1
|
Ursache A, Rollins BY, Chung A, Dawson-McClure S, Brotman LM. BMI Growth Profiles Among Black Children from Immigrant and US-Born Families. J Immigr Minor Health 2024:10.1007/s10903-024-01596-4. [PMID: 38619674 DOI: 10.1007/s10903-024-01596-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/16/2024]
Abstract
A large body of research has documented racial/ethnic disparities in childhood obesity in the United States (US) but less work has sought to understand differences within racial groups. Longitudinal studies are needed to describe BMI trajectories across development, particularly for Black children from immigrant families who have been underrepresented in childhood obesity research. The current study utilizes BMI data collected longitudinally from ages 5 to 8 years and growth mixture modeling to (1) identify and visualize growth patterns among Black children from primarily Caribbean immigrant families, and (2) to compare these patterns to growth trajectories among Black children from US-born families. First, we identified four classes or trajectories of growth for Black children from immigrant families. The largest trajectory (70% of the sample) maintained non-overweight throughout the study period. A second trajectory developed overweight by age 8 (25%). Two small trajectory groups demonstrated high rates of moderate and severe obesity-i.e., specifically, a trajectory of accelerated weight gain ending in moderate/severe obesity (3%), and a trajectory of early severe obesity with BMI decreasing slightly with age (2%). We identified a very similar four class/trajectory model among Black children from US-born families, and compared the model to the one for children from immigrant families using multi-group growth mixture modeling. We found that the patterns of growth did not differ significantly between the populations, with two notable exceptions. Among Black children from immigrant families, ∼ 5% were classified into the two heavier BMI trajectories, compared to ∼ 11% of children from US-born families. Additionally, among children with an accelerated weight gain trajectory, children from immigrant families had lower BMIs on average at each time point than children from US-born families. These findings describe the multiple trajectories of weight gain among Black children from immigrant families and demonstrate that although these trajectories are largely similar to those of Black children from US-born families, the differences provide some evidence for lower obesity risk among Black children from immigrant families compared to Black children from US-born families. As this study is the first to describe BMI trajectories for Black children from immigrant families across early and middle childhood, future work is needed to replicate these results and to explore differences in heavier weight trajectories between children from immigrant and US-born families.
Collapse
Affiliation(s)
- Alexandra Ursache
- Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, New York, NY, 10016, USA.
| | - Brandi Y Rollins
- Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, 16802, USA
| | - Alicia Chung
- Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, New York, NY, 10016, USA
| | - Spring Dawson-McClure
- Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, New York, NY, 10016, USA
| | - Laurie Miller Brotman
- Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, New York, NY, 10016, USA
| |
Collapse
|
2
|
Troxel AB, Bind MAC, Flotte TJ, Cordon-Cardo C, Decker LA, Finn AV, Padera RF, Reichard RR, Stone JR, Adolphi NL, Casimero FVC, Crary JF, Elifritz J, Faustin A, Ghosh SKB, Krausert A, Martinez-Lage M, Melamed J, Mitchell RA, Sampson BA, Seifert AC, Simsir A, Adams C, Haasnoot S, Hafner S, Siciliano MA, Vallejos BB, Del Boccio P, Lamendola-Essel MF, Young CE, Kewlani D, Akinbo PA, Parent B, Chung A, Cato TC, Mudumbi PC, Esquenazi-Karonika S, Wood MJ, Chan J, Monteiro J, Shinnick DJ, Thaweethai T, Nguyen AN, Fitzgerald ML, Perlowski AA, Stiles LE, Paskett ML, Katz SD, Foulkes AS. Researching COVID to enhance recovery (RECOVER) tissue pathology study protocol: Rationale, objectives, and design. PLoS One 2024; 19:e0285645. [PMID: 38198481 PMCID: PMC10781091 DOI: 10.1371/journal.pone.0285645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 11/23/2023] [Indexed: 01/12/2024] Open
Abstract
IMPORTANCE SARS-CoV-2 infection can result in ongoing, relapsing, or new symptoms or organ dysfunction after the acute phase of infection, termed Post-Acute Sequelae of SARS-CoV-2 (PASC), or long COVID. The characteristics, prevalence, trajectory and mechanisms of PASC are poorly understood. The objectives of the Researching COVID to Enhance Recovery (RECOVER) tissue pathology study (RECOVER-Pathology) are to: (1) characterize prevalence and types of organ injury/disease and pathology occurring with PASC; (2) characterize the association of pathologic findings with clinical and other characteristics; (3) define the pathophysiology and mechanisms of PASC, and possible mediation via viral persistence; and (4) establish a post-mortem tissue biobank and post-mortem brain imaging biorepository. METHODS RECOVER-Pathology is a cross-sectional study of decedents dying at least 15 days following initial SARS-CoV-2 infection. Eligible decedents must meet WHO criteria for suspected, probable, or confirmed infection and must be aged 18 years or more at the time of death. Enrollment occurs at 7 sites in four U.S. states and Washington, DC. Comprehensive autopsies are conducted according to a standardized protocol within 24 hours of death; tissue samples are sent to the PASC Biorepository for later analyses. Data on clinical history are collected from the medical records and/or next of kin. The primary study outcomes include an array of pathologic features organized by organ system. Causal inference methods will be employed to investigate associations between risk factors and pathologic outcomes. DISCUSSION RECOVER-Pathology is the largest autopsy study addressing PASC among US adults. Results of this study are intended to elucidate mechanisms of organ injury and disease and enhance our understanding of the pathophysiology of PASC.
Collapse
Affiliation(s)
- Andrea B. Troxel
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Marie-Abele C. Bind
- Department of Biostatistics, Massachusetts General Hospital, Boston, MA, United States of America
| | - Thomas J. Flotte
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, MN, United States of America
| | - Carlos Cordon-Cardo
- Department of Pathology, Molecular and Cell-Based Medicine, Mount Sinai Health System, New York, NY, United States of America
| | - Lauren A. Decker
- Department of Pathology, University of New Mexico Health Sciences Center, Albuquerque, NM, United States of America
| | - Aloke V. Finn
- Department of Pathology, CVPath Institute, Gaithersburg, MD, United States of America
| | - Robert F. Padera
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - R. Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, MN, United States of America
| | - James R. Stone
- Department of Pathology, Massachusetts General Hospital, Boston, MA, United States of America
| | - Natalie L. Adolphi
- Office of the Medical Investigator, University of New Mexico School of Medicine, Albuquerque, NM, United States of America
| | | | - John F. Crary
- Department of Pathology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, United States of America
| | - Jamie Elifritz
- Departments of Radiology and Pathology, University of New Mexico, Albuquerque, NM, United States of America
| | - Arline Faustin
- Department of Pathology, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Saikat Kumar B. Ghosh
- Department of Molecular Biology and Genomics, CVPath Institute, Gaithersburg, MD, United States of America
| | - Amanda Krausert
- Department of Pathology, Molecular and Cell-Based Medicine, Mount Sinai Health System, New York, NY, United States of America
| | - Maria Martinez-Lage
- Department of Pathology, Massachusetts General Hospital, Boston, MA, United States of America
| | - Jonathan Melamed
- Department of Anatomical Pathology, NYU Langone Hospital—Long Island, Mineola, NY, United States of America
| | - Roger A. Mitchell
- Department of Pathology, Howard University College of Medicine, Washington DC, United States of America
| | - Barbara A. Sampson
- Department of Pathology, Molecular and Cell-Based Medicine, Mount Sinai Health System, New York, NY, United States of America
| | - Alan C. Seifert
- Biomedical Engineering and Imaging Institute, Department of Radiology, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Aylin Simsir
- Department of Pathology, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Cheryle Adams
- Department of Pathology, Howard University College of Medicine, Washington DC, United States of America
| | - Stephanie Haasnoot
- Department of Pathology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, United States of America
| | - Stephanie Hafner
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, MN, United States of America
| | - Michelle A. Siciliano
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - Brittany B. Vallejos
- Office of the Medical Investigators, Department of Research, University of New Mexico, Albuquerque, NM, United States of America
| | - Phoebe Del Boccio
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Michelle F. Lamendola-Essel
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Chloe E. Young
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Deepshikha Kewlani
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Precious A. Akinbo
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Brendan Parent
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Alicia Chung
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Teresa C. Cato
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Praveen C. Mudumbi
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Shari Esquenazi-Karonika
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Marion J. Wood
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States of America
| | - James Chan
- Department of Biostatistics, Massachusetts General Hospital, Boston, MA, United States of America
| | - Jonathan Monteiro
- Department of Biostatistics, Massachusetts General Hospital, Boston, MA, United States of America
| | - Daniel J. Shinnick
- Department of Biostatistics, Massachusetts General Hospital, Boston, MA, United States of America
| | - Tanayott Thaweethai
- Department of Biostatistics, Massachusetts General Hospital, Boston, MA, United States of America
| | - Amber N. Nguyen
- Department of Biostatistics, Massachusetts General Hospital, Boston, MA, United States of America
| | - Megan L. Fitzgerald
- Patient-Led Research Collaborative on COVID-19, Washington DC, United States of America
| | | | - Lauren E. Stiles
- Department of Neurology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, United States of America
| | - Moira L. Paskett
- Department of Anatomical Pathology, NYU Langone Hospital—Long Island, Mineola, NY, United States of America
| | - Stuart D. Katz
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Andrea S. Foulkes
- Department of Biostatistics, Massachusetts General Hospital, Boston, MA, United States of America
| | | |
Collapse
|
3
|
Kinnett-Hopkins D, Ramsey-Goldman R, Milaeger H, Chmiel J, Chung A, Erickson D, Kenney A, Rosiles L, Ehrlich-Jones L. Operational changes to the lupus intervention fatigue trial as a result of COVID-19: An update to the study protocol. Contemp Clin Trials Commun 2023; 36:101221. [PMID: 38034842 PMCID: PMC10682518 DOI: 10.1016/j.conctc.2023.101221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/25/2023] [Accepted: 10/15/2023] [Indexed: 12/02/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) global pandemic drastically impacted the health system and the research community. As a result, research institutions and funding agencies recommended a moratorium on conducting in-person research and study enrollment until protocol changes to protect participant safety were approved and implemented. We detail the operational modifications made to the Lupus Intervention Fatigue Trial (LIFT) protocol and summarize how we met the varied challenges created by COVID-19. Methods We evaluated study protocols and determined that scheduling, acquiring consent, in-person assessments and intervention baseline visits, patient reported outcomes, and data processing procedures needed modification. Results Operational modifications were made to ensure study progress while adhering to COVID-19 restrictions. Major changes included electronic consent, remote baseline visits for those in the intervention, self-report outcome measures at home via emailed weblinks, and telemedicine physician assessment visits. The collection of safety labs presented the largest challenge since this required an in-person visit to a laboratory. The study team elected to delay this up to one month after the physician assessment. All follow-up visits were completed, and no participants withdrew from the study. Conclusion LIFT was severely impacted by COVID-19. We provide insight into how our study protocol was modified without compromising the integrity of the primary and secondary outcomes of the study. The modifications utilized by the LIFT study resulted in efficiencies that will be included in a revised protocol and may serve as a useful example for other behavioral interventions to adapt their research studies.
