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Tan CH, Tan JJX. Associations of cardiac function and arterial stiffness with cerebrovascular disease. Int J Cardiol 2024:132037. [PMID: 38604451 DOI: 10.1016/j.ijcard.2024.132037] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND White matter hyperintensities (WMHs) represent diffuse small vessel disease implicating the cardiac, systemic, and cerebral vasculatures. As the brain may be the end-organ of cumulative vascular disease, and higher education is protective of both cardiovascular and brain health, we aim to clarify their intertwining relationships. METHODS We evaluated participants (mean age = 64) from the UK Biobank with neuroimaging measures of WMHs, left ventricular ejection fraction (LVEF) quantified using cardiovascular MRI, and arterial stiffness index (ASI) quantified using finger photoplethysmography. We used multiple regression to evaluate the basic, independent, and interactive relationships of LVEF status (n = 27,512) and ASI (n = 33,584) with WMHs. Moderated mediation analysis was used to determine whether the relationship between LVEF status and WMH was mediated by ASI and moderated by education. RESULTS Abnormal LVEF (β = -0.082, p < 0.001) and higher ASI (β = 0.02, p < 0.001) were associated with greater WMHs separately and independently, but not interactively. Moderated mediation analyses revealed that the relationship between abnormal LVEF and WMH was mediated by ASI, for individuals with lower education (β = -0.004, p < 0.001). Abnormal LVEF was associated with lower cortical thickness in 16 predominantly frontotemporal and select parietal regions (FDR, q < 0.05). CONCLUSIONS Cardiovascular dysfunction is associated with regional cerebral atrophy and may precipitate cerebrovascular disease via stiffening of systemic vasculatures, particularly for individuals with lower education. Integrative approaches to study biophysiological vascular systems can elucidate the complex interplay between biological and social determinants of brain and cerebrovascular health.
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Affiliation(s)
- Chin Hong Tan
- Department of Psychology, Nanyang Technological University, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
| | - Jacinth J X Tan
- School of Social Sciences, Singapore Management University, Singapore, Singapore
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Tan JJX, Tan CH, Kraus MW. Correction To: Subjective Socioeconomic Status Moderates How Resting Heart Rate Variability Predicts Pain Response. Affect Sci 2024; 5:67. [PMID: 38495782 PMCID: PMC10942946 DOI: 10.1007/s42761-024-00236-2] [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] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
[This corrects the article DOI: 10.1007/s42761-023-00234-w.].
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Affiliation(s)
- Jacinth J. X. Tan
- School of Social Sciences, Singapore Management University, 10 Canning Rise, #05-01, Singapore, 179873 Singapore
| | - Chin Hong Tan
- Department of Psychology, Nanyang Technological University, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Michael W. Kraus
- School of Management, Yale University, New Haven, CT USA
- Department of Psychology, Northwestern University, Evanston, IL USA
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Mak E, Zhang L, Tan CH, Reilhac A, Shim HY, Wen MOQ, Wong ZX, Chong EJY, Xu X, Stephenson M, Venketasubramanian N, Zhou JH, O’Brien JT, Chen CLH. Longitudinal associations between β-amyloid and cortical thickness in mild cognitive impairment. Brain Commun 2023; 5:fcad192. [PMID: 37483530 PMCID: PMC10358322 DOI: 10.1093/braincomms/fcad192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/25/2023] [Accepted: 07/03/2023] [Indexed: 07/25/2023] Open
Abstract
How beta-amyloid accumulation influences brain atrophy in Alzheimer's disease remains contentious with conflicting findings. We aimed to elucidate the correlations of regional longitudinal atrophy with cross-sectional regional and global amyloid in individuals with mild cognitive impairment and no cognitive impairment. We hypothesized that greater cortical thinning over time correlated with greater amyloid deposition, particularly within Alzheimer's disease characteristic regions in mild cognitive impairment, and weaker or no correlations in those with no cognitive impairment. 45 patients with mild cognitive impairment and 12 controls underwent a cross-sectional [11C]-Pittsburgh Compound B PET and two retrospective longitudinal structural imaging (follow-up: 23.65 ± 2.04 months) to assess global/regional amyloid and regional cortical thickness, respectively. Separate linear mixed models were constructed to evaluate relationships of either global or regional amyloid with regional cortical thinning longitudinally. In patients with mild cognitive impairment, regional amyloid in the right banks of the superior temporal sulcus was associated with longitudinal cortical thinning in the right medial orbitofrontal cortex (P = 0.04 after False Discovery Rate correction). In the mild cognitive impairment group, greater right banks amyloid burden and less cortical thickness in the right medial orbitofrontal cortex showed greater visual and verbal memory decline over time, which was not observed in controls. Global amyloid was not associated with longitudinal cortical thinning in any locations in either group. Our findings indicate an increasing influence of amyloid on neurodegeneration and memory along the preclinical to prodromal spectrum. Future multimodal studies that include additional biomarkers will be well-suited to delineate the interplay between various pathological processes and amyloid and memory decline, as well as clarify their additive or independent effects along the disease deterioration.
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Affiliation(s)
- Elijah Mak
- Correspondence to: Elijah Mak, PhD Department of Psychiatry, University of Cambridge Hills Road, Cambridge, Cambridgeshire, CB20QQ, United Kingdom E-mail:
| | | | - Chin Hong Tan
- Division of Psychology, Nanyang Technological University, Singapore, 637331, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 308232, Singapore
| | - Anthonin Reilhac
- Clinical Imaging Research Centre, the Agency for Science, Technology and Research, and National University of Singapore, Singapore, 117599, Singapore
| | - Hee Youn Shim
- Memory Aging and Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Marcus Ong Qin Wen
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Zi Xuen Wong
- Memory Aging and Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Eddie Jun Yi Chong
- Memory Aging and Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Xin Xu
- Memory Aging and Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- School of Public Health, and the 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 311100, China
| | - Mary Stephenson
- Centre for Translational MR Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117549, Singapore
| | | | - Juan Helen Zhou
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Centre for Translational MR Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117549, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, 119077, Singapore
| | - John T O’Brien
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 2QQ, United Kingdom
| | - Christopher Li-Hsian Chen
- Memory Aging and Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
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Tan CH, Tan JJX. Low neighborhood deprivation buffers against hippocampal neurodegeneration, white matter hyperintensities, and poorer cognition. GeroScience 2023:10.1007/s11357-023-00780-y. [PMID: 37004594 PMCID: PMC10400521 DOI: 10.1007/s11357-023-00780-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/20/2023] [Indexed: 04/04/2023] Open
Abstract
There is increasing recognition that socioeconomic inequalities contribute to disparities in brain and cognitive health in older adults. However, whether neighborhood socioeconomic status (SES) buffers individuals with low individual SES against neurodegeneration, cerebrovascular disease, and poorer cognitive function is not well understood. Here, we evaluated whether neighborhood deprivation (Townsend deprivation index) interacted with individual SES (composite household income and education levels) on hippocampus volume, regional cortical thickness, white matter hyperintensities, and cognition in 19,638 individuals (mean age = 54.8) from the UK Biobank. We found that individuals with low individual SES had the smallest hippocampal volumes, greatest white matter hyperintensity burden, and poorest cognition if they were living in high deprivation neighborhoods but that these deleterious effects on brain and cognitive function were attenuated if they were living in low deprivation neighborhoods (p for interactions < .05). While neighborhood deprivation did not interact with individual SES to influence regional cortical thickness, higher neighborhood deprivation was independently associated with lower cortical thickness in 16 regions (false discovery rate q < .05). Across multiple brain indices and cognitive function analyses, we found converging evidence suggesting that low neighborhood deprivation may have a neuroprotective effect against neurodegeneration, cerebrovascular pathology, and cognitive impairment, particularly in vulnerable individuals with low household income and education levels.
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Affiliation(s)
- Chin Hong Tan
- Department of Psychology, Nanyang Technological University, 48 Nanyang Avenue, Singapore, S639818, Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, 48 Nanyang Avenue, Singapore, S639818, Singapore.
| | - Jacinth J X Tan
- School of Social Sciences, Singapore Management University, Singapore, Singapore
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Tan CH, Wright B, Black M, Devlin B. 630 Hailey-Hailey Disease: A Rare Presentation in the Hypopharnyx. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.143] [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: 11/06/2022]
Abstract
Abstract
Background
Hailey-Hailey disease or familial benign pemphigus is a rare genetic blistering skin disease due to mutation of the ATP2C1 gene inherited in autosomal dominant fashion. Prevalence is around 1 in 50,000 and positive family history is observed in 75% of cases. Patients typically present with well-demarcated painful erosive and yellow-crusted rash in the skin folds, following a relapsing-remitting pattern. There are very limited known cases of extra-dermatological presentation of this disease.
Case
64-year-old gentleman presented with dysphagia, hoarseness, sore throat, dry cough, and intermittent haemoptysis. Initial flexible nasendoscopy showed mild erythema of epiglottis and false cords, post-cricoid oedema and very mild Reinke's oedema. He was treated as acid reflux with omeprazole but to little effect. Endoscopy 4 months later showed similar findings hence biopsy of the hypopharynx was taken. The sample demonstrated intraepithelial clefting, suspicious of intraepithelial vesiculobullous disorder particularly pemphigus vulgaris.
Looking into this gentleman's medical history, it was found that he is under the care of dermatology for Hailey-Hailey disease, which he was diagnosed 30 years ago. He also has a strong family history of this condition. Based on the biopsy findings and patient profile, it was concluded that this gentleman has a hypopharyngeal manifestation of Hailey-Hailey disease.
Discussion
Hailey-Hailey disease is traditionally described as a dermatological condition. This gentleman is one of the rare few cases of non-dermatological manifestation of this disease.
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Affiliation(s)
- CH Tan
- Royal Victoria Hospital , Belfast , United Kingdom
| | - B Wright
- Royal Victoria Hospital , Belfast , United Kingdom
| | - M Black
- Royal Victoria Hospital , Belfast , United Kingdom
| | - B Devlin
- Royal Victoria Hospital , Belfast , United Kingdom
