 32% (29/90), respectively. We analyzed the differences between CI and control groups. We identified the use of steroid (77.3% vs. 46.2%, P = 0.018) and 5-aminosalicylic acid (90.9% vs. 64.1%, P = 0.022) as risk factors of CI infection. Clinical analysis showed that more patients in CI group presented with bloody stool (77.3% vs. 51.3%, P = 0.046). Although CI group had significantly lower overall occurrence of intraabdominal abscess (0% vs. 17.9%, P = 0.042), it showed a lower clinical remission rate (50% vs. 87.5%, P = 0.044) and higher Mayo score at the end of follow-up (10 points vs. 3 points, P = 0.008) in ulcerative colitis. Conclusion CI infection may lead to a poorer clinical remission in ulcerative colitis. We should take it into consideration in IBD patents with active inflamamtion or refractory diarrhea with or without CD infection. Precise identification of CI is imperative to guide approproate antimicrobial therapy because of its intrinsic vancomycin resistance nature.
10
Zhang, Wangdong, Yanyun Fan, and Meijun Chen. "Clinical Value of Detecting Fecal Calprotectin by Using Colloidal Gold Assay in Screening or Diagnosing Crohn’s Disease." Gastroenterology Research and Practice 2023 (November 9, 2023): 1–6. http://dx.doi.org/10.1155/2023/8866828.
Повний текст джерелаАнотація:
Background. Crohn’s disease (CD) is a chronic inflammatory disease, and its incidence is gradually increasing. Thus, the use of a simple and convenient examination method to detect CD in the natural population as early as possible is crucial. This study is aimed at using the colloidal gold semiquantitative assay to detect fecal calprotectin (FCP) and determine whether it is helpful in screening or diagnosing CD. Methods. Using a prospectively maintained database, 59 patients with CD were analyzed using FCP measurement. Subsequently, 76 patients and 89 healthy individuals were assigned to the gastrointestinal dysfunction and control groups, respectively. To aid in the screening or diagnosis of CD, the receiver operating characteristic curve was used to determine the diagnostic efficacy of FCP thresholds. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were presented with 95% confidence intervals (CIs). Results. Patients with CD showed significantly higher FCP levels. Compared with the healthy population, when the FCP level cut-off was 15 μg/g and 60 μg/g, the sensitivity, specificity, PPV, and NPV for CD diagnosis were 98.3% (CI, 95.0%–100%) and 78.0% (CI, 67.4–88.6%), 84.3% (CI, 76.7%–91.8%) and 98.9% (CI, 96.7%–100%), 80.6% (CI, 71.5%–89.7%) and 97.9% (CI, 93.7%–100%), and 98.7% (CI, 96.2%–100%) and 87.1% (CI, 80.6%–93.6%), respectively. The AUCs were 0.969 (CI, 0.941–0.997). Compared with the gastrointestinal dysfunction group, using the same FCP level cut-off, the sensitivity, specificity, PPV, and NPV for CD diagnosis were 98.3% (CI, 95.0%–100%) and 78.0% (CI, 67.4%–88.6%), 71.1% (CI, 60.9%–81.3%) and 89.5% (CI, 82.3%–96.7%), 72.5% (CI, 62.7%–82.3%) and 85.2% (CI, 75.7%–94.7%), and 98.1% (CI, 94.5%–100%) and 84.0% (CI, 76.0%–92.0%), respectively. The AUCs were 0.908 (CI, 0.856–0.960). Conclusion. Detecting FCP by using the colloidal gold semiquantitative assay can be effective in screening and adjunct diagnosing of CD.
11
Toba, Hapnes, Tjatur Kandaga Gautama, Julio Narabel, Andreas Widjaja, and Sendy Ferdian Sujadi. "Evaluasi Metodologi CI/CD untuk Pengembangan Perangkat Lunak dalam Perkuliahan." Jurnal Edukasi dan Penelitian Informatika (JEPIN) 8, no. 2 (August 11, 2022): 227. http://dx.doi.org/10.26418/jp.v8i2.51992.
Повний текст джерелаАнотація:
Saat ini sistem Continuous Integration (CI)/ Continuous Delivery (CD) merupakan standar baru dalam pengembangan perangkat lunak di industri. Sistem CI/CD merupakan langkah otomatisasi dari sebagian proses dalam pengembangan perangkat lunak. Ketika suatu sistem CI/CD digunakan oleh tim pengembang perangkat lunak maka akan diperoleh banyak data pemrosesan dan data hasil akhir dari proses CI/CD tersebut. Penelitian ini berupaya untuk mengevaluasi data yang terhimpun dalam sebuah sistem CI/CD dan diharapkan akan menemukan informasi yang bermanfaat sebagai umpan balik terhadap potensi sistem CI/CD dalam perkuliahan. Evaluasi riset dilakukan dengan metode survei pada kelas pilihan di semester ganjil tahun akademik 2021/22. Survei dimulai sejak masa ujian tengah semester sampai dengan akhir semester, yaitu pada saat mahasiswa peserta kelas mulai membuat sistem/ aplikasi guna memenuhi kelengkapan tugas besar mata kuliah. Adapun kelas yang dipilih tersebut adalah mata kuliah rekayasa perangkat lunak di program studi S-1 Teknik Informatika. Hasil survei menunjukkan bahwa mayoritas mahasiswa sangat antusias dan merasa penting untuk mendalami konsep CI/CD sebagai salah satu metode mutakhir pengembangan perangkat lunak.
12
Chandrasekhara Mokkapati, Shalu Jain, and Pandi Kirupa Gopalakrishna Pandian. "Implementing CI/CD in Retail Enterprises: Leadership Insights for Managing Multi-Billion Dollar Projects." Innovative Research Thoughts 9, no. 1 (March 30, 2023): 391–405. http://dx.doi.org/10.36676/irt.v9.i1.1458.
Повний текст джерелаАнотація:
In the fast-paced world of retail enterprises, the adoption of Continuous Integration and Continuous Deployment (CI/CD) has become a cornerstone for driving agility, innovation, and competitive advantage. This paper explores the critical leadership insights necessary for successfully managing CI/CD implementations in multi-billion-dollar retail projects. Retail enterprises face unique challenges, including complex legacy systems, diverse technology stacks, and the need for seamless integration across global operations. These complexities require a strategic approach to CI/CD that balances technical excellence with business objectives. Leadership plays a pivotal role in navigating these challenges, ensuring that CI/CD initiatives align with organizational goals while delivering tangible benefits such as reduced time-to-market, enhanced software quality, and improved customer experiences. Effective leadership in CI/CD implementation involves fostering a culture of collaboration, continuous learning, and resilience among cross-functional teams. Leaders must also champion the adoption of DevOps practices, which are essential for breaking down silos and promoting a unified approach to software development and operations. The paper delves into the key leadership competencies required for CI/CD success in large-scale retail environments. These include visionary thinking, change management, risk mitigation, and the ability to inspire and motivate teams amidst complex project dynamics. It also highlights the importance of aligning CI/CD strategies with broader digital transformation initiatives, ensuring that retail enterprises can adapt to evolving market demands while maintaining operational efficiency. Furthermore, the paper examines the role of technology in enabling CI/CD in retail enterprises. It discusses the selection of appropriate tools and platforms, the importance of automation in achieving scalability, and the need for robust monitoring and feedback mechanisms to ensure continuous improvement. Leaders must be adept at making informed decisions regarding technology investments, ensuring that CI/CD pipelines are resilient, secure, and capable of handling the scale and complexity of retail operations. One of the critical aspects of CI/CD implementation in retail enterprises is managing stakeholder expectations. Leaders must engage with stakeholders across various levels, including executives, IT teams, and business units, to build consensus and drive alignment. Clear communication, transparency, and a focus on measurable outcomes are essential for gaining stakeholder buy-in and ensuring the success of CI/CD initiatives. The paper also addresses the challenges and risks associated with CI/CD in multi-billion-dollar retail projects, such as the potential for disruption to existing operations, the complexities of integrating with legacy systems, and the need for robust security and compliance measures. Leadership must be proactive in identifying and mitigating these risks, ensuring that CI/CD initiatives are executed with minimal disruption to the business. Finally, the paper offers practical recommendations for retail leaders looking to implement CI/CD at scale. These include developing a clear roadmap for CI/CD adoption, investing in talent and training, and leveraging data-driven insights to continuously optimize processes. By embracing these strategies, retail enterprises can unlock the full potential of CI/CD, driving innovation, efficiency, and competitive advantage in a rapidly evolving market landscape.
13
Kempa, Michael. "Conceptualisation et réforme des processus policiers à l’ère de la mondialisation : l’économie politique de la sécurité humaine1." Criminologie 41, no. 1 (July 10, 2008): 153–75. http://dx.doi.org/10.7202/018423ar.
Повний текст джерелаАнотація:
Résumé Le présent article vise à alimenter la réflexion sur les façons par lesquelles les criminologues pourraient étudier, voire réformer, les processus policiers dans le contexte de la mondialisation. Les virages socio-politico-économiques et écologiques imposés par ladite mondialisation présentent des problèmes de « sécurité humaine » auxquels on répond par de nouvelles formes d’« intervention policière » étrangères aux paradigmes existants de la criminologie. Dans cet article, nous présentons un aperçu de ces nouvelles tendances. On avance que la conception actuelle des services policiers, à savoir la notion des processus techniques perfectibles, continue à dominer la pensée des criminologues, praticiens et spécialistes, et ce, au détriment de l’atteinte d’une sécurité humaine à long terme. En nous inspirant d’un vaste corpus d’ouvrages en sciences sociales, nous proposons aux criminologues de situer la police et les « processus policiers » à l’intérieur de la notion de « gouvernance de la sécurité », celle-ci étant elle-même inscrite dans le cadre plus large d’une « économie politique de la sécurité humaine » : une architecture de transformation socio-politico-économique ancrée dans des idées, des croyances et des valeurs occidentales considérée tour à tour comme étant exploitée sciemment par les élites, fondamentalement viciée ou encore contraignante, le tout aux dépens de la sécurité humaine à long terme.
14
Kongwattanakul, Kiattisak, Rungroj Thamprayoch, Chumnan Kietpeerakool, and Pisake Lumbiganon. "Risk of Severe Adverse Maternal and Neonatal Outcomes in Deliveries with Repeated and Primary Cesarean Deliveries versus Vaginal Deliveries: A Cross-Sectional Study." Journal of Pregnancy 2020 (May 4, 2020): 1–7. http://dx.doi.org/10.1155/2020/9207431.