Collapse
Affiliation(s)
- D. Kinnett-Hopkins
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
- Northwestern University, Chicago, IL, USA
| | | | | | | | - A. Chung
- Northwestern University, Chicago, IL, USA
| | | | - A. Kenney
- Northwestern University, Chicago, IL, USA
| | - L. Rosiles
- Northwestern University, Chicago, IL, USA
| | - L. Ehrlich-Jones
- Northwestern University, Chicago, IL, USA
- Shirley Ryan AbilityLab, Chicago, IL, USA
| |
Collapse
|
4
|
Miller EB, Canfield CF, Barajas-Gonzalez RG, Chung A, Katter J, Kerker BD. The Children, Caregivers, and Community (C3) study of together growing strong: A protocol for an observational, place-based initiative in Sunset Park, Brooklyn. PLoS One 2023; 18:e0290985. [PMID: 37656726 PMCID: PMC10473505 DOI: 10.1371/journal.pone.0290985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/25/2023] [Indexed: 09/03/2023] Open
Abstract
Reaching population-level impact for families in poverty requires moving beyond a sole focus on individuals, to a wider focus on interactions between individuals and their broader environmental contexts. Place-based initiatives have emerged as a policy response to promote community-level change around these broader interactions between individuals and their local communities through addressing long-standing disparities in housing, employment, education, and health. Together Growing Strong (TGS) is one such place-based initiative focused on transforming the health, wellbeing, and development of young children and their families in Sunset Park, Brooklyn. The Children, Caregivers, and Community (C3) Study is an outcomes-based study designed to assess the trajectories of children and families in Sunset Park along indicators such as family health and wellbeing and child development in relation to TGS program participation. The aims, scope, and protocol of the C3 Study are the subjects of this paper.
Collapse
Affiliation(s)
- Elizabeth B. Miller
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Caitlin F. Canfield
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States of America
| | | | - Alicia Chung
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Julie Katter
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Bonnie D. Kerker
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States of America
| |
Collapse
|
5
|
Rogers A, Chung A, Seixas A, Chung D, Zizi F, Jean-Louis G. Strategies to Engage Blacks in Sleep Medicine: Lessons Learned from Three Studies Applying Community-Based Participatory Research Principles. J Sleep Disord Ther 2023; 12:425. [PMID: 37425370 PMCID: PMC10327646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Introduction Awareness, assessment and treatment of sleep apnea are disproportionately lower among Blacks, compared to other racial/ethnic groups. To address this health disparity gap, communication strategies that connect Blacks to OSA education, detection and treatment adherence interventions are needed. Strategies that engage individuals through communication technologies, community-level social network support, and medical providers in clinical settings are also needed. We present lessons learned from three studies that offer these solutions using a community-engaged research model: The Metabolic Syndrome Outcome Study (MetSO), Peer-enhanced Education to Reduce Sleep Ethnic Disparities (PEERS-ED), and Tailored Approach to Sleep Health Education (TASHE), to capture program effectiveness and lessons learned from project successes and failures. Methods The methods of OSA community-based programs included the application of an OSA community-engaged research model. This model served as a strategic guideline for effective interventions to engage communities in research and ensure cultural appropriateness in OSA interventions. Focus groups, in-depth interviews and community steering committee meetings were conducted with various stakeholders. Delphi surveys were used to identify high priority diseases and conditions. Community barriers and needs were identified through iterative combinations of surveys and focus group meetings. Stakeholder groups participated in all aspects of our studies, including the development, dissemination and implementation phases, reflecting a bi-directional decision-making process that ensures the interests of both parties were considered. The MetSO, PEERS-ED and TASHE studies were reviewed to understand the effectiveness of the programs and to evaluate lessons learned. Results MetSO, PEERS-ED and TASHE interventions revealed that community-engaged strategies are successful in enrolling Black populations into clinical trials. The study teams reached nearly 3,000 Blacks at risk of OSA and screened about 2,000 people in sleep apnea studies in New York City. Sleep brochures were distributed to over 10,000 people. Lessons learned from MetSO, PEERS-ED and TASHE interventions revealed that building relationships, establishing trust, identifying a study champion, learning to adjust and providing participant incentives are key strategic elements for successful recruitment and retention of Blacks participations in clinical trials. Conclusion Strategic application of community-oriented frameworks ensures active community engagement throughout the research process, allowing for greater enrollment of Blacks in clinical studies as well as increased OSA awareness, diagnosis, and treatment.
Collapse
Affiliation(s)
- April Rogers
- Department of Health and Human Services, St. John’s University Collins College of Professional Studies, Queens, New York, 11432,USA
| | - Alicia Chung
- Department of Population Health, Center for Early Childhood Health and Development, Division of Health and Behavior, New York University Medical Center, New York, NY 10016, USA
| | - Azizi Seixas
- Department of Informatics and Health Data Science. Center for Translational Sleep and Circadian Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136,USA
- Department of Psychiatry and Behavioral Sciences, Translational Sleep and Circadian Sciences (TSCS), Miami, FL 33136, USA
| | - Debbie Chung
- Department of Psychiatry and Behavioral Sciences, Translational Sleep and Circadian Sciences (TSCS), Miami, FL 33136, USA
| | - Ferdinand Zizi
- Department of Psychiatry and Behavioral Sciences, Translational Sleep and Circadian Sciences (TSCS), Miami, FL 33136, USA
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences, Translational Sleep and Circadian Sciences (TSCS), Miami, FL 33136, USA
| |
Collapse
|
6
|
Concha D, Chung A, Lumish H, Batra J, Sayer G, Clerkin K, Raikhelkar J, Colombo P, Naka Y, Latif F, Takeda K, Fried J, Yuzefpolskaya M, Kaku Y, Uriel N. Actual-to-Expected Advanced Heart Failure Therapy Utilization in the United States by Race/Ethnicity. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
7
|
Chung A, Ashok D, Avinashi V, Barkey J, Bortolin K, Burnett D, Chen B, Critch J, Drouin É, Griffin J, Hulst J, Marcon M, Martinez A, Persad R, Sherlock M, Huynh H. A150 MODERATE AGREEMENT IN ENDOSCOPIC DISEASE SCORING OF PEDIATRIC EOSINOPHILIC ESOPHAGITIS AMONG PEDIATRIC GASTROENTEROLOGISTS IN CANADA. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991383 DOI: 10.1093/jcag/gwac036.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Endoscopy is an important tool in assessing the severity of gastrointestinal diseases including Eosinophilic Esophagitis (EoE). Agreement regarding endoscopy outcomes is important when using tools such as the Endoscopic Reference Score for EoE (EREFS). Purpose Our goal was to determine interrater and intrarater agreement of EREFS among Canadian pediatric gastroenterologists. Method Survey-based study of interrater and intrarater reliability amongst pediatric gastroenterologists with interest in pediatric EoE. Participants were sourced from the Canadian Pediatric EoE Network. Participants were asked how many years of training they’ve had with endoscopy for pediatric EoE and their comfort in disease scoring for pediatric EoE. Pediatric EoE cases were identified from the pediatric EoE registry at the Stollery Children’s Hospital with an endoscopic video associated with each case. Participants were asked to score each video using the EREFS questionnaire for the proximal, middle and distal segments of the esophagus. 15 endoscopic videos were evaluated, with 3 cases provided each week over a period of 5 weeks. Additional data included ratings of the video quality and endoscopy quality. Of 15 cases, 12 were unique cases, distributed evenly in severity between no active disease to severe disease. 3 cases were repeated to assess intrarater reliability. The maximum grade of the proximal, middle and distal segments of the esophagus for each component endoscopic finding (edema, rings, exudates, furrows, strictures) were used for reliability calculations. Fleiss Kappa was calculated for all EREFS items and for each component endoscopic finding. Cohen’s Kappa was calculated to assess intrarater reliability. Result(s) Fifteen participants were recruited for the study. The participants had a median of 12 years (IQR: 7, 19) of clinical experience in endoscopy for pediatric EoE. The majority of participants were “comfortable” (i.e., 4 on 5-point scale) with EREFS scoring for pediatric EoE. Fleiss Kappa for all EREFS items was 0.481. For each component endoscopic finding (edema, rings, exudates, furrows, strictures), Fleiss Kappa was 0.365, 0.293, 0.548, 0.263, 0.445 respectively. Cohen’s Kappa had a median of 0.620 (IQR: 0.593, 0.704). The majority of raters rated video quality and endoscopy quality as “good” (i.e., 4 on 5-point scale). Conclusion(s) There is moderate interrater reliability in EREFS scoring for pediatric EoE. Interrater reliability was between fair to moderate for each component endoscopic finding. Intrarater reliability was good. This study shows there is room for improvement in disease scoring for pediatric EoE. This could be in the form of additional training, expert-defined conventions, or centralized reading which have reduced variability in endoscopic reporting for adult GI disease in past studies and could be used in a follow-up study to attempt to improve agreement. Additionally, incorporating EREFS into routine clinical practice may increase agreement amongst endoscopists. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
Collapse
Affiliation(s)
- A Chung
- University of Alberta, Edmonton
| | - D Ashok
- University of Western Ontario, London,Canadian Pediatric EoE Network, -
| | - V Avinashi
- Canadian Pediatric EoE Network, -,BC Children's Hospital, Vancouver
| | - J Barkey
- Canadian Pediatric EoE Network, -,University of Ottawa, Ottawa
| | - K Bortolin
- Canadian Pediatric EoE Network, -,SickKids, Toronto
| | - D Burnett
- Canadian Pediatric EoE Network, -,Dalhousie University, Halifax,University of Saskatchewan, Saskatoon
| | - B Chen
- University of Alberta, Edmonton,Canadian Pediatric EoE Network, -
| | - J Critch
- Canadian Pediatric EoE Network, -,Memorial University, St. John's
| | - É Drouin
- Canadian Pediatric EoE Network, -,Université de Montréal, Montreal
| | - J Griffin
- Canadian Pediatric EoE Network, -,University of Manitoba, Winnipeg, Canada
| | - J Hulst
- Canadian Pediatric EoE Network, -,SickKids, Toronto
| | - M Marcon
- Canadian Pediatric EoE Network, -,SickKids, Toronto
| | - A Martinez
- Canadian Pediatric EoE Network, -,BC Children's Hospital, Vancouver
| | - R Persad
- University of Alberta, Edmonton,Canadian Pediatric EoE Network, -
| | - M Sherlock
- Canadian Pediatric EoE Network, -,McMaster University, Hamilton, -
| | - H Huynh
- University of Alberta, Edmonton,Canadian Pediatric EoE Network, -
| |
Collapse
|
8
|
Honaker SM, Chung A. Infant Behavioral Sleep Intervention in Black Families. JAMA Netw Open 2023; 6:e236286. [PMID: 37000455 DOI: 10.1001/jamanetworkopen.2023.6286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Affiliation(s)
- Sarah M Honaker
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis
| | - Alicia Chung
- Center for Early Childhood Health and Development, Department of Population Health, New York University Grossman School of Medicine, New York
| |
Collapse
|
9
|
Chung A, Farquharson L, Gopalkrishnan A, Honaker S. “Something is Wrong!”A Qualitative Study of Racial Disparities in Parental Experiences of OSA Detection in Their Child. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
10
|
Yasen Z, Smith M, Mani R, Chung A. 537 Oro-Nasal Fistula: A Very Rare Complication Following Routine Palatal Biopsy. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Biopsies of the palate are generally well-tolerated with known complications of pain, bleeding, or infection, that can usually be well-controlled. We report a case of a 63-year-old male who developed a rare complication following a biopsy of an ulcer on the junction between hard and soft palate. Despite an uneventful routine biopsy, the patient presented with an oro-nasal fistula and complaints of nasal discharge. The cause of the fistula was unclear, and the histopathology results excluded malignancy. The possible hypotheses considered for this very rare and unusual complication were infection, vascularity, and underlying systemic co-morbidities. We believe in this case that the cause of wound breakdown was secondary to loss of vascularity of the mucosa from his CPAP device. The patient has since been referred to a tertiary unit for consideration of surgical repair. To the author's knowledge, there are no similar published reports of such complications following routine palatal biopsy.