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al Bahri T, Bhoombla N, Rao BM, Titu L, Chatha S, Field C, Gandhi T, Gulati R, Jha R, Jones Sam MT, Karim S, Patel R, Saunders M, Sharma K, Abid S, Heath E, Kurup D, Patel A, Ali M, Cresswell B, Felstead D, Jennings K, Kaluarachchi T, Lazzereschi L, Mayson H, Miah JE, Reinders B, Rosser A, Thomas C, Williams H, Al-Hamid Z, Alsadoun L, Chlubek M, Fernando P, Gaunt E, Gercek Y, Maniar R, Ma R, Matson M, Moore S, Morris A, Nagappan PG, Ratnayake M, Rockall L, Shallcross O, Sinha A, Tan KE, Virdee S, Wenlock R, Donnelly HA, Ghazal R, Hughes I, Liu X, McFadden M, Misbert E, Mogey P, O'Hara A, Peace C, Rainey C, Raja P, Salem M, Salmon J, Tan CH, Alves D, Bahl S, Baker C, Coulthurst J, Koysombat K, Linn T, Rai P, Sharma A, Shergill A, Ahmed M, Ahmed S, Belk LH, Choudhry H, Cummings D, Dixon Y, Dobinson C, Edwards J, Flint J, Franco Da Silva C, Gallie R, Gardener M, Glover T, Greasley M, Hatab A, Howells R, Hussey T, Khan A, Mann A, Morrison H, Ng A, Osmond R, Padmakumar N, Pervaiz F, Prince R, Qureshi A, Sawhney R, Sigurdson B, Stephenson L, Vora K, Zacken A, Cope P, Di Traglia R, Ferarrio I, Hackett N, Healicon R, Horseman L, Lam LI, Meerdink M, Menham D, Murphy R, Nimmo I, Ramaesh A, Rees J, Soame R, Dilaver N, Adebambo D, Brown E, Burt J, Foster K, Kaliyappan L, Knight P, Politis A, Richardson E, Townsend J, Abdi M, Ball M, Easby S, Gill N, Ho E, Iqbal H, Matthews M, Nubi S, Nwokocha JO, Okafor I, Perry G, Sinartio B, Vanukuru N, Walkley D, Welch T, Yates J, Yeshitila N, Bryans K, Campbell B, Gray C, Keys R, Macartney M, Chamberlain G, Khatri A, Kucheria A, Lee STP, Reese G, Roy choudhury J, Tan WYR, Teh JJ, Ting A, Kazi S, Kontovounisios C, Vutipongsatorn K, Amarnath T, Balasubramanian N, Bassett E, Gurung P, Lim J, Panjikkaran A, Sanalla A, Alkoot M, Bacigalupo V, Eardley N, Horton M, Hurry A, Isti C, Maskell P, Nursiah K, Punn G, Salih H, Epanomeritakis E, Foulkes A, Henderson R, Johnston E, McCullough H, McLarnon M, Morrison E, Cheung A, Cho SH, Eriksson F, Hedges J, Low Z, May C, Musto L, Nagi S, Nur S, Salau E, Shabbir S, Thomas MC, Uthayanan L, Vig S, Zaheer M, Zeng G, Ashcroft-Quinn S, Brown R, Hayes J, McConville R, French R, Gilliam A, Sheetal S, Shehzad MU, Bani W, Christie I, Franklyn J, Khan M, Russell J, Smolarek S, Varadarassou R, Ahmed SK, Narayanaswamy S, Sealy J, Shah M, Dodhia V, Manukyan A, O'Hare R, Orbell J, Chung I, Forenc K, Gupta A, Agarwal A, Al Dabbagh A, Bennewith R, Bottomley J, Chu TSM, Chu YYA, Doherty W, Evans B, Hainsworth P, Hosfield T, Li CH, McCullagh I, Mehta A, Thaker A, Thompson B, Virdi A, Walker H, Wilkins E, Dixon C, Hassan MR, Lotca N, Tong KS, Batchelor-Parry H, Chaudhari S, Harris T, Hooper J, Johnson C, Mulvihill C, Nayler J, Olutobi O, Piramanayagam B, Stones K, Sussman M, Weaver C, Alam F, Al Rawi M, Andrew F, Arrayeh A, Azizan N, Hassan A, Iqbal Z, John I, Jones M, Kalake O, Keast M, Nicholas J, Patil A, Powell K, Roberts P, Sabri A, Segue AK, Shah A, Shaik Mohamed SA, Shehadeh A, Shenoy S, Tong A, Upcott M, Vijayasingam D, Anarfi S, Dauncey J, Devindaran A, Havalda P, Komninos G, Mwendwa E, Norman C, Richards J, Urquhart A, Allan J, Cahya E, Hunt H, McWhirter C, Norton R, Roxburgh C, Tan JY, Ali Butt S, Hansdot S, Haq I, Mootien A, Sanchez I, Vainas T, Deliyannis E, Tan M, Vipond M, Chittoor Satish NN, Dattani A, De Carvalho L, Gaston-Grubb M, Karunanithy L, Lowe B, Pace C, Raju K, Roope J, Taylor C, Youssef H, Munro T, Thorn C, Wong KHF, Yunus A, Chawla S, Datta A, Dinesh AA, Field D, Georgi T, Gwozdz A, Hamstead E, Howard N, Isleyen N, Jackson N, Kingdon J, Sagoo KS, Schizas A, Yin L, Aung E, Aung YY, Franklin S, Han SM, Kim WC, Martin Segura A, Rossi M, Ross T, Tirimanna R, Wang B, Zakieh O, Ben-Arzi H, Flach A, Jackson E, Magers S, Olu abara C, Rogers E, Sugden K, Tan H, Veliah S, Walton U, Asif A, Bharwada Y, Bowley D, Broekhuizen A, Cooper L, Evans N, Girdlestone H, Ling C, Mann H, Mehmood N, Mulvenna CL, Rainer N, Trout I, Gujjuri R, Jeyaraman D, Leong E, Singh D, Smith E, Anderton J, Barabas M, Goyal S, Howard D, Joshi A, Mitchell D, Weatherby T, Badminton R, Bird R, Burtle D, Choi NY, Devalia K, Farr E, Fischer F, Fish J, Gunn F, Jacobs D, Johnston P, Kalakoutas A, Lau E, Loo YNAF, Louden H, Makariou N, Mohammadi K, Nayab Y, Ruhomaun S, Ryliskyte R, Saeed M, Shinde P, Sudul M, Theodoropoulou K, Valadao-Spoorenberg J, Vlachou F, Arshad SR, Janmohamed AM, Noor M, Oyerinde O, Saha A, Syed Y, Watkinson W, Ahmadi H, Akintunde A, Alsaady A, Bradley J, Brothwood D, Burton M, Higgs M, Hoyle C, Katsura C, Lathan R, Louani A, Mandalia R, Prihartadi AS, Qaddoura B, Sandland-Taylor L, Thadani S, Thompson A, Walshaw J, Teo S, Ali S, Bawa JH, Fox S, Gargan K, Haider SA, Hanna N, Hatoum A, Khan Z, Krzak AM, Li T, Pitt J, Tan GJS, Ullah Z, Wilson E, Cleaver J, Colman J, Copeland L, Coulson A, Davis P, Faisal H, Hassan F, Hughes JT, Jabr Y, Mahmoud Ali F, Nahaboo Solim ZN, Sangheli A, Shaya S, Thompson R, Cornwall H, De Andres Crespo M, Fay E, Findlay J, Groves E, Jones O, Killen A, Millo J, Thomas S, Ward J, Wilkins M, Zaki F, Zilber E, Bhavra K, Bilolikar A, Charalambous M, Elawad A, Eleni A, Fawdon R, Gibbins A, Livingstone D, Mala D, Oke SE, Padmakumar D, Patsalides MA, Payne D, Ralphs C, Roney A, Sardar N, Stefanova K, Surti F, Timms R, Tosney G, Bannister J, Clement NS, Cullimore V, Kamal F, Lendor J, McKay J, Mcswiggan J, Minhas N, Seneviratne K, Simeen S, Valverde J, Watson N, Bloom I, Dinh TH, Hirniak J, Joseph R, Kansagra M, Lai CKN, Melamed N, Patel J, Randev J, Sedighi T, Shurovi B, Sodhi J, Vadgama N, Abdulla S, Adabavazeh B, Champion A, Chennupati R, Chu K, Devi S, Haji A, Schulz J, Testa F, Davies P, Gurung B, Howell S, Modi P, Pervaiz A, Zahid M, Abdolrazaghi S, Abi Aoun R, Anjum Z, Bawa G, Bhardwaj R, Brown S, Enver M, Gill D, Gopikrishna D, Gurung D, Kanwal A, Kaushal P, Khanna A, Lovell E, McEvoy C, Mirza M, Nabeel S, Naseem S, Pandya K, Perkins R, Pulakal R, Ray M, Reay C, Reilly S, Round A, Seehra J, Shakeel NM, Singh B, Vijay Sukhnani M, Brown L, Desai B, Elzanati H, Godhaniya J, Kavanagh E, Kent J, Kishor A, Liu A, Norwood M, Shaari N, Wood C, Wood M, Brown A, Chellapuri A, Ferriman A, Ghosh I, Kulkarni N, Noton T, Pinto A, Rajesh S, Varghese B, Wenban C, Aly R, Barciela C, Brookes T, Corrin E, Goldsworthy M, Mohamed Azhar MS, Moore J, Nakhuda S, Ng D, Pillay S, Port S, Abdullah M, Akinyemi J, Islam S, Kale A, Lewis A, Manjunath T, McCabe H, Misra S, Stubley T, Tam JP, Waraich N, Chaora T, Ford C, Osinkolu I, Pong G, Rai J, Risquet R, Ainsworth J, Ayandokun P, Barham E, Barrett G, Barry J, Bisson E, Bridges I, Burke D, Cann J, Cloney M, Coates S, Cripps P, Davies C, Francis N, Green S, Handley G, Hathaway D, Hurt L, Jenkins S, Johnston C, Khadka A, McGee U, Morris D, Murray R, Norbury C, Pierrepont Z, Richards C, Ross O, Ruddy A, Salmon C, Shield M, Soanes K, Spencer N, Taverner S, Williams C, Wills-Wood W, Woodward S, Chow J, Fan J, Guest O, Hunter I, Moon WY, Arthur-Quarm S, Edwards P, Hamlyn V, McEneaney L, N D G, Pranoy S, Ting M, Abada S, Alawattegama LH, Ashok A, Carey C, Gogna A, Haglund C, Hurley P, Leelo N, Liu B, Mannan F, Paramjothy K, Ramlogan K, Raymond-Hayling O, Shanmugarajah A, Solichan D, Wilkinson B, Ahmad NA, Allan D, Amin A, Bakina C, Burns F, Cameron F, Campbell A, Cavanagh S, Chan SMZ, Chapman S, Chong V, Edelsten E, Ekpete O, El Sheikh M, Ghose R, Hassane A, Henderson C, Hilton-Christie S, Husain M, Hussain H, Javid Z, Johnson-Ogbuneke J, Johnston A, Khalil M, Leung TCC, Makin I, Muralidharan V, Naeem M, Patil P, Ravichandran S, Saraeva D, Shankey-Smith W, Sharma N, Swan R, Waudby-West R, Wilkinson A, Wright K, Balasubramanian A, Bhatti S, Chalkley M, Chou WK, Dixon M, Evans L, Fisher K, Gandhi P, Ho S, Lau YB, Lowe S, Meechan C, Murali N, Musonda C, Njoku P, Ochieng L, Pervez MU, Seebah K, Shaikh I, Sikder MA, Vanker R, Alom J, Bajaj V, Coleman O, Finch G, Goss J, Jenkins C, Kontothanassis A, Liew MS, Ng K, Outram M, Shakeel MM, Tawn J, Zuhairy S, Chapple K, Cinnamond A, Coleman S, George HA, Goulder L, Hare N, Hawksley J, Kret A, Luesley A, Mecia L, Porter H, Puddy E, Richardson G, Sohail B, Srikaran V, Tadross D, Tobin J, Tokidis E, Young L, Ashdown T, Bratsos S, Koomson A, Kufuor A, Lim MQ, Shah S, Thorne EPC, Warusavitarne J, Xu S, Abigail S, Ahmed A, Ahmed J, Akmal A, Al-Khafaji M, Amini B, Arshad M, Bogie E, Brazkiewicz M, Carroll M, Chandegra A, Cirelli C, Deng A, Fairclough S, Fung YJ, Gornell C, Green RL, Green SV, Gulamhussein AHM, Isaac AG, Jan R, Jegatheeswaran L, Knee M, Kotecha J, Kotecha S, Maxwell-Armstrong C, McIntyre C, Mendis N, Naing TKP, Oberman J, Ong ZX, Ramalingam A, Saeed Adam A, Tan LL, Towell S, Yadav J, Anandampillai R, Chung S, Hounat A, Ibrahim B, Jeyakumar G, Khalil A, Khan UA, Nair G, Owusu-Ayim M, Wilson M, Kanani A, Kilkelly B, Ogunmwonyi I, Ong L, Samra B, Schomerus L, Shea J, Turner O, Yang Y, Amin M, Blott N, Clark A, Feather A, Forrest M, Hague S, Hamilton K, Higginbotham G, Hope E, Karimian S, Loveday K, Malik H, McKenna O, Noor A, Onsiong C, Patel B, Radcliffe N, Shah P, Tye L, Verma K, Walford R, Yusufi U, Zachariah M, Casey A, Doré C, Fludder V, Fortescue L, Kalapu SS, Karel E, Khera G, Smith C, Appleton B, Ashaye A, Boggon E, Evans A, Faris Mahmood H, Hinchcliffe Z, Marei O, Silva I, Spooner C, Thomas G, Timlin M, Wellington J, Yao SL, Abdelrazek M, Abdelrazik Y, Bee F, Joseph A, Mounce A, Parry G, Vignarajah N, Biddles D, Creissen A, Kolhe S, K T, Lea A, Ledda V, O'Loughlin P, Scanlon J, Shetty N, Weller C, Abdalla M, Adeoye A, Bhatti M, Chadda KR, Chu J, Elhakim H, Foster-Davies H, Rabie M, Tailor B, Webb S, Abdelrahim ASA, Choo SY, Jiwa A, Mangam S, Murray S, Shandramohan A, Aghanenu O, Budd W, Hayre J, Khanom S, Liew ZY, McKinney R, Moody N, Muhammad-Kamal H, Odogwu J, Patel D, Roy C, Sattar Z, Shahrokhi N, Sinha I, Thomson E, Wonga L, Bain J, Khan J, Ricardo D, Bevis R, Cherry C, Darkwa S, Drew W, Griffiths E, Konda N, Madani D, Mak JKC, Meda B, Odunukwe U, Preest G, Raheel F, Rajaseharan A, Ramgopal A, Risbrooke C, Selvaratnam K, Sethunath G, Tabassum R, Taylor J, Thakker A, Wijesingha N, Wybrew R, Yasin T, Ahmed Osman A, Alfadhel S, Carberry E, Chen JY, Drake I, Glen P, Jayasuriya N, Kawar L, Myatt R, Sinan LOH, Siu SSY, Tjen V, Adeboyejo O, Bacon H, Barnes R, Birnie C, D'Cunha Kamath A, Hughes E, Middleton S, Owen R, Schofield E, Short C, Smith R, Wang H, Willett M, Zimmerman M, Balfour J, Chadwick T, Coombe-Jones M, Do Le HP, Faulkner G, Hobson K, Shehata Z, Beattie M, Chmielewski G, Chong C, Donnelly B, Drusch B, Ellis J, Farrelly C, Feyi-Waboso J, Hibell I, Hoade L, Ho C, Jones H, Kodiatt B, Lidder P, Ni Cheallaigh L, Norman R, Patabendi I, Penfold H, Playfair M, Pomeroy S, Ralph C, Rottenburg H, Sebastian J, Sheehan M, Stanley V, Welchman J, Ajdarpasic D, Antypas A, Azouaghe O, Basi S, Bettoli G, Bhattarai S, Bommireddy L, Bourne K, Budding J, Cookey-Bresi R, Cummins T, Davies G, Fabelurin C, Gwilliam R, Hanley J, Hird A, Kruczynska A, Langhorne B, Lund J, Lutchman I, McGuinness R, Neary M, Pampapathi S, Pang E, Podbicanin S, Rai N, Redhouse White G, Sujith J, Thomas P, Walker I, Winterton R, Anderson P, Barrington M, Bhadra K, Clark G, Fowler G, Gibson C, Hudson S, Kaminskaite V, Lawday S, Longshaw A, MacKrill E, McLachlan F, Murdeshwar A, Nieuwoudt R, Parker P, Randall R, Rawlins E, Reeves SA, Rye D, Sirkis T, Sykes B, Ventress N, Wosinska N, Akram B, Burton L, Coombs A, Long R, Magowan D, Ong C, Sethi M, Williams G, Chan C, Chan LH, Fernando D, Gaba F, Khor Z, Les JW, Mak R, Moin S, Ng Kee Kwong KC, Paterson-Brown S, Tew YY, Bardon A, Burrell K, Coldwell C, Costa I, Dexter E, Hardy A, Khojani M, Mazurek J, Raymond T, Reddy V, Reynolds J, Soma A, Agiotakis S, Alsusa H, Desai N, Peristerakis I, Adcock A, Ayub H, Bennett T, Bibi F, Brenac S, Chapman T, Clarke G, Clark F, Galvin C, Gwyn-Jones A, Henry-Blake C, Kerner S, Kiandee M, Lovett A, Pilecka A, Ravindran R, Siddique H, Sikand T, Treadwell K, Akmal K, Apata A, Barton O, Broad G, Darling H, Dhuga Y, Emms L, Habib S, Jain R, Jeater J, Kan CYP, Kathiravelupillai A, Khatkar H, Kirmani S, Kulasabanathan K, Lacey H, Lal K, Manafa C, Mansoor M, McDonald S, Mittal A, Mustoe S, Nottrodt L, Oliver P, Papapetrou I, Pattinson F, Raja M, Reyhani H, Shahmiri A, Small O, Soni U, Aguirrezabala Armbruster B, Bunni J, Hakim MA, Hawkins-Hooker L, Howell KA, Hullait R, Jaskowska A, Ottewell L, Thomas-Jones I, Vasudev A, Clements B, Fenton J, Gill M, Haider S, Lim AJM, Maguire H, McMullan J, Nicoletti J, Samuel S, Unais MA, White N, Yao PC, Yow L, Boyle C, Brady R, Cheekoty P, Cheong J, Chew SJHL, Chow R, Ganewatta Kankanamge D, Mamer L, Mohammed B, Ng Chieng Hin J, Renji Chungath R, Royston A, Sharrad E, Sinclair R, Tingle S, Treherne K, Wyatt F, Maniarasu VS, Moug S, Appanna T, Bucknall T, Hussain F, Owen A, Parry M, Parry R, Sagua N, Spofforth K, Yuen ECT, Bosley N, Hardie W, Moore T, Regas C, Abdel-Khaleq S, Ali N, Bashiti H, Buxton-Hopley R, Constantinides M, D'Afflitto M, Deshpande A, Duque Golding J, Frisira E, Germani Batacchi M, Gomaa A, Hay D, Hutchison R, Iakovou A, Iakovou D, Ismail E, Jefferson S, Jones L, Khouli Y, Knowles C, Mason J, McCaughan R, Moffatt J, Morawala A, Nadir H, Neyroud F, Nikookam Y, Parmar A, Pinto L, Ramamoorthy R, Richards E, Thomson S, Trainer C, Valetopoulou A, Vassiliou A, Wantman A, Wilde S, Dickinson M, Rockall T, Senn D, Wcislo K, Zalmay P, Adelekan K, Allen K, Bajaj M, Gatumbu P, Hang S, Hashmi Y, Kaur T, Kawesha A, Kisiel A, Woodmass M, Adelowo T, Ahari D, Alhwaishel K, Atherton R, Clayton B, Cockroft A, Curtis Lopez C, Hilton M, Ismail N, Kouadria M, Lee L, MacConnachie A, Monks F, Mungroo S, Nikoletopoulou C, Pearce L, Sara X, Shahid A, Suresh G, Wilcha R, Atiyah A, Davies E, Dermanis A, Gibbons H, Hyde A, Lawson A, Lee C, Leung-Tack M, Li Saw Hee J, Mostafa O, Nair D, Pattani N, Plumbley-Jones J, Pufal K, Ramesh P, Sanghera J, Saram S, Scadding S, See S, Stringer H, Torrance A, Vardon H, Wyn-Griffiths F, Brew A, Kaur G, Soni D, Tickle A, Akbar Z, Appleyard T, Figg K, Jayawardena P, Johnson A, Kamran Siddiqui Z, Lacy-Colson J, Oatham R, Rowlands B, Sludden E, Turnbull C, Allin D, Ansar Z, Azeez Z, Dale VH, Garg J, Horner A, Jones S, Knight S, McGregor C, McKenna J, McLelland T, Packham-Smith A, Rowsell K, Spector-Hill I, Adeniken E, Baker J, Bartlett M, Chikomba L, Connell B, Deekonda P, Dhar M, Elmansouri A, Gamage K, Goodhew R, Hanna P, Knight J, Luca A, Maasoumi N, Mahamoud F, Manji S, Marwaha PK, Mason F, Oluboyede A, Pigott L, Razaq AM, Richardson M, Saddaoui I, Wijeyendram P, Yau S, Atkins W, Liang K, Miles N, Praveen B, Ashai S, Braganza J, Common J, Cundy A, Davies R, Guthrie J, Handa I, Iqbal M, Ismail R, Jones C, Jones I, Lee KS, Levene A, Okocha M, Olivier J, Smith A, Subramaniam E, Tandle S, Wang A, Watson A, Wilson C, Chan XHF, Khoo E, Montgomery C, Norris M, Pugalenthi PP, Common T, Cook E, Mistry H, Shinmar HS, Agarwal G, Bandyopadhyay S, Brazier B, Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Osman T, Lim LW, Ng JS, Tan CH. Fabrication of infrared linear arrays of InAs planar avalanche photodiodes. Opt Express 2022; 30:21758-21763. [PMID: 36224888 DOI: 10.1364/oe.460017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/20/2022] [Indexed: 06/16/2023]
Abstract
We report a, to the best of our knowledge, new device fabrication process for 128-pixel linear arrays of InAs planar avalanche photodiodes, utilizing selective area implantation of Beryllium ions into epitaxially-grown InAs wafers. The pixels exhibited uniform avalanche gain and responsivity. Room temperature responsivity values at 1550 and 2004 nm wavelengths are 0.49 ± 0.017 and 0.89 ± 0.024 A/W, respectively. Reverse dark current-voltage and avalanche gain measurements were carried out at different temperatures (from room temperature to 150 K). At 200 K at -15 V reverse bias, the pixels exhibited an avalanche gain of 22.5 ± 1.18 and dark current density of 0.68 ± 0.48 A/cm2.
