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Lau EPM, Ing M, Vekaria S, Tan AL, Charlesworth C, Fysh E, Shrestha R, Yap ELC, Smith NA, Kwan BCH, Saghaie T, Roy B, Goddard J, Muruganandan S, Badiei A, Nguyen P, Hamid MFA, George V, Fitzgerald D, Maskell N, Feller-Kopman D, Murray K, Chakera A, Lee YCG. Australasian Malignant PLeural Effusion (AMPLE)-4 trial: study protocol for a multi-centre randomised trial of topical antibiotics prophylaxis for infections of indwelling pleural catheters. Trials 2024; 25:249. [PMID: 38594766 PMCID: PMC11005276 DOI: 10.1186/s13063-024-08065-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/18/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Malignant pleural effusion (MPE) is a debilitating condition as it commonly causes disabling breathlessness and impairs quality of life (QoL). Indwelling pleural catheter (IPC) offers an effective alternative for the management of MPE. However, IPC-related infections remain a significant concern and there are currently no long-term strategies for their prevention. The Australasian Malignant PLeural Effusion (AMPLE)-4 trial is a multicentre randomised trial that evaluates the use of topical mupirocin prophylaxis (vs no mupirocin) to reduce catheter-related infections in patients with MPE treated with an IPC. METHODS A pragmatic, multi-centre, open-labelled, randomised trial. Eligible patients with MPE and an IPC will be randomised 1:1 to either regular topical mupirocin prophylaxis or no mupirocin (standard care). For the interventional arm, topical mupirocin will be applied around the IPC exit-site after each drainage, at least twice weekly. Weekly follow-up via phone calls or in person will be conducted for up to 6 months. The primary outcome is the percentage of patients who develop an IPC-related (pleural, skin, or tract) infection between the time of catheter insertion and end of follow-up period. Secondary outcomes include analyses of infection (types and episodes), hospitalisation days, health economics, adverse events, and survival. Subject to interim analyses, the trial will recruit up to 418 participants. DISCUSSION Results from this trial will determine the efficacy of mupirocin prophylaxis in patients who require IPC for MPE. It will provide data on infection rates, microbiology, and potentially infection pathways associated with IPC-related infections. ETHICS AND DISSEMINATION Sir Charles Gairdner and Osborne Park Health Care Group Human Research Ethics Committee has approved the study (RGS0000005920). Results will be published in peer-reviewed journals and presented at scientific conferences. TRIAL REGISTRATION Australia New Zealand Clinical Trial Registry ACTRN12623000253606. Registered on 9 March 2023.
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Affiliation(s)
- Estee P M Lau
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Matthew Ing
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, Australia
- Medical School, Faculty of Health & Medical Sciences, University of Western Australia, Perth, Australia
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Sona Vekaria
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia
- Department of Pharmacy, Sir Charles Gairdner Hospital, Perth, Australia
| | - Ai Ling Tan
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, Australia
| | - Chloe Charlesworth
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Edward Fysh
- Medical School, Faculty of Health & Medical Sciences, University of Western Australia, Perth, Australia
- Department of Respiratory Medicine, St John of God Hospital Midland, Perth, Australia
- Curtin University Medical School, Perth, Australia
| | - Ranjan Shrestha
- Department of Respiratory Medicine, Fiona Stanley Hospital, Perth, Australia
| | - Elaine L C Yap
- Department of Respiratory Medicine, Middlemore Hospital, Auckland, New Zealand
| | - Nicola A Smith
- Department of Respiratory Medicine, Wellington Regional Hospital, Wellington, New Zealand
| | - Benjamin C H Kwan
- Department of Respiratory and Sleep Medicine, The Sutherland Hospital, Sydney, Australia
- University of New South Wales, Sydney, Australia
| | - Tajalli Saghaie
- Department of Respiratory Medicine, Concord Repatriation General Hospital, Concord, NSW, Australia
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Bapti Roy
- Department of Respiratory and Sleep Medicine, Westmead Hospital, Sydney, Australia
| | - John Goddard
- Department of Respiratory Medicine, Sunshine Coast University Hospital, Birtinya, QLD, Australia
- Griffith University, Brisbane, QLD, Australia
| | | | - Arash Badiei
- Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia
- Adelaide Medical School, Faculty of Health and Medical Science, University of Adelaide, Adelaide, SA, Australia
| | - Phan Nguyen
- Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia
- Adelaide Medical School, Faculty of Health and Medical Science, University of Adelaide, Adelaide, SA, Australia
| | | | - Vineeth George
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| | - Deirdre Fitzgerald
- Department of Respiratory Medicine, Tallaght University Hospital, Dublin, Ireland
| | - Nick Maskell
- Academic Respiratory Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | - David Feller-Kopman
- Department of Medicine, Section of Pulmonary and Critical Care Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Aron Chakera
- Medical School, Faculty of Health & Medical Sciences, University of Western Australia, Perth, Australia
- Renal Unit, Sir Charles Gairdner Hospital, Perth, Australia
| | - Y C Gary Lee
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, Australia.
- Medical School, Faculty of Health & Medical Sciences, University of Western Australia, Perth, Australia.
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia.
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Ferguson S, Jones A, Murray K, Andrew R, Schwessinger B, Borevitz JO. Plant genome evolution in the genus Eucalyptus driven by structural rearrangements that promote sequence divergence. Genome Res 2024:gr.277999.123. [PMID: 38589251 DOI: 10.1101/gr.277999.123] [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] [Received: 04/19/2023] [Accepted: 03/22/2024] [Indexed: 04/10/2024]
Abstract
Genomes have a highly organized architecture (nonrandom organization of functional and nonfunctional genetic elements within chromosomes) that is essential for many biological functions, particularly, gene expression and reproduction. Despite the need to conserve genome architecture, a high level of structural variation has been observed within species. As species separate and diverge, genome architecture also diverges, becoming increasingly poorly conserved as divergence time increases. However, within plant genomes, the processes of genome architecture divergence are not well described. Here we use long-read sequencing and de novo assembly of 33 phylogenetically diverse, wild and naturally evolving Eucalyptus species, covering 1-50 million years of diverging genome evolution to measure genome architectural conservation and describe architectural divergence. The investigation of these genomes revealed that following lineage divergence genome architecture is highly fragmented by rearrangements. As genomes continue to diverge, the accumulation of mutations and subsequent divergence beyond recognition of rearrangements becomes the primary driver of genome divergence. The loss of syntenic regions also contribute to genome divergence, but at a slower pace than rearrangements. We hypothesise that duplications and translocations are potentially the greatest contributors to Eucalyptus genome divergence.
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Trentino KM, Murray K, Shander A. Anemia or Transfusion: Getting to the Heart of the Issue. Anesth Analg 2024; 138:725-727. [PMID: 38489791 DOI: 10.1213/ane.0000000000006779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Affiliation(s)
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Aryeh Shander
- Department of Anesthesiology, Critical Care and Hyperbaric Medicine, TeamHealth, Englewood Health, Englewood, New Jersey
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Schultz CJ, Dalgaard F, Bellinge JW, Murray K, Sim M, Connolly E, Blekkenhorst LC, Bondonno CP, Lewis JR, Gislason GH, Tjønneland A, Overvad K, Hodgson JM, Bondonno NP. Dietary Vitamin K 1 Intake and Incident Aortic Valve Stenosis. Arterioscler Thromb Vasc Biol 2024; 44:513-521. [PMID: 38152887 DOI: 10.1161/atvbaha.123.320271] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/30/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Leaflet calcification contributes to the development and progression of aortic valve stenosis. Vitamin K activates inhibitors of vascular calcification and may modulate inflammation and skeletal bone loss. Therefore, we aimed to determine whether higher dietary intakes of vitamin K1 are associated with a lower incidence of aortic stenosis. METHODS In the Danish Diet, Cancer and Health study, participants aged 50 to 64 years completed a 192-item food frequency questionnaire at baseline, from which habitual intakes of vitamin K1 were estimated. Participants were prospectively followed using linkage to nationwide registers to determine incident aortic valve stenosis (primary outcome) and aortic stenosis with subsequent complications (aortic valve replacement, heart failure, or cardiovascular disease-related mortality; secondary outcome). RESULTS In 55 545 participants who were followed for a maximum of 21.5 years, 1085 were diagnosed with aortic stenosis and 615 were identified as having subsequent complications. Participants in the highest quintile of vitamin K1 intake had a 23% lower risk of aortic stenosis (hazard ratio, 0.77 [95% CI, 0.63-0.94]) and a 27% lower risk of aortic stenosis with subsequent complications (hazard ratio, 0.73 [95% CI, 0.56-0.95]), compared with participants in the lowest quintile after adjusting for demographics and cardiovascular risk factors. CONCLUSIONS In this study, a high intake of vitamin K1-rich foods was associated with a lower incidence of aortic stenosis and a lower risk of aortic stenosis with subsequent complications.
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Affiliation(s)
- Carl J Schultz
- School of Medicine (C.J.S., J.W.B., M.S., C.P.B., J.R.L., J.M.H.), University of Western Australia
- Department of Cardiology, Royal Perth Hospital, Australia (C.J.S., J.W.B.)
| | - Frederik Dalgaard
- Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark (F.D., G.H.G.)
| | - Jamie W Bellinge
- School of Medicine (C.J.S., J.W.B., M.S., C.P.B., J.R.L., J.M.H.), University of Western Australia
- Department of Cardiology, Royal Perth Hospital, Australia (C.J.S., J.W.B.)
| | - Kevin Murray
- Department of Cardiology, Royal Perth Hospital, Australia (C.J.S., J.W.B.)
| | - Marc Sim
- School of Medicine (C.J.S., J.W.B., M.S., C.P.B., J.R.L., J.M.H.), University of Western Australia
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia (M.S., E.C., L.C.B., C.P.B., J.R.L., J.M.H., N.P.B.)
| | - Emma Connolly
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia (M.S., E.C., L.C.B., C.P.B., J.R.L., J.M.H., N.P.B.)
| | - Lauren C Blekkenhorst
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia (M.S., E.C., L.C.B., C.P.B., J.R.L., J.M.H., N.P.B.)
| | - Catherine P Bondonno
- School of Medicine (C.J.S., J.W.B., M.S., C.P.B., J.R.L., J.M.H.), University of Western Australia
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia (M.S., E.C., L.C.B., C.P.B., J.R.L., J.M.H., N.P.B.)
| | - Joshua R Lewis
- School of Medicine (C.J.S., J.W.B., M.S., C.P.B., J.R.L., J.M.H.), University of Western Australia
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia (M.S., E.C., L.C.B., C.P.B., J.R.L., J.M.H., N.P.B.)
- Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, NSW, Australia (J.R.L.)
| | - Gunnar H Gislason
- Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark (F.D., G.H.G.)
- National Institute of Public Health, University of Southern Denmark, Odense (G.H.G.)
- Danish Heart Foundation, Copenhagen, Denmark (G.H.G.)
| | - Anne Tjønneland
- Danish Cancer Institute, Copenhagen, Denmark (A.T., N.P.B.)
- Department of Public Health, University of Copenhagen, Denmark (A.T.)
| | - Kim Overvad
- Department of Public Health, Aarhus University, Denmark (K.O.)
| | - Jonathan M Hodgson
- School of Medicine (C.J.S., J.W.B., M.S., C.P.B., J.R.L., J.M.H.), University of Western Australia
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia (M.S., E.C., L.C.B., C.P.B., J.R.L., J.M.H., N.P.B.)
| | - Nicola P Bondonno
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia (M.S., E.C., L.C.B., C.P.B., J.R.L., J.M.H., N.P.B.)
- Danish Cancer Institute, Copenhagen, Denmark (A.T., N.P.B.)
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Adams EK, Murray K, Trost SG, Christian H. Longitudinal effects of dog ownership, dog acquisition, and dog loss on children's movement behaviours: findings from the PLAYCE cohort study. Int J Behav Nutr Phys Act 2024; 21:7. [PMID: 38287372 PMCID: PMC10826268 DOI: 10.1186/s12966-023-01544-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/30/2023] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION Regular physical activity is important for children's physical and mental health, yet many children do not achieve recommended amounts of physical activity. Dog ownership has been associated with increased physical activity in children, however, there have been no longitudinal studies examining this relationship. This study used data from the Play Spaces and Environments for Children's Physical Activity (PLAYCE) cohort study to examine the longitudinal effects of dog ownership status on children's movement behaviours. METHODS Change in dog ownership from preschool (wave 1, age 2-5) to fulltime school (wave 2, age 5-7) was used as a natural experiment with four distinct dog ownership groups: continuing non-dog owners (n = 307), continuing dog owners (n = 204), dog acquired (n = 58), and dog loss (n = 31; total n = 600). Daily movement behaviours, including physical activity, sedentary time, sleep, and screen time, were measured using accelerometry and parent-report surveys. Differences between groups over time and by sex were tested using linear mixed effects regression models. RESULTS Girls who acquired a dog increased their light intensity activities and games by 52.0 min/day (95%CI 7.9, 96.0) and girls who lost a dog decreased their light intensity activities and games by 62.1 min/day (95%CI -119.3, -4.9) compared to no change among non-dog owners. Girls and boys who acquired a dog increased their unstructured physical activity by 6.8 (95%CI 3.2, 10.3) and 7.1 (95%CI 3.9, 10.3) occasions/week, compared to no changes among non-dog owners. Girls and boys who lost a dog reduced their unstructured physical activity by 10.2 (95%CI -15.0, -5.3) and 7.7 (95%CI -12.0, -3.5) occasions/week. Girls who lost a dog decreased their total physical activity by 46.3 min/day (95%CI -107.5, 14.8) compared to no change among non-dog owners. Continuing dog ownership was typically not associated with movement behaviours. Dog ownership group was not associated with changes in sleep and had mixed associations with screen time. CONCLUSION The positive influence of dog ownership on children's physical activity begins in early childhood and differs by child sex. Further research should examine the specific contributions dog-facilitated physical activity makes to children's overall physical activity, including the intensity and duration of dog walking and play.
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Affiliation(s)
- Emma K Adams
- Telethon Kids Institute, University of Western Australia, 35 Stirling Hwy, Perth, Western Australia, 6009, Australia.
- School of Population and Global Health, University of Western Australia, 35 Stirling Hwy, Perth, Western Australia, 6009, Australia.
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, 35 Stirling Hwy, Perth, Western Australia, 6009, Australia
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Hayley Christian
- Telethon Kids Institute, University of Western Australia, 35 Stirling Hwy, Perth, Western Australia, 6009, Australia
- School of Population and Global Health, University of Western Australia, 35 Stirling Hwy, Perth, Western Australia, 6009, Australia
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O'Farrell R, Maguire S, Moore L, Murray K, Gorman A, Ball E, Riddell C, O'Neill M, Jordan N, O'Shea F, Veale D, Donnelly S, Murphy G, Fitzgerald G. Delivering Care for Pregnant Women with Rheumatic and Musculoskeletal Diseases. Ir Med J 2024; 117:894. [PMID: 38259237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
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George P, Murray K, Christian H. Young children's use of blue spaces and the impact on their health, development and environmental awareness: A qualitative study from parents' perspectives. Health Promot J Austr 2024; 35:45-56. [PMID: 36852565 DOI: 10.1002/hpja.710] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 03/01/2023] Open
Abstract
ISSUE ADDRESSED This study examined how families with young children access and use different types of blue spaces and the health and development benefits, and potential negative effects. METHODS Parents(n = 25) of young children across four coastal communities in Western Australia were recruited via purposive sampling to participate in interviews. A generic qualitative study design grounded in the pragmatism paradigm was utilised. RESULTS Beaches were the most frequently used blue space for families all year around, however families did not necessarily attend their closest beach. This appears due to certain beach features making them more or less attractive for use regardless of the distance from home. Parents perceived blue spaces as health promoting due to the increased physical activity children did in and around these spaces. They also reported blue spaces could be positive for child development, contributing to the development of identity. Blue spaces were also perceived to promote children's environmental awareness and environmentally friendly behaviours. However, blue spaces could also be potentially risky environments for families with young children. CONCLUSIONS The findings highlight blue spaces are an important setting for supporting children's health, development and environmental consciousness. SO WHAT?: It is important to protect natural outdoor environments such as blue spaces for future generations. The findings can be used by governments and policy makers to improve the quality (features and amenities) of blue spaces and positively impact how often families (including those with dogs) use blue spaces and the benefits they experience.
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Affiliation(s)
- Phoebe George
- Telethon Kids Institute, University of Western Australia, Crawley, Australia
- School of Population and Global Health, University of Western Australia, Crawley, Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Crawley, Australia
| | - Hayley Christian
- Telethon Kids Institute, University of Western Australia, Crawley, Australia
- School of Population and Global Health, University of Western Australia, Crawley, Australia
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Robinson T, Dhamrait G, Murray K, Boruff B, Duncan J, Schipperijn J, Christian H. Association between preschooler outdoor play and home yard vegetation as measured by high resolution imagery: Findings from the PLAYCE study. Health Place 2024; 85:103178. [PMID: 38262260 DOI: 10.1016/j.healthplace.2024.103178] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 12/08/2023] [Accepted: 01/15/2024] [Indexed: 01/25/2024]
Abstract
Outdoor play in the home yard is an important source of physical activity for many preschoolers. This study investigated if home yard size and vegetation are related to preschooler outdoor play time. High-resolution remotely sensed data were used to distinguish between types of vegetation coverage in the home yard. Shrub and tree cover, and yard size, were positively associated with outdoor play. Following stratification by socio-economic status (SES - parent education), only tree cover was positively associated with preschooler outdoor play in low SES households. All types of vegetation cover were positively associated with preschooler outdoor play in higher SES households. This study highlights the importance of larger yard sizes and higher levels of vegetation for facilitating outdoor play in preschoolers.