Collapse
Affiliation(s)
- Z Yasen
- Royal Albert Edward Infirmary , Wigan , United Kingdom
| | - M Smith
- Royal Albert Edward Infirmary , Wigan , United Kingdom
| | - R Mani
- Royal Albert Edward Infirmary , Wigan , United Kingdom
| | - A Chung
- Royal Albert Edward Infirmary , Wigan , United Kingdom
| |
Collapse
|
11
|
Chung A, Jin P, Kamboukos D, Robbins R, Blanc J, Jean-Louis G, Seixas A. Out Like a Light: Feasibility and Acceptability Study of an Audio-Based Sleep Aide for Improving Parent–Child Sleep Health. IJERPH 2022; 19:ijerph19159416. [PMID: 35954773 PMCID: PMC9368592 DOI: 10.3390/ijerph19159416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022]
Abstract
Our study examines the acceptability and feasibility of Moshi, an audio-based mobile application, among children 3–8 years old using a parent–child dyadic approach. Our 10-day within-subject pre–post study design consisted of five nights of a normal bedtime routine and a subsequent five nights exposed to one story on the Moshi application during the intervention. Each five-night period spanned three weeknights and two weekend nights. The Short-Form Children’s Sleep Habits Questionnaire (SF-CSHQ) was used to measure children’s sleep at baseline and post-intervention. The PROMIS, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index were used to assess parents’ sleep. Among the 25 child–parent dyads, the mean child age was 4 (SD = 1.23) and 63% were male (n = 15). Mean parent age was 35 (SD = 5.83), 84% were female (n = 21), and 48.0% were Black (n = 12). For child-only comparisons, mean post-SF-CSHQ measures were lower compared to baseline. A trend in parent sleep is reported. This study shows the potential of an audio-based mobile sleep aid to improve sleep health in a racially diverse parent and child dyad sample.
Collapse
Affiliation(s)
- Alicia Chung
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (P.J.); (D.K.)
- Correspondence:
| | - Peng Jin
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (P.J.); (D.K.)
| | - Dimitra Kamboukos
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (P.J.); (D.K.)
| | - Rebecca Robbins
- Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA;
| | - Judite Blanc
- Department of Psychiatry and Behavioral Science, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (J.B.); (G.J.-L.); (A.S.)
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Science, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (J.B.); (G.J.-L.); (A.S.)
| | - Azizi Seixas
- Department of Psychiatry and Behavioral Science, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (J.B.); (G.J.-L.); (A.S.)
| |
Collapse
|
12
|
Williams N, Grant A, Bubu O, Chung A, Wallace D. 0791 Perceived racial discrimination predicts poor PAP adherence: a pilot study. Sleep 2022. [DOI: 10.1093/sleep/zsac079.787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Although racial and ethnic differences in continuous positive airway pressure (CPAP) adherence for people with obstructive sleep apnea (OSA) are well known, no studies have examined the influence of racial discrimination on CPAP use. The aim of this study was to determine if racial discrimination influenced CPAP use trajectories.
Methods
Participants with OSA initiating CPAP were enrolled from two sleep centers in New York City. Participants completed questionnaires including sociodemographics, perceived discrimination, daytime sleepiness, and depressive symptoms. Racial discrimination was measured via the validated Everyday Discrimination scale (EDS) , Participants endorsed at least one discriminatory experience “at least once a year” and race was the main reason for this treatment. Sociodemographic and questionnaire comparison were performed between participants reporting the presence and absence of racial discrimination. To examine differences in the trajectory of CPAP use based on racial discrimination status (between-subjects factor), we performed a two-factor repeated measures ANOVA with mean hours of daily use at 7, 30 and 90 days serving as the time dependent variable (within-subjects factor). Analyses were adjusted for depressive symptoms.
Results
The sample consisted of 88 participants (40% female; 40% Non-Hispanic Black; mean age of 57 ± 14 yrs). Twenty-two individuals (25% of the cohort) reported racial discrimination. In unadjusted two-factor repeated measures ANOVA, the test statistic for equality of racial discrimination CPAP adherence means over time was highly significant [ F = 9.71 (1, 68); p = 0.003] while the test for interaction between racial discrimination and time was marginally significant [F = 3.19 (1.53, 103.8); p = 0.059). Main effects for time were significant for participants reporting discrimination (p=0.04) but not for those without racial discrimination experiences (p=0.25). Thus, people reporting racial discrimination experienced greater decrement in CPAP use over time while a more stable CPAP use pattern was observed in those not perceiving racial discrimination.
Conclusion
Racial discrimination status may determine future poor CPAP adherence. Larger studies examining mechanisms of how perceived racial discrimination mediates worse CPAP adherence may assist in mitigating CPAP adherence disparities.
Support (If Any)
Natasha Williams was supported by grant from the National Institutes of Health: K23125939
Collapse
Affiliation(s)
- Natasha Williams
- NYU Grossman School of Medicine, Institute for Excellence in Health Equity, New York, NY
| | - Andrea Grant
- Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY
| | - Omonigho Bubu
- NYU Grossman School of Medicine, Department of Psychiatry
| | | | - Douglas Wallace
- University of Miami Miller School of Medicine, Sleep Medicine Division, Department of Neurology
| |
Collapse
|
13
|
Honaker SM, Gopalkrishnan A, Brann M, Wiehe S, Clark AA, Chung A. “It made all the difference”: a qualitative study of parental experiences with pediatric obstructive sleep apnea detection. J Clin Sleep Med 2022; 18:1921-1931. [PMID: 35499142 PMCID: PMC9340584 DOI: 10.5664/jcsm.10024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To assess parental experience of their child's obstructive sleep apnea (OSA) detection process and inform the development of interventions and health communication strategies to improve OSA detection. METHODS Semistructured interviews were conducted with 30 parents of children (ages 3-14) who snored and were referred for an overnight polysomnogram (PSG). Parents (60.0% Black race, 93.3% mothers) described how their child was referred for PSG and their perceptions and feelings throughout the detection process. Parents also completed an OSA knowledge measure. Interview data were analyzed using a descriptive approach and thematic analysis was conducted using the NVivo 12 software system. RESULTS Twenty-one themes were identified across 5 categories (first steps; PSG facilitators and barriers; health information; health care experiences; parent experiences). Respondents experienced multiple pathways to OSA detection, with more than half of referrals initiated by parental concerns (vs. screening efforts). Parents reported a willingness to take any necessary steps to help their child. Both barriers and facilitators to completing a PSG were described. Parents observed both nighttime and daytime symptoms related to OSA in their child but often did not connect the symptoms to each other until later in the process. Participants had varying degrees of OSA knowledge, with a mean knowledge score of 56% correct (range 10%-90% correct). CONCLUSIONS Parental experiences highlight aspects of the health care system that are both effective and ineffective in detecting children with OSA. Implications include a need for strategies to promote timely detection and to provide parents with accurate information about pediatric OSA. CITATION Honaker SM, Gopalkrishnan A, Brann M, Wiehe S, Clark AA, Chung A. "It made all the difference": a qualitative study of parental experiences ith pediatric obstructive sleep apnea detection. J Clin Sleep Med. 2022;18(8):1921-1931.