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Taylor-Mew JD, Petticrew JD, Tan CH, Ng JS. Simulation of Al 0.85Ga 0.15As 0.56Sb 0.44 avalanche photodiodes. Opt Express 2022; 30:17946-17952. [PMID: 36221605 DOI: 10.1364/oe.458922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/28/2022] [Indexed: 06/16/2023]
Abstract
Al0.85Ga0.15As0.56Sb0.44 is a promising avalanche material for near infrared avalanche photodiodes (APDs) because they exhibit very low excess noise factors. However electric field dependence of ionization coefficients in this material have not been reported. We report a Simple Monte Carlo model for Al0.85Ga0.15As0.56Sb0.44, which was validated using reported experimental results of capacitance-voltage, avalanche multiplication and excess noise factors from five APDs. The model was used to produce effective ionization coefficients and threshold energies between 400-1200 kV.cm-1 at room temperature, which are suitable for use with less complex APD simulation models.
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Kan CN, Xu X, Schmetterer L, Venketasubramanian N, Chen C, Tan CH. Interactions of comorbid neuropsychiatric subsyndromes with neurodegenerative and cerebrovascular pathologies on cognition. Neurobiol Aging 2021; 109:239-246. [PMID: 34814099 DOI: 10.1016/j.neurobiolaging.2021.10.008] [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] [Received: 07/06/2021] [Revised: 09/23/2021] [Accepted: 10/17/2021] [Indexed: 10/20/2022]
Abstract
Comorbid neuropsychiatric symptoms are commonly found in individuals with dementia and is likely influenced by a combination of neurodegenerative and cerebrovascular pathophysiology. We evaluated the associations of a validated composite MRI-based quantitative measure of both neurodegeneration (hippocampus volume and cortical thickness of AD-specific regions) and cerebrovascular disease (CeVD; white matter hyperintensities and infarcts) with neuropsychiatric subsyndromes, and their interactions on cognition in a community-based sample across the disease spectrum (N = 773). Lower composite MRI scores corresponding to greater comorbid neurodegeneration and CeVD burden were associated with hyperactivity (OR = 1.48) and apathy (OR = 1.90) subsyndromes. Lower MRI scores with concomitant hyperactivity was associated with greater cognitive impairment, especially in patients who were at least moderately impaired, while the interaction with apathy was not dependent on disease stage. These MRI scores interaction models resulted in a better fit than models consisting of neurodegeneration or CeVD alone. Integrating multiple biomarkers with specific, disease stage-dependent neuropsychiatric subsyndromes may provide a more holistic risk profile to facilitate the identification of individuals at the highest risk of disease progression.
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Affiliation(s)
- Cheuk Ni Kan
- Memory Aging & Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xin Xu
- Memory Aging & Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, China
| | - Leopold Schmetterer
- Singapore Eye Research Institute (SERI), Singapore National Eye Center, Singapore; Academic Clinical Program, Duke-NUS Medical School, Singapore; SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore; School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore; Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria; Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria; Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | | | - Christopher Chen
- Memory Aging & Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chin Hong Tan
- Division of Psychology, Nanyang Technological University, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
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Chew N, Tan EX, Tan CH, Lim WH, Xiao JL, Chin YH, Syn N, Low TT, Wong R, Yip J, Siddiqui MS, Muthiah M. A network meta-analysis on the vasomodulators for portopulmonary hypertension. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1956] [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: 11/13/2022] Open
Abstract
Abstract
Background
In patients with portopulmonary hypertension (PoPH) who are eligible and awaiting liver transplant, guidelines recommend lowering pulmonary pressures with vasomodulators as a bridge to transplant. However, efficacy of each vasomodulator class as a bridge to transplant remains unknown.
Purpose
This review compares the use of endothelin receptor antagonists (ERA), phosphodiesterase type-5 inhibitors (PDE5-I), prostacyclin (PC) and combination therapy in its pulmonary pressure-lowering effects and pre-transplant mortality in this strictly selected subset of patients.
Methods
A search conducted on Medline and Embase on articles relating to vasomodulator use in PoPH for pulmonary pressure-lowering effects and mortality. Network analysis was conducted to summarize the evidence. Surface under the cumulative ranking curve (SUCRA) was used to rank treatments.
Results
Ten studies with 180 patients were included. SUCRA analysis demonstrated largest mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) lowering effects in ERA and combination therapy, followed by PDE5-I and PC. mPAP-lowering effects were largest in ERA (MD −19.440, CI: −62.280 to 23.400) and combination therapy (MD −18.223, CI: −29.677 to −6.770) when compared to PDE5-I (table 1). Pre-transplant mortality were comparable between ERA, PDE5-I and combination therapy. Both ERA (RR:0.349. CI: 0.137–0.891) and PDE5-I (RR: 0.279, CI: 0.091–0.854) had significantly lower mortality than PC (table 2).
Conclusion
This meta-analysis provides preliminary evidence that ERA have shown larger pulmonary pressure-lowering effects than PDE5-I in PoPH patients who were eligible for LT. Both ERA and PDE5-I have comparable mortality outcomes, with unfavorable outcomes in PC users.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Chew
- National University Health System, Singapore, Singapore
| | - E X Tan
- National University Hospital, Division of Gastroenterology and Hepatology, Singapore, Singapore
| | - C H Tan
- National University of Singapore, Singapore, Singapore
| | - W H Lim
- National University of Singapore, Singapore, Singapore
| | - J L Xiao
- National University of Singapore, Singapore, Singapore
| | - Y H Chin
- National University of Singapore, Singapore, Singapore
| | - N Syn
- National University of Singapore, Singapore, Singapore
| | - T T Low
- National University Heart Centre, Singapore, Singapore
| | - R Wong
- National University Heart Centre, Singapore, Singapore
| | - J Yip
- National University Heart Centre, Singapore, Singapore
| | - M S Siddiqui
- Virginia Commonwealth University, Division of Gastroenterology and Hepatology, Richmond, United States of America
| | - M Muthiah
- National University Hospital, Division of Gastroenterology and Hepatology, Singapore, Singapore
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11
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Tan CH, Hilal S, Xu X, Vrooman H, Cheng CY, Wong TY, Venketasubramanian N, Chen C. MRI Markers of Mixed Pathology and Cognitive Impairment in Multiethnic Asians. J Alzheimers Dis 2021; 73:1501-1509. [PMID: 31958085 DOI: 10.3233/jad-190866] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
There is a need to elucidate the combined influence of neurodegeneration and cerebrovascular disease (CeVD) on cognitive impairment, especially in diverse populations. Here, we evaluated 840 multiethnic individuals (mean age = 70.18) across the disease spectrum from the Epidemiology of Dementia in Singapore study. First, we determined whether a validated quantitative MRI score of mixed pathology is associated with clinical diagnosis and whether the score differed between ethnicities (Chinese, Malays, and Indians). We then evaluated whether the score was associated with multidomain cognitive impairment and if additional measures of CeVD were further associated with cognitive impairment. We found that lower quantitative MRI scores were associated with severity of clinical diagnosis and Chinese individuals had the highest quantitative MRI scores, followed by Indians and Malays. Lower quantitative MRI scores were also associated with lower performance in attention, language, visuoconstruction, visuomotor, visual, and verbal memory domains. Lastly, the presence of intracranial stenosis and cortical cerebral microinfarcts, but not cerebral microbleeds, were associated with memory performance beyond quantitative MRI scores. Taken together, our results demonstrate the utility of using multiple MRI markers of neurodegeneration and CeVD for identifying multiethnic Asians with the greatest cognitive impairment due to mixed pathology.
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Affiliation(s)
- Chin Hong Tan
- Division of Psychology, Nanyang Technological University, Singapore.,Department of Pharmacology, National University of Singapore, Singapore
| | - Saima Hilal
- Department of Pharmacology, National University of Singapore, Singapore.,Memory Ageing and Cognition Centre, National University Health System, Singapore
| | - Xin Xu
- Department of Pharmacology, National University of Singapore, Singapore.,Memory Ageing and Cognition Centre, National University Health System, Singapore
| | - Henri Vrooman
- Department of Radiology & Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,Academic Medicine Research Institute, Duke-NUS Graduate Medical School, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,Academic Medicine Research Institute, Duke-NUS Graduate Medical School, Singapore
| | | | - Christopher Chen
- Department of Pharmacology, National University of Singapore, Singapore.,Memory Ageing and Cognition Centre, National University Health System, Singapore
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12
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Tanaka T, Ruifen JC, Nai YH, Tan CH, Lim CZJ, Zhang Y, Stephenson MC, Hilal S, Saridin FN, Gyanwali B, Villaraza S, Robins EG, Ihara M, Schöll M, Zetterberg H, Blennow K, Ashton NJ, Shao H, Reilhac A, Chen C. Head-to-head comparison of amplified plasmonic exosome Aβ42 platform and single-molecule array immunoassay in a memory clinic cohort. Eur J Neurol 2021; 28:1479-1489. [PMID: 33370497 DOI: 10.1111/ene.14704] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/20/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Various blood biomarkers reflecting brain amyloid-β (Aβ) load have recently been proposed with promising results. However, to date, no comparative study amongst blood biomarkers has been reported. Our objective was to examine the diagnostic performance and cost effectiveness of three blood biomarkers on the same cohort. METHODS Using the same cohort (n = 68), the performances of the single-molecule array (Simoa) Aβ40, Aβ42, Aβ42/Aβ40 and the amplified plasmonic exosome (APEX) Aβ42 blood biomarkers were compared using amyloid positron emission tomography (PET) as the reference standard. The extent to which these blood tests can reduce the recruitment cost of clinical trials was also determined by identifying amyloid positive (Aβ+) participants. RESULTS Compared to Simoa biomarkers, APEX-Aβ42 showed significantly higher correlations with amyloid PET retention values and excellent diagnostic performance (sensitivity 100%, specificity 93.3%, area under the curve 0.995). When utilized for clinical trial recruitment, our simulation showed that pre-screening with blood biomarkers followed by a confirmatory amyloid PET imaging would roughly half the cost (56.8% reduction for APEX-Aβ42 and 48.6% for Simoa-Aβ42/Aβ40) compared to the situation where only PET imaging is used. Moreover, with 100% sensitivity, APEX-Aβ42 pre-screening does not increase the required number of initial participants. CONCLUSIONS With its high diagnostic performance, APEX is an ideal candidate for Aβ+ subject identification, monitoring and primary care screening, and could efficiently enrich clinical trials with Aβ+ participants whilst halving recruitment costs.