Повний текст джерелаАнотація:
Objective. To determine risks of severe adverse maternal and neonatal outcomes in women with repeated cesarean delivery (CD) and primary CD compared with those with vaginal delivery (VD). Methods. Data of this cross-sectional study were extracted from 2,262 pregnant women who gave birth between August 2014 and December 2016, at Srinagarind Hospital, Khon Kaen University. Severe maternal outcomes were categorized based on the World Health Organization criteria. Adjusted odds ratio (aOR) and 95% confidence intervals (CI) were calculated to indicate the risk of severe adverse maternal and neonatal outcomes among women underwent CD compared with those who underwent VD. Results. There were no cases of maternal death in this study. CD significantly increased risk of severe adverse maternal outcomes (SMO) (aOR 10.59; 95% CI, 1.19-94.54 for primary CD and aOR 17.21; 95% CI, 1.97-150.51 for repeated CD) compared with women who delivered vaginally. When compared with vaginal delivery, the risks of neonatal near miss (NNM) and severe adverse neonatal outcomes (SNO) were significantly higher in primary CD group (aOR 1.71; 95% CI 1.17-2.51 and aOR 1.66; 95% CI 1.14-2.43), respectively. For repeated CD, the risks were borderline significant (aOR, 1.58; 95% CI, 0.98-2.56 for NNM and aOR, 1.61; 95% CI, 0.99-2.60 for SNO). Conclusion. Primary and repeated CD significantly increased the risk of SMO compared with VD. Risks of NNM and SNO were also significantly increased in women with primary CD. The risks of NNM and SNO for repeated CD trended toward a significant increase.
15
Munster, Liesbeth Jozefien, Giulia Louise Emilia Mönnink, Susan van Dieren, Marco William Mundt, Geert Renaat Alfons Maria D’Haens, Willem Adrianus Bemelman, Christianne Johanna Buskens, and Jarmila Dagmara Wendelien van der Bilt. "Fistulizing Perianal Disease as a First Manifestation of Crohn’s Disease: A Systematic Review and Meta-Analysis." Journal of Clinical Medicine 13, no. 16 (August 12, 2024): 4734. http://dx.doi.org/10.3390/jcm13164734.
Повний текст джерелаАнотація:
Background: Incidences of perianal fistulas (PAFs) as a first manifestation of Crohn’s disease (CD) vary widely in the literature. Aim: To analyse the percentage of patients with a PAF preceding CD diagnosis and assess the time to diagnosis. Methods: A systematic literature search was conducted. Studies reporting on patients with a PAF preceding CD diagnosis were identified. Primary outcomes were the (weighted) percentage of patients with CD with a PAF preceding CD and their time to CD diagnosis. Secondary outcomes were the (weighted) percentage of patients with CD with a PAF preceding CD diagnosis in predefined patient subgroups, including (1) sex (men vs. women), (2) ethnicity (Asian vs. non-Asian), and (3) age (paediatric (0–18 y) and patients with elderly onset CD (>60 y) vs. adult patients (18–60 y)). Results: Seventeen studies were included (34,030 patients with CD). In the overall CD population, a PAF preceded CD in 8.6% [95%CI; 5.72; 12.71] with a weighted mean time to CD diagnosis of 45.9 (31.3) months. No studies reported details on sex differences in patients with a PAF as a manifesting sign of CD. In Asian populations, a PAF preceded CD in 17.66% [95%CI; 11.45; 26.25], which was significantly higher when compared with non-Asians (4.99% [95%CI; 3.75; 6.60], OR:3.99, p < 0.0001). In adolescents, an incidence of 9.17% [95%CI; 5.92; 13.93] was found with significantly lower incidences in paediatric patients (6.38% [95%CI; 1.84; 19.85], OR:0.53, p < 0.0001), and elderly-onset patients (3.77% [95%CI; 1.68; 8.25], OR:0.44, p = 0.0035). Conclusions: This systematic review shows that in the literature, almost 10% of patients present with a PAF as a first manifestation of CD, with a mean time to diagnosis of almost four years. These results emphasise that increased clinical awareness is needed.
16
Jayasooriya, Nishani, Sonia Saxena, Jonathan Blackwell, Alex Bottle, Hanna Creese, Irene Petersen, and Richard C. G. Pollok. "Associations between prior healthcare use, time to diagnosis, and clinical outcomes in inflammatory bowel disease: a nationally representative population-based cohort study." BMJ Open Gastroenterology 11, no. 1 (May 2024): e001371. http://dx.doi.org/10.1136/bmjgast-2024-001371.
Повний текст джерелаАнотація:
BackgroundTimely diagnosis and treatment of inflammatory bowel disease (IBD) may improve clinical outcomes.ObjectiveExamine associations between time to diagnosis, patterns of prior healthcare use, and clinical outcomes in IBD.DesignUsing the Clinical Practice Research Datalink we identified incident cases of Crohn’s disease (CD) and ulcerative colitis (UC), diagnosed between January 2003 and May 2016, with a first primary care gastrointestinal consultation during the 3-year period prior to IBD diagnosis. We used multivariable Cox regression to examine the association of primary care consultation frequency (n=1, 2, >2), annual consultation intensity, hospitalisations for gastrointestinal symptoms, and time to diagnosis with a range of key clinical outcomes following diagnosis.ResultsWe identified 2645 incident IBD cases (CD: 782; UC: 1863). For CD, >2 consultations were associated with intestinal surgery (adjusted HR (aHR)=2.22, 95% CI 1.45 to 3.39) and subsequent CD-related hospitalisation (aHR=1.80, 95% CI 1.29 to 2.50). For UC, >2 consultations were associated with corticosteroid dependency (aHR=1.76, 95% CI 1.28 to 2.41), immunomodulator use (aHR=1.68, 95% CI 1.24 to 2.26), UC-related hospitalisation (aHR=1.43, 95% CI 1.05 to 1.95) and colectomy (aHR=2.01, 95% CI 1.22 to 3.27). For CD, hospitalisation prior to diagnosis was associated with CD-related hospitalisation (aHR=1.30, 95% CI 1.01 to 1.68) and intestinal surgery (aHR=1.71, 95% CI 1.13 to 2.58); for UC, it was associated with immunomodulator use (aHR=1.42, 95% CI 1.11 to 1.81), UC-related hospitalisation (aHR=1.36, 95% CI 1.06 to 1.95) and colectomy (aHR=1.54, 95% CI 1.01 to 2.34). For CD, consultation intensity in the year before diagnosis was associated with CD-related hospitalisation (aHR=1.19, 95% CI 1.12 to 1.28) and intestinal surgery (aHR=1.13, 95% CI 1.03 to 1.23); for UC, it was associated with corticosteroid use (aHR=1.08, 95% CI 1.04 to 1.13), corticosteroid dependency (aHR=1.05, 95% CI 1.00 to 1.11), and UC-related hospitalisation (aHR=1.12, 95% CI 1.03 to 1.21). For CD, time to diagnosis was associated with risk of CD-related hospitalisation (aHR=1.03, 95% CI 1.01 to 1.68); for UC, it was associated with reduced risk of UC-related hospitalisation (aHR=0.83, 95% CI 0.70 to 0.98) and colectomy (aHR=0.59, 95% CI 0.43 to 0.80).ConclusionElectronic records contain valuable information about patterns of healthcare use that can be used to expedite timely diagnosis and identify aggressive forms of IBD.
17
Thatikonda, Vamsi Krishna. "Beyond the Buzz: A Journey Through CI/CD Principles and Best Practices." European Journal of Theoretical and Applied Sciences 1, no. 5 (September 1, 2023): 334–40. http://dx.doi.org/10.59324/ejtas.2023.1(5).24.
Повний текст джерелаАнотація:
Continuous Integration and Continuous Deployment (CI/CD) are pivotal in modern software development. Shifting from the classic waterfall models, the current age is dominated by Agile methodologies and DevOps practices. This article explores CI and CD's core principles, differences, and similarities. It touches upon essential techniques such as automation, ensuring consistency, and the importance of quick feedback mechanisms. Beyond these, the discussion extends to cutting-edge methods, infrastructure as code, potential security considerations, and monitoring within CI/CD environments. While CI/CD offers numerous benefits, it's essential to acknowledge its challenges, which necessitate attention and action. With an ever-evolving landscape featuring trends like AI/ML integration into CI/CD, businesses find themselves at a juncture where embracing and finetuning CI/CD is vital for competent software delivery.
18
Faro, Andre Ricardo Maia da Costa de, Wagner de Jesus Pinto, Aldo Pacheco Ferreira, Fernando Barbosa Junior, Vanessa Cristina de Oliveira Souza, Denys Eiti Fujimoto, Rosalina Jorge Koifman, and Sergio Koifman. "Serum cadmium levels in a sample of blood donors in the Western Amazon, Brazil, 2010-2011." Cadernos de Saúde Pública 30, no. 2 (February 2014): 403–14. http://dx.doi.org/10.1590/0102-311x00087113.
Повний текст джерелаАнотація:
A cross-sectional study was conducted to determine the distribution of serum cadmium (Cd) levels in blood donors in Rio Branco, Acre State, Brazil. Blood samples were obtained from 922 volunteer blood donors from 18 to 65 years of age at the Hemoacre blood center in 2010-2011. Mean serum Cd was 0.37µg/L (95%CI: 0.33-0.41). Increased serum Cd was associated with lower schooling; individuals with less than five years of schooling showed a mean Cd of 0.61µg/L (95%CI: 0.34-0.89), compared to 0.34µg/L (95%CI: 0.28-0.40) among those with more than nine years of schooling. Mean serum Cd was three times higher among smokers. Smoking showed a positive association with Cd level, with an OR of 12.36 (95%CI: 7.70-19.84). Meanwhile, serum Cd was lower among individuals that regularly drank tea, as compared to non-tea drinkers. Serum Cd levels were mostly below the reference value (88.3% of participants). Mean serum Cd in the current study indicates that in general the population studied here is not exposed to worrisome Cd levels.
19
James, J. K., S. M. Palmer, D. P. Levine, and M. J. Rybak. "Comparison of conventional dosing versus continuous-infusion vancomycin therapy for patients with suspected or documented gram-positive infections." Antimicrobial Agents and Chemotherapy 40, no. 3 (March 1996): 696–700. http://dx.doi.org/10.1128/aac.40.3.696.