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Affiliation(s)
- Trina Robinson
- Telethon Kids Institute, The University of Western Australia, Northern Entrance, Perth Children's Hospital, 15 Hospital Ave, Nedlands, Western Australia, 6009, Australia.
| | - Gursimran Dhamrait
- Telethon Kids Institute, The University of Western Australia, Northern Entrance, Perth Children's Hospital, 15 Hospital Ave, Nedlands, Western Australia, 6009, Australia; School of Population and Global Health, The University of Western Australia, Clifton St Building, Clifton St, Nedlands, Western Australia, 6009, Australia.
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Clifton St Building, Clifton St, Nedlands, Western Australia, 6009, Australia.
| | - Bryan Boruff
- School of Agriculture and Environment, The University of Western Australia, Crawley, Western Australia, 6009, Australia.
| | - John Duncan
- School of Agriculture and Environment, The University of Western Australia, Crawley, Western Australia, 6009, Australia.
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.
| | - Hayley Christian
- Telethon Kids Institute, The University of Western Australia, Northern Entrance, Perth Children's Hospital, 15 Hospital Ave, Nedlands, Western Australia, 6009, Australia; School of Population and Global Health, The University of Western Australia, Clifton St Building, Clifton St, Nedlands, Western Australia, 6009, Australia.
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Stacey I, Seth R, Nedkoff L, Wade V, Haynes E, Carapetis J, Hung J, Murray K, Bessarab D, Katzenellenbogen J. Excess Deaths Associated with Rheumatic Heart Disease, Australia, 2013-2017. Emerg Infect Dis 2024; 30:146-150. [PMID: 38147069 PMCID: PMC10756360 DOI: 10.3201/eid3001.230905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
During 2013-2017, the mortality rate ratio for rheumatic heart disease among Indigenous versus non-Indigenous persons in Australia was 15.9, reflecting health inequity. Using excess mortality methods, we found that deaths associated with rheumatic heart disease among Indigenous Australians were probably substantially undercounted, affecting accuracy of calculations based solely on Australian Bureau of Statistics data.
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Davies CR, Budgeon CA, Murray K, Hunter M, Knuiman M. The art of aging well: a study of the relationship between recreational arts engagement, general health and mental wellbeing in cohort of Australian older adults. Front Public Health 2023; 11:1288760. [PMID: 38098824 PMCID: PMC10720704 DOI: 10.3389/fpubh.2023.1288760] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/31/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Evidence of the benefits of arts engagement to community wellbeing has been mounting since the 1990s. However, large scale, quantitative, epidemiological studies of the "arts-healthy aging" relationship, or the types of arts older adults voluntarily choose to engage in as part of their everyday life, for enjoyment, entertainment or as a hobby (vs. therapy or interventions) are limited. The aims of this study were to describe older adult recreational arts engagement via the Busselton Healthy Ageing Study (BHAS) cohort, and to determine if there was an association between arts engagement, general health and mental wellbeing. Methods Overall, 2,843 older adults (born 1946-1964) from the BHAS cohort (n = 5,107) who had completed a supplementary arts survey (n = 3,055, 60%) and had data on required variables were included in this study (93% of those eligible). The dependent variable was general health (SF12) and subjective mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale, WEMWBS). The independent variable was hours engaged in recreational arts in the last 12 months. A descriptive analysis followed by a linear regression analysis was conducted. Results The prevalence of recreational arts engagement in the last 12 months was 85% (mean = 132 h/year). Older adults engaged in the arts in a number of ways including attending events (79%), actively participating/making art (40%), as an arts society/club/organization member (20%), by learning about the arts (13%) or by volunteering/working in the arts (non-professional, 11%). When general health was assessed via the SF12, the average physical component score (PCS) was 50.1 (SD 8.9) and the average mental component score (MCS) was 53.6 (SD 8.3). When mental wellbeing was assessed, the average WEMWBS score was 54.9 (SD = 8.6). After adjustment for 12 demographic and lifestyle covariates, it was found that older adults who engaged in any recreational arts in the last 12 months had significantly higher WEMWBS scores and higher SF12 physical component scores than those who did not engage in the arts (0 h/year). Discussion Evidence of an arts-health relationship was found in this study. The suitability of the arts as a population based, healthy aging strategy to influence the mental wellbeing and general health of older adults should be investigated further.
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Affiliation(s)
- Christina R. Davies
- Centre for Arts, Mental Health and Wellbeing WA, School of Allied Health and the School of Humanities, The University of Western Australia, Perth, WA, Australia
| | - Charley A. Budgeon
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Michael Hunter
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
- Busselton Population Medical Research Institute, Busselton, WA, Australia
| | - Matthew Knuiman
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
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Parmenter BH, Pokharel P, Dalgaard F, Murray K, Cassidy A, Bondonno CP, Lewis JR, Kyrø C, Tjønneland A, Overvad K, Hodgson JM, Bondonno NP. Higher Habitual Dietary Intakes of Flavanols and Anthocyanins Differentially Associate with Lower Incidence of Ischemic Stroke Subtypes-A Follow-Up Analysis. J Nutr 2023; 153:3280-3286. [PMID: 37716608 DOI: 10.1016/j.tjnut.2023.09.011] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/22/2023] [Accepted: 09/12/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND We previously reported that habitual consumption of dietary flavanol oligomers + polymers and anthocyanins is associated with a lower risk of ischemic stroke. However, no studies have investigated their relationship with ischemic stroke subtypes. OBJECTIVES In this follow-up analysis, we aimed to examine the association of flavanol oligomers + polymers and anthocyanin intake with ischemic stroke subtypes, including the following: 1) large-artery atherosclerosis, 2) cardioembolism, 3) small-vessel occlusion, 4) other determined etiology, and 5) undetermined etiology. METHODS Participants (n = 55,094) from the Danish Diet, Cancer, and Health Study were followed up for <16 y for first-time ischemic stroke events, which were classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Intakes of flavanol oligomers + polymers and anthocyanins were calculated from food frequency questionnaires using the Phenol-Explorer database, and their relationships with ischemic stroke subtypes were investigated using restricted cubic splines within Cox proportional hazards models. After multivariable adjustment, higher habitual intakes (quintile 5 compared with quintile 1) of flavanol oligomers + polymers and anthocyanins were associated with a lower risk of specific ischemic stroke subtypes, including large-artery atherosclerosis [flavanol oligomers + polymers, hazard ratio {HR} (95% confidence interval {CI}): 0.64 (0.47, 0.87)], cardioembolism [anthocyanins, HR (95% CI): 0.45 (0.25, 0.82)], and small-vessel occlusion [flavanol oligomers + polymers, HR (95% CI): 0.65 (0.54, 0.80); anthocyanins, HR (95% CI): 0.79 (0.64, 0.97)], but not stroke of other determined or undetermined etiology. CONCLUSIONS Higher habitual intakes of flavanols and anthocyanins are differentially associated with a lower risk of ischemic stroke from atherosclerosis and/or cardioembolism but not with other subtypes.
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Affiliation(s)
- Benjamin H Parmenter
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, Australia; Nutrition & Health Innovation Research Institute, Edith Cowan University, Perth, Australia
| | - Pratik Pokharel
- Nutrition & Health Innovation Research Institute, Edith Cowan University, Perth, Australia; The Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Frederik Dalgaard
- Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark; Department of Medicine, Nykøbing Falster Sygehus, Nykøbing Falster, Denmark
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Australia
| | - Aedín Cassidy
- Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
| | - Catherine P Bondonno
- Nutrition & Health Innovation Research Institute, Edith Cowan University, Perth, Australia; Medical School, University of Western Australia, Perth, Australia
| | - Joshua R Lewis
- Nutrition & Health Innovation Research Institute, Edith Cowan University, Perth, Australia; Medical School, University of Western Australia, Perth, Australia; Centre for Kidney Research, School of Public Health, The University of Sydney, Sydney, Australia
| | - Cecilie Kyrø
- The Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Anne Tjønneland
- The Danish Cancer Society Research Centre, Copenhagen, Denmark; Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Jonathan M Hodgson
- Nutrition & Health Innovation Research Institute, Edith Cowan University, Perth, Australia; Medical School, University of Western Australia, Perth, Australia
| | - Nicola P Bondonno
- Nutrition & Health Innovation Research Institute, Edith Cowan University, Perth, Australia; The Danish Cancer Society Research Centre, Copenhagen, Denmark.
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12
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Kong J, Aps J, Naoum S, Lee R, Miranda LA, Murray K, Hartsfield JK, Goonewardene MS. An evaluation of gingival phenotype and thickness as determined by indirect and direct methods. Angle Orthod 2023; 93:675-682. [PMID: 37407506 PMCID: PMC10633790 DOI: 10.2319/081622-573.1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 05/01/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVES To evaluate gingival phenotype (GP) and thickness (GT) using visual, probing, and ultrasound (US) methods and to assess the accuracy and consistency of clinicians to visually identify GP. MATERIALS AND METHODS The GP and GT of maxillary and mandibular anterior teeth in 29 orthodontic patients (mean age 25 ± 7.5 years) were assessed using probing and US by a single examiner. General dentist and dental specialist assessors (n = 104) were shown intraoral photographs of the patients, including six repeated images, and asked to identify the GP via a questionnaire. RESULTS An increasing trend in GT values of thin, medium, and thick biotype probe categories was found, though this was not statistically significant (P = .188). Comparison of probing method to determinations of GT made by US yielded slight agreement (κ = 0.12). Using the visual method, assessors' identification of the second GP determination ranged from poor to moderate agreement (κ = 0.29 to κ = 0.53). CONCLUSIONS The probe method is sufficient in differentiating between different categories of GP. However, further research is required to assess the sensitivity of the probe method in recognizing phenotypes in the most marginal of cases. Assessors using the visual method lack the ability to identify GP accurately and consistently among themselves.
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Affiliation(s)
| | | | | | | | | | | | | | - Mithran S Goonewardene
- Corresponding author: Dr Mithran S. Goonewardene, Orthodontics, Dental School, The University of Western Australia, 17 Monash Avenue, Nedlands 6009, Western Australia, Australia (e-mail: )
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13
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Pokharel P, Bellinge JW, Dalgaard F, Murray K, Sim M, Yeap BB, Connolly E, Blekkenhorst LC, Bondonno CP, Lewis JR, Gislason G, Tjønneland A, Overvad K, Hodgson JM, Schultz C, Bondonno NP. Vitamin K1 Intake and Incident Diabetes in the Danish Diet, Cancer, and Health Study. J Clin Endocrinol Metab 2023; 108:e1253-e1263. [PMID: 37235778 PMCID: PMC10583989 DOI: 10.1210/clinem/dgad293] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/10/2023] [Accepted: 05/22/2023] [Indexed: 05/28/2023]
Abstract
CONTEXT Observational studies have reported lower risks of type 2 diabetes with higher vitamin K1 intake, but these studies overlook effect modification due to known diabetes risk factors. OBJECTIVE To identify subgroups that might benefit from vitamin K1 intake, we examined associations between vitamin K1 intake and incident diabetes overall and in subpopulations at risk of diabetes. METHODS Participants from the prospective cohort, the Danish Diet, Cancer, and Health Study, with no history of diabetes were followed up for diabetes incidence. The association between intake of vitamin K1, estimated from a food frequency questionnaire completed at baseline, and incident diabetes was determined using multivariable-adjusted Cox proportional-hazards models. RESULTS In 54 787 Danish residents with a median (interquartile range) age of 56 (52-60) years at baseline, 6700 individuals were diagnosed with diabetes during 20.8 (17.3-21.6) years of follow-up. Vitamin K1 intake was inversely and linearly associated with incident diabetes (P < .0001). Compared to participants with the lowest vitamin K1 intake (median:57 µg/d), participants with the highest intakes (median:191 µg/d) had a 31% lower risk of diabetes (HR; 95% CI, 0.69; 0.64-0.74) after multivariable adjustments. The inverse association between vitamin K1 intake and incident diabetes was present in all subgroups (namely, men and women, ever and never smokers, low and high physical activity groups, and in participants who were normal to overweight and obese), with differences in absolute risk between subgroups. CONCLUSION Higher intake of foods rich in vitamin K1 was associated with a lower risk of diabetes. If the associations observed are causal, our results indicate that more cases of diabetes would be prevented in subgroups at higher risk (men, smokers, participants with obesity, and those with low physical activity).
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Affiliation(s)
- Pratik Pokharel
- Nutrition and Biomarkers, The Danish Cancer Society Research Center, Copenhagen 2100, Denmark
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia 6000, Australia
| | - Jamie W Bellinge
- Medical School, University of Western Australia, Perth, Western Australia 6009, Australia
- Department of Cardiology, Royal Perth Hospital, Perth, Western Australia 6000, Australia
| | - Frederik Dalgaard
- Department of Medicine, Nykøbing Falster Sygehus, Nykøbing 4800, Denmark
- Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen 2730, Denmark
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Western Australia 6009, Australia
| | - Marc Sim
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia 6000, Australia
- Medical School, University of Western Australia, Perth, Western Australia 6009, Australia
| | - Bu B Yeap
- Medical School, University of Western Australia, Perth, Western Australia 6009, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia 6150, Australia
| | - Emma Connolly
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia 6000, Australia
| | - Lauren C Blekkenhorst
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia 6000, Australia
| | - Catherine P Bondonno
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia 6000, Australia
- Medical School, University of Western Australia, Perth, Western Australia 6009, Australia
| | - Joshua R Lewis
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia 6000, Australia
- Medical School, University of Western Australia, Perth, Western Australia 6009, Australia
- Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia
| | - Gunnar Gislason
- Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen 2730, Denmark
- The National Institute of Public Health, University of Southern Denmark, Odense 5230, Denmark
- The Danish Heart Foundation, Copenhagen 1120, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen 2200, Denmark
| | - Anne Tjønneland
- Diet, Cancer and Health, The Danish Cancer Society Research Center, Copenhagen 2100, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen 1353, Denmark
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus 8000, Denmark
| | - Jonathan M Hodgson
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia 6000, Australia
- Medical School, University of Western Australia, Perth, Western Australia 6009, Australia
| | - Carl Schultz
- Medical School, University of Western Australia, Perth, Western Australia 6009, Australia
- Department of Cardiology, Royal Perth Hospital, Perth, Western Australia 6000, Australia
| | - Nicola P Bondonno
- Nutrition and Biomarkers, The Danish Cancer Society Research Center, Copenhagen 2100, Denmark
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia 6000, Australia
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14
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Marriott RJ, Murray K, Adams RJ, Antonio L, Ballantyne CM, Bauer DC, Bhasin S, Biggs ML, Cawthon PM, Couper DJ, Dobs AS, Flicker L, Handelsman DJ, Hankey GJ, Hannemann A, Haring R, Hsu B, Karlsson M, Martin SA, Matsumoto AM, Mellström D, Ohlsson C, O'Neill TW, Orwoll ES, Quartagno M, Shores MM, Steveling A, Tivesten Å, Travison TG, Vanderschueren D, Wittert GA, Wu FCW, Yeap BB. Factors Associated With Circulating Sex Hormones in Men : Individual Participant Data Meta-analyses. Ann Intern Med 2023; 176:1221-1234. [PMID: 37639720 PMCID: PMC10995451 DOI: 10.7326/m23-0342] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Various factors modulate circulating testosterone in men, affecting interpretation of testosterone measurements. PURPOSE To clarify factors associated with variations in sex hormone concentrations. DATA SOURCES Systematic literature searches (to July 2019). STUDY SELECTION Prospective cohort studies of community-dwelling men with total testosterone measured using mass spectrometry. DATA EXTRACTION Individual participant data (IPD) (9 studies; n = 21 074) and aggregate data (2 studies; n = 4075). Sociodemographic, lifestyle, and health factors and concentrations of total testosterone, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), dihydrotestosterone, and estradiol were extracted. DATA SYNTHESIS Two-stage random-effects IPD meta-analyses found a nonlinear association of testosterone with age, with negligible change among men aged 17 to 70 years (change per SD increase about the midpoint, -0.27 nmol/L [-7.8 ng/dL] [CI, -0.71 to 0.18 nmol/L {-20.5 to 5.2 ng/dL}]) and decreasing testosterone levels with age for men older than 70 years (-1.55 nmol/L [-44.7 ng/dL] [CI, -2.05 to -1.06 nmol/L {-59.1 to -30.6 ng/dL}]). Testosterone was inversely associated with body mass index (BMI) (change per SD increase, -2.42 nmol/L [-69.7 ng/dL] [CI, -2.70 to -2.13 nmol/L {-77.8 to -61.4 ng/dL}]). Testosterone concentrations were lower for men who were married (mean difference, -0.57 nmol/L [-16.4 ng/dL] [CI, -0.89 to -0.26 nmol/L {-25.6 to -7.5 ng/dL}]); undertook at most 75 minutes of vigorous physical activity per week (-0.51 nmol/L [-14.7 ng/dL] [CI, -0.90 to -0.13 nmol/L {-25.9 to -3.7 ng/dL}]); were former smokers (-0.34 nmol/L [-9.8 ng/dL] [CI, -0.55 to -0.12 nmol/L {-15.9 to -3.5 ng/dL}]); or had hypertension (-0.53 nmol/L [-15.3 ng/dL] [CI, -0.82 to -0.24 nmol/L {-23.6 to -6.9 ng/dL}]), cardiovascular disease (-0.35 nmol/L [-10.1 ng/dL] [CI, -0.55 to -0.15 nmol/L {-15.9 to -4.3 ng/dL}]), cancer (-1.39 nmol/L [-40.1 ng/dL] [CI, -1.79 to -0.99 nmol/L {-51.6 to -28.5 ng/dL}]), or diabetes (-1.43 nmol/L [-41.2 ng/dL] [CI, -1.65 to -1.22 nmol/L {-47.6 to -35.2 ng/dL}]). Sex hormone-binding globulin was directly associated with age and inversely associated with BMI. Luteinizing hormone was directly associated with age in men older than 70 years. LIMITATION Cross-sectional analysis, heterogeneity between studies and in timing of blood sampling, and imputation for missing data. CONCLUSION Multiple factors are associated with variation in male testosterone, SHBG, and LH concentrations. Reduced testosterone and increased LH concentrations may indicate impaired testicular function after age 70 years. Interpretation of individual testosterone measurements should account particularly for age older than 70 years, obesity, diabetes, and cancer. PRIMARY FUNDING SOURCE Medical Research Future Fund, Government of Western Australia, and Lawley Pharmaceuticals. (PROSPERO: CRD42019139668).