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Affiliation(s)
- Tomotaka Tanaka
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Joyce Chong Ruifen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying-Hwey Nai
- Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chin Hong Tan
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Division of Psychology, Nanyang Technological University, Singapore, Singapore
| | - Carine Z J Lim
- Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, Singapore.,Institute for Health Innovation and Technology, National University of Singapore, Singapore, Singapore
| | - Yan Zhang
- Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, Singapore
| | - Mary C Stephenson
- Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Saima Hilal
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Francis N Saridin
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Bibek Gyanwali
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Steven Villaraza
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Edward G Robins
- Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Bioimaging Consortium, Agency for Science, A*Star, Singapore, Singapore
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Michael Schöll
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.,Maurice Wohl Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,NIHR Biomedical Research Centre for Mental Health, Biomedical Research Unit for Dementia at South London, and Maudsley NHS Foundation, London, UK
| | - Huilin Shao
- Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, Singapore.,Institute for Health Innovation and Technology, National University of Singapore, Singapore, Singapore
| | - Anthonin Reilhac
- Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Christopher Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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13
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Fan CC, Banks SJ, Thompson WK, Chen CH, McEvoy LK, Tan CH, Kukull W, Bennett DA, Farrer LA, Mayeux R, Schellenberg GD, Andreassen OA, Desikan R, Dale AM. Sex-dependent autosomal effects on clinical progression of Alzheimer's disease. Brain 2020; 143:2272-2280. [PMID: 32591829 PMCID: PMC7364740 DOI: 10.1093/brain/awaa164] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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] [Received: 11/07/2019] [Revised: 02/27/2020] [Accepted: 03/31/2020] [Indexed: 11/15/2022] Open
Abstract
Sex differences in the manifestations of Alzheimer's disease are under intense investigation. Despite the emerging importance of polygenic predictions for Alzheimer's disease, sex-dependent polygenic effects have not been demonstrated. Here, using a sex crossover analysis, we show that sex-dependent autosomal genetic effects on Alzheimer's disease can be revealed by characterizing disease progress via the hazard function. We first performed sex-stratified genome-wide associations, and then applied derived sex-dependent weights to two independent cohorts. Relative to sex-mismatched scores, sex-matched polygenic hazard scores showed significantly stronger associations with age-at-disease-onset, clinical progression, amyloid deposition, neurofibrillary tangles, and composite neuropathological scores, independent of apolipoprotein E. Models without using hazard weights, i.e. polygenic risk scores, showed lower predictive power than polygenic hazard scores with no evidence for sex differences. Our results indicate that revealing sex-dependent genetic architecture requires the consideration of temporal processes of Alzheimer's disease. This has strong implications not only for the genetic underpinning of Alzheimer's disease but also for how we estimate sex-dependent polygenic effects for clinical use.
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Affiliation(s)
- Chun Chieh Fan
- Center for Human Development, University of California, San Diego, USA
| | - Sarah J Banks
- Department of Neuroscience, University of California, San Diego, USA
| | - Wesley K Thompson
- Family Medicine and Public Health, University of California, San Diego, USA
| | - Chi-Hua Chen
- Department of Radiology, University of California, San Diego, USA
| | - Linda K McEvoy
- Family Medicine and Public Health, University of California, San Diego, USA
- Department of Radiology, University of California, San Diego, USA
| | - Chin Hong Tan
- Department of Psychology, Nanyang Technological University, Singapore
| | - Walter Kukull
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
| | - David A Bennett
- Department of Neurological Science, Rush Medical College, Chicago, USA
| | | | - Richard Mayeux
- Department of Neurology and the Taub Institute at Columbia University, New York, USA
| | - Gerard D Schellenberg
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Ole A Andreassen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Rahul Desikan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Anders M Dale
- Department of Radiology, University of California, San Diego, USA
- Center for Multimodal Imaging and Genetics, University of California, San Diego, USA
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14
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Ho WYB, Wang D, Tan LYC, Bundele MM, Tan CH, Lim HLJ. Two cases of cutaneous eruptions due to CoVID-19 infection in Singapore: new insights into the spectrum of clinical presentation and histopathology. J Eur Acad Dermatol Venereol 2020; 34:e576-e579. [PMID: 32531121 PMCID: PMC7323431 DOI: 10.1111/jdv.16736] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- W Y B Ho
- National Skin Centre, Singapore City, Singapore
| | - D Wang
- National Skin Centre, Singapore City, Singapore
| | - L Y C Tan
- National Skin Centre, Singapore City, Singapore
| | - M M Bundele
- Department of Pathology, Tan Tock Seng Hospital, Singapore City, Singapore
| | - C H Tan
- National Skin Centre, Singapore City, Singapore
| | - H L J Lim
- National Skin Centre, Singapore City, Singapore
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15
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Kong TS, Gratton C, Low KA, Tan CH, Chiarelli AM, Fletcher MA, Zimmerman B, Maclin EL, Sutton BP, Gratton G, Fabiani M. Age-related differences in functional brain network segregation are consistent with a cascade of cerebrovascular, structural, and cognitive effects. Netw Neurosci 2020; 4:89-114. [PMID: 32043045 PMCID: PMC7006874 DOI: 10.1162/netn_a_00110] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 09/21/2019] [Indexed: 01/09/2023] Open
Abstract
Age-related declines in cognition are associated with widespread structural and functional brain changes, including changes in resting-state functional connectivity and gray and white matter status. Recently we have shown that the elasticity of cerebral arteries also explains some of the variance in cognitive and brain health in aging. Here, we investigated how network segregation, cerebral arterial elasticity (measured with pulse-DOT-the arterial pulse based on diffuse optical tomography) and gray and white matter status jointly account for age-related differences in cognitive performance. We hypothesized that at least some of the variance in brain and cognitive aging is linked to reduced cerebrovascular elasticity, leading to increased cortical atrophy and white matter abnormalities, which, in turn, are linked to reduced network segregation and decreases in cognitive performance. Pairwise comparisons between these variables are consistent with an exploratory hierarchical model linking them, especially when focusing on association network segregation (compared with segregation in sensorimotor networks). These findings suggest that preventing or slowing age-related changes in one or more of these factors may induce a neurophysiological cascade beneficial for preserving cognition in aging.
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Affiliation(s)
- Tania S. Kong
- Beckman Institute, University of Illinois at Urbana-Champaign, IL, USA
- Psychology Department, University of Illinois at Urbana-Champaign, IL, USA
| | - Caterina Gratton
- Department of Psychology, Northwestern University, IL, USA
- Department of Neurology, Northwestern University, IL, USA
| | - Kathy A. Low
- Beckman Institute, University of Illinois at Urbana-Champaign, IL, USA
| | - Chin Hong Tan
- Beckman Institute, University of Illinois at Urbana-Champaign, IL, USA
- Division of Psychology, Nanyang Technological University, Singapore
- Department of Pharmacology, National University of Singapore, Singapore
| | - Antonio M. Chiarelli
- Beckman Institute, University of Illinois at Urbana-Champaign, IL, USA
- Department of Neuroscience, Imaging and Clinical Sciences, University G. D’Annunzio of Chieti-Pescara, Chieti, Italy
| | - Mark A. Fletcher
- Beckman Institute, University of Illinois at Urbana-Champaign, IL, USA
| | | | - Edward L. Maclin
- Beckman Institute, University of Illinois at Urbana-Champaign, IL, USA
| | - Bradley P. Sutton
- Beckman Institute, University of Illinois at Urbana-Champaign, IL, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, IL, USA
| | - Gabriele Gratton
- Beckman Institute, University of Illinois at Urbana-Champaign, IL, USA
- Psychology Department, University of Illinois at Urbana-Champaign, IL, USA
| | - Monica Fabiani
- Beckman Institute, University of Illinois at Urbana-Champaign, IL, USA
- Psychology Department, University of Illinois at Urbana-Champaign, IL, USA
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16
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Chiarelli AM, Low KA, Maclin EL, Fletcher MA, Kong TS, Zimmerman B, Tan CH, Sutton BP, Fabiani M, Gratton G. The Optical Effective Attenuation Coefficient as an Informative Measure of Brain Health in Aging. Photonics 2019; 6. [PMID: 32377515 PMCID: PMC7202715 DOI: 10.3390/photonics6030079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Aging is accompanied by widespread changes in brain tissue. Here, we hypothesized that head tissue opacity to near-infrared light provides information about the health status of the brain’s cortical mantle. In diffusive media such as the head, opacity is quantified through the Effective Attenuation Coefficient (EAC), which is proportional to the geometric mean of the absorption and reduced scattering coefficients. EAC is estimated by the slope of the relationship between source–detector distance and the logarithm of the amount of light reaching the detector (optical density). We obtained EAC maps across the head in 47 adults (age range 18–75 years), using a high-density dual-wavelength optical system. We correlated regional and global EAC measures with demographic, neuropsychological, structural and functional brain data. Results indicated that EAC values averaged across wavelengths were strongly associated with age-related changes in cortical thickness, as well as functional and neuropsychological measures. This is likely because the EAC largely depends on the thickness of the sub-arachnoid cerebrospinal fluid layer, which increases with cortical atrophy. In addition, differences in EAC values between wavelengths were correlated with tissue oxygenation and cardiorespiratory fitness, indicating that information about cortical health can be derived non-invasively by quantifying the EAC.
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Affiliation(s)
- Antonio M. Chiarelli
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Department of Neuroscience, Imaging and Clinical Sciences, University G. D’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
- Correspondence: (A.M.C.); (M.F.); (G.G.)
| | - Kathy A. Low
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Edward L. Maclin
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Mark A. Fletcher
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Tania S. Kong
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Benjamin Zimmerman
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Chin Hong Tan
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Division of Psychology, Nanyang Technological University, Singapore 639818, Singapore
- Department of Pharmacology, National University of Singapore, Singapore 117600, Singapore
| | - Bradley P. Sutton
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Monica Fabiani
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
- Correspondence: (A.M.C.); (M.F.); (G.G.)
| | - Gabriele Gratton
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
- Correspondence: (A.M.C.); (M.F.); (G.G.)
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17
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Tan CH, Bonham LW, Fan CC, Mormino EC, Sugrue LP, Broce IJ, Hess CP, Yokoyama JS, Rabinovici GD, Miller BL, Yaffe K, Schellenberg GD, Kauppi K, Holland D, McEvoy LK, Kukull WA, Tosun D, Weiner MW, Sperling RA, Bennett DA, Hyman BT, Andreassen OA, Dale AM, Desikan RS. Polygenic hazard score, amyloid deposition and Alzheimer's neurodegeneration. Brain 2019; 142:460-470. [PMID: 30689776 PMCID: PMC6351776 DOI: 10.1093/brain/awy327] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [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] [Received: 06/19/2018] [Revised: 11/05/2018] [Accepted: 11/06/2018] [Indexed: 12/20/2022] Open
Abstract
Mounting evidence indicates that the polygenic basis of late-onset Alzheimer's disease can be harnessed to identify individuals at greatest risk for cognitive decline. We have previously developed and validated a polygenic hazard score comprising of 31 single nucleotide polymorphisms for predicting Alzheimer's disease dementia age of onset. In this study, we examined whether polygenic hazard scores are associated with: (i) regional tracer uptake using amyloid PET; (ii) regional volume loss using longitudinal MRI; (iii) post-mortem regional amyloid-β protein and tau associated neurofibrillary tangles; and (iv) four common non-Alzheimer's pathologies. Even after accounting for APOE, we found a strong association between polygenic hazard scores and amyloid PET standard uptake volume ratio with the largest effects within frontal cortical regions in 980 older individuals across the disease spectrum, and longitudinal MRI volume loss within the entorhinal cortex in 607 older individuals across the disease spectrum. We also found that higher polygenic hazard scores were associated with greater rates of cognitive and clinical decline in 632 non-demented older individuals, even after controlling for APOE status, frontal amyloid PET and entorhinal cortex volume. In addition, the combined model that included polygenic hazard scores, frontal amyloid PET and entorhinal cortex volume resulted in a better fit compared to a model with only imaging markers. Neuropathologically, we found that polygenic hazard scores were associated with regional post-mortem amyloid load and neuronal neurofibrillary tangles, even after accounting for APOE, validating our imaging findings. Lastly, polygenic hazard scores were associated with Lewy body and cerebrovascular pathology. Beyond APOE, we show that in living subjects, polygenic hazard scores were associated with amyloid deposition and neurodegeneration in susceptible brain regions. Polygenic hazard scores may also be useful for the identification of individuals at the highest risk for developing multi-aetiological dementia.