Повний текст джерелаАнотація:
Ten patients were treated with conventional dosing (CD) and continuous-infusion (CI) vancomycin therapy in this prospective, randomized, crossover study. Patients were randomized to receive either CD or CI therapy for 2 consecutive days and then crossed over to receive the opposite regimen for 2 days. CD therapy consisted of 1 g of vancomycin every 12 h. CI therapy consisted of a 500-mg loading dose followed by 2 g infused over 24 h. Ten serum samples were obtained on the second day of each therapy for pharmacokinetic and pharmacodynamic analyses. Two clinical isolates of Staphylococcus aureus, one methicillin sensitive (MSSA 1199) and one methicillin resistant (MRSA 494), were chosen for pharmacodynamic evaluation of both regimens. The patient demographics (means +/- standard deviations [SD]) were as follows: sex, six males, four females; age, 36 +/- 11 years; and serum creatinine, 0.72 +/- 0.18 mg/dl. Mean pharmacokinetic parameters +/- SD for CD therapy were as follows: elimination rate constant, 0.16 +/- 0.07 h-1; half-life, 5.6 +/- 3.5 h; volume of distribution, 33.7 +/- 25 liters, 0.5 +/- 0.2 liters/kg; maximum concentration in serum, 53.4 +/- 19.3 micrograms/ml; and minimum concentration, 8.4 +/- 5.9 micrograms/ml. The steady-state concentration for CI was 20.2 +/- 11.1 micrograms/ml. Overall, both regimens resulted in the MIC being exceeded 100% of the time. The mean CD trough serum bactericidal titer (SBT) was 1:8, and the average CI SBTs were 1:16 for both isolates. Even though there was no statistically significant difference between CD trough and CI SBTs, the CI SBTs remained > 1:8 for 100% of the time versus 60% of the time for CD therapy. During CI therapy, 20 and 40% of the patients maintained SBTs of > 1:32 throughout the dosing interval for MSSA 1199 and MRSA 494, respectively. During CD therapy, however, only 10% of patients maintained SBTs of > 1:32 during the entire dosing interval for both isolates. The mean areas under the bactericidal titer-time curve (AUBC24s) +/- SD for MSSA 1199 were 528 +/- 263 for CD therapy and 547 +/- 390 for CI therapy. The mean AUBC24s +/- SD against MRSA 494 were 531 +/- 247 for CD and 548 +/- 293 for CI therapy. Similar to the AUBC24, the mean area under the concentration-time curve for a 24-h dosing interval divided by the MIC (AUC/MIC24) ratios +/- SD were 550.0 +/- 265.7 for CD and 552.6 +/- 373.4 for CI therapy, respectively. No statistically significant differences were found between any of the pharmacodynamic parameters for CD and CI therapy. In addition, no adverse effects with either CD or CI therapy were observed during the study. We conclude that CI and CD vancomycin therapy demonstrated equivalent pharmacodynamic activities. Although CI therapy was more likely to result in SBTs that remained above 1:8 for the entire regimen, the clinical impact of this result is unknown. Serum drug concentration variability was observed with both treatment regimens but to a lesser extent with CI administration. CI administration of vancomycin should be further evaluated to determine the clinical utility of this method of administration.
20
Moon, J. M., E. A. Kang, K. Han, S. W. Hong, H. Soh, S. Park, J. Lee, H. J. Lee, J. P. Im, and J. S. Kim. "P772 Trends and risk factors of elderly-onset Crohn’s disease: A nationwide cohort study in South Korea." Journal of Crohn's and Colitis 14, Supplement_1 (January 2020): S612—S613. http://dx.doi.org/10.1093/ecco-jcc/jjz203.900.
Повний текст джерелаАнотація:
Abstract Background The incidence of inflammatory bowel disease (IBD) is increasing in Asia. Numerous risk factors associated with IBD development have been investigated. This study aimed to demonstrate the risk factors of Crohn’s disease (CD) diagnosed in persons aged >40 years in South Korea and to specify any differences between age groups by using the National Health Insurance Service (NHIS) database. Methods Using the National Health Insurance Service (NHIS) database, a total of 14,060,821 persons aged >40 years who underwent national health screening in 2009 were followed up until December 2017. Patients with newly diagnosed CD were enrolled and compared with non-CD cohort. CD was identified according to the International Classification of Diseases 10th revision and the rare/intractable disease registration programme codes from the NHIS database. The mean follow-up periods were 7.39 years. Age and sex were adjusted for in the multivariate analysis model. Results During the follow-up, 1337 (1.33/100,000) patients developed CD. Men in the middle-aged group (40–64 years) had a higher risk than women (adjusted HR [aHR] 1.46, 95% CI 1.29–1.66); however, this difference tended to disappear as the age of onset increases. In the middle-aged group, patients with a history of smoking (adjusted hazard ratio [aHR] 1.29, 95% confidence interval [CI] 1.06–1.58) and anemia (aHR 1.99, 95% CI 1.67–2.36) had a significantly higher CD risk. In the elderly group (age, ³65 years), ex-smoking and anemia also increased the CD risk (aHR 1.58 [95% CI 1.16–2.18] and 1.91 [95% CI 1.53–2.38], respectively). Especially in the middle-aged group, those with chronic kidney disease (CKD) had a statistically elevated CD risk (aHR 1.38, 95% CI 1.06–1.79). Alcohol consumption and higher body mass index showed negative association trend with CD incidence in both of the age groups. (Middle-aged: aHR 0.76 [95%CI 0.65–0.87] and aHR 0.38 [95%CI 0.27–0.53], respectively) (elderly-group: aHR 0.57 [95%CI 0.42–0.77] and aHR 0.52 [95%CI 0.32-.83], respectively) For regular physical activity and dyslipidemia, negative correlation between CD incidences was proved only in the middle-aged group (aHR 0.85 [95%CI 0.74–0.96] and aHR 0. [95%CI 0.75 [95% CI 0.63–0.89], respectively). Conclusion This study demonstrated four risk factors (ex-smoking, anemia, CKD, and lower BMI) and three possible protective factors (alcohol consumption, physical activity, and dyslipidemia) for CD in Asians age >40 years. Individuals with potential risk factors need more cautious monitoring for CD.
21
Buie, Michael, Joshua Quan, Joseph Windsor, Stephanie Coward, Richard Gearry, Tawnya Hansen, James King, et al. "GLOBAL HOSPITALIZATION TRENDS FOR CROHN’S DISEASE AND ULCERATIVE COLITIS: SYSTEMATIC REVIEW WITH TEMPORAL ANALYSES." Inflammatory Bowel Diseases 28, Supplement_1 (January 22, 2022): S45—S46. http://dx.doi.org/10.1093/ibd/izac015.070.
Повний текст джерелаАнотація:
Abstract INTRODUCTION The evolving epidemiologic patterns of IBD throughout the world, in conjunction with advances in therapeutic treatments, may influence hospitalization rates of IBD in the 21st century. We performed a systematic review with temporal analysis of hospitalization rates for IBD across the world in the 21st century. METHODS We systematically reviewed MedLine and Embase for population-based studies reporting hospitalization rates for IBD, Crohn’s disease (CD), or ulcerative colitis (UC) since 2000. Log-linear models were used to calculate average annual percentage change (AAPC) with associated 95% confidence intervals (CI). Random effects meta-analysis pooled AAPCs stratified by countries in the Western world (i.e. North America, Western Europe, and Oceania) versus newly industrialized countries in Eastern Europe, Asia, Latin America, and Africa. Secondarily, we compared hospitalization rates by primary diagnosis of IBD versus all-cause hospitalizations. QGIS 3.44 was used to create a choropleth map of AAPC and ArcGIS Pro 2.4.1 was used to develop an online, interactive map of global hospitalization trends. RESULTS Data were extracted from 87 studies comprising 42 countries. Overall, hospitalization rates were stable in countries of the Western world for IBD (AAPC=−0.25; 95% CI: −0.90, 0.41, n=22), CD (AAPC=2.76; 95% CI: −0.62, 6.15, n=8), and UC (AAPC=1.44; 95% CI: −1.98, 4.86, n=7) (Table 1). However, heterogeneity between countries was observed, for example, hospitalization rates for CD (−0.02%; 95%CI: −0.52, 0.48) and UC (0.40%; 95%CI: −0.81, 1.63) were stable in the USA, but increasing for CD (2.05%; 95%CI: 1.25, 2.84) and UC (1.69%; 95%CI: 0.99, 2.39) in Portugal (Figure 1). CD and UC hospitalization rates in newly industrialized countries increased in Mexico (CD: 5.21%; 95%CI: 3.07, 7.39; UC: 5.96%; 95%CI: 4.30, 7.64), Chile (CD: 6.03%; 95%CI: 5.21, 6.86; UC: 3.78%; 95%CI: 3.43, 4.13), Bahrain (CD: 12.98%; 95%CI: 7.83, 18.38; UC: 7.27%; 95%CI: 2.12, 12.69), and Hong Kong (CD: 8.67%; 95%CI: 5.81, 11.61; UC: 0.14%; 95%CI: −2.21, 2.53), but significantly decreased in Brazil for CD (−3.22%; 95%CI: −5.24, −1.15) and UC (−3.41; 95%CI: −4.63, −2.18) (Figure 1). Studies that defined hospitalization rates as the primary diagnosis of IBD versus all-cause hospitalizations may explain heterogeneity between countries (Table 1). CONCLUSION Hospitalization rates for IBD are stabilizing in North America, Europe, and Oceania. In contrast, newly industrialized countries in Asia and Latin America have rapidly rising hospitalization rates, contributing to an increasing burden on global healthcare systems. Future studies should explore clinical and methodological factors that explain heterogeneity between country-specific hospitalization rates.
22
Ho-Dac, Hung, and Van-Len Vo. "An Approach to Enhance CI/CD Pipeline with Open-Source Security Tools." European Modern Studies Journal 8, no. 3 (July 30, 2024): 408–13. http://dx.doi.org/10.59573/emsj.8(3).2024.30.
Повний текст джерелаАнотація:
Continuous Integration (CI) and Continuous Deployment (CD) are important aspects in software engineering today. In modern software production organizational models, CI/CD pipeline has become a mandatory element to improve speed and reduce team effort in developing, integrating, and deploying. In the context of increasing information security risks, deploying security tools for the CI/CD pipeline has become an inevitable trend. Deploying information security tools throughout the pipeline according to the "Shift Left" philosophy will help detect information security issues early for timely handling and reduce correction costs. In this research, we present an approach to improve the CI/CD pipeline by integrating information security tools introduced by the Open Source Foundation for Application Security Project (OWASP). In addition, we also present trade-offs when implementing information security into the CI/CD pipeline.
23
Lin, Po-Han, Chih-Hsin Muo, Long-Yuan Li, Hwai-I. Yang, Chang-Fang Chiu, and Fuu-Jen Tsai. "Prevalence and patterns of cancer in patients with congenital disease: A national-based cohort study." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 1600. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.1600.
Повний текст джерелаАнотація:
1600 Background: Association of congenital disease (CD) and malignancy was noted in some studies. However, the cancer risk and patterns of different CD was unclear. In this study, we aimed to assess and quantify the relationships between CD and cancers. Methods: In the National Health System of Taiwan, 2.9 million children were born between 1998 and 2010. Patients with CD were identified using ICD-9-CM 740-759. Cox’s proportional hazards regression analysis was used to assess the cancer risk of CD. Results: A total of 32358 CD patients were identified and 87 of them developed malignancy. The cancer diagnostic age was significantly younger in patients with CD (2.44 ± 2.28 years) than patients without CD (3.97 ± 3.04 years; p<0.001). The hazard ratio (HR) of cancer incidence was 2.70 (95% confidential interval (CI) 2.12-3.44). Subgroup analysis showed that significantly increased risk of cancer development was noted among patients with cardiac anomalies (N=26, HR=1.91, 95% CI 1.28-2.86), digestive anomalies (N=8, HR=3.32, 95% CI 1.64-6.70), cutaneous anomalies (N=2, HR=21.5, 95% CI 5.35-86.40) and chromosomal anomalies (N=29, HR=17.5, 95% CI 12.00-25.70); other congenital diseases did not. Considering cancer types, patients with cardiac anomalies had higher rate of hematological cancers (N=12, HR=2.09, 95% CI. 1.15-3.79), especially acute myeloid leukemia (AML; N=9, HR=12.2, 95% CI. 5.36-28.0). Patients with digestive anomalies also had higher rate of hematological cancers (N=4, HR=3.95, 95% CI. 1.46-10.70), and the dominant type was non-Hodgkin lymphoma (N=2, HR=14.70, 95% CI. 3.38-64.0). Patients with chromosomal anomalies had superior rate to have retroperitoneal sarcoma (N=1, HR=8.54, 95% CI. 1.14-63.90), anterior mediastinal tumor (N=1, HR=8.54, 95% CI. 1.14-63.90), and hematological cancers (N=23, HR=33.20, 95% CI. 21.20-51.80), especially the AML (N=21, HR=231, 95% CI. 119-448). Down syndrome patients had extremely high risk of AML (N=8, HR=388, 95% CI. 164-918). Conclusions: Patients with cardiac, digestive, cutaneous and chromosomal CD were at increased risk and younger age to develop cancer. Hematological malignancies, especially AML, were the most common cancer type among these patients.