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Affiliation(s)
- Ross J Marriott
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia (R.J.M., K.M.)
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia (R.J.M., K.M.)
| | - Robert J Adams
- Adelaide Institute for Sleep Health, Flinders University, Bedford Park, South Australia, Australia (R.J.A.)
| | - Leen Antonio
- Laboratory of Clinical and Experimental Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium (L.A., D.V.)
| | | | - Douglas C Bauer
- General Internal Medicine, University of California, San Francisco, San Francisco, California (D.C.B.)
| | - Shalender Bhasin
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (S.B.)
| | - Mary L Biggs
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington (M.L.B.)
| | - Peggy M Cawthon
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California (P.M.C.)
| | - David J Couper
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (D.J.C.)
| | - Adrian S Dobs
- School of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University, Baltimore, Maryland (A.S.D.)
| | - Leon Flicker
- Medical School and Western Australian Centre for Health and Ageing, University of Western Australia, Perth, Western Australia, Australia (L.F.)
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (D.J.H.)
| | - Graeme J Hankey
- Medical School, University of Western Australia, and Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia (G.J.H.)
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, and DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany (A.H.)
| | - Robin Haring
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia, and Faculty of Applied Public Health, European University of Applied Sciences, Rostock, Germany (R.H.)
| | - Benjumin Hsu
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia (B.H.)
| | - Magnus Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden (M.K.)
| | - Sean A Martin
- Australian Institute of Family Studies, Southbank, Victoria, Australia (S.A.M.)
| | - Alvin M Matsumoto
- Department of Medicine, University of Washington School of Medicine, and Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington (A.M.M.)
| | - Dan Mellström
- Centre for Bone and Arthritis Research at the Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Göteborg, Sweden (D.M., C.O.)
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research at the Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Göteborg, Sweden (D.M., C.O.)
| | - Terence W O'Neill
- Centre for Epidemiology Versus Arthritis, University of Manchester and National Institute for Health and Care Research Manchester Biomedical Research Centre, Manchester University National Health Service Foundation Trust, Manchester, United Kingdom (T.W.O.)
| | - Eric S Orwoll
- Oregon Health & Science University, Portland, Oregon (E.S.O.)
| | - Matteo Quartagno
- Medical Research Council Clinical Trials Unit, University College London, London, United Kingdom (M.Q.)
| | - Molly M Shores
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, Washington (M.M.S.)
| | - Antje Steveling
- Department of Internal Medicine, University Medicine Greifswald, Greifswald, Germany (A.S.)
| | - Åsa Tivesten
- Wallenberg Laboratory for Cardiovascular and Metabolic Research, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, and Department of Endocrinology, Sahlgrenska University Hospital, Region Västra Götaland, Göteborg, Sweden (Å.T.)
| | - Thomas G Travison
- Brigham and Women's Hospital and Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts (T.G.T.)
| | - Dirk Vanderschueren
- Laboratory of Clinical and Experimental Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium (L.A., D.V.)
| | - Gary A Wittert
- Freemasons Centre for Male Health & Wellbeing, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia (G.A.W.)
| | - Frederick C W Wu
- Division of Endocrinology, Diabetes & Gastroenterology, School of Medical Sciences, University of Manchester, Manchester, United Kingdom (F.C.W.W.)
| | - Bu B Yeap
- Medical School, University of Western Australia, and Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Western Australia, Perth, Australia (B.B.Y.)
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15
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Peyton MP, Yang TY, Higgins L, Markowski TW, Murray K, Vue C, Parker LL, Lowe DA. Natural aging and ovariectomy induces parallel phosphoproteomic alterations in skeletal muscle of female mice. Aging (Albany NY) 2023; 15:7362-7380. [PMID: 37580837 PMCID: PMC10457050 DOI: 10.18632/aging.204959] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 07/24/2023] [Indexed: 08/16/2023]
Abstract
The loss of skeletal muscle strength mid-life in females is associated with the decline of estrogen. Here, we questioned how estrogen deficiency might impact the overall skeletal muscle phosphoproteome after contraction, as force production induces phosphorylation of several muscle proteins. Phosphoproteomic analyses of the tibialis anterior muscle after contraction in two mouse models of estrogen deficiency, ovariectomy (Ovariectomized (Ovx) vs. Sham) and natural aging-induced ovarian senescence (Older Adult (OA) vs. Young Adult (YA)), identified a total of 2,593 and 3,507 phosphopeptides in Ovx/Sham and OA/YA datasets, respectively. Further analysis of estrogen deficiency-associated proteins and phosphosites identified 66 proteins and 21 phosphosites from both datasets. Of these, 4 estrogen deficiency-associated proteins and 4 estrogen deficiency-associated phosphosites were significant and differentially phosphorylated or regulated, respectively. Comparative analyses between Ovx/Sham and OA/YA using Ingenuity Pathway Analysis (IPA) found parallel patterns of inhibition and activation across IPA-defined canonical signaling pathways and physiological functional analysis, which were similarly observed in downstream GO, KEGG, and Reactome pathway overrepresentation analysis pertaining to muscle structural integrity and contraction, including AMPK and calcium signaling. IPA Upstream regulator analysis identified MAPK1 and PRKACA as candidate kinases and calcineurin as a candidate phosphatase sensitive to estrogen. Our findings highlight key molecular signatures and pathways in contracted muscle suggesting that the similarities identified across both datasets could elucidate molecular mechanisms that may contribute to skeletal muscle strength loss due to estrogen deficiency.
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Affiliation(s)
- Mina P. Peyton
- Department of Rehabilitation Medicine, Division of Rehabilitation Science, University of Minnesota – Twin Cities, Minneapolis, MN 55455, USA
- Department of Computer Science, Bioinformatics and Computational Biology Program, University of Minnesota, Minneapolis, MN 55455, USA
| | - Tzu-Yi Yang
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota – Twin Cities, Minneapolis, MN 55455, USA
| | - LeeAnn Higgins
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota – Twin Cities, Minneapolis, MN 55455, USA
| | - Todd W. Markowski
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota – Twin Cities, Minneapolis, MN 55455, USA
| | - Kevin Murray
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota – Twin Cities, Minneapolis, MN 55455, USA
| | - Cha Vue
- Department of Rehabilitation Medicine, Division of Rehabilitation Science, University of Minnesota – Twin Cities, Minneapolis, MN 55455, USA
| | - Laurie L. Parker
- Department of Computer Science, Bioinformatics and Computational Biology Program, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota – Twin Cities, Minneapolis, MN 55455, USA
| | - Dawn A. Lowe
- Department of Rehabilitation Medicine, Division of Rehabilitation Science, University of Minnesota – Twin Cities, Minneapolis, MN 55455, USA
- Department of Rehabilitation Medicine, Division of Physical Therapy, University of Minnesota – Twin Cities, Minneapolis, MN 55455, USA
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16
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Weber C, Hung J, Briffa T, Li I, Murray K, Hickling S. Unplanned Readmissions and Long-Term Mortality Risk After Incident Heart Failure Hospitalisation in Western Australia, 2001-2015. Heart Lung Circ 2023; 32:958-967. [PMID: 37271618 DOI: 10.1016/j.hlc.2023.04.297] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/14/2023] [Accepted: 04/20/2023] [Indexed: 06/06/2023]
Abstract
AIMS To investigate the frequency and predictors of unplanned readmissions after incident heart failure (HF) hospitalisation and the association between readmissions and mortality over two years. METHODS We performed a retrospective cohort study using Western Australian morbidity and mortality data to identify all patients, aged 25-94 years, who survived an incident (first-ever) HF hospitalisation (principal diagnosis) between 2001-2015. Ordinal logistic regression models determined the covariates independently associated with unplanned readmission(s). Cox proportional hazards models with time-varying exposures determined the hazard ratios (HR) of one or more readmissions for mortality over two years after incident HF. RESULTS Of 18,693 patients, 53.4% male, mean age 74.4 (standard deviation [SD] 13.6) years, 61.3% experienced 32,431 unplanned readmissions (39.7% cardiovascular-related) within two years. Leading readmission causes were HF (19.1%), respiratory diseases (12.6%), and ischaemic heart disease (9.6%). All-cause death occurred in 27.2% of the cohort, and the multivariable-adjusted mortality HR of 1 (versus 0) readmission was 2.5 (95% confidence interval [CI], 2.3-2.7) increasing to 5.0 (95% CI, 4.7-5.4) for 2+ readmissions. The adjusted mortality HR of 1 and 2+ (versus 0) HF-specific readmission was 2.0 (95% CI, 1.8-2.1) and 3.6 (95% CI, 3.2-3.9), respectively. Coexistent cardiovascular and other comorbidities were independently associated with increased readmission and mortality risk. CONCLUSION This study underlines the high burden of recurrent unplanned cardiovascular and other readmissions within two years after incident HF hospitalisation, and their additive adverse impact on mortality. Integrated multidisciplinary management of concomitant comorbidities, in addition to HF-targeted treatments, is necessary to improve long-term prognosis in HF patients.
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Affiliation(s)
- Courtney Weber
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia.
| | - Joseph Hung
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Tom Briffa
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Ian Li
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Siobhan Hickling
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
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17
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Vale SL, Murray K, Netting MJ, O’Sullivan M, Leeb A, Orlemann K, Peters I, Clifford R, Campbell DE, Salter SM. Making a SmartStart for peanut introduction to support food allergy prevention guidelines for infants. J Allergy Clin Immunol Glob 2023; 2:100102. [PMID: 37779522 PMCID: PMC10509985 DOI: 10.1016/j.jacig.2023.100102] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 01/17/2023] [Accepted: 02/02/2023] [Indexed: 10/03/2023]
Abstract
Background Food allergy affects up to 10% of Australian infants. It was hypothesized that if parents follow the Australasian Society of Clinical Immunology and Allergy guidelines, Australian food allergy rates may stabilize or decline. Objective This project aimed to determine whether SmartStartAllergy influenced parental introduction of peanut by age 12 months, including in high-risk infants. Methods SmartStartAllergy integrates with general practice management software to send text messages to parents via participating general practices. The intervention group participants were sent text messages when their child was aged 6, 9, and 12 months; the control group participants were parents of 12-month-old infants. When their child was aged 12 months, all participants completed a questionnaire regarding eczema and family history of atopy. Infants with severe eczema and/or a family history of atopy were considered high-risk. Results Between 21 September 2018 and 26 April 2022, a total of 29,092 parents were enrolled in SmartStartAllergy as intervention (n = 18,090) and control (n = 11,002) group members The intervention group was more likely to introduce peanut by 12 months (crude odds ratio = 5.18; P < .0001; 95% CI = 4.35-6.16). After adjustment for the infants' level of risk and family history of atopy and food allergy, the intervention group was more likely to introduce peanut by 12 months of age (adjusted odds ratio = 5.34; P < .01; 95% CI = 4.48-6.37). Conclusion SmartStartAllergy appears to be an effective tool for encouraging parental introduction of peanut. The ability to provide parents with credible allergy prevention information, along with the capacity to collect simple responses via text along with additional information via an online questionnaire, make this a useful public health tool.
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Affiliation(s)
- Sandra L. Vale
- The University of Western Australia, Perth, Australia
- National Allergy Strategy, Sydney, Australia
- Australasian Society of Clinical Immunology and Allergy, Sydney, Australia
- Centre for Food & Allergy Research, Melbourne, Australia
| | - Kevin Murray
- The University of Western Australia, Perth, Australia
| | - Merryn J. Netting
- National Allergy Strategy, Sydney, Australia
- Australasian Society of Clinical Immunology and Allergy, Sydney, Australia
- Centre for Food & Allergy Research, Melbourne, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Michael O’Sullivan
- The University of Western Australia, Perth, Australia
- Perth Children’s Hospital, Perth, Australia
- Telethon Kids Institute, Perth, Australia
| | - Alan Leeb
- Illawarra Medical Centre, Perth, Australia
- SmartVax, Perth, Australia
| | | | - Ian Peters
- SmartVax, Perth, Australia
- Datavation, Perth, Australia
| | | | - Dianne E. Campbell
- Australasian Society of Clinical Immunology and Allergy, Sydney, Australia
- Centre for Food & Allergy Research, Melbourne, Australia
- Discipline of Child and Adolescent Health, The University of Sydney, Australia
- Allergy & Immunology, Children’s Hospital at Westmead, Sydney, Australia
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Stacey I, Ralph A, de Dassel J, Nedkoff L, Wade V, Francia C, Wyber R, Murray K, Hung J, Katzenellenbogen J. The evidence that rheumatic heart disease control programs in Australia are making an impact. Aust N Z J Public Health 2023; 47:100071. [PMID: 37364309 DOI: 10.1016/j.anzjph.2023.100071] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/16/2022] [Accepted: 02/26/2023] [Indexed: 06/28/2023] Open
Abstract
OBJECTIVE Rheumatic heart disease (RHD) comprises heart-valve damage caused by acute rheumatic fever (ARF). The Australian Government Rheumatic Fever Strategy funds RHD Control Programs to support detection and management of ARF and RHD. We assessed epidemiological changes during the years of RHD Control Program operation. METHODS Linked RHD register, hospital and death data from four Australian jurisdictions were used to measure ARF/RHD outcomes between 2010 and 2017, including: 2-year progression to severe RHD/death; ARF recurrence; secondary prophylaxis delivery and earlier disease detection. RESULTS Delivery of secondary prophylaxis improved from 53% median proportion of days covered (95%CI: 46-61%, 2010) to 70% (95%CI: 71-68%, 2017). Secondary prophylaxis adherence protected against progression to severe RHD/death (hazard ratio 0.2, 95% CI 0.1-0.8). Other measures of program effectiveness (ARF recurrences, progression to severe RHD/death) remained stable. ARF case numbers and concurrent ARF/RHD diagnoses increased. CONCLUSIONS RHD Control Programs have contributed to major success in the management of ARF/RHD through increased delivery of secondary prevention yet ARF case numbers, not impacted by secondary prophylaxis and sensitive to increased awareness/surveillance, increased. IMPLICATIONS FOR PUBLIC HEALTH RHD Control Programs have a major role in delivering cost-effective RHD prevention. Sustained investment is needed but with greatly strengthened primordial and primary prevention.
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Affiliation(s)
- Ingrid Stacey
- School of Population and Global Health, The University of Western Australia, Australia.
| | - Anna Ralph
- Menzies School of Health Research, Charles Darwin University, Australia; Department of Medicine, Royal Darwin Hospital, Australia.
| | - Jessica de Dassel
- Rheumatic heart disease Control Program, Northern Territory Health, Australia.
| | - Lee Nedkoff
- School of Population and Global Health, The University of Western Australia, Australia; Cardiology Population Health Laboratory, Victor Chang Cardiac Research Institute, Australia.
| | - Vicki Wade
- Menzies School of Health Research, Charles Darwin University, Australia; National Heart Foundation of Australia, Australia.
| | - Carl Francia
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia; Department of Physiotherapy, The Prince Charles Hospital, Australia.
| | - Rosemary Wyber
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Australia; Telethon Kids Institute, Australia.
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Australia.
| | - Joseph Hung
- School of Medicine, The University of Western Australia, Australia.
| | - Judith Katzenellenbogen
- School of Population and Global Health, The University of Western Australia, Australia; Telethon Kids Institute, Australia.
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Parmenter BH, Shinde S, Croft K, Murray K, Bondonno CP, Genoni A, Christophersen CT, Bindon K, Kay C, Mena P, Del Rio D, Hodgson JM, Bondonno NP. Performance of Urinary Phenyl-γ-Valerolactones as Biomarkers of Dietary Flavan-3-ol Exposure. J Nutr 2023; 153:2193-2204. [PMID: 37394116 DOI: 10.1016/j.tjnut.2023.06.035] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Phenyl-γ-valerolactones (PVLs) have been identified as biomarkers of dietary flavan-3-ol exposure, although their utility requires further characterization. OBJECTIVES We investigated the performance of a range of PVLs as biomarkers indicative of flavan-3-ol intake. METHODS We report the results of 2 companion studies: a 5-way randomized crossover trial (RCT) and an observational cross-sectional study. In the RCT (World Health Organization, Universal Trial Number: U1111-1236-7988), 16 healthy participants consumed flavan-3-ol-rich interventions (of apple, cocoa, black tea, green tea, or water [control]) for 1 d each. First morning void samples and 24-h urine samples were collected with diet standardized throughout. For each participant, 1 intervention period was extended (to 2 d) to monitor PVL kinetics after repeat exposure. In the cross-sectional study, 86 healthy participants collected 24-h urine samples, and concurrent weighed food diaries from which flavan-3-ol consumption was estimated using Phenol-Explorer. A panel of 10 urinary PVLs was quantified using liquid chromatography tandem mass spectrometry. RESULTS In both studies, 2 urinary PVLs [5-(3'-hydroxyphenyl)-γ-valerolactone-4'-sulfate and putatively identified 5-(4'-hydroxyphenyl)-γ-valerolactone-3'-glucuronide] were the principal compounds excreted (>75%). In the RCT, the sum of these PVLs was significantly higher than the water (control) after each intervention; individually, there was a shift from sulfation toward glucuronidation as the total excretion of PVLs increased across the different interventions. In the extended RCT intervention period, no accumulation of these PVLs was observed after consecutive days of treatment, and after withdrawal of treatment on the third day, there was a return toward negligible PVL excretion. All results were consistent, whether compounds were measured in 24-h urine or first morning void samples. In the observational study, the sum of the principal PVLs correlated dose dependently (Rs = 0.37; P = 0.0004) with dietary flavan-3-ol intake, with similar associations for each individually. CONCLUSIONS Urinary 5-(3'-hydroxyphenyl)-γ-valerolactone-4'-sulfate and putatively identified 5-(4'-hydroxyphenyl)-γ-valerolactone-3'-glucuronide are recommended biomarkers for dietary flavan-3-ol exposure.