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Affiliation(s)
- Chin Hong Tan
- Division of Psychology, Nanyang Technological University, 48 Nanyang Avenue, Singapore
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA, USA
| | - Luke W Bonham
- Department of Neurology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA, USA
| | - Chun Chieh Fan
- Department of Cognitive Science, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, USA
| | - Elizabeth C Mormino
- Department of Neurology and Neurological Sciences, Stanford University, 300 Pasteur Dr, Palo Alto, CA, USA
| | - Leo P Sugrue
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA, USA
| | - Iris J Broce
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA, USA
| | - Christopher P Hess
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA, USA
| | - Jennifer S Yokoyama
- Department of Neurology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA, USA
| | - Gil D Rabinovici
- Department of Neurology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA, USA
| | - Bruce L Miller
- Department of Neurology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA, USA
| | - Kristine Yaffe
- Department of Neurology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, San Francisco, CA, USA
- Department of Psychiatry, University of California, San Francisco, 982 Mission St, San Francisco, CA, USA
| | - Gerard D Schellenberg
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, 204 N Broad St, Philadelphia, PA, USA
| | - Karolina Kauppi
- Department of Radiology, University of California, San Diego, 8929 University Center, La Jolla, CA, USA
| | - Dominic Holland
- Department of Neurosciences, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, USA
| | - Linda K McEvoy
- Department of Radiology, University of California, San Diego, 8929 University Center, La Jolla, CA, USA
| | - Walter A Kukull
- National Alzheimer’s Coordinating Center, Department of Epidemiology, University of Washington, 1959 NE Pacific St, Seattle, WA, USA
| | - Duygu Tosun
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA, USA
| | - Michael W Weiner
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA, USA
- Department of Neurology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, 15 Parkman St, Boston, MA, USA
| | - David A Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, 1750 W Harrison St, Chicago, IL, USA
| | - Bradley T Hyman
- Department of Neurology, Massachusetts General Hospital, 15 Parkman St, Boston, MA, USA
| | - Ole A Andreassen
- NORMENT Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Boks 1072 Blindern, Oslo, Norway
| | - Anders M Dale
- Department of Cognitive Science, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, USA
- Department of Radiology, University of California, San Diego, 8929 University Center, La Jolla, CA, USA
- Department of Neurosciences, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, USA
| | - Rahul S Desikan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA, USA
- Department of Neurology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA, USA
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Barkovich MJ, Tan CH, Nillo RM, Li Y, Xu D, Glastonbury CM, Glenn OA, Dillon WP, Hess CP, Mueller S, Kline C, Dale AM, Jernigan TL, Sugrue LP, Barkovich AJ, Desikan RS. Abnormal Morphology of Select Cortical and Subcortical Regions in Neurofibromatosis Type 1. Radiology 2018; 289:499-508. [PMID: 30179114 DOI: 10.1148/radiol.2018172863] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To evaluate whether patients with neurofibromatosis type 1 (NF1)-a multisystem neurodevelopmental disorder with myriad imaging manifestations, including focal transient myelin vacuolization within the deep gray nuclei, brainstem, and cerebellum-exhibit differences in cortical and subcortical structures, particularly in subcortical regions where these abnormalities manifest. Materials and Methods In this retrospective study, by using clinically obtained three-dimensional T1-weighted MR images and established image analysis methods, 10 intracranial volume-corrected subcortical and 34 cortical regions of interest (ROIs) were quantitatively assessed in 32 patients with NF1 and 245 age- and sex-matched healthy control subjects. By using linear models, ROI cortical thicknesses and volumes were compared between patients with NF1 and control subjects, as a function of age. With hierarchic cluster analysis and partial correlations, differences in the pattern of association between cortical and subcortical ROI volumes in patients with NF1 and control subjects were also evaluated. Results Patients with NF1 exhibited larger subcortical volumes and thicker cortices of select regions, particularly the hippocampi, amygdalae, cerebellar white matter, ventral diencephalon, thalami, and occipital cortices. For the thalami and pallida and 22 cortical ROIs in patients with NF1, a significant inverse association between volume and age was found, suggesting that volumes decrease with increasing age. Moreover, compared with those in control subjects, ROIs in patients with NF1 exhibited a distinct pattern of clustering and partial correlations. Discussion Neurofibromatosis type 1 is characterized by larger subcortical volumes and thicker cortices of select structures. Most apparent within the hippocampi, amygdalae, cerebellar white matter, ventral diencephalon, thalami and occipital cortices, these neurofibromatosis type 1-associated volumetric changes may, in part, be age dependent. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Matthew J Barkovich
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Chin Hong Tan
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Ryan M Nillo
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Yi Li
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Duan Xu
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Christine M Glastonbury
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Orit A Glenn
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - William P Dillon
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Christopher P Hess
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Sabine Mueller
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Cassie Kline
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Anders M Dale
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Terry L Jernigan
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Leo P Sugrue
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - A James Barkovich
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
| | - Rahul S Desikan
- From the Departments of Radiology and Biomedical Imaging (M.J.B., C.H.T., R.M.N., Y.L., D.X., C.M.G., O.A.G., W.P.D., C.P.H., L.P.S., A.J.B., R.S.D.), Pediatrics (S.M., C.K., A.J.B., R.S.D.), and Neurology (S.M., C.K., R.S.D.), University of California, San Francisco, 505 Parnassus Ave, Room L352, San Francisco, CA 94143-0628; and Department of Cognitive Science (A.M.D., T.L.J.), Multimodal Imaging Laboratory (A.M.D.), and Department of Radiology (A.M.D., T.L.J.), University of California, San Diego School of Medicine, La Jolla, Calif
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Tan CH, Kuan LY, K Heng Y, Pan JY, Tee SI, Lim YL, Tan LS. A polymorphous rash of an uncommon blistering disease. Clin Exp Dermatol 2018; 43:839-842. [PMID: 29749071 DOI: 10.1111/ced.13544] [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] [Accepted: 09/29/2017] [Indexed: 11/30/2022]
Affiliation(s)
- C H Tan
- Internal Medicine Department, Tan Tock Seng Hospital, Singapore, Singapore
| | - L Y Kuan
- Dermatology Department, National Skin Centre, Singapore, Singapore
| | - Y K Heng
- Dermatology Department, National Skin Centre, Singapore, Singapore
| | - J Y Pan
- Dermatology Department, National Skin Centre, Singapore, Singapore
| | - S I Tee
- Dermatology Department, National Skin Centre, Singapore, Singapore
| | - Y L Lim
- Dermatology Department, National Skin Centre, Singapore, Singapore
| | - L S Tan
- Dermatology Department, National Skin Centre, Singapore, Singapore
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Kauppi K, Fan CC, McEvoy LK, Holland D, Tan CH, Chen CH, Andreassen OA, Desikan RS, Dale AM. Combining Polygenic Hazard Score With Volumetric MRI and Cognitive Measures Improves Prediction of Progression From Mild Cognitive Impairment to Alzheimer's Disease. Front Neurosci 2018; 12:260. [PMID: 29760643 PMCID: PMC5937163 DOI: 10.3389/fnins.2018.00260] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/04/2018] [Indexed: 01/18/2023] Open
Abstract
Improved prediction of progression to Alzheimer's Disease (AD) among older individuals with mild cognitive impairment (MCI) is of high clinical and societal importance. We recently developed a polygenic hazard score (PHS) that predicted age of AD onset above and beyond APOE. Here, we used data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) to further explore the potential clinical utility of PHS for predicting AD development in older adults with MCI. We examined the predictive value of PHS alone and in combination with baseline structural magnetic resonance imaging (MRI) data on performance on the Mini-Mental State Exam (MMSE). In survival analyses, PHS significantly predicted time to progression from MCI to AD over 120 months (p = 1.07e-5), and PHS was significantly more predictive than APOE alone (p = 0.015). Combining PHS with baseline brain atrophy score and/or MMSE score significantly improved prediction compared to models without PHS (three-factor model p = 4.28e-17). Prediction model accuracies, sensitivities and area under the curve were also improved by including PHS in the model, compared to only using atrophy score and MMSE. Further, using linear mixed-effect modeling, PHS improved the prediction of change in the Clinical Dementia Rating-Sum of Boxes (CDR-SB) score and MMSE over 36 months in patients with MCI at baseline, beyond both APOE and baseline levels of brain atrophy. These results illustrate the potential clinical utility of PHS for assessment of risk for AD progression among individuals with MCI both alone, or in conjunction with clinical measures of prodromal disease including measures of cognitive function and regional brain atrophy.
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Affiliation(s)
- Karolina Kauppi
- Department of Radiology, University of California, San Diego, La Jolla, CA, United States
- Department of Radiation Sciences, University of Umea, Umea, Sweden
| | - Chun Chieh Fan
- Department of Radiology, University of California, San Diego, La Jolla, CA, United States
- Department of Cognitive Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Linda K. McEvoy
- Department of Radiology, University of California, San Diego, La Jolla, CA, United States
| | - Dominic Holland
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
| | - Chin Hong Tan
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Chi-Hua Chen
- Department of Radiology, University of California, San Diego, La Jolla, CA, United States
| | - Ole A. Andreassen
- NORMENT, Institute of Clinical Medicine, Division of Mental Health and Addiction, University of Oslo, Oslo University Hospital, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Rahul S. Desikan
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Anders M. Dale
- Department of Radiology, University of California, San Diego, La Jolla, CA, United States
- Department of Cognitive Sciences, University of California, San Diego, La Jolla, CA, United States
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
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Baladés N, Sales DL, Herrera M, Tan CH, Liu Y, Richards RD, Molina SI. Analysis of Bi Distribution in Epitaxial GaAsBi by Aberration-Corrected HAADF-STEM. Nanoscale Res Lett 2018; 13:125. [PMID: 29696397 PMCID: PMC5918147 DOI: 10.1186/s11671-018-2530-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 04/16/2018] [Indexed: 06/08/2023]
Abstract
The Bi content in GaAs/GaAs1 - xBi x /GaAs heterostructures grown by molecular beam epitaxy at a substrate temperature close to 340 °C is investigated by aberration-corrected high-angle annular dark-field techniques. The analysis at low magnification of high-angle annular dark-field scanning transmission electron microscopy images, corroborated by EDX analysis, revealed planar defect-free layers and a non-homogeneous Bi distribution at the interfaces and within the GaAsBi layer. At high magnification, the qHAADF analysis confirmed the inhomogeneous distribution and Bi segregation at the GaAsBi/GaAs interface at low Bi flux and distorted dumbbell shape in areas with higher Bi content. At higher Bi flux, the size of the Bi gathering increases leading to roughly equiaxial Bi-rich particles faceted along zinc blende {111} and uniformly dispersed around the matrix and interfaces. FFT analysis checks the coexistence of two phases in some clusters: a rhombohedral pure Bi (rh-Bi) one surrounded by a zinc blende GaAs1 - xBi x matrix. Clusters may be affecting to the local lattice relaxation and leading to a partially relaxed GaAsBi/GaAs system, in good agreement with XRD analysis.
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Affiliation(s)
- N Baladés
- Department of Material Science, Metallurgical Engineering and Inorganic Chemistry, University of Cádiz, Campus Río San Pedro, 11510, Puerto Real, Cádiz, Spain.
- Instituto Universitario de Investigación en Microscopía Electrónica y Materiales (IMEYMAT). Facultad de Ciencias. Universidad de Cádiz, Campus Río San Pedro s/n. 11510 Puerto Real, Cádiz, Spain.
| | - D L Sales
- Department of Material Science, Metallurgical Engineering and Inorganic Chemistry, University of Cádiz, Campus Río San Pedro, 11510, Puerto Real, Cádiz, Spain
- Instituto Universitario de Investigación en Microscopía Electrónica y Materiales (IMEYMAT). Facultad de Ciencias. Universidad de Cádiz, Campus Río San Pedro s/n. 11510 Puerto Real, Cádiz, Spain
| | - M Herrera
- Department of Material Science, Metallurgical Engineering and Inorganic Chemistry, University of Cádiz, Campus Río San Pedro, 11510, Puerto Real, Cádiz, Spain
- Instituto Universitario de Investigación en Microscopía Electrónica y Materiales (IMEYMAT). Facultad de Ciencias. Universidad de Cádiz, Campus Río San Pedro s/n. 11510 Puerto Real, Cádiz, Spain
| | - C H Tan
- Department of Electronic and Electrical Engineering, University of Sheffield, S3 7HQ, Sheffield, UK
| | - Y Liu
- Department of Electronic and Electrical Engineering, University of Sheffield, S3 7HQ, Sheffield, UK
| | - R D Richards
- Department of Electronic and Electrical Engineering, University of Sheffield, S3 7HQ, Sheffield, UK
| | - S I Molina
- Department of Material Science, Metallurgical Engineering and Inorganic Chemistry, University of Cádiz, Campus Río San Pedro, 11510, Puerto Real, Cádiz, Spain
- Instituto Universitario de Investigación en Microscopía Electrónica y Materiales (IMEYMAT). Facultad de Ciencias. Universidad de Cádiz, Campus Río San Pedro s/n. 11510 Puerto Real, Cádiz, Spain
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Tan CH, Desikan RS. Interpreting Alzheimer disease polygenic scores. Ann Neurol 2018; 83:443-445. [PMID: 29394507 DOI: 10.1002/ana.25164] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 12/12/2017] [Accepted: 01/28/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Chin Hong Tan
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco San Francisco, CA
| | - Rahul S Desikan
- Neuroradiology Section, Department of Radiology and Biomedical Imaging and Department of Neurology, University of California, San Francisco San Francisco, CA
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Tan CH, Fan CC, Mormino EC, Sugrue LP, Broce IJ, Hess CP, Dillon WP, Bonham LW, Yokoyama JS, Karch CM, Brewer JB, Rabinovici GD, Miller BL, Schellenberg GD, Kauppi K, Feldman HA, Holland D, McEvoy LK, Hyman BT, Bennett DA, Andreassen OA, Dale AM, Desikan RS. Polygenic hazard score: an enrichment marker for Alzheimer's associated amyloid and tau deposition. Acta Neuropathol 2018; 135:85-93. [PMID: 29177679 DOI: 10.1007/s00401-017-1789-4] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [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] [Received: 09/20/2017] [Revised: 11/10/2017] [Accepted: 11/10/2017] [Indexed: 01/19/2023]
Abstract
There is an urgent need for identifying nondemented individuals at the highest risk of progressing to Alzheimer's disease (AD) dementia. Here, we evaluated whether a recently validated polygenic hazard score (PHS) can be integrated with known in vivo cerebrospinal fluid (CSF) or positron emission tomography (PET) biomarkers of amyloid, and CSF tau pathology to prospectively predict cognitive and clinical decline in 347 cognitive normal (CN; baseline age range = 59.7-90.1, 98.85% white) and 599 mild cognitively impaired (MCI; baseline age range = 54.4-91.4, 98.83% white) individuals from the Alzheimer's Disease Neuroimaging Initiative 1, GO, and 2. We further investigated the association of PHS with post-mortem amyloid load and neurofibrillary tangles in the Religious Orders Study and Memory and Aging Project (ROSMAP) cohort (N = 485, age at death range = 71.3-108.3). In CN and MCI individuals, we found that amyloid and total tau positivity systematically varies as a function of PHS. For individuals in greater than the 50th percentile PHS, the positive predictive value for amyloid approached 100%; for individuals in less than the 25th percentile PHS, the negative predictive value for total tau approached 85%. High PHS individuals with amyloid and tau pathology showed the steepest longitudinal cognitive and clinical decline, even among APOE ε4 noncarriers. Among the CN subgroup, we similarly found that PHS was strongly associated with amyloid positivity and the combination of PHS and biomarker status significantly predicted longitudinal clinical progression. In the ROSMAP cohort, higher PHS was associated with higher post-mortem amyloid load and neurofibrillary tangles, even in APOE ε4 noncarriers. Together, our results show that even after accounting for APOE ε4 effects, PHS may be useful in MCI and preclinical AD therapeutic trials to enrich for biomarker-positive individuals at highest risk for short-term clinical progression.
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Affiliation(s)
- Chin Hong Tan
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA.
| | - Chun Chieh Fan
- Department of Cognitive Science, University of California, La Jolla, San Diego, CA, USA
| | - Elizabeth C Mormino
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Leo P Sugrue
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Iris J Broce
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Christopher P Hess
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - William P Dillon
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Luke W Bonham
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Jennifer S Yokoyama
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Celeste M Karch
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - James B Brewer
- Department of Neurosciences, University of California, La Jolla, San Diego, CA, USA
- Department of Radiology, University of California, La Jolla, San Diego, CA, USA
- Shiley-Marcos Alzheimer's Disease Research Center, University of California, La Jolla, San Diego, CA, USA
| | - Gil D Rabinovici
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Bruce L Miller
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Gerard D Schellenberg
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Karolina Kauppi
- Department of Radiology, University of California, La Jolla, San Diego, CA, USA
| | - Howard A Feldman
- Department of Neurosciences, University of California, La Jolla, San Diego, CA, USA
| | - Dominic Holland
- Department of Neurosciences, University of California, La Jolla, San Diego, CA, USA
| | - Linda K McEvoy
- Department of Radiology, University of California, La Jolla, San Diego, CA, USA
| | - Bradley T Hyman
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Ole A Andreassen
- NORMENT Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Anders M Dale
- Department of Cognitive Science, University of California, La Jolla, San Diego, CA, USA
- Department of Neurosciences, University of California, La Jolla, San Diego, CA, USA
- Department of Radiology, University of California, La Jolla, San Diego, CA, USA
| | - Rahul S Desikan
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA.