24
Kim, Kijoon, Melissa M. Melough, Junichi R. Sakaki, Kyungho Ha, Dalia Marmash, Hwayoung Noh, and Ock K. Chun. "Association between Urinary Cadmium-to-Zinc Intake Ratio and Adult Mortality in a Follow-Up Study of NHANES 1988–1994 and 1999–2004." Nutrients 12, no. 1 (December 24, 2019): 56. http://dx.doi.org/10.3390/nu12010056.
Повний текст джерелаАнотація:
Cadmium (Cd) is a toxic heavy metal associated with increased mortality, but the effect of zinc (Zn) intake on the association between Cd and mortality is unknown. The objective of this study was to examine the association of urinary Cd to Zn intake ratio (Cd/Zn ratio) and mortality risk. In total, 15642 US adults in NHANES 1988–1994 and 1999–2004 were followed until 2011 (15-year mean follow-up). Of the 5367 total deaths, 1194 were attributed to cancer and 1677 were attributed to CVD. After adjustment for potential confounders, positive associations were observed between urinary Cd and all-cause mortality (HR for highest vs. lowest quartile: 1.38; 95% CI: 1.14–1.68) and cancer mortality (HR: 1.54; CI: 1.05–2.27). Urinary Cd was positively associated with cancer mortality among the lowest Zn consumers, and the association diminished among the highest Zn consumers. Positive relationships were observed between the Cd/Zn ratio and all-cause mortality (HR: 1.54; CI: 1.23–1.93), cancer mortality (HR: 1.65; CI: 1.11–2.47) and CVD mortality (HR: 1.49; CI: 1.18–1.88). In conclusion, these findings indicate that Zn intake may modify the association between Cd and mortality. Furthermore, the Cd/Zn ratio, which was positively associated with mortality from all causes, cancer, and CVD, may be an important predictor of mortality.
25
Chappe, Capucine, Cecile Salut, Aurelien Amiot, Delphine Gaye, Nora Frulio, Bruno Lapuyade, Lucine Vuitton, et al. "Preoperative Predictors of Neoplasia in Patients Undergoing Small Bowel Resection for Complicated Crohn’s Disease: A Multicentre Case-Control Study." Cancers 15, no. 7 (March 28, 2023): 2004. http://dx.doi.org/10.3390/cancers15072004.
Повний текст джерелаАнотація:
Crohn’s disease (CD) is associated with an increased risk of small bowel neoplasia (SBN). We aimed to assess preoperative predictors of SBN in CD patients. We conducted a retrospective case-control study including CD patients who underwent surgery: cases were diagnosed with SBN on histopathological analysis and controls had no neoplasia. Preoperative cross-sectional imaging was reviewed by a panel of blinded expert radiologists. Fifty cases were matched to one hundred and fifty consecutive controls. In multivariable analysis, predictors of SBN were age ≥ 50 years (OR = 28, 95% CI = 5.05–206), median CD duration ≥ 17.5 years (OR = 4.25, 95% CI = 1.33–14.3), and surgery for stricture (OR = 5.84, 95% CI = 1.27–35.4). The predictors of small bowel adenocarcinoma were age ≥ 50 years (OR = 5.14, 95% CI = 2.12–12.7), CD duration ≥ 15 years (OR = 5.65, 95% CI = 2.33–14.3), and digestive wall thickening > 8 mm (OR = 3.79, 95% CI = 1.45–11.3). A predictive score based on the aforementioned factors was constructed. Almost 73.7% of patients with a high score had SBA. Old age, long small bowel CD duration, and stricture predicted the presence of SBN, particularly adenocarcinoma when patients have digestive wall thickening > 8 mm on preoperative imaging.
26
Kim, Hyunil, Ji Hoon Kim, Jung Kuk Lee, Dae Ryong Kang, Su Young Kim, Hyun-Soo Kim, and Hee Man Kim. "Incident Crohn’s Disease as a Risk Factor for Colorectal Cancer in the First 10 Years after Diagnosis: A Nationwide Population-Based Study." Journal of Clinical Medicine 10, no. 20 (October 12, 2021): 4663. http://dx.doi.org/10.3390/jcm10204663.
Повний текст джерелаАнотація:
We investigated the risk of colorectal cancer (CRC) in patients with Crohn’s disease (CD) using the claims data of the Korean National Health Insurance during 2006–2015. The data of 13,739 and 40,495 individuals with and without CD, respectively, were analyzed. Hazard ratios (HRs) were calculated using multivariate Cox proportional hazard regression tests. CRC developed in 25 patients (0.18%) and 42 patients (0.1%) of the CD and non-CD groups, respectively. The HR of CRC in the CD group was 2.07 (95% confidence interval (CI), 1.25–3.41). The HRs of CRC among men and women were 2.02 (95% CI 1.06–3.87) and 2.10 (95% CI, 0.96–4.62), respectively. The HRs of CRC in the age groups 0–19, 20–39, 40–59, and ≥60 years were 0.07, 4.86, 2.32, and 0.66, respectively. The HR of patients with late-onset CD (≥40 years) was significantly higher than that of those with early-onset CD (<40 years). CD patients were highly likely to develop CRC. Early-onset CD patients were significantly associated with an increased risk of CRC than matched individuals without CD. However, among CD patients, late-onset CD was significantly associated with an increased risk of CRC.
27
Krüger, Dieter. "Plus de soldats et moins de sécurité ?" Revue Historique des Armées 262, no. 1 (January 1, 2011): 20–34. http://dx.doi.org/10.3917/rha.262.0020.
Повний текст джерелаАнотація:
Cet article décrit le dilemme stratégique auquel fut confrontée la République fédérale d’Allemagne (RFA) à l’ère nucléaire. L’idée américaine d’une « guerre limitée » fut soutenue par la mise sur pied de la Bundeswehr . Celle-ci n’était cependant pas totalement prête pour la défense conventionnelle et semi-nucléaire ; mais pour les Américains, la stratégie conventionnelle paraissait néanmoins plausible face à une situation de guerre nucléaire. La Grande-Bretagne et la France s’opposèrent à l’idée d’une identité sécuritaire européenne. Par conséquent, le gouvernement allemand suivit les directives données par Washington. C’est en raison de sa contribution conventionnelle que la République fédérale devint le glacis des puissances nucléaires occidentales. En cas de conflit, ces dernières auraient décidé souverainement du destin des Allemands. De ce fait, la stratégie de la riposte graduée ne correspondait pas à l’intérêt sécuritaire de la RFA.
28
David, Charles-Philippe, and Sébastien Barthe. "Les entrepreneurs de la prise de décision : l'exemple des politiques de sécurité nationale de l'administration G. W. Bush (2001–2004)." Canadian Journal of Political Science 46, no. 3 (September 2013): 549–74. http://dx.doi.org/10.1017/s0008423913000851.
Повний текст джерелаАнотація:
Résumé.Comment expliquer la politique de sécurité nationale américaine, notamment l'évolution de certaines décisions en matière de politique étrangère et de sécurité intérieure ? Quels acteurs et quels facteurs rendent compte des résultats pour le moins controversés de celles-ci ? Au-delà des discours, des institutions et des énoncés, les choix de sécurité ont été l'œuvre de ceux que nous surnommons les « entrepreneurs » de la prise de décision. La question à laquelle cet article veut répondre est précisément de savoir qui sont ces « entrepreneurs » et comment ils ont réalisé cet objectif de transformation des politiques de sécurité des États-Unis. Trois prises de décision de la première administration Bush sont abordées : la guerre préventive en Irak, la redéfinition légale de la notion de torture, et l'institutionnalisation plus grande de la sécurité intérieure.Abstract.How are we to explain U.S. foreign policy, particularly policymaking on national security and homeland security, under the first administration of G. W. Bush? Who were the actors and what were the factors that produced what were, to say the least, controversial results? Looking beyond the speeches, statements and institutions, the security decisions can be seen as the work of “policy entrepreneurs.” This article considers who those entrepreneurs were and how they achieved their goal of transforming U.S. security policy. Three decisions are discussed: the pre-emptive war in Iraq, the legal redefinition of torture by the Bush administration, and the institutionalization of homeland security, in particular thePatriot Act.
29
Danur Wijayanto, Arizona Firdonsyah, and Faisal Dharma Adhinata. "Implementasi Continous Integration/Continous Delivery Menggunakan Process Manager 2 (Studi Kasus: SIAKAD Akademi Keperawatan Bina Insan)." Teknika 10, no. 3 (October 28, 2021): 181–88. http://dx.doi.org/10.34148/teknika.v10i3.400.
Повний текст джерелаАнотація:
Pada perkembangan perangkat lunak yang semakin beragam dan kompleks, diperlukan fleksibilitas dan adaptasi terhadap proses pengembangan perangkat lunak. Konsep DevOps muncul dari permasalahan yang muncul antara developer dan operation. CI/CD dapat mendukung DevOps dikarenakan dapat mempercepat proses integrasi dan delivery perangkat lunak kepada pengguna. Dalam menerapkan CI/CD diperlukan tools pendukung seperti git sebagai source code control dan jenkins untuk membantu proses deployment. Penelitian yang dilakukan penulis menggunakan Process Manager 2 (PM2) untuk implementasi CI/CD pada sistem Sistem Informasi Akademik (SIAKAD) Akademi Keperawatan Bina Insan. Diharapkan penelitian ini berkontribusi untuk memperluas wawasan mengenai tools dalam mengimplementasikan CI/CD. Hasil menunjukkan implementasi CI/CD menggunakan GitHub Repository, Jenkins, dan PM2 berhasil dilakukan dan berjalan dengan baik. PM2 menunjukkan performa yang lebih baik daripada Docker jika dilihat dari segi waktu build dan penggunaan RAM. PM2 memerlukan waktu deployment 185 detik, 46% lebih cepat daripada Docker. Sedangkan penggunaam RAM PM2 sebesar 1,9 GB, 45% lebih sedikit daripada Docker.
30
Zhang, Li, Yunjie Lu, Yuzheng Ge, Yun Shi, Xing Wu, Qinghua Xu, Xiaoping Li, Ling Lu, Feng Zhang, and Guozhong Yao. "Interleukin-23Rrs7517847 T/G Polymorphism Contributes to the Risk of Crohn’s Disease in Caucasians: A Meta-Analysis." Journal of Immunology Research 2015 (2015): 1–5. http://dx.doi.org/10.1155/2015/279849.