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Affiliation(s)
- Benjamin H Parmenter
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, Australia; Nutrition & Health Innovation Research Institute, Edith Cowan University, Perth, Australia
| | - Sujata Shinde
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, Australia
| | - Kevin Croft
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Catherine P Bondonno
- Nutrition & Health Innovation Research Institute, Edith Cowan University, Perth, Australia; Medical School, University of Western Australia, Perth, Australia
| | - Angela Genoni
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | | | - Keren Bindon
- Australian Wine Research Institute, Adelaide, Australia
| | - Colin Kay
- Plants for Human Health Institute, North Carolina State University, Kannapolis, United States
| | - Pedro Mena
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Daniele Del Rio
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Jonathan M Hodgson
- Nutrition & Health Innovation Research Institute, Edith Cowan University, Perth, Australia; Medical School, University of Western Australia, Perth, Australia
| | - Nicola P Bondonno
- Nutrition & Health Innovation Research Institute, Edith Cowan University, Perth, Australia; The Danish Cancer Society Research Centre, Copenhagen, Denmark.
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20
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Stacey I, Seth R, Nedkoff L, Hung J, Wade V, Haynes E, Carapetis J, Murray K, Bessarab D, Katzenellenbogen JM. Rheumatic heart disease mortality in Indigenous and non-Indigenous Australians between 2010 and 2017. Heart 2023; 109:1025-1033. [PMID: 36858807 DOI: 10.1136/heartjnl-2022-322146] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/26/2023] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVES To generate contemporary age-specific mortality rates for Indigenous and non-Indigenous Australians aged <65 years who died from rheumatic heart disease (RHD) between 2013 and 2017, and to ascertain the underlying causes of death (COD) of a prevalent RHD cohort aged <65 years who died during the same period. METHODS For this retrospective, cross-sectional epidemiological study, Australian RHD deaths for 2013-2017 were investigated by first, mortality rates generated using Australian Bureau of Statistics death registrations where RHD was a coded COD, and second COD analyses of death records for a prevalent RHD cohort identified from RHD register and hospitalisations. All analyses were undertaken by Indigenous status and age group (0-24, 25-44, 45-64 years). RESULTS Age-specific RHD mortality rates per 100 000 were 0.32, 2.63 and 7.41 among Indigenous 0-24, 25-44 and 45-64 year olds, respectively, and the age-standardised mortality ratio (Indigenous vs non-Indigenous 0-64 year olds) was 14.0. Within the prevalent cohort who died (n=726), RHD was the underlying COD in 15.0% of all deaths, increasing to 24.6% when RHD was included as associated COD. However, other cardiovascular and non-cardiovascular conditions were the underlying COD in 34% and 43% respectively. CONCLUSION Premature mortality in people with RHD aged <65 years has approximately halved in Australia since 1997-2005, most notably among younger Indigenous people. Mortality rates based solely on underlying COD potentially underestimates true RHD mortality burden. Further strategies are required to reduce the high Indigenous to non-Indigenous mortality rate disparity, in addition to optimising major comorbidities that contribute to non-RHD mortality.
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Affiliation(s)
- Ingrid Stacey
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Rebecca Seth
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Lee Nedkoff
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- Cardiology Population Health Laboratory, Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia
| | - Joseph Hung
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Vicki Wade
- RHD Australia, Menzies School of Health Research, Casuarina, New South Wales, Australia
| | - Emma Haynes
- Centre for Aboriginal Medical and Dental Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Jonathan Carapetis
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Judith M Katzenellenbogen
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
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21
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Rajendra A, Bondonno NP, Murray K, Zhong L, Rainey-Smith SR, Gardener SL, Blekkenhorst LC, Ames D, Maruff P, Martins RN, Hodgson JM, Bondonno CP. Habitual dietary nitrate intake and cognition in the Australian Imaging, Biomarkers and Lifestyle Study of ageing: A prospective cohort study. Clin Nutr 2023; 42:1251-1259. [PMID: 37331149 DOI: 10.1016/j.clnu.2023.05.022] [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] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/09/2023] [Accepted: 05/29/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND & AIMS Dietary nitrate improves cardiovascular health via a nitric oxide (NO) pathway. NO is key to both cardiovascular and brain health. There is also a strong association between vascular risk factors and brain health. Dietary nitrate intake could therefore be associated with better cognitive function and reduced risk of cognitive decline. This is yet to be investigated. The aim of this study was to investigate the association between habitual intake of dietary nitrate from sources where nitrate is naturally present, and cognitive function, and cognitive decline, in the presence or absence of the apolipoprotein E (APOE) ε4 allele. METHODS The study included 1254 older adult participants of the Australian Imaging, Biomarkers and Lifestyle Study of Ageing who were cognitively normal at baseline. Plant-derived, vegetable-derived, animal derived nitrate (not including meat where nitrate is an allowed additive), and total nitrate intakes were calculated from baseline food frequency questionnaires using comprehensive nitrate databases. Cognition was assessed at baseline and every 18 months over a follow-up period of 126 months using a comprehensive neuropsychological test battery. Multivariable-adjusted linear mixed effect models were used to examine the association between baseline nitrate intake and cognition over the 126 months (median [IQR] follow-up time of 36 [18-72] months), stratified by APOE ε4 carrier status. RESULTS In non APOE ε4 carriers, for every 60 mg/day higher intake of plant-derived nitrate at baseline there was an associated higher language score [β (95% CI): 0.10 (0.01, 0.19)] over 126 months, after multivariable adjustments. In APOE ε4 carriers, there was an associated better episodic recall memory [0.24 (0.08, 0.41)] and recognition memory [0.15 (0.01, 0.30)] scores. Similar associations were seen for the intakes of vegetable-derived and total nitrate. Additionally, in APOE ε4 carriers, for every 6 mg/day higher intake of animal-derived nitrate (excluding meat with nitrate as an allowed additive) at baseline there was an associated higher executive function score [β (95% CI): 1.41 (0.42, 2.39)]. We did not find any evidence of an association between dietary nitrate intake and rate of cognitive decline. CONCLUSION Our results suggest that habitual intake of dietary nitrate from sources where nitrate is naturally present impacts cognitive performance in an APOE genotype contingent manner. Further work is needed to validate our findings and understand potential mechanisms underlying the observed effects.
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Affiliation(s)
- Anjana Rajendra
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Nicola P Bondonno
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia; The Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Liezhou Zhong
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Stephanie R Rainey-Smith
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia; Lifestyle Approaches Towards Cognitive Health Research Group, Murdoch University, Murdoch, Western Australia, Australia; Centre of Excellence for Alzheimer's Disease Research & Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia; Australian Alzheimer's Research Foundation, Nedlands, Western Australia, Australia; School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Samantha L Gardener
- Lifestyle Approaches Towards Cognitive Health Research Group, Murdoch University, Murdoch, Western Australia, Australia; Centre of Excellence for Alzheimer's Disease Research & Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia; Australian Alzheimer's Research Foundation, Nedlands, Western Australia, Australia
| | - Lauren C Blekkenhorst
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - David Ames
- National Ageing Research Institute, Royal Melbourne Hospital, Melbourne, Victoria, Australia; Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, Victoria, Australia
| | - Paul Maruff
- The Florey Institute, The University of Melbourne, Parkville, Victoria, Australia; Cogstate Ltd, Melbourne, Victoria, Australia
| | - Ralph N Martins
- Centre of Excellence for Alzheimer's Disease Research & Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Jonathan M Hodgson
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia; Medical School, The University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Western Australia, Australia
| | - Catherine P Bondonno
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia; Medical School, The University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Western Australia, Australia.
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Lau W, Chisholm K, Gallagher M, Felmingham K, Murray K, Pearce A, Doyle N, Alexander S, O'Brien H, Putica A, Khatri J, Bockelmann P, Hosseiny F, Librado A, Notarianni M, O'Donnell M. Comparing the unified protocol for transdiagnostic treatment of emotional disorders to prolonged exposure for the treatment of PTSD: Design of a non-inferiority randomized controlled trial. Contemp Clin Trials Commun 2023; 33:101134. [PMID: 37228903 PMCID: PMC10205430 DOI: 10.1016/j.conctc.2023.101134] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/21/2023] [Accepted: 04/10/2023] [Indexed: 05/27/2023] Open
Abstract
Background Prolonged Exposure (PE), a trauma-focused therapy, is one of the most efficacious treatments available for PTSD. However, many people with PTSD do not lose their diagnosis following delivery of PE. The Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders is a non-trauma focused treatment that may offer an alternative treatment for PTSD. Methods This paper describes the study protocol for IMPACT, an assessor-blinded randomized controlled trial that examines the non-inferiority of UP relative to PE for participants who meet DSM-5 criteria for current PTSD. One hundred and twenty adult participants with PTSD will be randomized to receive either 10 × 90-min sessions of UP or PE with a trained provider. The primary outcome is severity of PTSD symptoms assessed by the Clinician Administered PTSD Scale for DSM-5 (CAPS-5) at post-treatment. Discussion While evidence-based treatments are available for PTSD, high levels of treatment dropout and non-response require new approaches to be tested. The UP is based on emotion regulation theory and is effective in treating anxiety and depressive disorders, however, there has been limited application to PTSD. This is the first rigorous study comparing UP to PE in a non-inferiority randomized controlled trial and may help improve clinical outcomes for those with PTSD. Trial registration This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry, Trial ID (ACTRN12619000543189).
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Affiliation(s)
- W. Lau
- Phoenix Australia – Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - K. Chisholm
- Phoenix Australia – Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - M.W. Gallagher
- Department of Psychology, The University of Houston, TX, USA
| | - K. Felmingham
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia
| | - K. Murray
- Phoenix Australia – Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - A. Pearce
- Phoenix Australia – Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - N. Doyle
- Phoenix Australia – Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - S. Alexander
- Phoenix Australia – Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - H. O'Brien
- Phoenix Australia – Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - A. Putica
- Phoenix Australia – Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - J. Khatri
- Canberra Health Services, Australian Capital Territory Government, Canberra, Australia
| | - P. Bockelmann
- Phoenix Australia – Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - F. Hosseiny
- Atlas Institute for Veterans and Families, Ottawa, Canada
- University of Ottawa Institute of Mental Health Research at The Royal, Canada
| | - A. Librado
- Atlas Institute for Veterans and Families, Ottawa, Canada
| | - M. Notarianni
- Atlas Institute for Veterans and Families, Ottawa, Canada
- University of Ottawa Institute of Mental Health Research at The Royal, Canada
| | - M.L. O'Donnell
- Phoenix Australia – Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Victoria, Australia
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Nedkoff L, Briffa T, Murray K, Gaw J, Yates A, Sanfilippo FM, Nicholls SJ. Risk of early recurrence and mortality in high-risk myocardial infarction patients: A population-based linked data study. Int J Cardiol Cardiovasc Risk Prev 2023; 17:200185. [PMID: 37122877 PMCID: PMC10139974 DOI: 10.1016/j.ijcrp.2023.200185] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/18/2022] [Accepted: 03/30/2023] [Indexed: 05/02/2023]
Abstract
Background Survival during the early period following myocardial infarction (MI) has significantly improved although there are limited data on cardiovascular recurrence during this period. Methods We identified all emergency hospitalisations for MI from November 1, 2011 to October 31, 2016 in Western Australia from a linked hospitalisation/mortality dataset. Patients were included if they survived >3 days, had no acute kidney injury, and had ≥1 of: ≥65 years, prior MI, diabetes or peripheral arterial disease. Outcomes were major adverse cardiovascular events (MACE, a composite of CVD death, recurrent MI or stroke), cardiovascular disease (CVD) death, all-cause mortality, recurrent MI and stroke. Cumulative risks at 90-days and 1-year were estimated from Kaplan-Meier analyses and predictors of each outcome from multivariable Cox regression models. Results There were 8024 high-risk MI patients identified (males 61.8%). Median age was 73.7 years (IQR 66.3-82.2). Half of the risk of MACE occurred in the first 90-days post-MI (6.6% vs 12.6% at 1-year) and was underpinned by risk of recurrent MI. Risk was generally higher in women than men (MACE: 6.0% males, 7.7% females, p = 0.0025; CVD mortality: 1.7% males, 3.7% females; all-cause mortality: 2.8% males, 5.6% females, p < 0.0001). Independent predictors of 90-day MACE were increasing age, heart failure history, hypertension and prior stroke. Female sex was not associated with a higher rate of any of the outcomes after multivariable adjustment. Conclusion Half of cardiovascular events in the year following an MI occur within 90-days, demonstrating that reductions in MI burden could be achieved by further targeted intervention in the early period following an MI.
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Affiliation(s)
- Lee Nedkoff
- The University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, Australia
- Corresponding author. School of Population and Global Health, The University of Western Australia, M431, 35 Stirling Hwy, Crawley, Western, 6009, Australia.
| | - Tom Briffa
- The University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, Australia
| | - Kevin Murray
- The University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, Australia
| | - James Gaw
- CSL Behring, 189 – 209 Camp Road, Broadmeadows, Victoria, 3047, Australia
| | - Andrea Yates
- CSL Behring, 189 – 209 Camp Road, Broadmeadows, Victoria, 3047, Australia
| | - Frank M. Sanfilippo
- The University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, Australia
| | - Stephen J. Nicholls
- Victorian Heart Institute, Monash University, Wellington Rd, Clayton, VIC, 3800, Australia
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Harse JD, Marriott RJ, Zhu K, Murray K, Bucks RS. Vitamin D status and cognitive performance in community-dwelling adults: A dose-response meta-analysis of observational studies. Front Neuroendocrinol 2023:101080. [PMID: 37268277 DOI: 10.1016/j.yfrne.2023.101080] [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: 09/30/2022] [Revised: 05/27/2023] [Accepted: 05/27/2023] [Indexed: 06/04/2023]
Abstract
Low vitamin D status is linked with poorer cognition in adults while findings in relation to high levels are mixed.We performed a systematic review and meta-analyses to examine dose-response associations between 25-hydroxyvitamin D (25OHD) levelsand cognitive performance in community-dwelling adults. Thirty-eight observational studies were included in dose-response meta-analyses. Positive, nonlinear associations were identified between baseline25OHD levels and global cognition incross-sectional and longitudinal analyses, and for performance in memory and executive function in longitudinal analyses. When restricted to studies involving older adults, thepattern emerged forspecific domains in cross-sectional analyses. Poorer performance was associated with low 25OHD levels, while a sharp improvement was associated withlevels up to 60-70 nM/L. Further improvement was observed only for longitudinal global cognition. Our findings support the association between low vitamin D and poorer cognition and suggest levels of at least 60 nM/L are associated with better cognition during ageing.
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Affiliation(s)
- Janis D Harse
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia.
| | - Ross J Marriott
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia
| | - Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia; Medical School, University of Western Australia, Crawley, Western Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia
| | - Romola S Bucks
- School of Psychological Science, University of Western Australia, Crawley, Western Australia
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Lopez D, Dwivedi G, Nossent J, Preen DB, Murray K, Raymond W, Inderjeeth C, Keen HI. Risk of Major Adverse Cardiovascular Event Following Incident Hospitalization for Acute Gout: A Western Australian Population-Level Linked Data Study. ACR Open Rheumatol 2023. [PMID: 37170735 DOI: 10.1002/acr2.11540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Cardiovascular disease is the most common cause of death in people with gout. Acute inflammation, which is a characteristic of gout, may have a mechanistic role in major adverse cardiovascular events (MACEs). We aimed to examine the relationship between admissions to a hospital with acute gout and MACEs in a large population-based data set. METHODS We extracted data from the Hospital Morbidity Data Collection and Death Registrations of the Western Australian Rheumatic Disease Epidemiology Registry. We identified patients admitted to hospital with incident acute gout and who had admissions or a death record because of MACEs. We compared the risk of MACEs during the postdischarge period (1-30 days after acute gout admission) and control period (365 days prior to admission and 365 days after the postdischarge period) using a self-controlled case-series (SCCS) design, which is a within-person design that controls for time-invariant patient-specific confounding. We performed conditional fixed-effects Poisson regression to obtain rate ratios (RRs). RESULTS We identified 941 patients (average age: 76.4 years; SD: 12.6; 66.7% male) with an incident acute gout admission and documented MACEs during the control and/or postdischarge periods. Of the 941 patients, 898 (95%) experienced MACEs during the combined control period (730-day period) and 112 (12%) during the postdischarge period (30-day period). The rates of MACEs during the total control and postdischarge periods were 0.84 and 1.45 events per person-year, respectively. Regression analysis confirmed increased rate during the postdischarge period (RR: 1.67; 95% CI: 1.38-2.03) compared with the control period. Sensitivity analyses indicated that our results were robust in relation to known limitations of the SCCS design. CONCLUSION We report an increased risk of MACEs in the first 30 days after an incident hospital admission with acute gout, suggesting a temporal association between acute inflammation and subsequent MACEs in patients with gout.