Collapse
Affiliation(s)
- Sarah M. Honaker
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Akila Gopalkrishnan
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch
| | - Maria Brann
- Department of Communication Studies, Indiana University Purdue University Indianapolis
| | - Sarah Wiehe
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Ann A. Clark
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Alicia Chung
- Center for Early Childhood Health and Development, Department of Population Health, New York University Grossman School of Medicine
| |
Collapse
|
14
|
Pham C, Parkin C, Chung A. Searching for a solution – is YouTube a reputable source for men investigating treatment for erectile dysfunction? J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
15
|
Lumish H, Kennel P, Concha D, Chung A, Oren D, Jain S, Jennings D, Clerkin K, Fried J, Raikhelkar J, Yuzefpolskaya M, Majure D, Choe J, Latif F, Uriel N, Sayer G. New-Onset Diabetes in Patients Post-Heart Transplantation; the Role of Hypertension and Novel Diabetic Medications. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
16
|
Lumish H, Kennel P, Concha D, Chung A, Oren D, Jain S, Jennings D, Clerkin K, Fried J, Raikhelkar J, Yuzefpolskaya M, Majure D, Choe J, Latif F, Sayer G, Uriel N. Incidence and Treatment of Arterial Hypertension After Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
17
|
Robbins R, Hays RD, Calderón JL, Seixas A, Newsome V, Chung A, Jean-Louis G. The development and psychometric evaluation of the Survey of Obstructive Sleep Apnea Functional Health Literacy. Sleep Med Res 2021; 12:64-73. [PMID: 34790431 DOI: 10.17241/smr.2021.00885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective and Objective Obstructive Sleep Apnea (OSA) is a highly prevalent disorder that disparately affects racial/ethnic minorities. OSA functional health literacy can contribute to health disparities. Documenting poor OSA functional health literacy is needed to inform research agendas, policy, and advocacy efforts. The objective of this study is to develop a scale for measuring OSA functional health literacy among diverse audiences and a variety of reading levels and to ascertain its reliability and validity. Methods Development of the 18-item Survey of OSA Functional Health Literacy (SOFHL) was guided by literature review and input from experts. A convenience sample of persons enrolled in a clinical trial completed the survey (n=194). The psychometric evaluation was conducted using factor analysis to identify the number of dimensions in the SOFHL and their relationship to other domains that are relevant to OSA functional health literacy. Results Internal consistency reliability (alpha) was estimated for the resulting scale and correlations with educational attainment and income completed. All respondents were Black and 29% reported average household income less than $10,000 USD. Confirmatory factor analysis provided support for two dimensions: OSA general knowledge (alpha=0.81) and self-efficacy for OSA self-management (alpha=0.71). Conclusions Higher educational attainment and socioeconomic status were associated with better OSA functional health literacy. These results provide preliminary support for the SOFHL, a measure that can be used to assess OSA functional health literacy.
Collapse
Affiliation(s)
- Rebecca Robbins
- Department of Sleep and Circadian Disorders, Brigham & Women's Hospital.,Division of Sleep Medicine, Harvard Medical School
| | - Ron D Hays
- Department of Health Policy and Management, UCLA Fielding School of Public Health
| | | | - Azizi Seixas
- Department of Population Health, NYU Grossman School of Medicine
| | - Valerie Newsome
- Department of Population Health, NYU Grossman School of Medicine.,Medical Education, Morehouse School of Medicine
| | - Alicia Chung
- Department of Population Health, NYU Grossman School of Medicine
| | | |
Collapse
|
18
|
Evans C, Arthur R, Omofoye F, Chung A, Moreton E, Moore C. 110 Incidental Radiology Findings on Computed Tomography Studies in Emergency Department Patients: A Systematic Review and Meta-Analysis. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
19
|
Kalantari A, Alvarez A, Chung A, Battaglioli N, Nwabueze A, Cooney R, Boehmer S, Gottlieb M. 228 Sex and Racial Visual Representation in Emergency Medicine Textbooks: A Call to Action to Dismantle the Hidden Curriculum Against Diversity in Medicine. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
20
|
Ursache A, Robbins R, Chung A, Dawson-McClure S, Kamboukos D, Calzada E, Jean-Louis G, Brotman LM. Sleep, Classroom Behavior, and Achievement Among Children of Color in Historically Disinvested Neighborhoods. Child Dev 2021; 92:1932-1950. [PMID: 34041742 PMCID: PMC9074088 DOI: 10.1111/cdev.13590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Children of color are more likely to have poor sleep health than White children, placing them at risk for behavioral problems in the classroom and lower academic performance. Few studies, however, have utilized standardized measures of both classroom behavior and achievement. This study examined whether children's sleep (parent and teacher report) in first grade concurrently related to independent observations of classroom behavior and longitudinally predicted achievement test scores in second grade in a sample of primarily Black (86%) children (n = 572; age = 6.8) living in historically disinvested neighborhoods. Higher teacher-reported child sleepiness was associated with lower adaptive behaviors and higher problem behaviors in the classroom, and predicted lower achievement. Parent-reported bedtime resistance and disordered breathing also predicted lower achievement.
Collapse
Affiliation(s)
- Alexandra Ursache
- Department of Population Health, NYU Grossman School of Medicine, 227 East 30th Street, New York, NY 10016
| | - Rebecca Robbins
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115
- Department of Sleep and Circadian Disorders, Brigham and Women’s Hospital, 75 Francis St., Boston, MA 02115
| | - Alicia Chung
- Department of Population Health, NYU Grossman School of Medicine, 227 East 30th Street, New York, NY 10016
| | - Spring Dawson-McClure
- Department of Population Health, NYU Grossman School of Medicine, 227 East 30th Street, New York, NY 10016
| | - Dimitra Kamboukos
- Department of Population Health, NYU Grossman School of Medicine, 227 East 30th Street, New York, NY 10016
| | - Esther Calzada
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712
| | - Girardin Jean-Louis
- Department of Population Health, NYU Grossman School of Medicine, 227 East 30th Street, New York, NY 10016
| | - Laurie Miller Brotman
- Department of Population Health, NYU Grossman School of Medicine, 227 East 30th Street, New York, NY 10016
| |
Collapse
|
21
|
Lee E, Mody S, Chung A. 79 A Qualitative Needs Assessment of COVID-19’s Impact on Emergency Medicine Interns. Ann Emerg Med 2021. [PMCID: PMC8335417 DOI: 10.1016/j.annemergmed.2021.07.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
22
|
Chung A, Vieira D, Donley T, Tan N, Jean-Louis G, Kiely Gouley K, Seixas A. Adolescent Peer Influence on Eating Behaviors via Social Media: Scoping Review. J Med Internet Res 2021; 23:e19697. [PMID: 34081018 PMCID: PMC8212626 DOI: 10.2196/19697] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/30/2020] [Accepted: 03/03/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The influence of social media among adolescent peer groups can be a powerful change agent. OBJECTIVE Our scoping review aimed to elucidate the ways in which social media use among adolescent peers influences eating behaviors. METHODS A scoping review of the literature of articles published from journal inception to 2019 was performed by searching PubMed (ie, MEDLINE), Embase, CINAHL, PsycINFO, Web of Science, and other databases. The review was conducted in three steps: (1) identification of the research question and clarification of criteria using the population, intervention, comparison, and outcome (PICO) framework; (2) selection of articles from the literature using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines; and (3) charting and summarizing information from selected articles. PubMed's Medical Subject Headings (MeSH) and Embase's Emtree subject headings were reviewed along with specific keywords to construct a comprehensive search strategy. Subject headings and keywords were based on adolescent age groups, social media platforms, and eating behaviors. After screening 1387 peer-reviewed articles, 37 articles were assessed for eligibility. Participant age, gender, study location, social media channels utilized, user volume, and content themes related to findings were extracted from the articles. RESULTS Six articles met the final inclusion criteria. A final sample size of 1225 adolescents (aged 10 to 19 years) from the United States, the United Kingdom, Sweden, Norway, Denmark, Portugal, Brazil, and Australia were included in controlled and qualitative studies. Instagram and Facebook were among the most popular social media platforms that influenced healthful eating behaviors (ie, fruit and vegetable intake) as well as unhealthful eating behaviors related to fast food advertising. Online forums served as accessible channels for eating disorder relapse prevention among youth. Social media influence converged around four central themes: (1) visual appeal, (2) content dissemination, (3) socialized digital connections, and (4) adolescent marketer influencers. CONCLUSIONS Adolescent peer influence in social media environments spans the spectrum of healthy eating (ie, pathological) to eating disorders (ie, nonpathological). Strategic network-driven approaches should be considered for engaging adolescents in the promotion of positive dietary behaviors.
Collapse
Affiliation(s)
- Alicia Chung
- Center for Early Childhood Health and Development, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Dorice Vieira
- NYU Grossman School of Medicine, New York, NY, United States
| | - Tiffany Donley
- NYU Grossman School of Medicine, New York, NY, United States
| | - Nicholas Tan
- SUNY Downstate College of Medicine, Brooklyn, NY, United States
| | | | - Kathleen Kiely Gouley
- Center for Early Childhood Health and Development, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Azizi Seixas
- NYU Grossman School of Medicine, New York, NY, United States
| |
Collapse
|
23
|
Chung A, Moore J, Jin P, Nunes J, Jean-Louis G, Seixas A. 638 Sleep and circadian markers of BMI in a diverse sample of 9-year old children from the Fragile Families Child and Wellbeing Study. Sleep 2021. [DOI: 10.1093/sleep/zsab072.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Hispanic and Black school-age children from low-income communities experience disproportionate rates of obesity (26% Hispanic, 22% Black) compared to their White counterparts (14%). Sleep patterns and circadian regulation of biological markers are associated with BMI status. However, little is known about racial and ethnic disparities in circadian regulation among children of color. These suggest that it is important to investigate biological markers that could help delineate associations between sleep-circadian regulation and obesity among children of color. Serotonin transporter gene, a neurotransmitter associated with circadian rhythm regulation, has emerged as an important biological variable. In this study, we investigated whether this factor could serve as a proxy for studying associations of circadian rhythm regulation with weight status in this diverse sample.