Повний текст джерелаАнотація:
The association betweenInterleukin-23Rgene polymorphism and Crohn’s disease (CD) in Caucasians is still controversial. Thus, a meta-analysis was performed to evaluate the correlation between this gene variant and CD risk. We retrieved the available data from EMBASE and PUBMED until May 1, 2014, and evaluated the effect of rs7517847 in Caucasians. The significant associations were confirmed between rs7517847 and CD risk in dominant models (TT/TG versus GG: OR = 1.652, 95% CI 1.277, 2.137), allelic model (T allele versus G allele: OR = 1.327, 95% CI 1.198, 1.469), homozygote comparison (TT versus GG: OR = 1.890, 95% CI 1.465, 2.437), heterozygote comparison (TG versus GG: OR = 1.509, 95% CI 1.161, 1.960), and recessive model (TT versus TG/GG: OR = 1.409, 95% CI 1.279, 1.552). In conclusion, this meta-analysis demonstrates that rs7517847 is associated with the risk of CD in Caucasians. These findings show that IL-23R genes confer susceptibility to CD in the Caucasians.
31
Chin Koon Siw, K., R. Kandel, G. Rosenfeld, S. Boet, S. Larrigan, and J. D. McCurdy. "A158 THE EFFECTIVENESS AND SAFETY OF HYPERBARIC OXYGEN THERAPY IN INFLAMMATORY BOWEL DISEASE AND ITS ASSOCIATED CONDITIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS." Journal of the Canadian Association of Gastroenterology 4, Supplement_1 (March 1, 2021): 164–66. http://dx.doi.org/10.1093/jcag/gwab002.156.
Повний текст джерелаАнотація:
Abstract Background Hyperbaric oxygen therapy (HBOT) corrects tissue hypoxia, mobilizes stem cells and has immunomodulatory effects, all of which are key mechanisms for healing wounds. A number of studies have suggested that HBOT may be effective for healing inflammatory bowel disease (IBD). Aims Our systematic review aimed to quantify the effectiveness and safety of HBOT in IBD and its associated conditions. Methods We performed a proportional meta-analysis. MEDLINE, EMBASE, Web of Knowledge and The Cochrane Central Register of Controlled Trials were systematically searched from inception through November 2020 with no language restriction. We included randomized controlled studies, cohort studies and case series that contained a minimum of three patients and reported effectiveness and/or safety outcomes for HBOT in patients with IBD. Studies were stratified by IBD phenotype and weighted summary estimates with 95% confidence intervals (CI) were calculated for clinical response and remission using random-effects models. Study quality was assessed using the Cochrane risk-of-bias tool for randomized trials and a modified version of the National Institutes of Health (NIH) checklist for observational studies. Results Nineteen studies met our study criteria: 3 randomized controlled trials and 16 case series. The studies reported outcomes for luminal ulcerative colitis (UC) (n=373), luminal Crohn’s disease (CD) (n=250), enterocutaneous fistulae (ECF) (n=21), perianal CD (n=115), pouch disorders (n=60), pyoderma gangrenosum (PG) (n=5) and perianal sinus/metastatic CD (n=7). Rates of clinical response were 86% (95% CI, 66–95%) for luminal UC, 86% (95% CI, 81–90%) for luminal CD, 85% (95% CI, 61–95%) for ECF, 80% (95% CI, 70–87%) for perianal CD, 65% (95% CI, 52–76%) for pouch disorders, 92% (95% CI, 38–99%) for PG and 79% (95% CI, 36–96%) for perianal sinus/metastatic CD. Rates of clinical remission were 87% (95% CI, 10–100%) for luminal UC, 88% for luminal CD (95% CI, 46–98%), 50% for ECF (95% CI, 12–88%), 64% (95% CI, 52–75%) for perianal CD, 31% (95% CI, 16–50%) for pouch disorders, 92% (95% CI, 38–100%) for PG and 65% (95% CI, 10–97%) for perianal sinus/metastatic CD. Of the ten studies that reported on safety of HBOT, 19 patients (10.5%) had minor adverse events and no major event was reported. Study quality was low in the majority of studies due to an absence of comparator arms, inadequate description of interventions, and poorly defined outcomes. Conclusions Limited high-quality evidence suggest that HBOT is safe and associated with high rates of clinical response and remission for luminal IBD, perianal CD and pouch disorders. A well-designed large multicenter randomized controlled trial is warranted to confirm the benefit of HBOT in IBD. doi:10.17605/osf.io/gpz6d Funding Agencies None
32
Cuffe, Steven P., Susanna N. Visser, Joseph R. Holbrook, Melissa L. Danielson, Lorie L. Geryk, Mark L. Wolraich, and Robert E. McKeown. "ADHD and Psychiatric Comorbidity: Functional Outcomes in a School-Based Sample of Children." Journal of Attention Disorders 24, no. 9 (November 25, 2015): 1345–54. http://dx.doi.org/10.1177/1087054715613437.
Повний текст джерелаАнотація:
Objective: Investigate the prevalence and impact of psychiatric comorbidities in community-based samples of schoolchildren with/without ADHD. Method: Teachers and parents screened children in South Carolina (SC; n = 4,604) and Oklahoma (OK; n = 12,626) for ADHD. Parents of high-screen and selected low-screen children received diagnostic interviews (SC: n = 479; OK: n = 577). Results: Psychiatric disorders were increased among children with ADHD and were associated with low academic performance. Conduct disorder/oppositional defiant disorder (CD/ODD) were associated with grade retention (ODD/CD + ADHD: odds ratio [OR] = 3.0; confidence interval [CI] = [1.5, 5.9]; ODD/CD without ADHD: OR = 4.0; CI = [1.7, 9.7]). School discipline/police involvement was associated with ADHD alone (OR = 3.2; CI = [1.5, 6.8]), ADHD + CD/ODD (OR = 14.1, CI = [7.3, 27.1]), ADHD + anxiety/depression (OR = 4.8, CI = [1.6, 14.8]), and CD/ODD alone (OR = 2.8, CI = [1.2, 6.4]). Children with ADHD + anxiety/depression had tenfold risk for poor academic performance (OR = 10.8; CI = [2.4, 49.1]) compared to children with ADHD alone. This should be interpreted with caution due to the wide confidence interval. Conclusion: Most children with ADHD have psychiatric comorbidities, which worsens functional outcomes. The pattern of outcomes varies by type of comorbidity.
33
Indriyanto, Rendy, and Diki Gita Purnama. "CI/CD Implementation Application Deployment Process Academic Information System (Case Study Of Paramadina University)." Jurnal Indonesia Sosial Teknologi 4, no. 9 (September 25, 2023): 1503–16. http://dx.doi.org/10.59141/jist.v4i9.729.
Повний текст джерелаАнотація:
This research discusses the implementation of Continuous Integration/Continuous Delivery (CI/CD) in the deployment process of the Academic Information System application at Paramadina University, where the application development process still uses manual methods. CI/CD is an approach in software development that enables development teams to automatically integrate code, run tests, and deploy applications periodically and continuously. The purpose of this research is to implement CI/CD in the deployment process of Academic Information System applications so that the development process becomes more effective and the quality of the resulting application is better and more adaptable to changes. The method used in this research is the qualitative method by conducting direct observation to collect data. The results of the research show that by implementing the stages of CI/CD, the application deployment process becomes more efficient and can provide a solution to the problems that arise in the previously conventional or manual application deployment process. The results of this research can serve as a guide for development teams and operations who want to adopt CI/CD in the application deployment process, as well as provide insights for researchers and practitioners to optimize the use of CI/CD in software development.
34
Moldovan, Max, Jyoti Khadka, Renuka Visvanathan, Steve Wesselingh, and Maria C. Inacio. "Using elastic nets to estimate frailty burden from routinely collected national aged care data." Journal of the American Medical Informatics Association 27, no. 3 (January 17, 2020): 419–28. http://dx.doi.org/10.1093/jamia/ocz210.
Повний текст джерелаАнотація:
Abstract Objectives To (1) use an elastic net (EN) algorithm to derive a frailty measure from a national aged care eligibility assessment program; (2) compare the ability of EN-based and a traditional cumulative deficit (CD) based frailty measures to predict mortality and entry into permanent residential care; (3) assess if the predictive ability can be improved by using weighted frailty measures. Materials and Methods A Cox proportional hazard model based EN algorithm was applied to the 2003–2013 cohort of 903 996 participants for selecting items to enter an EN based frailty measure. The out-of-sample predictive accuracy was measured by the area under the curve (AUC) from Cox models fitted to 80% training and validated on 20% testing samples. Results The EN approach resulted in a 178-item frailty measure including items excluded from the 44-item CD-based measure. The EN based measure was not statistically significantly different from the CD-based approach in terms of predicting mortality (AUC 0.641, 95% CI: 0.637–0.644 vs AUC 0.637, 95% CI: 0.634–0.641) and permanent care entry (AUC 0.626, 95% CI: 0.624–0.629 vs AUC 0.627, 95% CI: 0.625–0.63). However, the weighted EN based measure statistically outperforms the weighted CD measure for predicting mortality (AUC 0.774, 95% CI: 0.771–0.777 vs AUC 0.757, 95% CI: 0.754–0.760) and permanent care entry (AUC 0.676, 95% CI: 0.673–0.678 vs AUC 0.671, 95% CI: 0.668–0.674). Conclusions The weighted EN and CD-based measures demonstrated similar prediction performance. The CD-based measure items are relevant to frailty measurement and easier to interpret. We recommend using the weighted and unweighted CD-based frailty measures.
35
Panikratova, Yana, Olga Dobrushina, Alexander Tomyshev, Tatiana Akhutina, Ekaterina Pechenkova, Valentin Sinitsyn, and Roza Vlasova. "Context-dependency in the Cognitive Bias Task and Resting-state Functional Connectivity of the Dorsolateral Prefrontal Cortex." Journal of the International Neuropsychological Society 26, no. 8 (April 28, 2020): 749–62. http://dx.doi.org/10.1017/s1355617720000302.
Повний текст джерелаАнотація:
AbstractObjective:Goldberg, the author of the “novelty-routinization” framework, suggested a new pair of cognitive styles for agent-centered decision-making (DM), context-dependency/independency (CD/CI), quantified by the Cognitive Bias Task (CBT) and supposedly reflecting functional brain hemispheric specialization. To date, there are only three lesion and activation neuroimaging studies on the CBT with the largest sample of 12 participants. The present study is the first to analyze whole-brain functional connectivity (FC) of the dorsolateral prefrontal cortex (DLPFC), involved in contextual agent-centered DM.Method:We compared whole-brain resting-state FC of the DLPFC between CD (n = 24) and CI (n = 22) healthy participants. Additionally, we investigated associations between CD/CI and different aspects of executive functions.Results:CD participants had stronger positive FC of the DLPFC with motor and visual regions; FC of the left DLPFC was more extensive. CI participants had stronger positive FC of the left DLPFC with right prefrontal and parietal-occipital areas and of the left and right DLPFC with ipsilateral cerebellar hemispheres. No sex differences were found. CD/CI had nonlinear associations with working memory.Conclusions:The findings suggest that CD and CI are associated with different patterns of DLPFC FC. While CD is associated with FC between DLPFC and areas presumably involved in storing representations of current situation, CI is more likely to be associated with FC between DLPFC and right-lateralized associative regions, probably involved in the inhibition of the CD response and switching from processing of incoming perceptual information to creation of original response strategies.