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Affiliation(s)
- Derrick Lopez
- The University of Western Australia, Crawley, Western Australia, Australia
| | - Girish Dwivedi
- The University of Western Australia, Crawley, Fiona Stanley Hospital, Murdoch, and Harry Perkins Institute of Medical Research, Western Australia, Australia
| | - Johannes Nossent
- The University of Western Australia, Crawley, and Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - David B Preen
- The University of Western Australia, Crawley, Western Australia, Australia
| | - Kevin Murray
- The University of Western Australia, Crawley, Western Australia, Australia
| | - Warren Raymond
- The University of Western Australia, Crawley, Western Australia, Australia
| | - Charles Inderjeeth
- The University of Western Australia, Crawley, and Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Helen I Keen
- The University of Western Australia, Crawley, and Fiona Stanley Hospital, Murdoch, Western Australia, Australia
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Ferguson S, Jones A, Murray K, Schwessinger B, Borevitz JO. Interspecies genome divergence is predominantly due to frequent small scale rearrangements in Eucalyptus. Mol Ecol 2023; 32:1271-1287. [PMID: 35810343 DOI: 10.1111/mec.16608] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 07/02/2022] [Accepted: 07/04/2022] [Indexed: 11/27/2022]
Abstract
Synteny, the ordering of sequences within homologous chromosomes, must be maintained within the genomes of sexually reproducing species for the sharing of alleles and production of viable, reproducing offspring. However, when the genomes of closely related species are compared, a loss of synteny is often observed. Unequal homologous recombination is the primary mechanism behind synteny loss, occurring more often in transposon rich regions, and resulting in the formation of chromosomal rearrangements. To examine patterns of synteny among three closely related, interbreeding, and wild Eucalyptus species, we assembled their genomes using long-read DNA sequencing and de novo assembly. We identify syntenic and rearranged regions between these genomes and estimate that ~48% of our genomes remain syntenic while ~36% is rearranged. We observed that rearrangements highly fragment microsynteny. Our results suggest that synteny between these species is primarily lost through small-scale rearrangements, not through sequence loss, gain, or sequence divergence. Further examination of identified rearrangements suggests that rearrangements may be altering the phenotypes of Eucalyptus species. Our study also underscores that the use of single reference genomes in genomic variation studies could lead to reference bias, especially given the scale at which we show potentially adaptive loci have highly diverged, deleted, duplicated and/or rearranged. This study provides an unbiased framework to look at potential speciation and adaptive loci among a rapidly radiating foundation species of woodland trees that are free from selective breeding seen in most crop species.
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Affiliation(s)
- Scott Ferguson
- Research School of Biology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Ashley Jones
- Research School of Biology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kevin Murray
- Research School of Biology, Australian National University, Canberra, Australian Capital Territory, Australia.,Weigel Department, Max Planck Institute for Developmental Biology, Tuebingen, Germany
| | - Benjamin Schwessinger
- Research School of Biology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Justin O Borevitz
- Research School of Biology, Australian National University, Canberra, Australian Capital Territory, Australia
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Becerra R, Gainey K, Murray K, Preece DA. Intolerance of uncertainty and anxiety: The role of beliefs about emotions. J Affect Disord 2023; 324:349-353. [PMID: 36586604 DOI: 10.1016/j.jad.2022.12.064] [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: 02/14/2022] [Revised: 09/10/2022] [Accepted: 12/17/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Intolerance of uncertainty (IU) is a dimensional trait fundamental to most psychopathologies, and anxiety disorders in particular, making it an important transdiagnostic construct for researchers and clinicians. Current psychological therapies focus on changing underlying cognitive assumptions related to uncertainty. However, we posit that IU conveys beliefs about emotions too. In line with established findings on beliefs about emotions in general, we tested the hypothesis that the relationship between IU and anxiety is mediated by beliefs about the controllability and/or usefulness of emotions. METHODS Participants (N = 2260) were administered the Emotions Beliefs Questionnaire (EBQ); the General Anxiety Disorder 7-item (GAD-7), and the Intolerance of Uncertainty Scale (IUS - 12). A confirmatory factor analysis (CFA) on the EBQ was conducted followed by Pearson correlation coefficients among the central measures, and a parallel mediation analysis to address the central research question. RESULTS Our CFA supported the intended factor structure of the EBQ. The results of our mediation analysis supported the prediction that the association between IU and anxiety is partially mediated by general beliefs about emotions. LIMITATIONS Although our sample size was large, the age range was limited so future research could expand the age range to maximise generalizability. This is a cross-sectional study so causal inferences are restricted. CONCLUSION Given the present findings, current interventions for IU and their focus on beliefs about uncertainty, might benefit from incorporating strategies to improve beliefs about emotions, and thus improve therapeutic effectiveness.
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Affiliation(s)
| | | | | | - David A Preece
- The University of Western Australia, Australia; Curtin University, Australia
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Vale SL, Murray K, Netting MJ, Ong R, Clifford R, Stiles S, Campbell DE, Salter SM. Impact of public health interventions for food allergy prevention on rates of infant anaphylaxis. Ann Allergy Asthma Immunol 2023; 130:347-354.e1. [PMID: 36122889 DOI: 10.1016/j.anai.2022.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/07/2022] [Accepted: 09/07/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Eleven percent of Australian infants have confirmed food allergy. We hypothesized earlier introduction may lead to higher rates of infant anaphylaxis, irrespective of whether the overall rate of food allergy in the population was ultimately reduced. OBJECTIVE To determine whether a public health campaign, targeting earlier introduction of allergenic foods, affected rates of infant anaphylaxis. METHODS Data were obtained from St John Ambulance (SJA) Western Australia and Western Australian emergency departments (ED) on infant (≤12 months) anaphylaxis over a 5-year period (July 1, 2015 to June 30, 2020). Adrenaline administration data were collected in the SJA dataset. Poisson regression was undertaken to assess trends in anaphylaxis over time. Segmented regression analysis was undertaken to assess differences in anaphylaxis rates before and after intervention. RESULTS The SJA and ED datasets included 172 and 294 events, respectively, coded as infant anaphylaxis. Rates of infant anaphylaxis increased over time for both SJA and ED datasets, with a 1-year increase rate ratio of 1.21 (95% confidence interval, 1.09-1.35; P value < .01) and 1.11 (95% confidence interval, 1.02-1.20; P = .01), respectively. Segmented regression indicated no significant difference in rates after intervention. Adrenaline was not coded as being administered in 109 of the 172 anaphylaxis events. CONCLUSION Rates of infant anaphylaxis increased over the 5-year reporting period; however, there was no clear increase related to the timing of the public health campaign implementation. Reported adrenaline use was suboptimal. Assessing rates of food allergy in all age groups is required to determine whether there has been an overall reduction in food allergy owing to the intervention.
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Affiliation(s)
- Sandra L Vale
- The University of Western Australia, Crawley, Western Australia, Australia.
| | - Kevin Murray
- The University of Western Australia, Crawley, Western Australia, Australia
| | | | - Royston Ong
- Saint John Ambulance Western Australia, Belmont, Western Australia, Australia
| | - Rhonda Clifford
- The University of Western Australia, Crawley, Western Australia, Australia
| | - Samantha Stiles
- The University of Western Australia, Crawley, Western Australia, Australia
| | | | - Sandra M Salter
- The University of Western Australia, Crawley, Western Australia, Australia
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Marriott RJ, Murray K, Budgeon CA, Codd V, Hui J, Arscott GM, Beilby JP, Hankey GJ, Wittert GA, Wu FCW, Yeap BB. Serum testosterone and sex hormone-binding globulin are inversely associated with leucocyte telomere length in men: a cross-sectional analysis of the UK Biobank study. Eur J Endocrinol 2023; 188:7031076. [PMID: 36751991 DOI: 10.1093/ejendo/lvad015] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/15/2022] [Accepted: 02/07/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVE Older men on an average have lower testosterone concentrations, compared with younger men, and more age-related comorbidities. Whether lower testosterone concentrations contribute to biological ageing remains unclear. Shorter telomeres are a marker for biological age. We tested the hypothesis that testosterone concentrations are associated with leucocyte telomere length (LTL), in middle- to older-aged men. DESIGN Cross-sectional analysis of the UK Biobank study, involving community-dwelling men aged 40-69 years. METHODS Serum testosterone and sex hormone-binding globulin (SHBG) were assayed. Free testosterone was calculated (cFT). Leucocyte telomere length was measured using polymerase chain reaction. Multivariable models were used to assess associations of hormones with standardised LTL. RESULTS In 167 706 men, median age 58 years, adjusting for sociodemographic, lifestyle, and medical factors, total testosterone was inversely associated with standardised LTL, which was 0.09 longer (95% confidence interval [CI], 0.08-0.10, P < .001) in men with total testosterone at median of lowest quintile [Q1] vs highest [Q5]. This relationship was attenuated after additional adjustment for SHBG (0.03 longer, CI = 0.02-0.05, P = .003). The association between cFT and LTL was similar in direction but lower in magnitude. In multivariable analysis, SHBG was inversely associated with standardised LTL, which was 0.12 longer (CI = 0.10-0.13, P < .001) for SHBG at median Q1 vs Q5. Results were similar with testosterone included in the model (0.10 longer, CI = 0.08-0.12, P < .001). CONCLUSIONS Total testosterone and SHBG were independently and inversely associated with LTL. Men with higher testosterone or SHBG had shorter telomeres, arguing against a role for testosterone to slow biological ageing in men.
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Affiliation(s)
- Ross J Marriott
- School of Population and Global Health, University of Western Australia, Perth 6009, Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth 6009, Australia
| | - Charley A Budgeon
- School of Population and Global Health, University of Western Australia, Perth 6009, Australia
- Department of Cardiovascular Sciences, University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Veryan Codd
- Department of Cardiovascular Sciences, University of Leicester, Leicester LE1 7RH, United Kingdom
- National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester LE3 9QP, United Kingdom
| | - Jennie Hui
- PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth 6009, Australia
| | - Gillian M Arscott
- PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth 6009, Australia
| | - John P Beilby
- School of Biomedical Sciences, University of Western Australia, Perth 6009, Australia
| | - Graeme J Hankey
- Medical School, University of Western Australia, Perth 6009, Australia
| | - Gary A Wittert
- Freemasons Centre for Male Health and Wellbeing, University of Adelaide, Adelaide 5005, Australia
| | - Frederick C W Wu
- Division of Endocrinology, Diabetes and Gastroenterology, School of Medical Sciences, University of Manchester, Manchester M13 9PL, United Kingdom
| | - Bu B Yeap
- Medical School, University of Western Australia, Perth 6009, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth 6150, Australia
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Weber C, Hung J, Hickling S, Li I, Murray K, Briffa T. Emergent readmission and long-term mortality risk after incident atrial fibrillation hospitalisation. Heart 2023; 109:380-387. [PMID: 36384748 DOI: 10.1136/heartjnl-2022-321560] [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: 06/27/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To assess the frequency and predictors of unplanned readmissions after hospitalisation for incident atrial fibrillation (AF) and the association of readmissions with mortality over 2 years. METHODS We performed a retrospective cohort study using Western Australian morbidity and mortality data to identify all patients, aged 25-94 years, who survived incident (first-ever) hospitalisation for AF (principal diagnosis), between 2001 and 2015. Ordinal logistic models determined the covariates independently associated with unplanned readmission(s), and Cox proportional hazards models with time-varying exposures determined the hazard ratios (HR) of one or more readmissions for mortality over 2 years after incident AF. RESULTS Of 22 956 patients, 57.7% male, mean age 67.9 (SD 13.8) years, 44.0% experienced 22 053 unplanned readmissions within 2 years, 50.6% being cardiovascular-related. All-cause death occurred in 8.0% of the cohort, and the multivariable-adjusted mortality HR of 1 (vs 0) readmission was 2.9 (95% CI 2.6 to 3.3), increasing to 5.6 (95% CI 5.0 to 6.5) for 3+ readmissions. First emergent readmission for AF, stroke, heart failure or myocardial infarction was independently associated with an increased hazard for mortality. Coexistent cardiovascular and other comorbidities were independently associated with increased readmission and mortality risk, whereas AF ablation was associated with reduced risk. CONCLUSION This study highlights the large burden of unplanned all-cause and cardiovascular-specific readmissions within 2 years after being hospitalised for incident AF and their associated adverse impact on mortality. Concomitant comorbidities are independently associated with unplanned hospitalisations and mortality, which supports integrated multidisciplinary management of comorbidities, along with AF-targeted treatments, to improve long-term outcomes in patients with AF.
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Affiliation(s)
- Courtney Weber
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Joseph Hung
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Siobhan Hickling
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Ian Li
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Tom Briffa
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
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Pokharel P, Kyrø C, Olsen A, Tjønneland A, Murray K, Blekkenhorst LC, Bondonno CP, Hodgson JM, Bondonno NP. Vegetable, but Not Potato, Intake Is Associated With a Lower Risk of Type 2 Diabetes in the Danish Diet, Cancer and Health Cohort. Diabetes Care 2023; 46:286-296. [PMID: 36463930 PMCID: PMC9887631 DOI: 10.2337/dc22-0974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/28/2022] [Indexed: 12/07/2022]
Abstract
OBJECTIVE To examine the relationship between intake of vegetables/potatoes and incident type 2 diabetes (T2D) and explore whether the relationship between vegetable intake and incident T2D is mediated by baseline BMI. RESEARCH DESIGN AND METHODS Cross-sectional associations between exposure (baseline intake of total vegetables, vegetable subgroups, and potatoes) and baseline BMI were assessed by multivariable-adjusted linear regression models. Associations between exposure and incident T2D were examined by multivariable-adjusted Cox proportional hazards models. Mediation by BMI was quantified through exploration of natural direct and indirect effects. RESULTS Among 54,793 participants in the Danish Diet, Cancer and Health cohort, 7,695 cases of T2D were recorded during a median follow-up of 16.3 years. Participants in the highest total vegetable intake quintile (median 319 g/day) had a 0.35 kg/m2 (95% CI -0.46, -0.24) lower BMI and a 21% (95% CI 16, 26%) lower risk of incident T2D after multivariable adjustment compared with those in the lowest quintile (median 67 g/day). Baseline BMI mediated ∼21% of the association between vegetable intake and incident T2D. Participants in the highest compared with the lowest (median 256 vs. 52 g/day) potato intake quintile had a 9% (95% CI 2, 16%) higher risk of T2D after multivariable adjustment, with no association found after accounting for underlying dietary pattern. Of the vegetable subclasses, higher intake of green leafy and cruciferous vegetables was associated with a statistically significantly lower risk of T2D. CONCLUSIONS The findings provide evidence that a higher vegetable, but not potato, intake might help mitigate T2D risk, partly by reducing BMI.
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Affiliation(s)
- Pratik Pokharel
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Cecilie Kyrø
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Lauren C. Blekkenhorst
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- Royal Perth Hospital Medical Research Foundation, Perth, Australia
| | - Catherine P. Bondonno
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- Royal Perth Hospital Medical Research Foundation, Perth, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - Jonathan M. Hodgson
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- Royal Perth Hospital Medical Research Foundation, Perth, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - Nicola P. Bondonno
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
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Parmenter BH, Dalgaard F, Murray K, Marquis-Gravel G, Cassidy A, Bondonno CP, Lewis JR, Croft KD, Kyrø C, Gislason G, Scalbert A, Tjønneland A, Overvad K, Hodgson JM, Bondonno NP. Intake of dietary flavonoids and incidence of ischemic heart disease in the Danish Diet, Cancer, and Health cohort. Eur J Clin Nutr 2023; 77:270-277. [PMID: 36284213 PMCID: PMC9908533 DOI: 10.1038/s41430-022-01226-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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 10/06/2022] [Accepted: 10/06/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Few studies have investigated the association between dietary flavonoid intake, including all major subclasses, and the long-term risk of ischemic heart disease (IHD). We examined whether dietary flavonoid intake associated with IHD incidence, assessing the possible modifying role of sex and smoking, in participants from the Danish Diet, Cancer, and Health study. SUBJECTS/METHODS In a cohort study design, 54,496 adults (46.8% male), aged 50-64 years, without a history of IHD, were followed for up to 23 years. Habitual dietary flavonoid intake was estimated from food frequency questionnaires using Phenol-Explorer. Incident cases of IHD were identified within Danish nationwide health registries. Restricted cubic splines in Cox proportional hazards models were used to examine associations between flavonoid intake and IHD risk. RESULTS During follow-up, 5560 IHD events were recorded. No overall association was seen between total flavonoid intake, nor any subclass, and IHD, following adjustment for demographics, lifestyle, and dietary confounders. Stratified by sex and smoking status, higher intakes of specific subclasses associated with lower IHD risk among ever-smokers [Q5 vs. Q1 flavonols HR (95% CI): 0.90 (0.82, 0.99); flavanol oligo+polymers: 0.88 (0.80, 0.97)], but not among never-smokers, nor either sex specifically. CONCLUSIONS While we did not find clear evidence that higher habitual dietary flavonoid intake was associated with lower IHD risk, these results do not exclude the possibility that certain subclasses may have a protective role in prevention of IHD among population sub-groups; this was evident among smokers, who are at a higher risk of atherosclerosis.
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Affiliation(s)
- Benjamin H Parmenter
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, WA, Australia
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Frederik Dalgaard
- Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | | | - Aedín Cassidy
- Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
| | - Catherine P Bondonno
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- Medical School, University of Western Australia, Perth, WA, Australia
| | - Joshua R Lewis
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- Medical School, University of Western Australia, Perth, WA, Australia
- Centre for Kidney Research, School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Kevin D Croft
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, WA, Australia
| | - Cecilie Kyrø
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Gunnar Gislason
- Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark
- The National Institute of Public Health, University of Southern Denmark, Odense, Denmark
- The Danish Heart Foundation, Copenhagen, Denmark
| | | | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Jonathan M Hodgson
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- Medical School, University of Western Australia, Perth, WA, Australia
| | - Nicola P Bondonno
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, WA, Australia.
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.
- Danish Cancer Society Research Center, Copenhagen, Denmark.