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
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Broce I, Karch CM, Wen N, Fan CC, Wang Y, Tan CH, Kouri N, Ross OA, Höglinger GU, Muller U, Hardy J, Momeni P, Hess CP, Dillon WP, Miller ZA, Bonham LW, Rabinovici GD, Rosen HJ, Schellenberg GD, Franke A, Karlsen TH, Veldink JH, Ferrari R, Yokoyama JS, Miller BL, Andreassen OA, Dale AM, Desikan RS, Sugrue LP. Correction: Immune-related genetic enrichment in frontotemporal dementia: An analysis of genome-wide association studies. PLoS Med 2018; 15:e1002504. [PMID: 29377952 PMCID: PMC5788346 DOI: 10.1371/journal.pmed.1002504] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pmed.1002487.].
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25
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Broce I, Karch CM, Wen N, Fan CC, Wang Y, Hong Tan C, Kouri N, Ross OA, Höglinger GU, Muller U, Hardy J, Momeni P, Hess CP, Dillon WP, Miller ZA, Bonham LW, Rabinovici GD, Rosen HJ, Schellenberg GD, Franke A, Karlsen TH, Veldink JH, Ferrari R, Yokoyama JS, Miller BL, Andreassen OA, Dale AM, Desikan RS, Sugrue LP. Immune-related genetic enrichment in frontotemporal dementia: An analysis of genome-wide association studies. PLoS Med 2018; 15:e1002487. [PMID: 29315334 PMCID: PMC5760014 DOI: 10.1371/journal.pmed.1002487] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 12/05/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Converging evidence suggests that immune-mediated dysfunction plays an important role in the pathogenesis of frontotemporal dementia (FTD). Although genetic studies have shown that immune-associated loci are associated with increased FTD risk, a systematic investigation of genetic overlap between immune-mediated diseases and the spectrum of FTD-related disorders has not been performed. METHODS AND FINDINGS Using large genome-wide association studies (GWASs) (total n = 192,886 cases and controls) and recently developed tools to quantify genetic overlap/pleiotropy, we systematically identified single nucleotide polymorphisms (SNPs) jointly associated with FTD-related disorders-namely, FTD, corticobasal degeneration (CBD), progressive supranuclear palsy (PSP), and amyotrophic lateral sclerosis (ALS)-and 1 or more immune-mediated diseases including Crohn disease, ulcerative colitis (UC), rheumatoid arthritis (RA), type 1 diabetes (T1D), celiac disease (CeD), and psoriasis. We found up to 270-fold genetic enrichment between FTD and RA, up to 160-fold genetic enrichment between FTD and UC, up to 180-fold genetic enrichment between FTD and T1D, and up to 175-fold genetic enrichment between FTD and CeD. In contrast, for CBD and PSP, only 1 of the 6 immune-mediated diseases produced genetic enrichment comparable to that seen for FTD, with up to 150-fold genetic enrichment between CBD and CeD and up to 180-fold enrichment between PSP and RA. Further, we found minimal enrichment between ALS and the immune-mediated diseases tested, with the highest levels of enrichment between ALS and RA (up to 20-fold). For FTD, at a conjunction false discovery rate < 0.05 and after excluding SNPs in linkage disequilibrium, we found that 8 of the 15 identified loci mapped to the human leukocyte antigen (HLA) region on Chromosome (Chr) 6. We also found novel candidate FTD susceptibility loci within LRRK2 (leucine rich repeat kinase 2), TBKBP1 (TBK1 binding protein 1), and PGBD5 (piggyBac transposable element derived 5). Functionally, we found that the expression of FTD-immune pleiotropic genes (particularly within the HLA region) is altered in postmortem brain tissue from patients with FTD and is enriched in microglia/macrophages compared to other central nervous system cell types. The main study limitation is that the results represent only clinically diagnosed individuals. Also, given the complex interconnectedness of the HLA region, we were not able to define the specific gene or genes on Chr 6 responsible for our pleiotropic signal. CONCLUSIONS We show immune-mediated genetic enrichment specifically in FTD, particularly within the HLA region. Our genetic results suggest that for a subset of patients, immune dysfunction may contribute to FTD risk. These findings have potential implications for clinical trials targeting immune dysfunction in patients with FTD.
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Affiliation(s)
- Iris Broce
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, United States of America
| | - Celeste M. Karch
- Department of Psychiatry, Washington University, St. Louis, Missouri, United States of America
| | - Natalie Wen
- Department of Psychiatry, Washington University, St. Louis, Missouri, United States of America
| | - Chun C. Fan
- Department of Cognitive Sciences, University of California, San Diego, La Jolla, California, United States of America
| | - Yunpeng Wang
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Chin Hong Tan
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, United States of America
| | - Naomi Kouri
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Owen A. Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Günter U. Höglinger
- Department of Neurology, Technical University of Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Ulrich Muller
- Institut for Humangenetik, Justus-Liebig-Universität, Giessen, Germany
| | - John Hardy
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, United Kingdom
| | | | - Parastoo Momeni
- Laboratory of Neurogenetics, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, United States of America
| | - Christopher P. Hess
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, United States of America
| | - William P. Dillon
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, United States of America
| | - Zachary A. Miller
- Department of Neurology, University of California, San Francisco, San Francisco, California, United States of America
| | - Luke W. Bonham
- Department of Neurology, University of California, San Francisco, San Francisco, California, United States of America
| | - Gil D. Rabinovici
- Department of Neurology, University of California, San Francisco, San Francisco, California, United States of America
| | - Howard J. Rosen
- Department of Neurology, University of California, San Francisco, San Francisco, California, United States of America
| | - Gerard D. Schellenberg
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Tom H. Karlsen
- Norwegian PSC Research Center, Research Institute of Internal Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Division of Gastroenterology, Institute of Medicine, University of Bergen, Bergen, Norway
- K.G. Jebsen Inflammation Research Centre, Research Institute of Internal Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Jan H. Veldink
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Raffaele Ferrari
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, United Kingdom
| | - Jennifer S. Yokoyama
- Department of Neurology, University of California, San Francisco, San Francisco, California, United States of America
| | - Bruce L. Miller
- Department of Neurology, University of California, San Francisco, San Francisco, California, United States of America
| | - Ole A. Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Anders M. Dale
- Department of Cognitive Sciences, University of California, San Diego, La Jolla, California, United States of America
- Department of Radiology, University of California, San Diego, La Jolla, California, United States of America
- Department of Neurosciences, University of California, San Diego, La Jolla, California, United States of America
| | - Rahul S. Desikan
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, United States of America
- Department of Neurology, University of California, San Francisco, San Francisco, California, United States of America
| | - Leo P. Sugrue
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, United States of America
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Tan CH, Hyman BT, Tan JJX, Hess CP, Dillon WP, Schellenberg GD, Besser LM, Kukull WA, Kauppi K, McEvoy LK, Andreassen OA, Dale AM, Fan CC, Desikan RS. Polygenic hazard scores in preclinical Alzheimer disease. Ann Neurol 2017; 82:484-488. [PMID: 28940650 DOI: 10.1002/ana.25029] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/21/2017] [Accepted: 08/23/2017] [Indexed: 02/04/2023]
Abstract
Identifying asymptomatic older individuals at elevated risk for developing Alzheimer disease (AD) is of clinical importance. Among 1,081 asymptomatic older adults, a recently validated polygenic hazard score (PHS) significantly predicted time to AD dementia and steeper longitudinal cognitive decline, even after controlling for APOE ɛ4 carrier status. Older individuals in the highest PHS percentiles showed the highest AD incidence rates. PHS predicted longitudinal clinical decline among older individuals with moderate to high Consortium to Establish a Registry for Alzheimer's Disease (amyloid) and Braak (tau) scores at autopsy, even among APOE ɛ4 noncarriers. Beyond APOE, PHS may help identify asymptomatic individuals at highest risk for developing Alzheimer neurodegeneration. Ann Neurol 2017;82:484-488.
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Affiliation(s)
- Chin Hong Tan
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA
| | - Bradley T Hyman
- Department of Neurology, Massachusetts General Hospital, Boston, MA
| | - Jacinth J X Tan
- Center for Health and Community, University of California, San Francisco, San Francisco, CA
| | - Christopher P Hess
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA
| | - William P Dillon
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA
| | - Gerard D Schellenberg
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Lilah M Besser
- National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, Seattle, WA
| | - Walter A Kukull
- National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, Seattle, WA
| | - Karolina Kauppi
- Department of Radiology, University of California, San Diego, La Jolla, CA
| | - Linda K McEvoy
- Department of Radiology, University of California, San Diego, La Jolla, CA
| | - Ole A Andreassen
- NORMENT Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Anders M Dale
- Department of Radiology, University of California, San Diego, La Jolla, CA.,Department of Neurosciences, University of California, San Diego, La Jolla, CA.,Department of Cognitive Science, University of California, San Diego, La Jolla, CA
| | - Chun Chieh Fan
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA
| | - Rahul S Desikan
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA.,Department of Neurology, University of California, San Francisco, San Francisco, CA
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Yang YX, Chong MS, Lim WS, Tay L, Yew S, Yeo A, Tan CH. Validity of estimating muscle and fat volume from a single MRI section in older adults with sarcopenia and sarcopenic obesity. Clin Radiol 2017; 72:427.e9-427.e14. [PMID: 28117037 DOI: 10.1016/j.crad.2016.12.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 12/07/2016] [Accepted: 12/15/2016] [Indexed: 01/10/2023]
Affiliation(s)
- Y X Yang
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore.
| | - M S Chong
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore; Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
| | - W S Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
| | - L Tay
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore; Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
| | - S Yew
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore
| | - A Yeo
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore
| | - C H Tan
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
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Tan CH, Low KA, Kong T, Fletcher MA, Zimmerman B, Maclin EL, Chiarelli AM, Gratton G, Fabiani M. Mapping cerebral pulse pressure and arterial compliance over the adult lifespan with optical imaging. PLoS One 2017; 12:e0171305. [PMID: 28234912 PMCID: PMC5325189 DOI: 10.1371/journal.pone.0171305] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 01/19/2017] [Indexed: 12/22/2022] Open
Abstract
Cerebrovascular health is important for maintaining a high level of cognitive performance, not only in old age, but also throughout the lifespan. Recently, it was first demonstrated that diffuse optical imaging measures of pulse amplitude and arterial compliance can provide estimates of cerebral arterial health throughout the cortex, and were associated with age, estimated cardiorespiratory fitness (eCRF), neuroanatomy and cognitive function in older adults (aged 55-87). The current study replicates and extends the original findings using a broader age range (a new adult sample aged 18-75), longer recording periods (360 s), and a more extensive optical montage (1536 channels). These methodological improvements represent a 5-fold increase in recording time and a 4-fold increase in coverage compared to the initial study. Results show that reliability for both pulse amplitude and compliance measures across recording blocks was very high (r(45) = .99 and .75, respectively). Pulse amplitude and pulse pressure were shown to correlate with age across the broader age range. We also found correlations between arterial health and both cortical and subcortical gray matter volumes. Additionally, we replicated the correlations between arterial compliance and age, eCRF, global brain atrophy, and cognitive flexibility. New regional analyses revealed that higher performance on the operation span (OSPAN) working memory task was associated with greater localized arterial compliance in frontoparietal cortex, but not with global arterial compliance. Further, greater arterial compliance in frontoparietal regions was associated with younger age and higher eCRF. These associations were not present in the visual cortex. The current study not only replicates the initial one in a sample including a much wider age range, but also provides new evidence showing that frontoparietal regions may be especially vulnerable to vascular degeneration during brain aging, with potential functional consequences in cognition.
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Affiliation(s)
- Chin Hong Tan
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Kathy A. Low
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Tania Kong
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Mark A. Fletcher
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Benjamin Zimmerman
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Edward L. Maclin
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Antonio M. Chiarelli
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Gabriele Gratton
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Monica Fabiani
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
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Lee CH, Gu HZ, Vellayappan BA, Tan CH. Water as neutral oral contrast agent in abdominopelvic CT: comparing effectiveness with Gastrografin in the same patient. Med J Malaysia 2016; 71:322-327. [PMID: 28087955] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Positive oral contrast is no longer deemed necessary for abdominopelvic computed tomography (CT) scans. Studies have shown water to be an equally effective oral contrast agent. However, to our knowledge no study has compared effectiveness between gastrografin and water in the same patient, which will provide a more objective evaluation of the two oral contrast agents. We aim to make a head-to-head comparison of water as neutral oral contrast (OC) against gastrografin as positive OC for abdominopelvic CT scans in the same patient. METHODS A retrospective review of 206 abdominopelvic CT scans of 103 patients was performed. The scans were reviewed in consensus by two blinded radiologists. The ability to visualise each abdominopelvic organ, contrastassociated artefacts and small bowel wall delineation, was qualitatively scored on a 5-point scale. Each patient had two sets of scores, one with water and another with gastrografin as OC. Paired scores from the two OCs were evaluated by Wilcoxon signed rank test to determine any significant difference in performance between the two OCs for visualisation of abdominopelvic anatomy on CT. RESULTS There was significantly better delineation of duodenal wall (p<0.001) and overall visualisation of the duodenum (p=0.011) using water as OC compared to gastrografin. No statistically significant differences were demonstrated between water and gastrografin for visualisation of the rest of the abdominopelvic organs, walldelineation of the rest small bowel and contrast-associated artefacts. CONCLUSIONS Water can be used in place of gastrografin as oral contrast in abdominopelvic CT without compromising visualization of abdominopelvic organs.
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Affiliation(s)
- C H Lee
- Tan Tock Seng Hospital, Department of Radiology, 11 Jalan Tan Tock Seng, Singapore, 308433 Singapore.
| | - H Z Gu
- Ministry of Health Holdings, Singapore
| | - B A Vellayappan
- National University Hospital, National University Cancer Institute Singapore, Singapore
| | - C H Tan
- Tan Tock Seng Hospital, Department of Radiology, 11 Jalan Tan Tock Seng, Singapore, 308433 Singapore
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Tan CH, Low KA, Schneider-Garces N, Zimmerman B, Fletcher MA, Maclin EL, Chiarelli AM, Gratton G, Fabiani M. Optical measures of changes in cerebral vascular tone during voluntary breath holding and a Sternberg memory task. Biol Psychol 2016; 118:184-194. [PMID: 27235126 PMCID: PMC9906974 DOI: 10.1016/j.biopsycho.2016.05.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 05/20/2016] [Accepted: 05/20/2016] [Indexed: 12/24/2022]
Abstract
The human cerebral vasculature responds to changes in blood pressure and demands for oxygenation via cerebral autoregulation. Changes in cerebrovascular tone (vasoconstriction and vasodilation) also mediate the changes in blood flow measured by the BOLD fMRI signal. This cerebrovascular reactivity is known to vary with age. In two experiments, we demonstrate that cerebral pulse parameters measured using optical imaging can quantify changes in cerebral vascular tone, both globally and locally. In experiment 1, 51 older adults (age range=55-87) performed a voluntary breath-holding task while cerebral pulse amplitude measures were taken. We found significant pulse amplitude variations across breath-holding periods, indicating vasodilation during, and vasoconstriction after breath holding. The breath-holding index (BHI), a measure of cerebrovascular reactivity (CVR) was derived and found to correlate with age. BHI was also correlated with performance in the Modified Mini-Mental Status Examination, even after controlling for age and education. In experiment 2, the same participants performed a Sternberg task, and changes in regional pulse amplitude between high (set-size 6) and low (set-size 2) task loads were compared. Only task-related areas in the fronto-parietal network (FPN) showed significant reduction in pulse amplitude, indicating vasodilation. Non-task-related areas such as the somatosensory and auditory cortices did not show such reductions. Taken together, these experiments suggest that optical pulse parameters can index changes in brain vascular tone both globally and locally, using both physiological and cognitive load manipulations.