36
Yiu, T. H., R. Leong, Y. Ko, and A. Pudipeddi. "P564 vedolizumab versus infliximab and adalimumab in the real-world persistence in Ulcerative Colitis and Crohn’s disease – a meta-analysis." Journal of Crohn's and Colitis 17, Supplement_1 (January 30, 2023): i694—i695. http://dx.doi.org/10.1093/ecco-jcc/jjac190.0694.
Повний текст джерелаАнотація:
Abstract Background In Ulcerative Colitis (UC), vedolizumab demonstrated increased efficacy over adalimumab in the VARSITY study. However, the real-world effectiveness of vedolizumab against adalimumab, infliximab and in UC and Crohn’s disease (CD) is not well-known. Drug persistence measures the duration of time from initiation to discontinuation of a therapy, is a surrogate marker that combines therapeutic efficacy, safety, and tolerability. This meta-analysis compared drug persistence of vedolizumab versus anti TNF alpha inhibitors (TNFi) adalimumab and infliximab in UC and CD. Methods Systematic review and meta-analysis were conducted with observational studies identified in electronic database – EMBASE and PubMed search from inception of 2017 to July 2022 and abstracts screened from recent gastroenterology conference – Digestive disease week 2022 San Diego. 6 observational studies evaluating persistence of vedolizumab versus TNFi (infliximab and adalimumab) among participants aged >18 years with diagnosis of IBD met inclusion criteria and were included. Results Overall, 1 year persistence of vedolizumab is 71.2% in UC and 76% in CD, significantly higher than infliximab (56.4% in UC, 53.7% in CD) and adalimumab (53.7% in UC, 55.6% in CD). (Table 1) Head-to-head comparison shows RR of 1.15 (95% CI of 1.12 – 1.19), favouring vedolizumab. 2-years persistence was pooled from 4 studies. Vedolizumab had a 2-years persistence of 66% in UC and 61% in CD, which also shows superiority to both infliximab (49.7% for UC, 59.1% for CD) and adalimumab (31.4% for UC and 56% for CD). (Table 2) Meta-analysis with head-to-head comparison continue to show a statistically significant difference in 2 years persistence of vedolizumab versus TNFi (RR of 1.12, 95% CI 1.01 – 1.25). For UC patients, vedolizumab shows superiority over both adalimumab and infliximab with a RR of 1.41 (95% CI 1.14 – 1.74) and 1.15 (95% CI 1.06 – 1.25) respectively and RR of 1.23 (CI 1.14 – 1.33) when adalimumab and infliximab combined. For CD, vedolizumab has a slightly higher 1-year persistence over TNFi combined (RR 1.10 95% CI 1.02 – 1.19) but fails to show any statistically significant difference from adalimumab (RR 1.07 95% CI 0.86 – 1.32) and infliximab (RR 0.55 95% CI 0.07 – 4.35) individually. Vedolizumab has a higher 1-year persistence in bio-naïve subgroup (RR 1.14 95% CI 1.07 – 1.22) but fails to show statistically significant advantage in bio-experienced group (RR 1.04 95% CI 0.80 – 1.35) when compare with TNFi. Conclusion Vedolizumab achieved a higher overall 1- and 2-years persistence compared to adalimumab and infliximab in both CD and UC but mainly in bio-naïve subjects. The benefit of vedolizumab over TNFi was more evident in UC than CD.
37
Rispo, A., P. P. Mainenti, A. Testa, R. de Sire, N. Imperatore, O. M. Nardone, S. Ricciolino, et al. "P225 David against Goliath: direct comparison of hand-held bowel sonography and magnetic resonance enterography for diagnosis of Crohn’s disease." Journal of Crohn's and Colitis 16, Supplement_1 (January 1, 2022): i275. http://dx.doi.org/10.1093/ecco-jcc/jjab232.352.
Повний текст джерелаАнотація:
Abstract Background The diagnosis of small bowel Crohn’s disease (CD) is mainly performed by ileo-colonoscopy (IC), while the assessment of its extension can be achieved non-invasively by using magnetic resonance enterography (MRE) and bowel sonography (BS) in view of a very concordant agreement about diagnostic accuracy. More recently, hand-held sonography has been used effectively in cardiological and orthopaedical diagnostic settings, while data about its use for CD diagnosis are still scarce. The aim of this pilot study was to evaluate the diagnostic accuracy of hand-held BS (HHBS) in comparison with MRE for the diagnosis of CD. Methods From September 2019 to June 2021, we prospectively studied 85 consecutive subjects who attended our third level IBD Unit for suspected CD. All patients underwent IC (as gold standard for CD diagnosis), HHBS (VScan, dual probe, 5–7.5 MHz; General Elelectric®) and MRE in a random order and blind way. MRE was assumed as reference standard for defining the extension of small bowel CD. Bivariate correlation about CD extension between MRE and HHBS was calculated by Spearman’s coefficient (r). To test the consistency between MRE and HHBS for CD location and complications (strictures, abscesses, fistulas) the Cohen’s k measure was applied. A p value of 0.05 was considered significant. Results The diagnosis of small bowel CD was made in 48 out of 85 subjects (56%), whereas the remaining 37 subjects received a different diagnosis. Sensitivity, specificity, positive and negative predictive values for CD diagnosis were 87% (95%CI 74–95%), 91% (95%CI 78–98%), 91% (95%CI 78–96%), 88% (95%CI 77–93%) for HHBS (TP 42, TN 34, FP 3, FN 6) and 92% (95%CI 80–97%), 95% (95%CI 81–99%), 94% (95%CI 81–98%), 91% (95%CI 85–97%) for MRE (TP 44, TN 35, FP 2, FN 4), without significant differences (p=N.S.). On the other hand, MRE was superior to HHBS in defining CD extension (r=0.67; p<0.01) and location (k = 0.81; p<0.01). Also, MRE showed a better diagnostic performance than HHBS for detecting strictures (k=0.75; p<0.01), abscesses (k=0.68; p<0.01) and fistulas (k=0.65; p<0.01). Conclusion HHBS and MRE are two accurate and non-invasive procedures for the diagnosis of CD, even if MRE appears to be more sensitive in defining the extension, location and intestinal complications. HHBS could be used as effective ambulatory (or out-of-office) screening tool for selecting the patients to submit to MRE examination because of high probability of CD diagnosis.
38
Osooli, M., G. Bruze, N. Bryder, C. Nordenvall, P. Myrelid, E. Åsa Hallqvist, and O. Olén. "P827 Has opioid use increased among adults with Crohn’s disease? A Swedish Nationwide cohort Study 2008-2020." Journal of Crohn's and Colitis 18, Supplement_1 (January 1, 2024): i1541—i1543. http://dx.doi.org/10.1093/ecco-jcc/jjad212.0957.
Повний текст джерелаАнотація:
Abstract Background Chronic opioid use has turned into a global health challenge. Crohn’s disease (CD) patients may experience severe pain requiring opioids which could exacerbate CD symptoms and pose a risk of chronic use. The use of opioids among CD patients has not been explored on a national level. We compared the secular trends of opioid use among prevalent CD patients and matched reference individuals in Sweden. Methods This nationwide cohort study included adults with a prevalent CD diagnosis who lived in Sweden for at least 12 consecutive months at some point between 1 January 2008 and 31 December 2020. For each patient, up to 10 reference individuals from the general population were matched on birth year, sex, calendar year, and place of residence. We retrieved the data on dispensed opioid prescriptions (opioid use) from the National Prescribed Drug Register. We defined opioid use as ≥1 filled prescription per calendar year. We also estimated the annual prevalence of ≥1 dispensation of weak (codeine combinations, tramadol, and Dextropropoxifen) and/or strong opioids (Oxycodone, Morphine, Hydromorphone, Fentanyl, Buprenorphine, Tapentadol, and Petidin). Results We identified 43,155 adult CD patients and 418,218 reference individuals (Table 1). The prevalence of opioid use was stable from 2008-2016. However, between 2017 and 2020 it decreased from 19.7% (95% CI: 19.2, 20.2) to 16.9% (95% CI: 16.2, 17.7) and from 8.5% (95% CI: 8.4, 8.7) to 6.9% (95% CI: 6.7, 7.1) among CD patients and reference individuals, respectively (Figure 1a). However, between 2008 and 2020, the prescription of strong opioids more than doubled among both CD patients (increasing from 4.3% [95% CI: 4.1, 4.6] to 11.5% [95% CI: 11.1, 11.8]), and reference individuals (increasing from 1.3% [95% CI: 1.3, 1.4] to 5.4% [95% CI: 5.3, 5.5]) (Figure 1b). In 2020, the last year of the observation, compared with males, both female CD patients (20.3% [19.7, 20.8] vs 9.3% [9.2, 9.5]) and their matched reference individuals (15.3% [14.8, 15.9] vs 7.1% [6.9, 7.2]) had a higher prevalence of annual opioid use. The secular trends of overall opioid use and increasing use of strong opioids were similar for males and females (data not shown). Conclusion Annual opioid use among prevalent CD patients in Sweden, a country with publicly-funded healthcare and access to modern CD treatment, was two-fold higher than in the general population in the last 13 years. The annual opioid use remained stable from 2008-2016 and slightly decreased from 2017-2020 for CD patients and reference individuals. During the same period, the use of strong opioids more than doubled for CD patients and the general population.
39
Monzani, Alice, Elena Lionetti, Enrico Felici, Lucia Fransos, Danila Azzolina, Ivana Rabbone, and Carlo Catassi. "Adherence to the Gluten-Free Diet during the Lockdown for COVID-19 Pandemic: A Web-Based Survey of Italian Subjects with Celiac Disease." Nutrients 12, no. 11 (November 12, 2020): 3467. http://dx.doi.org/10.3390/nu12113467.
Повний текст джерелаАнотація:
We aimed to assess the perceived impact of the lockdown, imposed to control the spreading of COVID-19, on the adherence of Italian celiac disease (CD) subjects to the gluten-free diet by a web-based survey. A total of 1983 responses were analyzed, 1614 (81.4%) by CD adults and 369 (18.6%) by parents/caregivers of CD children/adolescents. The compliance with the GFD was unchanged for 69% of the adults and 70% of the children, and improved for 29% of both. The factors increasing the probability to report stricter compliance were the presence of CD symptoms in the last year before the lockdown (odds ratio (OR) 1.98, 95% confidence interval (CI) 1.46–2.26), a partial usual adherence to gluten-free diet (GFD) (OR 1.91, 95% CI 1.2–3.06), and having tried recipes with naturally gluten-free ingredients more than usual (OR 1.58, 95% CI 1.28–1.96) for adults; the presence of CD symptoms in the last year (OR 2.05, 95% CI 1.21–3.47), still positive CD antibodies (OR 1.89, 95% CI 1.14–3.13), and other family members with CD (OR 2.24, 95% CI 1.3–3.85) for children/adolescents. Therefore, the lockdown led to a reported improved adherence to the GFD in one-third of the respondents, in particular in those with previous worse disease control, offering the opportunity to avoid sources of contamination/transgression and increase the use of naturally gluten-free products.