Methods
Statistical analysis included descriptive and linear regression analysis of the wave 5, Year 9 cohort of the Fragile Families Child and Wellbeing Study dataset. Interviews were conducted with the participant child around their ninth birthday for data collection on home routines and other parent relationship and school connectedness variables. Biological variables were derived from saliva samples at Year 9 to assess telomere length and DNA methylation levels and changes. Variables of interest included sleep duration, sleep timing, and biological variables 5httlpr (insomnia and sleep quality), skin 2 (serotonin transporter), telomere length (stress) and rs9939609 (fat mass and obesity), with BMI as the outcome.
Results
The final sample of 466 children comprised 52% male were 9 years old. Participants’ race was: 35% White, 46% Black, 20% Hispanic, 4% Asian and 5% other. Median family income was $42,500. Sleep duration obtained from these children was negatively associated with BMI (β = -0.245 with p=0.022). We found that gk5stin212 (serotonin transporter gene) was positively associated with BMI (β = 0.991, p = 0.009), while no significant associations was found for genetic variable gk5stin210.
Conclusion
Circadian rhythm dysregulation may serve as a biological mechanism driving overweight or obesity among minority children. Lifestyle and behavioral interventions aimed at the family unit may be needed to modify household and environmental factors that affect circadian regulation among children.
Support (if any)
NIH (T32HL129953), K07AG052685, R01MD007716, R01HL142066, K01HL135452, R01HL152453
Collapse
|
24
|
Chung A, Jin P, Moore J, Nunes J, Seixas A, Jean-Louis G. 640 Regular bedtime routines and biological obesity risk among 9-year old children from the Fragile Families Child and Wellbeing Study. Sleep 2021. [DOI: 10.1093/sleep/zsab072.638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Obesity rates among Hispanic (26%) and Black (22%) children are considerably higher compared to their white counterparts (14%), which evidence suggests may be attributable to biological, behavioral, and psychosocial factors affecting the family unit. Bio-behavioral factors in the household may affect child health behaviors, including sleep, a known predictor for obesity. Hispanic and Black children report shorter sleep duration, later bedtimes, and are often lacking in bedtime routines, compared to white children. Evidence suggests that early childhood routines are highly predictive of overweight status in children. Herein, we investigate whether bedtime routines are associated with the genetic allele for obesity in a racially diverse sample of children.
Methods
Data for the present analysis emanated from wave 5 (Year 9--2007–2010) cohort of the Fragile Families Child and Wellbeing Study dataset. During home visits, interviews with children’s mother and father during home visits, around the target child’s ninth birthday collected data on home routines and other parent-child relationship and school connectedness topics. Saliva samples were also collected at Year 9 to assess telomere length and DNA methylation levels and changes. The independent variable was regular bedtime routine, and biological variable for fat mass and obesity (rs9939609) was the dependent variable. Adjusted covariates included child’s age and BMI, and parent household income.
Results
Analysis of the final sample of 466 children showed 52% of the children were male and were 9 years old, on average; 35% were White, 46% Black, 20% Hispanic, 4% Asian and 5% other. The median family income was $42,500. The child’s sleep measures captured was ‘children have a regular bedtime routine’ was associated with (β = -0.137, p = 0.01) decrease in the odds of having the genetic allele for obesity.
Conclusion
Regular bedtime routines among 9-year old Black and Hispanic children may be associated with genetic alleles related to fat mass and obesity. Regular bedtime routines could aid in promoting healthy weight in children.
Support (if any)
NIH (T32HL129953, K07AG052685, R01MD007716, R01HL142066, K01HL135452, R01HL152453.
Collapse
|
25
|
Bouchareychas L, Duong P, Covarrubias S, Alsop E, Q Phu T, Chung A, Gomes M, Wong D, Meechoovet B, Capili A, Yamamoto R, Nakauchi H, Mcmanus M, Carpenter S, Van Keuren-Jensen K, Raffai R. M2 macrophage exosomes regulate hematopoiesis & resolve inflammation in atherosclerosis via microrna cargo. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
26
|
Schiff J, Sittig M, Cook-Wiens G, Mirhadi A, Burnison M, Amersi F, Chung A, Dang C, Giuliano A, Karlan S, Basho R, el-Masry M, McAndrew P, McArthur H, Mita M, Park D, Shiao S. Impact of Age in Women with Stage I-III Triple Negative Breast Cancer (TNBC): A National Cancer Data Base (2004-2014) Report. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
27
|
Weygandt P, Smylie L, Ordonez E, Chung A, Jordan J. 140 Recruitment “Red Flags”: A Thematic Analysis of Emergency Medicine Applicant Experience. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
28
|
Seixas AA, Moore J, Chung A, Robbins R, Grandner M, Rogers A, Williams NJ, Jean-Louis G. Benefits of Community-Based Approaches in Assessing and Addressing Sleep Health and Sleep-Related Cardiovascular Disease Risk: a Precision and Personalized Population Health Approach. Curr Hypertens Rep 2020; 22:52. [PMID: 32671477 DOI: 10.1007/s11906-020-01051-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW In this current review, we describe the benefits of community-based and "precision and personalized population health" (P3H) approaches to assessing and addressing sleep health problems and sleep-related cardiovascular diseases (CVD) among vulnerable populations such as racial/ethnic minorities, the elderly, and the socioeconomically disadvantaged. RECENT FINDINGS Very few sleep health programs utilize a community-based or P3H approach, which may account for low estimates of sleep health problems, related CVD outcomes, and inadequate healthcare infrastructure to address sleep-related health outcomes at the community and population level. We describe community-based and P3H approaches and programs as solutions to accurately capture estimates of sleep health and reduce burden of sleep health problems and corollary CVD outcomes at the level of the community and population. Specifically, we describe seven critical steps needed to successfully implement a community-based and P3H approach to address sleep health problems. Community-based and P3H approaches are effective strategies to assessing and addressing sleep health problems and related health conditions.
Collapse
Affiliation(s)
- Azizi A Seixas
- Department of Population Health, NYU Langone Health, 180 Madison Avenue, New York, NY, 10016, USA. .,Department of Psychiatry, NYU Langone Health, 180 Park Avenue, New York, NY, 10016, USA.
| | - Jesse Moore
- Department of Population Health, NYU Langone Health, 180 Madison Avenue, New York, NY, 10016, USA
| | - Alicia Chung
- Department of Population Health, NYU Langone Health, 180 Madison Avenue, New York, NY, 10016, USA
| | - Rebecca Robbins
- Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Michael Grandner
- University of Arizona College of Medicine, Tucson, AZ, 85721, USA
| | | | - Natasha J Williams
- Department of Population Health, NYU Langone Health, 180 Madison Avenue, New York, NY, 10016, USA
| | - Girardin Jean-Louis
- Department of Population Health, NYU Langone Health, 180 Madison Avenue, New York, NY, 10016, USA.,Department of Psychiatry, NYU Langone Health, 180 Park Avenue, New York, NY, 10016, USA
| |
Collapse
|
29
|
Chung A, Seixas A, Williams N, Senathirajah Y, Robbins R, Newsome Garcia V, Ravenell J, Jean-Louis G. Development of "Advancing People of Color in Clinical Trials Now!": Web-Based Randomized Controlled Trial Protocol. JMIR Res Protoc 2020; 9:e17589. [PMID: 32673274 PMCID: PMC7388047 DOI: 10.2196/17589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Participation in clinical trials among people of color remains low, compared with white subjects. This protocol describes the development of "Advancing People of Color in Clinical Trials Now!" (ACT Now!), a culturally tailored website designed to influence clinical trial decision making among people of color. OBJECTIVE This cluster randomized study aims to test the efficacy of a culturally tailored website to increase literacy, self-efficacy, and willingness to enroll in clinical trials among people of color. METHODS ACT Now! is a randomized trial including 2 groups: (1) intervention group (n=50) with access to the culturally tailored website and (2) control group (n=50) exposed to a standard clinical recruitment website. Clinical trial literacy and willingness to enroll in a clinical trial will be measured before and after exposure to the website corresponding to their assigned group (intervention or control). Surveys will be conducted at baseline and during the 1-month postintervention and 3-month follow-up. Website architecture and wireframing will be informed by the literature and experts in the field. Statistical analysis will be conducted using a two-tailed t test, with 80% power, at .05 alpha level, to increase clinical trial literacy, self-efficacy, and willingness to enroll in clinical trials 3 months post intervention. RESULTS We will design a culturally tailored website that will provide leverage for community stakeholders to influence clinical trial literacy, self-efficacy, and willingness to enroll in clinical trials among racial and ethnic groups. ACT Now! applies a community-based participatory research approach through the use of a community steering committee (CSC). The CSC provides input during the research study conception, development, implementation, and enrollment. CSC relationships help foster trust among communities of color. ACT Now! has the potential to fill a gap in clinical trial enrollment among people of color through an accessible web-based website. This study was funded in July 2017 and obtained institutional review board approval in spring 2017. As of December 2019, we had enrolled 100 participants. Data analyses are expected to be completed by June 2020, and expected results are to be published in fall 2020. CONCLUSIONS ACT Now! has the potential to fill an important gap in clinical trial enrollment among people of color through an accessible web-based website. TRIAL REGISTRATION ClinicalTrials.gov NCT03243071; https://clinicaltrials.gov/ct2/show/NCT00102401. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/17589.
Collapse
Affiliation(s)
- Alicia Chung
- NYU Grossman School of Medicine, New York, NY, United States
| | - Azizi Seixas
- NYU Grossman School of Medicine, New York, NY, United States
| | | | - Yalini Senathirajah
- University of Pittsburgh, Department of Biomedical Informatics, Pittsburgh, PA, United States
| | | | | | - Joseph Ravenell
- NYU Grossman School of Medicine, New York, NY, United States
| | | |
Collapse
|
30
|
Zhuo K, Wang N, Vaux K, Lazzaro E, Vass J, Rasiah K, Wines M, Chalasani V, Chung A. Association between ureteric stent dwell time and urinary tract infection. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33390-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
31
|
Seixas A, Connors C, Chung A, Donley T, Jean-Louis G. A Pantheoretical Framework to Optimize Adherence to Healthy Lifestyle Behaviors and Medication Adherence: The Use of Personalized Approaches to Overcome Barriers and Optimize Facilitators to Achieve Adherence. JMIR Mhealth Uhealth 2020; 8:e16429. [PMID: 32579121 PMCID: PMC7381082 DOI: 10.2196/16429] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/16/2020] [Accepted: 01/29/2020] [Indexed: 12/26/2022] Open
Abstract
Patient nonadherence to healthy lifestyle behaviors and medical treatments (like medication adherence) accounts for a significant portion of chronic disease burden. Despite the plethora of behavioral interventions to overcome key modifiable/nonmodifiable barriers and enable facilitators to adherence, short- and long-term adherence to healthy lifestyle behaviors and medical treatments is still poor. To optimize adherence, we aimed to provide a novel mobile health solution steeped in precision and personalized population health and a pantheoretical approach that increases the likelihood of adherence. We have described the stages of a pantheoretical approach utilizing tailoring, clustering/profiling, personalizing, and optimizing interventions/strategies to obtain adherence and highlight the minimal engineering needed to build such a solution.