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Weber C, Hung J, Hickling S, Li I, Murray K, Briffa T. Unplanned 30-day readmissions, comorbidity and impact on one-year mortality following incident heart failure hospitalisation in Western Australia, 2001-2015. BMC Cardiovasc Disord 2023; 23:25. [PMID: 36647020 PMCID: PMC9843857 DOI: 10.1186/s12872-022-03020-x] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 12/19/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Readmissions within 30 days after heart failure (HF) hospitalisation is considered an important healthcare quality metric, but their impact on medium-term mortality is unclear within an Australian setting. We determined the frequency, risk predictors and relative mortality risk of 30-day unplanned readmission in patients following an incident HF hospitalisation. METHODS From the Western Australian Hospitalisation Morbidity Data Collection we identified patients aged 25-94 years with an incident (first-ever) HF hospitalisation as a principal diagnosis between 2001 and 2015, and who survived to 30-days post discharge. Unplanned 30-day readmissions were categorised by principal diagnosis. Logistic and Cox regression analysis determined the independent predictors of unplanned readmissions in 30-day survivors and the multivariable-adjusted hazard ratio (HR) of readmission on mortality within the subsequent year. RESULTS The cohort comprised 18,241 patients, mean age 74.3 ± 13.6 (SD) years, 53.5% males, and one-third had a modified Charlson Comorbidity Index score of ≥ 3. Among 30-day survivors, 15.5% experienced one or more unplanned 30-day readmission, of which 53.9% were due to cardiovascular causes; predominantly HF (31.4%). The unadjusted 1-year mortality was 15.9%, and the adjusted mortality HR in patients with 1 and ≥ 2 cardiovascular or non-cardiovascular readmissions (versus none) was 1.96 (95% confidence interval (CI) 1.80-2.14) and 3.04 (95% CI, 2.51-3.68) respectively. Coexistent comorbidities, including ischaemic heart disease/myocardial infarction, peripheral arterial disease, pneumonia, chronic kidney disease, and anaemia, were independent predictors of both 30-day unplanned readmission and 1-year mortality. CONCLUSION Unplanned 30-day readmissions and medium-term mortality remain high among patients who survived to 30 days after incident HF hospitalisation. Any cardiovascular or non-cardiovascular readmission was associated with a two to three-fold higher adjusted HR for death over the following year, and various coexistent comorbidities were important associates of readmission and mortality risk. Our findings support the need to optimize multidisciplinary HF and multimorbidity management to potentially reduce repeat hospitalisation and improve survival.
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Affiliation(s)
- Courtney Weber
- grid.1012.20000 0004 1936 7910School of Population and Global Health, University of Western Australia, Crawley, WA Australia
| | - Joseph Hung
- grid.1012.20000 0004 1936 7910Medical School, University of Western Australia, Crawley, WA Australia
| | - Siobhan Hickling
- grid.1012.20000 0004 1936 7910School of Population and Global Health, University of Western Australia, Crawley, WA Australia
| | - Ian Li
- grid.1012.20000 0004 1936 7910School of Population and Global Health, University of Western Australia, Crawley, WA Australia
| | - Kevin Murray
- grid.1012.20000 0004 1936 7910School of Population and Global Health, University of Western Australia, Crawley, WA Australia
| | - Tom Briffa
- grid.1012.20000 0004 1936 7910School of Population and Global Health, University of Western Australia, Crawley, WA Australia
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Peddle-McIntyre CJ, Muruganandan S, McVeigh J, Fitzgerald DB, Straker L, Newton RU, Murray K, Lee YCG. Device assessed activity behaviours in patients with indwelling pleural catheter: A sub-study of the Australasian Malignant PLeural Effusion (AMPLE)-2 randomized trial. Respirology 2023; 28:561-570. [PMID: 36642702 DOI: 10.1111/resp.14451] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/19/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVE Device-assessed activity behaviours are a novel measure for comparing intervention outcomes in patients with malignant pleural effusion (MPE). Australasian Malignant PLeural Effusion (AMPLE)-2 was a multi-centre clinical trial where participants with MPE treated with an indwelling pleural catheter were randomized to daily (DD) or symptom-guided (SGD) drainage for 60-days. Our aim was to describe activity behaviour patterns in MPE patients, explore the impact of drainage regimen on activity behaviours and examine associations between activity behaviours and quality of life (QoL). METHODS Following randomization to DD or SGD, participants enrolled at the lead site (Perth) completed accelerometry assessment. This was repeated monthly for 5-months. Activity behaviour outcomes were calculated as percent of daily waking-wear time and compared between groups (Mann-Whitney U test; Median [IQR]). Correlations between activity behaviour outcomes and QoL were examined. RESULTS Forty-one (91%) participants provided ≥1 valid accelerometry assessment (DDn = 20, SGD n = 21). Participants spent a large proportion of waking hours sedentary (72%-74% across timepoints), and very little time in moderate-to-vigorous physical activity (<1% across timepoints). Compared to SGD group, DD group had a more favourable sedentary-to-light ratio in the week following randomization (2.4 [2.0-3.4] vs. 3.2 [2.4-6.1]; p = 0.047) and at 60-days (2.0 [1.9-2.9] vs. 2.9 [2.8-6.0]; p = 0.016). Sedentary-to-light ratio was correlated with multiple QoL domains at multiple timepoints. CONCLUSION Patients with MPE are largely sedentary. Preliminary results suggest that even modest differences in activity behaviours favouring the DD group could be meaningful for this clinical population. Accelerometry reflects QoL and is a useful outcome measure in MPE populations.
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Affiliation(s)
- Carolyn J Peddle-McIntyre
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Sanjeevan Muruganandan
- Department of Respiratory Medicine, Northern Hospital, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Joanne McVeigh
- School of Allied Health, Curtin University, Bentley, Western Australia, Australia.,Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
| | - Deirdre B Fitzgerald
- Respiratory Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Institute for Respiratory Health & Medical School, University of Western Australia, Nedlands, Western Australia, Australia
| | - Leon Straker
- School of Allied Health, Curtin University, Bentley, Western Australia, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Nedlands, Western Australia, Australia
| | - Yun Chor Gary Lee
- Respiratory Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Institute for Respiratory Health & Medical School, University of Western Australia, Nedlands, Western Australia, Australia
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Elton AC, Cedarstrom V, Quraishi A, Wuertz B, Murray K, Markowski TW, Seabloom D, Ondrey FG. Metabolic and Metabolomic Effects of Metformin in Murine Model of Pulmonary Adenoma Formation. Nutr Cancer 2023; 75:1014-1027. [PMID: 36688306 DOI: 10.1080/01635581.2023.2165692] [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: 01/24/2023]
Abstract
Epidemiologic studies of diabetic patients treated with metformin identified significantly lower incidences of cancer. From this, there is growing interest in the use of metformin to treat and prevent cancer. Studies have investigated chemopreventive mechanisms including alterations in calorie intake, cancer metabolism, and cell signaling. Repurposing the drug is challenging due to its metabolic effects and non-uniform effects on different types of cancer. In our previously published studies, we observed that benzo[a]pyrene treated mice receiving metformin significantly reduced lung adenomas; however, mice had reduced weight gain. In this study, we compared chemoprevention diets with and without metformin to evaluate the effects of diet vs. effects of metformin. We also performed tandem mass spectrometry on mouse serum to assess metabolomic alterations associated with metformin treatment. In metformin cohorts, the rate of weight gain was reduced, but weights did not vary between diets. There was no weight difference between diets without metformin. Interestingly, caloric intake was increased in metformin treated mice. Metabolomic analysis revealed metabolite alterations consistent with metformin treatment. Based on these results, we conclude that previous reductions in lung adenomas may have been occurred from anticancer effects of metformin rather than a potentially toxic effect such as calorie restriction.
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Affiliation(s)
- Andrew C Elton
- Department of Otolaryngology - Head and Neck Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Vannesa Cedarstrom
- Department of Otolaryngology - Head and Neck Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Arman Quraishi
- Department of Otolaryngology - Head and Neck Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Beverly Wuertz
- Department of Otolaryngology - Head and Neck Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA.,AeroCore, Department of Otolaryngology - Head and Neck Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Kevin Murray
- Center for Mass Spectrometry & Proteomics, Department of Biochemistry, Molecular Biology & Biophysics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Todd W Markowski
- Center for Mass Spectrometry & Proteomics, Department of Biochemistry, Molecular Biology & Biophysics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Donna Seabloom
- Department of Otolaryngology - Head and Neck Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA.,AeroCore, Department of Otolaryngology - Head and Neck Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Frank G Ondrey
- Department of Otolaryngology - Head and Neck Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA.,AeroCore, Department of Otolaryngology - Head and Neck Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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Zhu K, Hunter M, Hui J, Murray K, James A, Lim EM, Cooke BR, Walsh JP. Longitudinal Stability of Vitamin D Status and Its Association With Bone Mineral Density in Middle-aged Australians. J Endocr Soc 2022; 7:bvac187. [PMID: 36578880 PMCID: PMC9780649 DOI: 10.1210/jendso/bvac187] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Indexed: 12/12/2022] Open
Abstract
Context The skeletal effects of vitamin D remain controversial and it is uncertain whether variation in serum 25-hydroxyvitamin D (25OHD) levels over time influences bone mineral density (BMD). Objective We evaluated longitudinal stability of serum 25OHD and associations with changes in BMD in participants aged 46-70 years at baseline. Methods We studied 3698 Busselton Healthy Ageing Study participants (2040 female) with serum 25OHD and dual-energy x-ray absorptiometry (DXA) BMD assessments at baseline and at ∼6 years follow-up. Restricted cubic splines were used to evaluate associations between changes in 25OHD and BMD. Results Mean season-corrected serum 25OHD was 81.3 ± 22.7 and 78.8 ± 23.1 nmol/L at baseline and 6 years, respectively, and showed moderate correlation (intraclass correlation coefficient: 0.724). Significant predictors of change in 25OHD concentration (Δ25OHD) included baseline 25OHD, change in body mass index and vitamin D supplementation at follow-up. Greater decline in serum 25OHD over time was associated with significantly greater reduction in BMD at total hip and femoral neck, but the magnitude of the differences was small (estimated differences 0.004 g/cm2 and 0.005-0.007 g/cm2, respectively, for lowest quartile of Δ25OHD compared with higher quartiles, adjusted for sex, baseline BMD, 25OHD, and demographics). No significant associations between Δ25OHD and lumbar spine BMD were observed. Increase in 25OHD levels was not associated with change in BMD. Conclusions In this predominantly vitamin D-replete middle-aged cohort, serum 25OHD showed moderate longitudinal stability. Declining serum 25OHD over time was associated with greater reduction in BMD at the total hip and femoral neck.
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Affiliation(s)
- Kun Zhu
- Correspondence: Kun Zhu, PhD, Department of Endocrinology and Diabetes, Sir Charles Gardiner Hospital, Hospital Ave, Nedlands, WA 6009, Australia.
| | - Michael Hunter
- School of Population and Global Health, University of Western Australia, Crawley, WA 6009, Australia,Busselton Population Medical Research Institute, Busselton, WA 6280, Australia
| | - Jennie Hui
- School of Population and Global Health, University of Western Australia, Crawley, WA 6009, Australia,Busselton Population Medical Research Institute, Busselton, WA 6280, Australia,Department of Clinical Biochemistry, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, WA 6009, Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Crawley, WA 6009, Australia
| | - Alan James
- Medical School, University of Western Australia, Crawley, WA 6009, Australia,Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
| | - Ee Mun Lim
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia,Department of Clinical Biochemistry, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, WA 6009, Australia
| | - Brian R Cooke
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia,Medical School, University of Western Australia, Crawley, WA 6009, Australia
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Parmenter BH, Bondonno CP, Murray K, Schousboe JT, Croft K, Prince RL, Hodgson JM, Bondonno NP, Lewis JR. Higher Habitual Dietary Flavonoid Intake Associates With Less Extensive Abdominal Aortic Calcification in a Cohort of Older Women. Arterioscler Thromb Vasc Biol 2022; 42:1482-1494. [PMID: 36325901 DOI: 10.1161/atvbaha.122.318408] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The extent of abdominal aortic calcification (AAC) is a major predictor of vascular disease events. We have previously found regular apple intake, a major source of dietary flavonoids, associates with lower AAC. Whether total dietary flavonoid intake impacts AAC remains unknown. Here, we extend our observations to habitual intakes of total flavonoids, flavonoid subclasses, and specific flavonoid-containing foods, with the odds of extensive AAC. METHODS We conducted cross-sectional analyses on 881 females (median [interquartile range] age, 80 [78-82] years; body mass index, 27 [24-30] kg/m2) from the PLSAW (Perth Longitudinal Study of Ageing Women). Flavonoid intake was calculated from food-frequency questionnaires. Calcifications of the abdominal aorta were assessed on lateral lumbar spine images and categorized as less extensive or extensive. Logistic regression was used to investigate associations. RESULTS After adjusting for demographic, lifestyle and dietary confounders, participants with higher (Q4), compared with lower (Q1) intakes, of total flavonoids, flavan-3-ols, and flavonols had 36% (odds ratio [95% CI], 0.64 [0.43-0.95]), 39% (0.61 [0.40-0.93]) and 38% (0.62 [0.42-0.92]) lower odds of extensive AAC, respectively. In food-based analyses, higher black tea intake, the main source of total flavonoids (75.9%), associated with significantly lower odds of extensive AAC (2-6 cups/d had 16%-42% lower odds compared with 0 daily intake). In a subset of nonconsumers of black tea, the association of total flavonoid intake with AAC remained (Q4 versus Q1 odds ratio [95% CI], 0.11 [0.02-0.54]). CONCLUSIONS In older women, greater habitual dietary flavonoid intake associates with less extensive AAC.
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Affiliation(s)
- Benjamin H Parmenter
- School of Biomedical Sciences (B.H.P., K.C.), University of Western Australia, Perth.,Nutrition and Health Innovation Research Institute, Edith Cowan University, Perth' Western Australia (B.H.P., C.P.B., J.M.H., N.P.B., J.R.L.)
| | - Catherine P Bondonno
- Medical School (C.P.B., R.L.P., J.M.H., J.R.L.), University of Western Australia, Perth.,Nutrition and Health Innovation Research Institute, Edith Cowan University, Perth' Western Australia (B.H.P., C.P.B., J.M.H., N.P.B., J.R.L.)
| | - Kevin Murray
- School of Population and Global Health (K.M.), University of Western Australia, Perth
| | - John T Schousboe
- Park Nicollet Osteoporosis Center, HealthPartners Institute, HealthPartners, Minneapolis, MN (J.T.S.).,Division of Health Policy and Management, University of Minnesota, Minneapolis (J.T.S.)
| | - Kevin Croft
- School of Biomedical Sciences (B.H.P., K.C.), University of Western Australia, Perth
| | - Richard L Prince
- Medical School (C.P.B., R.L.P., J.M.H., J.R.L.), University of Western Australia, Perth
| | - Jonathan M Hodgson
- Medical School (C.P.B., R.L.P., J.M.H., J.R.L.), University of Western Australia, Perth.,Nutrition and Health Innovation Research Institute, Edith Cowan University, Perth' Western Australia (B.H.P., C.P.B., J.M.H., N.P.B., J.R.L.)
| | - Nicola P Bondonno
- Nutrition and Health Innovation Research Institute, Edith Cowan University, Perth' Western Australia (B.H.P., C.P.B., J.M.H., N.P.B., J.R.L.).,The Danish Cancer Society Research Center, Copenhagen, Denmark (N.P.B.)
| | - Joshua R Lewis
- Medical School (C.P.B., R.L.P., J.M.H., J.R.L.), University of Western Australia, Perth.,Nutrition and Health Innovation Research Institute, Edith Cowan University, Perth' Western Australia (B.H.P., C.P.B., J.M.H., N.P.B., J.R.L.).,Centre for Kidney Research, School of Public Health, The University of Sydney, New South Wales' Australia (J.R.L.)
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Salter SM, Li D, Trentino K, Nissen L, Lee K, Orlemann K, Peters I, Murray K, Leeb A, Deng L. Safety of Four COVID-19 Vaccines across Primary Doses 1, 2, 3 and Booster: A Prospective Cohort Study of Australian Community Pharmacy Vaccinations. Vaccines (Basel) 2022; 10:vaccines10122017. [PMID: 36560426 PMCID: PMC9786585 DOI: 10.3390/vaccines10122017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
Four COVID-19 vaccines are approved for use in Australia: Pfizer-BioNTech BNT162b2 (Comirnaty), AstraZeneca ChAdOx1 (Vaxzevria), Moderna mRNA-1273 (Spikevax) and Novavax NVX-CoV2373 (Nuvaxovid). We sought to examine adverse events following immunisation (AEFI) at days 3 and 42 after primary doses 1, 2, 3 and booster. We conducted active vaccine safety surveillance from 130 community pharmacies in Australia integrated with AusVaxSafety, between August 2021-April 2022. Main outcomes: AEFI at 0-3 days post-vaccination; medical review/advice at 3 days and 42 days post-vaccination; SARS-CoV-2 breakthrough infection by day 42. Of 110,024 completed day 3 surveys (43.6% response rate), 50,367 (45.8%) reported any AEFI (highest proportions: Pfizer 42%, primary dose 3; AstraZeneca 58.3%, primary dose 1; Moderna 65.4% and Novavax 58.8%, both primary dose 2). The most common AEFI reported across all doses/vaccines were local reactions, systemic aches and fatigue/tiredness. Overall, 2172/110,024 (2.0%) and 1182/55,329 (2.1%) respondents sought medical review at days 3 and 42, respectively, and 931/42,318 (2.2%) reported breakthrough SARS-CoV-2 infection at day 42. We identified similar AEFI profiles but at lower proportions than previously reported for Pfizer, AstraZeneca, Moderna and Novavax COVID-19 vaccines. Moderna vaccine was the most reactogenic and associated with higher AEFI proportions across primary doses 2, 3, and booster.