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Affiliation(s)
- Chin Hong Tan
- Department of Psychology, University of Illinois at Urbana-Champaign, United States,Beckman Institute, University of Illinois at Urbana-Champaign, United States
| | - Kathy A. Low
- Beckman Institute, University of Illinois at Urbana-Champaign, United States
| | | | - Benjamin Zimmerman
- Beckman Institute, University of Illinois at Urbana-Champaign, United States
| | - Mark A. Fletcher
- Beckman Institute, University of Illinois at Urbana-Champaign, United States
| | - Edward L. Maclin
- Beckman Institute, University of Illinois at Urbana-Champaign, United States
| | | | - Gabriele Gratton
- Department of Psychology, University of Illinois at Urbana-Champaign, United States,Beckman Institute, University of Illinois at Urbana-Champaign, United States
| | - Monica Fabiani
- Department of Psychology, University of Illinois at Urbana-Champaign, United States; Beckman Institute, University of Illinois at Urbana-Champaign, United States.
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Yang YX, Teo SK, Van Reeth E, Tan CH, Tham IWK, Poh CL. A hybrid approach for fusing 4D-MRI temporal information with 3D-CT for the study of lung and lung tumor motion. Med Phys 2016; 42:4484-96. [PMID: 26233178 DOI: 10.1118/1.4923167] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Accurate visualization of lung motion is important in many clinical applications, such as radiotherapy of lung cancer. Advancement in imaging modalities [e.g., computed tomography (CT) and MRI] has allowed dynamic imaging of lung and lung tumor motion. However, each imaging modality has its advantages and disadvantages. The study presented in this paper aims at generating synthetic 4D-CT dataset for lung cancer patients by combining both continuous three-dimensional (3D) motion captured by 4D-MRI and the high spatial resolution captured by CT using the authors' proposed approach. METHODS A novel hybrid approach based on deformable image registration (DIR) and finite element method simulation was developed to fuse a static 3D-CT volume (acquired under breath-hold) and the 3D motion information extracted from 4D-MRI dataset, creating a synthetic 4D-CT dataset. RESULTS The study focuses on imaging of lung and lung tumor. Comparing the synthetic 4D-CT dataset with the acquired 4D-CT dataset of six lung cancer patients based on 420 landmarks, accurate results (average error <2 mm) were achieved using the authors' proposed approach. Their hybrid approach achieved a 40% error reduction (based on landmarks assessment) over using only DIR techniques. CONCLUSIONS The synthetic 4D-CT dataset generated has high spatial resolution, has excellent lung details, and is able to show movement of lung and lung tumor over multiple breathing cycles.
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Affiliation(s)
- Y X Yang
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 637459
| | - S-K Teo
- Institute of High Performance Computing, Agency for Science, Technology and Research, Singapore 138632
| | - E Van Reeth
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 637459
| | - C H Tan
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore 308433
| | - I W K Tham
- Department of Radiation Oncology, National University Cancer Institute, Singapore 119082
| | - C L Poh
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 637459
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Chee KY, Tripathi A, Avasthi A, Chong MY, Xiang YT, Sim K, Kanba S, He YL, Lee MS, Chiu HFK, Yang SY, Kuga H, Udomratn P, Tanra AJ, Maramis MM, Grover S, Mahendran R, Kallivayalil RA, Shen WW, Shinfuku N, Tan CH, Sartorius N. Prescribing Pattern of Antidepressants in Children and Adolescents: Findings from the Research on Asia Psychotropic Prescription Pattern. East Asian Arch Psychiatry 2016; 26:10-17. [PMID: 27086755] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Pharmacotherapy of depression in children and adolescents is complex. In the absence of research into the efficacy and safety of antidepressants in this group of patients, their off-label prescription is common. This paper aimed to illustrate the prescription pattern of antidepressants in children and adolescents from major psychiatric centres in Asia. METHODS The Research on Asia Psychotropic Prescription Pattern on Antidepressants worked collaboratively in 2013 to study the prescription pattern of antidepressants in Asia using a unified research protocol and questionnaire. Forty psychiatric centres from 10 Asian countries / regions participated and 2321 antidepressant prescriptions were analysed. RESULTS A total of 4.7% antidepressant prescriptions were for children and adolescents. Fluoxetine, sertraline, and escitalopram were the most common antidepressants prescribed for children and adolescents. Almost one-third (30.3%) of prescriptions were for diagnoses other than depressive and anxiety disorders. There was less antidepressant polypharmacy and concomitant use of benzodiazepine, but more concomitant use of antipsychotics in children and adolescents compared with adults. CONCLUSION Off-label use of antidepressants in children and adolescents was reported by 40 Asian psychiatric institutions that participated in the study. In-service education and regulatory mechanisms should be reinforced to ensure efficacy and safety of antidepressants in children and adolescents.
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Affiliation(s)
- K Y Chee
- Department of Psychiatry & Mental Health, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - A Tripathi
- Department of Psychiatry, King George's Medical University, Chowk, Lucknow, India
| | - A Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - M Y Chong
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital-Kaohsiung Medical Center and School of Medicine, Chang Gung University, Taiwan
| | - Y T Xiang
- Faculty of Health Sciences, University of Macao, Macao SAR, PR China
| | - K Sim
- Institute of Mental Health, Buangkok View, Buangkok Green Medical Park, Singapore
| | - S Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y L He
- Department of Psychiatric Epidemiology, Shanghai Mental Health Center, Shanghai, PR China
| | - M S Lee
- Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea
| | - H F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, PR China
| | - S Y Yang
- Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan
| | - H Kuga
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - P Udomratn
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - A J Tanra
- Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | - M M Maramis
- Dr Soetomo Hospital-Faculty of Medicine, Airlangga University, Jawa Timur, Indonesia
| | - S Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - R Mahendran
- Department of Psychological Medicine, National University Hospital, Singapore
| | - R A Kallivayalil
- Department of Psychiatry, Pushpagiri Medical College, Thiruvalla, India
| | - W W Shen
- Department of Psychiatry, TMU-Wan Fang Medical Center and School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - N Shinfuku
- Department of Psychiatry, Kobe University, Kobe, Japan
| | - C H Tan
- Department of Pharmacology, National University of Singapore, Singapore
| | - N Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
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Tay L, Ding YY, Leung BP, Ismail NH, Yeo A, Yew S, Tay KS, Tan CH, Chong MS. Sex-specific differences in risk factors for sarcopenia amongst community-dwelling older adults. Age (Dordr) 2015; 37:121. [PMID: 26607157 PMCID: PMC5005859 DOI: 10.1007/s11357-015-9860-3] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 11/17/2015] [Indexed: 06/01/2023]
Abstract
With considerable variation including potential sex-specific differential rate of skeletal muscle loss, identifying modifiable factors for sarcopenia will be pivotal to guide targeted interventions. This study seeks to identify clinical and biological correlates of sarcopenia in community-dwelling older adults, with emphasis on the role of anabolic and catabolic stimuli, and special reference to gender specificity. In this cross-sectional study involving 200 community-dwelling and functionally independent older adults aged ≥50 years, sarcopenia was defined using the Asian Working Group for Sarcopenia criteria. Comorbidities, cognitive and functional performance, physical activity and nutritional status were routinely assessed. Biochemical parameters included haematological indices, lipid panel, vitamin D level, anabolic hormones [insulin-like growth factor-1 (IGF-1), free testosterone (males only)] and catabolic markers [inflammatory markers (interleukin-6, C-reactive protein) and myostatin]. Multiple logistic regression was performed to identify independent predictors for sarcopenia. Age was associated with sarcopenia in both genders. Malnutrition conferred significantly higher odds for sarcopenia in women (OR = 5.71, 95% CI 1.13-28.84.44, p = 0.035) while higher but acceptable range serum triglyceride was protective in men (OR = 0.05, 95% CI 0.00-0.52, p = 0.012). Higher serum myostatin independently associated with higher odds for sarcopenia in men (OR = 1.11, 95% CI 1.00-1.24, p = 0.041). Serum IGF-1 was significantly lower amongst female sarcopenic subjects, with demonstrable trend for protective effect against sarcopenia in multiple regression models, such that each 1 ng/ml increase in IGF-1 was associated with 1% decline in odds of sarcopenia in women (p = 0.095). Our findings support differential pathophysiological mechanisms for sarcopenia that, if corroborated, may have clinical utility in guiding sex-specific targeted interventions for community-dwelling older adults.
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Affiliation(s)
- L Tay
- Department of Geriatric Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore.
| | - Y Y Ding
- Department of Geriatric Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore
| | - B P Leung
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore
- Department of Physiology, National University of Singapore, Singapore, Singapore
| | - N H Ismail
- Department of Geriatric Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
- Department of Continuing and Community Care, Tan Tock Seng Hospital, Singapore, Singapore
| | - A Yeo
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore
| | - S Yew
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore
| | - K S Tay
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore
| | - C H Tan
- Department of Pharmacology, National University of Singapore, Singapore, Singapore
| | - M S Chong
- Department of Geriatric Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore
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Azwa I, Yee I, Hairunisa N, Tan CH, Harun S. P10.03 Anal human papillomavirus (hpv) infection and anal intraepithelial neoplasia (ain) among men who have sex with men (msm) in kuala lumpur, malaysia. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.431] [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: 11/03/2022]
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Azwa I, Yee I, Hairunisa N, Tan CH, Harun S. P17.17 Anal human papillomavirus (hpv) infection and anal intraepithelial neoplasia (ain) among men who have sex with men (msm) in kuala lumpur, malaysia. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.595] [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: 11/03/2022]
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Grover S, Avasthi A, Tripathi A, Tanra AJ, Chee KY, He YL, Chiu HF, Kuga H, Lee MS, Chong MY, Udormatn P, Kanba S, Yang SY, Si TM, Sim K, Tan CH, Shen WW, Xiang YT, Sartorius N, Shinfuku N. Antidepressant Prescription Pattern in the Presence of Medical Co-morbidity: REAP-AD 2013 Study. East Asian Arch Psychiatry 2015; 25:99-107. [PMID: 26429836] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the prescription pattern of antidepressants in patients with medical co-morbidity from major psychiatric centres in Asia. METHODS The Research on Asian Psychotropic Prescription Pattern for Antidepressants (REAP-AD 2013) collected data from 42 psychiatric centres in 10 Asian countries and regions. Antidepressant prescriptions of 2320 patients with various psychiatric disorders were evaluated. Of these, 370 patients who had specified medical co-morbidities formed the study cohort. RESULTS Escitalopram (20%) and mirtazapine (20%) were the most commonly prescribed antidepressants in patients with medical co-morbidity followed by sertraline (16%), trazodone (15%), and paroxetine (12%). Overall, more than half (52%; 247/476) of prescriptions comprised selective serotonin reuptake inhibitors. Slightly less than two-thirds (63%; n = 233) of patients received at least 1 selective serotonin reuptake inhibitor. In addition, 79% of patients were prescribed only 1 antidepressant. The mean number of antidepressants used per patient was 1.25 (standard deviation, 0.56). There were subtle differences in the most preferred antidepressant across medical illnesses such as diabetes mellitus, liver dysfunction, acid peptic disease, and cerebrovascular disease. Differences were also seen in prescription patterns across different countries. CONCLUSION Although selective serotonin reuptake inhibitors formed the bulk of antidepressant prescriptions in the presence of medical co-morbidity, mirtazapine was also commonly used in the presence of medical co-morbidities. Specified medical morbidities do influence the selection of antidepressants.
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Affiliation(s)
- S Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - A Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - A Tripathi
- Department of Psychiatry, King George's Medical University, Chowk, Lucknow, India
| | - A J Tanra
- Department of Psychiatry, Hasanuddin University Faculty of Medicine, Makassar, Sulawesi Selatan, Indonesia
| | - K Y Chee
- Department of Psychiatry and Mental Health, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Y L He
- Department of Psychiatric Epidemiology, Shanghai Mental Health Center, Shanghai, PR China
| | - H Fk Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, PR China
| | - H Kuga
- Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan
| | - M S Lee
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Korea
| | - M Y Chong
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital-Kaohsiung Medical Center and School of Medicine, Chang Gung University, Taiwan
| | - P Udormatn
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - S Kanba
- Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan
| | - S Y Yang
- Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan
| | - T M Si
- Department of Psychiatry, Peking University Institute of Mental Health, Beijing, PR China
| | - K Sim
- Institute of Mental Health, Buangkok View, Buangkok Green Medical Park Singapore, Taipei, Taiwan
| | - C H Tan
- Department of Pharmacology, National University of Singapore, Singapore
| | - W W Shen
- Department of Psychiatry, TMU-Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan
| | - Y T Xiang
- Faculty of Health Sciences, University of Macau, Macao SAR, PR China
| | - N Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
| | - N Shinfuku
- Department of Psychiatry, Kobe University, Kobe, Japan
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Pang SC, Chiang LP, Tan CH, Vythilingam I, Lam-Phua SG, Ng LC. Low efficacy of delthamethrin-treated net against Singapore Aedes aegypti is associated with kdr-type resistance. Trop Biomed 2015; 32:140-150. [PMID: 25801264] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
There has been a worldwide surge in the number and severity of dengue in the past decades. In Singapore, relentless vector control efforts have been put in to control the disease since the 1960's. Space spraying, fogging, chemical treatment and source reduction are some commonly used methodologies for controlling its vectors, particularly Aedes aegypti. Here, as we explored the use of a commercially available delthamethrin-treated net as an alternative strategy and the efficacy of the treated net was found to be limited. Through bioassays and molecular studies, the failure of the treated net to render high mortality rate was found to be associated with the knockdown resistance (kdr) mutation. This is the first report of kdr- mutations in Singapore's Ae. aegypti. At least one point mutation, either homozygous or heterozygous, at amino acid residue V1016G of DIIS6 or F1269C of DIIIS6 was detected in 93% of field strains of Ae. aegypti. Various permutations of wild type and mutant amino acids of the four alleles were found to result in varying degree of survival rate among local field Ae. aegypti when exposed to the deltamethrin treated net. Together with the association of higher survival rate with the presence of both V1016G and F1269C, the data suggest the role of these mutations in the resistance to the deltamethrin. The high prevalence of these mutations were confirmed in a country wide survey where 70% and 72% of the 201 Ae. aegypti analysed possessed the mutations at residues 1016 and 1269 respectively. The highest mutated frequency combination was found to be heterozygous alleles (VG/FC) at both residues 1016 and 1269 (37.8%), followed by homozygous mutation at allele 1269 (24.4%) and homozygous mutation at allele 1016 (22.9%). The kdr- type of resistance among the vector is likely to undermine the effectiveness of pyrethroids treated materials against these mosquitoes.