Collapse
Affiliation(s)
- Azizi Seixas
- NYU Grossman School of Medicine, New York, NY, United States
| | | | - Alicia Chung
- NYU Grossman School of Medicine, New York, NY, United States
| | - Tiffany Donley
- NYU Grossman School of Medicine, New York, NY, United States
| | | |
Collapse
|
32
|
Hollimon L, Moore J, Richards S, Robbins R, Grandner M, Chung A, Chung D, Jean-Louis G, Seixas A. 1212 A Systematic Assessment Of Engagement, Functionality, Aesthetics, Information, And Recommendation Features In Sleep Mobile Applications. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Initial download and use of sleep tracking is very high, but prolonged use is very low. Poor prolonged use may be attributable to several factors such as engagement, functionality, aesthetics, information, and recommendation. We appraised these five factors in 16 consumer- and research/medical- grade digital sleep devices.
Methods
Three reviewers independently assessed 16 consumer- and medical-grade sleep digital devices using the Mobile Application Rating Scale (MARS) App quality ratings, which measures engagement (engagement, entertainment, interest, customization, interactivity, target group), functionality (functionality, performance, ease of use, navigation, gestural design), aesthetics (layout, graphics, visual appeal), information (Accuracy. Goals, Quality of information, Quantity of information, Visual information, Credibility, and Evidence base) and recommended on a Likert scale, with 1- Inadequate to 5 Excellent. Each subcategory is rated on a 1-5 Likert scale which is summed for each category: engagement (30), functionality (25), aesthetics (15), information (35) and recommended (yes or no).
Results
Devices that had the highest engagement score were Fitbit (27), Apple Watch (27), Garmin (27), and Dreem 2 headband (25.5). Apple Watch (30) had highest score; while Fitbit (13), Apple Watch (13), Garmin (13), Samsung Gear (13) had highest aesthetic score. While for information, ActiGraph (35), SOMNOwatch plus (35), CleveMed SleepView Monitor (35), CleveMed Sapphire PSG (35), SOMNOscreen plus (35), Nox T3 Sleep Monitor (35) and Nox A1 PSG System (35) had the highest ratings. The Dreem 2 headband has the potential induce prolong use among users with and without sleep disorders, based on high scores on engagement (25.5), Functionality (20.5), and Information (26.5).
Conclusion
Consumer- and research-grade digital devices that measure sleep have varying levels of engagement, functionality, aesthetics, information and recommendations to facilitate prolong use. Consumer grade devices had higher engagement, functionality and aesthetics scores, while research grade devices had higher information and recommendation scores. If consumer- and research-grade devices are to have prolonged use, standardization is needed across the five MARS components.
Support
K01HL135452, R01MD007716, R01HL142066, and K07AG052685
Collapse
Affiliation(s)
- L Hollimon
- NYU Grossman School of Medicine, New York, NY
| | - J Moore
- NYU Grossman School of Medicine, New York, NY
| | - S Richards
- NYU Grossman School of Medicine, New York, NY
| | | | | | - A Chung
- NYU Grossman School of Medicine, New York, NY
| | - D Chung
- NYU Grossman School of Medicine, New York, NY
| | | | - A Seixas
- NYU Grossman School of Medicine, New York, NY
| |
Collapse
|
33
|
Chung A, Martinez S, Ursache A, Chang S, Huang Y, Jean-Louis G, Brotman L. 0995 Nightcap For School-nights: Association Between Milk Intake And Sleep Duration In First-graders. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Insufficient sleep has been identified as an obesity risk factor due to mechanistic pathways contributing to higher carbohydrate intake, including in children. Dietary intake of macronutrients, such as fats and protein found in milk, may serve as a modifiable risk factor for adequate sleep. We hypothesize that milk intake among a sample of urban first-graders may be associated with sleep duration.
Methods
Cross-sectional analysis of parent reports of an adapted version of the Child Sleep Health Questionnaire (CSHQ) and Block Dietary Data Systems Food Frequency Questionnaire (FFQ) were analyzed among a sample of 837 Black children in Brooklyn, New York. Summary scores were created for milk type. Milk intake was classified by fat content: whole milk and 2% categorized as high-fat, and 1% and skim as low-fat. Independent t-test, correlations and regression analysis to identify associations between parent reports of child’s sleep duration and milk intake were conducted.
Results
On average, children were 7.3 + 0.6 years old and 52% female. Nearly 57% of parents were immigrants. Children’s mean BMI was 17.27, approximately at the 85th BMI percentile according to CDC index-for-age percentiles. On average, FFQ data reported children consumed high-fat milk 6 days a week. Linear variable regression analysis between high-fat milk intake and sufficient sleep were significant (β =, 0.090, p < 0.05). BMI was significantly associated with high-fat milk intake (β= 0.17, p<0.05). However, high-fat milk intake was not significantly associated with (in)sufficient sleep, after controlling for BMI, sex and age. No difference was reported between immigrant parents and U.S. born parents.
Conclusion
Plausibly, high-fat milk is contributing to satiety and longer sleep duration. Future studies should include more comprehensive measurement of milk consumption (i.e. time of day and volume) to consider possible effects on children’s sleep. Actigraphy measures and sleep diaries should also be considered.
Support
Bezos Grant and Community Service Plan grant.
Collapse
Affiliation(s)
- A Chung
- New York University School of Medicine, New York, NY
| | - S Martinez
- University of California, San Francisco, San Francisco, CA
| | - A Ursache
- NYU Grossman School of Medicine, New York, NY
| | - S Chang
- NYU Grossman School of Medicine, New York, NY
| | - Y Huang
- NYU Grossman School of Medicine, New York, NY
| | | | - L Brotman
- NYU Grossman School of Medicine, New York, NY
| |
Collapse
|
34
|
Chung A, Chanko N, Blanc J, Donley T, Robbins R, Brotman L, Jean-Louis G. 0964 Out Like a Light: Preliminary Results of Parent-Child Dyad Use of an Audio-Based Mobile Application Aiding Bedtime Routine and Sleep Health. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Adequate sleep is essential for a child’s growth and development. However, a growing number of children are experiencing trouble falling asleep. Smartphone audio-based mobile applications with soothing melodies and calming nighttime stories may improve sleep onset. Our study examined the efficacy of Moshi Twilight, an app designed to improve sleep onset, among children ages 3-8 years old using a parent-child dyadic approach.
Methods
Our within-subjects pre-post study design focused on healthy children studied over 10 days, spanning 3 weeknights and 2 weekend nights. During the baseline (Days 1-5) and exposure (Days 6-10) conditions the Child Sleep Health Questionnaire was used to measure children’s sleep behavior. The PROMIS and Pittsburgh Sleep Quality Index were used to assess parents’ sleep quality. Parents exposed their child to 1 story per night (15-20 minutes) during the exposured condition. Statistical analysis was based on paired t-tests, independent t-tests, and correlations.
Results
On average, participating parents were 37 (SD +9.6) year-old mothers. The sample was: 60% Black; 20% White, 20% other race/ethnicity. On average, children were 4 (SD + 0.78) years old and 50% male. Paired t-tests showed significant differences in children’s sleep onset within 20 minutes (t=2.582, 95% CI 0.116, 2.634, p= 0.036). Significant correlations were noted for children’s bedtime consistency (r = -0.755, p = 0.030), falling asleep in own bed (r = 0.735, p=0.015) and sleep duration (r = -0.715, p=0.046,) Significant correlations and paired t-test in parents’ sleep onset were also found (r = 0.744, p = 0.014); (mean= -1.2, t= -3.674, 95% CI -1.939, -0.461, p=0.005)
Conclusion
Our results showed that the audio-based sleep app, Moshi Twilight, might be useful in improving sleep health among both children and parents. This could be included in enhance bedtime routine among preschool-aged children.
Support
Bezos Grant and Community Service Plan grant.
Collapse
Affiliation(s)
- A Chung
- NYU Grossman School of Medicine, New York, NY
| | - N Chanko
- NYU Grossman School of Medicine, New York, NY
| | - J Blanc
- NYU Grossman School of Medicine, New York, NY
| | - T Donley
- NYU Grossman School of Medicine, New York, NY
| | | | - L Brotman
- NYU Grossman School of Medicine, New York, NY
| | | |
Collapse
|
35
|
Rogers AJ, Kaplan I, Chung A, McFarlane SI, Jean-Louis G. Obstructive Sleep Apnea Risk and Stroke among Blacks with Metabolic Syndrome: Results from Metabolic Syndrome Outcome (MetSO) Registry. ACTA ACUST UNITED AC 2020; 5. [PMID: 32587931 PMCID: PMC7316191 DOI: 10.15344/2456-8007/2020/143] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: The American Stroke Association estimates that stroke is the fifth leading cause of death in the United States. According to the Center for Disease Control and Prevention someone in the United States has a stoke every 40 seconds, affecting more than 795,000 people of which 140,000 result in death [1]. Emerging evidence suggests that obstructive sleep apnea (OSA) is a strong risk factor for stroke. This study using The Metabolic Syndrome Outcome (MetSO) registry explored whether blacks at risk for obstructive sleep apnea (OSA) are at greater risk for a stroke. Method: The present study utilized data from the MetSO study, an NIH-funded cohort study of blacks with metabolic syndrome (MetS). Patients were diagnosed with MetS using standard criteria articulated in the joint interim statement for harmonizing the MetS. The study assessed OSA risk using the Apnea Risk Evaluation System (ARES); defining high risk as a total ARES score ≥6. Data was coded and analyzed by an experienced statistician using SPSS 20.0. Results: A total of 1035 participants were screened for MetS in the MetSO registry. During the data collection period 875 participants were enrolled during the time of analysis. The average age of the sample was 62±14 years (range: 20–97); 71% were female, and all were of black race/ethnicity. Seventy-one percent reported finishing high school, and 43% reported annual income <10K. Descriptive analyses showed 93% of the participants were diagnosed with hypertension; 61%, diabetes; 72%, dyslipidemia; 90% were overweight/obese; 33% had a history of heart disease and 10% had a stroke history. Using the ARES screener, we estimated that 48% were at high risk for OSA. Logistic regression analysis, adjusting for age and gender, showed that patients at high risk for OSA had a nearly three-fold increase in the odds of having a stroke (OR = 2.79, 95% CI: 1.64–4.73). Conclusion: In the MetSO registry, a cohort of blacks with MetS, the prevalence of stroke is greater than in the general US population. Blacks at risk for OSA are particularly vulnerable to experiencing a stroke.