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Affiliation(s)
- Sandra M. Salter
- School of Allied Health, The University of Western Australia, Perth, WA 6000, Australia
| | - Dani Li
- MedAdvisor International Pty Ltd., Melbourne, VIC 3000, Australia
| | - Kevin Trentino
- Medical School, The University of Western Australia, Perth, WA 6000, Australia
| | - Lisa Nissen
- Centre for Business and Economics of Health, Faculty of Business, The University of Queensland, Brisbane, QLD 4000, Australia
| | - Kenneth Lee
- School of Allied Health, The University of Western Australia, Perth, WA 6000, Australia
| | | | | | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Perth, WA 6000, Australia
- Correspondence:
| | - Alan Leeb
- SmartVax, Perth, WA 6000, Australia
- Illawarra Medical Centre, Perth, WA 6000, Australia
| | - Lucy Deng
- National Centre for Immunisation Research and Surveillance, Westmead, NSW 2145, Australia
- The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia
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Tuson M, Yap M, Kok MR, Boruff B, Murray K, Vickery A, Turlach BA, Whyatt D. Improving the Efficiency of Geographic Target Regions for Healthcare Interventions. Int J Environ Res Public Health 2022; 19:14721. [PMID: 36429437 PMCID: PMC9691133 DOI: 10.3390/ijerph192214721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
Appropriate prioritisation of geographic target regions (TRs) for healthcare interventions is critical to ensure the efficient distribution of finite healthcare resources. In delineating TRs, both 'targeting efficiency', i.e., the return on intervention investment, and logistical factors, e.g., the number of TRs, are important. However, existing approaches to delineate TRs disproportionately prioritise targeting efficiency. To address this, we explored the utility of a method found within conservation planning: the software Marxan and an extension, MinPatch ('Marxan + MinPatch'), with comparison to a new method we introduce: the Spatial Targeting Algorithm (STA). Using both simulated and real-world data, we demonstrate superior performance of the STA over Marxan + MinPatch, both with respect to targeting efficiency and with respect to adequate consideration of logistical factors. For example, by design, and unlike Marxan + MinPatch, the STA allows for user-specification of a desired number of TRs. More broadly, we find that, while Marxan + MinPatch does consider logistical factors, it also suffers from several limitations, including, but not limited to, the requirement to apply two separate software tools, which is burdensome. Given these results, we suggest that the STA could reasonably be applied to help prevent inefficiencies arising due to targeting of interventions using currently available approaches.
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Affiliation(s)
- Matthew Tuson
- Department of Mathematics and Statistics, The University of Western Australia, Crawley, WA 6009, Australia
| | - Matthew Yap
- Medical School, The University of Western Australia, Crawley, WA 6009, Australia
| | - Mei Ruu Kok
- Medical School, The University of Western Australia, Crawley, WA 6009, Australia
| | - Bryan Boruff
- UWA School of Agriculture and Environment, The University of Western Australia, Crawley, WA 6009, Australia
- Department of Geography, The University of Western Australia, Crawley, WA 6009, Australia
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Crawley, WA 6009, Australia
| | - Alistair Vickery
- Medical School, The University of Western Australia, Crawley, WA 6009, Australia
| | - Berwin A. Turlach
- Department of Mathematics and Statistics, The University of Western Australia, Crawley, WA 6009, Australia
| | - David Whyatt
- Medical School, The University of Western Australia, Crawley, WA 6009, Australia
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Lu J, Hutchens R, Hung J, Bennamoun M, McQuillan B, Briffa T, Sohel F, Murray K, Stewart J, Chow B, Sanfilippo F, Dwivedi G. Performance of multilabel machine learning models and risk stratification schemas for predicting stroke and bleeding risk in patients with non-valvular atrial fibrillation. Comput Biol Med 2022; 150:106126. [PMID: 36206696 DOI: 10.1016/j.compbiomed.2022.106126] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/10/2022] [Accepted: 09/18/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Appropriate anticoagulant therapy for patients with atrial fibrillation (AF) requires assessment of stroke and bleeding risks. However, risk stratification schemas such as CHA2DS2-VASc and HAS-BLED have modest predictive capacity for patients with AF. Multilabel machine learning (ML) techniques may improve predictive performance and support decision-making for anticoagulant therapy. We compared the performance of multilabel ML models with the currently used risk scores for predicting outcomes in AF patients. METHODS This was a retrospective cohort study of 9670 patients, mean age 76.9 years, 46% women, who were hospitalized with non-valvular AF, and had 1-year follow-up. The outcomes were ischemic stroke (167), major bleeding (430) admissions, all-cause death (1912) and event-free survival (7387). Discrimination and calibration of ML models were compared with clinical risk scores by area under the curve (AUC). Risk stratification was assessed using net reclassification index (NRI). RESULTS Multilabel gradient boosting classifier chain provided the best AUCs for stroke (0.685 95% CI 0.676, 0.694), major bleeding (0.709 95% CI 0.703, 0.716) and death (0.765 95% CI 0.763, 0.768) compared to multi-layer neural networks and classifier chain using support vector machine. It provided modest performance improvement for stroke compared to AUC of CHA2DS2-VASc (0.652, NRI = 3.2%, p-value = 0.1), but significantly improved major bleeding prediction compared to AUC of HAS-BLED (0.522, NRI = 22.8%, p-value < 0.05). It also achieved greater discriminant power for death compared with AUC of CHA2DS2-VASc (0.606, p-value < 0.05). ML models identified additional risk features such as hemoglobin level, renal function. CONCLUSIONS Multilabel ML models can outperform clinical risk stratification scores for predicting the risk of major bleeding and death in non-valvular AF patients.
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Affiliation(s)
- Juan Lu
- Department of Computer Science and Software Engineering, The University of Western Australia, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia; Harry Perkins Institute of Medical Research, Perth, Australia
| | - Rebecca Hutchens
- Medical School, The University of Western Australia, Perth, Australia; Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Joseph Hung
- Medical School, The University of Western Australia, Perth, Australia
| | - Mohammed Bennamoun
- Department of Computer Science and Software Engineering, The University of Western Australia, Perth, Australia
| | - Brendan McQuillan
- Medical School, The University of Western Australia, Perth, Australia; Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Tom Briffa
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Ferdous Sohel
- Discipline of Information Technology, Murdoch University, Perth, Australia
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Jonathon Stewart
- Medical School, The University of Western Australia, Perth, Australia; Harry Perkins Institute of Medical Research, Perth, Australia
| | - Benjamin Chow
- Department of Medicine, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Frank Sanfilippo
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Girish Dwivedi
- Medical School, The University of Western Australia, Perth, Australia; Harry Perkins Institute of Medical Research, Perth, Australia; Cardiology Department, Fiona Stanley Hospital, Perth, Australia.
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Pedrick-Case R, Bailey R, Beck B, Beesley B, Boruff B, Brophy S, Cross D, Dhamrait G, Duncan J, Gething P, Johnson RD, Lyons RA, Mizen A, Murray K, Pouliou T, Rafferty J, Robinson T, Rosenberg M, Schipperijn J, Thompson DA, Trost SG, Watkins A, Stratton G, Fry R, Christian H, Griffiths LJ. Built Environments And Child Health in WalEs and AuStralia (BEACHES): a study protocol. BMJ Open 2022; 12:e061978. [PMID: 36283749 PMCID: PMC9608521 DOI: 10.1136/bmjopen-2022-061978] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Childhood obesity and physical inactivity are two of the most significant modifiable risk factors for the prevention of non-communicable diseases (NCDs). Yet, a third of children in Wales and Australia are overweight or obese, and only 20% of UK and Australian children are sufficiently active. The purpose of the Built Environments And Child Health in WalEs and AuStralia (BEACHES) study is to identify and understand how complex and interacting factors in the built environment influence modifiable risk factors for NCDs across childhood. METHODS AND ANALYSIS This is an observational study using data from five established cohorts from Wales and Australia: (1) Wales Electronic Cohort for Children; (2) Millennium Cohort Study; (3) PLAY Spaces and Environments for Children's Physical Activity study; (4) The ORIGINS Project; and (5) Growing Up in Australia: the Longitudinal Study of Australian Children. The study will incorporate a comprehensive suite of longitudinal quantitative data (surveys, anthropometry, accelerometry, and Geographic Information Systems data) to understand how the built environment influences children's modifiable risk factors for NCDs (body mass index, physical activity, sedentary behaviour and diet). ETHICS AND DISSEMINATION This study has received the following approvals: University of Western Australia Human Research Ethics Committee (2020/ET000353), Ramsay Human Research Ethics Committee (under review) and Swansea University Information Governance Review Panel (Project ID: 1001). Findings will be reported to the following: (1) funding bodies, research institutes and hospitals supporting the BEACHES project; (2) parents and children; (3) school management teams; (4) existing and new industry partner networks; (5) federal, state and local governments to inform policy; as well as (6) presented at local, national and international conferences; and (7) disseminated by peer-reviewed publications.
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Affiliation(s)
| | - Rowena Bailey
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Ben Beck
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Bridget Beesley
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Bryan Boruff
- School of Agriculture and Environment, University of Western Australia, Perth, Western Australia, Australia
| | - Sinead Brophy
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Donna Cross
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Gursimran Dhamrait
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - John Duncan
- School of Agriculture and Environment, University of Western Australia, Perth, Western Australia, Australia
| | - Peter Gething
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Rhodri D Johnson
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Ronan A Lyons
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Amy Mizen
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Theodora Pouliou
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - James Rafferty
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Trina Robinson
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Michael Rosenberg
- School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Daniel A Thompson
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Alan Watkins
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Gareth Stratton
- Research Centre in Applied Sports, Technology, Exercise and Medicine, Swansea University, Swansea, UK
| | - Richard Fry
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Hayley Christian
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Lucy J Griffiths
- Population Data Science, Swansea University Medical School, Swansea, UK
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Marriott RJ, Murray K, Flicker L, Hankey GJ, Matsumoto AM, Dwivedi G, Antonio L, Almeida OP, Bhasin S, Dobs AS, Handelsman DJ, Haring R, O'Neill TW, Ohlsson C, Orwoll ES, Vanderschueren D, Wittert GA, Wu FCW, Yeap BB. Lower serum testosterone concentrations are associated with a higher incidence of dementia in men: The UK Biobank prospective cohort study. Alzheimers Dement 2022; 18:1907-1918. [PMID: 34978125 DOI: 10.1002/alz.12529] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 08/04/2021] [Accepted: 10/14/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION The association of testosterone concentrations with dementia risk remains uncertain. We examined associations of serum testosterone and sex hormone-binding globulin (SHBG) with incidence of dementia and Alzheimer's disease. METHODS Serum total testosterone and SHBG were measured by immunoassay. The incidence of dementia and Alzheimer's disease (AD) was recorded. Cox proportional hazards regression was adjusted for age and other variables. RESULTS In 159,411 community-dwelling men (median age 61, followed for 7 years), 826 developed dementia, including 288 from AD. Lower total testosterone was associated with a higher incidence of dementia (overall trend: P = .001, lowest vs highest quintile: hazard ratio [HR] = 1.43, 95% confidence interval [CI] = 1.13-1.81), and AD (P = .017, HR = 1.80, CI = 1.21-2.66). Lower SHBG was associated with a lower incidence of dementia (P < .001, HR = 0.66, CI = 0.51-0.85) and AD (P = .012, HR = 0.53, CI = 0.34-0.84). DISCUSSION Lower total testosterone and higher SHBG are independently associated with incident dementia and AD in older men. Additional research is needed to determine causality.
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Affiliation(s)
- Ross J Marriott
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Leon Flicker
- Medical School, University of Western Australia, Perth, Australia.,Western Australian Centre for Healthy Ageing, University of Western Australia, Perth, Australia
| | - Graeme J Hankey
- Medical School, University of Western Australia, Perth, Australia
| | - Alvin M Matsumoto
- Department of Medicine, University of Washington School of Medicine, Seattle, USA.,Geriatric Research, Education and Clinical Center, VA Puget Sound Health Care System, Seattle, USA
| | - Girish Dwivedi
- Medical School, University of Western Australia, Perth, Australia.,Harry Perkins Institute of Medical Research, Fiona Stanley Hospital, Perth, Australia
| | - Leen Antonio
- Laboratory of Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
| | - Osvaldo P Almeida
- Medical School, University of Western Australia, Perth, Australia.,Western Australian Centre for Healthy Ageing, University of Western Australia, Perth, Australia
| | - Shalender Bhasin
- Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Adrian S Dobs
- Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, USA
| | | | - Robin Haring
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
| | - Terence W O'Neill
- Centre for Epidemiology Versus Arthritis, University of Manchester and NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Vastra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Dirk Vanderschueren
- Laboratory of Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
| | - Gary A Wittert
- Freemasons Centre for Men's Health and Wellbeing, School of Medicine, University of Adelaide, Adelaide, Australia
| | - Frederick C W Wu
- Division of Endocrinology, Diabetes & Gastroenterology, School of Medical Sciences, University of Manchester, Manchester, UK
| | - Bu B Yeap
- Medical School, University of Western Australia, Perth, Australia.,Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia
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43
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Trentino KM, Leahy MF, Erber WN, Mace H, Symons K, Budgeon CA, Murray K. Hospital-Acquired Infection, Length of Stay, and Readmission in Elective Surgery Patients Transfused 1 Unit of Red Blood Cells: A Retrospective Cohort Study. Anesth Analg 2022; 135:586-591. [PMID: 35977367 DOI: 10.1213/ane.0000000000006133] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Most patients transfused red blood cells in elective surgery receive small volumes of blood, which is likely to be discretionary and avoidable. We investigated the outcomes of patients who received a single unit of packed red blood cells during their hospital admission for an elective surgical procedure when compared to those not transfused. METHODS This retrospective cohort study included elective surgical admissions to 4 hospitals in Western Australia over a 6-year period. Participants were included if they were at least 18 years of age and were admitted for elective surgery between July 2014 and June 2020. We compared outcomes of patients who had received 1 unit of red blood cells to patients who had not been transfused. To balance differences in patient characteristics, we weighted our multivariable regression models using the inverse probability of treatment. In addition to propensity score weighting, our multivariable regression models adjusted for hemoglobin level, surgical procedure, patient age, gender, comorbidities, and the transfusion of fresh-frozen plasma or platelets. Outcomes studied were hospital-acquired infection, hospital length of stay, and all-cause emergency readmissions within 28 days. RESULTS Overall, 767 (3.2%) patients received a transfusion of 1 unit of red blood cells throughout their admission. In the propensity score weighted analysis, the transfusion of a single unit of red blood cells was associated with higher odds of hospital-acquired infection (odds ratio, 3.94; 95% confidence interval [CI], 2.99-5.20; P < .001). Patients who received 1 unit of red blood cells throughout their admission were more likely to have a longer hospital stay (rate ratio, 1.57; 95% CI, 1.51-1.63; P < .001) and had 1.42 (95% CI, 1.20-1.69; P < .001) times higher odds of 28-day readmission. CONCLUSIONS These results suggest that avoidance of even small volumes of packed red blood cells may prevent adverse clinical outcomes. This may encourage hospital administrators to implement strategies to avoid the transfusion of even small volumes of red blood cells by applying patient blood management practices.
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Affiliation(s)
- Kevin M Trentino
- From the School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia.,Data and Digital Innovation, East Metropolitan Health Service, Perth, Western Australia, Australia
| | - Michael F Leahy
- Department of Haematology, PathWest Laboratory Medicine, Royal Perth Hospital, Perth, Western Australia, Australia.,School of Medicine and Pharmacology
| | - Wendy N Erber
- School of Biomedical Sciences, The University of Western Australia, Perth, Western Australia, Australia.,PathWest Laboratory Medicine, Nedlands, Western Australia, Australia
| | - Hamish Mace
- Department of Anaesthesia and Pain Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.,Division of Emergency Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Kylie Symons
- Department of Anaesthesia and Pain Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Charley A Budgeon
- From the School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Kevin Murray
- From the School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
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44
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Lopez D, Preen D, Raymond W, Inderjeeth C, Murray K, Nossent H, Dwivedi G, Keen H. Risk of a major adverse cardiovascular event (MACE) following first-ever hospitalisation for acute gout: a Western Australian population-level linked data study. Int J Popul Data Sci 2022. [PMCID: PMC9644716 DOI: 10.23889/ijpds.v7i3.1805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Lopez D, Murray K, Preen DB, Sanfilippo FM, Trevenen M, Hankey GJ, Yeap BB, Golledge J, Almeida OP, Flicker L. The Hospital Frailty Risk Score Identifies Fewer Cases of Frailty in a Community-Based Cohort of Older Men Than the FRAIL Scale and Frailty Index. J Am Med Dir Assoc 2022; 23:1348-1353.e8. [PMID: 34740563 DOI: 10.1016/j.jamda.2021.09.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 07/22/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The recently developed Hospital Frailty Risk Score (HFRS) allows ascertainment of frailty from administrative data. We aimed to compare the HFRS against the widely used FRAIL Scale and Frailty Index. DESIGN Population-based cohort study linked to Western Australian Hospital Morbidity Data Collection and Death Registrations. SETTING AND PARTICIPANTS The Health in Men Study with frailty determined at Wave 2 (2001/2004), mortality in the 1-year period following Wave 2, and disability at Wave 3 (2008). Participants were 4228 community-based men aged ≥75 years, followed until Wave 3. MEASUREMENTS We used multivariable regression to determine the association between each frailty measure and outcomes of length of stay (LOS), death, and disability. We also determined if the additional cases of frailty identified by one measure over the other was associated with these outcomes. RESULTS Of 4228 men studied, the HFRS (n = 689) identified fewer men as frail than the FRAIL Scale (n = 1648) and Frailty Index (n = 1820). In the fully adjusted models, all 3 frailty measures were associated with longer LOS and mortality, whereas only the FRAIL Scale and Frailty Index were significantly associated with disability. The additional cases of frailty identified by the FRAIL Scale and Frailty Index had longer LOS and greater risks of death and disability. The fully adjusted hazard ratio for death among the additional cases of frailty identified by the FRAIL Scale (compared to being not frail on both HFRS and FRAIL Scale) was 2.14 (95% CI 1.48-3.08). CONCLUSIONS AND IMPLICATIONS The HFRS is associated with adverse outcomes. However, it identified approximately 60% fewer men who were frail than the FRAIL Scale and Frailty Index, and the additional cases identified were also at high risks of adverse outcomes. Users of the HFRS should be aware of the differences with other frailty measures.