40
КРАВЧУК, Ольга. "МОДЕЛЬ ВПРОВАДЖЕННЯ CI/CD ДЛЯ ОПТИМІЗАЦІЇ УПРАВЛІННЯ IT-ПРОЄКТАМИ". MEASURING AND COMPUTING DEVICES IN TECHNOLOGICAL PROCESSES, № 3 (29 вересня 2023): 73–82. http://dx.doi.org/10.31891/2219-9365-2023-75-8.
Повний текст джерелаАнотація:
В статті пропонується метод впровадження CI/CD (Continuous Integration/Continuous Deployment) для оптимізації управління IT-проєктами. Вона розглядає принципи та практики DevOps, що стали важливими інструментами для підвищення ефективності розробки та впровадження програмного забезпечення. В статті аналізується як CI/CD може покращити процеси розробки, тестування та впровадження програмного забезпечення, зменшуючи час впровадження та підвищуючи якість продукту. Також розглядаються потенційні виклики та обмеження, пов'язані з впровадженням CI/CD, та пропонуються стратегії їх подолання.
41
Ferraro, Alexandre Archanjo, Marco Antônio Barbieri, Antonio Augusto Moura da Silva, Marcelo Zubaran Goldani, Maria Teresa Bechere Fernandes, Viviane Cunha Cardoso, Aryeh David Stein, and Heloisa Bettiol. "Cesarean Delivery and Hypertension in Early Adulthood." American Journal of Epidemiology 188, no. 7 (May 21, 2019): 1296–303. http://dx.doi.org/10.1093/aje/kwz096.
Повний текст джерелаАнотація:
Abstract The rate of cesarean delivery (CD) is high in many parts of the world. Birth via CD has been associated with adverse later health outcomes, such as obesity, asthma, and type 1 diabetes mellitus. Few studies have focused on hypertension. We investigated the associations of CD with hypertension, systolic blood pressure (BP), and diastolic BP and tested whether body mass index (BMI; weight (kg)/height (m)2) was a mediator of these associations in a birth cohort (n = 2,020) assembled in 1978–1979 and followed up in 2002–2004 in Ribeirão Preto, Brazil. The CD rate was 32.0%. Hypertension was present in 11.7% of persons born via CD and 7.7% of those born vaginally. Being born by CD increased the odds of hypertension by 51% (odds ratio = 1.51, 95% confidence interval (CI): 1.10, 2.07). After adjustment for confounders, this estimate changed little (odds ratio = 1.49, 95% CI: 1.07, 2.06). In a mediation analysis, odds ratios for the indirect and direct effects were 1.18 (95% CI: 1.11, 1.25) and 1.31 (95% CI: 0.97, 1.65), respectively. CD also had indirect effects on both systolic and diastolic BP via BMI. Our findings suggest that CD is associated with young-adult hypertension and that this association is at least partially mediated by BMI. This has implications for countries struggling with the burden of noncommunicable diseases and where CD rates are high.
42
Ndzo, J., T. Trimble, K. Yan, G. Figueredo, S. Vuyyuru, and G. Moran. "P390 Adiposity is negatively associated with a stenosing Crohn’s disease behaviour: a UK wide study in 8797 patients within the IBD Bioresource." Journal of Crohn's and Colitis 18, Supplement_1 (January 1, 2024): i818—i819. http://dx.doi.org/10.1093/ecco-jcc/jjad212.0520.
Повний текст джерелаАнотація:
Abstract Background Obesity has been implicated in the pathogenesis of fibrosis. With the rising incidence of Crohn`s Disease (CD) alongside an obesity pandemic, we hypothesise that adiposity may be associated with stenosing CD. Methods Using NIHR IBD Bioresource data, we retrospectively assessed the relationship between body mass index (BMI) and stenosing CD by logistic regression. BMI was the primary variable of interest; CD behaviour the dependent variable; stenosing CD the primary outcome. Confounders were adjusted for in a multivariate model. Statistical analyses were performed using SPSS 28.0.1.1. Results 8,797 patients diagnosed between 1942 and 2020 were included. Mean overall BMI was 26.3kg/m2 (SD = 5.5). 52.7% had a BMI >25kg/m2 (mean 30.2kg/m2, SD 4.5). Majority had inflammatory CD (62.9%) followed by stenosing (25.1%) and penetrating CD (12%). Stenosing and penetrating CD were more common in the <25kg/m2 BMI group (50.7%, 50.3% respectively) p<0.001. On univariate analysis, stenosing disease was positively associated with ileal disease location, disease duration, a surgical history, use of advanced therapies (infliximab, ustekinumab, vedolizumab, adalimumab) and azathioprine but negatively associated with BMI even after adjusting for confounders (OR 0.98, 95% CI [0.967-0.988]). On multivariate analyses, disease duration (OR 1.135, 95% CI [1.135-1.105-1.170]), ileal disease location (OR 3.69, 95% CI [3.22-4.24]), adalimumab (OR 1.47, 95% CI [1.30-1.66]) and ustekinumab (OR 1.512, 95% CI [1.14-2.01]) and azathioprine (OR 1.34, CI [1.189-1.529]) usage remained positively associated with stenosing CD (Table 1). Conclusion We observed a negative relationship between BMI and stenosing disease. This might reflect a change in eating behaviour due to persistent abdominal pain related to stenosing disease. Large longitudinal studies are needed to investigate this relationship further.
43
Ali, Josh Mahmood. "DevOps and continuous integration/continuous deployment (CI/CD) automation." Advances in Engineering Innovation 4, no. 1 (November 22, 2023): 38–42. http://dx.doi.org/10.54254/2977-3903/4/2023031.
Повний текст джерелаАнотація:
The rapid integration of DevOps and Continuous Integration/Continuous Deployment (CI/CD) has ushered in a transformative era in software development, streamlining processes and bolstering release efficiency. The amalgamation of development (Dev) and IT operations (Ops) into a cohesive DevOps model facilitates a more synergistic and responsive approach to the software lifecycle. Simultaneously, CI/CD automation accelerates the software release cadence, promising quicker feedback loops and more frequent feature releases. This paper delves into the underlying principles of DevOps and CI/CD, elucidating their collaborative benefits while also highlighting the associated challenges. Furthermore, the study assesses the impact of CI/CD on software quality, providing insights into best practices and potential future trends in the landscape of DevOps-driven software engineering.
44
Ebert, A., R. Elmahdi, G. Poulsen, M. Bøgsted, B. Verstockt, C. Lees, and T. Jess. "P1167 Inflammatory Bowel Disease: a phenome-wide pre- and post-diagnostic association study." Journal of Crohn's and Colitis 18, Supplement_1 (January 1, 2024): i2080. http://dx.doi.org/10.1093/ecco-jcc/jjad212.1297.
Повний текст джерелаАнотація:
Abstract Background Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is known to be associated with various extra-intestinal manifestations, impacting organ systems beyond the gastrointestinal tract. Identifying comorbidities in IBD and the timing of their development can provide valuable insight into the mechanisms underlying IBD development. Methods We conducted the first population- and disease-wide phenomic association study in IBD, using >6 million ICD-10 coded healthcare contacts from 10 years before and up to 17 years after IBD diagnosis to investigate associations with 1583 diseases. To explore co-morbidities with potential aetiological significance with IBD, we additionally assessed the strength of association with all diseases in the pre-diagnostic compared with the post-diagnostic period. To correct for multiple testing, we adjust our significance threshold (p<0.05) with the Bonferroni correction, resulting in an adjusted p-value of 7.90×10, which we refer to as disease-wide statistical significance. Results We identified 312 disease-wide statistically significant associations with 125 of these diseases appearing up to 10 years before diagnosis. The risk of immune-mediated diseases and extra-intestinal manifestations are among those diseases increased up to 10 years prior to IBD diagnosis (psoriasis: CD-RR: 2.57, 95% CI: 2.00-3.29; UC-RR: 1.54, 95% CI: 1.25-1.87; enteropathic arthropathies: CD-RR: 3.57, 95% CI: 2.65-4.78; UC-RR: 1.8, 95% CI: 1.38-2.32). This was also the case for gastroenterological and liver disorders (gall stones: CD-RR: 1.82, 95% CI: 1.62-2.04; UC-RR: 1.26, 95% CI: 1.15-1.37; acute pancreatitis: CD-RR: 1.83, 95% CI: 1.30- 2.53; UC-RR: 2.27, 95% CI: 1.84-2.79). The risk of cardiometabolic diseases and neuropsychological disorders had increased disease-wide statistical significance both pre- and post-diagnostically, whereas potential sequelae of treatment, such as osteoporosis (CD-HR: 2.56, 95% CI: 2.30-2.86; UC-HR: 1.92, 95% CI: 1.79-2.07) or herpes simplex infections (CD-HR: 4.04, 95% CI: 2.76-5.91; UC-HR: 1.69, 95% CI: 1.2-2.38) were primarily seen post-diagnostically. Of potential aetiological importance to CD, diagnosis with infectious mononucleosis (RR: 1.87, 95% CI: 1.37-2.52) was significantly associated with the pre- compared to the post-diagnostic period. Conclusion Our results demonstrate IBD as an essentially multisystemic disease, particularly manifesting as gastrointestinal, metabolic, immune, and neuropsychological disorders, present up to 10 years prior to IBD diagnosis. Infectious diseases of aetiological interest identified warrant further investigation.
45
Pane, Syafrial Fachri, Amri Yanuar, Alit Fajar Kurniawan, and Maulyanda Az. "Implementasi Middleware Pada Evomo Dengan Metode Web Service Restfull Dan Pengujian CI/CD, Coverage Serta Simulasi Protokol Grafana." Jurnal Tekno Insentif 15, no. 2 (October 31, 2021): 110–21. http://dx.doi.org/10.36787/jti.v15i2.507.
Повний текст джерелаАнотація:
ABSTRAK
Penelitian ini membantu dalam melakukan proses analisis data monitoring dalam bentuk grafik, memanfaatkan CI/CD pipeline dalam melakukan implementasi CI/CD dapat memberikan kenyamanan dalam melakukan develop dan mengurangi bug, dari hasil implementasi CI/CD didapatkan hasil statements 93,33%, branch 100%, functions 87,88%, lines 94,92%. Grafik data disiapkan oleh grafana dalam bentuk script iframe diterapkan pada code program sistem. Penelitian ini menggunakan metodologi penelitian yang dapat menyatakan bahwa sistem yang dibangun dapat berfungsi dengan baik. Jadi, penelitian ini mampu menjawab permasalahan yang terjadi pada sistem Evomo.