Collapse
Affiliation(s)
- April J Rogers
- St. John's University, Division of Health and Human Services, College of Professional Studies, Queens, New York, USA
| | - Ian Kaplan
- SUNY Down State Medical, Department of Internal Medicine Center Brooklyn, New York, USA
| | - Alicia Chung
- Center for Healthful Behavior Change (CHBC), Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Samy I McFarlane
- SUNY Down State Medical, Department of Internal Medicine Center Brooklyn, New York, USA
| | - Girardin Jean-Louis
- Center for Healthful Behavior Change (CHBC), Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| |
Collapse
|
36
|
Williams NJ, Butler M, Roseus J, Parra Y, Krieger AC, Ebben M, Barnes A, Wallace DM, Blanc J, Chung A, Jean-Louis G. 0528 Insomnia Symptoms and Adherence to CPAP: Exploring the Role of Resilience. Sleep 2019. [DOI: 10.1093/sleep/zsz067.526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Natasha J Williams
- NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change, New York, NY, USA
| | - Mark Butler
- NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change, New York, NY, USA
| | - Josue Roseus
- NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change, New York, NY, USA
| | - Yoanna Parra
- NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change, New York, NY, USA
| | - Ana C Krieger
- Weill Cornell Medical College, Center for Sleep Medicine, Cornell University, New York, NY, USA
| | - Matthew Ebben
- Weill Cornell Medical College, Center for Sleep Medicine, Cornell University, New York, NY, USA
| | - Andrea Barnes
- New York Veterans Affairs- Brooklyn Campus, Brooklyn, NY, USA
| | - Douglas M Wallace
- University of Miami, Miller School of Medicine, Department of Neurology, Miami, FL, USA
| | - Judite Blanc
- NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change, New York, NY, USA
| | - Alicia Chung
- NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change, New York, NY, USA
| | - Girardin Jean-Louis
- NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change, New York, NY, USA
| |
Collapse
|
37
|
Bubu OM, Umasabor-Bubu OQ, Andrade A, Chung A, Parekh A, Kam K, Mukhtar F, Seixas A, Varga A, Rapoport D, Ayappa I, Forester T, Jean-Louis G, Osorio RS. 0302 Interactive Associations of Obstructive Sleep Apnea and β-Amyloid Burden among Clinically Normal and Mild Cognitive Impairment Elderly Individuals: An examination of conversion risk. Sleep 2019. [DOI: 10.1093/sleep/zsz067.301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Omonigho M Bubu
- Population Health, NYU Langone Medical Center, New York, NY, USA
| | | | - Andreia Andrade
- Population Health, NYU Langone Medical Center, New York, NY, USA
| | - Alicia Chung
- Population Health, NYU Langone Medical Center, New York, NY, USA
| | - Ankit Parekh
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Korey Kam
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Azizi Seixas
- Population Health, NYU Langone Medical Center, New York, NY, USA
| | - Andrew Varga
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David Rapoport
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Indu Ayappa
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Ricardo S Osorio
- Population Health, NYU Langone Medical Center, New York, NY, USA
| |
Collapse
|
38
|
Chung A, Seixas A, Bubu OM, Williams N, Kamboukos D, Chang S, Ursache A, Jean-Louis G, Brotman L. 0791 Teacher Perception of Child Fatigue and Behavioral Health Outcomes Among Black First Graders in High-Poverty Schools. Sleep 2019. [DOI: 10.1093/sleep/zsz067.789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Chung
- New York University School of Medicine, New York, NY, USA
| | - A Seixas
- New York University School of Medicine, New York, NY, USA
| | - O M Bubu
- New York University School of Medicine, New York, NY, USA
| | - N Williams
- New York University School of Medicine, New York, NY, USA
| | - D Kamboukos
- New York University School of Medicine, New York, NY, USA
| | - S Chang
- New York University School of Medicine, New York, NY, USA
| | - A Ursache
- New York University School of Medicine, New York, NY, USA
| | - G Jean-Louis
- New York University School of Medicine, New York, NY, USA
| | - L Brotman
- New York University School of Medicine, New York, NY, USA
| |
Collapse
|
39
|
Nguyen H, Hellstrom W, Alzweri L, Chung A, Virasoro R, Tapscott A, Ziegelmann M, Trost L, Gelbard M. 108 Intralesional Collagenase Clostridium Histolyticum Causes Meaningful Improvement in Men with Peyronie’s Disease: The Results of a Multi-institutional Analysis. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
40
|
Chung A, Wallace B, Stanton-Koko M, Seixas A, Jean-Louis G. Feasibility and Acceptability of a Culturally Tailored Website to Increase Fruit and Vegetable Intake and Physical Activity Levels in African American Mother-Child Dyads: Observational Study. JMIR Pediatr Parent 2019; 2:e12501. [PMID: 31518320 PMCID: PMC6715398 DOI: 10.2196/12501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/31/2018] [Accepted: 12/31/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND African American youth (aged 8-14 years) do not adhere to national dietary and physical activity guidelines. Nonadherence to these recommendations contributes to disproportionate rates of obesity compared with their white counterparts. Culturally tailored electronic health (eHealth) solutions are needed to communicate nutrition and physical activity messages that resonate with this target population. OBJECTIVE This study aimed to identify the impact of exposure to a website hosting culturally tailored cartoons to inspire fruit and vegetable uptake and physical activity levels in African American mother-child dyads. METHODS Statistical analysis included paired sample t tests to evaluate knowledge gains, self-efficacy, and readiness to change. Adapted items from Prochaska's Stages of Change toward the following 4 behaviors were assessed with pre- and posttest surveys: (1) fruit and vegetable selection on my plate, (2) meal preparation, (3) fruit and vegetable selection outside of home, and (4) physical activity. Open-ended comments on videos from mother-child dyads were used to determine user acceptance. Observations of repeated responses during content analysis informed coding and development of key themes. RESULTS A final sample size of 93 mother-child dyads completed the study. Mothers reported significant improvement from precontemplation or contemplation stages to preparation or action stages for (1) fruit and vegetable selection on her plate (P=.03), (2) meal preparation for her family (P=.01), (3) fruit and vegetable selection outside the home (P<.001), and (4) physical activity (P<.001). Significant improvements were found in knowledge, stage of change, and self-efficacy for the 4 target behaviors of interest (P<.001). Children's open-ended commentary reported vicarious learning and positive character identification with brown-skinned cartoons exhibiting healthful food and exercise behaviors. Mothers commented on the lack of accessible produce in their neighborhoods not depicted in the cartoon videos. CONCLUSIONS Culturally adapted cartoons that incorporate tailored preferences by African American families, such as race or demography, may help increase adherence to target health behaviors when developing eHealth behavior solutions.
Collapse
Affiliation(s)
- Alicia Chung
- New York University School of Medicine, New York, NY, United States
| | - Barbara Wallace
- Teachers College, Columbia University, New York, NY, United States
| | | | - Azizi Seixas
- New York University School of Medicine, New York, NY, United States
| | | |
Collapse
|
41
|
McArthur HL, Basho R, Shiao SL, Park D, Mita M, Chung A, Arnold B, Martin C, Dang C, Karlan S, Knott S, Giuliano A, Ho A. Abstract P2-09-07: Preoperative pembrolizumab (Pembro) with radiation therapy (RT) in patients with operable triple-negative breast cancer (TNBC). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-09-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Radiation therapy (RT) induces immune-mediated cell death and could generate a rich supply of tumor antigens if administered in the pre-operative, curative-intent setting. The addition of PD-1 mediated checkpoint blockade to pre-operative RT could thus, generate robust anti-tumor immune responses, induce long-term tumor-specific memory, and ultimately, improve cure rates. This study aims to establish the safety of pre-operative pembrolizumab (pembro)-mediated immune modulation with a RT “boost” equivalent in patients with operable triple negative breast cancer (TNBC) for whom lumpectomy and adjuvant RT are planned (NCT03366844). Serial research biopsies permit interrogation of conventional biomarkers including tumor infiltrating lymphocytes (TILs) and novel immune correlates as potential predictors of response to pembro alone versus pembro with RT.
Methods: Ten women with operable, primary TNBC >2cm for whom breast-conserving therapy is planned are being enrolled in this single-institution pilot study. Study treatment consists of 1 cycle of pre-operative pembro (200 mg IV) alone, followed 3 weeks later by a RT boost (24 Gy/3 fractions) to the primary breast tumor concurrently with pembro (+/- 5 days). Curative-intent, standard-of-care, neoadjuvant chemotherapy (NAC) or breast-conserving surgery is then undertaken within 8 weeks of study enrollment (i.e. within 5 weeks of pembro #2). Adjuvant RT is administered per standard-of-care after surgery, but without a boost dose. Research blood and fresh tumor biopsies are obtained at baseline and after cycles 1 and 2 of pembro. Co-primary endpoints are: 1) safety/tolerability, as defined by the number of patients who do not necessitate a delay in standard-of-care chemotherapy or surgery and 2) change in TIL score. Secondary endpoints include safety/toxicity up to 19 weeks after study enrollment, pCR rates and disease-free survival. Correlative analysis will include single-cell RNA sequencing of the tumor immune infiltrate and multispectral immunohistochemistry
Results: Seven patients enrolled between 12/19/17 and 7/1/18. As of 7/1/18, 5 patients have completed the experimental pembro/RT phase of the trial and are currently completing standard-of-care NAC; 1 patient is currently being treated in the experimental pembro/RT phase; and 1 patient with a cT2N0 tumor at baseline achieved a pathologic complete response (pCR, ypT0/Tis ypN0) after completing the experimental pembro/RT phase followed by anthracycline- and taxane-based NAC. No grade 3 or 4 toxicities have been observed during pembro/RT in the 6 patients completing the experimental phase to date. Three additional patients will be enrolled
Conclusions: This is the first trial of curative-intent, pre-operative checkpoint blockade with RT in breast cancer and the strategy appears to be well tolerated to date. At the time of presentation, safety, change in TIL score, and pCR rates for all patients completing the experimental and NAC phases of the study will be reported.