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Affiliation(s)
- Derrick Lopez
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia.
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - David B Preen
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Frank M Sanfilippo
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Michelle Trevenen
- Western Australian Centre for Health and Ageing, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Graeme J Hankey
- Medical School, The University of Western Australia, Crawley, Western Australia, Australia
| | - Bu B Yeap
- Medical School, The University of Western Australia, Crawley, Western Australia, Australia; Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Australia; Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Australia
| | - Osvaldo P Almeida
- Western Australian Centre for Health and Ageing, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Leon Flicker
- Western Australian Centre for Health and Ageing, Medical School, The University of Western Australia, Perth, Western Australia, Australia
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Bondonno NP, Parmenter BH, Dalgaard F, Murray K, Rasmussen DB, Kyrø C, Cassidy A, Bondonno CP, Lewis JR, Croft KD, Gislason G, Scalbert A, Tjønneland A, Overvad K, Olsen A, Hodgson JM. Flavonoid intakes inversely associate with COPD in smokers. Eur Respir J 2022; 60:2102604. [PMID: 35058251 PMCID: PMC9363846 DOI: 10.1183/13993003.02604-2021] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/18/2021] [Indexed: 12/04/2022]
Abstract
INTRODUCTION Higher flavonoid intakes are beneficially associated with pulmonary function parameters; however, their association with chronic obstructive pulmonary disease (COPD) is unknown. This study aimed to examine associations between intakes of 1) total flavonoids, 2) flavonoid subclasses and 3) major flavonoid compounds with incident COPD in participants from the Danish Diet, Cancer and Health study. METHODS This prospective cohort included 55 413 men and women without COPD, aged 50-65 years at recruitment. Habitual flavonoid intakes at baseline were estimated from a food frequency questionnaire using Phenol-Explorer. Danish nationwide registers were used to identify incident cases of COPD. Associations were modelled using restricted cubic splines within Cox proportional hazards models. RESULTS During 23 years of follow-up, 5557 participants were diagnosed with COPD. Of these, 4013 were current smokers, 1062 were former smokers and 482 were never-smokers. After multivariable adjustments, participants with the highest total flavonoid intakes had a 20% lower risk of COPD than those with the lowest intakes (quintile 5 versus quintile 1: HR 0.80, 95% CI 0.74-0.87); a 6-22% lower risk was observed for each flavonoid subclass. The inverse association between total flavonoid intake and COPD was present in both men and women but only in current smokers (HR 0.77, 95% CI 0.70-0.84) and former smokers (HR 0.82, 95% CI 0.69-0.97), not never-smokers. Furthermore, higher flavonoid intakes appeared to lessen, but not negate, the higher risk of COPD associated with smoking intensity. CONCLUSION Dietary flavonoids may be important for partially mitigating the risk of smoking-related COPD. However, smoking cessation should remain the highest priority.
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Affiliation(s)
- Nicola P. Bondonno
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- The Danish Cancer Society Research Centre, Copenhagen, Denmark
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, Australia
| | - Benjamin H. Parmenter
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, Australia
| | - Frederik Dalgaard
- Dept of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Daniel Bech Rasmussen
- Respiratory Research Unit Zealand, Dept of Respiratory Medicine, Naestved Hospital, Copenhagen University Hospital, Naestved, Denmark
- Dept of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Cecilie Kyrø
- The Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Aedin Cassidy
- Institute for Global Food Security, Queen's University Belfast, Belfast, UK
| | - Catherine P. Bondonno
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- Medical School, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia
| | - Joshua R. Lewis
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- Medical School, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia
| | - Kevin D. Croft
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, Australia
| | - Gunnar Gislason
- Dept of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark
- The National Institute of Public Health, University of Southern Denmark, Odense, Denmark
- The Danish Heart Foundation, Copenhagen, Denmark
| | | | - Anne Tjønneland
- The Danish Cancer Society Research Centre, Copenhagen, Denmark
- Dept of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kim Overvad
- Dept of Public Health, Aarhus University, Aarhus, Denmark
| | - Anja Olsen
- The Danish Cancer Society Research Centre, Copenhagen, Denmark
- Dept of Public Health, Aarhus University, Aarhus, Denmark
| | - Jonathan M. Hodgson
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- Medical School, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia
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47
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Zhu K, Walsh JP, Murray K, Hunter M, Hui J, Hung J. DXA-Derived vs Standard Anthropometric Measures for Predicting Cardiometabolic Risk in Middle-Aged Australian Men and Women. J Clin Densitom 2022; 25:299-307. [PMID: 35177350 DOI: 10.1016/j.jocd.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 12/08/2021] [Accepted: 01/04/2022] [Indexed: 12/11/2022]
Abstract
It is not clear if dual-energy X-ray absorptiometry (DXA) adiposity measures are superior to standard anthropometric measures for predicting cardiometabolic (CM) risk factors in a middle-aged general population. In the Busselton Healthy Ageing Study, we assessed a range of standard anthropometric and DXA-derived adiposity measures to predict metabolic syndrome (MetS) and CM risk factors in 4831 "baby boomers" aged 45-69 yr. Anthropometric and whole body DXA (GE Lunar Prodigy) measures were collected. Cross-sectional relationships of overall adiposity (BMI; DXA fat mass index, body fat %), central adiposity (waist circumference (WC); DXA trunk fat, android fat, abdominal visceral adipose tissue (VAT)) and ratio index (waist-to-hip ratio; DXA trunk/legs fat, android/gynoid ratio, VAT/total fat) with MetS and its components (as both continuous and binary outcomes) were evaluated using linear and logistic regression adjusting for age and lifestyle factors. Youden's Index was used to determine the optimal cut-points for predicting MetS. In linear regression analyses, central adiposity measures showed stronger associations with MetS score and CM risk factors than overall adiposity measures and fat ratio index, and DXA-VAT provided stronger associations than WC. Logistic regression models showed similar findings. For MetS diagnosis present in 35.9% of males and 24.4% of females, the highest odds ratio (95% CI) per SD change was observed for DXA-VAT (males: 5.02 [4.28, 5.88]; females: 3.91 [3.40, 4.49]), which remained significant (all p < 0.001) after further adjustment for BMI (males: 3.27 [2.65, 4.02]; females: 3.37 [2.79, 4.06]) or WC (males: 2.46 [1.95, 3.10]; females: 2.75 [2.21, 3.43]). The optimal DXA-VAT mass cut-point for predicting MetS was 1608 grams in males and 893 grams in females. DXA-VAT was superior to standard anthropometric and other DXA-derived adiposity measures for prediction of cardiometabolic risk factors, and has clinical utility for identifying middle-aged individuals at increased risk of MetS.
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Affiliation(s)
- Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; Medical School, University of Western Australia, Crawley, Western Australia, Australia.
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; Medical School, University of Western Australia, Crawley, Western Australia, Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia
| | - Michael Hunter
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia; Busselton Population Medical Research Institute, Busselton, Western Australia, Australia
| | - Jennie Hui
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia
| | - Joseph Hung
- Medical School, University of Western Australia, Crawley, Western Australia, Australia
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Fitzgerald DB, Sidhu C, Budgeon C, Tan AL, Read CA, Kwan BCH, Smith NA, Fysh ET, Muruganandan S, Saghaie T, Shrestha R, Badiei A, Nguyen P, Burke A, Goddard J, Windsor M, McDonald J, Wright G, Czarnecka K, Sivakumar P, Yasufuku K, Feller-Kopman DJ, Maskell NA, Murray K, Lee YCG. Australasian Malignant PLeural Effusion (AMPLE)-3 trial: study protocol for a multi-centre randomised study comparing indwelling pleural catheter (±talc pleurodesis) versus video-assisted thoracoscopic surgery for management of malignant pleural effusion. Trials 2022; 23:530. [PMID: 35761341 PMCID: PMC9235203 DOI: 10.1186/s13063-022-06405-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 01/06/2022] [Accepted: 05/16/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction Malignant pleural effusions (MPEs) are common. MPE causes significant breathlessness and impairs quality of life. Indwelling pleural catheters (IPC) allow ambulatory drainage and reduce hospital days and re-intervention rates when compared to standard talc slurry pleurodesis. Daily drainage accelerates pleurodesis, and talc instillation via the IPC has been proven feasible and safe. Surgical pleurodesis via video-assisted thoracoscopic surgery (VATS) is considered a one-off intervention for MPE and is often recommended to patients who are fit for surgery. The AMPLE-3 trial is the first randomised trial to compare IPC (±talc pleurodesis) and VATS pleurodesis in those who are fit for surgery. Methods and analysis A multi-centre, open-labelled randomised trial of patients with symptomatic MPE, expected survival of ≥ 6 months and good performance status randomised 1:1 to either IPC or VATS pleurodesis. Participant randomisation will be minimised for (i) cancer type (mesothelioma vs non-mesothelioma); (ii) previous pleurodesis (vs not); and (iii) trapped lung, if known (vs not). Primary outcome is the need for further ipsilateral pleural interventions over 12 months or until death, if sooner. Secondary outcomes include days in hospital, quality of life (QoL) measures, physical activity levels, safety profile, health economics, adverse events, and survival. The trial will recruit 158 participants who will be followed up for 12 months. Ethics and dissemination Sir Charles Gairdner and Osborne Park Health Care Group (HREC) has approved the study (reference: RGS356). Results will be published in peer-reviewed journals and presented at scientific meetings. Discussion Both IPC and VATS are commonly used procedures for MPE. The AMPLE-3 trial will provide data to help define the merits and shortcomings of these procedures and inform future clinical care algorithms. Trial registration Australia New Zealand Clinical Trial Registry ACTRN12618001013257. Registered on 18 June 2018. Protocol version: Version 3.00/4.02.19 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06405-7.
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Affiliation(s)
- Deirdre B Fitzgerald
- Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.,Medical School, Faculty of Health & Medical Sciences, University of Western Australia, Perth, WA, Australia.,Pleural Medicine Unit, Institute for Respiratory Health, Perth, WA, Australia
| | - Calvin Sidhu
- Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.,Pleural Medicine Unit, Institute for Respiratory Health, Perth, WA, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Charley Budgeon
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Ai Ling Tan
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, WA, Australia
| | - Catherine A Read
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, WA, Australia
| | - Benjamin C H Kwan
- Department of Respiratory and Sleep Medicine, The Sutherland Hospital, Sydney, NSW, Australia.,University of New South Wales, Sydney, NSW, Australia
| | - Nicola Ann Smith
- Respiratory Department, Wellington Regional Hospital, Wellington, New Zealand
| | - Edward T Fysh
- Medical School, Faculty of Health & Medical Sciences, University of Western Australia, Perth, WA, Australia.,Respiratory Medicine, St John of God Hospital Midland, Midland, WA, Australia
| | | | - Tajalli Saghaie
- Respiratory Medicine, Concord Repatriation General Hospital, Concord West, NSW, Australia.,Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Ranjan Shrestha
- Respiratory Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Arash Badiei
- Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia.,Adelaide Medical School, Faculty of Health and Medical Science, University of Adelaide, Adelaide, SA, Australia
| | - Phan Nguyen
- Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia.,Adelaide Medical School, Faculty of Health and Medical Science, University of Adelaide, Adelaide, SA, Australia
| | - Andrew Burke
- Thoracic Medicine, The Prince Charles Hospital, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland School of Medicine, Brisbane, QLD, Australia
| | - John Goddard
- Respiratory Department, Sunshine Coast University Hospital, Birtinya, QLD, Australia.,Griffith University, Brisbane, QLD, Australia
| | - Morgan Windsor
- Thoracic Surgery, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Julie McDonald
- Respiratory and Sleep Medicine Department, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Gavin Wright
- Department of Cardiothoracic Surgery & University of Melbourne Department of Surgery, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Kasia Czarnecka
- Division of Thoracic Surgery, Toronto General Hospital University Health Network, University of Toronto, Toronto, Ontario, Canada
| | | | - Kazuhiro Yasufuku
- Division of Thoracic Surgery, Toronto General Hospital University Health Network, University of Toronto, Toronto, Ontario, Canada
| | | | - Nick A Maskell
- Academic Respiratory Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Y C Gary Lee
- Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia. .,Medical School, Faculty of Health & Medical Sciences, University of Western Australia, Perth, WA, Australia. .,Pleural Medicine Unit, Institute for Respiratory Health, Perth, WA, Australia.
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Christian H, Murray K, Trost SG, Schipperijn J, Trapp G, Maitland C, Divitini M. Meeting the Australian 24-Hour Movement Guidelines for the Early Years is associated with better social-emotional development in preschool boys. Prev Med Rep 2022; 27:101770. [PMID: 35321215 PMCID: PMC8935500 DOI: 10.1016/j.pmedr.2022.101770] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/24/2022] [Accepted: 03/13/2022] [Indexed: 11/18/2022] Open
Abstract
Only 8% of preschool children meet all three 24-hour movement guidelines. Meeting 24-hour movement guidelines associated with boy’s social-emotional development. Dose–response evidence needed to identify guideline thresholds for health outcomes.
24-hour Movement Guidelines for the Early Years promote that achieving all three-movement behaviour (sleep, sedentary behaviour and physical activity) recommendations is important for child health and development. We examined the association between meeting all, none and combinations of the Australian 24-Hour Movement Guidelines for the Early Years and social-emotional development in 1363 preschool (2–5 years) boys (52%) and girls. The PLAYCE study (Perth, Western Australia) parent survey collected data on children’s social-emotional development (Strengths & Difficulties Questionnaire), screen time, sleep and socio-demographic factors. Physical activity was measured using seven-day accelerometry. Only 8% of preschoolers met all three guidelines (5% met none). A higher proportion of boys than girls met physical activity-related guideline combinations (physical activity only, physical activity plus screen, physical activity plus sleep, all), while more girls than boys met sleep only guidelines (all p < 0.05). In boys, meeting all guidelines, compared with none, was associated with a lower total difficulties score (adjusted difference in means −1.90; 95%CI: −3.88, −0.10). Meeting the screen only guideline or the screen plus sleep guidelines, compared with none, were associated with lower total difficulties, conduct problems and hyperactivity scores in boys (all p < 0.05). Meeting the physical activity plus sleep guidelines, compared with none, were associated with lower total difficulties and conduct problems scores in boys (all p < 0.05). No significant associations were found for girls. These findings highlight the positive impact for boys social-emotional development in meeting all guidelines. Future guideline development should consider dose–response evidence to identify guideline thresholds for specific health and developmental outcomes for boys and girls.
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Affiliation(s)
- Hayley Christian
- Telethon Kids Institute, University of Western Australia, Nedlands WA 6009, Australia
- School of Population and Global Health, University of Western Australia, Nedlands WA 6009, Australia
- Corresponding author at: Telethon Kids Institute, PO Box 855, West Perth, WA 6872, Australia.
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Nedlands WA 6009, Australia
| | - Stewart G. Trost
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane QLD 4001, Australia
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense DK-5230, Denmark
| | - Georgina Trapp
- Telethon Kids Institute, University of Western Australia, Nedlands WA 6009, Australia
- School of Population and Global Health, University of Western Australia, Nedlands WA 6009, Australia
| | - Clover Maitland
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth WA 6009, Australia
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC 3004, Australia
| | - Mark Divitini
- School of Population and Global Health, University of Western Australia, Nedlands WA 6009, Australia
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Weber C, Hung J, Hickling S, Li I, Murray K, Briffa T. Unplanned 30-day readmission, comorbidity, and impact on mortality after incident atrial fibrillation hospitalization in Western Australia, 2001–2015. Heart Rhythm O2 2022; 3:511-519. [PMID: 36340485 PMCID: PMC9626741 DOI: 10.1016/j.hroo.2022.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background The healthcare burden of atrial fibrillation (AF) is dominated by hospitalizations, but data on 30-day unplanned readmissions after AF hospitalization and impact on mortality are limited. Objective To assess causes and trends of 30-day unplanned readmission in incident (first-ever) hospitalized AF patients, and the risk of readmission for subsequent all-cause mortality. Methods Patients aged 25–94 years, with an incident AF hospitalization (principal diagnosis) between 2001 and 2015, and surviving 30 days post discharge, were identified from linked Western Australian hospitalization and mortality data. Unplanned 30-day readmissions were categorized by principal diagnosis. Multivariable logistic and Cox regression analyses determined the independent predictors of readmission and the hazard ratio (HR) with 95% confidence intervals (CI) of readmission for subsequent 1-year mortality. Results Of 22,814 patients, 57.7% male, mean age 67.8 ± 13.8 (standard deviation) years, 9.5% experienced 1 or more 30-day unplanned readmissions, with standardized rates increasing 2.0% annually (95% CI, 1.0%–3.1%). Among all readmissions, 64.8% were cardiovascular-related, with AF (31.7%), coronary events (12.2%), and heart failure (8.5%) being the most frequent. In 30-day survivors, 4.3% died within 1 year. Patients with any cardiovascular or noncardiovascular readmission (vs none) had a multivariable-adjusted mortality HR of 2.12 (95% CI, 1.82–2.45). Coexistent comorbidities were independently associated with 30-day unplanned readmission and 1-year mortality. Conclusion Following incident AF hospitalization, 30-day unplanned readmissions were common, mostly cardiovascular-related, but any readmission, regardless of cause, was associated with a 2-fold higher adjusted mortality risk. Our findings also support the importance of comorbidity optimization within an integrated care pathway to reduce adverse outcomes in AF patients.
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