ABSTRACT
This research helps in carrying out the monitoring data analysis process in graphical form, utilizing the CI/CD pipeline in implementing CI/CD can provide convenience in developing and reducing bugs. functions 87.88%, lines 94.92%, Graphic data prepared by grafana in the form of iframe script applied to the system program code. This study uses a research methodology that can state that the system built can function properly. So, this research is able to answer the problems that occur in the Evomo system.
46
Clappison, Emma, Marios Hadjivassiliou, and Panagiotis Zis. "Psychiatric Manifestations of Coeliac Disease, a Systematic Review and Meta-Analysis." Nutrients 12, no. 1 (January 4, 2020): 142. http://dx.doi.org/10.3390/nu12010142.
Повний текст джерелаАнотація:
Background: Coeliac disease (CD) is increasingly prevalent and is associated with both gastrointestinal (GI) and extra-intestinal manifestations. Psychiatric disorders are amongst extra-intestinal manifestations proposed. The relationship between CD and such psychiatric disorders is not well recognised or understood. Aim: The aim of this systematic review and meta-analysis was to provide a greater understanding of the existing evidence and theories surrounding psychiatric manifestations of CD. Methodology: An online literature search using PubMed was conducted, the prevalence data for both CD and psychiatric disorders was extracted from eligible articles. Meta analyses on odds ratios were also performed. Results: A total of 37 articles were included in this review. A significant increase in risk was detected for autistic spectrum disorder (OR 1.53, 95% CI 1.24–1.88, p < 0.0001), attention deficit hyperactivity disorder (OR 1.39, 95% CI 1.18–1.63, p < 0.0001), depression (OR 2.17, 95% CI 2.17–11.15, p < 0.0001), anxiety (OR 6.03, 95% CI 2.22–16.35, p < 0.0001), and eating disorders (OR 1.62, 95% CI 1.37–1.91, p < 0.00001) amongst the CD population compared to healthy controls. No significant differences were found for bipolar disorder (OR 2.35, 95% CI 2.29–19.21, p = 0.43) or schizophrenia (OR 0.46, 95% CI 0.02–10.18, p = 0.62). Conclusion: CD is associated with an increased risk of depression, anxiety, eating disorders as well as ASD and ADHD. More research is required to investigate specific biological explanations as well as any effect of gluten free diet.
47
SOHAR, Istvan, David SLEAT, Chang-Gong LIU, Thomas LUDWIG, and Peter LOBEL. "Mouse mutants lacking the cation-independent mannose 6-phosphate/insulin-like growth factor II receptor are impaired in lysosomal enzyme transport: comparison of cation-independent and cation-dependent mannose 6-phosphate receptor-deficient mice." Biochemical Journal 330, no. 2 (March 1, 1998): 903–8. http://dx.doi.org/10.1042/bj3300903.
Повний текст джерелаАнотація:
Two proteins have been implicated in the mannose 6-phosphate-dependent transport of lysosomal enzymes to lysosomes: the 300 kDa cation-independent and the 46 kDa cation-dependent mannose 6-phosphate receptors (CI- and CD-MPRs). The mammalian CI-MPR also mediates endocytosis and clearance of insulin-like growth factor II (IGF-II). Mutant mice that lack the CD-MPR are viable, mice that lack the CI-MPR accumulate high levels of IGF-II and usually die perinatally, whereas mice that lack both IGF-II and CI-MPR are viable. To investigate the relative roles of the MPRs in the targeting of lysosomal enzymes in vivo, we analysed the effect of a deficiency of either MPR on lysosomal enzyme activities in animals lacking IGF-II. In CD-MPR-deficient mice, most activities were relatively normal in solid tissues and some were marginally elevated in serum. In CI-MPR-deficient mice, some enzyme activities were moderately decreased in solid tissues and multiple enzymes were markedly elevated in serum. Finally, total levels of serum mannose 6-phosphorylated glycoproteins were ~ 45-fold and ~ 15-fold higher than wild type in CI- and CD-MPR-deficient mice respectively, and there were specific differences in the pattern of these proteins when comparing CI- and CD-MPR deficient animals. These results indicate that while lack of the CI-MPR appears to perturb lysosome function to a greater degree than lack of the CD-MPR, each MPR has distinct functions for the targeting of lysosomal enzymes in vivo.
48
Prabhu, P. Rajesh, Mayank Jain, Piyush Bawane, Joy Varghese, and Jayanthi Venkataraman. "Role of Colonoscopy in Differentiating Intestinal Tuberculosis from Crohn’s Disease." Journal of Digestive Endoscopy 08, no. 02 (April 2017): 072–77. http://dx.doi.org/10.4103/jde.jde_13_17.
Повний текст джерелаАнотація:
ABSTRACT Background: The interface between tuberculosis (TB) and Crohn’s disease (CD) is relevant as TB complicates both the diagnosis and management of CD. Aim: This study aimed to identify the distinctive characteristics of ileocaecal and colonic TB (C‑TB) and colonic CD (C‑CD) at colonoscopy and to correlate the colonoscopy findings with histology. Materials and Methods: This prospective study included consecutive patients presenting with classical symptoms of TB or CD. The colonoscopic findings were compared with histology, which was taken as gold standard. Appropriate statistical tests were applied. Results: Fifty‑eight individuals fulfilled the inclusion criteria. Nine and 16 patients with C‑TB and C‑CD, respectively, had histological confirmation of respective diagnosis. In 33 specimens, the histological diagnosis was inconclusive. The sensitivity of colonoscopy for diagnosing C‑TB was high at 88.9% (95% confidence interval [CI]: 51.8–99.7). It was 50% (95% CI: 24.7–75.4) for CD. The reverse was true for CD whose specificity was high at 71.4% (95% CI: 55.3–84.3) and low for TB at 46.9% (95% CI: 32.5–61.7). All the patients diagnosed as confirmed CD or TB responded well to respective treatment. Six of the thirty patients with failed response to anti‑TB treatment required surgery or change in treatment after 2 months. Conclusion: Colonoscopic findings of isolated ileal involvement, aphthous ulcer, cobble stoning, long‑segment strictures, skip lesions and perianal involvement favored a diagnosis of CD. Correlation of colonoscopy with histology is poor for both CD and TB. The accuracy, sensitivity and specificity of colonoscopy were better and superior for the diagnosis of CD, than in the diagnosis of TB.
49
Zhu, Shibai, Xiaotian Zhang, Xi Chen, Yiou Wang, Shanni Li, and Wenwei Qian. "Comparison of cell therapy and other novel adjunctive therapies combined with core decompression for the treatment of osteonecrosis of the femoral head." Bone & Joint Research 10, no. 7 (July 1, 2021): 445–58. http://dx.doi.org/10.1302/2046-3758.107.bjr-2020-0418.r1.
Повний текст джерелаАнотація:
Aims The value of core decompression (CD) in the treatment of osteonecrosis of the femoral head (ONFH) remains controversial. We conducted a systematic review and meta-analysis to evaluate whether CD combined with other treatments could improve the clinical and radiological outcomes of ONFH patients compared with CD alone. Methods We searched the PubMed, Embase, Web of Science, and Cochrane Library databases until June 2020. All randomized controlled trials (RCTs) and clinical controlled trials (CCTs) comparing CD alone and CD combined with other measures (CD + cell therapy, CD + bone grafting, CD + porous tantalum rod, etc.) for the treatment of ONFH were considered eligible for inclusion. The primary outcomes of interest were Harris Hip Score (HHS), ONFH stage progression, structural failure (collapse) of the femoral head, and conversion to total hip arthroplasty (THA). The pooled data were analyzed using Review Manager 5.3 software. Results A total of 20 studies with 2,123 hips were included (CD alone = 768, CD combined with other treatments = 1,355). The combination of CD with other therapeutic interventions resulted in a higher HHS (mean difference (MD) = 6.46, 95% confidence interval (CI) = 2.10 to 10.83, p = 0.004) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (MD = −10.92, 95% CI = -21.41 to -4.03, p = 0.040) and a lower visual analogue scale (VAS) score (MD = −0.99, 95% CI = -1.56 to -0.42, p < 0.001) than CD alone. For the rates of disease stage progression, 91 (20%) progressed in the intervention group compared to 146 (36%) in the control group (odds ratio (OR) = 0.32, 95% CI = 0.16 to 0.64, p = 0.001). In addition, the intervention group had a more significant advantage in delaying femoral head progression to the collapsed stage (OR = 0.32, 95% CI = 0.17 to 0.61, p < 0.001) and reducing the odds of conversion to THA (OR = 0.35, 95% CI = 0.23 to 0.55, p < 0.001) compared to the control group. There were no serious adverse events in either group. Subgroup analysis showed that the addition of cell therapy significantly improved clinical and radiological outcomes compared to CD alone, and this approach appeared to be more effective than other therapies, particularly in precollapse (stage I to II) ONFH patients. Conclusion There was marked heterogeneity in the studies. There is a trend towards improved clinical outcomes with the addition of stem cell therapy to CD. Cite this article: Bone Joint Res 2021;10(7):445–458.
50
Little, Bert B., Robert Reilly, Brad Walsh, and Giang T. Vu. "Cadmium Is Associated with Type 2 Diabetes in a Superfund Site Lead Smelter Community in Dallas, Texas." International Journal of Environmental Research and Public Health 17, no. 12 (June 24, 2020): 4558. http://dx.doi.org/10.3390/ijerph17124558.
Повний текст джерелаАнотація:
Objective: To test the hypothesis that cadmium (Cd) exposure is associated with type 2 diabetes mellitus (T2DM). Materials and Methods: A two-phase health screening (physical examination and laboratory tests) was conducted in a lead smelter community following a Superfund Cleanup. Participants were African Americans aged >19 years to <89 years. Multiple logistic regression was used to analyze T2DM regressed on blood Cd level and covariates: body mass index (BMI), heavy metals (Ar, Cd, Hg, Pb), duration of residence, age, smoking status, and sex. Results: Of 875 subjects environmentally exposed to Cd, 55 were occupationally exposed to by-products of lead smelting and 820 were community residents. In addition, 109 T2DM individuals lived in the community for an average of 21.0 years, and 766 non-T2DM individuals for 19.0 years. T2DM individuals (70.3%) were >50 years old. Blood Cd levels were higher among T2DM subjects (p < 0.006) compared to non-T2DM individuals. Logistic regression of T2DM status identified significant predictors: Cd level (OR = 1.85; 95% CI: 1.14–2.99, p < 0.01), age >50 years (OR = 3.10; 95% CI: 1.91–5.02, p < 0.0001), and BMI (OR = 1.07; CI: 1.04–1.09, 0.0001). In meta-analysis of 12 prior studies and this one, T2DM risk was OR = 1.09 (95% CI: 1.03–1.15, p < 0.004) fixed effects and 1.22 (95% CI: 1.04–1.44, p < 0.02) random effects. Discussion: Chronic environmental Cd exposure was associated with T2DM in a smelter community, controlling for covariates. T2DM onset <50 years was significantly associated with Cd exposure, but >50 years was not. Meta-analysis suggests that Cd exposure is associated with a small, but significant increased risk for T2DM. Available data suggest Cd exposure is associated with an increased propensity to increased insulin resistance.