Citation Format: McArthur HL, Basho R, Shiao SL, Park D, Mita M, Chung A, Arnold B, Martin C, Dang C, Karlan S, Knott S, Giuliano A, Ho A. Preoperative pembrolizumab (Pembro) with radiation therapy (RT) in patients with operable triple-negative breast cancer (TNBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-09-07.
Collapse
Affiliation(s)
- HL McArthur
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - R Basho
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - SL Shiao
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - D Park
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - M Mita
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - A Chung
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - B Arnold
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - C Martin
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - C Dang
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - S Karlan
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - S Knott
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - A Giuliano
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - A Ho
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| |
Collapse
|
42
|
McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
Collapse
|
43
|
Jehan S, Farag M, Zizi F, Pandi-Perumal SR, Chung A, Truong A, Jean-Louis G, Tello D, McFarlane SI. Obstructive sleep apnea and stroke. Sleep Med Disord 2018; 2:120-125. [PMID: 30680373 PMCID: PMC6340906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Obstructive Sleep Apnea (OSA) is a common co-morbid condition in stroke patients. It represents a very important risk factor for stroke in addition to the other established ones such as hypertension, cardiovascular disease (CVD), hyperlipidemia, atrial fibrillation (AF), type 2 diabetes mellitus (T2DM), stress, smoking, and heavy drinking. Although in the United States the prevalence of OSA has somewhat decreased from the previous years, globally its prevalence remains constant, or in some cases, is on the rise. In this review we present the epidemiology for OSA in stroke populations and discuss the risk factors for stroke as well as the underlying pathogenetic mechanisms linking OSA, stroke and CVD. We also emphasize the more thorough evaluation and control of OSA in order to prevent the disabling side effects of a stroke, which not only compromises the physical and mental health of a person and increases the burden on families, but also adds a severe burden to national health economics. OSA should always be considered when assessing a patient with transient ischemic attacks (TIA). Work up and treatment for OSA will not only help prevent stroke with its devastating consequences, but will also help prevent CVD, and ameliorate co-morbid conditions such as diabetes and hypertension in these vulnerable populations.
Collapse
Affiliation(s)
- Shazia Jehan
- Department of Population Health, New York University School of Medicine, USA
| | - Mahmoud Farag
- Department of Surgery, SUNY Downstate Medical Center, USA
| | - Ferdinand Zizi
- Department of Population Health, New York University School of Medicine, USA
| | | | - Alicia Chung
- Department of Population Health, New York University School of Medicine, USA
| | - Anrew Truong
- Department of Medicine, SUNY Downstate Medical Center, USA
| | | | - Daniela Tello
- Department of Medicine, SUNY Downstate Medical Center, USA
| | | |
Collapse
|
44
|
Sharma N, Hunt P, Hine B, Sharma N, Chung A, Swick R, Ruhnke I. Performance, egg quality, and liver lipid reserves of free-range laying hens naturally infected with Ascaridia galli. Poult Sci 2018; 97:1914-1921. [DOI: 10.3382/ps/pey068] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 02/08/2018] [Indexed: 01/20/2023] Open
|
45
|
Chung A, Seixas A, Bademosi-Kalinowski J, Williams N, Robbins R, Ogedegbe O, Jean-Louis G. 0730 Association Between Fruit Drink Intake and Healthy Sleep: An Examination of National Health Interview Survey data. Sleep 2018. [DOI: 10.1093/sleep/zsy061.729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Chung
- New York University School of Medicine, New York, NY
| | - A Seixas
- New York University School of Medicine, New York, NY
| | | | - N Williams
- New York University School of Medicine, New York, NY
| | - R Robbins
- New York University School of Medicine, New York, NY
| | - O Ogedegbe
- New York University School of Medicine, New York, NY
| | - G Jean-Louis
- New York University School of Medicine, New York, NY
| |
Collapse
|
46
|
Kalinowskisi J, Seixas A, Chung A, Chery K, Richards S, Chung D, Jean-Louis G. 0582 High Rate of OSA among Blacks Using Home-Based WatchPAT Recordings. Sleep 2018. [DOI: 10.1093/sleep/zsy061.581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - A Seixas
- New York University School of Medicine, New York, NY
| | - A Chung
- New York University School of Medicine, New York, NY
| | - K Chery
- New York University School of Medicine, New York, NY
| | - S Richards
- New York University School of Medicine, New York, NY
| | - D Chung
- New York University School of Medicine, New York, NY
| | - G Jean-Louis
- New York University School of Medicine, New York, NY
| |
Collapse
|
47
|
Williams NJ, Perlis M, Castor C, Barnes A, Chung A, Kalinowski J, Roseus J, Rogers A, Jean-Louis G. 0193 An Exploratory, Descriptive Study Of African American’s Experiences Of Insomnia Symptoms And Treatment. Sleep 2018. [DOI: 10.1093/sleep/zsy061.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N J Williams
- NYU Langone Health, Department of Population Health, New York, NY
| | - M Perlis
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
| | - C Castor
- Howard University, Division of Allied Health, Washington, DC
| | - A Barnes
- Brooklyn Campus of the VA NY Harbor Healthcare System, Brooklyn, NY
| | - A Chung
- NYU Lngone Health, New York, NY
| | | | - J Roseus
- NYU Langone Health, New York, NY
| | - A Rogers
- New York University School of Medicine, New York, NY
| | - G Jean-Louis
- NYU Langone Health, Department of Population Health, New York, NY
| |
Collapse
|
48
|
Friedman AB, Brown SJ, Bampton P, Barclay ML, Chung A, Macrae FA, McKenzie J, Reynolds J, Gibson PR, Hanauer SB, Sparrow MP. Randomised clinical trial: efficacy, safety and dosage of adjunctive allopurinol in azathioprine/mercaptopurine nonresponders (AAA Study). Aliment Pharmacol Ther 2018; 47:1092-1102. [PMID: 29468701 DOI: 10.1111/apt.14571] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 09/26/2017] [Accepted: 01/25/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Thiopurine hypermethylation towards 6-methylmercaptopurine (6MMP) instead of 6-thioguanine nucleotides (6TGN) is associated with inefficacy in patients with IBD. Allopurinol reverses such hypermethylation. AIMS To prospectively determine efficacy of allopurinol-thiopurine combination and to compare 2 doses of allopurinol. DESIGN In a multicentre, double-blind trial, patients with clinically active or steroid-dependent IBD and thiopurine shunting were randomised to 50 or 100 mg/d allopurinol and 25% of their screening thiopurine dose, which was subsequently optimised, aiming for 6TGN of 260-500 pmol/8x108 RBCs. The primary endpoint was steroid-free clinical remission at 24 weeks. RESULTS Of 73 patients, 39 (53% [95% CI 42-65]) achieved steroid-free remission, (54% with 50 mg/d and 53% with 100 mg/d). 81% were able to discontinue steroids. Therapeutic 6TGN levels were achieved in both groups. Final thiopurine doses were lower with 100 mg/d allopurinol (P < 0.005). 6MMP: 6TGN ratio decreased from mean 64 to 4 (P < 0.001), being higher with 50 mg/d (6 ± 1.83) than for 100 mg/d ([1 ± 0.16], P = 0.003). Three patients on 50 mg/d failed to sustain low ratios at 24 weeks. Toxicity was minimal; three patients on 50 mg/d allopurinol developed transient leukopenia. Alanine aminotransferase concentrations decreased (P < 0.001) similarly in both arms. Faecal calprotectin levels at study end were lower in patients who achieved the primary endpoint (median 171 [85-541] vs 821[110-5892] ug/g, P = 0.03). CONCLUSIONS Low-dose allopurinol-thiopurine combination safely reverses shunting and optimises 6TGN with associated improvement in disease activity. 100 mg/d allopurinol is preferable due to greater metabolite profile stability and lower thiopurine dose without additional toxicity.
Collapse
Affiliation(s)
- A B Friedman
- Department of Gastroenterology, The Alfred Hospital and Monash University, Melbourne, Australia
| | - S J Brown
- St Vincent's Hospital, Melbourne, Australia
| | - P Bampton
- Flinders medical Centre, Adelaide, Australia
| | - M L Barclay
- Christchurch Hospital, Christchurch, New Zealand
| | - A Chung
- Eastern Health and Monash University, Melbourne, Australia
| | - F A Macrae
- Royal Melbourne Hospital, Melbourne, Australia
| | - J McKenzie
- The Alfred Hospital and Monash University, Melbourne, Australia
| | - J Reynolds
- The Alfred Hospital and Monash University, Melbourne, Australia
| | - P R Gibson
- The Alfred Hospital and Monash University, Melbourne, Australia
| | | | - M P Sparrow
- The Alfred Hospital and Monash University, Melbourne, Australia
| |
Collapse
|
49
|
DeLay K, Nguyen H, Chung A, Virasoro R, Ziegelmann M, Trost L, Gelbard M, Hellstrom W. 135 Intralesional Collagenase Clostridium Histolyticum causes meaningful improvement in most men with Peyronie's Disease: The results of a multi-institutional analysis. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2017.11.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
50
|
Sittig M, David J, Yoshida E, Reznik R, McArthur H, Chung A, Mita M, Amersi F, Giuliano A, Cook-Wiens G, Shiao S. Effect of Age in Young Women With Stage I-III Triple-Negative Breast Cancer: A Report From the National Cancer Database. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|