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Affiliation(s)
- S C Pang
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way #06-05/08, Helios Block, Singapore138667
| | - L P Chiang
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way #06-05/08, Helios Block, Singapore138667
| | - C H Tan
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way #06-05/08, Helios Block, Singapore138667
| | - I Vythilingam
- Parasitology Department, Faculty of medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - S G Lam-Phua
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way #06-05/08, Helios Block, Singapore138667
| | - L C Ng
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way #06-05/08, Helios Block, Singapore138667
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Ting YH, Tan CH, Vu C. Pancreatic cystic lesions and guidelines: a review. Med J Malaysia 2014; 69:203-209. [PMID: 25638232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
No abstract available.
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Affiliation(s)
- Y H Ting
- Tan Tock Seng Hospital, Department of Diagnostic Radiology, 11 Jalan Tan Tock Seng, Singapore 308433.
| | - C H Tan
- Tan Tock Seng Hospital, Department of Diagnostic Radiology, 11 Jalan Tan Tock Seng, Singapore 308433
| | - C Vu
- Tan Tock Seng Hospital, Department of Gastroenterology, 11 Jalan Tan Tock Seng, Singapore 308433
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Lim MC, Tan CH, Cai J, Zheng J, Kow AWC. CT volumetry of the liver: where does it stand in clinical practice? Clin Radiol 2014; 69:887-95. [PMID: 24824973 DOI: 10.1016/j.crad.2013.12.021] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 12/14/2013] [Accepted: 12/17/2013] [Indexed: 02/07/2023]
Abstract
Imaging-based volumetry has been increasingly utilised in current clinical practice to obtain accurate measurements of the liver volume. This is particularly useful prior to major hepatic resection and living donor liver transplantation where the size of the remnant liver and liver graft, respectively, affects procedural success and postoperative mortality and morbidity. The use of imaging-based volumetry, with emphasis on computed tomography, will be reviewed. We will explore the various technical factors that contribute to accurate volumetric measurements, and demonstrate how the accuracies of these techniques are influenced by their methodologies. The strengths and limitations of using anatomical imaging to estimate liver volume will be discussed, in relation to laboratory and functional imaging methods of assessment.
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Affiliation(s)
- M C Lim
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore.
| | - C H Tan
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
| | - J Cai
- School of Computer Engineering, Nanyang Technological University, Block N4 Nanyang Avenue #02a-32, Singapore 639798, Singapore
| | - J Zheng
- School of Computer Engineering, Nanyang Technological University, Block N4 Nanyang Avenue #02a-32, Singapore 639798, Singapore
| | - A W C Kow
- University Surgical Cluster, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore
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Zimmerman B, Sutton BP, Low KA, Fletcher MA, Tan CH, Schneider-Garces N, Li Y, Ouyang C, Maclin EL, Gratton G, Fabiani M. Cardiorespiratory fitness mediates the effects of aging on cerebral blood flow. Front Aging Neurosci 2014; 6:59. [PMID: 24778617 PMCID: PMC3985032 DOI: 10.3389/fnagi.2014.00059] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [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] [Received: 02/15/2014] [Accepted: 03/18/2014] [Indexed: 11/13/2022] Open
Abstract
The brain's vasculature is likely to be subjected to the same age-related physiological and anatomical changes affecting the rest of the cardiovascular system. Since aerobic fitness is known to alleviate both cognitive and volumetric losses in the brain, it is important to investigate some of the possible mechanisms underlying these beneficial changes. Here we investigated the role that estimated cardiorespiratory fitness (eCRF) plays in determining the relationship between aging and cerebral blood flow (CBF) in a group of older adults (ages 55–85). Using arterial spin labeling to quantify CBF, we found that blood flow in the gray matter was positively correlated with eCRF and negatively correlated with age. Subsequent analyses revealed that eCRF fully mediated the effects of age on CBF in the gray matter, but not in the white matter. Additionally, regional measures of CBF were related to regional measures of brain volume. These findings provide evidence that age-related effects on cerebrovascular health and perfusion in older adults are largely influenced by their eCRF levels.
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Affiliation(s)
- Benjamin Zimmerman
- Neuroscience Program, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Bradley P Sutton
- Department of Bioengineering, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Kathy A Low
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Mark A Fletcher
- Neuroscience Program, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Chin Hong Tan
- Department of Psychology, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Nils Schneider-Garces
- Department of Psychology, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Yanfen Li
- Department of Bioengineering, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Cheng Ouyang
- Department of Bioengineering, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Edward L Maclin
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Gabriele Gratton
- Department of Psychology, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Monica Fabiani
- Department of Psychology, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
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Yau TY, Alkandari L, Haaland B, Low W, Tan CH. Is intravenous contrast necessary for detection of clinically significant extracolonic findings in patients undergoing CT colonography? Br J Radiol 2014; 87:20130667. [PMID: 24625066 PMCID: PMC4067030 DOI: 10.1259/bjr.20130667] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 01/20/2014] [Accepted: 02/11/2014] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To determine whether intravenous contrast (IVC) is necessary for detection of extracolonic findings (ECFs) in patients undergoing CT colonography (CTC). METHODS We performed a retrospective review of CT findings in 179 cases of CTC studies performed over 18 months where both pre-contrast (NECT) and post-contrast (CECT) scans were performed in the prone and supine positions, respectively, in the same patients. All ECFs were recorded on a per patient basis and graded according to the colonography reporting and data system classification. RESULTS There was no significant change in E grade for the cohort (p = 0.171) between the NECT and CECT scans. On the CECT scans, additional findings were detected in 49.1% of patients. Overall, there were 27/179 (15.1%) patients graded E3 and 18/179 (10.1%) patients graded E4 on the CECT study. Compared with the NECT study, there was a decrease of 12.9% of patients graded E3 and no change in the number of patients graded E4. CONCLUSION With IVC administration, additional ECFs are detected in nearly half of all patients. However, there was no increase in the number of patients with clinically significant lesions. The risk-benefit ratio of routine IVC administration for CTC in symptomatic patients thus requires further evaluation. ADVANCES IN KNOWLEDGE This study reviews the utility of IVC in CTC and is thus relevant to current clinical practice at many institutions.
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Affiliation(s)
- T Y Yau
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
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Faccenda D, Tan CH, Seraphim A, Duchen MR, Campanella M. IF1 limits the apoptotic-signalling cascade by preventing mitochondrial remodelling. Cell Death Differ 2013; 20:686-97. [PMID: 23348567 PMCID: PMC3619234 DOI: 10.1038/cdd.2012.163] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 10/30/2012] [Accepted: 11/11/2012] [Indexed: 12/15/2022] Open
Abstract
Mitochondrial structure has a central role both in energy conversion and in the regulation of cell death. We have previously shown that IF1 protects cells from necrotic cell death and supports cristae structure by promoting the oligomerisation of the F1Fo-ATPsynthase. As IF1 is upregulated in a large proportion of human cancers, we have here explored its contribution to the progression of apoptosis and report that an increased expression of IF1, relative to the F1Fo-ATPsynthase, protects cells from apoptotic death. We show that IF1 expression serves as a checkpoint for the release of Cytochrome c (Cyt c) and hence the completion of the apoptotic program. We show that the progression of apoptosis engages an amplification pathway mediated by: (i) Cyt c-dependent release of ER Ca(2+), (ii) Ca(2+)-dependent recruitment of the GTPase Dynamin-related protein 1 (Drp1), (iii) Bax insertion into the outer mitochondrial membrane and (iv) further release of Cyt c. This pathway is accelerated by suppression of IF1 and delayed by its overexpression. IF1 overexpression is associated with the preservation of mitochondrial morphology and ultrastructure, consistent with a central role for IF1 as a determinant of the inner membrane architecture and with the role of mitochondrial ultrastructure in the regulation of Cyt c release. These data suggest that IF1 is an antiapoptotic and potentially tumorigenic factor and may be a valuable predictor of responsiveness to chemotherapy.
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Affiliation(s)
- D Faccenda
- Department of Comparative Biomedical Sciences, The Royal Veterinary College, University of London, London, UK
| | - C H Tan
- Department of Cell and Developmental Biology and Consortium for Mitochondrial Research (CfMR), University College London, London, UK
| | - A Seraphim
- Department of Cell and Developmental Biology and Consortium for Mitochondrial Research (CfMR), University College London, London, UK
| | - M R Duchen
- Department of Cell and Developmental Biology and Consortium for Mitochondrial Research (CfMR), University College London, London, UK
| | - M Campanella
- Department of Comparative Biomedical Sciences, The Royal Veterinary College, University of London, London, UK
- Department of Cell and Developmental Biology and Consortium for Mitochondrial Research (CfMR), University College London, London, UK
- European Brain Research Institute (EBRI), Rome, Italy
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Tan CH, Leong MK, Ng FH. A novel sodium-dependent uptake system for l-leucine in rat brain synaptosomes. Neurochem Int 2012; 12:91-5. [PMID: 20501208 DOI: 10.1016/0197-0186(88)90153-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/1987] [Accepted: 09/07/1987] [Indexed: 10/27/2022]
Abstract
A novel Na(+)-dependent system for the uptake of l-leucine by rat brain synaptosomes is described. At a constant osmolarity of 270 mOsm/L, it functions optimally at a Na(+) concentration of 10 mM. This system is determined by measuring the difference in leucine uptake in the presence and absence of Na(+) as well as by measuring the residual uptake of leucine in the presence of an excess amount of 2-aminobicyclo-(2,2,1)-heptane-2-carboxylic acid in a Na(+) -containing medium. Mg(2+) is found to enhance leucine uptake in the presence and absence of Na(+). However, its presence in the incubation medium reduces net leucine uptake rates due to Na(+) and also alters K(m) and V(max) values for the Na(+) -dependent uptake system.
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Affiliation(s)
- C H Tan
- Department of Biochemistry, Faculty of Medicine, National University of Singapore, 10 Kent Ridge Crescent, Singapore 0511, Republic of Singapore
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Lim AYN, Shen L, Tan CH, Lateef A, Lau TC, Teng GG. Achieving treat to target in gout: a clinical practice improvement project. Scand J Rheumatol 2012; 41:450-7. [DOI: 10.3109/03009742.2012.689325] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Chua HC, Chan LL, Chee KS, Chen YH, Chin SA, Chua PLW, Fones SLC, Fung D, Khoo CL, Kwek SKD, Lim ECL, Ling J, Poh P, Sim K, Tan BL, Tan CH, Tan LL, Tan YHC, Tay WK, Yeo C, Su HCA. Ministry of Health clinical practice guidelines: depression. Singapore Med J 2012; 53:137-144. [PMID: 22337190] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The Ministry of Health (MOH) have updated the clinical practice guidelines on Depression to provide doctors and patients in Singapore with evidence-based treatment for depression. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on Depression, for the information of readers of the Singapore Medical Journal. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/home/Publications/guidelines/cpg/2012/depression.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
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Affiliation(s)
- H C Chua
- Alexandra Hospital/Jurong Health Services, Singapore
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Verma S, Chan LL, Chee KS, Chen H, Chin SA, Chong SA, Chua W, Fones C, Fung D, Khoo CL, Kwek SKD, Ling J, Poh P, Sim K, Tan BL, Tan C, Tan CH, Tan LL, Tay WK. Ministry of Health clinical practice guidelines: schizophrenia. Singapore Med J 2011; 52:521-526. [PMID: 21808964] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The Ministry of Health (MOH) has updated the clinical practice guidelines on Schizophrenia to provide doctors and patients in Singapore with evidence-based treatment for schizophrenia. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on Schizophrenia, for the information of readers of the Singapore Medical Journal. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov. sg/mohcorp/publications.aspx?id=26138. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
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Affiliation(s)
- S Verma
- Ang Mo Kio Polyclinic, Singapore.
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Chow J, Tan CH, Ong SH, Goh YS, Gan HW, Tan VH, Chai SC. Transradial percutaneous coronary intervention in acute ST elevation myocardial infarction and high-risk patients: experience in a single centre without cardiothoracic surgical backup. Singapore Med J 2011; 52:257-262. [PMID: 21552786] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Primary transradial percutaneous coronary intervention (TRI) is shown to be efficacious in stable patients with acute coronary syndrome. We aimed to evaluate the application of primary TRI for acute ST elevation myocardial infarction (STEMI), including among high-risk patients from our registry. METHODS This was a single-centre case series comprising 138 patients who underwent primary TRI for STEMI between May 2007 and June 2008. TRI was attempted with a 6-Fr guiding catheter in all patients regardless of Killip class status. Outcome measures were success rates of primary TRI, door-to-balloon time, procedure duration and volume of contrast used. All patients were followed up for major adverse cardiac events in-hospital, at 30 days and six months. RESULTS A total of 138 patients had primary TRI attempted for STEMI. Four patients failed primary TRI and required a femoral approach. The remaining 134 patients underwent primary TRI. The mean patient age was 56.4 years. Most patients with acute STEMI presented in Killip class I and II (91.8 percent). Only 8.2 percent were in Killip class III or IV on admission. 50 percent of patients presented with anterior STEMI. The median door-to-balloon time for this group was 92 (interquartile range [IQR] 77-121) minutes, with a median procedure time of 39 (IQR 29-51) minutes. The success rate of primary TRI was 97.1 percent. CONCLUSION Success rate, procedural and radiation time for TRI are comparable to those achieved via the femoral approach. Primary TRI is therefore a feasible and effective approach for acute STEMI, even in high-risk patients.
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Affiliation(s)
- J Chow
- Department of Cardiology, Changi General Hospital, 2 Simei Street 3, Singapore 529889
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Abstract
Mesenteric desmoid tumour (MDT) is an uncommon neoplasm that typically presents as a solid soft-tissue mass on cross-sectional imaging. MDT manifesting as a fat-containing cystic mass on CT has not been described in the literature. We report such an unusual case with clinicopathological correlation.
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Affiliation(s)
- C H Tan
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore.
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Tan CH, Sim SM, Gnanathasan CA, Fung SY, Ponnudurai G, Pailoor J, Tan NH. Enzymatic and toxinological activities of Hypnale hypnale (hump-nosed pit viper) venom and its fractionation by ion exchange high performance liquid chromatography. J Venom Anim Toxins Incl Trop Dis 2011. [DOI: 10.1590/s1678-91992011000400015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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